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needinfo on quitting hydro painkillers.

my situation is if the doc would change my meds to longer half life meds with no APAP (already got a prob liver) I could got to work and get off disability.

Why is this? The half-life of hydrocodone is actually a bit longer than oxycodone, and hydrocodone is a pretty good painkiller for most.

I'm with Cane, it sounds like your problem is mainly that you are abusing medicines which you need for pain. Buprenorphine is something I'd seriously consider. If it works for you, it is a good opiate for maintenance and will be easier to use in a responsible manner. It also won't suppress your testosterone levels, a big benefit IMO.
 
They weren't. The highest opiate addiction rates may have been after the Civil War, where many soldiers had morphine habits, but that still represented a small proportion of the population. Incidentally, there wasn't much of a social stigma against it at the time, as it was viewed as "the soldier's disease" rather than a moral failing or weakness. I doubt that the average victim of an industrial accident in the early 1900s had the wherewithal, or desire, to consult a doctor or pharmacist, let alone afford an admittedly cheaper habit compared to today's standards.

Even when cocaine was legal, the majority of the population was not addicted. It's probably a more recent phenomenon that Americans have the attitude that medications can cure their ailments, risk free; certainly, the advent of televised pharmaceutical ads have increased the receptiveness of the average person toward taking medication, even for pain.

TL;DR, I don't think there was ever a "generation of junkies."

Also, I don't think the DEA has standards for addiction. Addiction is viewed as a medical/psychological problem, and as such, the only criteria for addiction that I can think of that has been formalized and accepted by professionals are the DSM-IV definitions of substance abuse and substance dependence.

Yeah the Civil War, but they didn't even know why the so called soldiers sickness was caused by opium. They only knew the had to give them opiates
to stop the sickness. By 1900 they knew morphine was addictive.
And I stand by what i said about losing a whole generation to addiction around the turn of the century.
 
<snip>

You didn't answer my question about how the DEA is 'raising the bar on what an addict is'.

I've been studying addiction and addiction treatment formally for a few years now and I've never seen a DEA definition of what addiction is so I'm a little lost about what you're talking about.

Lastly, how do you quantify the claim that during the historical period you're referring to, 'a whole generation' was addicted to opiates? Its been a while since I've seen the figures, but I don't remember the overall addiction rates ever getting very high let alone approaching anything close to warranting a claim that an entire generation was addicted.

You should check some very old books written at the time. The idea was that
Heroin was created to cure Morphine addiction----- a heroine to rescue man from an addiction.

<snip>
 
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Yeah the Civil War, but they didn't even know why the so called soldiers sickness was caused by opium. They only knew the had to give them opiates
to stop the sickness. By 1900 they knew morphine was addictive.
And I stand by what i said about losing a whole generation to addiction around the turn of the century.

So they lost an entire generation that helped to fight the First World War and engaged in public works projects to reverse the Great Depression?

I see what you're getting at, but without sound data, I don't think your statement is true. At the very least, it's kinda hyperbolic, y'know?
 
So they lost an entire generation that helped to fight the First World War and engaged in public works projects to reverse the Great Depression?

I see what you're getting at, but without sound data, I don't think your statement is true. At the very least, it's kinda hyperbolic, y'know?

The guys who fought in WWI were a little to old for the New Deal work program.
My uncle was a vet of WWII and he said there were no older guys like forty or older And that's how old most WWI vets would have been . And even though the New Deal put people to work it did not reverse the Depression. WWII was what did it.

As to my comments about losing a generation, don't forget what happened to a lot of vets who came home with drug problems. They worked and coped.
I imagine it was the same way for the generation I speak of. We also had an alcohol problem among factories workers too, back then. But they got the work done.

There are so many functional addicts in the work place to day it's unrealistic to assume that 100 years ago the addicts could not do the same.
 
Why is this? The half-life of hydrocodone is actually a bit longer than oxycodone, and hydrocodone is a pretty good painkiller for most.

I'm with Cane, it sounds like your problem is mainly that you are abusing medicines which you need for pain. Buprenorphine is something I'd seriously consider. If it works for you, it is a good opiate for maintenance and will be easier to use in a responsible manner. It also won't suppress your testosterone levels, a big benefit IMO.

To me abusing is over doing your scrip and coming up short every month.
That is not me. I stole ten pills when i found my wife's hiding place. I ain't proud.

So lets not pin a label that does not apply please.
I am snapping in some of my responses. Sorry...I am just not feeling proud of myself at the Moment. I'd been in 100% compliance of my doctors for the last Five years and I don't think abuse a fair characterization. I
 
^ whether its due to abuse, under-treated pain, stress or whatever - almost all of us who have been prescribed medication for chronic pain have been there and this shame (or however you'd characterize it) you're experiencing isn't warranted or helpful.

