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Addiction--how does it start?

JoyJJoy Posts: 560
edited 06/11/2012 - 8:20 AM in Pain Medications
I had lumbar decompression (L4-S1) and fusion surgery (L4-L5) with instrumentation one month ago today. Have been on hydrocodone and now the doc has cut the dosage down so low I can't stand it. I was taking 1-1/2 tab every 4 hours and now the rx is for 1 every 6 hours. The pain is unbearable for those last 1-1/2 to 2 hours. My question is this: am I addicted to the pain med or am I still having expected pain from the surgery. How do you know when you are addicted? I don't want to go down that road, but when I awake from a deep sleep crying in pain, I need help. Do I push myself to cut the meds down like this or what? Your thoughts will be appreciated.



  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Do you take more medication than prescribed? .... Then you maybe addicted.

    Do you have a history of alcohol or drug abuse? ..... Then you maybe addicted.

    If the pill bottle says TAKE ONE EVERY FOUR HOURS and you take FOUR EVERY ONE HOURS .... Then you maybe addicted.

    If you feel you can't live without them ... Then you maybe addicted.

    If you think you maybe addicted .... Then you maybe addicted.

    SERIOUSLY .. how long have you been taking opiate medications? It sounds to me like you have uncontrolled pain and your Dr shouldn't be reducing at this time. The above posts about withdrawl are correct ... If you have signs of withdrawl .... then your body has gotten use to the med and you are suffering from physical cravings .... Tell us more about your mental and physical craving status.

    Prayers for us all,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • I've been taking the vicodin 4 weeks after surgery and about 2 weeks before the surgery. I don't get any "high" feeling from the drug--only some relief from the pain. It doesn't make me sleepy or anything, so I know I'm not seeking that kind of feeling. My question is, I guess, does withdrawl from the drug result in more of the pain you are seeking to get relief from? Right now my goal for the next couple of days is to take 1-1/2 tab every 5-6 hours instead of the 2 tabs every 4 hours even though the bottle says to take 1 every 6 hours. When I try to go the 6 hours and take only 1 tab, the pain in my back is terribly intense and I can't stand it.

  • I have been taking Vicodin 750's for almost 8 months now. Some days I take 1 some days I take 4-5. It all depends on how i'm feeling and how much pain i'm in the mood for putting up with.

    8 months ago I got to the point where it really did not matter anymore. I was tired of the pain and the thought of addiction was so insignificant that it did not even figure into the equation anymore.

    Narcotics/addiction or daily pain. You have to ask your self whats worse the pain or possible addiction. When the pain becomes bad enough addiction will become an after thought.


  • How does addiction start...

    In 1983 I had just left the military, Worked for Lockheed. I was young and had the whole world ahead of me.

    So there I was at this party. A few folks were snorting this white powder called crystal. I did a line....

    4 years later. No job. No Car. No Life.

  • I understand where you are coming from Joy. You should let the dr know you are in alot of pain. Maybe he can give something that is time release. You are still early out from the fusion. It can be several months before you feel better. My fusion was 10 months ago and I still have problems. Everybody heals differently. Take it easy I hope you feel better.........Hoot
  • No I don't think that you are addicted... see what I've posted below.
  • Let me start off first by saying I don't think that you are addicted. In my opinion, you just don't have your pain under control.

    I for one have gone through withdrawls. I had gallstones and needed to have my gallbladder removed. For a month and a half prior to my surgery was taking 5/500 percocet four times a day. Immediately after surgery and for up to a month, I was taking the maximum dose prescribed (2) 5/500mg percocet every four hours ROUND THE CLOCK. My husband had to wake me up at night to take my med or else I would wake up in the morning SCREAMING with pain.

    I never imagined I would be in so much pain from such a "simple" outpatient procedure. But even with only 4 tiny incisions, I couldn't use my stomach muscles AT ALL! A month after my surgery, I called for a refill, and the surgeon wrote me a script for 5mg vicodin, to be taken every 6 hours. THAT WAS BRUTAL!! Not only was the vicodin not controlling the pain, I was actually having extra pain/anxiety/vomitting, which I was sure was withdrawls. I had pain all over my body, the most terrible leg cramps! I was like a zombie, cried all day, couldn't get out bed, but couldn't sleep at all. It was one of the most terrible things I had ever gone through.

