For JD: Vicodin Query

>> Sunday, May 31, 2009


JD asked: How many days in a row can you take Vicodin before something bad happens?

Short answer: I don't know. If you're worried, talk to your doctor.

Long answer: I still don't know, I'm not a doctor or pharmacist and still recommend you go to an expert if you're worried for any reason. But this is what I know about Vicodin. (Yes, I know that's a Wikipedia reference, but it's a good place to start for a lot of topics. There are references included).

It's a combination of semi-synthetic opiates (hydrocodone) and acetominophen (tylenol) that has a potential for both physical and emotional dependency. It's classified as a Schedule III drug by the FDA. Additionally, both main ingredients, acetominophen and hydrocodone, can be fatal if overdosed. Acetominophen can also lead to liver damage if somewhat overdosed (~4g [aka 4000mg]/day) so it's very important not to take this drug with any other drugs containing acetominophen. There are also a number of side effects list, not (fortunately) including anal leakage, though there are plenty of unpleasant ones.

As a layman, trying to tell someone I've only met in the cyberworld they've taken their medicine too long would be foolish of me. Even for professionals, it's not clear how long it can be taken safely given that people's tolerance and period of time before dependency occurs varies.

Here's my gut feel, though, as a friend. If you're worried about it, if you find the Vicodin less effective or if you're afraid to cut back, contact your doctor. If you can cut back, try it and definitely call your doctor if you find you can't.

16 comments:

  • Therese Haberman
     

    Great Response, Stephanie. I have taken Vicodin for long periods and the key is to wean yourself off very slowly. Cut the dose by one third each month until you are down to a half a tablet and then cut to half a tab every other day. Slow weaning will ensure no withdrawal symptoms. Love your blogs. Keep up the good work, Therese

  • Lola
     

    I have terrible back pain and the doctors I've had always want to whip out their RX pad and write up scripts for vicodin. It's a personal preference, and everyone's pain tolerance is different, but I use the vicodin as a last resort and I personally won't take it for more than a day or 2. I take a prescription dose of ibuprofen daily and I also have flexeril for when pain. That also knocks me on my butt, so it's not really the lesser of the 2 evils, although supposedly it isn't as potentially addictive.

  • Stephanie B
     

    I've actually had a number of prescriptions for vicodin that I've never filled. I don't like being dependent and keep my migraines at bay, somewhat anyway, with over the counter. But it's not always easy.

  • JD at I Do Things
     

    Thanks, Stephanie.

    HA! I already know what my doctor will say! All four doctors I've asked have the same line: "once or twice a week." Then, ironically, they ALL try to give me a prescription. I currently have only one, with my pain management doc.)

    I know some people take Vicodin long-term--with their doctor's blessing--and I was wondering about this. So far the longest I've gone taking it is 10 days (Hey, today is Day 11 and I just took 7 Advil in an effort to stay off it!) Hopefully injections and PT are going to put me back on the "once or twice a week" schedule again.

    Be very, very glad you can manage your pain with OTC medications. That used to be me. But then the pain gets to a point where you don't care about dependance, being a slave to drugs, your liver developing a hole . . . you just want relief.

    Sorry! Didn't mean to go on so much. Us addicts are always gonna be a bit defensive!

  • Stephanie B
     

    I've been very lucky to be as healthy as I have.

    In the past, the prescriptions have been for knee surgery, childbirth, and dental work, neither of which turned out to be as painful as expected. Plus, vicodin knocks me unconscious (or did when they gave it to me after the knee surgery). Given that, it's probably not so much stoicism as fear that has kept me from taking more pain medication.

    I'm not here to judge. Everyone has different limits and, to be honest, I probably haven't been in that much overwhelming pain.

    I tried to answer a question I was ill qualified to answer and, if I failed, I'm sorry.

  • flit
     

    Vicodin can result in your having to spend the summer in a psychiatric hospital ...I know cuz I saw it on House

  • JD at I Do Things
     

    Flit: Yes, I saw that too! House is such a bad role model.

    Stephanie: You CAN'T fail -- no need EVER to apologize. You gave your best answer. I was just wondering if you or anyone here knew of someone who took Vicodin long-term and what the effects were. I try not to judge either. We're all different.

