I don't know about the Tramadol or the Ambien, but I don't think taking 2-3 vicodin per week is too much pain medication. Even at 2-3 a day (vicodin) I don't think that is "too much", but others might disagree on that. My RA does not give me any pain so I don't have any advice to give you, but I hope that somehow you can resolve all the pain you are having. **hugs**

I am so sorry for your pain! I understand your frustration and anxiety while you wait to see if the new med will help. I was told once that when people are in constant severe pain and need something to help them thru it they don't get addicted to it, it's only when they take the pain meds for no reason or in case they hurt that they become addicted, I don't know if this is true, but in your case , I would think if you took them as prescribed you will be ok. I pray your meds help you soon, praying for you.

That's absolutely not too many pain meds. I'm amazed you're able to get by on that few. I have a longer reply for you, but my hands are really not able to type right now. Just wanted to let you know really quick that that's by no means a large amount of pain meds, particularly since you can't take NSAIDs.

Ncgranny, I am so sorry to hear about your pain! I am surprised you have managed for as long as you have on as little as you have. Have you seen a pain management doctor? A good doc will take your needs and concerns into consideration when deciding which meds to use. I have found Cymbalta and prednisone to keep my pain levels "bearable". I use tramadol 100mg extended release for those nights when pain keeps me from sleeping. Unfortunately no days or nights are pain free. I hope you find relief. Will keep you in my prayers. Take care!
Jenn

Thanks everyone. I do have a Pain Management physician but I only use him for epidurals for my bad back. My PCP makes sure, though, that I have some pain meds on hand. Cannot take Cymbalta or Lyrica. Side effects too bad. Oh, I do take Neurontin for diabetic neuropathy. Just anxious that during this bad flare, I do not become too dependent upon pain meds.

Maybe you are confusing addiction with dependence?

Dependence is when your body comes to rely on a regular dose, and without tapering down, you may experience symptoms of withdrawal (easily avoided with a doctor's supervision). It's common with pain patients but nothing to fear, and simple to solve. I've went from 4 norco (Vicotin 10s) for months, now I usually take 3 but as a rare treat 2 daily and have experienced zero withdrawal symptoms. But taking it regularly every day, I would not quit cold turkey without consulting my doc.

Addiction is a behavior (or disease if you prefer) where you are taking more than prescribed, buying them or other drugs on the streets, stealing, using drugs in self harming ways... basically abusing drugs (which includes alcohol). Generally this doesn't just happen in people 30+ who have experience with pain medications and others that can cause addiction 'problems'.

If you've never experienced 'addiction', in my opinion, enduring pain because of fear is only self punishment and lowers quality of life. There is a lot of stigma involved with these meds, but they should NOT apply to people who really need them to function with pain.

I'd very very highly recommend this reading:
http://health.howstuffworks.com/diseases-conditions/pain/medication/addiction-v-dependence-on-pain-medications.htm

I think my fear is not addiction but being impaired. I spend 95 percent of my time alone. I have to be clear-headed in order to drive myself wherever I need to go and take care of myself. I am insulin dependent and it would be too easy to mix up my insulins and mess up the dosage. Too much of the wrong insulin is bye-bye land. (I actually did make that mistake one time.) At 67 years old, my faculties ain't what they used to be and I have to be uber careful. And that is why I am anxious not to take too many pain meds. At the same time, I do need to take some to help with the pain.

Thanks for all your help.

Ahh I understand. And you totally don't like 67! I'm lucky in that my husband is usually able to cart me around. Got a cab company in town? When I HAD to drive, I would take half and get a little relief. I'm lucky enough that I don't have to deal with something like diabetes, that would be rough... I have a hard enough time keeping RA and migraine meds in order. Best of luck, hope you get to feeling better!

I am on Tramadol and Norco and finally they are helping! I had to call my dr. last friday and beg him to give me something else, (Norco).
I am still really tired and don't sleep well, but now I have something else for the pain and it is working for now.

You are not taking too many pain pills. You are just trying to balance your need for relief with your need to care for yourself. I take a tramodol most nights, sometimes I can sleep and sometimes I can't. Seems to me it would be better to at least try and get some relief so you can sleep.

Hi ncgranny,
I can relate to your need to keep your faculties about you. I don't live alone and my wife is a great help, so at night I am more free to take pain meds when needed. However, during the day I work full-time in a responsible, detail oriented job. I make a lot of lists for myself!

I had a spinal cord injury a few years before RA set in, so I'm very experienced with pain medications by now. I do the best with a constant low dose. I recently switched to a drug called Butrans, which is a 7 day slow release patch. I like it because I have no peaks and valleys, and after the first day I haven't noticed any euphoric feelings. Most people will eventually adjust to a medication that they take every day. I used Norco almost every day for years, and the side effects were no longer noticeable at all. I also know that opiate pain meds work better when you take them when the pain is just starting to kick up, not when you wait until you're in agony. It's possible that taking a small dose more frequently might be a better idea than trying to hold out so your total number of pills per week isn't too high.

