Purple
Enthusiast
Reged: 07/15/03
Posts: 233
Loc: Midwest
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I have been here 2 months now and reading all the boards/threads. I posted this question before and I don't want to do a poll. I currently order from a few OP'S mentioned here, HOW MUCH IS TOO MUCH? in terms of taking Lortab 10/500's? I take for headaches & back problems.Let me just say that my tolerance has grown very high and without telling everyone how much I take on a daily basis, please give me your HONEST input as to how much is TOO MUCH before I am into addiction!! (I feel I may already be there) and I am being 100% honest that I know I am taking way too much, but when/how do I stop short of going into rehab? Nothing else works for me except for narcotics, my PCP says that's the way I am. He has given me Vicodin 5/500 but that does not even touch the pain. I have ordered from OP'S mentioned here, but when is enough????? How do I stop from being so dependent on narcotic's? I tried a holiday but it did not last long. Is it time for me to stop for good? If so, what do I do for the pain? I have tried EVERYTHING out there! Please advise your honest opinion -----PLEASE!!!  How did I get this way?
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james001
Stranger
Reged: 09/15/03
Posts: 3
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I feel you're already addicted. The only way to come off other that rehab is to ween yourself off. Switch to the non addictive Ultram. This won't be as good on the pain but you'll be better off then on the Lortabs. Immodium will help with some of the withdrawals too. If you're taking more than the precribed dose you're abusing them. I've been through this, you can do it but it wont be easy. Hope this helps.
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hkristof
Journeyman
Reged: 09/10/02
Posts: 65
Loc: Houston
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i agree that weening down is the best way to go, but ultram is no longer considered non-addictive. from RXList:
"Tramadol HCl has a potential to cause psychic and physical dependence of the morphone-type (mc-opioid). The drug has been associated with craving, drug-seeking behavior and tolerance development. Cases of abuse and dependence on tramadol HCl have been reported. Tramadol HCl should not be used in opioid-dependent patients. Tramadol HCl can reinitiate physical dependence in patients that have been previously dependent or chronically using other opioids. In patients with a tendency to drug abuse, a history of drug dependence, or are chronically using opioids, treatment with tramadol HCl is not recommended."
i imagine that it is different for different people, but i have experienced both tramadol and hydrocodone withdrawals, and for me the tramadol was worse. your mileage may vary.
anyway, i would suggest that you start with some even number of pills and make an actual written schedule of the number of pills that you plan to take a day. try to slowly decrease the amount that you take over time. you might try to take a potentiator with your pills to increase the pain killing effect of each pill. tagamet is said to work well. you also might try replacing a nighttime dose of vicodin with a valium and an aleve or ibuprofen. this works for me, though i know others for who it is completely ineffectual. valium can also help with withdrawal symptoms, though it is of course addictive as well. immodium, as mentioned above, is vital for withdrawal. i suggest doubling the recommended dosage at first, then adjusting depending upon your needs. there are other things that help, some over the counter, some RX. Do a search on google for "opiate withdrawals".
As far as a holiday versus stopping completely, only you know the answer to that. Just like alcohol and nicotine, some people can keep their usage under control others cannot. I don't neccesarily agree with the statement that taking more than the precribed dosage automaticaly equals abuse. Undertreatment of pain is a real and serious problem, and the prescribed dose can be a fairly arbitrary decision made by the doc. in the past year i have seen 2 neurologists for the same problem. one prescribed 800MG of ibuprofen every 12 hours, while one prescribed 1 lortab every 8 hours. what you need to ask yourself is why you are taking the dosage that you are. if it is because you can't deal with your pain, then maybe you need to see a PM doc, or at least get a second opinion from another PCP. As the saying goes, there is a difference between physical dependence and addiction. Check out this link Maybe some other regiment of meds or PT can help you to decrease the pain. if you are taking your meds for reasons other than pain management, that is where you can get into trouble. that is not a value judgement, it is my personal experience.
Finally, whatever you do, watch your apap intake. The 4000MG daily dosage is really not meant to aply to every day. In other words taking 4000MG of APAP in a day every now and then is fine. taking 4000MG of APAP every day is probably not a good idea.
good luck to you. as james said above, it is not easy, but you can do it.
hk
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Stacy
Enthusiast
Reged: 11/15/02
Posts: 245
Loc: USA
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I don't know how much you are taking but there are certain amounts that would be considered dangerous to just stop.
