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    Old 11-23-2009, 05:56 PM   #1
    Madison104
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    Question about opana/percocet

    Hi everyone, I am new to these boards. I presently take Opana Er, 20 mg 2 times a day, with 2 percocet 7.5/325 mg for breakthrough pain. I have been in physical therapy and if things "should by chance" improve can I just drop the percocet and stick with the opana. Do I need to slowly come off the percocet or will the opana hold me? And if I may ask, which I feel silly about, is there any withdrawals for just stopping the tylenol in the percocet?

    I hope to get to know everyone, and I thank you in advance for any information you may have about me dropping the percocet IF I find that I am okay with the opana and some physical therapy to help with pain control.
    Madison104

     
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    Old 11-23-2009, 06:10 PM   #2
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    Re: Question about opana/percocet

    Quote:
    Originally Posted by Madison104 View Post
    Hi everyone, I am new to these boards.
    Welcome to Healthboards. This is a great site....I hope you find your time here beneficial. Many regulars have lots of experiences, thus, can offer quite a bit of support and guidance.


    Quote:
    Originally Posted by Madison104 View Post
    Do I need to slowly come off the percocet or will the opana hold me?
    It depends on how long you've been on the med(s). If you've been on the meds for a couple months or more, chances are you'll need to ween. All the pain meds you take contribute to an overall BPL, or blood plasma level. Once your body is dependent upon the med and it's corresponding BPL level, any level below a certain BPL will result in slight WDs. The worst WDs come when you make major cuts or stop altogether.

    If it were me, I'd decrease by half a perc at a time and see how it goes from there. This way, you can differentiate between the actual WDs and any possible increased pain that may result. You're not on a lot of meds, so any type of WDs won't be that bad, or last that long. It you titrated slowly and took your time, you may not experiencing any WDs at all. Most of the patients I've worked with who desire little to no WDs go very slow. So, in your case, maybe a quarter perc or so. And stay at each stage for about two weeks or so. You can go faster of course....It's all up to you and what you're comfortable with.


    Quote:
    Originally Posted by Madison104 View Post
    And if I may ask, which I feel silly about, is there any withdrawals for just stopping the tylenol in the percocet?
    No....You have absolutely nothing to worry about here. In fact, if you've been taking Tylenol for a while, a switch to Motrin will probably result in much better pain control. Then, after some period of time, you can switch back and your body will respond much better to the Tylenol at that point. This is a very natural type of thing with the body. A good example would be the morning coffee drinker...At some point, one cup of coffee just doesn't give the "punch" anymore and then, they move to 1 1/2 or 2. If they were to stop for a while, that one cup would then be potent again.

    Best of luck to you.

    Regards,

    Ex

     
    Old 11-23-2009, 06:34 PM   #3
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    Re: Question about opana/percocet

    Thank you very much Executor. I appreciate the feedback. I was originally on 6-8 percocet a day, only. I wanted to get away from all of the tylenol and I so, so needed a long acting pain med that my doctor put me on the opana er 20 mg 2 a day and down to 2 percocet a day for breakthrough. When I was on the percocet alone, that had been for about 6 years. Interestingly enough, the drop in the percocet, when he switched me to the opana/ with percocet for breakthrough, it did nothing to me. (except great pain relief) I felt not one withdrawal. I totally believe what you are saying....but because I had no problems before, I guess I thought I could just drop these 2 percocets a day and be fine. BUT I certainly do not want to get sick.

    Oh and thank you for the nice welcome too!!! Nice to meet you
    Madison104

    Last edited by Madison104; 11-23-2009 at 06:37 PM.

     
    Old 11-23-2009, 07:16 PM   #4
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    Re: Question about opana/percocet

    Quote:
    Originally Posted by Madison104 View Post
    Interestingly enough, the drop in the percocet, when he switched me to the opana/ with percocet for breakthrough, it did nothing to me. (except great pain relief) I felt not one withdrawal. I totally believe what you are saying....but because I had no problems before, I guess I thought I could just drop these 2 percocets a day and be fine. BUT I certainly do not want to get sick.
    You may be able to just drop them....Everyone is different. However, if you don't have any supply issues and a free supply of meds, then I would go slow, just to make sure. If you've been on the meds for 6 years or so, then I wouldn't rush. You can play it by ear as you go, depending on how your body adjusts.

    As far as the WDs go, you wouldn't get "sick" regardless. The most that would be happen would be light flu like symptoms....If that. Actually, it may be more like just a general yuck feeling. Patients only get "sick" when they go into full blown WDs....From sudden stopage....Usually from very high levels.

    Lastly, as you decide on your course of action, I would somehow build up a little safety stock of inventory (of your meds)....i.e I would use your reduction as way to build some back up meds. You never know what could happen down the road somewhere, and a small cache of meds could be very useful in the event of something happening. Perc generics are very cheap, thus, it wouldn't cost a lot to build up this back up inventory. Anything can happen, and a good healthy safety stock of meds would permit one to buffer any unforeseen event(s)....Natural disaster, your Doc suddenly moving or something happening to him, you name it. I've read a lot of testimonials on here about people suddenly losing their PM for one reason or another and depending on one's situation, and where they live, it can take a some time to transition to another PM Doc.

