For the past 4 years, John, a patient of mine has been living with liver tumors that cause him uncomfortable episodes of flushing and nausea several times a day and often in the middle of the night. After trying several different types of medicine, he found good results with oxycodone, a potent pain medicine.
John takes one long-acting oxycodone tablet called Oxycontin® twice a day but if that’s not enough to tame his flushing episodes he takes two additional tablets of short-acting oxycodone. He’s been taking a combination of long and short acting oxycodone for nearly 3 and a half years and it has worked pretty well for him. But since he’s been slowly increasing the amount of oxycodone he takes to control his episodes of flushing, he needed to know about The Invisible Line.
As we sat down together one afternoon last week, he started the conversation. “I try to keep what I take as little as possible, but sometimes I wake up at night with flushing and have to take an oxycodone in order to get back to sleep. I’m not abusing it; I only take it when I really need it.”
“I agree, John. But oxycodone is a very potent pain medicine, even if you aren’t using it specifically for pain. Oxycodone, hydrocodone, methadone or morphine, all of these can do the same thing to you: if you get enough of any of them in your system, you’ll STOP BREATHING.”
I added, “I really think there should be some kind of warning sign for these medicines, telling you that you were getting close to danger, like when paddling a canoe down a river you hear a roaring sound getting louder and louder, warning you that up ahead is a waterfall.”
“What if there no warning whatsoever that a waterfall lurked ahead? It was right there but you couldn’t hear it or see it until you were swept right over the edge. That river would be very dangerous to anyone heading downstream, wouldn’t it?”
“We don’t