In rehabs when one stops high amounts of hydro they have been known to make a person have an IV "in case it is needed".
You might want to get some detailed info over the phone. Try a public hospital detox unit, someone there will probably talk with you over the phone.
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Greycie
Old Hand
Reged: 07/08/03
Posts: 461
Loc: Pacific NorthWest
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Purple, the easiest way for me to stop was to give my pills to somebody I trusted with instructions not to give them back to me for 2 weeks even if I came begging, crawling, crying or vomiting in pain. A person you trust must be somebody you trust to stick to that wish and somebody you trust not to take or get rid of your pills. It's not easy- imagine this- I also play volleyball and my first game of the season I couldn't have them back from, lol- that sucked- but when I did get them back (and I still won't take them all back- I have her rationing them to me on weekends only) my tolerance was down to normal. There is nothing easy about the withdrawal- it sucks- big time- but it's worth it. Best of luck to you.
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"I may not agree with what you say, but I will defend to the death your right to say it." - Voltaire
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gage
Member
Reged: 11/27/02
Posts: 138
Loc: south central U.S.A.
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wow, purple thats one honest post you made girl!!!i sure admire your guts for opening up here like you did.
they say the 1 st step to recovery is honsety with yourself that you do have a problem and admitting that,which you certainly seem to have done!!!
now take some kind of action, pick your plan of action and stick to it!! giving the pills to someone you can trust not to give you one when you come asking is a great idea to help you slowly tapor.
do you have plenty of pills to tapor with??? start slowly so you wont notice the wds suddenly, heck even cutting down 1or2 pills a day is progress.
what im afraid of is you may be takeing a VERY LARGE AMOUNT
since you dont want to tell us how much(and i dont blame you)PLEASE REMEMBER THIS STUFF CAN BE FATAL, I LOST A GOOD FRIEND TO A OVERDOSE FROM HYDRO, SHE TOLD ME ONCE SHE COULD TAKE 30 A DAY EASY!!!she was only 39.
im not trying to scare you but i am trying to show you the seriousness of it, IF you dont do something.
please dont beat yourself up for letting this happen, beleive me i really doubt your the only one around here with this problem. i sure take more than my rx says and end up suffering the end of every month.
im going to pm you with an addictions site, so you can do some reading there, i think youll find it encourageing.
gage
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MadandMsG
Member
Reged: 12/17/01
Posts: 127
Loc: PNW
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I applaud you for making such an honest post. Here is my feeling on this subject. First you need to ask yourself "Why" you are taking narcotics. Is it truely for pain? Is it for the "feeling" you get when you take them? Are you increasing your ammount to acheive that "feeling or to knock out the pain? These are issues that Chronic pain patients deal with on a day to day basis. You have every right NOT to suffer with pain. If that is your goal, than I don't feel you have a problem with narcotics...you have a problem with your doctor. If you are seriously in that much pain that it is necessary to use "several" OP's, than maybe you should inquire about a Pain Management Specialist. There are other ways to control your pain without having to pop that many pills per day. Now that also brings us to a problem MOST of us have. There are not that many PM Docs around that understand the need of a patient with chronic pain. Only you really know yourself and you are the only one that can make that decision, but don't forget...you have the right to find relief from your pain and don't beat yourself up about that.
JMHO...
Good luck and God Bless,
Mad 
ETA: I just wanted to say that chronic pain patients deal with this Addictive vs. Dependance issue all of the time. It is an unavoidable situation. If you take narcotics on a regular basis....your body gets used to it, therefore to achieve the desired result, you must take more. If you NEED these meds to function, then why should you be labeled an addict?
Edited by MadandMsG (09/23/03 06:51 AM)
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Stacy
Enthusiast
Reged: 11/15/02
Posts: 245
Loc: USA
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Quote:
Purple, the easiest way for me to stop was to give my pills to somebody I trusted with instructions not to give them back to me for 2 weeks even if I came begging, crawling, crying or vomiting in pain. A person you trust must be somebody you trust to stick to that wish and somebody you trust not to take or get rid of your pills.
