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chronic pain and narcotics

edited 06/11/2012 - 8:39 AM in Chronic Pain
I just wanted to share a story with you guys and gals and maybe get some input, my sister also has chronic back pain and is up to like 10 loratabs per day, I only use what I need as prescribed, but isnt that alot to use in a days time and how do we not become addicted?


  • That is not a lot of medications for nerve pain. If your sisters pain is not managed well enough, she should let the doctor know. I take much more medication then your sister and my pain is still not managed. I'm taking oxycontin and percocet, the maxed I'm allowed, which is 90mgs of oxycodone per day. I'm having the dosage increased at my next appointment and the PM will increase the oxycontin dose slowly until it's at the right dose. I'm hoping to eliminate the percocet all together. I have permanent spinal cord nerve damage.

    If the medications are taken the correct way, there is a minimum chance of addiction. I do not in any way have the buzzy feeling with any of my medications. My body has adjusted to the medication and the only side effects I have is constipation here and there when I do not eat enough fiber in my diet.
  • I also agree 10 Lortabs is too much because of its Tylenol content, and the maximum allowed per day is only 6 tablets. You shouldn't take more than 4000 grams(?) of Tylenol a day.

    Your sister should go back to her doctor and have her meds readjusted. Maybe her doctor will think it's appropriate to put her on an ER medication like Ms Contin, Avinza, Fentanyl patch, or Oxycontin. She still can use the Lortabs for breakthrough pain and take it as needed.
  • She should speak with a pain management doctor and make sure that's an OK amount. Taking more than prescribed is one of the first signs of dependency (and tylenol overdose is nothing to play with!).
  • dilaurodilauro ConnecticutPosts: 9,865
    by a doctor then there should not be many concerns.
    Of course there are some doctors that tend to overmedicate some patients. Hopefully in today's environment with DEA and other problems, doctors are more careful.

    When a patient needs medications and its easy to see that, any good doctor will provide the patient with what they need.

    My Pain Management doctor has always said she has no problem prescribing my pain medications and refills. She sees and understands the pain I am in. She is also the first to say she will know when I am NOT in the pain where I need much pain medication. And I trust her 100%.

    Its hard to come up with any guidelines when it comes to medications. Someone might be taking a large dose of Oxycontin daily, another patient may be very high in their daily Neurontin dosage, while another might be taking a good amount of Zanaflex daily. But whats good for one person, does not mean its good or ok for another person.

    Here is where the doctors come into play
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I agree with statements above regarding Tylenol. I am in a position where I have to work 100% "drug-free" for the first part of my day, which some days is living h*ll, and I was taking Excedrin with 1500-2000 mg tylenol in the am, and then in the afternoon & evening my prescription pain med with tylenol, I was pushing close to 4000 mg (=toxicity) per day. Plus, I was taking tizandine muscle relaxer which also has liver toxicity. My PM said I could go up to 3000 gr at one point (2 years ago).
    I did worry about liver toxicity. Liver toxicity is the same for everyone across the board, even if you are only taking OTC Tylenol. And it is the most common cause of death due to drug OD!
    The doctor prescribing those amounts could be significant trouble if she develops liver problems.

    When it comes to amounts,mgs or number of pills, nothing surprises me anymore now that I have become a chronic pain patient myself. I personally metabolize meds very quickly, so even though the mg quantity isn't that great (actually pretty low), I have to take more frequently and my doc adjust his Rx writing because of it. But he also doesn't want me "pain-free" for fear of developing tolerance. This is hard to accept as a patient suffering, but it does make sense.

    I have to admit I was judgmental in the past of others that took chronic pain meds, karma sure put me in my place about that! But I am grateful to have a PM, that after several years of establishing trust and being compliant in every way possible, I know believes my pain "is real". This was the doc that after my MRI's were read as "normal" (when they really weren't), believed me enough to pursue a discogram which led to discovering my source of pain and subsequent fusion. I feel very strongly that unless you live in the boonies where a pain med doc is not available, it is imperative to be under the management of a pain doc for many reasons.

    On taking more than prescribed - I can count the number of times in 3 years I took a dose more than prescribed on one hand (usually weather/tornado-condition related) and was sure to call the PM office to have it documented or told him on my about that month. Taking more than prescribed on a regular basis is a big flag to PM docs!

    Kentucky girl: On your sister is sound like she should be on more of an ER (extended release) medicine; or stronger med taken less frequently. I wonder if her PM doc is restricted to DEA class III an can't write class II drugs for some reason and that's why she is taking a larger number of Lortabs.
  • I would like to thanks everyone for the comments, my sister really has me worried that I also might become dependent on drugs for pain, on most days I only take two 7.5 loratabs to get through the pain and that is enough,do I have a reason to worry? She went to some kind of clinic today and they put her on suboxne I think thats how it is spelled but still what about the pain ? I think her pain managment doctor can help I hope. I told her tonight we need to be trying to do some kind of therapy like walking or swimming but when you work all day and get home you just dont feel like it..I am a bit over weight and I know its putting extra strain on my spine, when I try to do anything physical I spasm and then I am down for weeks before they go away..It seems like a big circle that never ends!
  • In my humble opinion, I think it's a mistake for your sister to have been put on Subuxone. It's a huge jump from Lortabs if the reason is for pain mgt. Are they trying to wean her off the Lortabs? If so, Subuxone isn't necessary since Lortab isn't a really strong narcotic. You can cut back gradually on a schedule with the help of her doctor, if this is the case.
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