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My Mom is 83, has early stage dementia, and sees a pain management Dr. She says she has back pain for years and the Dr has prescribed Oxicodone. Pills ran out and she couldn't get an appt to see the Dr for 2 weeks. The 1st week she was asking for the pills everyday she said “I have to have my pain pills”. After a week she tapered off only asking every few days. Now 3 weeks later she isn’t asking at all. I’m wondering was she going through withdrawals or really in pain?? Due to dementia, it’s hard to believe her. I think out of habit she wants the pain pills.

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If she isn’t asking for them I’d be inclined to just let it lay.

However - I would suggest two “safeguards” to ensure this is the
right choice:

First - is she able to accurately assess and communicate her needs in other areas such as hunger, thirst, bathroom needs, etc?

And -

Based in your own observations - is she able to move about as freely as she had previously on the pain meds? Is she grimacing or wincing when she gets up and down?

Dont let the Oxy Hysteria keep
you from allowing your mother relief from actual pain.

AND - I say this as a daughter who watched my mother abuse Oxycodone for years. But, living with chronic pain needlessly - when relief is available - is just a miserable way to have to exist.
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I wouldn't be giving her pain medication unless she specifically says she's in pain and needs them. There are too many potential complications associated with oxicodone to give them to your Mom if they're not warranted.

Best of luck!
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If she isn't in pain, then why would you give her pain meds?
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Check her blood pressure. If Mom is in pain it will be elevated. My nephew has an extremely high threshold for pain. The only way the nurses knew he was in pain from a back operation was checking his blood pressure.
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My mother was seriously addicted to pain meds, benzos, barbiturates and amphetamines for 40+ years--before the opioid "crisis". She was so stoned all the time, it was hard for her to do anything. I know she took WAY too many and had several doctors prescribing them. I really didn't think much of it. That was just mom.

After her last hip surgery, they had her on Ultram, which I had always felt was pretty weak sauce, pain med wise, but she went kooky on them. Falling all the time, acting demented& hallucinating--they took her off those and she was fine. She actually really doesn't complain of pain. All she can have now is Tylenol, her liver and kidneys are shot. I don't know why, when you'd think pain would be a real issue, due to age and osteoporosis, etc., that NOW is when she'd need something for pain, but she doesn't seem to.

I was with her as she supposedly de-toxed from oxycodone & Valium and she had zero side effects.

Life is funny--I have chronic back pain that 2 back surgeries have "helped" but not "cured". My PCP has been a good sport to let me have x number of Tylenol #4 but it just takes the edge off. I'm in pain 24/7. I can't go "up" in dosage or type of drug, in fact, last checkup my doc said he wants me to start weaning off the meds. If something else worked, you better believe I'd do it. I'm pre-emptively terrified of the constant unrelenting pain that will come. I can bend over and touch the floor, I can walk (well, when my broken foot has healed I can walk) for miles, I am 100% "fine"---but to be able to have a quality of life--I do need something for pain. Ibuprofen is off the table--stomach issues.

I wouldn't give your mom anything she didn't ask for. Often when people get very old, the synapses in their brain simply don't fire the same-they no longer feel pain--or they feel pain that isn't there, or is not that bad--but I will never judge another person's pain level.

The idea to take her BP if she seems uncomfortable is a good one. When I am in real pain, my BP will raise to 160/100 or so--normal for me is 90/60.

And some people have incredible tolerances for pain. I'm not one of those, much as I may wish for it.

Life has a way of karmically biting us in the tush--don't be hard on mom if she needs relief from pain. Tomorrow, that could be you. Just sayin'.
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ToskaBlue1957 Feb 2019
Wow, your journey with your mom sounds so much like mine. My mom has been on opiates for 40+ years. Her family doctor got her started on Darvon, years ago before they took it off the market because people were overdosing. He then switched her to Vicodin. She has been on the highest dose for 3 years now. Twice in the last year she has almost overdosed.

She had her left leg amputated above the knee 10 years ago due to PAD. Now she has phantom pain to deal with, which is not chronic, but to her, it is devastating. She was 75 years old at the time of the amputation, and from what I've read, the longer you've had the limb, the more the brain recalls it being there, and the stronger the phantom pain.

Most recently, at the end of January 2019, I found her in her apartment, passed out, slumped over the kitchen counter. When I roused her I realized something horrible was happening to her. Yep, she was overdosing. However, even as much as I spread the word about the Vicodin in the ER and once they admitted her, in the end, her discharge papers said "severe confusion and hallucinations". I did notify the prescribing doctor and he will no longer be prescribing the Vicodin and wants to move her slowly to medical marijuana. She and I are both agreeable to this, but she doesn't yet know that there Vicodin well has run dry.

On the plus side, in the past 2 weeks since discharged, she is more perky than usual. Not necessarily like her old self, but like a rejuvenated version of the previous self. And it's really refreshing and reassuring to see!

As the main caregiver for my mother, I appreciate this opportunity to vent. This forum is a good place for it. I feel better already.

Thanks Midkid, and everyone else here. We're all in similar circumstances and feel the need for the companionship.
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It does sound like she is through the worst of the drug withdrawal, but she may still be in pain too, and yet no longer be able to voice her pain level and the need for pain relief to you in the usual way. You Really need to be discussing this with he Pain Dr, for sure! There may be other medications that are more appropriate for her now, but she should have access to proper pain relief, you might need to find a better way to access her symptoms if she is unable to verbalize it. Ask the Dr what is best, but do i insist on proper relief, pain sucks!
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She’s 83. She has dementia. Talk to her doctor. I would not be concerned about being dependent. If she’s in pain. She’s in pain. Do NOT quit her cold turkey.
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So, how is she now?

I don't think you can rely on her reporting pain in the ordinary way: she may feel it without being able to express it.

So check for other signs. Is she as mobile as normal? Do you see any changes in expression, grimaces, does she shift around trying to get comfortable? When you move her, does she resist certain changes of position, or anything like that?

If there is absolutely no sign of anything wrong and she has got out of the habit of taking her oxycodone, then it's not so much that she doesn't really need the pain relief as that there doesn't seem any point in giving it to her. But do not make this decision on your own: consult her doctor, and perhaps keep her next px on standby in case.
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early stages of dementia she should be able to tell you she is in pain. Actually pain medication--any narcotic--will increase the likelihood of FALLS and constipation will become a severe issue. Administration of narcotics and psychotropics are also linked to increased risk of dementia and Alzheimer's and a more rapid *decline*. www.ebm.bmj.com/content/18/5/e50
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If she's not asking, I wouldn't give them to her.

Look for signs that she may be in pain (wincing, moving her body in a protective way...) if there aren't any significant signs, then good. She's successfully weaned off of a very powerful and addictive drug and, as a side benefit, she has a MUCH lower risk of falling. (Seniors on opioids are 7 times more likely to fall.)

When she asks for something for pain, try Tylenol first.
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