Discussions that mention tylenol

Pain Management board


Hey Jay, The reason why percocet is harder to get, or doctors prefer not to use it if they don't have to is the drug scheduling system inacted in 1970, drugs in class 1 are deemed to have no medical value and are illegal. Drugs in class 2 have medical value but are seen as the most likely to be abused, cause addiction, and I'm using their term addiction. I doubt many people that work for the DEA could explain the difference betwen addiction and being physically dependent which is just a natural physiological reponse to certain meds.

You experience abstinence syndrome if it's any other med that causes a physical response if discontinued abruptly. They use the term withdrawal when speaking about discontinuing opiates because of the negative connatation it brings with the drug. But if someone were to stop taking their Ppaxil after taking a healthy dose for a year, that would more likely kill them, but they call that abstinence syndrome because the DEA doesn't clasify antidepressants as drugs for high risk abuse and diversion.

Hydrocodone procucts contain tylenol, so does percocetand Tylox but "They" decided oxycodone was more likely a target for drug addicts/diversion, along with morphine, dilaudid, fentanyl, methadone, Ritalin and the other amphetamines are in the highest schedule which is scrutinized by several different groups. Pharmacist are the front line, they can report over prescribing to the board of pharmacy, the medical board or go federal and get police involved.

There are reports generated weekly of every doc and every patient and every shecduled 11 pill that was prescribed that week. At any moment you can walk into a drug store and they can tell you to the pill how many percocet or morphine tablets they have. It's the law, they have to keep a log, they have to send a duplicate to the board of pharmacy, who likely sends a dup. to the DEA and if a doc is drawaing a lot of attn due to the number of class 11 meds he is prescribing he may have to justify it.

It may be a simple phone call, or they can shut him down and take every record out of the bulding.

Norco and all other hydro products contain tylenol, they believe the amount of apap restricts the dose in which people can take safely. Even 3 Norco and your right at the virge of maxing the single dose max for tylenol. The apap limits the dose, unlike a class 11 med like Oxycodone 30 mg tabs. No apap so you can takea sas much pure opiate without daming any organs, ,,,,,, and take as much as you require safely, or that you want to abuse the stuff. The drugs without APAP are much easier to turn into injectable drugs.

So hydro is stil a calass 111 med, doesn't have anything even close to the controls the govt demands. It's pretty much each pharmcy cover your back side and it's easily done. My wife was in the biz.

All hydro products, unless compounded into higher strenght is class 111, nobody from the govt , board of pharmnacy and nobody from the medical board is looking for class 111 meds. To many other C-111 meds are out there and have potential for harm when abused when people self medicate and can cause withdrawal or abstinence syndrome, Hydro products are the most abused because there aren't controls in place like their are for oxy products and all the rest of the drugs for severe pain.

Anyway, all oxycodone product are class 11 and Hydro Class 111. Akthough a 10 mg hydro would be considered stronger than a 5mg percocet. They do bind to different receptors and subclasses of receptors, they break down into different drugs and cross the blood brain barrier at different rates. Have different half lives and metabolites.

10 mgs of hydro is roughly equielent to 7.5 mgs of oxy, That's an average of several conflicting equianelgesic charts, where drugs are compared in strenght. It not so much the drug but also the mgs.

10 mgs of hydro should be that more effective than 5mgs of oxy, except your excellent point, it's a different opiate and acts slightly different, in a way you may benefit from.

Class IV meds are like antibiotocs , class V meds are drugs that have virtually no potential for harm or abuse. Some can be signed for without a prescription, LIke Robotussin with codeine, It's not alot of codeine, but they do keep a log of who is buying it.

But the class 11 meds are so closely scrutinized, the docs don't want to be bothered with having to justify a long term , or higher than averge dose patient. Whatever average is.

You do need to tell him what's working though. One of these refills that's not lasting the number of days supply that is calculated when you pick up the script, will catch the eye of an over zealous pharmacist who will call the doc, and docs don't want to be questioned. Their spine tends to soften and they say don't refill untill your supposed to be out. Then the pharmacy red flags you . They have a warning attched to your profile to watch for early refills.

The day supply is calculted by the number of pills and the way it's prescribed. If your taking 3 at a time, your probably running out early and beyond your GP's ability or comfort zone. You will find out at some point. All it takes in one call and I have seen surgeons back down, IF they don't respond properly, they just call the board of pharmacy and they start pulling records which is a nightmare for the doc.

If yorur In the PM biz, and are legit, Your ducks are in a row and a simple inquirey as to your dose or presccreibing is handled with ease. If the doc can't justifyt his precribing, he will spend alot more time on the phone. Or if ehe continues to allow early refills there are all kinds of warnigs to watch for and doc.

Docs know this and some flat out won't prescribe opiates, some are very limited, they all have a comfort zone as far as what thye feel is safe or apropriate and was the dose aproached safely. That's the long version..LOL

Sorry so long winded.
Dave.