Possible vicodin withdrawal?

Discussion in 'The Watercooler' started by flutterbee, Jul 4, 2008.

  1. flutterbee

    flutterbee Guest

    Maybe I'm just being paranoid or dramatic, but there is such a strong history of addiction in my family that this concerns me.

    My doctor prescribed hydrocodone (vicodin) for pain on June 20. The prescription is as follows: Hydrocodone 5/500 (which means - I think - 5mg hydrocodone, 500 mg acetaminophen), 1-2 tablets every 4 to 6 hours (max 8 per day). She prescribed 30 with 2 refills. Obviously, she doesn't expect me to be taking them every day and I have no intention of that.

    I've had a lot of pain the last couple of weeks - been in a flare or whatever you want to call it. And when I use the word 'pain', I'm talking 7 or higher on the pain scale. The rest of the time I use words such as, aching, burning, discomfort, etc. I only take one at a time - never two. The most I've taken in one day is 3 and those were at least 4 hours apart and I've only done that 2 days. The other days I've taken either 2 or 1 per day and one day I didn't take any. As I stated above, this was prescribed June 20 and I've taken a total of 28 pills (as I have 2 left).

    The first day I took a total of 3 pills, was Monday, June 23. The other days that week I took either 1 or 2 per day. I don't get 'high', although I do get a little chatty, but mostly I notice that I'm mentally sluggish and tend to trip over my words. That Friday, June 27, I didn't take any. I felt horrible that day, but was going to the movies and didn't want to be drugged. I was horribly irritable. It can easily be said that it was from the pain, but I really don't know. The movie was too loud, it was loud in the theater, I am very sensitive to noise and smells and I used a little bit of hairspray that day and could smell it all night. It was making me sick. I couldn't filter out the noise and it was sounding just like a roar. The noise and smell issues are a constant with me. When I'm feeling worse, I have less tolerance, but it's always there to some degree.

    This past Wednesday I started feeling really bad. Besides the pain, I just felt really ill all over. Thursday, was horrible. I only took 1 pain pill Thursday and that was around 5pm. I slept most of the day Thursday.
    This does seem to be part of whatever is going on with me. This ebb and flow, the feeling ill, etc. Today, however, I felt awful. I felt so bad. I didn't want to stand up. I couldn't get comfortable no matter what. Just the kind of thing where you just want out of your body. But, I wasn't having pain in the sense I use the word. I had a lot of discomfort and it was pretty miserable, but not pain. I have been hot and cold all day. I woke up at 1am freezing and actually turned the furnace on. I turned it on again at 1pm. Then, I had the A/C on and it's been up and down all day. I've been on the couch with a blanket and it's been on and off me all day.

    I was just feeling worse and noticed that my heart just really seemed to be thumping so I checked my BiPolar (BP) and pulse. My BiPolar (BP) was 186/106 and my resting pulse was 106. I went to the ER a few weeks ago (before the pain medications) with this thing and they didn't do anything so I wasn't in a big hurry to go again. However, I was feeling so bad that I was considering it. I called easy child home from his girlfriend's, as he had the car, and took a warm shower to see if that would relax me some. After the shower, my BiPolar (BP) did come down some - 166/100, but my resting pulse was 133. (!!!) Normal is between 60-80. So, I decided to take a nitro glycerin. I wasn't having angina, but I know it will bring down the BiPolar (BP) and pulse rate. Unfortunately, it also causes an incredibly, intense headache and so I took the nitro and my first pain pill today at around 9pm. It did bring my BiPolar (BP) down some more and brought my pulse down under 100.

    Thing is, now I don't feel nearly so horrible. I suppose it could have been the nitro bringing down the BiPolar (BP) and pulse, but I have serious concerns that what I was experiencing all day was withdrawal from the hydrocodone.

    I'm afraid to talk about this with my doctor. I'm not drug seeking. I didn't have a craving for the medication today and didn't take any because I wasn't having high levels of pain. But, I felt so horrible. I'm afraid if I bring this up with my doctor that she will be afraid to rx me anything and while I don't want to have dependency issues, the vicodin is the only way I've been able to function at all the last couple weeks. Otherwise, I wouldn't have been much more useful than if I were in a coma. Seriously. I could barely move and walk as it was WITH the pain medication. And, like I said, I'm not drug seeking. I'm just concerned that with my family history there is some kind of genetic predisposition to becoming dependent quicker and that what I experienced today was withdrawal.

