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Addiction (Expert Forum)
Fiorinal w/codeine
Questions in the Addiction forum are answered by a medical expert.
Fiorinal w/codeine
by Bert-Brewer, Aug 02, 1999 12:00AM
Posted by Bert
Brewer on August 02, 1999 at 20:30:21
I have had classic migraines on a fairly regular basis since about age 12.
Until a few years ago, I normally had about two per month. However, as the
stress of my job and family demands has mounted, and following a severe back
& neck injury (four years ago)resulting in chronic spondilolysis, I began to
have more headaches, both migraines and severe tension-type headaches. In
response to this, I began to use more and more Fiorinal with codeine. (I have
tried many, many other migraine drugs, but no other has been reliably
effective.) The step to dependency was natural enough, as the drug helps both my
headaches and the frequent bouts of back pain, enabling me to function
reasonably well. At any rate, I now average about one pill per day; some days
none, other days (when a real migraine strikes- maybe once every two weeks) as
many as six. My HMO, of course, has been instrumental in keeping my physician's
hands tied as far as non-drug therapies are concerned. My question, then, is
two-fold:
1. Is my current usage high enough to be considered a physical
dependency, with all its perils and side effects? Or is it more an issue of
"mind over matter" in my case?
2. Is there another alternative drug, safe for
long-term frequent usage, that might be helpful in combatting my various pains?
Sorry to be so long-winded; I am very frustrated, but seemingly unable to
get on top of this myself...
Posted by Acey on August 03, 1999 at 20:48:24
Okay, here's another person stuck in the bind of bad tension headaches,
migraine headaches, fiorinal (I didn't know it had codeine in it ... that wasn't
listed as one of the components in what I read and was told -- just the
barbituate, caffeine, and aspirin)and resulting REBOUND headaches. The rebound
headaches are the worst. I have been doing my best to keep a grip on things but
I worry about addiction ... there really aren't very many days when I don't wind
up taking at least one pill. On days when I take more than one (so far I haven't
taken more than three per day but my prescription and the doctor who wrote it
said I should never NEED to take more than two), I make sure to take one less
the next day ... yet I remain stuck in the one-pill track. The problem is
headaches. The cure CAUSES headaches.
Posted by SA, M.D. - HVMA on August 12, 1999 at 20:38:51
Not all fiorinal contains codeine - only if listed as such. You are both wise
to be concerned about daily use of controlled substances for headache control.
This is, in fact, a pathway into substance dependence for some people. However,
it sounds to me that neither of you is abusing these controlled substances to a
significant extent (aside from the occasional "extra" pill - something which is
to be discouraged and which would indicate an incipient problem if it began
occurring with greater and greater frequency). And the rather moderate daily
intake does not represent a high degree of physical dependence. It is, as you
have noted, possible that you are experiencing withdrawal headaches.
If you are not satisfied with your physicians' management of your headaches,
you should consider getting evaluated by doctors who specialize in headache
management and/or chronic pain. My good friend, Larry Lockerman, D.M.D., is a
local headache specialist here in Massachusetts (he's a dentist with a
particular interest in TMJ), and he is frequently able to help patients overcome
their chronic headaches using treatment protocols which involve minimal amounts
of controlled substances.
Good luck to both of you!
DrSteve
This information is for educational purposes only. For diagnosis and
treatment of your individual medical problems, consult your personal physician.
Keywords: chronic pain, barbiturate, codeine, headache
Brewer on August 02, 1999 at 20:30:21
I have had classic migraines on a fairly regular basis since about age 12.
Until a few years ago, I normally had about two per month. However, as the
stress of my job and family demands has mounted, and following a severe back
& neck injury (four years ago)resulting in chronic spondilolysis, I began to
have more headaches, both migraines and severe tension-type headaches. In
response to this, I began to use more and more Fiorinal with codeine. (I have
tried many, many other migraine drugs, but no other has been reliably
effective.) The step to dependency was natural enough, as the drug helps both my
headaches and the frequent bouts of back pain, enabling me to function
reasonably well. At any rate, I now average about one pill per day; some days
none, other days (when a real migraine strikes- maybe once every two weeks) as
many as six. My HMO, of course, has been instrumental in keeping my physician's
hands tied as far as non-drug therapies are concerned. My question, then, is
two-fold:
1. Is my current usage high enough to be considered a physical
dependency, with all its perils and side effects? Or is it more an issue of
"mind over matter" in my case?
2. Is there another alternative drug, safe for
long-term frequent usage, that might be helpful in combatting my various pains?
Sorry to be so long-winded; I am very frustrated, but seemingly unable to
get on top of this myself...
Posted by Acey on August 03, 1999 at 20:48:24
Okay, here's another person stuck in the bind of bad tension headaches,
migraine headaches, fiorinal (I didn't know it had codeine in it ... that wasn't
listed as one of the components in what I read and was told -- just the
barbituate, caffeine, and aspirin)and resulting REBOUND headaches. The rebound
headaches are the worst. I have been doing my best to keep a grip on things but
I worry about addiction ... there really aren't very many days when I don't wind
up taking at least one pill. On days when I take more than one (so far I haven't
taken more than three per day but my prescription and the doctor who wrote it
said I should never NEED to take more than two), I make sure to take one less
the next day ... yet I remain stuck in the one-pill track. The problem is
headaches. The cure CAUSES headaches.
Posted by SA, M.D. - HVMA on August 12, 1999 at 20:38:51
Not all fiorinal contains codeine - only if listed as such. You are both wise
to be concerned about daily use of controlled substances for headache control.
This is, in fact, a pathway into substance dependence for some people. However,
it sounds to me that neither of you is abusing these controlled substances to a
significant extent (aside from the occasional "extra" pill - something which is
to be discouraged and which would indicate an incipient problem if it began
occurring with greater and greater frequency). And the rather moderate daily
intake does not represent a high degree of physical dependence. It is, as you
have noted, possible that you are experiencing withdrawal headaches.
If you are not satisfied with your physicians' management of your headaches,
you should consider getting evaluated by doctors who specialize in headache
management and/or chronic pain. My good friend, Larry Lockerman, D.M.D., is a
local headache specialist here in Massachusetts (he's a dentist with a
particular interest in TMJ), and he is frequently able to help patients overcome
their chronic headaches using treatment protocols which involve minimal amounts
of controlled substances.
Good luck to both of you!
DrSteve
This information is for educational purposes only. For diagnosis and
treatment of your individual medical problems, consult your personal physician.
Keywords: chronic pain, barbiturate, codeine, headache
