Need help stopping Fioricet with Codeine

[GottaQuit]

I just joined today and after reading old threads about getting off Fioricet and/or Fiorinal (Butalbital compound) WITH Codeine, it appears I'm in a minority group.  I take at LEAST 8 capsules a day along with 4 30mg tabs of Codeine Sulfate - cuz the Dr who originally prescribed all of the F3 to me in the first place was concerned about the amount of Acetaminophen I was ingesting.  I also take about 20 5/325mg Hydros per week and 8-10 10mg of Diazepam for sleep.  I also take Amitryptaline...but no problem there. Only my Dr and Pharm know about the F3, Codeine & Diazepam; and only my Dentist and a different Pharm know about the Hydrocodone.

I have a wonderful man that loves me dearly, but is about as "anit-drug" as anybody could possibly be!  SO, with my confession out there to all of you, here's my most pressing issue:  I have Trigeminal Neuralgia (TN) as a result of a Parotid tumor (salivary gland mass) compressing the Trigeminal nerve in my jaw, and must have surgery to remove the tumor.  (By the way, Narcotic pain meds don't even begin to touch the pain of TN -- can you believe that!!?  I have to eat popcycles to numb my tongue and mouth enough just to talk without jolting pain that sends me into spasms!)  BUT this is not why I'm here... well actually it kinda is.  Because I must have surgery, probably within 6-8 weeks, I'm scared to death of having surgery while taking excessive amounts of this drug due to the anesthsia and/or other drug interactions.  So I want to wean myself off of it, or at least down so that I don't have to let my dirty little secret out to my loved ones.  I have to believe that many of you are in similar situations who won't judge me for hiding my addiction.  I'm 51 years old and tapered off a Diazepam addiction thru a county program about 5 years years ago, so my family and loved ones (that knew about it) think I'm clean and sober now...  I'm ashamed, but I'm an addict thru and thru.  I guess knew that I would have to clean up my act at some point in my life, but now the clock is ticking.  Any and all advice is so very much appreciated!  It feels good to be among a group who won't judge me and will hopefully become future friends. Can't wait to hear your thoughts and ideas!

[ZJILLIAN]

Good morning. At least it's morning here. I just reread all of your posts and the more I hear the more I believe you need medical guidance on these decisions. We all have different experiences and can support you through whatever you decide to do but your drug history is complicated and your level of chronic pain is exceedingly high. If it were me, and this would be extremely hard for me to do because I love to control all my options and not give up control on anything, I would talk to me doctor about the situation being as honest as I could be. I would write it all down as best as I can remember. None of us are very good at being honest with ourselves on how much we are using.

Your surgery sounds delicate and certainly all of the variables should be known. I do think you will have WD symptoms on anything you do. Just a guess, but we can help you through that. We are good at that. HOWEVER, what you decrease, when to decrease, and how much should be supervised. Also if something goes wrong you will need a doctor on board to call who already knows your case.

I had two different surgeries in my life both over 10 years ago. I didn't tell on my second surgery but I withdrew from everything. Of course the doctors were perplexed by the extreme level of pain I was experiencing. This is unnecessary. They have heard it all and if they are shocked it doesn't matter one bit.

Please get medical supervision for your taper. Each of your drugs alone are challenging and the combination plus your history is an unpredictable combination for us on this site to guide you with confidence.

I really am thinking about you and I understand how "telling" spoils everything. But this is very serious and you deserve the best chance with your surgery and a pain free life. Keep posting

[flob]

first of all, i must say that addiction to butalbital unfortunately often gets dissmissed. it's not an opiate, and therefore it's often not considered to be as addicting....but believe me, if given the chance, it can be. it's a short to intermediate acting barbiturate...just like seconal and nembutal. this mixed with codeine obviously is going to breed a very strong addiction indeed. at 8 tablets a day, you're ingesting 400mg of the barbiturate. this is not going to be easy to withdrawal from. it's very important if you're going to be sedated to share this addiction with your doctor...not doing so really could kill you. the lethal dose of bariburates isn't much higher than theraputic doses and if by chance you're sedated with another barbiturate...that's a rather scary thought.

also...keep in mind that about 5% of sudden withdrawal's are fatal. withdrawal can be life threatening...cause seizures...and will probably cause severe migraines at the doses you're taking. because of all this, it really is best to withdrawal under the supervision of a doctor. it may even be possible to withdrawal using phenobarbital...a longer acting barbiturate. the withdrawal might be less severe and certainly safer.

