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3+ years on Pain Meds, Finally Getting Off of Them!

Hello all,

PM here and I'd like to say I find this forum much better than most. Some seem like people trying to figure out how to get drugs and not solve the situation at hand.

SO here's my situation and how I resolved it:

I had (HAD being the operative word) a torn biceps/labrum tendon in my left shoulder and it is my non-dominant arm. I had this happen to me in late 2009 when my COBRA coverage was ending after I was let go from my company in 2008. Great time to have an injury right? I am an athlete and always have been. I play sports whenever possible -- doesn't matter what it is. I tore it a little playing tennis. Then a little more playing basketball...then finally the "kill" shot was a backhand ripped (literally!) down the line while playing tennis. I was in so much pain that I went to my PCP at the time since I was within the 18 month period of COBRA coverage. Also during this time, Obama had put through a COBRA subsidy so instead of paying the full premium of close to $450/mo for health insurance...it dropped to a manageable $130ish a month. I don't remember the exact amount. But anyway after seeing my PCP and then a surgeon I had an MRI and I could have told them what they saw -- a labral tear in the biceps tendon that connects to the shoulder joint.

The day after I had the injury I went to my PCP and he prescribed an anti-inflammatory and Vicodin 5-500. Since he did not know right away without scans what actually happened he just kept giving my Rx's of Vicodin. The Vicodin went from 5/325 to 10/325 in about a year so that brings us to 2011. I had been on Vicodin 10/325 for years. I would get 100 tablets and the instructions read take 1-2 every 4 hours as needed for pain. So that's 12/day if people are counting. I would get a refill every week for 2+ years. I then had to switch PCP's because I moved and my current PCP gave me the same Vicodin...but lowered my dose from 1-2 every 4 hours to 1-2 every 6 hours for 3 months and then finally we settled on 4 tablets a day. I went from 100 per 5 days to 120 tablets per 30 days. After the first year of taking the pain meds, I didn't even really need them. I took them because I was hooked mentally and physically. I honestly couldn't function without taking 2 tablets right away when I woke up every morning. It was terrible but my doctor knew my health insurance was going to lapse and had lapsed after a while. Luckily (I guess) I got some kind of discount card but my Rx's went from $10 per to around $40 per. There was a time I was paying close to $80/refill! It was insane.

I then moved to MA where health insurance is mandatory. I had found a great new job but messed that up as fast as you can read this. It was due to my meds and drinking. Drinking on pain-killers for those who have a high tolerance is not good no matter what...but a few beers mellowed me out pretty good on football Sundays. My problem was that I had no end in sight. Every 3 months (after I got fired) I would see my PCP, get my 120 pills with 2 refills and be on my way. All of a sudden June of this year, I had to sign an Opioid Treatment Agreement with my PCP. Obviously they can check to see if you're getting pills elsewhere or stronger ones from a different doctor because I had health insurance. The mandatory health insurance in MA saved my life. It's not because of an accident -- it's because I was (and still am) mentally and physically addicted to pain killers. That's the bottom line. It happens. It creeps up on you like a little campfire into a wildfire and finally I had surgery. I explained to my surgeon the medication I was taking as he spoke with my PCP as well. He had never seen someone so physically dependent on the meds. So as I type this I am currently tapering down from the Percocet AND Oxycodone Rx's (he gave both -- the oxy for breakthrough severe pain). I started off with 2 every 4 hours of Percocet and 1-4 tabs of Oxycodone 5mg every 4 hours. I was a walking zombie but I also had surgery.

I am writing this because it's a release for me (I am also in therapy if people can't tell) and so now I'm down to 2 Percocet's every 8 hours and 1-2 Oxycodone 5mg every 8 hours. Problem is...my 8 week Treatment Agreement with my surgeon is coming to an end pretty damn soon and I have 2 refills left on my Vicodin that I got in June that I obviously never filled. I am happy to say that I only really take the medication after physical therapy and at night! It's great. I don't think I could be happier. I have one more refill(s) of the Perc and Oxy (both 60 count) to get me past the 8 week mark and then I'm back to my PCP. My problem is my tolerance now. As great as I can say it and type it -- it's not the truth. My tolerance is through the roof on these pain meds. They last probably a day or two before I can refill again.

