Opioids Vicodin or better alternatives long term & something stronger for severe pain

I had a Lumbar Laminectomy some years ago and recovered very well then July 2010 I hurt my back again and I have been on Vicodin since then with only 2 periods of two weeks without any meds except for over the counter. It was my choice, just to see how bad life was without pain meds and a concern over increasing tolerance. I started with 2 5MG/500MG per day and now I am up to 5 or 6 per day. Even then it does not eliminate the pain but makes it manageable. My script says 4 per day but I have not had a problem refiling it early.

I have had typical sciatica with 95% of the pain in my butt cheek and down my leg but last week I had a two day episode of severe pain in the back itself. It was so bad that I would have to walk shuffling my feet because normal foot falls were painful — couldn’t bend over, etc.

I have been seeing the same doctor for over 10 years and have good relationship. At my last appointment we were discussing pain meds and I asked if I could be prescribed the lower Acetaminophen, 5MG/325MG based on what I have learned here and elsewhere. After he realized I had done some research he asked what would you like to try.

I am looking for some advice on an opiate that would be good used in conjunction with Vicodin for the extreme debilitating pain like I experienced because the Vicodin was like taking a knife to a gunfight — out matched. I am back to my normal pain (Normal pain: how crazy is that?) but I would like to have something if it returns, as I have had a very short reoccurrence of it lasting just a couple of hours and not quite as bad.

Also, longterm, are there better alternatives to Vic? They don’t relive the pain like they used to — witnessed by my increasing dosage. It seems to me I read that there is a benefit from rotating opiates because each work a little differently on the receptors or the like. Any recommendations there?

I recommend asking your doctor for Percocets 5/325.........they are 1.5 stronger than the Vicodin 5/325's. Imo, for several pain like you are experiencing, I would say Morphine SR pills but we both know the doctor wont prescribe them unless you've been on other strong meds for years.

Ask him if he can move you up to Percocets, thats usually the route doctors take after Vicodin, unless he moves you up to 10/325 Vicodin pills. Vicodin=Hydrocodone, Percocets=oxycodone

Norco 10-325's might be a good route, maybe taken four times a day for a total of 40 mg of hydrocodone, with only 1300 mg of APAP. You take between 25 and 30 mg of hydrocodone now, still with pain, so upping you to that might be best, if he doesn't want to jump that far maybe Norco 7.5-325's four times a day, for less APAP with an rx'd 30 mg hydro daily. You could also try Soma (carisoprodol), it can work wonders esp. in combo with hydro.

Both replies have good advice. If your not afraid of the negative effects of opiates (addiction, overdose) than go ahead and try to get oxycontin 40 or 80 mg pills and then dilaudid / opana for breakthrough pain. This would be like bringing a gun to a gun fight for ya.

Hope all goes well and your pain gets managed better.

Dont know if you have used (oxy)codone for relief, but (hyrdo)codone can be stimulating in comparison Test's have also shown (oxy) to be extremely sedating in comparison in most...Be safe (driving etc)...before you know for sure how it affects your own body/brain

For my pain management I started w/ vicodin then moved to percocet (5 mg then 10 mg--500 mg APAP). This was effective for a short while. Tolerance rising inevitably occurs. Then, I tried Morphine sulfate (an ER med) 15 mg with 5 mg oxy IR for breakthrough pajn. This has no APAP -better for the liver. After that, I moved to 15 mg oxycodone IR 15 mg 4 times daily. This is my current prescription. I have been on this for nearly a half year and my tolerance has risen causing this to be less effective than when I started. I agree that it is wise to switch it up on occasion for efficacy. Combining meds (per doc. recommendation of course) is a great way to treat chronic pain.

From where you are at now, I would perhaps try Oxycontin at a lower dose in combination with an IR breakthrough med such as norco (10 mg hydrocodone), or low dose dilaudid (however this has a very low oral BA). It is unlikely your doc will allow this, but there is also Opana... but that seems like too big a jump from where you currently are in terms of tolerance Perhaps well down the road Opana could be an option. I know a handful of people who take methadone plus dilaudid or Oxy IR for (moderate to severe chronic pain), however methadone is a bitch to become dependent on... and horrendous if you need to ever get off of it. It IS a great pain medicine, if used as directed.

percocet would be more effective

woamotive said:

For my pain management I started w/ vicodin then moved to percocet (5 mg then 10 mg--500 mg APAP). This was effective for a short while. Tolerance rising inevitably occurs. Then, I tried Morphine sulfate (an ER med) 15 mg with 5 mg oxy IR for breakthrough pajn. This has no APAP -better for the liver. After that, I moved to 15 mg oxycodone IR 15 mg 4 times daily. This is my current prescription. I have been on this for nearly a half year and my tolerance has risen causing this to be less effective than when I started. I agree that it is wise to switch it up on occasion for efficacy. Combining meds (per doc. recommendation of course) is a great way to treat chronic pain.

From where you are at now, I would perhaps try Oxycontin at a lower dose in combination with an IR breakthrough med such as norco (10 mg hydrocodone), or low dose dilaudid (however this has a very low oral BA). It is unlikely your doc will allow this, but there is also Opana... but that seems like too big a jump from where you currently are in terms of tolerance Perhaps well down the road Opana could be an option. I know a handful of people who take methadone plus dilaudid or Oxy IR for (moderate to severe chronic pain), however methadone is a bitch to become dependent on... and horrendous if you need to ever get off of it. It IS a great pain medicine, if used as directed.

Click to expand...

Opana will likely (in the near future) be changed into an epoxy/wax based stone, that will pale in effectiveness in comparison to the current version...

The doctor will not jump from 5mg Vicodin's to Opana or Oxy 40 & 80's, we can forget about that. He will probably jump up to 10/325 hydrocodone or 5/325 percocets..............

I'd agree with Alex000.

Thanks for the replies, guys.