    Now that I have written a novel about me *lol* Lets get back to you.

    If I read correctly, you are getting some pain relief, but only for four hours or so. Are you taking anything else for pain? This is what I would do:

    1st. I would tell your doctor that pain is coming back after 4 hours, see if he will give the ok to take 1 tab every four hours instead of every six. If he is not willing to do so then:

    2nd Ask your doctor if you can alternate vicodin with 800mg ibufrofen. He can prescribe it for you, or you can get it over the counter in 200mg form, and take 4 (ASK YOUR DOCTOR 1ST!) In certain cases this has worked well for me (such as after dental procedures) egxample: take vicodin, 3 hours later take ibu, 3 hours later take vic, etc. So that both meds are being taken as directed... every six hours, and you are getting round the clock pain relief.

    I am not a doctor, I am not a medical professional, and this is just a suggestion. Please ask your doctor about any medication changes.

    I hope this all works out for you!! Please let me know how you are doing. You can PM me, anytime, I am always around =)

    Good Luck,

    P.S. I am sure you already know, but don't take tylenol (acetaminophen) with vicodin, since vicodin contains acetaminophen....

  • First off why would your doctor cut you down like that? What kind of doctor is he/she? I see a Pain Managment doctor who sees me every month and manages my Norco. I think alot of the Neuro/Ortho/Family Practice do not like to be responsible for narcotics. Especially if they get cracked down on because some idiot is abusing them, it affects us who are taking them for a reason! I know my Neuro Surgeon only would give me Nocro for 30 days after my surgery. Um hello I had been taking it for 2 years prior you just can't stop it like that. I think our bodies get used to the opiates and you will have withdrawl symptoms if stopped suddenly. This dosen't mean you are an "addict". If you are taking it as prescribed then you are fine. If you are popping more than you need to "get high" then you have a problem. Its sad that because pain meds are so abused that like I said earlier, we are the ones who suffer!

    Good Luck!

  • I would agree that addiction is more akin to taking medication when you do not need to, and we should all be aware of the volumes we take, it is understandable that time increases our pain to a level that medication alone in adequate dose would bring no relief and is a daily challenge to manage it at all, let alone at a functional level.

    We are then playing catch up attempting to alleviate the existing pain with increasing medication, only finding our own level of performance when pain is not increased through activity would be beneficial and as this threshold has a fluidity of its own making, finding that level let alone functioning below it is problematic and a continual challenge. When we are in pain we should be believed, and adequate medication available to assist in the quality of our existence. I have been expected to live with higher levels of pain that when in hospital my levels were monitored more closely and never allowed to attain this higher level.

    We are our own moderators and even when taking increasing levels and volumes of medication are constantly aware of the implications internally and otherwise, taking larger volumes is not the panacea that people presume, the impact of side effects diminish our capability to function normally and is comparable to the pain we endue and not the easier option that is presumed.

    It is rare that we are tarnished by association and emphasises the need to have a good working relationship with practitioners, for me the benefit of PM teams are that they are more experienced in dealing with patients in pain.Any change in medication type volume or timing will take time to acclimatise, the medication I take works for me, if it does not work for you to are entitled to seek more appropriate coverage.

    You could use a pain diary as evidence and record of what works for you, the level of your pain and when, the McGill pain questionnaire may be useful also.

    Take care and keep trying. John.

  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    that you have an addiction problem ..... you have a pain problem. Take your medication as directed, tell your doctor if you are not getting the needed relief.

