Herniated Disk Pain Mgmt/ Hydrocodone 10/325 - want to detox soon

[ShelleyN720]

In October 2010 I had an MRI hoping to find out why I had recurrent stabbing lower back pain and numbing (but painful) sensations down both thighs, mostly the right leg. The MRI showed a large centralized herniated disk @ L1/L2. I was referred to a neurosurgeon but could not get an appt until mid Dec. It was suggested to me that I go to a pain mgmt clinic in the meantime. I was prescribed Lortab 5/500 2X a day. It worked well enough that I was able to manage at work. In December I decided to try a steroid injection (epidural) to see if that would work. It was awful. Right at the end of the procedure I passed out and woke up with medical personnel hovering over me - heart monitor going etc.  My back hurt worse due to inflammation from the shots! The feeling of pressure made me nauseous for several days. I went to the neurosurgeon and he stated I wasn't a candidate for surgery and suggested another MRI in 6 months (June) In January I had my prescription changed to reduce the amount of acetaminophen from 500mg to something less. The physician assistant suggested Norco 10/325. One tablet 2X a day. She thought it would work as well if not better. (a bit more hydrocodone, less tylenol)
So since Jan 22 2010 (approx 2.5 months) I have taken 1 tablet twice a day.
I've noticed recently that I am starting to have a bit of shakiness about 6 hours after taking a tablet - like my body is wanting more of the medication! This is NOT what I want to happen! I've read that your body can build a tolerance to these types of drugs. I definitely want to get off of them now!  What is the best way to do this? It doesn't seem like I take a high dose (10 mg 2 X a day) I do plan to discuss this at my next visit but I am interested in comments & recommendations for withdrawing at home because I would not want to go to a clinic. I could probably take annual leave from work for a couple days - but I wonder how many days would I possibly need?

[J T Junig, MD PhD]

It may be hard to believe, but your dose of opioid is quite low compared to that of someone addicted to pain medications.  I do not think that a doctor would even consider an inpatient detox-- let alone your insurance company.  The good news is that you do not have the severe withdrawal ahead, as you would if you were taking 70 tabs per day-- which was a certain NFL quarterback was supposedly taking each day, a number of years ago.  

If you simply stopped the pain pills, you would feel  as if you had the 'flu' for about a week or two, peaking at about 3 or 4 days and then slowly improving.  You could alternatively cut your dose in half, or even go more slowly-- reducing by half a tab per day-- and decrease the dose another step each week or two.  Or you could keep things 'ad lib', and just reduce the dose a small amount each week.  The main thing in such a case is to draw a line in the sand-- and decide that no matter what, you will not INCREASE your dose for any reason.

Unfortunately, you may have a problem with pain, if you lower the dose of Vicodin.  Disc herniations tend to get better over time-- over 10-12 months-- and it may be appropriate to use a small amount of narcotic, like the amount you are taking, for the worst of it.  Perhaps you could take a pain tablet as needed, with a MAX of two per day-- but taking it only when absolutely necessary.

These are several options, and your path will depend on several things-- the amount of pain, your ability to control your use of medications, and even your relationship with your doctor.  The amount of medication you are taking is not dangerous, provided you are able to prevent uncontrolled dose escalation.

[Eebb26]

Can u tell me if mydose is considered high and how bad will my withdrawal will be. I take 2-3 10/325 percs every 4 hours(10-15 a day)
Ty

[Eebb26]

Thanks. I saw my primary today and he told me to start weaning down. I am mostly concerned I've done liver damage. He did blood work and I'll know Monday. I'm so scared and Embareased . I'm afraid to tell me pain dr cuz ive been getting scripts from diff Dr's and I feel so bad. I never expected to loose conrol of my life like this. I don't want to check in to a detox center, I'm too depressed to be alone like that for days. I also would rather not take another type of drug cuz I gave heard so many stories that u can be addicted to those too. Idk what to do and am feeling so guilty and sad

[ShelleyN720]

I would discuss your desire to get off of the percocet with your doctor at your very next visit. This is what I plan to do next week. I understand your concern because I have great anxiety over weaning off only two 10/325 a day. I have already begun by cutting the 10/325 in half and am taking 1/2 a tablet every 6 hours. This way, that feeling of well-being the drug produces is from only approximately 5 mg instead of 10mg. Its the same amount of drug in my system, but less instense.
I expect to start weaning beginning next weekeend by reducing the medication by 25% a day a few days at a time just like the doctor above suggests. I do expect some withdrawal shakiness & nausea and I do expect to have to deal with some pain. But its the only way for me to know how much pain remains from my herniated disk. I am supposed to have another MRI in June.
Tell your doctor you want to get off the drugs and he/she should be able to instruct you how to do it with the least discomfort, but there will be discomfort, physical & emotional - I am sure of this. I know it is frightening.
I am resolved to do this and hope you will be successful too.

[Eebb26]

I need help. Taking percs for a year. Scared and want to get off!! Afraid I'm taking too much 2-3 10/325 every 4 hours. Please help

[ShelleyN720]

I suspect I will be asking to reduce gradually as you suggest by reducing 1/2 a tab a day over the course of a couple weeks. I have never taken more than two 10 mg tablets a day generally 8-12 hrs apart. What has bothered me is I've noticed that by hour 6 after taking it...I am starting to feel a little shakey now...like my body is saying it needs more. I don't like that feeling!
I do very much want to see if the herniated disk has improved and it seems the only way to determine this is to wean off the norco slowly to see what kind of pain is left to deal with. Right now, I don't think its too bad but of course I have norco in my system.
I admit to being worried about withdrawal because I have to work and don't want to suffer with any kind of shaking or nausea. I've read scary posts on this forum!
I greatly appreciate your response!