kimbell1
Board Addict
Reged: 08/20/03
Posts: 309
Loc: Route 666, Painville, Texas 6...
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My doctor is getting screwy for no reason that I know. I have been on Lortab 10 4 times a day. Now I am taking this along with 60 mgs of Avinza. I have herniated l-4 and l-5 disks which are pinching my sciatic nerve. I have also lost nearly all of the nucleus in l4 and L5 vertera.
Qestion 1. Do you think by medical standards that i am over-medicated? This combination finally seems to be the one that works after years of trying.
Question 2. Since my doctor is getting screwy and it would be hard to find another doctor in my area willing to give me these drugs without time to build a rapport (5 years with current doctor), if I got off the lortab and just used the Avinza, how additicive is Avinza just by itself? I know that I am addicted to the lortab since I have been taking it for years and I will have to sometime go through dreaded withdrawl. I also know its not good for my liver (it was tested a couple of months ago and it was fine).
But what I need to know most of all is how addictive Avinza is by itself?
Thanks.
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therhino
Enthusiast
Reged: 06/06/04
Posts: 224
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What is Avinza, I have never heard of that, I just looked in the drug list and it's not there.
thanks in advance for the info.
regards
therhino
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hope46
Journeyman
Reged: 11/08/03
Posts: 81
Loc: CALI-DREAMIN
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Glad you asked! Thought I was the only one who did't know!-Hope 
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jptrick
Journeyman
Reged: 05/20/03
Posts: 57
Loc: Midwest
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I believe Avinza is Morphine, sustained release.
As far as how addictive it is compared to Hydro-
The politically correct term for chronic pain patients is dependent, not addictive.
However, for those of the population that aren't in chronic pain, addicitve suits them just fine to describe anyone on these drugs.
You are going from a Class III to a class II so you are getting a more powerful med.
Regardless of the class of opiate, if you stop taking it suddenly, you are going to be in a world of withdrawl hurt.
The withdrawl symptoms from any opiate are about the same.
Degrees of severity are related to strength, dose, and length of time taking a particular drug.
It also varies from person to person.
Even two people taking identical doses will have different mental withdrawl experiences and difficulties.
I think the sh**s are pretty universal though.
The theory behind the Avinzas, Oxycontins, Methadones, etc. is that the drug gets released into your bloods stream at a measured rate and dose-anywhere from 8-24 hours per pill- as opposed to popping 3-4 Hydros, getting all of that med in about 30 minutes, and then having to repeat the whole process again in 4-6 hours (more like 2-3 hours for us "tolerant" users)
Hope this helps
JP
One more thing since I'm too lazy to check for myself:
Withdrawl or withdrawal?
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Mercedes116x
Newbie
Reged: 12/18/03
Posts: 48
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As I have said before, Hydrocodone by itself is a schedule II drug. It only becomes a schedule III when it is compounded. I think your best bet would be to get the Avinza from your doctor, and if you must you can order the hydrocodone from an online OP. The Avinza is longer lasting for pain relief.
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SuseCue
Member
Reged: 04/25/04
Posts: 169
Loc: Tampa, FL
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I am on Avina. I take 120mgs once a day. If you are interested in getting off of the Hydrocodone than I would sugest doing it when you start the Avinza.
I am pretty sure that the Avinza would keep your withdrawal in check from the Lortab. At least it did for me.
I was taking about 8 Percocet 10's a day when I started taking the Avinza. And I really had no problems not taking any Prcocet the day after starting the Avinza.
Now I just take the Percocet when I really need it. I can take it up to 4 X a day but never need it that much.
Best of luck to you.
Susie**
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Fighting for peace is like screwing for virginity.
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toe
Pooh-Bah
Reged: 10/09/02
Posts: 1439
Loc: MidWest USA
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Withdrawal from hydrocodone is nothing compared to withdrawal from morphine. It takes me 5 days at best to get off hydro-and only if I've been on it consistantly for months, alternating with more controlled drugs.
It took over 3 weeks to withdrawal from MSContin, and I was eating boxes of imodium tablets the whole time. Or, well, I wasn't eating the boxes, of course, because that would have made the situation worse.
If you think you're about to lose your doc, taper down on your avinza (use your imagination-I know it's time released, but once every 24 hours will keep you okay) AND your hydro so you won't be left with nothing if it comes down to the worst.
Trust me. Being addicted to morphine and losing your doctor and your your script is the worst. Any hydro you have left will do nothing for your pain and it will be gone too fast to outlast the withdrawals.
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"It's the end of the World as We Know it. . ."
-REM "and I'm seeking asylum in Canada"-toe
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jptrick
Journeyman
Reged: 05/20/03
Posts: 57
Loc: Midwest
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The boxes are fiber aren't they? You might wanna try eating them as well, good for your digestive system.