    I know that I will see how tomorrow goes, but I'm just really worried tonight and if anyone has any experience or insight, I'd like to hear them. If it ends up that I think over the next few days that this is becoming a dependency issue, I will have to find other alternatives for pain relief so any ideas on that would be appreciated as well.

    Sorry this is so long. If you've made it this far, well, you really need a hobby. :tongue:

  2. witzend

    witzend Well-Known Member

    Three is a lot, in my opinion. I have a huge prescription, but I never use all of them as alloted. When I do take them, I often have to take advil to ward off a "bounce back" headache. It's a real battle for me. If I take them, I can do more of the everyday things that everyone else does. But, when I do that, I hurt myself more so I need more to feel better. It's easy to get into a cycle. I make sure to take "down days" so that I know for my own comfort that I am not addicted to them.

    My doctor tried to prescribe daily doses of methadone for my chronic pain. That made me so darned pain free and happy that I said no after a couple of days. There was no way I could have gotten on in life if I had been that stoned every day!
  3. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I dont think 3 a day is a lot in my opinion. I think its a matter of dealing with the level of pain. One thing I have learned is to stay ahead of the pain. If you only take the pain medications when the pain is at a 7 or 8 it will take more of the pills to get the pain down to a dull roar than if you take one or two a day and keep it at say a 3 or 4.

    I hate taking the pain pills. I fought going back on them tooth and nail. When I got my script back I would only take one if I was in such dire pain I was miserable. I ended up getting yelled at by everyone saying that I was putting more stress on my body than what was necessary. Now I am getting by on 2 a day most days. If its really bad it takes 3. I finally got my appointment with the neurology clinic at duke for the end of august and Im hoping they can give me some more clues. I actually want to consider moving to something long acting again because I did much better when I had a steady stream of medication in my blood than I do with having to take a pill every 6 hours.
  4. KTMom91

    KTMom91 Well-Known Member

    I agree with Janet that three is not a lot. I believe that the purpose of pain medication is to manage the pain. If you're not in pain, don't take anything. But if you're heading towards 5 on the pain scale, it's time. And take what you know works for you. My doctor gave me 800 mg Motrin for my knee pain. It hasn't done a thing. Now, the leftover Vicodin has dulled the pain considerably. I'm just hanging on till Tuesday and the orthopedist.

    Hope you feel better soon, Heather.
  5. Fran

    Fran Former Site Owner

    Heather, there is no way of knowing what brought on your symptoms but your b/p and pulse rate are a concern. I would have to discuss these symptoms and see if the doctor has a better idea of what was going on.

    I'm pretty much a tylenol for pain and 2glasses of wine/year sort of person but a few years back my dentist give me nitrous oxide. It was so wonderful that I was drooling for it again. I couldn't wait until my next appointment. How scary is that? Addiction is not one of the issues our family tree deals with and I'm not a substance user of any sort(well, maybe cookies). Fortunately, the dentist never gave me nitrous oxide again but he did give me whatever it takes to dull the pain of dental work. He never discussed the incident but he made sure I was comfortable and not vulnerable to becoming hooked.

    For me, it's scary how good and not drunk it made me feel. Never again. I'll stick to cookies.

    I hope your doctor can help calm your fears and give you appropriate treatment for pain and b/p/heart issues.
  6. Marguerite

    Marguerite Active Member

    Heather, whether three is a huge amount, or nothing much, really depends on you and how sensitive you are to the medications.

    mother in law can't take opiates at all, When she is in severe pain she takes paracetamol and finds that just 500 mg paracetamol sedates her. This is good, because when she had open heart surgery, the only pain medications she could take to help, was paracetamol. And for open heart surgery, it barely did a thing.

    On the other hand, I take large amounts of heavy opiates and have done for many years now. I understand about addiction and withdrawal, not so much from personal experience as from sharing your fears in the early stages, and also from trying to ease the fears of one of my specialists (who kept using the term "addiction" in his letters to other doctors about me, which really got me riled).

