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I had my first Rx of Vicodin in 12/2009. I had my first surgery to repair my L5,S1 on 06/2010 and that was followed by my second and third surgeries both in 07/2010. I have now been on Vicodin and Percocet since then. These drugs take away my pain and allow me to enjoy life's pleasures. In my opinion, I am not abusing them. I make sure that I do not use over the 4mgs. of acetemenophen as suggested by the FDA.

How long can I stay on these drugs or am I already too long on them? I have tried other pain management programs that my doctor has recommended, but the pills are definitely the best. They work quickly and are effedtive.

What do any of you say?


  • It used to be 4gms a day but it`s now 3 gms a day for acetaminophen. I take a slow release medication and when i need something for breakthrough pain I take a Percocet which is usually only once a day. Not sure if you`ve ever been on a slow release narcotic at all. I have been on MS Contin and Oxycontin and now presently getting relief with a Fentanyl patch. I think it depends on how many you take a day and if you`re able to get through the night on an instant relief med and how much you take a day may benefit according to your usage of slow release. That `s my understanding of slow release and short acting meds from my experience only. Usually a few months on instant release leads to slow steady release and a referral if necessary to a pain management Dr. Best wishes. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • EMS GuyEEMS Guy Posts: 916
    edited 08/08/2012 - 1:45 AM
    I'm a little surprised the doctor has you on two quick acting opiods instead of a long lasting then a breakthrough if that was needed. You will build a tolerence to the medication. But really, it's beast to have the discussion with your doctor. You don't want to mess around with dosing unless your doctor tells you to.

    That being said, some people wean off after a couple months so that if they begin taking it again, it has more of a theraputic value. Its best to keep the doses as low as you can and achieve relief if your a chronic pain patient. Eventually, it becomes more difficult to find something that works when you've been on stronger medications for a long period of time.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • LovetrotravelLLovetrotravel Posts: 296
    edited 08/08/2012 - 6:02 AM
    I am also surprised that the same Dr. is giving your prescriptions for Vicodin and Percocet. This is very unusual and unfortunately can cause a red flag to be raised by the state and DEA so just be aware of this in that they can contact your Dr. at any time and abruptly take you off this.

    Many states are now passing new laws/regulations to have there be a prescribing difference from acute pain patients and chronic pain patients. Once someone gets past the 3 month mark, they move into the chronic area.

    And usually, a good PM Dr. will move their chronic pain patient to a long acting medication so that you don't have to chase the pain all day long as well as not have so much acetaminophen in every dose.

    May I ask what type of Dr. is prescribing these to you? It doesn't sound like a PM Dr. or someone knowledgeable in the area of pain management.

    Usually the process goes from something like Tylenol 3 or Tramadol, then to Vicodin, then to Percocet or Dilaudid, then if someone is taking more than 2-3 of these a day for a few months, they are moved to a long acting medicaion like Oxycontin, MSContin, Opana ER, etc. And as Charry mentioned, if those aren't working well, then Fentanyl is the next step as it is the strongest.

    What else is the Dr. having you do to help your pain levels besides opiates? Most chronic pain patients realize that an opiate is a very small piece of the puzzle and just one modality.

    It is a bit concerning that you say this takes away all your pain and that you "tried" other things but the narcotics are the best. Usually an opiate is meant to get someone that is a chronic pain patient to about a 50% reduction in pain with medication and then using other modalities to help. I don't think there is anyone on these boards that is pain free...I would never take that much medication to get to a 0 as this is a life long process and there needs to be room to move up slowly. So if you are expecting other things to bring you to a 0, this is where your Dr. is not really giving you realistic expectations. Everything is meant to take the pain down a tiny bit and then add up all together.

    There is exercise, yoga/stretching, massage, acupuncture, aqua therapy, TENS unit, biofeedback, injections, steroids, SCS unit, counseling, traction, etc.

    As well as other medicines that work for specific types of pain. A muscle relaxer, a nerve pain medication, an antidepressant which also has pain relieving properties.