    Regards,

    Ex

     
    Old 11-24-2009, 05:03 AM   #5
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    Re: Question about opana/percocet

    Hi Executor
    You have great information. I think I better understand. I would not get sick because I have the opana er, therefore there is no being without medicine, right? That is good to know, because I don't want to feel ill. I have enough pain daily with all that I deal with, with my autoimmune issues.

    I think I will take your advice and continue my refills so that I do have some in the house in case an emergency situation arose. I do know that my doctor is not feeling so well and he is thinking about retiring. I do have my GP, and they were in the same practice together, a year ago, and he says he will follow what my rheumy does for me medicine wise, but you never know. That was a really good piece of advice.

    Again I thank you. I don't know a lot about medicines as far as stopping something. I actually thought I was on a high dose! Then I read and see that others have to take a lot more than I do. And I certainly can understand needing to get relief from our pain.

    I think it was you that posted in another post about pseudo addiction. I have a friend that is not being treated adequately, because her doctor does not believe in handing out narcotics. She is always hurting and always running out of meds because she needs more, and they treat her like an addict. She has horrible bone pain and I find that so sad.

    I hope to be of help to others here too....at least I can offer support as I learn more about medicines and such.

    I appreciate your help
    Madison104

     
    Old 11-24-2009, 07:57 AM   #6
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    Re: Question about opana/percocet

    Quote:
    Originally Posted by Madison104 View Post
    I think I will take your advice and continue my refills so that I do have some in the house in case an emergency situation arose. I do know that my doctor is not feeling so well and he is thinking about retiring. I do have my GP, and they were in the same practice together, a year ago, and he says he will follow what my rheumy does for me medicine wise, but you never know. That was a really good piece of advice.
    I know it should go without saying, but make sure you lock them away somewhere and don't leave them easily accessible. You'd be surprised how many people will rummage through things when they visit and etc....Especially the people closest to you who you'd never suspect. I can't stress this enough.


    Quote:
    Originally Posted by Madison104 View Post
    Again I thank you. I don't know a lot about medicines as far as stopping something. I actually thought I was on a high dose! Then I read and see that others have to take a lot more than I do. And I certainly can understand needing to get relief from our pain.
    Glad to help...Anytime.


    Quote:
    Originally Posted by Madison104 View Post
    I think it was you that posted in another post about pseudo addiction. I have a friend that is not being treated adequately, because her doctor does not believe in handing out narcotics. She is always hurting and always running out of meds because she needs more, and they treat her like an addict. She has horrible bone pain and I find that so sad.
    Yes, "pseudo addiction" is when someone is under treated for their pain and they exhibit addictive like behavior, but the reality is they are in severe pain and aren't treated properly. There is no real "addiction" present....Just the under treatment of pain. I could give you a zillion stories, but it sounds like you understand. Hopefully, this person won't ever ask you for your meds. She should get a new Doc.

    Regards,

    Ex

     
    Old 11-24-2009, 05:11 PM   #7
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    Re: Question about opana/percocet

    Just wanted to let you know Ex, that I did go ahead and get my refill, and I will go from here. Better to have them and not need them, then to need them and not have them.

    I will not share my meds with others. I would worry so much about that person taking too much or something going wrong. I have great compassion, but I don't want their "life" literally in my hands, AND things can and do go wrong.

    I am reading and learning a lot here. I think an open dialogue with our doctors is very helpful, but with that being said, I also know that not everyone gets a nice, compassionate doctor like I have.
    Wishing you good things and thank you again!

     
    Old 11-24-2009, 07:29 PM   #8
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    Re: Question about opana/percocet

    Quote:
    Originally Posted by Madison104 View Post
    I am reading and learning a lot here. I think an open dialogue with our doctors is very helpful, but with that being said, I also know that not everyone gets a nice, compassionate doctor like I have. Wishing you good things and thank you again!
    You are so right about Docs. There is a big variation out there between Docs. Just as an fyi, I posted on this subject and you might be interested in it. The thread is called "Chronic pain- Frustration"......

    http://www.healthboards.com/boards/showthread.php?t=694491&highlight=rehab+ Docs

    This is a very good site....I learn all the time. Please let me know if I can help further.

    Regards,

    Ex

     
    Old 11-24-2009, 07:39 PM   #9
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    Re: Question about opana/percocet

    Madison:

    Welcome!

    In thinking forward I may be in the same boat as you. I had been taking vicodin on occasion for pain but for the last 6 months as my pain got worse I was put on Opana ER twice a day (10 mg) and vicodin for break through pain. Now I'm anticipating possible spine surgery soon. I've already talked to the PM doctor and he said if I go through with surgery he'd increase my Opana in the months after surgery. And then if I begin feeling better first we'd reduce my vicodin (or percocet which I may use for pain after surgery) until we get that down to a minimum and then he'd taper my Opana back down to the lowest dosage. Ideally I'd get off Opana and if I ever have pain maybe use vicodin for occasional pain (as I was doing before my recent pain increase).

