Myself

[chig1130]

I c/t off of 60mgs/day of Norco in March of this year. A week ago, the doctor put me back on 30mgs of Norco. I am still feeling like im in withdrawals for pete's sake!!!!  Can anyone tell me why, Im still feeling the wds, when im back on the Norco?

Thanks and would appreciate any info. I can get about this.

[philnoir]

Chig,

Please take 3 a day, every 8 hours, as your doctor directed. The whole point is to treat your pain early -- it's easier to manage before it gets severe, and in the long run, better for you.

The anxiety is something else, and it is not unusual for pain patients to need an anxiety medication.

Dr. Forest Tennant, MD, PharmD, is a world famous pain doctor who's been practicing in pain management for over 40 years. He's a well-known expert in the field. Here's what he has to say to pain doctors about treating both pain and anxiety.

http://www.practicalpainmanagement.com/treatments/pharmacological/non-opioids/benzodiazepines-pain-practice-necessary-troubling

Don't worry, be happy.

[Tuckamore]

I know you think it's the Hydrocodone that is making - or has made you feel the way you do/have. I disagree. It may not be the opiate for you but it's not such a potent drug that it can cause anxiety and depression for 8 months.

Sorry my friend in pain - it's not the opiate. Can it be contributing to the big picture? Possibly but not probably.

I truly think you should be treating your depression and anxiety. That's not something an opiate can treat.

The majority of we chronic pain patients have something called Situational Depression. It's not the typical depression and it's not clinical.  As the name suggests it's due to the situation the pain has caused in our lives. I am not saying you have that - but by your own words you have depression and anxiety. I don't know a thing about you besides you have chronic pain. The actual type of depression and/or anxiety you are experiencing can only be DX by a good clinician.

You're correct. You need to talk to you PMP. There are some great anti-depressants that will work on your pain and your depression and the anxiety - often hand in hand with an opiate. Let your PMP determine what those meds should be. What's effective for one doesn't necessarily work for another. Hydrocodone is much more effective for me than oxycodone, a more potent opiate. It shouldn't be - but it proves our systems are different.

Your "receptors" certainly healed in a few months at most. It's time to treat your depression and anxiety along with your pain. You deserve to feel better - you deserved it a long time ago.

~Tuck

[chig1130]

My script says I can take 3 a day,  Some days I don't hurt bad enough to take 3 a day, so it is just according to how my pain is, whether I take, 1 or 2 or sometimes yes 3 a day,  I guess from being in wds for so long I get really scared about getting back on it,  As in the beginning of this journey, back in March  I realized I didn't need 60mgs a day to control my pain, so that's when I made the decision to jump off of  them March 22, was my last Norco, until 2 weeks ago. I wanted to just do the injections to see if they would work and not have to take pain meds anymore, but the Pain Mgmt doctor after he saw my MRI said I needed to take 3 a day, That is nothing to most ppl but I really didn't want to take 3 a day, but I did for the first week,  Then I started only taking 2 a day and that's where im at now.  Since I  got back on them after being for 100days, which I was still having a ton of anxiety before I got back on them,, I am I guess a different kind of a person as far as getting off opiates is concerned,  That flu like stuff doesn't affect me much, what affects me is the pacing, anxiety, and depression. and it stays that way until my receptors heal. Like I said 2 times before it stayed with me for 8 months, then one morning I woke up and had no more anxiety or depression, I just thought since I was back on them, the anxiety and depression would leave, it hasn't, so I wrong I suppose. I guess im going to have to tell Pain Mgmt I cant use Norco anymore, so what else is there? Maybe I will have to get off of the Norco again and tough it out until all my receptors heal,

Thanks for listening, Im at my wits end

[chig1130]

I do not have the flu like symptoms at all. What I am having is a ton of anxiety and not being able to get out of my house without my husband. I still feel like im not functionable,  because of the anxiety and depression

[philnoir]

Remar has made an excellent point.

Opioid withdrawal is also known as opioid abstinence syndrome.Since there is no abstinence, there is no withdrawal.

Compare the common symptoms of opioid withdrawal:

http://www.nlm.nih.gov/medlineplus/ency/article/000949.htm

with the common symptoms of an influenza viral infection:

http://www.flu.gov/symptoms-treatment/symptoms/index.html

Note the points of similarity.I'm not suggesting that you have the flu. I have not been following your posts carefully, but I have to agree with Tuck and others here. It is unlikely that you're experiencing opioid withdrawal when you're taking an opioid medication around the clock, as directed by your physician.

