Discussions that mention vicodin

Pain Management board

Hi All,

My 16 year old daughter has severe back pain. My doc in OR thought she might have a herniated thoracic spine disc but it was never "diagnosed" with films.

About a month ago she had what I call an "episode" where she could not move from one position and was actually writhing in pain from her back. She has always had moderate back pain (she has a large "chest" and has carried a very heavy backpack for school for some years now).

I took her to an urgent care place that gave her 600mg ibuprofen and 5/500 vicodin. We also went to a physical therapist three times.

We have since found a primary care doc (we are new to the area). My daughter had an MRI last week (don't know the results yet), and she had to go to the ER in over the holidays while she was visiting her dad. The ER did regular xray films but they were inconclusive.

My issue is that when she takes the vicodin it helps the pain but she also has a really bad "come down" that causes her to be depressed and want to take more and more vicodin. She and I are very close so I know of her plight with the narcotics.

I'm wondering if any of you can recommend a different pain killer w/o such severe side effects for her. She suffers from depression already and doesn't need to be taking pain killers that make it even worse, although she knows that if that is what she needs to help the pain, she will take them. We told the doc about the side affects, but all she said was that the vic's are a depressant (duh) we already knew that.

Anyone have any ideas??

I would recommend a continuous dose of MS Contin ie 15 mg's every 12 hours, with a small prescription for BT pain, say Vicoprofen 7.5/200 1-2 tabs every 6 hours as needed for pain. With a long acting narcotic like Ms Contin, there will be a much steadier state of serum in her system, which should greatly cut down on the peaks and valleys the short acting vicodin is causing, while also elimitating the possiblility of her overdosing on the APAP inadevertently. The breakthough med Vicoprofen is especially appropriate in her case because it contains 7.5 mg's hydrocodone (same med as in vicodin) but it also contains 200 mg's of ibuprofen instead of the 500 mg's tylenol, which is better because ibuprofen is an anti-inflamatory that she is already on, so it kinda kills two birds with one stone, so to speak. I would wait on the anti-depressant to see if the MS Contin eliminates some of the cycling associated with the shorter acting narcotics. Good luck.
:wave: Hi Ruby! I'm sorry that your daughter is having so much pain at such a young age! shes lucky to have such a great mom in her corner! I have a son in high school, and I have noticed for the past few years kids using back packs that have the wheels and the pull handle on them, like suitcases. I have seen them at ross for less than $20, that may help her. You might want to discuss Ultram (tramadol) with your doctor like the other poster mentioned. It is a very effective pain killer, and while it does have some synthetic opiate properties it does not have any where near the dangers of medications like vicodin. It also works as an anti depressant, so if she is suffering from depression that would be a good choice, you have to monitor carefully going on to ultram and taper off very very slowly, but it can be a very effetive medication. After reading your second post though I wonder if she just isn't undermedicated, and needs something more long acting. Best of luck to you and her, let us know how you both are doing. Hugs, Fabby
I'm glad to hear that you will be mentioning soem of the pain medication alternatives to the doc. For the poster that recommended tramadol (ultram), while ultram can be a very effective pain medication, and even though it is a fully synthetic opiate-like medicine, not a true opiate, I would actually not recommend it in your daughter's case. Tramadol does indeed cause substantial withdrawal symptoms in most patients using it long-term, despite what the drug manufacturer would have you believe, and so in that respect it has no advantage over the more conventional narcotics. Additionally, the med also has properties of drugs called "benzos" which included meds like xanax, and thus can cause more significant psychotrophic reactions, which your daughter obviously does not need. (if she did go on an anti-depressant, i would recommend one of the SSRI's such as zoloft or paxil.) And Ultram (tramadol) is short acting, just like the vicodin, and what your daughter obiously needs is a longer acting med to keep a more steady serum level in her system. Plus tramadol is known to cause seizures if used in higher then recommended doses, during tapering, and even at the prescribed dose it has a much higher seizure risk then meds such as vicodin and morphine. So all things considered, I would still go with the meds I recommended in my previous post. Good luck and keep us posted.
Catnap - we are going to try all kinds of therapies...chiropractic, massage, homeopathic, etc. The last thing I want to do is have her undergo surgery since the outcome is so iffy.

Director...I take methadone 30mg bid (want to go to tid but that's another post :) ) I do like the methadone much better than oxycontin as well as there are less side effects.

My daughter's pain comes and goes. It's not constant but not regular either. Some weeks she is out of school for three days or more while others she is just fine. So I'm really thinking hard about if she should be medicated continuously (sp?).

The ideal for her would be to ease the compression on her spine with medical treatments be it chiropractic or massage or whatever - then treat her pain with something other than vicodin that she can take "as needed" that won't make her feel so "high". The real problem with the vic's is the "low" that happens when the drug wears off....it's such a hard thing to try to find the right chemicals (antidepressants in the form of and SSRI type and a good pain med).

Thanks to all for your support! My daughter thanks you too!! :bouncing:
What about a long-acting med (like Kadian/Avinza), not daily, but just for the day(s) she is in severe pain? Has anyone ever heard of that?

IMO, there would be less addiction if the long-acting (or sustained release) opiates were used more often instead of the short-acting ones (like Vicodin and perocets).

Some people feel the high (with short-acting opiates) and want to duplicate it. Or they feel the low (after they stop taking it) and they want the "low" to go away. But with a long-acting opiate, mood is not altered, or not altered as much anyway.

Quote from Wren9:
What about a long-acting med (like Kadian/Avinza), not daily, but just for the day(s) she is in severe pain? Has anyone ever heard of that?

IMO, there would be less addiction if the long-acting (or sustained release) opiates were used more often instead of the short-acting ones (like Vicodin and perocets).-Wren


The la drugs you mentioned are for opiate tolerant patients only. So that means she would already be physically dependant before taking these drugs LA drugs like Kadian and Avinza are not meant to be taken on an as needed basis.

I don't believe there is any opiate that is less addicting whether it be la or sa.