    Take care,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • There are many opions on what addition is, including doctors. What I have seen and I truly believe..."Addiction" is to continue to seek drugs of sorts to get "high"! Chronic pain patients do not get high from their perscriptions. Do we build up a tolerance.....of course we do. Keep in check with yourself to be as comfortable as possible, but your goal is not to get high! Tolerance also has been stated to me personally and is not addition, but 'dependant'.........we are not any more depandant on our meds for pain as a person that takes blood pressure meds. If they don't take the meds for their blood pressure, their body reacts......just like ours, exept ours is pain. It does not take much to make our bodies 'tolerant' to the meds and we take more.......we don't get high, however; we need more to control the pain. It is essinial in my mind to keep these meds as minimal as possible as we have really bad days and need more to control the pain.
    Hope this makes sense! I went to emergency over something totally different than pain......obviously you are asked what meds are you taking and I got a darn lecture that was sooooo out of line. It is very easy to get out of control if you don't monitor. I sadly lost my step son with an over dose of still trying to get high....it started with vicodine.....this does not help us as pain patients doing the right and correct dosages.
    Please talk with your doctor!
    Sorry if I sounded lecture on my part.....I am a serious advocate on pain meds for pain patients and it all depends on what DR. you see and their personal opinion. Our pain meds need to be respected!
  • They are various kinds of drug treatments for various diseases. As some People don't know all these things and suffer a lot with their diseases. It could be danger for their health also. For those I suggest them with various Drug treatment centers located near to them. For details on those drug Centers.

    Post edited to remove URL. Solicitation on Spine-Health is not permitted

    Ron DiLauro, Spine-Health Administrator 04/17/09
  • If you are having pain and need pain meds then you are not addicted. I have been taking hydrocodone for 5 months and I have never felt high.....it does take the edge off of pain.
  • Addiction - how does it start?

    I believe that I am addicted to hydrocodone. I really hate to admit it, but I am nearly pain free and still taking it. I am basically taking it because I don't want to suffer withdrawal symptoms if I quit taking it.

    I have been in pain for over a year and started taking hydrocodone 5 months ago. Right now I am taking 9 pills a day, 2 every 4 hours starting at 6:00 am and then 1 pill at night. I want to be pill free before my 6 week post op and have 90 pills left.

    Does anyone have any suggestions on how to ween myself off in 14 days on 90 pills?
  • Bfromaz said:
    How does addiction start...

    In 1983 I had just left the military, Worked for Lockheed. I was young and had the whole world ahead of me.

    So there I was at this party. A few folks were snorting this white powder called crystal. I did a line....

    4 years later. No job. No Car. No Life.

    Have you had any surgeries?
  • Hi Joy, honestly I don't know your surgeon has you on such a low dose of vicodin, even after your fusion 1 month ago. It can take up to a year for you to fuse and feel better, and they know this for a fact. I've seen some surgeons stipulate that they will not prescribe pain meds after a month after surgery; personally I think it's crazy but it's their prerogative to do so.

    I don't think you're addicted either, you are struggling with inadequate pain control. I remember how I was a month post op after a 2 level fusion- OMG was the pain brutal. My pain mgt was in charge of most my pain meds and they increased my long acting med (Fentanyl patches)to help me deal with post op pain. At the time I was taking that and 10/325 mg Norco and 10 mg Valium.

    Now I'm 10 months post op, and have permanent nerve damage and scar tissue to go with my chronic back pain. I moved up to percocets for BT pain and I'm at the maximum for the patches. I find that a combination of pain meds, muscle relaxers, nerve pain meds, and anti inflammatories work best to cope with chronic pain

    As far as taking your vicodin, do whatever you can to stick to how it's prescribed because you'll run out sooner and then you'll run into more problems. I also agree that you should ask for Motrin 800 to take in conjunction with the vicodin. It will help with the inflammation aspect of your pain. I also think it's best for you and your doctor to have a frank discussion about how your pain is affecting your life- they understand it when it is put in those terms. Well, I hope this issue gets resolved so that you won't feel so miserable anymore.