Good thinking, Care! You should get a cookie or something for that one :D

I went on Nucynta ER awhile back. Didn't like the impaired feeling I'd occasionally get with norco, and didn't like watching the clock, watching until it was time to take the next pill. First I tried 50's, not quite enough so went to 100's, ended up interacting with another med. Worked fantastic at 100mg and never once felt impaired... just felt normal. When I read up on it, I found they use it frequently for people with addiction problems for this very reason - a lack of the euphoria sensation or other similar side effects.

Wow NCgranny, you are going through a lot!!. I am so sorry that you are in so much pain. I don't know how you bear it. When I am in pain, and it cannot be for long because I will be calling my Rheumatologist every minute and something has to be done. If the something does not work, I am on the phone again until I am on the way to feeling better. I was on Orencia, I was on almost all the biologics and now am on Rituxan and still waiting to see how it does the second go round since it is twice yearly. When I was on some other biologics and I would have break through pain or on rare occassions go into a flare, I stop what I am doing and take my pain meds every 3-4 hours Tramadol even though it is ordered twice daily as needed and get in the bed. I do let my doctor know what I am taking and how I am taking it when I am in a great deal of pain. I have been to a pain management doctor when I was having severe pain about 2 years ago and I received Nucenta for unrelenting pain. I think a pain management MD would be to your benefit. Sometimes your body gets used to certain meds and the doctor needs to change them around. And sometimes doctors are reluctant to bump our pain meds up for fear of addiction. When I am in pain, I need my pain medication and I am definitely not addicted. I just cannot tolerate being in pain. If I have no pain I am okay. I think nowadays we are more cognizant of people having overdoses as we have read about so much in the news and afraid maybe we will take to much and not wake up.
I do not think two to three Vicodin per week is much at all. If you were taking that amount per day everyday that may be considered a bit excessive. The thing is your Rheumatologist should want to find ways to control the RA so that you are not in so much pain. Maybe one more dose of Orencia and then on to something else and some other combo. When I was on Arava i loved it and it kept the stiffness andd joint pain along with the biologics at bay. The MTX should be out of your system enough now to be able to start Arava. I had a two week break in between Arava and MTX in the reverse order. Hope you are feeling better soon. Please keep us posted.

I read the other posts NC Granny and it seems most agree that you are not taking too many meds and I see you are seeing a pain management doctor, but maybe he should address your RA pain instead of the PCP? Just a thought. Also when I am in pain, I time my pain meds around what I have to do, drive ect. stay home, and go to work. If I wake up in pain and it is a weekday and I have to work, I will take a 600 of Motrin. I know you said you cannot take NSaids, and grit my teeth and take another Motrin later in the day. When I get home it is Tramdol and a bath. If the pain is eradicated by the next day, I go to work. If I am up all night pain on and off and pain medication all throughout the night, that means stay home. If I cannot break the pain cycle, I call the Rheumatologist and he usually has me come in for an eval and to switch my meds around.

I'm right there with you with the being allergic or having bad side effects from everything. Just went off Orencia, can't stand steroids, so now I'm on very little except painkillers. And you are definitely not taking too much - you're taking much less than I need to just function and get out of bed every day. I take 2 oxycontin 15 a day (it's every 12 hours, and it's never made me feel stoned, so I like that drug much more than most, because I feel like a functional person with it and it's decent at controlling pain), and have Vicodin for breakthrough pain. I usually take 1-2 per day, and am allowed to take up to 4. Since I'm on nothing else (I'm supposed to be starting Arava, but waiting on my insurance right now), I sometimes have to take more Vicodin because the Oxycontin doesn't do the job on its own. I won't take Vicodin while I'm at work unless I'm in really dire straits - it does make me feel a bit woozy and I don't feel as comfortable driving while on it, so I usually wait until after I'm home and don't need to drive anywhere. I also have Mobic 7.5 that I take twice a day to keep the inflammation down. I don't really notice it doing anything for the pain, but I'm sure I'd be worse off without it.

And whoever said something about the difference between dependence and addiction was right. I'm sure that I'm dependent on my painkillers. Probably have been for quite some time, as I've been taking the oxy for about a year twice a day. My body would not like it if I stopped abruptly. But I've never taken it any differently than prescribed, which is the biggest contributor to addiction. So really, take what you need to keep yourself comfortable, within the limits of what your doctor has prescribed. There's no reason to make yourself miserable just because you're afraid of being addicted.