I had back surgery in june. Prior to that i had to be taking Hydrocodone 10/325 from 8-10 a day at times. But for the last 2 weeks, i have been taking only 2-3 norcos, and then 2-3 darvocet at night to sleep. I was hoping that the darvocet would help to stop the norco. but now i find out its the same opiate family.
After (at the most) about 12 hours of taking nothing, even if my pain level is manageable with tylenol or advil, I get this intense feeling of anxiety and agitation. could this mean I have developed an addiction to opiates?
I am so fearful that I have. I know that i have the sleeping pill dependency, once i feel better and can go to work, i think that will help to diminish that. but the pain meds thing is really bothering me.
How do I detox or stop without going out of my mind and driving my poor family nuts while they see me going crazy and complaining like mad?
any help on how to detox would be very helpful.
Thank you for your update. It is good to hear from you again but not good to hear about your new problem, I am not an expert on withdrawal so you really should discuss this with your physician.
I can tell you that what you are feeling is your bodies need for the opiate. You body has become depend on these omedications. It would happen to any of us that require and have taken opiates for any length of time. So what you are experiencing is normal. Addiction and dependency are two different things.
You obviously recognize your bodies dependence and craving for the opiates. Don't beat yourself up, talk to your physician and he will advise you how best to wean yourself off these opiates that you no longer need for pain. Don't make the mistake of continuing to take them when you don't need them. That is addiction and sometimes there can be a fine line between the two.
The Substance Abuse Forum may offer you some advice also but I don't want you to think that you are an addict or abusing narcotics. The decisions you make from here on in will be very important. You are more than welcome to stay with us and I hope you will.
Best of luck to you and as always please keep us posted and let us know how you are doing. We are here to support you and will do so to the best of our ability.
OK, now I am really confused. I went to the DR today for my check up, he reviewed everything, answered all my written questions, then when my wife chimed in about my intense anxiety and agitation due to not enough pain relief or my refusal to take any and am withdrawing from them, he calls in the Internal med dr to suggest putting me on Adavan or some other type of sedative to calm me down. As my wife put it I am going crazy. either to much medicine at once, or not enough and I start to withdraw.
So, he puts me on a 25mcg fentynal patch Needless to say i was distraught all day. Here i am trying to go off the meds and he puts me on something stronger! Ok so i find out that its the same as the mix of darvo and norco i was using. So all i did was go sideways.
So, from a PM point of view, is "measured regular delivery" method better than what I have been doing? Taking some at night, waiting most of the day with nothing, then only taking it when the pain comes on. Is that the best option for me while I am still in pain and needing something to keep it all under control.
The withdrawal thing will have to be something i deal with later. I guess I am just not there yet. especially since we are going on a 5 hour plane ride next week for a preplanned family vacation.
Sound right to you guys?
Fentanyl is NOT sideways from darvocet and norco! It is MUCH stronger! Ativan is the least addictive of anxiety medications. I think if you are still in pain you should continue with the pain medication, but be careful that you are aware of what you are taking! Fentanyl is one of the strongest pain medications available, I am not aware of anything stronger. It is stronger than oxy, morphine, etc. As for the method of delivery, the medication will be evenly distributed, and you will not have the ups and downs that you have with the pills. I strongly suspect this is why your Dr. chose the fentanyl patch. Did you tell him that you were trying to cut back? I am shocked that he would choose to put you on the patch before trying a long-acting medication such as a time released morphine or oxy medication (Kadian or Opana). If I were you, I would continue to take the pain medication while you are in pain, be aware of the strength of the medication, realize there is a difference between dependency and addiction, and do some research on that so that when the time comes to get off of the medication you can either do a long taper or take Suboxone or Methadone to get off of it. You could do a taper with the medication you were taking previously, but you will probably need to take Suboxone or Methadone to get off of the Fentanyl. Doctors are notorious for putting the patient on strong medication without telling them what it will take to get off of the medication! If it were me, I would stick to taking medication only when the pain is bad, rather than having a constant flow of Fentanyl going into my system, unless I was in so much pain that I really needed the patch. The good news is that you shouldn't have any pain on your vacation! Best of luck to you!