    And, can I ask, have you had any side effects from Opana? I sleep much better than I do on vicodin alone. But on Opana I seem to have these very vivid dreams. And they aren't sporadic they are like an entire story line in a dream. And unlike some dreams the story line is not unbelievable. The other day I dreamed we moved back to the midwest and when I woke up I had to look around to realize I was still in AZ. But the dream was the entire story line from selling the house to moving.....weird!
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    Old 11-24-2009, 09:38 PM   #10
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    Re: Question about opana/percocet

    Quote:
    Originally Posted by SpineAZ View Post
    I sleep much better than I do on vicodin alone. But on Opana I seem to have these very vivid dreams. And they aren't sporadic they are like an entire story line in a dream. And unlike some dreams the story line is not unbelievable. The other day I dreamed we moved back to the midwest and when I woke up I had to look around to realize I was still in AZ. But the dream was the entire story line from selling the house to moving.....weird!
    Two reasons....

    (1) You sleep better because your BPL (blood plasma level) is higher and more stable. Thus, you are more relaxed and more importantly, your BPL doesn't fall and hence, put you into mini WDs. When one is on pain meds regularly, keeping one's BPL stable is crucial. Short acting (SA) meds can eventually cause a roller coaster type effect. Upon taking the med, the BPL spikes and then falls off a cliff. These "ups and downs" cause irregular sleep as well as emotional instability...i.e moody, mild anger, and etc....Not to mention the quest for more meds (with many people).

    (2) The vivid dreams aren't from the Opana per se, as much as it's from the LA opiate. You're now in a much deeper REM state, thus, more likely to dream. You'd likely have the same effect if you were taking some other type of LA pain med, assuming of course it kept your BPL elevated and stable.

    Sleep is one of the first symptoms to either improve or worsen in relation to narcotics. For example, addicts who detox (or anyone for that matter), all report that they can't sleep and when they do, it's very interrupted and distorted. Upon detoxing, it can take quite a while to return to a very normal sleep pattern. Just another reason why a slow ween is recommended when coming off of pain meds.

    Regards,

    Ex

     
    Old 11-24-2009, 10:27 PM   #11
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    Re: Question about opana/percocet

    Thanks!

    It's just been weird. I swear if I could actually remember all that I dream I could write some good novels. I've always dreamed but no in such complete story lines ;-) Often it was a nonsensical dream.
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    Old 11-25-2009, 01:57 AM   #12
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    Re: Question about opana/percocet

    Hi Spine Ex is right, the sleep pattern for me changed so that I now love life. I finally sleep! I have to add something though, and maybe I am just not the "typical" person and maybe someone can help me with this. When I was on oxycontin, I would still wake up! I would take that twice a day with percocet for breakthrough pain, and I would still roam the floors. Once switched to the Opana, I sleep straight through. Of course not being sleep deprived really helps me overall now!

    I FORGOT my Opana last night, after a hard day and being upset over something and for some reason I still slept. I guess I forget I can just be plain exhausted.

    I don't have vivid dreams, on the Opana. Only twice, when my doctor gave me permission to take an extra opana due to a terrible, horrific body pain due to a procedure that I had, and WOW did I ever have a nightmare! And it was vivid. I did not like that.

    We must be having that deep sleep. I don't know why the Oxy did not allow me to sleep. I was engaged a few years ago, and before getting a long acting med. my boyfriend said I would cry out in pain most of the night. I did not remember it, but I hurt so bad when I woke in the morning.

    About that book Spine! My life is so colorful, it seems I too could write one on just my daily events. LOL

     
    Old 11-25-2009, 01:59 AM   #13
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    Re: Question about opana/percocet

    Oh I forgot, thanks for that link Ex..I will check that out

     
    Old 11-25-2009, 05:57 AM   #14
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    Re: Question about opana/percocet

    Oh the irony....I write about how much better I sleep on Opana and then for the last 2 night I've barely slept at all. I jinxed myself. Now it's just about 7 am and I'm hoping for a nap since I've been up since 4. :-)


    If I take a vicodin after 7 pm I often have problems staying asleep but don't recall taking one at night recently. Oh well. Nap time.
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    Old 11-25-2009, 07:25 AM   #15
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    Re: Question about opana/percocet

    Quote:
    Originally Posted by SpineAZ View Post
    If I take a vicodin after 7 pm I often have problems staying asleep but don't recall taking one at night recently.
    This may be because hydrocodone activates the excite pathways on the receptors....A sort of "energizer" effect in many people. Thus, it creates a paradoxical effect, or opposite of what it's intended. That would be my guess.

    Just as a side note, this is "why" hydro can be such an abused med.

    Regards,

    Ex

    Last edited by Executor; 11-25-2009 at 07:26 AM.

     
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