    I started taking ongoing pain medications in 1988. Back then I was taking Panadeine Forte, which is 500 mg paracetamol and 30 mg codeine phosphate. I was taking up to 8 a day.

    My pain was episodic back then, it would ebb and flow over a period of 8 weeks. There were times when I was not in much pain and would cut right back; there were other times when I was taking the maximum. On days with little pain, I would just take less medications. On days with a lot of pain I would be watching the clock for the time when I could take more.

    An addict generally takes far more than is prescribed. An addict also takes it not for pain relief, but for the euphoria or other 'feel good' response. When their physical pain eases, they still take the medications for the euphoria.

    If you're taking the medications primarily in response to pain, and if you stop increasing your dose before you get to the euphoria point, and if you cut back your dose when the pain is less, then you are most unlikely to currently be an addict or to develop addiction.

    I found when I began taking it, and at times when my medications have been changed to something stronger, there was a period during which I did feel a small amount of euphoria as well as some sedation. There was also a corresponding period when pain was COMPLETELY relieved.

    I learned tat for me, it was best to take just enough medications to get the pain to manageable levels. Trying to totally eliminate the pain was not a good idea.

    Another thing I did wrong initially - I tried to hold off on taking pain medications until I just couldn't stand the pain any longer. A doctor finally nagged some sense into me - if you know the pain isn't likely to have subsided, then you should take a single, larger, loading dose and then take a regular smaller top-up dose. In this way, your pain will be better managed and you also will take less pain medications overall.

    I have found in the years since, that she was right.

    That doesn't mean you're not going to get habituated to long-term pain medications. Your body does get accustomed to them and it does take more to get the same level of pain relief. This is not addiction. If your dose can still drop back to a lower level on days when pain is not so bad, then you are not addicted.

    But you CAN get withdrawal symptoms, even if you're not addicted.

    If someone waved a magic wand and all my pain vanished overnight, I wouldn't need my pain medications. But if I stopped taking them, I would get withdrawal symptoms.

    The fist thing you notice on opiates - they bind you up. Constipation. Your body does adapt (at least mine does) so after a few weeks on them, my body has adapted back to a more normal pattern in terms of bowel habits. Of course, the first few times you feel like your body is trying to pass the Rock of Gibraltar, and the fallout of this is bleeding, small tears and discomfort next time as well when the tears open up again.
    You can alleviate this by making sure that if you're taking opiates, you also take A LOT of fibre and drink a lot of water.

    The constipation is caused by the opiates slowing down your gut motility. Peristalsis is slowed and transit time greatly increased. This means more water is absorbed, everything backs up and it can be very uncomfortable.

    If you're only taking a small amount, this effect will be minimal.

    But as I said, your body adjusts to it and over time, the constipation is no longer a big deal.

    But if you suddenly STOP the opiates, then this adjustment of your body suddenly has to deal with the sudden cessation of the opiate-induced suppression of peristalsis. In other words, everything gets moving again, very fast, much faster than normal.

    So the first thing you will notice, when you drastically cut back your opiates (or are just late with your medications) is diarrhoea and sometimes GI cramps. Maybe it's all you will notice.
    I find that this hits about the same time as the pain kicks in (pain from not taking my pain medications).

    Other symptoms I've noticed - increased sensitivity to noise, irritability, anxiety - are all due to the increase in pain, I believe.

    A lot of withdrawal symptoms are generally due to your body adjusting back and overshooting (because after a long time on the medications, your body has adapted in other ways too). Dilated pupils, for example - addicts' pupils tend to clamp right down to pinpoints. It's a sign of overdose, to have contracted pupils. So going off the drugs - your pupils go the other way, and dilate.

    I just did a bit of checking online and came up with this reference:

    "Symptoms of withdrawal include:

    Abdominal pain
    Dilated pupils
    Goose bumps
    Runny nose
    Vomiting "

    Looking at this list, I've only ever had abdominal cramps and diarrhoea. Maybe some agitation, although it depends on why I'm withdrawing. I know I do get agitated if withdrawal is due to a gastric attack, because the combination of the vomiting from, say, food poisoning, means that my medications are not able to be kept down. This speeds up diarrhoea which speeds up the loss from my body of any medications which made it past the point of no return. Any medications they try to get into me orally are going to keep on going, fast, and not get absorbed. And the biggest problem this causes for me - PAIN. A lot of it.

