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purplegdaisy
Regular Member


Date Joined Feb 2005
Total Posts : 242
   Posted 7/1/2009 6:26 AM (GMT -7)   
When I went to my Pain Management Doc yesterday he brought up MJ and the drug issues. Said they were posting black box warnings on meds and only allowed to fill oxycodone prescriptions for 180 pills per month.  (Only 6 per day) (And that was not enough for me) so now I am on MC Contin twice a day in addition...
 
I hate it when people do stupid stiff and ruin it for the rest of us. 
 
I have had migraines for 27 years. I have tried so many meds I have forgotten their names...
I also have chronic back pain due in part to a car accident in 2005.  I have also been diagnosed with facet disease which was aggravated by the accident and started the flare up.  3 bulging discs to the left.  Lower back pain that goes down my right leg to my knee....
 
Currently taking Oxycodone, Verapamil, Fioricet, Migrainal, Prozac, and having repeat injections in my facets and nerve ablation. 


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/1/2009 3:39 PM (GMT -7)   
Dear Purple,
I'm not sure but I think you were the one I read that was taking 10 percs/day. If that's so, it's way above the MDD (Maximum Daily Dose) because of the acetomenophen. The recent actions by the FDA in that area I don't believe are related to MJ. There will be plenty of that to come later, I'm sure. But you probably should have been on a combination of medications to limit you to 6/day. I limit myself to 6 percocets/day for that reason. And even though I was able to get an Rx for 200 pills in the past, that will likely change. Fortunately, I just got my 90 day supply, but having the 200 means I have extra and since I no longer have insurance I can stretch these scripts probably to nearly 4 months. I'll need it until I find someone else who will prescribe to someone with no insurance!

Anyway, I'm getting off track. I just don't think we can blame everything on MJ's death.

Investigating doctors who overprescribe, or patients who doctor shop, or celebrities who can pay for their house doc who will Rx anything, isn't a problem with me. Unfortunately, a wider net is usually cast.

PaLady

purplegdaisy
Regular Member


Date Joined Feb 2005
Total Posts : 242
   Posted 7/1/2009 5:54 PM (GMT -7)   

I wasn't blaming everything on MJ.  My pain med doctor was.  He brought it up.


I have had migraines for 27 years. I have tried so many meds I have forgotten their names...

I also have chronic back pain due in part to a car accident in 2005.  I have also been diagnosed with facet disease which was aggravated by the accident and started the flare up.  3 bulging discs to the left.  Lower back pain that goes down my right leg to my knee....
 
Currently taking Oxycodone, MS Contin, Gabapentin Verapamil, Fioricet, Migrainal, Prozac, prednisone,  and having repeat injections in my facets and nerve ablation. 


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13455
   Posted 7/1/2009 8:33 PM (GMT -7)   
PurpleDaisy, I just read a lengthy article from National Pain forum called "How to take Acetomenophen correctly wthout causing liver damage." The gist of it relates to people taking way too much per day in their orals meds. This has been a long standing problem that goes back to the OTC meds. My daughter once was having extensive dental work done, she took way too much OTC per day and she ended up with liver damage. They were not trying to stop the meds just want people to take that take pain meds containing the Acetomenphen on the correct max daily dosage.
Straydog/Susie
Moderator Chronic Pain
 
crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & decreased circulation in both legs. Swveral other health issues just not enough roo to list it all. Too many surgeries to list and too many medications to list. Currently on 16 different daily medications. Intrathecal pain pump implanted June 05.


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3459
   Posted 7/1/2009 10:22 PM (GMT -7)   
It seems crazy that something so seemingly benign can cause such problems, but people who take too much acetaminophen can end up needing a liver transplant!!!  Please be careful!!!
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/1/2009 10:23 PM (GMT -7)   
Susie,
From what I understand one option being considered right now by the FDA is removing percocet and vicodin from the market. Another is decreasing the amount of acetamenophen in OTC products. Maybe if they just educated people it would help.

I did hear today that the difference between the maximum amount of acetamenophen that's recommended and the amount needed to cause liver damage is quite small. I was surprised at that.

But I'll bet lots of people don't know what the "APAP" stands for on the Rx bottle. Maybe they just need to label things in a different way to make it easier for people to count up the amount they're taking each day - and clearly note the dose that can begin to cause liver damage.

It's probably easier for them to just add more restrictions rather than educate.

PaLady

Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3459
   Posted 7/1/2009 10:30 PM (GMT -7)   
Ah interesting!!!  Thanks PAlady. 
Gretchen       co-moderator MS board       diagnosed with MS July 2006
 
I have no lesions on my soul and so I will live with no limits.


BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 7/2/2009 6:06 AM (GMT -7)   
PA, I think people also don't recognize how many other products contain Tylenol.

If someone is getting the MDD of tylenol from their pain meds alone, it may not even cross their mind that drinking one of those Theraflu hot drinks because they have a cold or taking Midol because they're having period cramps will give them another 1000mg of Tylenol per dose. The instructions on those OTC products are written to assume you're not getting any Tylenol from any other source, so if you take one of those two products every 6 hours, following the directions on the box to a perfect T, you'll take 4000mg of Tylenol from them. Add that to the Tylenol you get from your pain medications and you're suddenly taking 8000mg of Tylenol per day. Since colds and period cramps rarely last 1 day, a person could possibly take that dose daily for 3-7 days and not even realize they're dropping an atomic bomb on their liver.

