Chronic Pain Support Group

Physicians and professionalsdefine pain as chronic if it lasts longer than three to six months and is persistent. It's distinct from acute pain that is a direct result of injury or trauma. This support group is dedicated to those suffering from chronic pain. Discuss treatments that have worked for you, find advice for your specific experience, and find support. You're not alone in your pain.

2 Online

Newbie

hey everyone I am new to this group & have some questions. I have been taking 4 hydrocodone 10/325 a day for roughly 3 years now. I have rheumatoid arthritis & levoscoliosis plus possible lupus.  My doctor just switched me to 5 10/325 oxycodone a day (there's no way I will take 5 that's crazy I weigh 100 pounds) will switching over cause me to have withdrawl? I've went down to 2 a day alternating the oxy & hydro. Do I need to taper or just go ahead & switch? Thank you!

Replies

OlderCPer
OlderCPer

So welcome to the Group. You don't have withdrawals when you're going from a weaker Narcotic to a Stronger Narcotic. You've been switched from Vicodin to Percocet. You don't need to taper from one to the other, just take the Oxycodone and stop the Hydrocodone. These are short acting med's meant to be taken every 4 - 6 hours, they have a halflife of 2.5 hours, which means half way into your dose, the meds are wearing off. For your conditions and the length of time you've been taking pain meds, its a bit unusual that you're taking Short Acting meds instead of a Long Acting med on a once a day or twice a day dose.

FYI 5 Percs a day is not a high dose of pain meds for someone with Rheumatoid Arthritis. You do need to be aware of the Tylenol amount if you do take 5 pills a day, that's 1625 mg. of Tylenol a day, edging over the 1600 mg daily max. Tylenol (Acetaminophen) is not good for the Renal System, the less you take the better. I have Rheumatoid Arthritis, Advanced Osteo Arthritis and 7 other Diseases I won't bore you with and I take Long Acting Morphine with pure Oxycodone (no tylenol) for Breakthru pain, Flexeril (muscle relaxer) 30 mg, Ibuprofen 2000 mg; those make up my Pain Management cocktail.

Having said all that, if you're only taking 2 pain pills a day, then it seems you don't need the amount of pain meds that your Dr. thinks you do. Your Dr. prescribes meds based on what you tell him your pain is. The downside to you taking such a reduced amount is, if you get called in for a random urine test, you won't have near the amount of Narcotic in your system that you would be expected to. That can raise a red flag for someone selling their meds. You can handle that how you like, but if you're getting RX'd 5 pills a day but are only taking 2 pills a day, you probably need to have a talk with your Dr. about your pain med needs.

Take care,

Kat
keatonsmm
keatonsmm

I'm only taking 2 hydrocodone a day the rest of the day i take the Percocet. I total 5-6 pills a day at the moment due to flaring. She does overprescribe me always has. at this point I do need more although months from now maybe I won't. My goal is to eventually get off these meds. I also take Celebrex which is amazing! I don't know why she hasn't put me on a long acting medicine. Where I live abuse of meds is really bad maybe that's why? Thank you for the reply! I hope you feel better!
OlderCPer
OlderCPer

Okay, so you need to stop the hydrocodone and only take the Percocet your prescribed now. The hydro is weaker than the Percs, with the halflife and cross tolerance reduction, you only get about an hour and a half to 2 hours max pain relief from the hydro, its a waste of a 4-6 hr dosing med.

Have you asked about a long acting med? Generally they are less abused than Hydro's and Percs. The Celebrex is for Nerve/Rheumy pain and is probably giving you more relief than the Percs. It doesn't always work for people but when it works it's great. I have BiPolar Disorder and Celebrex and other off-label nerve meds tend to make me Manic, so I can't take them. Glad you get relief with them.
keatonsmm
keatonsmm

I haven't asked about long acting. I'm just now learning they even make such a thing lol. I'm guessing it's a time release type of med? I can't imagine how much pain I would have without celebrex considering how much I have with it. If I skip one day I know it real quick.
OlderCPer
OlderCPer

That's really great, if you can get pain control from a non-narcotic, its good.

Long acting pain meds would be Morphine, Oxycontin, Kadian, Methadone, Opana or Fentanyl. They are generally RX'd twice a day, 1 every 12 hours or 3 per day, 1 every 8 hours, depending on how your pain is controlled. I find that taking a smaller dose 3 times a day, controls the pain with less flares than when I took a larger dose twice a day. With your description of your pain and how it's controlled, Morphine (MS Contin) or Oxycontin (a Long Acting Perc with no Tylenol) would probably be where your Dr. would start if you got them to switch, these are the 2 safest, standard LA meds. Fentanyl should not be used unless nothing else worked as a last resort. Fentanyl is the strongest Narcotic a person can get outside of a hospital, its 100 times stronger than Morphine and is delivered by transdermal patch. Methadone and Opana (Oxymorphone) are the middle range newer meds used for long acting pain control.