I am going to have to be honest with my PCP and tell him that physical therapy is seriously making me go through more pain than I remember. I had ACL Reconstructive Surgery in 2003 and I barely took the Vicodin 5/500!! Now look at me. One of those is pretty much a Tylenol. I wouldn't even feel it. I am asking people here how to approach this situation with my Surgeon and PCP. Once I run out of my Perc and Oxy, I won't have anything. But the goal is to be off the meds halfway through physical therapy. If I can go back to taking an Aleve once in a while (like once every couple weeks after a hard match playing tennis) or an Advil...I will be the happiest person in the world. I don't want to be on these meds and the people at the pharmacy look at me now as someone who is solving his problem via surgery because they can tell by the way the Rx's are written that I'm tapering down. It seems like they're happy too.

Question again is: what do I tell my PCP when I see him AFTER I see my surgeon again? Should I refill the Vicodin that I have leftover from the previous script after my 8 week agreement is over with my surgeon and go from there or should I not? He's not the type of PCP who really cares either so he won't return any call asking what I should do. I feel like I need an Rx of Oxycodone of a stronger strength while I go through physical therapy and take the Vicodin as needed. That's my thinking. My PCP will prescribe the Oxycodone if I ask I'm pretty damn sure because he'll be happy he's done prescribing narcotics to me. I just don't know what to do! Please help!

Thank you for reading all of this, whoever you are that might respond. I truly appreciate it.

-PM45
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Comments

  • Most every doctor I've ever been treated by and worked with deal much better with patient's who tell them the truth instead of finding out through questioning and drug usage reports that your not being honest about something. I do have one suggestion for you; when you see him again I wouldn't ask for a drug by name. Explain what your feeling and let him be the one who suggests a medication to begin. It never hurts to be educated about the medications you may take and do ask questions about the medication he prescribes. There's nothing wrong with being an "educated" patient. If you ever read your medical reports from the doc, you are referred as being "educated" if you ask questions regarding side effects and how well the med will work for you.

    Hope this helps a bit.
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • EMS Guy,

    Thank you for your response. I appreciate it. I know what I'm going to do -- and it sounds weird but I think it's my best course of "action" if you will. I have one more Rx remaining sitting in my drawer of Oxycodone and one more of Percocet. Both the 5mg ones except the Perc has the 325 of tylenol. Both are for quantity of 60. I cannot fill them until August 24th. I do not see my surgeon until September 9th and then my PCP September 10th. Perfect timing right? Not actually how I drew it up but it's the way it is. I am going to fill my Vicodin tomorrow because I have to go to one pharmacy according to my Opioid Treatment Agreement with my PCP. I will be out of my Percocet and Oxycodone before the 24th just due to my tolerance. I am not taking more Percocet than normal because of the tylenol content...but I am taking more of the OxyIR and more frequently due to the pain. It's still physically there and it's not the mental or physical dependence talking. There's legitimate pain that 10 years ago wouldn't phase me but now my tolerance for pain is very low. It stinks. If you read my story about ACL Reconstructive surgery and barely needing the lowest dose Vicodin then, it boggles my mind. My plan of action is to fill my Vicodin tomorrow and wait until the 24th for my Percocet and Oxycodone. The reason I cannot wait on the Vicodin is that the Rx is at the pharmacy near my PCP and surgeon. My Opioid Treatment Agreement clearly states that I have to get the Vicodin at one pharmacy only and it is 2 hours away. But I'll be there tomorrow. I can fill the Percocet and Oxycodone on the 24th as that's the earliest I can. I have the written Rx from my surgeon. He wrote out 6 Rx's that date and post-dated them. He said if I needed to fill them earlier to give him a call and he'd approve an override. The thing is -- I don't want to get the override! I feel like I can handle the pain and am going to try but want the Vicodin as a backup in case my pain is unbearable. I do not want to take more tylenol than 3g/day. I know they say 4g/day but I'll play it safe and stick with 3g/day. The percocet just doesn't do anything anymore. It's turning into a placebo pill!
  • EMS Guy,

    To continue to clear of confusion: I can go to any pharmacy to get my Percocet and Oxycodone Rx's because my surgeon's OTA doesn't state a specific pharmacy PLUS you have to have a new Rx every time. Not for Vicodin. Do you think I should hold off on picking up the Vicodin completely and just waiting it out? If I don't hear back from my doc's tomorrow I'm kinda screwed from August 31st until September 10th when I see my PCP. My refill on the 24th of my Perc and Oxy will get to August 31st. My OTA agreement with surgeon ends August 27th. That's my dilemma to clear it up. I won't be risking anything by obtaining the Vicodin Rx because I want to be off the opiates for good. If it gives me unbearable pain I'll take an Ibuprofen 800 haha. I just don't know what I should do regarding whether or not I should pick up my Vicodin Rx. My PCP won't care...I know that. And then when I see him next I'll tell him what's going on. Worst case scenario: I have 120 Vicodin's left and that's it. That's in addition to the Percocet and Oxy I will fill on the 24th.
  • EMS GuyEEMS Guy Posts: 926
    edited 08/19/2013 - 3:37 AM
    I would go ahead and fill it so that if the doctor does give you a plan to wean off of everything, you've got it available to do it. Also, if you explain to them the geographical separation of where to get your meds filled, they may approve a new pharmacy closer to where you live.

