How to sever the bond with drugs

Compared to many of your stories, this may seem insignificant but in my mind, it is huge so please bare with me.  I have been taking Hydro-acetaminophen 5-500, 1+1/2 pills per evening, about 5 times a week to deal with chronic neck pain and tension.  It literally melts away the pain.  I do not like taking any more than that and never take it during the day.  I have been doing this for almost 2 years  and am wanting to stop taking them because I can tell I have become, at the very least, psychologically dependent.  What would be a good way to go about this and when can I ge this out of my system.  Also, I recently have been diagnosed with high blood pressure which has scared me because I am physically in great shape so I am getting my heart and kidneys checked.  This has inspired me to clean up wherever I can. Any advice any of you can give will be helpful.  I have great resolve in the morning but am completely of a different opinion in the evening when the tension builds.  Thanks!!!

[el_em_en_oh]

Dealing with chronic-pain is a difficult tight-rope to balance. There's a very fine line indeed between medicating your pain adequately and abusing your medication. Another 'fine line' is the psychological dependence vs. physical dependence aspect. The body has a funny way of tricking you into thinking you're in more pain than you really are.

Case & point... me.

While I was taking narcotic pain-killers for my chronic-pain & acute-pain, both associated with kidney-stones, my mind & body had me convinced, utterly CONVINCED, that I was in a substantial amount of pain. Now, I'm not going to lie and tell you that I wasn't in any pain at all, because that would be a lie, but my body/mind had me convinced of the fact that my pain-level was a constant 8 and that I needed the heavy narcotics I was taking in order to survive.

Once I detoxed myself from the narcotics (with the help of a 30-day inpatient treatment center), my body/mind adjusted, and I realized that I wasn't in nearly the amount of pain that I thought I was in. My mind/body liked the pain-killers, and re-wired my pain-receptors and basically turned them 'on' full time, making me think that I needed the meds. Until I came off them and allowed those receptors to basically 'reset', I didn't know any better.

That being said, I went cold-turkey off a 100mg Oxymorphone/72mg Hydromorphone (daily) habit and lived to tell about it. I'm not going to say it was a pleasant experience (the wd's), but it's doable.

I can appreciate your situation and your trying to get cleaned up for the sake of your long-term health. What, if anything, will you do regarding your chronic-pain, besides narcotics?  

[Jaybay]

I totally agree with el_em_en_oh's post and how our brains can fool us, so I'll comment more on the physical aspects.  What happened to your neck to cause the pain?  Have you done the physical therapy routine or had surgery?  

The reason I ask is that many years ago I was in your shoes and worse after two neck surgeries complete with fusion and titanium plates.  The docs could do nothing with it and at the time pain management was in its infancy.  It finally got so bad I figured I'd either completely disable myself or fix myself.  I hired a personal trainer, lifted weights and got buffed up and fit. Within a month of intensive work, the pain was gone and has never returned.  Same for the shooting arm and shoulder blade pain and numbness.

Do not try this at home!  What I did was physical therapy on steroids with large amounts of stupid and desperation thrown in.  At the time I really didn't think I could hurt any worse or be any more disabled.  I had nothing to lose.  No doctor in his right mind would have approved of it.  The one thing I did do right was to hire a professional who knew what he was dealing with.

Most people give up on physical therapy because it flat out HURTS, and we are conditioned to stop doing something when we hurt.  PT brought some of the worst pain I've ever gone through in my life after orthopedic surgeries.  If you don't stay active with weight-bearing exercise and let your mucles atrophy, your pain will only continue to get worse.  Since you want to stop taking the pain meds, you'll need to find some alternative therapies like physical therapy for muscle strengthening, massage for muscle spasms, and also learn relaxation techniques.  Tension is a huge contributor to increased pain because our muscles clench without being consciously aware of it.  Learning how to relax specific muscles is a learned skill, so you have to practice the technique.

Have you spoken to your prescribing doctor about both the physical and psychological problems you're having with the meds?  There are plenty of non-narcotic meds that might help.  Granted, the relief probably won't be as spectacular as the hydrocodone, but with other alternative therapies you should be in good shape.  You might also consider asking for a referral to a pain psychologist.  A good one can help you get through the psychological issue and also teach you some different coping skills so that your first thought isn't to automatically reach for the pill bottle.

[bubbup]

My daughter would totally concur with the physical therapy angle and has been wanting me to look into it so I will.  My pain comes from a couple of car accidents I was in many years ago, both sideways whiplash in that I was a passenger and looking "sideways" at impact.  Also, I carry tension in my neck and shoulders and my job is physically demanding as well.  Other than that, I work out, eat right, hardly drink, don't smoke etc.My pain is not devastating and I have been able to live with it.  It's just that around evening time, my resolve to deal with it naturally goes out the back door. Since I am a naturally wound up person, just one hydro seems to improve the quality of my life.  I mentioned that I take 1+1/2 but actually, 1 does the trick.  The rare occasions I took "2", I did not like it.  But, I can tell I look forward to it and I don't really want to be a slave to anything.  I literally feel anxious if I imagine going without it and that's my personal red flag.

[Jaybay]

That's a good red flag to be aware of!  :-)

Have you tried to just put down the pills yet?  If not, what is your plan?  You're on a low but consistent dose so you'll probably have some withdrawal symptoms if you quit cold turkey, but it shouldn't last too long.  Fix a taper plan in your mind and stick to it.  Write it down and hand your meds over to someone you trust and have them follow the written dosing plan.  Expect to feel more anxiety.  That's part of withdrawal but like the other symptoms it doesn't last forever.

If you haven't talked to your doctor about getting off the vicodin, do it!  That's a resource too few pain patients consider.  There is no shame in telling him you want off the stuff but think you might need help to do it.  Tell him you're anxious about it.  He can't treat any of the symptoms unless you tell him.  Be proud that you recognize there is a potential problem and that you're doing something about it.  :-)