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Everybody at my pain mgmt clinic gets Lortabs. What's the deal with Lortabs?

blackberrybunnybblackberrybunny Posts: 157
edited 06/11/2012 - 8:42 AM in Pain Medications
My mom first started going there for degenerative disc disease and spondylosis. So he prescribed her Lortabs. Then, few years later, I start going there. I get Lortabs. We meet people in the lobby, other ladies, talk, they too all get Lortabs. It is as if no one else gets anything like a Percocet or a Lorcet or an Oxycontin, or a Vicodin. Not sure what the differences are, but I know like in lortabs you get codeine with acetominophine, and the other one has ibuprofin, one aspirin, something like that....

We are in the state of FL. Could that have soemthing to do with it? Or is it just this certain dr's thing to only give out Lortabs? He has my mom on the fentanyl patch, and some other patients have said they too receive those from him, but other than that, just the patch, and the lortabs.

What makes lortabs so special I wonder? You'd think after several years of taking them that maybe you'd get a tolerance to them and maybe it would be good to try something else, to manage the pain? What do you guys think?


  • Lortab, Lorcet and Vicodin all contain hydrocodone, a medium-strength opioid analgesic (between codeine and morphine in potency) and acetaminophen. Doctors seem to have their own preferences when it comes to medication - I guess yours likes prescribing Lortab (perhaps because it is a Schedule 3 compound drug, and as such easier to prescribe than, say, oxycodone). I wouldn't have thought it a good choice for treating ongoing pain though, due to the acetaminophen content.
  • Hi huggy, that is what I'm worried about. The acetominophine. I'm probably killing my liver. I have to look up what this schedule class 3 drug stuff is. Thanks for your help!

    Um, not trying to be nosey, but it sounds like you must be in a lot of pain!! I am facing a multi level lumbar fusion. May I ask what you are taking now to manage your pain? If anything? It's okay if you don't want to say--I'll understand.
  • The combination meds are considered lower risk of abuse, since you'll rot out your liver before you can get much of a high from it ;)

    Personally, I find they work so much better. I don't think hydrocodone would do much on its own, I need the tylenol too.
  • Yes, it's commonly used for moderate to severe pain and it is usually the first narcotic medicine prescribed by doctors. I started off on them before going on to Fentanyl patches long ago, but I still took them for breakthrough pain. The next step up would be Percocet but it also contains Tylenol. Oxycodones have no Tylenol and is easier on the liver but of course it totally depends on what the doctor's prescribing preference is.
  • Hi blackberrybunny, at the moment I'm in pain management and the doctor prescribes one 24-hour Tramadol slow-release tablet (200mg), Temgesic (buprenorphine, a stronger opioid), diazepam for muscle spasm and gabapentin to help with neuropathic (i.e. nerve) pain. I'm hoping to switch from gabapentin to something else soon, as the side effects are bothering me.

    I used to take NSAIDs way back when I first started having spine problems but they didn't help very much and really did a number on my stomach (I'm now on meds for stomach problems too, as well as gout). I was only prescribed opioids after my surgery. The Temgesic is the most helpful for me, but I am keeping my dose as low as possible, as it can block the effects of other opioids in higher doses.

    Hydrocodone is actually a schedule 2 drug on its own, but when it is combined with another non-opioid analgesic like acetaminophen or ibuprofen it is Schedule 3 (same as my Temgesic, which is supposed to have less abuse potential than other pain relievers of a similar potency like morphine, oxycodone, etc.).

    I am in quite a lot of pain, yes! Just like everyone else here, I guess. It's funny, after such a long time you kind of get used to it, but never completely. I'm going to see another neurosurgeon soon to see if there is any point in having a fusion or ADR (artificial disc replacement) or other some other operation that will help my lower back. None of the surgeons I've seen seem sure what to do! Good luck with your upcoming fusion. I hope it is a success for you.
  • Thanks for all your comments, you guys! And for explaining this class 2 schele 3 dgu stuff, LOL Huggy.

    What meds are there in these 'oxycodones'==do you mean like oxycontin? Is there something else?

    And why do some people swear a percot worked much better for them, if it is basically the same thing as a lortab? I don't get it. Is it a mind thing?
  • Percocet contains oxycodone, which is stronger than hydrocodone (which is in Lortab, Norco, Vicodin, etc.). Hydrocodone has about 60-70% the potency of morphine by most estimates, while oxycodone is about the same strength as morphine (although it is more effective when taken orally). Oxycodone is in OxyContin, Percocet, Roxicodone, and so on. Some people seem to prefer hydrocodone-containing compounds though, just as some people find codeine better than hydrocodone, despite it being a weaker drug overall. It depends a lot on the individual and the doses used, I guess.
  • Thank you, Huggy, that helps me understand a lot better.

    So does that mean that Lortabs and say something with oxycodone is NOT a schedule 3 drug like the lortab?

    Could one of the reasons my dr. gives every lortabs instead of Percocet or something like that because maybe he'll be 'checked on' more by the regulatory board or something? We live in FL. I just can't help but feel like he's scared to give out anything other than Lortabs. And the Fentanyl patch.

    I'd like to try Percocet, but I'm scared that what if it didn't help me---I'd be stuck with a whole month of something that didn't help and he wouldn't give me my prescription for lortabs then that month. Oh, what a dilemma!

    And if feels like when you DO ask them for soemthing different, they are just thinking in their minds that you must be an addict or something. At least, that is how *I* feel when I attempt to ask for something else.
  • Oxycodone is always a Schedule 2 drug, whether it is on its own (e.g. OxyContin) or as a compound (e.g. Percocet). Hydrocodone is a Schedule 2 drug on its own, but when added to acetaminophen, aspirin or ibuprofen it drops to Schedule 3. It's less of a hassle for a doctor to prescribe Schedule 3 drugs as the level of scrutiny and paperwork is less than with Schedule 2 medications such as oxycodone, fentanyl and morphine.

    If this doctor is willing to prescribe fentanyl then it can't be that he's entirely opposed to giving CII drugs (which fentanyl is). Perhaps he is used to hearing horror stories about how many people abuse oxycodone, and therefore more reluctant to prescribe that, instead of fentanyl?

    I understand how it can be frustrating when doctors don't prescribe a medication that seems to be the logical next step when it comes to treating pain. Where I live, CII drugs are never prescribed for non-cancer pain, not even codeine (they don't even have hydrocodone and oxycodone here, and tramadol is Schedule 4, so you can see, it's very different in different parts of the world!). I was only able to get an ongoing prescription for Schedule 3 analgesics after providing a lot of medical records and going through a load of tests to prove that I have chronic moderate-severe pain. It can be very tricky sometimes. I think it's largely a matter of building up a good, trusting relationship with a competent, knowledgeable doctor.
  • Thank you Huggy, you really explained it well to me this time. I sure do appreciate you taking the time to help me understand this.

    I hope you are feeling well, not a lot of pain. I woke up hurting as always, but less than usual, so I'm hoping for a good quiet day. Thank you, Huggy, you area great teacher!! ;-) ~Molly
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