Hello Everyone,
Once again I got woken up at 2am by the stupid chronic back pain that is such a large part of my life. I am sitting here literally in tears as I type this waiting for the dose of percocet to kick in. So, here is the question. I take morphine xr for the pain and it does a pretty decent job, the percocet is for the breakthrough pain and I take one of those two or three times a day. Of course over the years both the percocet and morphine doses have increased due to my tolerance rising.
What I have noticed recently is that the time for each of these medications to take effect seems to be longer than it used to be. I remember that when I first started using the percocet (or vicodin before that) for breakthrough pain I could usually start feeling relief within about 20 to 30 minutes. Now it takes 40 minutes to an hour before I start seeing any change in my pain level. So, as my tolerance to these drugs increases will the time they take to work increase as well?
I do apologize for all of the pain related questions I ask on here. It just seems that if I understand what is going on I somehow feel better. I wish someone had an answer on how to stop the pain all together, but we don’t seem to have the technology yet to do that. Hell, I would sacrifice a live chicken if I thought it would help. It won’t, will it?
Not a doctor or a pharmacist, so I’m sure someone will be along shortly with more authority and specific knowledge.
Based on what I do know, I’d expect this to be very variable depending the specific drug, absorbtion, target receptors, type of metabolic pathway and a bunch of other stuff, but its certainly possible.
Have you had a careful look at the instructions that came with the medication? Things like what you are eating and drinking can have a big impact on initial absorbtion.
Otherwise can you talk to your doctor about faster acting medication? He might also be able to advise you whether taking breaks from using a specific medication can help with tolerance, but don’t experiment with that yourself without getting medical advice.
It’s possible that the reason it seems to be taking longer is that it’s simply no longer as potent.
For example, assume you eventually achieve a blood level of 100 (arbitrary units) when you take a standard, fixed dose of your medication. When you were new to the drug, say it took a blood level of 50 to be attained for it to provide pain relief. You might hit the 50 level after 30 minutes. But now, perhaps, you require a level of 75 for the same relief (i.e. it’s 50% less potent). Presumably, it takes longer to get to a blood level of 75 than it does to get to 50. So, it’s gonna take longer than 30 minutes to get relief. (And note that the same phenomenon will occur as it wears off).