    So if I'm desperately trying to persuade the hospital to give me an injection of pethidine to stop this process, and they're not listening, then yes, I get agitated. But once the pain gets away from me, I go into shock. This is not a withdrawal symptom. it's purely a reaction to the pain.

    And symptoms of shock - raised blood pressure (sometimes) or alternatively, much-lowered blood pressure. Raised pulse. Sometimes, low-grade fever (or that could be the infection causing the vomiting).

    Your description could simply have been raised BiPolar (BP) and pulse from the return of pain severe enough for your doctor to prescribe vicodin.

    You took a nitro pill as well as the vicodin. And you began to feel better. It is entirely possible that you began to feel better as your pain eased.

    A few years ago I was able to completely stop my morphine, cold turkey, to the consternation of health professionals at the time. However, I happened to be on the immunology ward which included a lot of HIV patients, a number of whom were also, coincidentally, heroin addicts on methadone. So they also were thinking along the lines of my being an addict, instead of a chronic pain patient. Some kidney X-rays had been ordered and the prep for this was fairly drastic - purgatives. The form of morphine I was taking was in sustained release form, which means one dose was supposed to last 12 hours. But those purgatives meant that anything I ingested was being shunted through to the exit sign in about two hours. That meant the medications weren't going to have time to work. So if it's not going to work, why take it? That was my logic, anyway.

    So on the morning of the tests, with the laxatives given the night before now well and truly doing their job, I refused my morphine. Added to the problems caused by the laxatives was the withdrawal diarrhoea caused by the morphine (previous night's dose) being shunted from my system extra fast. It meant those laxatives hit me very hard.

    The nursing staff were in a panic. They were used to patients trying to con more medications out of them; not used to patients refusing it.

    I was in pain. But it was going to happen anyway, with the purgatives.

    I had the tests. By the time it was all over, the purgatives had done their worst. I got back to the ward at about 2 pm. My next medication dose wasn't due for another four hours. But because I hadn't taken the morning dose, I was able to ask for it at 2 pm. And because the purgatives had worn off, the pain medications were able to work. The diarrhoea began to stop about an hour later at about the same time as my pain eased.

    If I'd taken my morning dose I would have still been in as much pain, but wouldn't have been permitted to take my next dose until 6 pm. Another four hours of pain.

    Since that time another ten years have passed. I now take a stronger dose. My pain levels have increased too, to a point where I try to avoid missing my medications, because the pain now can be so severe that I go into shock much faster and need hospitalisation, purely for the pain management.

    But I still have days when either I'm too busy, or my pain level is lower, and I forget to take my morphine. The diarrhoea is what lets me know, at about the same time as I'm aware that I'm in more pain than usual.

    If I'm able to put up with the pain, I sometimes take a lower dose of medications. Hey, maybe I've been tapped with that magic wand! But there is always some pain, unfortunately.

    And on days when the pain is extra bad, my pain specialist has told me to take a little more if I feel I need it. He knows I will drop back to a lower dose again as soon as I can.

    So, I recommend you see a pain specialist, to oversee your pain management. An expert lie this can reassure you and help you cope better not only with managing your pain but also with your concerns of addiction.

    I am not an addict. I've also been on this same strength medications for the last few years and do not see any likelihood of needing to increase the dose any time soon. For me, this is a sign that my pain levels are currently stable.

    But I do know about withdrawal. As long as I stay well, do not get a gastric bug or need to have purgatives for tests, and do not forget my medications or run out of them, I needn't worry about withdrawal, either.

    But I really don't find withdrawal as much a hassle as the pain. It's really bad, these days. It locks me up, I can't move, it feels like someone is hammering spikes into every joint and stamping on every bone. I hurt to touch, every nerve feels like a line of fire along every limb and I get blinding, nauseating headaches which feel like my head is a large egg and a giant is cracking it open to have breakfast.

    On medications, I function so well that people really wouldn't know. I don't get sedated (I avoid taking enough to sedate me) and instead, my brain is much sharper (not distracted by pain) and I do all the usual things people do. I drive my car. I organise family events. I cook complex meals. I give lectures, often speaking off the cuff. I go walking.