With 200+ OTC medications on the market that contain Tylenol, it's almost impossible for an average person to know which are safe and which are not.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 7/2/2009 7:57 AM (GMT -7)   
Your Both right, PALady and BionicWoman,
If People would just plain and simply read the labels and sometimes the doctors will write up
for thera flu and tylenol without educating about not exceeding the dosages..
But I still think that the makers of Tylenol should be standing up and saying,
when used as recommended Tylenol is safe. which is true as well. I think the main point is
that the FDA is overstepping on this and if they'd just add more warnings to the
general public, maybe more people would read the labels,
Anyways, I agree with ya, not trying to argue..
Soft hugz to ya both...
(((((((((((((((((((((((((((((((((((HUGZ))))))))))))))))))))))))))))))))))))))))
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc, Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's and Ocular Migraines

********>^..^<********>^..^<********>^..^<********


fatherjohn
Veteran Member


Date Joined Feb 2009
Total Posts : 999
   Posted 7/2/2009 9:16 AM (GMT -7)   
Freinds, as you know I work on the end where people abuse their medications and not for the acetamenophen but the narcotics. The problem seems to lie in two areas of abuse. The first being people that are taking either more prescription meds than they should or a combination of prescription meds and OTC which leads to an excess of the acetamenophen which causes liver damage. That is a real concern. The other issue is the number of people that are misusing prescription drugs and the elevated level of acetamenophen simply because they are looking for a high. I am not sure what the figure is as I have seen two seperate reports one shows 14 million Americans are in that class of misuing drugs. The other figure is as high as 50 million. When it is viewed from that perspective it is a major problem. Those who are using illegal drugs amount to about 20 million Americans. I believe the problem lies not with people who need the meds and take them responsibly. It lies with the major problem of those who are abusing the prescription drugs. Our government has proven that they are not that effective dealing with the drug problem. Simply making them harder to get, taking some off the market or even substituting others is not dealing with the problem. That is the only way it seems that the powers to be know how to address the problem. There will always be those who misuse or abuse their medications. Unfortunately that is the sad part. But when they take the steps that end up hurting the people that depend on the medications to function, work and have some level of life that is possitive, they need to look at other ways of dealing with the problem. I personally don't have a problem with them taking the acetamenophen out of the medications but from many peoples view, decision makes, that does not address the issue with the 15 or 50 million who are taking the meds to get high and taking the meds off the market is their attempt to deal with the problem. That seems the main way they have tried to deal with these kinds of problems. There is an old saying that insanity is doing the same thing the same way and expecting different results.

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/2/2009 11:17 AM (GMT -7)   
Fatherjohn,
My only problem with them just dropping medications like percocet is that I take percocet, and I've never tried the oxycodone without it. I have no idea if it will work as well. I'd be willing to try it, but that's the med that's had recent shortages. But what if it's not as helpful to me, and that for some of us - who recognize the MDD issue in terms of acetomenaphen and respect it - the combination of the tylenol and oxycodone is what helps us the most.

But I do agree that a lot of people don't recognize this, as Bionic said. What I heard was that liver damage starts between 5000-7000mg/day. That's not much higher than the 4000mg max. So those of us taking meds with it REALLY need to be aware of it.

I separate this issue, however, from that of illegal drug use or drug abuse, although I think it gets lumped all together by the media, the general public, and even the agencies like the FDA and DEA. The fear permeates and clouds the difference between when too much tylenol is being taken due to ignorance of the real damage that can be done, and too much taken because someone is abusing drugs. I'm growing increasingly weary and angry at being punished for the sins of the latter, even though I understand addiction and appreciate the difficulty of recovery. I didn't used to feel this way.

PaLady

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13455
   Posted 7/2/2009 3:54 PM (GMT -7)   
Bionic hit it on the head. Another problem that arises is many people do not read info on labels, this is not limited to OTC meds either. We get lots of questions here from people starting a new med, that if they would read the insert they woud know about potential side effects. To the best of my knowledge all rx's come with a complete print-out telling you important info about the drug. This is a bigger problem than many will admit to. Also, lets face it, some folks do not know how to read or their reading skills are limited. many are too embarrassed to ask a pharmacist questions, I think that is so sad too.

I feel quite sure the numbers are high out there on the amounts being used by folks unknowingly.
Straydog/Susie
Moderator Chronic Pain
 
crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & decreased circulation in both legs. Swveral other health issues just not enough roo to list it all. Too many surgeries to list and too many medications to list. Currently on 16 different daily medications. Intrathecal pain pump implanted June 05.


Boxerlover
Regular Member


Date Joined Dec 2006
Total Posts : 274
   Posted 7/2/2009 6:36 PM (GMT -7)   

I am not one for conspiracy stories, but the timing of this seems a little hinky to me.  First the issue with  propoxyphene (darvacett).  Then they halted production of oxy and some others saying that the manufactorer did not have a right to be making those meds.  Next comes the news that almost all the narcotics but percocet and hydrocodone will need special doctors, special pharmacies,special warnings. And now this, the ban on percocet and hydrocodone.