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SuseCue
Member
Reged: 04/25/04
Posts: 169
Loc: Tampa, FL
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I am assuming if I ever am to come off the Avinza that my doctor will help me ween off. However, my illness, Brittle Bone Disease will be with me for life so I don't think I will ever be weening off. If anything, I will be moving up to something stronger.
This is why Avinza is not recommended for people who have anykind of short term illness, right? Am I wrong on this? That is what I was told. My doctor told me that once a doctor puts a patient on Morphine, it is unlikely that they will be coming off. But if they are, it would be done under his control.
Is he blowing smoke up my a**?..lol
I think I trust the folks here more than any of my doctors sometimes.
Susie**
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Fighting for peace is like screwing for virginity.
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kimbell1
Board Addict
Reged: 08/20/03
Posts: 309
Loc: Route 666, Painville, Texas 6...
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Thanks to all that have posted to my question. I believe that addiction and dependence are basically the same thing. Perhaps to some it is different. This si not meant to start any type of arguement. So I will say that I am dependent on these drugs.
The reason for the post is a letter that I got supposedly by mistake from my doctor that I would love to post since it is the most heartless letters I have ever received. Espeically since I have seen this doctor since 1998. I had no idea this termination letter was coming and he acted like nothing was wrong my last vist. Had I not driven the 50 miles to his office and had he not been there, I would never have gotten past the reception desk if I had only called since the lady that runs it says that once this letter was sent (certified no less), that I could only see the doctor on a life threating emergency. But I am stubborn and wanted to look the ___ in the eye and ask why did he send this. He was in meetings that day but I did get a few minutes betwen his meetings. He said that the leter was a total mistake. He mentioned to one (maybe more?) of his staff that he was having trouble finding the right medication to help. He finally found it. The four lortab 10 as breakthough and 60 mgs of Avinza which is time release morphine and a shcdule 2 drug. IT only took over 12 months to find a soultion and I lived in pain the entire time.
It may have been a mistake because his staff is so incompetent that they ran off a friend of mine that got tired of their _______. I too am at that point. I don't figure that another doctor would give me the pain meds that my current doctor is giving me expecially since the termination letter does not even mention a reason for termination.
Once a new doctor saw my perscription history, he would probably think "drug seeker' and act accordingly. In essence, this termination letter sort of 'black balled ' me from narcotic pain killers.
IF I could figure a way to post the lettter, I would.
This letter is so poorly written that they used the word "incontinence' instead of inconveince.
I believe that incontinence means urinate on yourself.
In two years, I plan to put my house up for sale and seek a better place to live whether it is in this country or not. I am tired of the way medical treatment is dispensed in this one. This is the reason I want to decrease or hopefully eliminate my need for high doses of pain killers. In the next two years, I want to investigate other forms of treatment that another doctor would not be hesitant to preform.
I want my life back and not bound to a bunch of pills if it can be avoided.
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kandi
Veteran
Reged: 05/07/02
Posts: 681
Loc: Maryland
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Quote:
My doctor is getting screwy for no reason that I know. I have been on Lortab 10 4 times a day. Now I am taking this along with 60 mgs of Avinza. I have herniated l-4 and l-5 disks which are pinching my sciatic nerve. I have also lost nearly all of the nucleus in l4 and L5 vertera.
Qestion 1. Do you think by medical standards that i am over-medicated? This combination finally seems to be the one that works after years of trying.
Question 2. Since my doctor is getting screwy and it would be hard to find another doctor in my area willing to give me these drugs without time to build a rapport (5 years with current doctor), if I got off the lortab and just used the Avinza, how additicive is Avinza just by itself? I know that I am addicted to the lortab since I have been taking it for years and I will have to sometime go through dreaded withdrawl. I also know its not good for my liver (it was tested a couple of months ago and it was fine).
But what I need to know most of all is how addictive Avinza is by itself?
Thanks.
I know that everyone's body chemistry is different, but I was on 90mg. Avinza a day for a gazillion back issues for almost three months, and recently stopped cold turkey with NO W/D symptoms. I was fully expecting SOMETHING, but it never came. OTOH, I have gone for days without hydro without any problems either, so maybe it's just me. Now, Benzos are a whole nutha story...but even though Avinza is straight morphine, you may get lucky like me and not have any problems at all, except my pain came back.
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Monte Montgomery ROCKS!
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Imago
Member
Reged: 01/12/02
Posts: 165
Loc: Lone Star State
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Quote:
One more thing since I'm too lazy to check for myself:
Withdrawl or withdrawal?
Withdrawl?
I think that word is used to describe how people from the South speak. Withdraaaaawl.
(Don't jump on me. I'm from the South myself.)
Okay...seriously...the correct spelling is withdrawal. There's no such word as withdrawl.