It is likely there is another explanation for what you are experiencing.

Perhaps you could describe precisely, what you are feeling?

[Tuckamore]

I'm sorry I wasn't clear.

No, it's not my opinion, "jumping off the 60mgs for over a 100 days. Then starting back on 30mgs, is this why I still feel in wds."

It makes no sense to me that you were still feeling physical w/d after over a 100 days off hydrocodone - and now being back on them. Something doesn't sound right to me. Again I'm wondering if it's an abnormal reaction to hydrocodone.

Remar asked a good question. Exactly what are your feeling that you're calling w/d SX (symptoms)? It's concerning to me. Can you explain your sx to us a bit better?

I'm delighted that there is no surgery in your near future. Sounds like you have a good surgeon. Phil is the "King" of knowledge regarding injection (Facet Joint Injections) and burning the nerves, Radiofrequency Ablation (RFA).  I know the mechanics of them but I'm blessed, I've had neither - which means no personal knowledge.

If you have Nerve Pain has any physicians RX Lyrica or Gabapentin? They often work better than an opiate for treating nerve pain - or in combination with an opiate.

~Tuck

[corey4433]

I agree with remar I have thoracic hernations pain wraps in my chest and I get upset stomach alot if I eat to much omg pain is terrible in my mid backit is a fact that thoracic hernation causes stomach pain google the symptom my opinion if your pain is untreated you will feel sick you might be have anxiety knowing you was taking your husbands meds not wanting Togo back on meds almost a feeling of butterflies in your tummy if the 30 mg isn't covering the pain let your doctor know immediately remember big difference between dependent on on pain meds and abusing pain meds you have the right  to be pain free or at least comfortable noone should have to live in pain.Pain cause's alot of things depression anger anxiety talk to your doctor best of luck to you keep us posted

[remar]

Can you please explain in detail what you're feeling? Is it nausea, headaches and a flu like feeling? I'm asking because you may not be going through W/D's. Our spines control everything in our bodies. If you have something wrong with a vertebra in the middle of your back it can make you nauseous. If you have problems with any in your neck it can give you problems with your ears, jaws, shoulders and can cause headaches.
It's just that I've never heard of anyone going through withdrawals for this long. Like Tuck said, it might be this particular medication you may want to try something different. It could also be your back and neck problems that are causing you to feel this way.
Ask your Dr if it's safe for you to do a little stretching. This could help with the trapezoid muscles. If he says it's not safe then alternate heat and cold.It may give you a little pain relief and loosen those muscles.  

[philnoir]

Yes, the procedure that destroys the nerves that send pain signals to the spinal cord and brain from the facet joints is called a medial-branch neurotomy. Some people call it RF ablation, because of the electronic tool they use to destroy the nerve.

If a major piece of you pain syndrome is coming from the facet joints, then this procedure will help.

The facet injection is a test to see if numbing the joint reduces your pain -- if this works (and it works for a few days at best), then they will continue with the neurotomy -- nerve destruction.

Know that there are risks to with the procedure -- as your doc about them in detail.

Know that it requires 2 treatments to get both sides of the neck, as standards of care recommend only doing one side of the spine at a time. Also know that it will require perhaps a week to recover. Beginning on the day after the procedure, when anesthesia is completely gone, pain may be increased. You treat this by applying ice packs, 20 minutes every hour. Do not increase your dose because of the increased pain, because you'll run out of meds too soon.

Finally, some people develop a rash, similar to a bad sunburn, as a side effect of the procedure. Do not sit and suffer. Call your doc's office, and he can phone in a steroid cream that will treat this rash.

Also know that these nerve grow back, in an average of 250 days. So, you may need a repeat procedure as early as 9 months from the procedure.

For other information, visit a spine site like spineuniverse.com and look up the procedure, as well as the condition called facet symdrome.

[chig1130]

So is it everyones opinion that by jumping off the 60mgs for over a 100 days. Then starting back on 30mgs, is this why I still feel in wds.  See, the other 2 times I jumped off the Lortab, I never went back on it for 2yrs give or take. So, I have never had this kind of thing happen before to me.

