Tapering, Withdrawals, & Rebound Headaches

[m72]

I am addicted to Hydrocodone and have been "off and on" for about 3 years. Sometimes I go through periods of not taking them, or taking very little. But in the last few months I've been going on binges. I'd take 3-4 5/500s a day at the most. I am now at the end of one of those binges. I managed to get off them a few months ago and was miserable physically for a good three weeks. Now I want to taper off and STOP. But I can't taper because I'm having rebound headaches from the medicine. What can I do to deal with the headache? It's been bordering on migraine for two days. I had no hydros yesterday and one 5/500 this morning, which inflamed the rebound headache. I know this isn't going to be easy....restlessness, weakness, sick to my stomach, and the psychological need (the addiction) to take hydros, but the headaches are the worst part. I don't know what to do about it. Can I take a Darvocet or Excederine for Migraine to deal with the headache, or would those only exacerbate it?

Thank you.

[J T Junig, MD PhD]

The 'rebound' often comes from 'NSAIDs' like aspirin, ibuprofen, and naprosyn, but can come from pretty much any medication.  Excedrin would be one to avoid-- not to get into brand names, but the standard product by the name contains caffeine, which tends to cause withdrawal headaches in most people.  

I recommend checking labels for caffeine;  darvon or darvocet contains propoxyphene which is a weak narcotic, and so that would likely take you back to opiates in the long run.

The bigger problem though is that every recovering opiate addict I know used to think he/she could stop on his/her own.  The person generally goes through the same cycle over and over until eventually either getting into trouble or getting sufficiently desperate to seek definitive treatment.  I do hope that you can stop, but if you can't, get help-- there is a phrase, 'terminal uniqueness', that refers to the belief each addict has that he is somehow different, and will be able to do things a different way-- and find a way to avoid the trouble that happens for everyone else.  The 'recovery' process includes understanding that with addiction, we have more similarities than differences.

One thing to consider-- the first step of 12 step programs has always interested me from a scientific and psychological perspective--  I have seen firsthand, and in many others, that an attitude of 'powerlessness' can have a dramatic effect on cravings, suddenly eliminating the desire to use in many cases.  The easiest way to understand the mental process behind the effect is that if a person believes he has 'will power', it is a very small shift of thinking to decide 'I will use today and stop tomorrow'.  With will power, that is a reasonable idea.  On the other hand, when one believes that the smallest use will result in death, there is no place for rationalization to take you.  If that makes sense, consider giving up on will power, and trying the other approach.  

[m72]

I also have Maxalt that I can take for the migraine but I am wary of using it. Just not sure what to do.

Ok, I think I remembered everything this time!

Thank you.

[m72]

And also, my neck at the base of my skull is killing me. Is this also part of the withdrawals and/or rebound?

Thanks again
:)