I took myself off of pain medications after taking them for 20 years. They simply stopped working effectively. I also built up a huge tolerance to them, despite escalating dosages, and changing medications over the years. As an example: I went from 3 Percocet tablets daily 20 years ago, to 3- 80mg. oxycontin tablets, and 12- 10mg. dilaudid tablets daily, not to mention muscle relaxers, etc. My pain levels are basically the same since stopping them. I have noticed that I seem to be able to think with a much clearer head than when I was on the meds. I know they helped me lead a much better quality of life for many years. I'm going to have a stimulator implanted to target my leg pain. My advice for someone just starting pain management with narcotics is to ask to switch medications before simply escalating dosages due to tolerance issues. I think you will have the same pain relief, without worrying about hitting the dosage ceiling, etc. like I did, and not getting pain relief at all.