Mine is alot nerve pain, some bone pain. My TMJ, issues are burning mouth inside of my mouth.
If anyone on here knows of anyone who has TMJ and got  good results with treatment please pm me and let me know.

On the other note, I went to surgeon today, he said no surgery. Try injections into the facet joints, and if that doesn't work, then trying burning lthe nerves.

You see my neck, makes the trapezoid muscles tighten up til I about die. It is killer. Has anyone on here had the procedures im talking about injections into the facet joints and the burning of the nerves, if you have did it work?

Im so looking for help here. I want to thank anyone that can help me out.
I so appreciated any info I can get about neck or TMJ.

Thank you all so much for all of your kindness,
Kim

Ps: How do I get out of the damn withdrawals

[Tuckamore]

I'm not about to beat you up for controlling your pain. Yes it wasn't advisable but you're a big girl and you know that.  I've heard of ppl being prescribed that amount - though not so much in this climate. So no judgement here.

I can't figure out why you have this feeling of withdrawal (w/d). It certainly doesn't make sense to me that you felt the w/d for eight months - other than that is just your system and the way you respond to this particular opiate. Your pain may be better controlled and you may avoid the w/d feelings on a different opiate.

Have you thought of requesting a different opiate? This may be a type of reaction to hydrocodone. I'd discuss this with the physician that you trust the most - hopefully that's your PMP.

I would avoid surgery at all costs. It's always a last result - as I am sure you know.

Thanks for explaining and adding more info. It helps when we understand the whole situation. :0)  

[chig1130]

Here is my story,its long and parts of it Im embarrassed to tell, but here it is. I started having back problems at about the age of 24. My back would go out and I would fall in the floor with no feelings in my legs. Well I went to chiropractors for this. Eventually I would get back on my feet and all was well. In 1986, I whiplashed my neck, hitting a cement light pole at a car dealership. I hit it so hard, it bent the top of my car, meaning the frame.  I heard something like the sound of paper tearing in my neck. I did not go to the doctor at all. Now fast-forward to about 1998, I started hurting more in my back so I went to Ortho-doctor and at this time he said I had a tear in my low back, and some other things, but that right then I didn't need surgery. So, I go on till 1999, went back and had more MRI'S, on neck and back. Well they said yes I had damage but they couldn't see it was pinching on a nerve. So fast-forward to 2005. I was put on Lortab, same thing as Norco.  In 2007, I got a virus and was laying a lot on my couch and so I didn't need the Lortab and so I quit taking it, cause my back was not hurting laying around.  UN-Beknownst to me, I went into wds. I had no idea that you couldn't stop taking it. So, when my friend told me what was going on with me, why I was shaking and couldn't function, she told me I was in wds. So, I didn't take anymore of it and toughed out the wds for 8 months, that is how long it took my brain to get back to normal. I was in total misery for those 8 months. I was able to deal with my back for about 2yrs. then I went back to doctor and got back on it, cause he said I needed it for the pain I was having, and recommended me to take it. I hated taking it but hated being in pain worse. Well in 2010, I c/t off of to see where my pain was level was. In 2013, I was getting where I was hurting badly in my neck and shoulders and low back, really bad. I got back on the Lortab in 2013. I was taking more than I should have, cause my husband also got it and he didn't need it, so I was using his. I was taking 60mgs a day at this point. I had back surgery last year in 2014, right sided laminectomy this helped that side but not the left side. The in August of last year I had total right knee replacement. All these surgeries I was still on the Noco. I was told I needed neck surgery at the time I had my back surgery, but I just thought I could handle my neck and back on the pain med.  BUT... I knew I was in trouble taking my husbands, so I c/t off of it in March of this year. My doctor didn't know I was using my husbands, Im so embarrassed to tell this.Please don't beat me up, I know I did wrong. So, I was off of it until about 2 weeks ago. I went to Pain Mgmt. I told that doctor what I had done,
but he never asked me what dose I c/t off of. I didn't volunteer it. I did ask if there was anything I could do for my neck, it has started killing me. I asked like was there injections or anything other than pain meds for me to be on.  Well he sent me for MRI'S, this time it is bad. My neck reads like this: C3-4 and C4-5 bulging disc, C5-6 and C6-7 herniated disc. My low back, there are disc messed up and bone spurs. So, the pain mgmt. doctor gave me and injection in my neck, it didn't help at all. Oh, and by the way I got TMJ from a dental apt last year. Well the pain mgmt. doctor put me on 3 Norco a day. That is exactly what I have been taking. I have not abused it and never will. But my question is. Why am I still feeling like I am in wds, I am taking Norco again, but at 30mgs instead of the 60mgs I c/t off of in March. I cannot get the wds to leave me. Anybody ever had this happen to them? Im going to see a Neurosurgeon about my neck, but Im thiking surgery is not an option. Plus,the TMJ, I have what to do about it. It is very painful also. Im a mess for sure. Thank anyone for reading this. I just thought maybe you could add some insight, as to why im still having wds after being back on the Norco.  Im sorry this is so long.

