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j_f_2003 04-03-2003 12:06 PM

How do I taper off pain meds?
I have been taking pain meds since last August for chronic pain due to several bulging and one hernated disc. I origianlly started taking 1 vicodin 5/500 (5 mg of hydrocodone to 500mg of tylenol)every six hours. I was down to one vicodin per day a couple months ago but then had to get back on it because I re-injured the discs from coughing during a bad chest cold. I also had to increase to Lortab 10/500 10mg hydrocodone to 500 mg tylenol) because the vicodin wasn't working as well for me. The dose was 1-2 lortab every six to eight hours. I never took more than one lortab at a time. I was taking 2-3 lortab per 24 hour period for pain for about a week and a half while waiting for an injection. I recently had an injection and initially had strong pain afterwards and the nurse told me I could take one every 4 hours. I did this for two days and then on the third day I started taking it 5 hours and then increased to one every six hours. My hubby says he thinks I should taper off over a two week time frame. He says this because he doesn't know how "addicted" I am. I know when I took plain vicodin 5/500 I tapered off from 4 a day to 3 a day and then 2 a day and also cut it in half and stayed on the half dose for a few days before finally tapering off but still needed about one per day for pain in the evening. I wonder how to do it with lortab because it's twice the strength. Can anyone with info have any ideas for me. I don't think it will take me 2 weeks. I was planning on going down from 4 lortab a day to 3 a day the next (while increasing the amount of time between each dose), 2 the next day, 1 the next day and then 1/2lortab=5mg hydrocodone the following day and then 1/2 vicodin=2.5 mg hydrocodone (I still have a few left after they switched me to the lortab) the following day (roughly about six days). Is this to fast tapering? I really don't want to go through withdrawl and never have but I understand that if I take pain meds when I am not in much pain the chance for becoming addicted rises? I am not having a true addiction but have been told by the dr I would become "dependant" on the pain meds while on them. Pain wouldn't allow me to heal and three dr's told me to keep on the pain meds so I could heal better.

GinaLee 04-03-2003 01:24 PM

JF, you are in pain, right? Going off the pain killers is not condusive to feeling better if you actually need them.

I really don't see how you could be addicted, from what I read; you took them as prescribed. I didn't see signs of abuse.

Are you prone to addiction? Have you kicked a previous addiction before?

Being dependent on pain killers to stop pain like you have is nothing to be ashamed of. Maybe I'm just missing something here.

I've had the kind of pain you describe; if the pills kill the pain and keep you from having to resort to surgery... press on!!!


Risky Business 04-03-2003 01:32 PM

Good advice Gina: I would add that I must be missing something. Even so, I hope you do not think it may be ok to take more or not worry. My friend, you are doing well to know the dangers of addiction and withdrawals.

I wish I would have been concerned at the level you are at. Oh well, I do hope for your well being and thanks for posting, good luck,

Risky Business

j_f_2003 04-03-2003 02:08 PM

Yes I am in some pain. I tried to have just 1/2 lortab this morning and boy did I feel the bumps on the way home,I wasn't driving. I don't drive until 1- 2 hours after a dose. Since the injection though I figured I could let go of some of the meds. I am hoping to be on no meds but I don't know if that's possible. I went forward with the injections in the hopes of having to take no pain meds. I don't mind the muscle relaxers for the spasms because they help me sleep at night and do keep the pain down but I was concerned about taking pain meds for seven months.

I guess I got a bad impression of myself from a physical therapist who told me that taking two vicodin 5/500 a day (while I was still finishing up p.t. sessions earlier this year) was to much and she labeled me as "hooked". I told her specifically that the dr. wanted me out of pain. My orthopedic guy said take the pain killers and do the therapy. She pleaded with me before the sessions to not take the pain killers so hubby said just take them and don't tell her about it. So I did and I progressed well with the exercises. I never could get her to see my point with her about but I don't see her anymore. I've never abused anything before and never got addicted. I've never even been drunk. :-) Lost to many family members due to alcoholism. Thanks for helping and the responses. They are appreciated.

GinaLee 04-03-2003 02:34 PM

Seems to me you are doing everything right. Ignore the therapist! She's probably just used to people getting addicted and underemphasizing what they actually take. I think you are so aware of the possibility that you are overly cautious...which isn't a bad thing but don't allow yourself to suffer as much as you do.


Risky Business 04-03-2003 03:01 PM

Yes: When I was going to PT, I told them I was taking 6 and sometimes more. They did not act surprised. Everybody seems to have their own opinion and most people are againt pain meds.

Take Care,

Risky Business

j_f_2003 04-04-2003 07:42 AM

Thanks for the responses. You're right I bet she saw many addicted patients. There was one guy in there doing p.t. after being hit by a truck. He had surgery on both his legs and was in so much pain. He asked another patient what they were taking for pain and she mentioned vicodin. My p.t. said "no you don't want to take that it's addicting." I think she needs a course in the difference between addiction and dependence on pain meds.

