Hi Dr Fudin –
I am 35 years old and have severe chronic pain in my lower back and legs due to a lumbar fusion surgery 3 years ago that failed to alleviate my symptoms. Recent CT and MRI shows spinal stenosis, bulging discs and facet arthritis.
My pain management doctor in Charlotte North Carolina will not increase my oxycodone dosage. I am on 30mg of oxycodone a day and have asked if we can increase to 40mg a day (so that I am taking a dose every 4 hours instead of every 6 hours).
My pain management doctor says he will not do this due to “my young age”. Keep in mind I’ve been on oxycodone 30mg a day for the past 8 months and my rationale is I need adequate analgesia every 4 hours instead of 6 hours.
Question – What can I do? I’ve never had a physician tell me they won’t do something due to my age….
Thank you in advance!
Clemsonguy, Age has nothing to do with opioid dosing limits generally speaking. You doctor might be thinking that if he raises the dose when you’re young, that you as you become tolerant over the years, you will require exceptionally high doses, for example, in your 70’s. The dose should be based on the cause of your pain, the underlying pathology, what has been tried previously, and risk of abuse/misuse. One way to get around increasing the dose, is to switch to a different opioid and “reduce” the equivalent dose by 15-20%. This could be as or more effective than what you are taking now – the concept is explained by “cross tolerance”. See Opioid Tolerance Development: A Pharmacokinetic/Pharmacodynamic Perspective.