    Hi Pepper, I think it is courageous of you to admit the problem you are having, and I know you truly want to take care of it. Six vicodins are the daily limit because of the tylenol content, so you should really cut down for safety reasons as well. I am no expert on weaning down but I hope someone here can help you with that. Did your surgeon said to come off the vicodin at your post op appt, or is it a goal of yours? I really hope you succeed. Take care
  • How does addiction start?
    It can start several ways. For most of us, dealing with chronic pain, it seems to start when we start taking more than we are prescribed. Ex. dosage of pain med is one tablet every 6 hours, but we feel that we are in more pain that day, don't want to call our doctor, but feel that is okay----just this once to take more,so we do.....and unfortunately, those really bad pain days start happening a few times a month, so for those days, we are taking one or more tablets more at each dosing...before we know it, we are out of pain meds, at first a few days before we are supposed to see our PM/surgeons...then a week or even two weeks short! How did that happen???? We only took an extra pill here and there...
    Or, we like the extra boost of energy we get from the pill, so we decide on one day that we didn't sleep so well the night before and could really use that extra energy boost because we have a huge project due today or tons of errands to do with the family.....so we find ourselves doing the same thing a few times a month and lo and behold, we are in the same spot as our friend above....
    Or, it could start out that our pain is under medicated, so rather than fight it out with the doctor, we just figure we know our pain levels best and are just not into fighting with the PM/surgeon about taking more....so we don't. We adjust our meds on our own, taking more some days and less others to compensate. The only problem is that our pain levels keep rising or so it seems. In reality, it may be our brain trying to trick us into taking more of the meds on those days that we have to cut back to try to have enough meds to last until we see the doctor again...
    Addiction does happen to those of us with chronic pain...maybe not as often as the general population but it does happen and it happens for as many reasons as there are people taking pain meds. It happens because we don't follow directions of our doctors, the ones we pay to treat us...it happens because we like the way the meds make us feel ...at least for a time anyway....or because we think we know more than the doctors we pay to care for us.
    As far as the original poster goes, you said that the bottle says take 1 pill every 6 hours...then that is what you should be doing. If you feel that you are in more pain than the medications can cover or are covering, you either need to discuss it with your surgeon ( he may not realize that you still feel that you need the meds more often) or he may feel that at this point, you are doing physically better and therefore need less medication. If you are not happy with the answer from you surgeon, you can always make an appointment with a PM for an evaluation. Most surgeons these days will automatically start a tapering schedule for post op patients after 30 days, unless there is a specific reason why they should not. You won't know what his reasons are unless you ask him directly.
    For the poster who thinks she is addicted. The best way is to taper the medications. The usual standard taper is about 10% of the current dosage, so instead of 9 pills, you would take 8 for two or three days and then cut that by another 10 % every three days or so, for the most comfortable/easy taper...some doctors go faster at about 20%, and that is usually pretty tolerable as well. Not much more than that and the three days gives your body time to adjust to the decline in dosage without traumatizing your body and causing major withdrawal. Not everyone can stick to a taper though. If you have a family member you trust to hold your meds for you, it might be better. The best option however, would be to talk to your doctor and ask him for a taper plan suited to you.
    Best wishes to you both,
  • Thanks Sandi for the tapering information. That is helpful. It's going to be hard to get off of hydrocodone especially when I am having pain today, but it's nothing that tylenol can't handle.
  • Hi Pepper,
    You're quite welcome. I do hope that you are able to taper your meds on your own. It's not really that hard to do, if you are determined, especially if you follow the taper religiously. It's helpful to have someone that you are accountable to, other than yourself too, if you find that you are still tempted to take more than you are supposed to.
    You may still experience some withdrawal symptoms, but those can be managed with some over the counter meds to handle any diarrehea or upset stomach problems and they are uusually pretty mild compared to stopping completely all at once.
    I wish you success.
  • some of the other more innocent looking meds need to be tapered for withdrawal too!
    ---basically any med you have taken long term, your body has become used to it, and will crave it when it is gone!
  • you are on a far too low does{in my opinion} .in this day and age you should not have to be in much pain .i do know what i am talking about because i was going through 28 days worth of pain meds in 15 days not because i am an addict but because i am in pain and the idiot of a consultant had not work out how many pills i required .i talked to my doctor and after a consultation with him i am now on the correct amount of sustained and breakthrough meds.and i have been on this does since my last operation {Nov 07} .you may be having problems with addiction if you wake in the morning WITHOUT pain and still want your pills.i am woken every night after 3 hours sleep and i have to take more medication and end up sleeping on my recliner .like most people on narcotics i will have some degree of physical dependence on my pills because my body require them to deal with the pain..i dont have a problem with the fact i am on narcotic i know some folk have a problem with it .but if you are in pain and likely to be for the rest of your life whats the problem .i see it like a diabetic you would not have a problem with a diabetic taking his/her medication every day would you?
    only you know if you have a drug problem .if you feel that you have { and from what you have said i dont believe that you have a problem ..only the fact that you dont have enough!} then talk to your doctor .if on the other hand you are in pain and your doctor wont give you enough pain killers then go and see another doctor ..they and not always right you know!i started on 10 mg of oxycontin 2 times a day back in 05 after another operation and major back problems i am up to 80 mg 3 times a day with up to 8 x20 mg of the instant type if required and i normaly have to take the 8 in a 24 hour period if you were wondering that's 320 mg a day ..that may sound like a lot but i have been on it for over 18 months and not had to up the does any more .pain control is just that control you can never remove it all the time you would require too much to be pain free and it would kill you.but you should be able to do most things like wash your self make some food etc with out being in to much pain .if you carnt do stuff like that you are not having enough meds .