Thank you for your feedback. I feel like you are right. I hate the pain but the feeling I have been going thru today is miserable. the patch *****. I called and he told me to cut it in half, but I still am going nuts. the pain is very low, but I am still going thru this terrible anxiety feelings. Like I need to take the hydrocodone only.
Could I have a dependency on the Hydro only? The patch seems to be keeping my pain low, but I still have tons of anxiety like I did when I was withdrawing from the meds. I just don't know what to do. Nothing helps. I must have walked 5 miles today. I just could not stay still at all. When I tallke to the DR tonight all he said was take a small amount of Hydrocodone. Damn, still need something for pain, but I hate the withdrawals even when I am on a strong patch. AGHH
What would any body suggest? take small amounts of pain meds only when I need it? He did not want me to take any valium or atavan. The valium did help with the anxiety.
HELP,...........anybody know what I should do?
Jarileigh is correct that Fentanyl is a more potent narcotic than the hydrocodone and the even lesser potent Darvon. I am not "shocked" by his choice. It is also a long acting and time released medication similar but more potent than the MS Contin and Oxycontin. More issues and abuse seem to be associated with Oxy than Fentanyl.
You should follow your physicians directions. If he prescribed the patch for you he obviously did so with good reason. One of those is to keep your pain under control and to avoid the ups and downs of it's severity. I disagree with the statement that you will require methadone or suboxone when the fentanyl is discontinued, unless you are on it for several months. It was prescribed for me. I took it for three weeks and did not have any major problems when my physician and I agreed that I could stop taking it.
12mcg of Fentanyl is not a large dose. It should get your through the next few weeks of pain with some hydro for break through pain. But I am confused by your statement that your physician said you should cut the dose in half. Does this mean that you have a 12 mcg patch also. Never cut the patch, to do so could be life threatening.
Fentanyl should be dealing with any withdrawal symptoms that you would experience from the precious lesser opiates. I am not an addiction specialist but it seems strange to me that you still have anxiety. I question that true source of that anxiety. Does it disappear completely when you take the hydrocodone?
There are many types of dependencies and most ppl have their "drug of choice". I think that at this time you need to be concerned with keeping your pain controlled so you can heal effectively from surgery. You may had a dependency on hydro and there may come a time in the near future that you will have to treat that dependency before it becomes an addiction. For now follow your physicians instructions.
Thank you for your feedback. I have a 25Mcg patch, he instructed me to cut it in half so I have a 12.5 Mcg. Last night I took (at his direction) a little Hydro for the breakthru pain. That dose did effectively control my pain. so that was good. However, the severe anxiety did not go away until I took half of a valium. But the Dr did not approve of that previously. So I am not sure what to do. My pain is under control, but my mind was going nuts. I could not relax all day until i eventually took the valium.
So, I guess would it be normal to keep the low dose patch, some norco for breakthru pain, and add atavan for the anxiety emergence? then as pain goes down, lose the norco, then cut back on the patch? and then just get off all of them? I hate the pain meds but I need some meds right now. The pain med combo last night seemed to work fine for my pain control but the agitation was very difficult to deal with.
first of all, please calm down and breathe... I can feel the anxiety just reading your posts. I think a lot of this is in your head, Not the pain necessarily but I think you are so afraid of withdrawl that you are making yourself upset. I know I do it and I spend restless hours at night worrying about not having enough meds to make it through the month even though I take what I'm supposed to and have an appointment lined up but still it is a scary thing to ponder. That being said, You should talk to your doctor about how much you don't want the Fentanyl and ask his reasons for giving it to you explained more and then tell him how much the vallium helps. Ask him why he doesn't think you need it, Maybe it is a respatory issue (sp) who know. But you definatley need more information from your Doctor. that and buy your wife some flowers! for putting up with your anxeity! LOL You'll be okay. You seem to have things in perspective it's just a little off is all. I hope I didnt' sound condescending, that was not my intent, We are all here for you and you are never alone. Best of luck please let us know how it goes
OMG, I am not alone, thank god. Some other people understand how unrelenting pain can take over your whole life and being. It's incredible how difficult the balance of meds and not having mind altering drugs. Its horrible. I don't know if the DR was cold hearted today. I called him to ask about what to do to relieve this horrible anxiety and agitation, and he says life it tough right now. I just don't know what to say to that. He just says you have to deal with it and it will go away.
