Migraine and Pain Meds

By lk26

2 min read

I am at a sort of crossroads in my treatment. My story is somewhat common, episodic migraines starting in my 20s, gradually increased in frequency, severity and endurance. About 6-7yrs ago the pain became daily & non-stop, except when I took the Fioricet with codeine, prescribed by my primary care MD. Have tried many, many preventatives w/o any help. Since then, I have seen 1 migraine specialist, who was killed in an auto accident 3yrs ago, and a neurologist. The 2 MDs worked together on several patients. Basically after about 3years of trying everything they threw at me and the pain continued to get worse. I had to apply & was approved for disability.

Remember by the time I got to both MDs, my pain was constant & the Fioricet was no longer helping. Along with other meds, they were also giving me different pain meds. Then they mutually decided that they had tried all they knew to try & referred me to Pain Management. She was great and after trials of different things, the only thing that had improved my quality of life were the pain meds. So 3 monthes ago, the neurologist decided that I am addicted to my narcotics and all I need for my migraines were Topamax & Botox. Both of which I have tried on numerous occasions without sucess. Speaking with my pain MD, she is not sold completely on his plan. She says there is a difference from addiction to medical need not her exact words but basically the same meaning. With her, I have gone from counting my pills to see how many I can take until my next appt to a month Rx lasting me close to 2 monthes. At first I thought my panic was maybe I am an addict, then realizing the ONLY thing that has helped me was the pain med.

Since I have tried topamax, having to stop & start 6-8 times due to side effects, the last one & the scariest was hallucinations, visual & auditory. So no more topamax. I got one series of Botox injections about 6 wks ago, no change in pain, except now I have bodyaches, hot & cold, flu like symptoms. So now what???? My pain MD agreed to supervise gradually stopping the pain med, but says that I am not ready for that right now. Have a lot of personal & family issues to deal with. She told me after getting completely off them, my pain maybe gone or my pain could not change. When I asked then what? She said I will need to develop coping skills to deal with the pain. I am terrified!!!! I don't want to be on the pain meds forever, but at least I had improved some quality of life VS high levels of pain that I have to learn to "just deal with it"! Anybody with advice, similiar situation, anything........

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Katie M. Golden Moderator
LK26, Managing chronic pain is so difficult and the argument over what meds to use is a very sensitive topic. First, I'd like to tell you to stick with the Botox for at least 2 more rounds. I've read that people can have flu-like symptoms during their first round. And it's not completely uncommon for someone to not respond the first time, but to have better results after multiple injections. Botox has a life-cycle, which is why you should do it every 3 months. For me it takes about 2 weeks after to feel any effects and then it starts to wear off a few weeks before my next injections. Everyone responds differently. Of course keep your doctor informed if you continue to get sick after each round. Eventually you may find it is not for you. You can read and interact with others who have tried Botox here: <a href='http://migraine.com/topic/botox-for-migrains/' target='_blank'>http://migraine.com/topic/botox-for-migrains/</a> The problem with using pain meds like Fioricet is that eventually your body needs more and more of it to give you the same pain relief. Also, it masks the pain but does not get to the root of the problem. Using pain meds 10 or more times per month can cause Medication Overuse Headache or rebound headaches. Only making the headaches worse. <a href='http://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/' target='_blank'>http://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/</a> You're already making big strides by reducing the amount you're using. And you're under the care of a pain specialist who really understands your needs. It sounds like she won't take you off before you are ready. You may ask if there is a pain management class that is offered that can introduce some alternative ways of "dealing with it." Such as acupuncture, yoga, meditation. I've been able to find a healthy balance between using paid meds and using alternative methods along with my preventatives. There isn't a right or wrong answer about using pain meds. It's between you and your doctor. You seem very aware of the issues and want to do what is right for your body. Thanks for sharing your story and let us know how you are! -Katie
migrainestl Member
I too was on Fiorecet & scared to stop taking it. My doctor offered a different pain med that doesn't take the edge off as quickly, but does help so maybe it's worth alternating w/ something new before going off fiorecet completely? Besides lots of alternative therapies (hot bath, ice pack, yoga, staying active, resting frequently), I found that when my pain starts to increase I can take 2mg of a muscle relaxant (tizanidine) & that can usually take the edge off to where I can function, albeit never completely migraine free. It has helped me keep my acute med days down to a decent number. Good luck, I hope you find something that works for you in conjunction w/ your Docs.
1. Katie M. Golden Moderator
 Migrainestl, I recently had a discussion with my doctor about alternating meds to deal with the pain in a chance to decrease dependency on any one of them. I'm not suggesting this is right for you, but it may be worth talking to your doctor about. It sounds like you are very conscious and aware of the choices regarding your meds and that's fantastic! -Katie
annie64 Member
I too suffer daily, with varying degrees of pain that is always there TBH. I also have tried numerous things without success. Doubling up on strong px painkillers is my current coping mechanism, however, I feel weak, depressed & in pain. Do you feel the doctors right you off when things px do not work? I have even tried anti depressants incase it WAS "all in my head" "stress" etc.. etc.. There must be some cure out there....
margaret75 Member
It really saddens me to hear of people suffering in constant pain. I know what migraines can do to a person having suffered with them for years and it's not fair. Living in chronic pain is not living at all. I just want to share my PERSONAL experience in what helped me overcome my chronic migraines. Please read this article as it explains the treatment that I did to help me put my migraine days to rest. I'm still in treatment but when I started I was in daily pain and now I get 1 manageable migraine a month but I'm not done treatment yet. I have my life back and I only wish the same for every person who suffers from chronic pain. Best of luck to you and hopefully you will find what works for you. <a href='http://www.chatelaine.com/health/wellness/migraine-therapy/' target='_blank' rel='noopener noreferrer ugc'>http://www.chatelaine.com/health/wellness/migraine-therapy/</a>
Jmfo Member
Hi, Yes, this just happened to me where I learned that the new trend is NOT to allow prescriptions for fioricet with codeine. This med along with rizatriptan has me pain free and functioning! I am not addicted to it, and when I asked the pharmacist whether my body was, he answered, No, not the way you take it and at your dosage. The new class of blockers is absolutely not for me: I have tortuous colon (no symptoms), constipation is a trigger, brain gut health link is real, and besides the fact that the long term effects of these new drugs are not acceptable to me, I have a TBI--I don't want this blocker. I am highly irritated at the DEA etc getting involved in patient care. I love my neurologist, she has successfully treated me for 15 years, and I have no faith at all in the pain clinic and their willy nilly dispensing of this new med.

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