I feel I have allowed myself to suffer more than I should have in the beginning because I was concerned about the amount of tylenol in the vicodin to which the first dr. told me I could take two at a time if needed. Another dr. just said that was a LOT of vicodin. I got scared at his response so I suffered more than I should have. With the lortab (that I just recently discovered) has the same amount of tylenol but twice the strength of hydrocodone so I don't have to worry as much.

A neurologist who I saw about a month after the injury said I'd be better in a few weeks and I expected to and also said to continue with the chiropractor and physical therapy there. The lady that I was complaining about earlier was a p.t. at another place after chiro made me worse. I even tapered off meds back then (chiro and p.t. urged me that if I didn't try to get off the meds I would become dependant) and I got worse every time I did so, so my hubby told me to stay on the meds and don't do the exercises. I wish I hadn't listened to the p.t. and chiro's advise to go off the meds back then. Maybe I would have been healed by now. The dr. said I would heal from this and didn't need surgery. After the MRI I had chiropractic treatment and manipulation of the neck which made me worse and I wish I would have known not to have that done. Here I am seven months later after three epidural injections and a joint one, now trying to see if I can taper off the meds. I wonder if an additional MRI should be done to see if I am actually healed. No one told me the pain and muscle spasms would last this long and I expected to be 100% several months ago. Sorry for all the venting but I have been tired of all this pain and limitations.

Autumn Angel 04-04-2003 10:48 AM

It is people like your PT that give us chronic pain sufferers most of our anxiety about becoming addicted!! Here you are obviously in pain , ready to exchange quality of life as pain free as you can be right now for a life where it hurts to even get out of bed in the morning and all for what?? The term "addicted" all these docs that know nothing untill they have suffered some of our pain? The doctors that dont know the difference between addiction and dependence? Becoming dependent on pain meds is normal if you have been taking them for a long period of time and there is nothing abnormal about it your PT should be keeping her mouth shut and doing her job which doesnt include butting into your life and critisizing what a "real doctor" has prescribed as your treatment. I wish I could say I was just taking 4 percocets a day after the 2 years I have been on them. I tried every NSAID going for 10 years untill they damaged my stomach so badly I have to take Losec the rest of my life. All because they werent narcotic?? Like Risky I developed a dependence too but thats not what worried my doctor he was worried about all the TYLENOL in the percocet. He has put me on Oxycontin now which has no tylenol and I take 2 pills a day as opposed to say 6 to 10 of the percs to get the same relief. Of course I am now tapering off the percs. The plan my doc gave me was to decrease my dose by one pill every 2 weeks but I am doing it every week. Since I started the oxycontin I have only been taking 4 percs a day so my plan is 4 percs a day for a week...3 percs a day for the next week...then 2 then one. I have the oxycontin for my initial pain so hopefully this wont be so bad. Thanks for letting me rant but stupid "docs or Pts or whoever" lol that know nothing about us or who we are casting judgment makes me mad. I wish you the best and take care of your pain first before you worry about what no brainers have to say about it.

CRAZE 04-05-2003 02:45 AM

J. F. , I agree with the rest. The amount you are taking should not cause bad withdrawls if you were to stop cold turkey today. If anything you might have some mild flu like symptoms. Now on the other hand, if a person is taking 2 Oxycontins and 3 or 4 percs for any length of time they will defenitly have bad WD's if they were to go cold turkey. And I mean bad!!!
So if you are in pain and you can control it with the small amount you are on, I would not worry about addiction. Now if you were taking 8 a day you would want to taper down to 1 or 2 a day before you quit.
I have been on 4 20mg Oxycontin a day for 3 months. I am going to taper to 1 a day within a 3 week period.
I think you are doing just fine with your present amount. Not to worry.

j_f_2003 04-08-2003 06:58 AM

Thanks for all the responses. I am still experiencing some pain on the left side. I have cut down to 2 1/2 to 3 per day (I'm back to one every 6-7 hours during the day) and go 10-11 hours from bedtime till morning. Thank God for the injections. I never realized how much pain I was in till I have had a LOT of relief since this last one.

Autumn I appreciate your words. I'm sorry you damaged your stomach. I didn't take anti-inflammatories because the chiro warned me it may tear up my stomach. Actually I have trouble with my stomach and anti-inflammatories anyway so I agreed with him. I just wish he had told me that something like an epidural injection was available rather than tell me to cut off the meds.