    People don't know this about me. They really don't. Most people wouldn't understand, so not even my best friends know (apart from two). I've become so accustomed to being secretive about this, that even talking about it here, anonymously, makes me feel exposed.

    husband & I see the same pain specialist. husband takes far less pain medications than I do, but his pain is also much more difficult to control. I am very grateful that at least one of us CAN be managed well, because at least I can function when he cannot. But I do wish the doctor could help him as much as I have been helped.

    Heather, have courage. And hold onto this bit of information - it has been shown that when patients take opiates purely to manage severe pain, they do not become addicted. They may become habituated but as long as their main reason for taking the medications is to relieve pain, then if/when the pain goes away, the pain medications can stop without the cravings etc that addicts get. This research was done in Britain, where chronic pain patients (such as cancer patients) are given heroin. This enables them to go home from hospital and live a full, productive, happy life instead of a drug-soaked twilight in hospital somewhere.

    Once I learned that, I felt a lot better about what I have to take.

  7. Marcie Mac

    Marcie Mac Just Plain Ole Tired

    Heather, my only point of reference with pain medications is thru my SO - who is on massive doses of morphine, vicoden, and something else, I forget the name, Norco maybe? He was even on methadone at one point he had a new doctor for pain management, and he was worried SO was becomming an addict. His bones are disinigrating, and to me, an becomming an addict was the least of his problems we needed to worry about. But he put him on the methadone, which did very little to help the pain.

    One thing I have seen, if his pain would start getting bad because he was not taking his pain medications as prescribed, it does cause hugh levels of anxiety, which makes the pain worse, and with that comes a hugh spike in his BiPolar (BP) and pulse is racing, and he needs to take the nitro, and on occasion because he had waited so long, had to go to the er.

    It could be you are having a reaction to the vicodin and maybe need another pain medication. When I had foot surgery a while back, they gave me an RX for vicodin when I left the hospital, and told me to start taking it before I had any pain every couple of hours.
    I think I took three that day, and that was enough. Couldn't even get out of bed they made me so sedated - didn't like that feeling at all so didn't take any more.

    As far as SO being an addict, he had cut back on the morphine on his own to very little if any - He says he still has the pain, but likes the feeling of being clear headed. Unfortunately now both knees have pretty much started to go so he has started up on it again, but no where near the massive doses he was on.

    The one drug he did like that took away the pain and he was able to stay clear headed was Fentanol - the dose was in a sucker so if the pain started up, a few licks of that and it was in control again - it would last him maybe a whole day doing it that way. Unfortunately medi cal won't let it be rx'd unless you are a cancer patient.

    Have you got a pain management doctor? I would tell your doctor about what happened - maybe vicodin isn't the pain pill you need. I think pain management is all about letting you function with a severe illness, not taking something that puts you out in left field most of the day.

    Am sorry - I know it absolutely bites being sick all of the time and not being able to find any comfort.

  8. flutterbee

    flutterbee Guest

    Well, I'm putting my mind at ease today. My BiPolar (BP) is down - still high, but much better - and I feel so much better today. No vicodin today either.

    The BiPolar (BP) issue started before the pain medications. What's really interesting is that I never had BiPolar (BP) issues until the last few months. Even when I was having a heart attack, my BiPolar (BP) was 147/90-something. At this time last year, my BiPolar (BP) and pulse was dropping too low and they removed the ace inhibitor and adjusted the beta blocker. I have an appointment coming up with my cardiologist and my GP wants him to test me for pheocromocyte (sp?) which has something to do with the adrenals and causes high blood pressure and I guess the symptoms I have when my blood pressure goes up matches. I dunno. It just seems like I have new symptoms all the time and it's hard to tell what is what. My GP did add back in the ace inhibitor (I'm really not sure the difference between the ace inhibitor and the beta blocker). And then I worry about what all of these medications that I'm on are doing to my body. Could they be helping one problem, but creating another? I have 9 or 10 medications that I take everyday, some twice a day, plus supplements, plus things that I take as needed.

    So, since I feel soooo much better today and I haven't had any vicodin, I think it's safe to say that it was the other issue that was causing me to feel so poorly. That and the pain combined. I will continue to remain cognizant of it, though. There is such a strong history in my family and I'm a bit paranoid.