So, From a PM stand point, I have to just find a balance of the lowest possible dose of meds to keep my pain in control and not so much that I have to withdrawal symptoms later? Then hopefully the pain will go away and I can slowly reduce my meds.
Does that sound right to you guys? Yes, my wife is a saint. the DR seems a little cold hearted, but I feel like he is very competient and I trust him, its just really hard at times to balance the meds and anxiety.
Your BODY is used to the pain medication. It does not mean YOU are addicted to anything or an addict. There is a difference. In fact, and I should have kept it, there are studies showing chronic pain people are not addicted to their drugs. We have no mental desire for the drug itself, only the relief it brings so we who are in pain use pain medication because we need it to function and be able to participate in life as much as we are able. Yes, probably what you are feeling is the result of your body wanting the dose it is accustomed to. It would take a couple days to get over it. I actually saw a person trying to go cold-turkey from heroin. Now that was withdrawel.
I hope that you are feeling somewhat better! While you should not be having any withdrawal symptoms at all while switching from hydrocodone to Fentanyl, it is easy to see that your anxiety is severe. You seem to be obsessing about your medication and possible related drug dependence, which is of course, understandable. There is a difference in drug dependence vs. drug addiction. A person who takes narcotics for recreational purposes (over an extended amount of time) has a 94% chance of becoming addicted to said narcotics, while a person taking narcotics purely for pain relief has a 15% chance of becoming addicted to narcotics. If any person takes narcotics for any reason for an extended period of time they will become physically DEPENDENT on narcotics, but not necessarily addicted. Therein lies the difference. You seem to be extremely concerned with your body becoming dependent/addicted to narcotics, which is more than understandable, it can be a nightmare and dependency is sometimes unavoidable. And as I understand it, you are taking stronger meds when you thought that you would be cutting back, due to your health situation and continued pain. I think this is where your anxiety is coming from. May I suggest that you find a reliable source on dependence vs addiction and get some firm, detailed information on it so that your mind is not filled with horrible "what ifs?" and "how am I going to get off this?" Withdrawals are horrible on the body, soul, and spirit, and the last thing that someone who is or has been suffering from severe pain needs is the added stress of withdrawals, or the worry of having them. A recent study proved that the body produces stress hormones in response to chronic pain. That is one of the reasons so many pain patients take a benzo (valium, klonopin,etc) along with their pain meds. The vast majority of pain patients take a benzo with their pain meds for a variety of reasons, each medication helps the other one work better, it helps with sleep and anxiety that comes along prolonged severe pain,etc. I personally don't think that you will have a problem getting off of your medication when the time comes, you seem very responsible and aware, the issue of your current unrelenting anxiety I can only say that I understand, and that it is a valid concern, but I see no reason that you should not be taking a anti-anxiety medication considering the level of stress/anxiety this situation is causing. Perhaps it is simply your Dr.s preference (to not prescribe anti-anxiety medications) because they can cause dependency as well, but I have known people to take them for up to 3 months and quit with no withdrawal, and they certainly wouldn't hurt you to take them in the short term. I am sorry that you are suffering intense anxiety, and I hope that your Dr. comes around and gives you something for the anxiety. The only reason for him not to, aside from the one previously mentioned, is if you were at risk for respiratory depression, which hardly seems to be the case. If there is anything I can do to help, just ask. Best of luck to you!
In response to your original question, you appear to have some level of physical dependency on narcotics, but this does not mean that you are addicted to them. I think you should concentrate on relieving the current pain situation and realize that you can deal with withdrawals in a variety of safe, relatively painless ways when the time comes. Being aware of your level of dependency is not a bad thing, but when the anxiety over the situation becomes severe, it seems to have become a problem in itself. Talk with people who have been through the situation that you are currently in, and I hope that you have something to take for anxiety short term. Try telling your Dr. that you would like a medication for anxiety short term, and he may be more willing to give it to you. God bess and good luck! peace&love J
I wanted to add that the reduction in pain can cause even more anxiety in some situations. I agree with Tuck that you should avoid beating yourself up over being dependent on PM. Physical dependency is unavoidable if pain meds are taken long term, but that is no sign of addiction. Do not put yourself down or let anyone else put you down for something that is not your fault and not humanly possible to avoid, and I have confidence in that you can deal with weaning yourself off the meds when the time comes. Try not to worry in the meantime!
ok, I'm on Norco too. And, I have to say, it does make me feel jittery and anxious....And, I don't feel like I'm an addict because I'm in pain. Actually, the Norco doesn't even really work that well anymore. But I totally understand.... I feel tired and out of it all the time from taking pain meds. They make me feel like a zombie especially when I take 2 b/c I'm in a lot of pain. And, I feel like I miss out on a lot b/c I'm drugged all the time.