I have to go back to the p.t. lady because she gave me a theraband that wasn't long enough. Hubby said he didn't want me doing any exercises till I'm better but I know I'll have to start back sometime. I mentioned it to the p.t. before during therapy that the theraband was not long enough and she said I would just get used to it and as my muscles got stronger it woudl be ok. It never has been ok and I don't feel like I'm doing the exercises properly with such a short band. I always got a longer one at the place. I want to take something to her that tells the difference between addiction and dependence. I found this link and may print it out for her because I'm so mad at the way she treated me as "hooked" and told me to not take the meds after the dr. told me to. [url=""][/url] "The opioid-dependent patient with chronic pain has improved function with his use of the drugs and the patient with opioid addiction does not." I had improved in p.t. and just took the pain meds before hand without telling her. I wonder if I should fess up and tell her that because I feel that that's the reason I did well.

It may help other patients and her attitude. I know she will ask how I've been feeling. She told me at one time that a dr. gave her vicodin but she never took it and resorted to something else either herbal or over the counter, I can't remember. She sounds like a "tree hugger" as my hubby put it and wants things done her way only. Thanks Craze, Risky, and Gina for the additional info. You've all been very helpful.

j_f_2003 04-08-2003 07:04 AM

Forgot to mention, after the therapy was over and I mentioned that I was taking two vicodin per day, she said "I put myself into a chronic pain state." I don't think so. The injections killed the pain and helped with the spams. I mentioned something about the muscle relaxers and spasms, and her reply was "if you had muslce spasms your shoulder would be up to your head." The MRI clearly showed straightening of the lordotic curve indicative of intristic muscle spasms. I don't think the dr. would have put me on muscle relaxers if he didn't think I needed it.

Ok one more question and then, i'll be quiet. She mentioned that I get sore after working out because when someone works out they tear muscle fibers. I corrected her and said I learned it was from lactic acid build up. Who's correct?

jono1767 04-08-2003 07:40 AM

hello j_f 2003 i belong to a local gym and when i first started lifting my muscles were so sore i couldnt even move they said when u first work out you tear muscle tissue and thats what makes the muscle sore.hmmmm thought i'd add that in...

[This message has been edited by jono1767 (edited 04-08-2003).]

Autumn Angel 04-08-2003 08:14 AM

Grrrr J_F let me have a crack at your PT lol. She is wrong and you know she is wrong. Print out that link and tell her if she doesnt quit "labelling" you you will report her. She has no right to second guess your doctor and attack who you are. Your meds did not make this chronic pain state where the heck did she get her medical certificate?? A cracker Jack box?? Sorry for venting here but she just sounds so stupid the way she talks to you. Take that print out and make her look like the fool she is and I would tell your doctor what shes saying too and get a note or responce from him to take to her. What you are taking is nothing compared to what some of us take my doc gives me percocet, oxycontin and dilaudid (for bedtime) my meds would blow your PT away lol. And she wouldnt dare treat me like an addict or she would be facing a legal complaint. You go ahead and take what makes you feel better and listen to your Doc and not your PT she doesnt need to know anything about what your taking. I wish you the best in your quest to be pain free. God Bless

Irish Cream 04-10-2003 11:30 PM

I wish the article mentioned that as long as pain patients have good opiod drug management that reduces or we can all hope eliminate their pain then they will have improved function. Some don't get adequate pain relief. Then when we ask for more,something different,whatever then we are treated like addicts. Even though it has more to do with still being in pain and not seeking drugs.

j_f_2003 07-06-2003 04:47 PM

Update... It's been awhile since I wrote on this thread but I wanted to let those interested that
I talked with my pm dr. about the p.t. lady. He said that she needs to stick with p.t. because medicine is not her job. I told him I had a concern about addiction and he explained to me that dependency is similar to a diabetic in need of insulin. Basically as long as I was having pain I didn't need to worry. Now if I was taking pain meds to feel good that was a different thing.
I have printed out the link and thought about mailing it to her annonymously. I never did have to see her about getting a new theraband because the first was to short. Hubby just went in and got one for me by a different therapist. I'm just still mad about what she said to me and I can't seem to leave it alone. I need to know if anyone thinks it's ok to mail a print out copy of what the link said to my p.t. annonymously? If I decide to make a formal complaint later on like say if I need therapy again, I sure won't go back to that same place. My pm dr. knows that. I really don't want to go to a lawyer or anything but I think she needs to know the difference between addiction and dependency. Maybe she will be clueless as to who sent it to her since I've heard her tell other patients that vicodin is addicting.

On another thought, I was thinking about writing a letter to her boss. It may get her fired. I've already seen her arguing with the boss. If I don't write to her boss, I'm hoping that the information I have to send will help her understand and hope that she doesn't ever tell another patient that they shouldn't take pain meds after their dr. told them to.

What to do? Write to her boss or send her the information annonymously. I could put she treated me and I was upset that she labled me as "hooked". Maybe then she will remember though. Any advice?

By the way the dr. put me on the duragesic patch. My pain came back full force and the new MRI showed a couple of changes. I asked if I could try p.t. again at a different place. He said he doesn't want me doing any therapy now. I'm seeing a spine specialist next week.

[This message has been edited by j_f_2003 (edited 07-06-2003).]

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