what is rationale for high dose narcotic in chronic pain?

---

Request for Question Clarification by cynthia-ga on 17 Jul 2005 03:45 PDT

It REALLY depends on the type and severity of pain, the length of time
you've been in pain, and what you have been taking for it in the past,
and at what dose for how long.

Also, what narcotic drug specifically?  Can you give us some of the
details I mentioned above?

~~Cynthia

---

Clarification of Question by pspringer-ga on 17 Jul 2005 17:24 PDT

I was in pain management until 2003 and since have been in emergency
psychiatry at a max security prison. I have lost touch and must now
defend myself to the Board of Medicine on several cases. Please get me
most recent articles on the subject. Will pay what the reasonable
charge be.

Many thanks 

Philip K Springer, MKd

---

Clarification of Question by pspringer-ga on 17 Jul 2005 17:29 PDT

I was in pain management until 2003 and since have been in emergency
psychiatry at a max security prison. I have lost touch and must now
defend myself to the Board of Medicine on several cases. Please get me
most recent articles on the subject. Will pay what the reasonable
charge be.I am 72 and don't have the energy for all that is needed 

Many thanks 

Philip K Springer, MD

---

Request for Question Clarification by pafalafa-ga on 17 Jul 2005 18:29 PDT

Dr. P.

You might want to have a look at this resource page on pain and pain management:


http://www.uspharmacist.com/oldformat.asp?url=newlook/files/Feat/cancerpain.htm&pub_id=8&article_id=675


with particular attention to the WHO "analgesic ladder" approach.  

There is a good overview here, along with links to a lot of good resources.

Is this the sort of thing you need?  If not, please let us know in a
bit more detail what you're after.

Thanks,

pafalafa-ga

---

Request for Question Clarification by pafalafa-ga on 17 Jul 2005 18:47 PDT

P.S.  In the comments section, below, a commentor (who is not a Google
Answers researcher) has provided a link to a site called pharm-text. 
I suggest you ignore this.  Its name notwithstanding, it is not a
valid site for medical information.

paf

---

Clarification of Question by pspringer-ga on 06 Aug 2005 03:22 PDT

rationale such as "to keep substance P level from rising in spinal cord"

By a high dose of narcotic for pain, you are going to need an opiate
analogue such as oxycodone, or hydromorphone.  A high dosage for
oxycodone for pain relief within safe limited for most body weights
would be 40mg ingested.  For hydromorphone it would be 2mg.  Notice
the difference between the two dosages and don't get the two confused.

www.pharm-text.com has a lot of information regarding this type of information.

Here is a list of dosages for opiates in general
http://www.pharm-text.com/opiates/dosage/

This is veru useful. Thank you and continue on.