As long as you realize that this is unsustainable and are looking for solutions that are, you shouldn't feel bad.
 
OP, your language is a little confusing and I think that is the reason most of us are saying that you problem is a little deeper than just treating the pain.

You are talking about craving the buzz and guilt related to your use witch along with tolerance and dependence are all indicators (I think???) of addiction according to the DSM IV.

That being said you have a few options:

1. Continue the path your on and just deal with the situation with your meds, your pain and your wife.

2. Find a new doctor that will hopefully treat your pain properly and bring your wife to the appointment so the Dr. can explain to her that these meds are for real pain that you have and that they are necessary for you to live a happy life.

3. Just quit cold turkey and deal with the pain.

You also have the option to acknowledge the fact that yes you do have some addictive/drug seeking behaviors, but this does not mean you do not have the right to have your pain treated properly. In this situation you may find that a low dose of Suboxone (something like 1mg 2x-3x a day) with both treat your pain and allow you to live a life in which your are not compelled to use more of your meds than your prescribed.
 
Cane2theLeft said:
Butrans patches come in doses of 5-20µg/hour so they range from .12mg/day-.48mg/day... doses that aren't really sufficient for many looking to maintain on and/or block other opioids.

That's not exactly true. I haven't ever done such little doses to help my withdrawals myself. But a friend of mine told me that a 0.4mg sublingual buprenorphine pill was enough for her boyfriend to survive a day (and these are for pain here, only one hospital used them as a maintenance treatment, I don't know if they still do as Suboxone is available now so it's probably prohibited now for doctors to prescribe 0.4mg s.l. pills for drug treatment). I know the guy and I saw how much heroin he had to take to feel alright. It was a lot of heroin.

I guess it's more of a psychological problem. It always is. The fear of withdrawal is totally psychological. And so is this. It seems like the earlier phase of addiction - "I just need the drug". I'm not sure if he really wants to quit for good. I know it from experience. I talked like that many times and I can swear now I wasn't "ready". I tapered down from methadone a lot of times and I always came back to shooting up first and then methadone again, bewitched circle. However, it's a drug for pain as well so the problem is more complex. Studies actually show that people who take opioids for pain don't get addicted to them psychologically like people who start taking opioids to "abuse" them. But it happens, it happened here (well, if the wife has to hide the pills, it's no good).

Anyway, knowing the policy of drug treatment, 40mg of hydrocodone a day probably won't qualify the OP to be allowed to switch to buprenorphine. Actually I don't think it'd be a good idea. Buprenorphine is a strong painkiller itself and it works for 30 hours without the need of redosing because some W/D symptoms start kicking in. It might turn out to be a worse chain. And even though buprenorphine withdrawal is lighter, it goes on and on. Who'd like to walk with flu-like symptoms for a month? Not me. And abrupt discontinuation of 40mg of hydrocodone is like a week of standard withdrawal.
 
^ whether its due to abuse, under-treated pain, stress or whatever - almost all of us who have been prescribed medication for chronic pain have been there and this shame (or however you'd characterize it) you're experiencing isn't warranted or helpful.

As long as you realize that this is unsustainable and are looking for solutions that are, you shouldn't feel bad.

Thanks. That helped:)
 
OP, your language is a little confusing and I think that is the reason most of us are saying that you problem is a little deeper than just treating the pain.

You are talking about craving the buzz and guilt related to your use witch along with tolerance and dependence are all indicators (I think???) of addiction according to the DSM IV.

That being said you have a few options:

1. Continue the path your on and just deal with the situation with your meds, your pain and your wife.

2. Find a new doctor that will hopefully treat your pain properly and bring your wife to the appointment so the Dr. can explain to her that these meds are for real pain that you have and that they are necessary for you to live a happy life.

3. Just quit cold turkey and deal with the pain.

You also have the option to acknowledge the fact that yes you do have some addictive/drug seeking behaviors, but this does not mean you do not have the right to have your pain treated properly. In this situation you may find that a low dose of Suboxone (something like 1mg 2x-3x a day) with both treat your pain and allow you to live a life in which your are not compelled to use more of your meds than your prescribed.
Some solid advice. Thank you.
My history was asked for and I posted it.That may have been what confused you?

I have admitted more than once I am an addict.

Does this help to make the issue more clear.
 
That's not exactly true. I haven't ever done such little doses to help my withdrawals myself. But a friend of mine told me that a 0.4mg sublingual buprenorphine pill was enough for her boyfriend to survive a day (and these are for pain here, only one hospital used them as a maintenance treatment, I don't know if they still do as Suboxone is available now so it's probably prohibited now for doctors to prescribe 0.4mg s.l. pills for drug treatment). I know the guy and I saw how much heroin he had to take to feel alright. It was a lot of heroin.