Imago
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jptrick
Journeyman
Reged: 05/20/03
Posts: 57
Loc: Midwest
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Quote:
I know that everyone's body chemistry is different, but I was on 90mg. Avinza a day for a gazillion back issues for almost three months, and recently stopped cold turkey with NO W/D symptoms. I was fully expecting SOMETHING, but it never came. OTOH, I have gone for days without hydro without any problems either, so maybe it's just me.
I bet you don't get nasty hangovers, either!
I hate you.
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dmoe
Member
Reged: 03/25/04
Posts: 193
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uses listed from medscape.com there are 4 types of avinza
copied from medscape.com
There is more than one Patient Monograph for AVINZA ORAL Please select from the list below.
1 NARCOTIC ANALGESICS - ORAL
2 MORPHINE SUSTAINED ACTION CAPSULE - ORAL
COMMON BRAND NAME(S): Kadian
3 NARCOTIC ANALGESICS - ORAL TABLET SUSTAINED ACTION
4 MORPHINE EXTENDED-RELEASE CAPSULES - ORAL
COMMON BRAND NAME(S): Avinza ----
Interactions for #4
Certain medications taken with this product could result in serious drug interactions. Avoid taking MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine) for at least 2 weeks before or after taking this drug. Tell your doctor of all prescription and nonprescription medication you may use, especially: certain other pain medicine (e.g., narcotic agonist/antagonists such butorphanol, nalbuphine, or pentazocine), cimetidine. Tell your doctor if you take any drugs that cause drowsiness such as: medicine for sleep (e.g., sedatives or tranquilizers), anti-anxiety drugs (e.g., diazepam, lorazepam), other narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., phenothiazines such as chlorpromazine or tricyclic antidepressants such as amitriptyline), anti-seizure drugs (e.g., carbamazepine, topiramate), muscle relaxants, certain antihistamines (e.g., diphenhydramine). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of these products. Do not start or stop any medicine without doctor or pharmacist approval.
Drug Class
OPIATE AGONISTS
Codeine, Codeine Phosphate, Codeine Sulfate
Fentanyl Citrate
Hydrocodone Bitartrate
Hydromorphone Hydrochloride
Levorphanol Tartrate
Meperidine Hydrochloride
Methadone Hydrochloride
Morphine Sulfate
Opiate Agonists General Statement
Opium
Oxycodone, Oxycodone Hydrochloride, Oxycodone Terephthalate
Oxymorphone Hydrochloride
Propoxyphene Hydrochloride, Propoxyphene Napsylate
Sufentanil Citrate
Tramadol Hydrochloride
Labeled Uses
Chronic Pain
Chronic Pain
Chronic Pain
General Anesthesia Adjunct
Local Anesthesia Adjunct
Pain
Pain with Opioid Tolerance
Severe Pain
Severe Pain
Severe Pain
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 894
Loc: usa
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Who knows what makes these docs get screwy all of the sudden. But you are on a perfectly normal regimine. Most people who take long acting opiates are given short acting opiates for "break thru pain" and you're certainly very MODEST in your use of the lortabs. I think you need to keep a pain diary for a week or so and take that to your next appointment...what are you doing to alleviate the pain besided the lortab, what makes your pain worse, better...you may try adding 800 mg Ibuprophen three times a day (with food, and add tagamet or other acid blocker) to your regimine...you'll be amazed how much difference this can make in your overall pain scores. It's a simple, but very effective anti inflammatory that will actually reduce your pain level somewhat...I'm on Oxy 80 mgs twice a day and percocet 10/325's for btp and I function fine...I work 8-10 hours a day...as long as your not lying around or giving him some reason to think you're "enjoying " your pain meds, it may just be time to sit down and have a heart to heart and a pain diary often puts the whole picture in perspective.
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 894
Loc: usa
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ok I'm confused now, did your doctor just terminate your relationship? He made no referrals to another pain specialist? You need to think about getting a good attorney, it's called patient abandonment, especially when HE has prescribed a medication that got you physically dependent (not addicted, you don't sound like an addict to me) and wants to just drop you??? PM me if you want
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kandi
Veteran
Reged: 05/07/02
Posts: 681
Loc: Maryland
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Quote:
Quote:
I know that everyone's body chemistry is different, but I was on 90mg. Avinza a day for a gazillion back issues for almost three months, and recently stopped cold turkey with NO W/D symptoms. I was fully expecting SOMETHING, but it never came. OTOH, I have gone for days without hydro without any problems either, so maybe it's just me.
I bet you don't get nasty hangovers, either!
I hate you.