But, if you're trying to quit an opiate pain med, why isn't your doctor mentioning suboxone? It's for withdrawing from pain meds. I was Workers Comp Claims supervisor and have seen many people get RX'ed this medication. I got fired in April '09 for taking too much time off. Exhausted my FMLA time due to lumbar radiculopathy.
But if you aren't taking anxiety meds and antidepressants, you can take Ultram for pain. I can't b/c I also take Cymbalta and Klonapin. WAY TOO MANY PILLS !!! and still in pain...
My point is that maybe there is a strong medication like Ultram that helps with the pain but doesn't make you feel weird or anxious.
OK, from a PM standpoint, I am almost got my meds right. Thank you so much for all your responses to my severe anxiety, both from pain and pain meds. Its just so bad either way. I am not ready to throw in the towel, but....it is tough sometimes to keep the mental toughness of another day is coming. Just going to the store can be a chore, maybe not quite up to yet. The hardest thing with chronic pain is to balance the meds with your phsycy, not drive your family nuts, try to have some quality of life, not long for the time when we were whole again etc etc.
So......for now I am balancing the fentynal patch, and herbal meds, throw in the occasional valium and i am getting by with life. I marvel at the people that have chronic pain for years. you are a wonder to all of us whining surgery patients, who hopefully will get better, at least not to have serious opiate meds.
So, here is my current question, My severe anxiety and agitation has been dying down the last few days. I am hoping that is a good sign. Only on the 12.5 mcg fentynal patch. No norco in the last week.
Is that a good sign that the build up of the opiates has been decreasing and hopefully the small amount of patch will be easy to quit in another month or so when my pain starts to go down more.
What have any of you all experienced? What about acupuncture for pain relief? Any body have any luck with that for PM? What about herbal meds for pain relief?
What can we do other than opiates for pain relief? Is Ultram the only prescription pain non opiate pain relievers out there?
So, it goes on. I went on the plane rides, enjoyed the best I could a long preplanned vacation that the Back DR approved me going on. I had my ups and downs, however, I just refused to take any Norco and go backwards in time. I stayed on the half patch the whole time, using just advil, hot baths and rest to keep the pain down. It was tough, but except for the 17 hour of traveling, planes and cars to get home i made it. I only had to take half norco yesterday to take the edge off. I was given the medrol dose pack to take with me for a flare up, just in case. I started it before the plane rides thinking that the imflammation coming i can start to die down in advance, back was in pain already before i left so figured it was a good idea.
So, today i am full of agitation again, almost the same but not the same as the W/D feelings i had couple weeks ago.
Does the Medrol cause severe agitation? Is Ativan addicting?
I asked the Dr about suboxone or ativan and he said I should go to a pain management DR. 8.5 weeks after back surgery......do I really need to go to pain management? I was hoping just to be ok and not need this saga to continue.
So....I am only on 12.5 mcg of fentynal patch and seeming to be pretty stable.
Should I just stop taking the patch and take small doses now for pain at nights?
Can i just stop the medrol without it having negative effects? Or is it like anti biotics? start and finish the whole thing? I asked the DR and he gave me wishy washy answers.
I am thinking of going to a pain management DR for med controls and therapy. Maybe some ativan and a more understanding DR?
how do i know when I am not going to be any better and I should resign myself to long term pain management therapy. Meds and such.
Is 12.5 mcg fentynal comparable to 2 norcos a day? that seems pretty low. is that correct?
How do i get the DR to prescribe a benzo like described above? He seems in sensitive to the mind hormonal stresses that go along with all this ****.
I suggested Ultram today, he said that is drug seeking behavior! I can not win!
I am glad that you enjoyed your vacation. I'll try to respond to all your questions but excuse me if I miss one....just ask again.