    I wouldn't just quit the meds cold turkey. You may get quite sick and have even more back pain than you did to get put on the meds in the first place. When your body starts to detox from stopping cold turkey, you will feel like it's the worst case of the flu you have ever had. Not pleasant!

    Good luck!
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Hi EMS Guy,

    I appreciate you responding to my inquiries. I filled the Vicodin today (120 count 10/325 strength) in the location where my PCP is. It's not far from where I normally live. My surgeon is actually just 20 minutes north of where my PCP is. The thing is, I am recovering at my parents house from the surgery because I cannot drive and do some simple tasks until my physical therapy is over. I refuse to drive being on percocet and oxycodone. I know the main ingredient in percocet IS oxycodone but I like to repeat that I receive a Percocet 5/325 Rx and an OxyIR 5mg Rx. So anyway I was in the area that's 2 hours away today for blood work and some other appointments and picked up my Vicodin Rx refill. Since it was already at the pharmacy, they put it through. Then my surgeon's office called after 3 days of leaving messages and says "we'll give you another Rx after you run out of the Rx you're going to fill on 8/24 of Percocet and OxyIR. I almost flipped my lid. I explained to her that I had already gotten a call from my PCP's office saying they spoke with my surgeon and they ok'd the refill of Vicodin. I live in 2 states technically. I reside in both Massachusetts and Rhode Island. MA has very strict laws on controlled substances (i.e. they write your Driver's License # down on the Rx and put it in the computer when you drop off AND pick up the Rx). This is to prevent any chance that someone else steals your script or puts in an order for refill over the phone without you even knowing and then picking it up. I actually use CVS and have asked them to put "ID/PATIENT ONLY PICK UP" followed by my address that's in MA. So back to the surgeons office. When she called the FIRST time she had no idea what I meant by my messages last week. So she basically didn't understand what I wanted from the doctor. I told her I wanted his advice on what to do from September 3rd-September 10th when I will not have any pain medication. She finally realized that the last Rx she is giving me (she's the secretary to my surgeon) will be filled this coming Saturday or Sunday when I get around to it. I told her that it would last me from the 24th to September 3rd. She said she would call me back. While she's doing whatever for a few hours I get a call from my PCP's office saying to pick up my refill they ok'd at the CVS I put down on the Opioid Treatment Agreement. My PCP is fairly flexible where I can get my meds. You can only transfer controlled substances once with CVS. I'm assuming it's the same with all the major pharmacies. So I get my Rx of Vicodin and before I do I told her (the PCP's secretary) that I am going to be filling my percocet and oxy on the 24th or 25th and she said that's fine. My PCP wants me to hold onto my 120 pills of Vicodin 10/325 until September 3rd she says or a couple days prior -- whenever I run out of my supply from my surgeon. As you may recall my surgeon's OTA ends Aug 27th but when his secretary called me after I had filled the Vicodin and told me she will give me another Rx on the condition that I sign another OTA form saying I will only get narcotics from them for the week of September 3rd-10th. Seeing as I already had the Vicodin in my hand and on my way back to my parents house in RI, I told her I would call her tomorrow to explain everything because I NEED to figure out what I'm going to say. I'm obviously going to tell her the truth that I was concerned from any kind of withdrawal AND someone called from my PCP's office!! It wasn't like I just refilled it online and picked it up like I usually would other Rx's. She asked when I could pick up the Rx before I told her I'd call her tomorrow. So basically this is what's going on:

    (I am going to leave out the fact that it was all nurses and/or secretaries)

    1. I get a phone call from my surgeon saying she's sorry she hasn't gotten back to me because she was away at the end of last week. She said she wanted clarity on my message. I told her what was going on and she said she would call back. This was at 11:50am

    2. I get a phone call from my PCP around 3pm saying to pick up the Rx since I'm in the area. The doctors are being very nice and accommodating to the fact that I am only in the area once every few weeks so she said to get the Rx. I had assumed she had spoken to my surgeon because why else would she randomly call me to pick up the Rx right?

