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Old 09-24-2005, 07:32 AM   #1
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Need Input on Oxycontin Tapering After Surgery

I required an open distal clavicular resection in May, and was placed on 60mg Oxy + 15 mgs oxycodone/day for the excruciating post-surgical pain. The medical situation is complicated in that I use a wheelchair and must use both arms a lot. Am doing aquatherapy and shoulder is healing well, although still quite painful. Since July I've tapered from 75 mg/day to 60 then to 45. I'm now at about 45, and am in a hurry to get off completely due to emotional lability, depression, weakness/tiredness, nightmares, lack of motivation. Can I minimize withdrawal symptoms by staying at a stepped-down dose for several days, then decreasing by about 25% again, or just keep decreasing daily? When in withdrawal I'm depressed and my mentation is very poor. I've read that the lower the dose, the slower the taper should be. I want to get to the point where I only reguire 5 mgs for incited pain, as this shoulder will be painful for several more months. Any recommendations?..Have heard that tapering doesn't work and that I'll require suboxone to get off the oxycodone. I've been able to slowly taper so far as much as the pain allows. I am thinking that I should just keep very slowly tapering down as the pain gradually improves. Anyone with similar experiences? Thanks and Bless All

 
Old 09-25-2005, 05:25 AM   #2
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Re: Need Input on Oxycontin Tapering After Surgery

The only people that don't believe tapering works are the ones that don't understand the difference between simple physical dependnece and psychological addiction. Who told you that you would need suboxone?

Prior to the invention of OxyC, most post surgical pain was managed with 2 5mg percs every 4 hours after you come home from the hospital. There was nothing stronger 10 years ago. You are already pretty much there as far as mgs of oxy.Raplece the 40 mgs of oxy a day with 40 mgs of hydro per day and once your stable on that start working down from there.

AS far as a descending taper, you do need time at each step to allow your body to accomadate to the new dose. Once your stable at that dose than continue on.

Prior to OxyC everyone was pretty much treated the same, you took percs post op when you first came home, then the doc switched you to hydrocodone when he felt like it and then you he discontinued it when he felt like it and people didn't flock to rehab to get off 6 vicodin a day unless there was a psych factor that made this something more than simple physical dependence.

You can slowly taper the vicodin down at your own rate and be completely off the stuff in a month if you want and maintain complete control of the rate of your taper. If you buy into it can't be done and the suboxone mentality than now you are preaching the belief that everyone that takes opiates for pain is not only dependenet but also addicted which is BS.

People succcesfully taper from much higher doses, You could be greatful you had surgery when there was something stronger than a 5 mg perc or curse the physical dependence that higher dose meds create. Either way, you won't die from experiencing a few days of withdrawal. The method your using now, decrease every day, strings out the withdrawal process where you never get used to the lowr dose so it's a continual withdrawal the entire time and you feel it the entire time.

That's what makes it miserable, drawing out the process when done improperly, like decresing every day. You need time at each decrease to adjust so you don't feel wrotten every day for 6 weeks. If you went cold turkey from where you are you would be over the hump in 10 days and avoid all that time feeling bad.

A better solution would be to switch to hydro now. You could go to 5mgs of hydro every 3 hours, slowly decrease to every 4 hours and then every 6, In a couple weks you would be at 20 mgs of hydro a day or 4 vicodin a day.

That's not alot, then start breaking every other dose in half or waiting more time between doses. How you do it just depends on what you can tolerate and how long you want to stretch it out. Adding suboxone just means your going to have to taper off the suboxone, at some docs rate rather than your own comfort.

It really shouldn't be that hard to switch from oxy to hydrocodone now and work from there. In the old days, everyone discontinud meds after surgery and not everyone got labeld an addict that needed suboxone or meth to stop. Just those that took it for reasons other than pain and refused to taper. Usually tapering wasn't even an option. They simply refused to refill your meds one day and you stopped taking vicodin at some point after surgery. You may feel bad for 5-10 days but then it's over and most people moved on with their life. The pain got better, the withdrawal deminshed and that's it.This method worked for decades on every post ortho surgery patient there was. Only a few foks had problems or reported it.


The dose you are at is no higher than 2 percs every 4 hours, That's a standard post op dose, at least the first few weeks before switching to hydrocodone, why don't you try it the old fashioned way and step down to a milder drug and take less every couple of days.

I've had at least a half dozen orthopedic surgeries the old fashioned way and didn't die when the doc said no more percs or no more vicodin. If your lucky you got some darvecet to continue the step down in strength, but for the most part after vicodin comes advil. It's really not complicated.You felt bad a few days and got over it. You have already tapered enough to where they can step you down to hydro to use PRN instead of around the clock. Coming off the meds is only as hard as you think it's going to be.

If you can handle painful ortho surgery I bet you can handle feeling bad for a few days while you discontinue the opiates or step down to something milder and easier to DC.
Good luck, Dave

Last edited by Shoreline; 09-25-2005 at 05:37 AM.

 
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Old 09-25-2005, 05:55 AM   #3
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shoulderpain HB User
Re: Need Input on Oxycontin Tapering After Surgery

Dear Shoreline- thanks so much for the great info!! I had gotten the suboxone misinformation from an MD on a different message board. Your info on stepping down and letting my body adjust to the decreased dose, rather than being in prolonged withdrawal makes sense. I still have pain to manage, and the shoulder needs to heal so I don't need the physical stress of withdrawal. Your reply was really helpful!!

In reading these posts as a newbie I am struck by the remarkable courage and compassion all of you have, and feel kinda silly whining about my shoulder. It was not fun, post-surgery though. Bless all of you.

If my experience with shoulder surgery is useful, the key is to keep it moving, gently, in all directions, as soon as possible post-op. My doc rx'd enough oxycodone so I could keep it moving thru the pain.

Also, I do aquatherapy in a heated pool. It can be extraordinarily helpful, mentally as well as physically. Physical therapy, good pain control, and good nutrition can help a lot.

Thanks again, shoreline. I'm gonna visit this site regularly. Best to All!!

 
Old 09-27-2005, 02:36 PM   #4
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Re: Need Input on Oxycontin Tapering After Surgery

I have taken 3 years to get off of oxycontin, but I have made it! I was at 300 mgs at my heighth, but now I have been off of it for over a week. I slowly tapered down over a period of a of about two months. It can be done. Can anyone tell how to post a message rather than just reply? I have some things of my own I want to say. Thank you . Bill

 
Old 09-27-2005, 03:18 PM   #5
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Re: Need Input on Oxycontin Tapering After Surgery

Hi Bill,
You can post a new message by going to the thread listings page and go to the bottom and click on New Thread. From there you just type your message. I hope this helps.
Kimberly

 
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