Steroids (Medrol) can and often does cause anxiety along with insomnia. You should not stop taking it. It has to be gradually decreased so take as directed. Sometimes it has me "bouncing off the walls" and other times it does not seem to bother me as much. I take it about every 10-18 months depending on my flare ups.
What you are experiencing is not all that abnormal. "Back surgery" is a tramatic insult to your body and it's systems, as is any major surgical procedure. Don't be so impatient to return to 100%. You are not even 6 months post-op. Frequently following spinal surgery is takes closer to a year to fully recover.
I am not crazy about your physicians attitude. But that is just my opinion. I think you are seeking to control your pain with the least amount of medications as well as trying to understand it.
I do think you should see a PMP. They are better trained to deal with pain and the problems associated with it. I doubt he will say you have "drug seeking behavior." They see CP patients every day and they have better comprehension of it.I doubt he will say that you have drug seeking behavior. I am not a physician but I see just the opposite in you, along with a little denial of your limitations and pain. All which is normal when our lives are interrupted by acute and than chronic pain. This is a journey that may be life long. It is much too early in the healing and recovery process to determine what and if you will have to eventually deal with daily pain .
And yes I think your pain meds are fairly "low" right now. You have nothing to be ashamed of or to apologize for because you have pain. Some medical professionals can make us feel that we should be stronger or "suck it up." I would venture a bet that they have never been there.
Be cautious with Ativan. It does have addictive qualities but it is an effective drug.
I'll look forward to your continued updates. We are here to support you. Do the best you can and take care.
Here is my story and I highly suggest to get off the fentynal IMMEDIATELY!!!!
Hope this helps and all keep me in your prayers as I will you!!!!!!
I am about to embark on this seriously scary part of detoxing from hydros 10/325's 3x day and fentanyl patches as high as 100's x 48hrs. and now I am down to 25's and will reduce to 12's tomorrow which I plan to take until this Sunday. This is my second try at getting off the patch as my pain mgmt doc rapidly reduced me off the patch per my request going from 100's to 12's in a short 5 weeks. I had a surgery back in sept. of 08' that went bad and lead to 5 more surgeries over the next 7 months that was living hell. I had never been on opiates of any kind other than the occasional hydros given for when I pulled a muscle in my back or groin, etc. I had only been given about 10 to 14 days worth and never experienced w/d's from them. I had no idea what I was getting into when they prescribed me the patches!!! I feel so stupid for not researching out how hard it is to get of the ****!!!! I am a very intelligent man and did read up on what the medication was and it did state it would be addictive but never explained to this level of w/d's.... I am furious with the docs as they should clearly explain the end result of the road you about to go down. Anyways, after the rapid detox off the patches I had no problems for the first 7 to 9 days as I was still on the hydros. and then it all hit!!!! Every w/d symptom you can put in the book hit me and it was living hell... I went to the pain mgmt. doc cuz I was going out of my mind and he told me I was having a reaction to gabapentin which I was using due to a nerve being severed in my leg on my 3rd surgery. I didn't know any better cuz it was a nerve medicine and I felt like I was crawling out of my skin!!!! I thought it was from the nerve meds. This went on for 2 1/2 wks. of sweating, sleepless nights going out of my mind along with all the other things associated with w/d's!!!! I finally went back to my pain mgmt. doc who was on vacation and I had to see his partner and she confirmed it to be w/d's and not a reaction to the nerve meds. I was devastated as my suspicions had finally come to reality... This was last Wed. and she told me to go home and put a patch on as I had a couple of 12's and a 25 left.... What kind of an answer is that!!!! I no longer have pain as I have recovered from the surgeries and am dependent upon the drug... I didn't know what to do besides follow her advise to keep from going insane.... Now I feel like I am back at step 1 again. Since putting the patch back on I have not taken a single hydro and plan to use the Thomas Recipe to try and kick this **** once and for all!!!! It has been devastating as I called my primary doc and he didn't even call me back!!!! I feel so alone with no one to turn to as I asked about Suboxone with the pain mgmt. doc. and she would not even engage the discussion. Maybe cuz i'm not her patient or maybe cuz i'm $$$$ to them!!!! If I get off the drugs I can no longer make that Benz payment for them... Who knows with how screwed up the system is.... Anyways, I live close to the Mexican border and went and picked up the necessary drugs for the Thomas recipe and am going to face the BULL come this Sunday.... I am scared and called my primary doc back yesterday and threatened complaining to the board if he didn't contact me so I can talk with him about all this and make sure I am doing this right!!!! I know it can be done and I will be successful as this has gone on too long and I feel like I have no life or energy.... I am a successful structural engineer, but am about to loose my job cuz I can't go back to work like this and have been out since my original surgery on 9/17/08. My benefits are about to run out and reality has just set in. I am very depressed but I WILL PREVAIL OVER THIS MONSTER!!!! All your comments and PLEASE, PLEASE, PLEASE your success stories will be much appreciated. I plan to write on many blogs starting with day 1 as this is going to be part of my plan to stay off the ****!!!!