    An opiate, especially a short acting one taking it long term as EMSguy mentions, will have you building up a tolerance quickly as you are chasing the pain as it takes effect in 45 minutes and then tapers down over the next hours. So every 4-6 hours you are having to take more and then going on the roller coaster again.

    That is why I am really curious who is handling your pain mgmt. as it seems to me (obviously I'm not a Dr. or medical professional) that you are not being given the appropriate medication for being this far along in your chronic pain journey 2 years out on these.

    You need to find a Dr. that is going to help you find the best comprehensive pain program that uses all or most of the modalities I mentioned as well as other medicines that can target the pain better. Opiates are just meant to "dull" the pain but they don't specifically help muscle or nerve pain.

    I am on MSContin for my long acting medication and then OxyIR for my break through medication. This way, I don't have any acetaminophen and I can add a Tylenol if I get a cold or flu for my fever or Advil to use for inflammation.

    Since the FDA has now recommended that all manufacturers go down to 325mg of acetaminophen in their short acting pills, this ends up being 2600mg daily for the max amount taken of 8 a day (Which is not meant to be done, but has been the max by law for short acting meds like Vicodin or Percocet) May I ask how many Vicodin and Percocets you take a day?

  • My doctor is the actual surgeon that performed the surgeries. He is a D.O. Osteopath and has an outstanding reputation as a surgeon in this area. He keeps switching me from Vicodin to Percocet, I think because I tell him that the medication that I am on has become non-effective. I take 5/325 percocet and 7.5/500 Vicodon, I believe. If I am having a bad day, the pills are a life saver and I can still enjoy my activities. If I am having a bad day and try to get through it without medication, the pain makes me miserable and then everyone else is too because I become very irritable and grumpy. What am I supposed to do?
  • That's what I was thinking...he may be a wonderful surgeon...but they are not trained in pain management. All I was trying to say was that with all the new laws, it may come soon that you will not be allowed to be on two short acting meds at the same time. It's just not the normal treatment for chronic pain.

    An actual PM Dr. would be able to move you to a long acting medication which would make your life easier with having a steady stream of medication without the ups/downs. That's why you get irritable and grumpy. The long acting medication does a much better job and then you would have either Vicodin or Percocet for breakthrough medication most likely.

    As well as developing a comprehensive pain program for you...What else do you do for your pain besides narcotics?

    You asked for help...that is what we are giving...There is so much more to pain mgmt. than a narcotic and a good PM Dr. is most knowledgeable on that subject. Just like you wouldn't go to a PM for surgery....a surgeon shouldn't handle chronic pain mgmt. They are fine to handle the acute pain right after surgery.

    Certainly your choice....we are just trying to share our experience. I've been at this for 11 years now through many surgeries, every single pain med as well as other medications and modalities. Everyone needs to find the best plan that includes a lot of modalities so that you aren't relying soley on a narcotic to make your life enjoyable.
  • oberlin_patientooberlin_patient Posts: 58
    edited 08/08/2012 - 3:22 PM
    Yes, I like the idea of going to a PM Doctor and I will certainly suggest it to him on my next visit, which is 8/21. I guess I am somewhat ignorant about these things because I never knew a doctor that was skilled in this area was avialable. This is exactly what I am looking for; someone who can get my pain under control or managed. I spent 5 hours in the E-Room yesterday because I was out of pills. Guess what they did for me. I received 2 injections of Dilauden (sp?), the first injection was 1mg and the second was 2mgs., or at least I believe that is what the doctor said it was. She then sent me home with an Rx for 10 mgs. of Percocet to be taken one every 8 hours until I can see my surgeon.

    Also, if my pain meds are taken away, they better have a rubber room available. I can stand the pain for about 8-10 hours and then I am ready to go out on the interstate and stand in front of the first semi that comes down the highway. No, I am not comtemplating suicide, just using may analogy to demonstrate the severity of my pain. I used to get Demerol, which worked beautifully for about 12 hours, but then I found out that I am allergic to it. I have what is called "Breathing Supression." Other words, I have trouble breathing or getting my breath. Funny thing is that this just started maybe a year ago.