[GottaQuit]

U know what .. Ur post really does make me feel better about being up front about my situation prior to surgery.  Had minor surgical procedures before but nothing as scary as this will be ...having tumor (on saliva gland) in front of my ear removed so A LOT at stake --potential nerve complications, blah blah blah ... so I DO get that I need to be honest or I'll have serious trouble. THANK YOU for helping me realize it hopefully won't be as big of a deal as I'm worried about -- that I'll hopefully be able to handle it privately.

Now that that's settled, I'll still have the issue of stopping all the pain meds I'll need post-op as well as all the ones I'm CURRENTLY using.  I'm reading a lot of posts about Methadone being used ... guess I need to read up on that.  Any personal advice on use of Methadone to help?

Thanks so much!!

[emwave]

You absolutely have to tell your anesthesiologist about all of the meds you've been on.  Even if you were off of all of the meds for long time, you tolerance will still be higher than normal.  He/she has to know.  Normally the anesthesiologist meets with a patient before surgery -- if not, request that he meets with you.  Look, this is your private medical information so it's not the end of the world to tell him.  Your entire family doesn't need to know your situation -- but I bet the ones you are closest to probably suspect something is going on with you, anyway.  Please be careful -- even alcoholics who haven't had a drink in years should inform the anesthesiologist that they've had a problem.
You can save yourself a lot of worrying and stress by teling the anesthesiologist information that he needs to know.  Trust me -- you won't be the first patient he/she has seen with your type of problem.  You are going to find out that it is not as big a deal as you think.  And as said above, you really don't want to wake up during surgery.  Good luck and please let us know how things go.

[GottaQuit]

Thx for sharing ur story with me ... After my first & followup post here I find I'm not even trying to taper my usage back right now since I'll need narcotic pain relief post-surgery and might as well wait until afterwards.  I know I'm rationalizing but what sense does it make to start tapering back when I'm gonna need even MORE pain meds post-surgery!? Can you PLS tell me more about your surgery situation ... I've gotten good advice from everyone, and know I HAVE to fess up to docs/surgeon,etc. but need help motivating!  Were you able to get ANY pain relief post-op? What stage of recovery are you in and what has/hasn't worked for you? THANKS again!

[struggling_college_student]

I am unfamiliar with all those drugs except for the hydrocodone(my drug of choice) so Im sorry I cant help with those.  But I am a nursing student and when your surgery time comes you MUST tell the anesthesiologist exactly how much and what you are taking whether you are embarassed or not!!  That is the only way they will know how much sedatives to give you to keep you under for the length of the surgery!  See our liver becomes might efficient at breaking down these drugs as we ingest high quantities over long periods of time.  Thats the reason for what people call "tolerance". So for an addict it could take as much as 3-4 times the sedative as it would a normal person who has no history of narcotic use!  Anyways please make sure you spill the beans to them.....I would hate for you to wake up in the middle of surgery!!  Good luck and God Bless!!

Jeff

[GottaQuit]

Thank you all so very much for your caring wisdom and understanding advice.  I now know what I must do.  PLEASE LET ME KNOW WHAT YOU THINK about my "Plan of Action" as I truly value and appreciate your all of your insights, experience and input!  

My plan is this: Taper my Fioricet w/Codeine and Codeine Sulfate use to HALF of what I'm taking now by the time of my surgery (estimated to be about 6 weeks away, optimistically). This is the biggy!
Currently take 8-10 Fioricet w/Codeine caps/day plus 4 30mg Codeine Sulfate tabs/day. That's a total of 720mg of Codeine tapered down to 360mg; 500mg Butalbital down to 250mg; 400mg Caffeine down to 200mg; and 3250mg Acetaminophen down to 1625mg.