It's good info to have in case you ever want to have that conversation with your Dr. The short acting meds you're on now work, but you have the whole peaks and valleys thing to deal with, so your pain is never steadily controlled. The long acting meds build up to a therapeutic amount in your Blood Plasma Level and don't wear down between doses, so the pain is evenly controlled if you take your doses timely.
ItsJustMe2012
ItsJustMe2012

They make Extended Release Hydrocodone. They also make Extended Release Oxycodone.
keatonsmm
keatonsmm

Thank you guys for all the info! I'll ask my doctor about it the next time I go in. Luckily I have a great relationship with her so bringing it up wouldn't make her think anything bad. It's scary to ask for stronger meds. I always feel like they're going to think I'm a drug seeker!
OlderCPer
OlderCPer

And my best bud picks up my slack when my brain forgets one! lol BTW LA Oxycodone is Oxycontin! I covered that one.. ssppllbbtttt!!! lol

Thank you, my friend!!!!
OlderCPer
OlderCPer

With MS Contin (Morphine) and Oxycontin (LA Oxycodone) your not really asking for stronger meds, your asking for a different formulation of a med you already take, that is easier to take and keeps your pain more level and controlled. So try to think of it like that. And honestly, my PM is a friend, she's been my Dr. for 17 years and we have lunch once a month. They don't think drug seeker when you ask about something that is the natural progression of things. Most prefer not to mess with short acting meds because they have a high street value, and when your taking 5 or 6 a day, its a lot on your Renal System. She's been treating you for a while, I'm sure she's thought about this at some point or other.
fibrolizzy
fibrolizzy

I haven't been on here in a long time, so I was just reading through the posts, and I automatically am interested in the ones about short acting meds compared to long lasting. I'm currently on 4 norco a day, but I'm either going to ask my doctor to let me switch to Percocet or try a long acting med. I've been thinking about that for quite a while. I feel like I fight my pain all day. Even taking the norco, I still hurt quite a bit.

I really appreciate the great info from this post! Thank you.
OlderCPer
OlderCPer

Hey lizzy,

You've been on SA meds for quite a while now havn't you? I'd definitely have the LA med talk. With the Norco and its short half life, your pain is barely getting covered before the meds start to wear off. All those Peaks and Valley's when your in pain can drive you mad. I hope you find some better pain management.

Its nice to see you back!

Kat
fibrolizzy
fibrolizzy

Thank you, Kat. I made an appointment with my doctor (GP) for this afternoon. He's the one who still prescribes my pain meds. He's known me for about 30'years, so we have a great relationship. This switching of meds makes me nervous. Not so much switching to Percs, but going to a LA med seems scary to me.
keatonsmm
keatonsmm

I agree the LA meds are def scary! Know what to expect with the SA so I'm not afraid of them. I go next month & im going to ask my pain doctor about the longer ones. I always worry about meds due to the fact I'm so small.
OlderCPer
OlderCPer

If you think about it logically and break it down so, it might not seem so scary.

Percs are just Oxycodone with Tylenol, then you have Pure Oxycodone for people like me with Renal issues who can't take Tylenol. Oxycontin is the Long Acting version of Oxycodone, the only difference in the medication is that its formulated so that it releases medication over a 8 - 12 hour period. By doing this the narcotic in your Blood Plasma Level gets to a therapeutic dose that does not drop off, like it would with a Percocet after a few hours. Your the medication continually releases portions throughout the day or night, and after your first dose there is no uncovered time, by the time you take your 2nd dose 12 hours later, that pill just releases medication slowly into your system. This way your pain is always covered. You're not constantly playing catch up with the pain.

Society, the Government, FDA, CDC, etc. makes the medications sound scary, but they aren't any more "dependence causing" than the short acting versions. Its just a time release that's built in so your not fighting the pain. And pretty much all of the LA meds, except Fentanyl have a short acting version, so your not taking this whole new medication that you've never had before.

Its a psychological step that you have to get past in your brain, that fear barrier, but generally LA meds are safer than short acting meds, as your not taking them all day and taking more than you should because it still hurts, and your not getting all of the acetaminophen that is really not good for your liver and kidneys.

Honestly, I've been on them so long, I don't remember having to mess with the short acting ones, but I know I prefer to take 1 pill twice a day as opposed to having to remember to take multiple pills every 4 or 6 hours. And generally if you've already been taking narcotics for a while, there's no euphoric feeling, no wackyness. I drive, I work, I do all the normal stuff that my crappy body will let me do. lol
keatonsmm
keatonsmm

That weird feeling is what I'm afraid of. Since I am a stay at home mom I don't want to feel all "drugged". I get it with any new pain med but it goes away quickly. Usually a couple of weeks.
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