    3. The surgeon calls back at 4:47pm and tells me she will extend my Rx and give me another week as long as I sign an extension of the OTA with the surgeon's office.

    I am SO confused now. My PCP never calls me. This is the first time in the year+ I have EVER gotten a phone call and she said to pick up one of my last refills on the current Vicodin script. I assumed she spoke with the surgeon or else she knows that my surgeon is prescribing narcotics already.

    When I call the surgeon tomorrow I am going to be honest and tell her I was very confused today (which I am!) plus I was really sick from allergies. They're coming earlier than normal in the New England area this year. The weather has been sucking lately (temperature wise). It should be in the 90's.

    But anyway -- I am going to tell the surgeon that hey, I assumed the PCP talked to you but apparently they didn't because you're saying to sign another treatment agreement not knowing I filled the Vicodin. I will let her know I filled the Vicodin per my PCP's phone call, and that if it's okay, I'm going to fill the 2 Rx's I still have on the 24th/25th of the Percocet and Oxycodone. Even thought she said she wants to give me a script from September 3rd to September 10th when I see my surgeon on the 9th and PCP on the 10th, that there's no way I can even make it up that way to pick up the Rx's and that I will just stick with the Rx's I have now. I think that's the best route. I could always play dumb...and I really am dumbfounded that my PCP never spoke with my surgeon or else she wouldn't have told me to fill the Vicodin and the surgeon wouldn't have offered 2 new Rx's to be filled on September 3rd. I'm confused writing this.

    Let me know what you think!
  • You should thank your lucky stars that you have been on on a relatively low dose of opiates for the 3 years, it will make it that much easier to stop them. I wish you luck in your endeavor. I'm in the position to have to take a very high dosage of opiates everyday in order to function minimally. I am very thankful to have no issues with addiction, but I do know that I'm at least physically addicted to opiates. I combat tolerance and super high dosages by switching the type of opiate i take every few months. Again, i wish you the best of luck. you can do it.
  • TuffStuffTTuffStuff Posts: 11
    edited 09/13/2013 - 9:23 AM
    Having read this gentlemans story..it occurs to me that most everyone THINKs that people get ADDICTED to pain meds, Ive heard it for YEARS..but I believe that it is an individual thing..sure, it can get physically addictive, because it IS a physical chronic condition in MY body; whom can tolerate such excruciating pain? I 'thought' I had an okay tolerance, considering as a woman, Ive had C-sections, natural child birth (at age 18 no less - a nightmare indeed); various operations through my life, and I was stronger than some folks..so when my herniated discs made their prescence known..I of course was put on narcotic pain meds by my primary doc ( I was a county clinic patient then..later I was awarded Disability, and with it, Medicare/Medicaid), and I NEVER ever abused them..in fact, I took less than prescribed, just enough so that I could function. I complied with all requirements by Doc..and so suddenly, when I moved to Dallas, , I had to find a pain management doc., whom was wonderful & took right up with my regimen; then a yr later, I moved back here to S.TX.to spend the last two months of my dads life with him, I went.back to original primary physician, he continued for 3mo. before he left his practice, I was left "in the dark" so to speak...suffered a lot before being referred to a pain mgmt' doc whom has refused to give me any more meds other than the ONE I initially talked him into...but with conditions. I was to WEAN off..then - consider the injections he offered, which I was scared of..but having NO CHOICE, I went ahead, humored them...they ignored all my pleas to NOT do it, based upon my general health, etc.etc., and .. I got WORSE! I refused to do any more injection(s)..so what was left? I cried because I have never felt so badly...and without ANY relief, I realized HOW bad my condition had turned., now .. there is no remedy other than to try the Spinal Stimulation ( or surgery )...I feel that I have undergone a tragic situation...it kills me to think that for some folks whom ABUSE...(and I know there are lots) the ones that do NOT..have to suffer, whatever happened to my civil rights? I was doing just fine on those meds., and now? I am starting to see why some people actually do end their lives., the pain is unimagineable...and mine is not even as BAD as some others, I am not so much feeling sorry for myself...but JUSTICE eludes me., I have done tons of research on areas offered to me, *as on the spinal stimulation thread* .. I find myself 2nd quessing all 'remedies'...Unlike Pedro, I am NOT happy that I had to give up the meds, as problematic as being on them can be...it is WORSE to not have some relief., I am still young enough to want so much more from my life...I have much to look forward to..yet, this pain puts a MAJOR damper on my life, its hard just to walk...to get into & out of...any vehicle, etc.etc. I AM going to do the trial on the Spinal Stimulator, but it is with dread.
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