    Fran, I *hate* nitrous oxide. I hate how out of it I feel, how I have no memory of the time that I was on it and then it causes a rebound headache like you wouldn't believe that lasts for days. I have pretty high dentist anxiety, but I'd rather just s*ck it up then go through that. Maybe the dentists that used it with me didn't have the mixture right, but ugh, ugh, ugh.

    Marg, thank you for sharing your story with me. And thank you for the info on what to look for. I do have to keep in mind that pain management is a part of our health. I know that when the pain was really bad and I had no pain medications, I was so frustrated because it was like, what about quality of life???

    Marcie - I don't have a pain specialist. The rheumy mentioned it, but then they went on about 'that' clinic (Mayo or Cleveland Clinic, I still don't know) and I didn't hear anything else about it. I actually wasn't too hip on it because I want symptom mgmt not just pain mgmt, but the last 2 weeks have shown me that I don't give a darn about symptoms when the pain is so out of control.

    Witz - I take off days, too. The vicodin I'm prescribed is the lowest dose, so I really don't think that 3 in one day is a lot when that's what I needed just to be able to bear it. I have noticed that I tend to overdo it when I'm on the pain medications and have to make sure I rein myself in. There's just always so much to be done and when I'm physically able to do it, I want to do it. It's hard to find that balance.

    Janet and KtMom - The thing is I might be at 3 or 4 and then wake up at 9 the next day. It's this ebb and flow thing all the time. I don't like feeling loopy or drugged and I know if I take 2 pills at once as it says I can that I will probably have much better pain control, but I won't be lucid so what's the point? I appreciate your experience and insight. I'm just trying to figure this out and strike some kind of balance between pain, functionality and my own comfort level with the medications. Bleck.

    Thank you for helping to ease my rising panic last night. I was so freaked out and just kept thinking about my being like my dad and...well...I'd rather suffer with pain than be anything like him.
  9. Hound dog

    Hound dog Nana's are Beautiful


    Trust me. You'll know if you're going thru withdrawl. It's like any other. Aggitation, nervousness, often a headache, sweats, sometimes nausa and vomiting. Some people get the shakes. Some get that restless leg syndrome feeling only it's all over and all day.

    To be frank, I've had worse withdrawl from psychiatric medications than from vicodin or any pain medication. (also was physically dependent on morphine but that's a whole other story and too long to get into here)

    Three a day isn't bad. Three a day short term is not going to make you addicted.

    I took double that dose 6 times a day for 3 straight months due to a blocked kidney doctor didn't want to do surgery on til our insurance kicked in. I didn't want to take it, but it was either that or be in hospital on morphine.

    And yes, I developed a dependence. My body had grown used to it. But I assure you I didn't go seek out the medication once the prescription was gone and I no longer had pain.

    I went thru withdrawl. It wasn't fun, but it wasn't horrid either. I felt crappy for a couple of days. Period. Flu like mostly. I assume they get worse the longer the usage. Once the withdrawl was over I was fine.

    And I've used it again repeatedly without incident.

    I understand your concern with possible addiction. But honestly, I think your wariness about it will prevent it from happening, even if your body would become dependent on it.

    Addiction is as much a state of mine as it is physical state of the body.

    If you need you pain medication, take it. Staying ahead of the pain, as Janet put it, often makes the medication work much better which can lessen the amt you need in the long run.

  10. timer lady

    timer lady Queen of Hearts


    I've been on methadone & vicodin for pain for the last year. On average I take, on average, 3-4 vicodin/daily & the prescribed dose of methadone daily. When I don't take those medications I'm beside myself in pain - cannot walk at all & the head pain is horrendous. There is no way I could function at all with-o those medications.

    While the prescribing doctors are watching the levels of medications I take they aren't concerned. I haven't asked for an increase in dosage nor have I run out of medications before the end of the script. I haven't noticed any of the withdrawl symptoms on days I might not take as much vicodin as prescribed.

    I guess it show how different each of us are biochemically. I take what I need to function - to be a wife & parent. My doctors are watching & waiting for the day that PT can start hoping this will build my strength, lessen the pain.