That is a good idea, but I can't stress something enough....Purple needs to check with a medical professional and make sure it is safe to stop cold turkey, since we have no idea the amount she is taking.
If it is not safe to just stop, then I would suggest that she have a person to help her, come up with an amount to taper down......maybe starting with 1/4-1/2 of her daily dose and lowering it every day or couple of days. This way might also be easier even if it is safe to stop cold turkey. It would be easier to taper down if someone was dispensing the meds to you than trying to do it yourself. I would suggest to figure out an amount for each dose and if it all possible, have them give it to you a dose at a time and not the "dosage for the day" so you aren't tempted to take a days dosage all at once. Also, I would suggest that when the med is given to you that you take it immediately, in front of the person. If you don't take it, then you don't get it, so you don't stockpile and take a lot at one time. Tapering down will be easier on you physically and emotionally than just stopping. If you can do that and then eventually stop all together for a short while, your tolerance will go down. You must remember something though......your tolerance can and will go back right to where it is now if you aren't careful after you taper down and take a holiday. Also, it will go back up to the same tolerance very, very quickly.
Let us know what you decide and how it is going.
One other thing, to the person that lost a friend. Odds are more likely to die from too much APAP than the hydro. The problem with the APAP is that too much over a long period of time can slowly do damage that gets worse and worse and can still kill you, even after you stop taking any APAP at all.
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dixierose
Newbie
Reged: 06/03/03
Posts: 33
Loc: Deep South
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FYI....Ultram is addictive...or at least the withdrawals are H***. I was on Ultram before I got put on Hydro. There was about a month when I was between doctors when I had nothing. The withdrawals from the Ultram were more severe than ANY withdrawals I've gotten from my Hydro holidays. Some people do use Ultram to help with withdrawals from Hydro, but my advice is to be careful with it. Everyone is different, and everyone has different tolerences. Ultram may be the thing for you; but if you go that route, make sure you are under a doctor's care. Good luck!!
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American by birth...Southern by the Grace of God.
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tansun
Pooh-Bah
Reged: 05/28/02
Posts: 1152
Loc: southern USA
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Dixie is right- Ultram is way addictive. ( i should know ) Be careful if you use it , and if you do , do not take hydro with it as you can get a seizure. I think ultram is more addictive than hydro personally. I was on hydro for 3 yrs , and the last yr noticed some dependance. I was on ultram 1 month , and noticed dependance right away. Soon as you think you may be dependant , do something about it before its too late.
Tansun
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"Madam Meanness"
---------where theres a will, theres a way ----------
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Purple
Enthusiast
Reged: 07/15/03
Posts: 233
Loc: Midwest
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Thanks to all that replied to my post. I did read each and every one of them and I do feel much better. I did not list how much I was taking on a daily basis when I posted because I did not want to be beat up. So here goes: My 90ct Lortab 10/500 is only lasting 7 days, so approx 13 a day.
I was having a HORRIBLE HORRIBLE day that day and I applied for another position in my company and was told by someone who can be trusted that I am not getting the position because the lady who is the boss of that position told this other person that I am not "front desk material and that she does not care for me"
Well, I heard that and FREAKED out! So with hearing that I am not "GOOD ENOUGH" everything just exploded in my mind and I started beating myself up about my usage. I do have an appt with my PCP next Tuesday and I will be discussing going to a PM specialist for the headaches. I had a heart to heart with my husband and he says I am beating myself up way too much because I am feeling guilty for taking the Lortab. He knows I take it for the pain and not to get "high" but my tolerance has grown very high. 90ct of anything used to last at least a month. I am worried about my liver but I more worried about the w/d's and stopping for good. I will keep you all posted. Again, THANK YOU ALL FROM THE BOTTOM OF MY HEART FOR YOUR HONESTY & KIND WORDS!!!!
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mightymouse
Stranger
Reged: 09/08/03
Posts: 20
Loc: Secret star above Earth
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No, thank YOU, Purple, for YOUR honesty. 
All I can say is that I have taken more than 13 in one day.