  • Along with the list of the other meds, soma, baclofen and I'm sure that other can add more to the list of additional meds that have to be tapered before stopping them.
    Tramadol ( Ultram /Ultracet)
    are just a few of the others that need tapering

  • I firmly believe that addiction starts at the exact moment you lose proper respect for your medications and has absolutely nothing to do with pain levels.
  • I agree with you Bionic Woman, and I also believe that it starts the second that a patient decides that they know better than their physician how much pain medication they "need".
    I've been in Pain Management on and off for 15 or 16 years , first for RSD after a botched shoulder reconstruction and now for the problems that I developed after my first back surgery and missed CES.
    I have never once taken more of a pain med than I was prescribed, and never once thought that I knew better than my doctor. It doesn't make me better than anyone else, but it does make me respectful of the physicians that I see and of more importantly, the medications that they have put me on.
    I built a relationship with both of my PM's of trust and reliability. I rely on them to take care of my pain levels so that I can function as best that I can each day, and they rely on me to let them know if a medication is not working as well as it should be for me, or needs tweaking after being on it for some time. I don't ever expect to be pain free, but I do expect to have my pain levels somewhat controlled so that I can function in my daily life.
    PM is a two way street, and while I know that there are good and bad PM's out there, I also know that there are good and bad patients as well.
    Pain management is not about being pain free, but it should be about keeping pain levels in control enough to allow the patient to function and perform the adl's that we all need to be able to do in order to have a comfortable life.
  • well from what i have read above i doubt you are addicted!!!!!!
    get to the doc and get it sorted noway on this earth should you be suffering in anyway you have done enough of that previous to your op!!
    so many docs just dont get it and i think most of us have came across a doc like that in our time of suffering.
    good luck

    LOVE P
  • I now see why the world is all messed up...

    It blows my mind that a year ago I use to frown upon and look down at pill poppers and drug addicts...flash forward to 2009 and I would literally kick in a door and stick a pistol in somebodys mouth for a bottle of percocet and have not a drop of guilt nor feel no remorse in doing it..Sadly it took me a hard lesson in pain 101 to understand drug crime and the more complex problems in society. I hope this does not lead to me getting locked up this weekend...

  • Suboxone, I read over and over people recommending sub for avoiding withdrawals of pain medication, but that is not what it is meant for. It is meant for helping drug addicts to help get their addictions under control, and long term management to keep them off drugs.
    It is also used ( when properly used that is- to manage chronic pain in those with a history of addiction too)
    Withdrawal from pain medication is not that bad. It is over in a few days, with the exception of methadone. In most instances, you will not die from it, and if the tapering is done correctly, most will not experience full blown withdrawal in the first place.
    Suboxone withdrawal is just as prolonged as withdrawal from methadone for those who do go on it.
    I believe it has a place in the world of addiction and addiction + chronic pain, but it is not for the every day joe , who is withdrawing from pain medication post op, or to manage chronic pain in those who don't have a history of addiction.
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