Help With Oxy Weaning

It's a strange thing...at this time in my cancer journey, I feel like I may be having more symptoms from withdrawing from OxyContin/oxycodone than from my cancer.  As of this week, I’m down to 10 mg of OxyContin/oxycodone, (oxy). About 10 days ago my friend, Debbie, said to me, “You know a lot of people…don’t you know someone that can help you with getting off of it?”  I then remembered that I have a childhood friend, W.H., who is a Pharm.D. at a large medical center in St. Louis.  W.H. and I have been dear friends since grade school and I don’t know why I didn’t think of him sooner.  I kept thinking I needed to consult someone in the detox or pain management fields.  Since I contacted W.H., he has given me his professional advice and a weaning schedule, all wrapped up in friendship.  I, once again, am so grateful for the support I have around me and have learned a few things:

OxyContin is the extended release version of oxycodone. The dosing for oxycodone is one pill every 4-6 hours to control pain, while OxyContin only needs to be taken every 12 hours.  OxyContin releases the medication into our system slowly by way of a unique outside coating. Users should never chew, cut, or crush an OxyContin pill, because the entire dose would be received immediately, which in some cases, could be a lethal dose.  So, the first thing W.H. told me was to never cut an OxyContin pill, as I had been doing for the past several weeks. 

I also learned that Asians are particularly sensitive to opiates.  In the future, if I need to restart OxyContin or oxycodone, I’ll ask my oncologist start me on a lower dose. 

W.H. had me switch to the immediate-release form, oxycodone, which is not only safer than shaving off pieces of OxyContin with a razor blade, but will also allow me to reduce my intake more easily.  So now I’m taking 2.5 mg, 4-times/day.  I’ll do this for a week, or so, then reduce to 2.5 mg, 3-times/day, and so on.

Now that I’m on such a low dose of oxycodone, I’ve realized that I’m not as ‘pain-free’ as I thought I was.  (A real bummer.)  Although it’s mild, I have some bone achiness that I thought I didn’t have.  I’ve been taking ibuprophen (Motrin) to manage my pain sometimes…but not often. It’s a little disheartening because I really thought that the new oral chemo was working in all ways.  So my new hope is that, with time, the new oral chemo will also take away my bone achiness. 

A few of months ago I started taking advantage of the Cancer Wellness Place in our suburb. Every two to four weeks, I meet with a cancer counselor, Kathy, who I find so helpful.  Along with being a counselor, Kathy is a nurse and has personal experience with the loss of her husband to cancer.  Going to see Kathy is part of balancing the mind-body-spirit triad I mentioned a few blogs ago.  Kathy asked me an interesting question the other day, “So what’s the psychology behind needing to get off of oxycodone?”  Given that I still have some pain, I could choose to stay on oxycodone, instead of going through the long, (and sometimes painful), weaning process and then taking ibuprofen.  She also asked, “Does it make the cancer seem less severe if you’re able to manage your pain with an over-the-counter medication?”  The answer is yes.  Not only do I not want to be on a narcotic, I feel like my disease is less severe if ibuprofen takes care of my pain.  Although I have no idea how well Xalkori will work for me or for how long, for now I like the idea that I may be moving toward control of my cancer.  I’d love to have total control of this disease, but that seems unlikely.  So I continue to Keep Calm and….you know.