Thanks for listening/reading and God Bless us all....
None of us deserve this misery that I believe the system wants to keep us in.... You break down a person's will and desire and you control them!!!! That is what all these insurance and pharmacy companies want along with our doctor's as we are $$$$ in their pockets too!!!!
I have to put my two cents in here. I totally get the fact that when you are in severe pain that you need pain meds. Please,please be careful. If you will read my profile, you will undertand why. I rarely took more than what was prescribed, but I began taking them for other reasons besides the pain. that is where the addiction process begins.
I have had surgery on L5/S1 in 2002, then implanted Morphine Pump in 2004. I have been taking Hydrocodone, Soma, and Xanax for years. I was able to taper off of the Hydro and Soma after awhile with no severe problems. I couldn't quit taking Xanax to save my life, and was only taking .5mg once a day, so I checked myself into a Detox Hospital. They couldn't totally detox me because of my implanted Morphine pump, but I want to share with everyone what I learned at this Facility. I am just an average Joe, so this is just my plain English way of passing on what I was told, excuse any mis spelling etc. They told me that I suffered from Hyperalgesics (The excessive sensitiveness or sensibility to pain). When you quit taking these meds, your brain will tell you you your pain is excessive, like 10 times greater than what it really is. They gave me Valium every 6 hours, then changed it to Klonopin (clonazepam). They say the half life of Xanax is very short, it is fast acting, but doesn't stay in your system, so it is like a terrible addiction, they said it was the worst drug on the market and the hardest to get off of. It probably cost my insurance company 40K to learn this. I took the Valium for 2 days, then Clonazepam, I will try to wean myself off of it if I can in the future. I hope this has helped everyone else out. Pain mediacations which are necessary, are one tough cookie to discontinue. I don't consider myself an Addict, but I might as well be, as my body is DEPENDENT on them, and breaking the cycle has been as real or as bad as the pain. Hope this helps everyone.
The Medrol dose-pak can cause gawdawful anxiety! I was prescribed a dose-pak after my spinal surgery, and between the IV steroids that they bolused in after the surgery and the Medrol-pak I developed steroid psychoses. I was a MESS, to put it mildly! I couldn't sit still! I couldn't fall asleep, and when I did, I had HORRIBLE nightmares, I'd dream that demons were chasing me and I'd wake up exhausted from being strung out all night in my sleep! DH called my neurosurgeon, who told me to just stop taking the steroids. I would never have just stopped them like that on my own, because they tell you not to, that you need to stop them gradually so that your immne system has a chance to return to its normal self, but since the neurosurgeon told me to just quit taking them, I followed his orders and did just that, and within two days I was back to my old self.
This is a reply to a very old question. Sorry, I just found this site. First of all I had the worst case of rebounding from pain and migraine meds that the Neurologist had ever seen. He told me to take one less pill a day and slowly get off the meds. In the middle of working a migraine hit and I took that extra pill. The doctor threatened to put me in the hospital to get off the meds. The next time I had taken all the pills I was allowed, I had a migraine for 36 hours. After the migraine left, I was pain free!! I have since learned I need to go "cold turkey" to stop them from rebounding. Now I have been on Vicodin for years for OA. I realized if I got off the Vicodin my OA pain was almost gone!! In order to get off the Vicodin, I spend a very restless night going cold turkey. I have found taking an old med like Librium gets me through the night. Some people might not agree with me but I truly feel going 'cold turkey' is the answer.
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