    I definitely do not abuse my pills. I go as long as I can before I take a pill for pain. My doctor is on a 2-week long vacation and I was unaware that this was going to happen. So, I ran out of meds and that is how I ended up in the E-Room. I still get relief from 5mgs. of hydrocodone and the E-Room doctor said yesterday that if I was addicted or abusing my pills and after being on them for over 2 years, I probably would get NO relief from just 5 mgs. However, in all honesty, the 7.5's do much better and have more lasting time.

    Now, I am upset learing that my pain meds may be taken away and I really don't know what I will do if that should happen. I just want to enjoy life and the meds allow me to do that. Tramadol is useless and so is Advil, Tylenol, and other types of Non-Steroidal meds.

    I appreciate the infomation that you have posted here and I will most certainly begin my asking around about the PM Doctors in my area. Thanks so much and sorry for the long post. I am just confused now and when I become confused, I sometimes babble.
  • dilaurodilauro ConnecticutPosts: 9,839
    involved with total pain management then just medications.
    Take a look at: The Blend

    I totally believe in both Eastern and Western medicine. There is a lot to be said about Alternative medicine. I have had great success with Aroma and Music Therapy, Thai Deep Tissue massage saved me, and there are so many other avenues that you can try. Its important to have an open mind. Chemical science can do what they can do, explore other ways to help manage your pain.
    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 do agree and get what your saying. Just asking have you tried the other meds. I have been thru over 5 different pain mang. docs and each one was worse than the first. Who was a straight out _itch. I called my surgeon who referred me yrs ago...and as always they got me right in. He said well she is thinking of retiring . Each one wanted to to rounds of injections. And well the last one after the 2nd injection I had few ??'s for her. I asked again for the dosage of injection I ended up in er and my body was swollen all over. She this time handing me script with 5 meds on it, said lets try these and see you in a month. I have a great primary doc. I called him and (had to spell names of meds) he said have the rn make copy of it. And had the doc back the original and get the heck out of there. I was very upset and tried to ask this quack to explain the meds to me. She didn't liked to be questioned. I tore up the script and said no thanks. besides the muscle relaxers she gave me refill on a pain med. I showed her I had full It did nothing.
    I don't have good luck with pain m. docs at all. For me I tried the combo drugs, patches. All I had severe side effects.
    So my surgeon from 2006 surgery, refills norco and flexeril for me when needed. I do go see him every 6 months. And he still on search for a good pain mang doc for me.
    I have recently lost that great insurance I had. So my doc gave me refills for next month in case takes awhile to find new docs.

    For sure I would try to find a doc that can help you, and also do you do any water exercises I have found for me its that or some poses of yoga. Even on bad days try to do some stretching.
    I'm not expert nor medical person. But for me norco dulls the pain so I can even walk . When I have those screaming muscle spasms I take half of flexeril. full one i'm passed out.
    So many meds I have tried over 6 yrs of pain, make me sleep or so dopey can't do anything. And yes I have given them all time to work . I say you have to do whats good for you. We are all different in our bodies reaction to medication. I don't want any long lasting meds in my body they just don't see worth the vomiting and the vertigo or the super swelling all over. I have had just about every bad reaction poss. So do what you can to get thru the day, and to live your best life.

    And for sure the vics make ya very irritable...I send out warning msgs to my family when I'm on pain meds.
    neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
    good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
    daily goal do good thing for someone.
  • I agree that the meds make me feel dopey at times. I try my best to avoid Percocet, which is the worse. Vicadin relieves the pain and I am still able to function. Yesterday, I did not need any meds for pain. My pain level on a scale of 1-10 was maybe a 2, which to me is good and no meds required. So far today, still no meds. Things are looking up. I take it one day at a time, but I know if I want to go back to running or playing basketball or softball, I will probably need a dose of something later. This is why I think a PM doctor may be good for me. I want off the pills all together and that day will come because that is my goal.
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