I was careful with my phrasing when I referenced use for maintenance and utilizing the blockade effect. Lower doses most certainly are useful and often sufficient for detox or withdrawal-cessation but won't provide many of the advantages that clinicians and addicts alike seek.

Many users here will testify that they prefer doses smaller than 2mg SL qd however the reason that larger doses are preferred clinically is because its easier to produce stable plasma levels with once-daily administration and utilize buprenorphine's ability to block the effects of other opioids. You'll notice many here who do maintain on <2mg often split their doses.

In addiction treatment, you want to move people away from use that wears off and move them away from focusing on using substances so its preferred that people take it once a day and establish doses where there is next to little-to-no fluctuation in plasma levels so they never start to feel sick, never feel relief or high from their maintenance meds, etc.

Its not a perfect system for everyone, but this is essentially the philosophy behind once-daily administration of high(er) dose buprenorphine used for maintenance.
 
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cane said:
you may want to discuss temgesic patches

just a little nitpick - temgesic are the 0.2 and 0.4mg sublingual bupe tabs which i believe are only available in europe now - they were taken off the australian market going back to the earli 2000's i think - though may still be available in the US so someone correct me if i'm wrong. i can't recall the name of the transdermal patches brand they're marketed under in the US but they're Norspan here in australia.
 
^ thanks lefty - I'm not sure why I put patches there, I wasn't thinking - also it appears temgesic isn't marketed in the US so perhaps suboxone is the only option outside of Butrans (the patch, which is equivalent to norspan in Oz).

Does anyone know if there are any other commercially available bupe preparations besides suboxone, subutex and butrans in the US?
 
Guys i want to apologize if i came off the hook a few times.
I always do a good job of beating my self up when I feel honest (deserved?) guilt and i think i become a bit paranoid.

I'm the new guy and what I did was not cool. Apologizes all around.

I have had a lot to think about and I have made a final decision.
I think some where that is part of recovery strategy anyway.


Cane2theLeft: I want to go back to work (please bare with me as i explain)

First off you have earned my respect thru the advice you have posted.

I am a closed head injury patient and it makes thing difficult sometimes

If my doc won't give me the meds i need to return to work, I want off hydro completely. But I will still have bad pain..

What and how much of an alternative med should I take or ask the doc to give me?

Cold turkey is not an option. My blood pressure and cardio make that impossible. And I am very hostile in withdrawal.

And what do I do about cravings

Thanks for listening./I]
 
You are 100% right about the lower dose and having to dose at least twice a day. I usually take 2mg in the AM and 2mg in the PM and through out the day if I have a fluctuation in pain I will take a very small amount, maybe .5mg, up to twice a day. This means my max daily dose of Suboxone is roughly 5mg. I have to maintain my regiment otherwise I find myself starting to feel the edge of withdrawal fairly quickly.

I find Suboxone taken like this is fairly effective for pain. I actually use to take one dose once a day and found that it held me but the way I am dosing now seems to be so much better for controlling my pain level. It could just be a mental thing but I am surprisingly happy with the sub It just took the change to my dosing schedule from once to 2-4x a day for it to really make me feel like it was helping me actually control the pain.

Anyone have any idea why the change in the dosing schedule would make such a big difference how it works on pain?

Again to the OP this has worked for me so it might be something to think about.
 
^ (hvac) this is one of the reasons that we're suggesting buprenorphine - its a superior analgesic to hydrocodone and will address the issues of cravings and such as well.

There are lots of different ways to treat pain both pharmacologically and otherwise (somewhat depending on the origin of the pain). Some examples include anticonvulsants, tricyclic antidepressants, SNRI's, skeletal muscle relaxants, local anesthetics, benzodiazepines, NSAIDs and many others.

Aside from those you have options such as nerve blocks, epidural steroid injections, physical therapy, biofeedback, neurofeedback, meditation, counseling, massage, acupuncture and many other options.

Pain clinics are your best bet for finding the right combination of treatments to get you as pain-free and functional as possible and pain management specialists obviously have the most training and experience in being able to work with patients to find what works for them individually while taking into account any special considerations you may have.
 
Thanks.

I am looking the safest option for my endangered liver. NAIDS are out becasue they give me i
arrhythmia. And they are bad for your liver like APAP, no?
 
Ok thanks again.


Just an aside ....last time I was detoxed my brain chemistry was totally causing me to be a vegetable. I could do things but was unable to hold a conversation.

LOL wife took video of me trying to explain an a/c repair over the phone.


It's one of those videos you show at a party when everyone has had a few beers and are ready for a laugh.
 
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