I believe I can cut down and eliminate the Diazepam completely. (Currently take 10mg tab nightly at bedtime plus a few more throughout the week when I'm stressed).

I also believe I can eliminate the Hydrocodone altogether as it's just a supplemental thing I take for random aches and pains on days I use less Fioricet--simply cuz I have it... and again, I'm an addict. (Currently take about 20 5/325mg tabs/week as needed/wanted.)

So there you have it -- hopefully this isn't too confusing.  PLEASE let me know your thoughts... Is this realistic and doable without being dangerous or having withdrawl symptoms? Am I being too ambitious?

Please help -- I know this will be easier with your support!
THANK YOU AGAIN!

[worried878]

agree with bmdad..talk to ur dr..but even if u stop a week before..ur tolerence will not change much at all..if u read the article on dopamine/receptor sites in the health pages..u will c that u have built new recptors to handle the overload of endorphins from the pills when u bombard it..that is why time released meds are safe unless chewed or snorted...fact is they never go away/those extra receptors//they can lay dormant if u quit with some recovery time behind u..but when u use again they wake up and crave...that is why addiction is never-ending..those extra receptors u built will never go away..u need to talk with ur dr

[bmdad]

The people above gave some great advice. I just thought I would add that when I was getting ready for my back surgery my neurologist said I had to stop taking my vicodin 1 week prior to my surgery. They told me the reason for this is so after the surgery the pain meds they would give me in the hospital would work. I did not stop taking the vicodin one week prior and they had to keep pumping me full of morphine via IV just so I could get some pain relief. They couldn't believe I was still in horrible pain due to the fact that they had me on a high dose of morphine. I'm sure they knew what was going on. I would talk to your doctor and ask him the steps you need to take before hand. Best of luck with your surgery!

[worried878]

Amitryptilline usually solves most anyones sleep issues and knocks most out like a light plus it has AD properties that many addicts need...u state u were addicted to sumpin 5 yrs ago?  Unfortunately this crud doesnt go away..when u started using narcotics, benzos and barbituates/the odds were against u ..and the pills usually win if u let them back into ur life

Ur benzo dose is low/valium being one of the weaker benzos//but how do u take 8 mgs?  here they come in 5 mg tabs or 10 mg tabs?
Ur narcotic dose is substantial if u add the hyro and the codeine together//but very do-able CT
Ur fiorinal dose would have to be tapered as it is not sumpin u can quit CT///nor benzos/valium/but that dose is not substantial...but still would be best to taper to 5 mgs of valium then even 2.5 mgs

have u spoken with ur drs to let them know u want to quit?  u need to cos they can help u/perhaps not the dentist but the other one/plus they need to know or u will be faced with scrips and refills which can do a freshly clean addict in...make them relapse in a heartbeat

As far as anesthesia..talk to the doctors about this being honest about what u take...that is really not ur true problem cos many who use undergo anesthesia and live thru it...they will notice tho cos it will take alot to get u sedated/and pain relief post-op will be harder due to ur tolerence

u need to let go for u...keep posting

[Lisa034]

I agree you need to tell the doc about the meds. I wish I could tell you something else but I can not I do not know anything about the meds you are on, I know about codiene but that is about it and my only exp with that is taking tylenol 3 with codiend in it. What I do know is if you keep posting some one will know what you are talking about. You can also go thru the health pages you may get some info there as well. I am so sorry you are going thru so much. Once you are done with all this it will get a whole lot better I promise. Please keep posting and let us know how you are doing. You will be in my prayers

Lisa
Jacksonville,FL

[ZJILLIAN]

I am so sorry you are going through so much pain! It sounds horrible. Your drug history is very very complicated and I couldn't begin to give you advice on how to stop which drug and when. I leave that to someone smarter here. BUT I do know one thing for sure. Before surgery you absolutely must tell you anesthesiologist what drugs you are on. Extremely important for many reasons, but really this would be confidential so you needn't worry about the doctor telling your family. You could stress the amount of pain you are in chronically and also the length of time on narcotic pain meds since you probably have developed a tolerance to them. I think you need to come clean, as it were, with your doctors. It is too dangerous not to. Also too painful.