I felt guilty in my conscience but on the other hand, I felt good to be painless. Which is better? Unfortunately, chronic pain comes with complications and there are no simple solutions. Tolerance is another battle to deal with along with the pain, politics, distant doctors, etc. It's hard to recognize the rewards of suffering through all this trauma. I don't think anyone of us asked to be in this situation...but we are. At times, I do have to convince myself that it's okay to pop the pills to kill the physical pain because I believe in the bonus of being able to 'bounce the bed' with my beautiful fiancee. I pray for miracles for all of us but until it arrives, I'll take it no matter how small they are and how infrequent they can be. In the meantime, I'll just try and focus on the positives, stay as painless as possible with minimal medications as possible, and count my blessings each day.
So, please Purple, don't beat yourself up. You are not alone. Remember, there is strength in numbers.  We are all common, compassionate chronic pain sufferers trying to do ordinary, everyday things in life...it just takes extraodinary effort on our part because of our levels of discomforting pain. Hey, that makes us even more astonishing, outstanding, and super special! 
Oh,about the fear...forget about it, literally. I think you are already aware of what needs to be done. There are previous posts with experiences, suggestions, and ways which will work wonders and wonderfully with you.
God bless and good luck, Purple! 
p.s. "front desk material"? I think she was intimidated because you are CEO/President material! 
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"Pain is inevitable...suffering is optional."
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kittykatbone
Member
Reged: 06/20/03
Posts: 150
Loc: City of lost Angels
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PURPLE (ahhhh ~ my FAVORITE color!)
looks like many of us are in the same boat. i see a lot of talk about ultram on this thread, though i've never used it myself. have you done any research on Buprenorphine (Temgesic, etc)??? some dependent/addicted (whatever your choice of termanology is here) peoples have used this with GREAT success. i myself have a small stockpile for that one day i keep telling myself i'm gonna take a looooong hydro break. i have not used these yet either as i am still doing research on their proper usage, & honestly... i'm not mentally committed to taking that long break yet.
it sounds like you're a step closer than i to breaking the cycle, so please don't be too hard on yourself.
CHIN UP!!! & please keep us all posted on how things are going. you can PM me if i can be of any help & support to you.
TAKE CARE ~ louis
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some days you're the windshield, some days you're the bug
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kittykatbone
Member
Reged: 06/20/03
Posts: 150
Loc: City of lost Angels
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GAGE ~ i'm very interested to absorb more details on your friend who passed away because of a hydro OD.
that is if it's not too hard for you to talk about (my condolences). i would like to know if it was acetaminophen poisoning, or just too much hydro at once? also were there any other contributing factors such as other chemicals in the body, past history of other drug abuse, etc. you can PM me or better yet post the info ~ i think it could help to possibly save a life.
very truly, louis
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some days you're the windshield, some days you're the bug
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pescado1
Journeyman
Reged: 07/22/03
Posts: 86
Loc: The Southwest
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Have you ever thought of H-Bomb?
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"One man gathers what another man spills"
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kittykatbone
Member
Reged: 06/20/03
Posts: 150
Loc: City of lost Angels
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Quote:
Have you ever thought of H-Bomb?
Pesc ~ what are you talking about???
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some days you're the windshield, some days you're the bug
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Sovereign
Stranger
Reged: 09/21/03
Posts: 3
Loc: USA
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"So here goes: My 90ct Lortab 10/500 is only lasting 7 days, so approx 13 a day."
You are taking WAY too much acetaminophen (tylenol). The max you should take is 4000 milligrams per day and you are taking 6500. Even 4000 mg shouldn't be taken for extended periods, and you should NEVER take ANY if you are drinking alcohol.
I'd get a liver test and strongly consider switching to something with less tylenol.
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gage
Member
Reged: 11/27/02
Posts: 138
Loc: south central U.S.A.
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im not sure about the exact cause of death except shed been addicted to pain meds for many yrs, she just came into a larger amount of money, and to tell you the truth i think she just plain old od'd, probably forgot how many she had taken. i know she took them for the high and in large doses
i dont think she was on any street drugs or booze but any pain meds she could get her hands on(includeing stealing my percs)she took!!! it was a weird deal how she stole from me
she new i went to church on sun mornings and came during church and stole all but 3 of my 40. didnt touch anything else not even cash setting on the table!!!
even though she did that i still miss her and wish she couldve kicked her habit beofre it was to late!!