    And I used to pass out when I first took Vicodin, too. That wears off.:)

  • Stephanie B
     

    I only know two people who were on long-term painkillers and, in both cases, I thought they were bad examples. One is my ex mother-in-law who had a friend in pharmacy who kept her in fuirinol (a lower level painkiller), but she ran through 90 of those a month. I didn't think that was healthy.

    My ex-husband did not go through so many, but after a prescription from a dental procedure, he found excuse after procedure to get more hydrocodone (same thing). He wanted me to fill those prescriptions so he could take them; it's one reason I didn't.

    Most of the rest of the people I know either (a) have not had to face long term dependence on painkillers, (b) have taken special steps to prevent long term dependence or (c) they haven't told me about whatever the drugs they're on.

    I'm thinking most of the people I know fit under (c).

    I hope you find another way to control the pain. Chronic pain STINKS.

  • Lola
     

    JD - Ask your pain doc for 800mg ibuprofen. Also, have you tried Flexeril? There is also an ER (extended release) version that is supposed to cause less drowsiness (unfortunately for me, it doesn't work that way, it still knocks me on my butt, but according to my doc, I'm the oddball, as if I didn't know.)

    Have you tried injections? I had several epidurals and 2 courses of facet injections, but they didn't help at all. It works for some people. It might be worth a try?

  • Lola
     

    Oh, if you're doing PT, try hydrotherapy. There is a treadmill in the big water tank and you walk and do exercises in there. It's great because it doesn't irritate the lower back as much as land therapy.

  • JD at I Do Things
     

    Thank you again, Stephanie.

    And thank YOU, Lola. I had an injection in January that only lasted about a month (and my current doctor won't give me another one) and I've had injections on both sides of my lower back (right side still good, left side not so much). I'm definitely going to ask about the ibuprofin and Flexeril. Oh, but wait. Is Flexeril cyclobenzaprine? If so, that doesn't help me too much. Makes me very very sleepy and weirdly crabby. But I'll check it out. And hydrotherapy sounds good too. Thanks for all the great suggestions.

  • The Mother
     

    I am a doctor, and the answer is: it depends.

    Different people have different tolerances to medication. Plus people who take narcotics for a long period of time develop tolerances.

    The good news is that there is a fairly new subspecialty of medicine known as pain management. These docs are the experts. Also, for things like back pain, they have loads of other non-narcotic tricks up their sleeves (my hubby just had his back injected with steroids, and it got him up out of his comfy chair and back out playing tennis).

    If you are concerned about your usage of any drug, ask your pharmacist for information. And feel free to consult a pain management doc to look at alternatives to narcotic therapy.

    And PLEASE don't use HOUSE as any sort of medical textbook. Honestly.

  • Stephanie B
     

    Damn, one of the things I LOVE about this blog is the many commenters who step up and add something else to the mix, often experience or, better, expertise and/or resources.

    I love you guys.

  • Lola
     

    The generic for Flexeril is Cyclobenzapr, but there is an ER (extended release) version that is supposed to reduce the drowsiness. Can't say about the crabiness. Lol!

    Though I've been trying to limit my pain meds since I overdid it on Friday. And it's really silly because by overdid it, I mean I stood too long and sat in the bleachers (no back support) too long. (It's not like I did some activity I shouldn't.) I have been one mean, crabby beyotch since Friday. I'd be willing to take the punishment if I at least did something fun, like golf.

  • flit
     

    LOL I would think that anyone that watched House all the way through ONCE would KNOW that using him as any sort of a medical textbook would be a VERY BAD IDEA.

    they NEVER get it right until long after they've made everyone worse!

  • JD at I Do Things
     

    Thanks again to everyone who chimed in. (Stephanie, you're right: this blog encourages some great participation!)

    To Dr. "Mother": (can I call you that?) Thanks for the advice. I've seen two pain management docs (loved the first one but then our insurance changed; hated the second one), and since everything they tried BUT injections and Vicodin didn't work, I'm relying on my PCP for the drugs and my orthopedist for the shots. For now. My PCP keeps me honest and won't throw handfuls of Vicodin at me, like some other doctors I've had.

    Are you sure about House? He's so damn COOL!

    Tho, flit, you're right. Patients have to suffer at least an hour of bleeding from every orifice, heart attacks, and/or skin falling off before House has an epiphany while stealing Wilson's lunch. Not good.

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