LMAO! I rarely drink, but when I do I tend to be a binger, and YES, I get some nasty hangovers, if it makes you feel any better! LOL! I used to be quite the weekend warrior back in the day but knew it was time to stop when a Sunday hangover lasted until WEDNESDAY....ROFL! Now it's limited to TWO drinks, and only on special occasions. Seriously, I don't know how or why I don't seem to get addicted or dependent on opiates...God knows I have been on almost EVERYTHING in the last six months, but I have yet to have a problem coming off of anything! (Knocking wood REALLY hard here...LOL)Having gone through BENZO withdrawal several times however, I can definitely sympathize with all of you, trust me! Benzo W/D is like a month long BAD acid trip, for those that grew up in the sixties...that's the best way I can think of to describe it.
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Monte Montgomery ROCKS!
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toe
Pooh-Bah
Reged: 10/09/02
Posts: 1439
Loc: MidWest USA
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Quote:
I am assuming if I ever am to come off the Avinza that my doctor will help me ween off. However, my illness, Brittle Bone Disease will be with me for life so I don't think I will ever be weening off. If anything, I will be moving up to something stronger.
This is why Avinza is not recommended for people who have anykind of short term illness, right? Am I wrong on this? That is what I was told. My doctor told me that once a doctor puts a patient on Morphine, it is unlikely that they will be coming off. But if they are, it would be done under his control.
You would be really astounded by the magical power that ibuprophen acquires when you go on Medicaid. Really, I swear to god it's true. Of course, I can't get a new MRI done but Medicaid has endowed whatever intern is working at the family practice clinic when I come with Magnetic Resonance Vision, so that she or he can actually see that my canal is widening and those 3 discs have returned happily back to their proper places.
It's truly amazing. I'm so glad I have Medicaid. It keeps me from feeling any pain at all. Just in the past few weeks, I found out that I don't have pain so long as 2 weeks following an (orthopedic) surgery. And even more recently, I was in the emergency room and learned that I had broken my toe, but that didn't hurt at all! No need for a shot (at 12am midnight) or a prescription. I'm a medicaid patient! I don't have pain!
My response to the original post was based on my experience. I did not have the luxury of having a doctor to prescribe a "tapering off" dose. I had a PM doc, part of practice where none of the doctors actually prescribed ("We used to have a doctor who prescribed for our Medicaid patients, but now he's off in Afghanistan or something." Yeah, some kind of silly do-gooder, I suppose). He was benevolent enough to break custom and put me on a 4-week methadone taper. The whole experience was awful.
I was addressing the question at hand, having had experience with the problem. The original post seemed to indicate a concern that the doctor might suddenly retire? drop the patient? reveal himself to be superman? Hellifino. And the issueat hand was morphine and hydrocodone dependance, and concern about how to prepare for a feared change in prescription. That's how I understood it. I've been through it. I didn't agree with what the posters before me had said on the issue.
It's pretty well known that the few providers who do (usually for legal reasons) accept Medicaid discriminate against them, as I've described above. Thanks for the joining the club. You'll be receiving your first newsletter shortly.
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"It's the end of the World as We Know it. . ."
-REM "and I'm seeking asylum in Canada"-toe
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tone
Veteran
Reged: 06/29/03
Posts: 555
Loc: Chicago
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whats with the brand names? stop that. just say what drug you are on. say "how addictive is time released morphine" no one knows obscure brand names. some people dont even know what drug they are taking i guess, they just know it by the brand name, isnt that amazing?
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kimbell1
Board Addict
Reged: 08/20/03
Posts: 309
Loc: Route 666, Painville, Texas 6...
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I confronted my doctor as soon as I got the letter and he said the letter was a 'mistake'. He felt that a month ago or so, he felt like he was not helping. Apparently he let it slip to one or more of his staff and one or more of his staff had a hand in this letter. Call me paranoid, but after the old office manager who was a friend left about a year ago, I feel like his staff would love to get rid of me. I don't know why either. I don't lose prescriptions and call with that excuse for new ones, I treat everyone with respect, etc.
I would LOVE to post the letter but don't know how and DB might not let me. It was signed by his office manager (funny, I thought she was just the assistant office manager). But my doctor likes to keep moving his staff around like chess pieces on the board. Example: one person will do his clinic's workers comp for a year or so and then get assigned new duties. A nurse might become a receptionist for a while. The are no no management skills on anyones' part including the doctor. But he is a decent guy-or so I thought.
The was no referral for another doctor or pain management. Just that I could only contact his office of a life threatening emergency.
I had planned to post this question and not just reply to a question. But I will do it here. Doesn't a doctor (I live in Texas) and maybe state laws differ, but doesn't the doctor have to sign a patient termination letter?
Things were going very well after we had spent over a year to find a good pain medication combination. I was hit totally out of the blue.
Sorry about the grammar. I will run this though spell check.
But I would appreciate any legal minds answering my question -doesn't the doctor have to sign the termination letter? Also, no provision was made for another month of Avinza. He did write 2 refills on the hydro. But I had not planned to be looking for a new doctor. He does write me refills most of the time so I thought nothing unusual.
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