sorry i couldnt be more specific other than she took LARGE amounts at a time!!gage
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Dr123
Newbie
Reged: 08/19/03
Posts: 39
Loc: south
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Good question (how much hydrocodone can one take before one becomes addicted?) Most writers of addiction books (including my own book on addiction)and of drug courts say that there is a difference between addiction and chemical dependency. While there is a great deal of confusion in the air concering this topic, addiction is defined most often as having some relationship to ones inability to say no to a drug even when there is no pain. Such a behavior represents a 'loss of control' over one's life. As a 20/20 episode illustrated about a year ago, chemical dependency occurs when one can not stop taking a drug without feeling withdrawal symptoms, and this situation should not be used to define addiction. Chemical dependency is usually brought on by increased dosages of a drug over time in order to gain the same effects that a drug once had when it was taken (months) earlier. This tolerance factor is common in people with chemical dependency and this is what makes many trained people think that one is addicted. While an addict may experience tolerance and chemical dependency, to distuingish between an addict and a person who is chemical dependent, I agree with others in the field that since an addict can be one who is not chemical dependent, the defination of addiction must reveal something within a person besides limiting the definition to an increased tolerance to a drug. I think that 'something' is a genetic makeup within an individual that makes one an addict and one that finds that 'one drug is too many and a thousand is never enough.' Thus, taking too many drugs so that one experiences withdrawal symptoms should not be the criteria one uses to determine if one is addicted. While withdrawal symptoms MAY signal addiction you should have realized that earlier in the initial stages of your drug taking behavior (which isn't a bad thing if you are in chronic pain!!!!). Because of your pain, you may be chemically dependent, however, and find yourself in the same 'boat' as an addict in needing detox treatment. In either case the drug does not have the power it once did. In cancer patients or chronic pain patients, I think the great physicians are those who understand tolerance and what I have discussed above and realize that they have to increase the dose of the existing medication or if the pain receptors are all filled (as in extreme tolerance), the physician should switch the patient from one type of pain killer to another because in the end, IT IS THE PAIN THAT MUST BE TREATED IN ORDER FOR THE PATIENT TO LIVE OR HAVE A LIFE WORTH LIVING. Hope this helps.
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kittykatbone
Member
Reged: 06/20/03
Posts: 150
Loc: City of lost Angels
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thank you for your reply Gage ~ tho i'm sorry to hear what happened to your friend
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some days you're the windshield, some days you're the bug
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Greycie
Old Hand
Reged: 07/08/03
Posts: 461
Loc: Pacific NorthWest
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Purple,
You should not feel guilty or ashamed for needing to take medication to relieve your pain and it is not for any body else to judge you. Still, you know that it's gotten to a point for you that you're taking a dangerous amount of the medication- for that reason, speak with your doctor- he's the best person to help you overcome what you're going through in the safest way possible. Good luck to you
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"I may not agree with what you say, but I will defend to the death your right to say it." - Voltaire
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Purple
Enthusiast
Reged: 07/15/03
Posts: 233
Loc: Midwest
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Pesc:
I am with Kitty on this one, what are you referring to when you said H-Bomb?
If you think I am a bomb (or whatever) ready to go off, you are totally wrong! And if you read my original post, I AM seeing my PCP this coming Tuesday to get some plan in order to get off the Hydro and get on something non-narcotic or without as much APAP as I know I am taking too much. I don't know how long it takes to damage the liver when taking too much APAP, but I can assure you it's been a short time that I have been taking this much med on a daily basis. I can & will get this chronic pain under control once and for all. I personally, did not appreciate the H-Bomb remark.... 
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Purple
Enthusiast
Reged: 07/15/03
Posts: 233
Loc: Midwest
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Greycie-
The above post was not meant for you, but I am seeing my PCP on Tuesday to have a discussion about my cronic pain, this won't be the first time I've talked with PCP, this has been going on for years now but from reading the posts I realize I am taking way too much APAP for my liver, thanks for your nice reply, much appreciated.