[Tuckamore]

Maybe I am the on that is reading this wrong - but I've reread it several times.

I understand it to say that Chig has never stopped feeling the withdrawals (w/d) - and now that Chig is back on the opiate that w/d feeling is still present.

No where did Chig say he had an addiction issue - no where. I don't think that is an issue.  I just added the link as that forum has such good information regarding w/d.

A word from Chig will clear this up.

Peace,
~Tuck

[GreenLeafyNothing]

I have *definitely* heard of what you are talking about. In fact, TAKING a small dose of a narcotic can CAUSE mild withdrawal feelings. Notice I said "withdrawal feelings."

Those aren't "true withdrawal symptoms," because obviously, by definition, "withdrawal" is when the body gets all antsy when it doesn't have ENOUGH opiate. However. those exact-same-feelings CAN be triggered by the opiate itself!

And the scary thing is that "antsy" feeling is what causes some people to want to "up" their dosage.

So, I am going to venture a guess -- you probably had big withdrawal feelings back in March when you ct'd. And then they mostly went away, still a 'twinge here' and a 'twinge there.' But you still have lots of pain so your doc put you on a smaller dose. And, as soon as you hopped onto the 30mg per day dose, those mild "remainder" withdrawal feelings BOUNCED BACK and now you feel extra crappy. Right?

It all has to do with the body _physically_ creating opiate receptors. It takes quite a while for the body to absorb/dissolve these receptors back into itself after cessation of the opiate. After 5 months, the body still remembers how to create all those receptors, and I think when you started back on the pills, your body "went to town" on recreating all those receptors that it once had. Why? Probably because your body remembers and expected the full 60mg dose.

The thing to discuss with your doctor is your actual pain. Is your actual pain treated okay? If so, please rest assured all this 'opiate receptor' / withdrawal thingy will all balance out in the end. Takes time, don't rush it. If you pain is NOT treated okay, then you and doc can hash out a revised regime.

[mandi66]

Hi Chig,

I hesitated answering your post because.....well, I really don't know why!  I hope I am not giving you the wrong answer because I don't want to lead anyone in the wrong direction.

You were on 60mg when you stopped (not a large dose by any means) and now you are on 30mg.  My feeling (only my opinion) is that the 30mg is not enough to cover your needs!  You may be so afraid to take these meds because of addiction, ect., that you are not properly medicated to take any your pain (which has increased).

Too many folks are afraid to take the meds they need to control their pain!  Why suffer needlessly?  On the other hand, if you feel that you take your meds to get high (which I know you don't), then you need to reevaluate.  I am glad I came on this forum.  I take my meds responsibly.  I am on a much larger dose, by the way.

Its nice to come on this forum and have the support of others who suffer with CP and can relate.  I am glad to have something to help me cope with my pain and I have no regrets about taking it. I can live my life easier, and I think that's what pain management is all about!

Good luck to you Chig.  We all here understand and care.      mandi

[Tuckamore]

Hi Chig,

If the Norco was DCed in March you should not have been experiencing any withdrawals (w/d) - at least nothing physically.  

Normal physical symptoms of w/d last 3-4 weeks - some can last a bit longer. Mentally it can last longer.

I'm wondering if something else is going on with you? What are your symptoms?

There's another community that may have better answers for you. You are more than welcome here. I'm just trying to help. Please don't think I am even suggesting that you are an addict - it's just that the Substance Abuse Community knows more about these things that we do at the  Pain Management Forum. Here's the link:

http://www.medhelp.org/forums/Addiction-Substance-Abuse

Please let us know how you are doing. I'll look forward to hearing from you again soon.

Peace,
~Tuck