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 874
Loc: usa
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Purple...do you take the hydro mostly for the headaches or the back pain...because one problem with narcotics & tylenol, ibuprophen, etc, is rebound headaches! It's a vicious cycle....I'd try to see if your doc would be willing to swith you to either oxycontin twice a day 10-20 mg to start....or perhaps try a duragesic patch....see if this gets the pain under control....and you need to figure out if you are having a problem with rebound headaches...If you're truly in pain, addiction is not an issue, and addiction and physical dependence on opiates are TWO different things....yes, and addict is physically dependent, so is a chronic pain patient who has been on long term opiod therapy....the difference is the addict exhibits compulsive behaviors to obtain a substance, even in the presence of negative consequences...i.e. he has credit card debt of 10,000 from using OP's, won't go to work because he's afraid he'll miss the UPS man, will bounce a check, steal your walkman, whatever....only you know where you are...and it sounds like you're being really hard on yourself.
With respect to the position you didn't get...I'd ask for a meeting with your supervisor...or other mentor in the company in managment, dress ULTRA professionally, write down a list of questions and ask for an honest (and yes, it may be painful) assessment of the reasons why you're not "Front office material"....it may be things you can fix quite easily...and you can then set some goals for yourself in that respect....but I can tell you from experience, if your hurting 24/7, you can't work, your no good to your family, nor to yourself.....It sounds like you need a more extensive medical work up and to see a Pain Management Specialist who can help you find a pain control regimine that lets you get your life back in order, and feel normal....but don't beat yourself up, if you were a fiend...you wouldn't be here asking the question, my friend...so take heart..and don't do anything drastic...and DON"T stop cold turkey....especially with the usage you've described....it could have serious medical consequences...and some pretty unnecessary ones.....take this logically and one step at a time. I have faith in you!
Edited by IMSUSCOT1 (09/25/03 06:03 PM)
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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If you are taking 13 a day, that is 390 pills per month. That amount is only going to get bigger and more expensive as your tolerance grows. I am not passing judgment at all, I know the situation you are in, and it sucks.
Tolerance is an unfortunate side-effect of opiates, and for some people it ramps up quite quickly. Only you know why you need that much, and that is entirely your business.
I have a few suggestions:
1) Switch to compounded meds. You can get 15/80 or 15/100 from a few companies listed on these boards. http://www.cyberscriptsrx.com , http://www.drmwatson.com , http://www.painmeds4u.com are a few that I know of, but I have no personal experience. I don't know if there are any companies providing compounded meds who won't require a port-a-medic visit, but some will prescribe up to 360 a month, and while this is expensive, it's cheaper in the long-run than ordering from several OP's and obsessing over where your next refill will come from. Do yourself a favor and look into it.
2) You have to do something about the amount of tylenol you are taking. Get a bottle of NAC (it shouldn't be more than $15) and take that throughout the day. It will go a long way in helping your liver.
3) The amount of tylenol you are taking is way beyond any amount that could be contributing to pain relief. If you won't do the compounded med thing, at least switch to 10/325's. That way you will be taking about 2000 mg less of tylenol per day, and it won't affect your pain relief.
4) You will come to a point when hydrocodone is simply not strong enough, and you will have to be taking ridiculous doses. FIND A PAIN MANAGEMENT DOCTOR! Try a few if you don't like the results you get at first, but your liver and pain will be in better shape if you got on OxyContin, Duragesic, MSContin, Methadone, etc. This is what will work for you in the long-term, you'll only be getting your meds from one doctor, one pharmacy, and you will feel much better and less stressed out. Compassionate PM docs do exist, and you will find one if you search hard enough. You will probably save yourself a ton of money, too.
5) Don't even think about ordering Oxy from an e-mail source.
Please at least give these choices some consideration. I think you will find your life in much more manageable shape, and I know what you are going through, it really does suck, but there are ways to get better. If you need to be on opiates the rest of your life, then so be it, but don't keep doing what you're doing now because you're only killing time as it slowly gets worse. Good luck, I really do feel for you.
-yawkaw
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Purple
Enthusiast
Reged: 07/15/03
Posts: 233
Loc: Midwest
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Thank you, Thank you, Thank you Yaw for your response. You really gave me some great information. I posted a new thread about my visit today with my PCP.
Thanks again!!
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kittykatbone
Member
Reged: 06/20/03
Posts: 150
Loc: City of lost Angels
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GREAT post Yak! great facts for better living.
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some days you're the windshield, some days you're the bug
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kittykatbone
Member
Reged: 06/20/03
Posts: 150
Loc: City of lost Angels
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GREAT post Yak! great facts for better living.
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some days you're the windshield, some days you're the bug
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