Can we hear the writing on the wall?

Melissa


fatherjohn
Veteran Member


Date Joined Feb 2009
Total Posts : 999
   Posted 7/2/2009 10:30 PM (GMT -7)   
PAlady, I agree with you that them taking the meds off the market does not solve the problem for the illigal or misuse and it causes more problems with those who need the meds. It is difficult to understand the reasoning that these decision makers use. They try to solve one problem by creating more.  
 
Susie, Are we supposed to read those papers that come with our pills? I hear you and Bionic very clearly. I wonder how frustrating it is to our doctors when they have patients who don't follow directions or advise. I have problems with our students at times not using things like tylenol pm correctly.
 
 Mellisa, It does make you wonder. Here is another aspect that I deal with. In the state where I live, young people between the ages of 12 and 17 who are seeking treatment for drug abuse has risen 270% in the last 10 years. They are known as poly drug users, meaning they abuse more that one drug. The major abuse is in the form of prescription drugs that are taken, stolen from parents, grandparents etc. It is a major problem and it is sad that people who are not misusing or abusing have to pay the price.
 
I don't even pretend to be an authority on the issue but I get calls every day from parents, wives/husbands, grandparents etc wanting help for family members. Ut is so sad that we get lumped with the groups that are messing up. 

Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 7/2/2009 11:53 PM (GMT -7)   
I just wanted to say that the tylenol thing does cause liver damage in way less doses then they once thought so. But drug abusers do a thing call Cold Water Extraction (CWE) to remove the tylenol from drugs like hydrocodone and percocets. I know for a fact that I cant do tylenol at all cause just one small dose makes me terribly sick and makes my liver enzymes go crazy even though normally I have a great liver. But life is getting harder and harder for us CPPs, in Utah now they just started a thing where if you get any pain meds that equal 60mg worth of morphine or higher that it must be prescribed by a specialized pain doctor, I feel like if they start spreading this to other states (which they will soon) that many people in pain wont be able to get treatment since for some of us it's very hard to find a pain doctor and the doctors that are around will be full and have a huge waiting lists. I just know for a fact that probably 5 years from now that pain treatment will be very hard and rare to find and many of us are just going to have to suffer cause it seems like everyday there is something new going on.

-hellokitty

Chronic Pain Moderator

Dx-Gallstones at age 14 that caused Fibromyalgia in 1998. Chronic Pancreatitis at age 15 from Pancreatic Divisum. Fell down cement basement stairs on my bottom in 2001. Got severe migraines after the epidural from my 2nd childbirth in 2002. Was rear-ended by a lady doing 55mph in 2004 then 2 months later rolled my car down a hill and did even more damage to my back. Depression caused by having chronic pain. Asthma from allergies.

meds- Suboxone for pain, Cymbalta for pain and depression, Lyrica for pain and migraines, Imitrex for migraines, Ibprofen for migraines, Ventolin Albuterol inhaler for asthma. Phenergan for nausea, Seroquel for sleep.

"I know God will not give me anything I can't handle. I just wish that He didn't trust me so much."         -Mother Teresa


SpaceButler
Regular Member


Date Joined Jun 2009
Total Posts : 23
   Posted 7/2/2009 11:59 PM (GMT -7)   
Michael Jackson is a bad example of many situations: this one is no different. Also, does anyone else dislike the heavy celebrity worship/fascination seen today?
Web development, programming, camping, chess, go, painting


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/3/2009 12:02 AM (GMT -7)   
Kitty,
Yes, and add to this the issue of those of us either without insurance or with insurances like Medicaid that some specialists don't accept.

I hate that I'm becoming so resentful. But it shouldn't be this hard for us to get treatment. No harder than for any other serious condiion.

But I'm preaching to the converted.

PaLady

SpaceButler
Regular Member


Date Joined Jun 2009
Total Posts : 23
   Posted 7/3/2009 12:06 AM (GMT -7)   
hellokitty,

I also wanted to say that you'd be hard-pressed to find any recreational drug users that go to the length of cold water extraction to use higher doses of oxy or hydrocodone. They will most likely just take the liver damage knowingly/unknowingly, or get the higher-dosage pills of oxycodone as OxyContin or a generic brand name of the same concoction. Many "street pharmacists" only deal with high-dosage (40-80mg) oxycodone pills, high dosage morphine, sometimes the roxy or hydromorphone, and fentanyl. Where this situation will go from here is anyone's guess - your prediction seems quite valid, but I think we're all agreed that these illegal users, or the very illegality of recreational usage, is the thing that is making it harder for you and similar sufferers to get their needed medication.

Logan
Web development, programming, camping, chess, go, painting


Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 7/3/2009 4:39 PM (GMT -7)   
I agree that many drug abusers would rather get the stronger pain meds, but some seem to just like hydro for some odd reason (I guess because they're easier to obtain then other drugs at ERs??). I know that if they where to switch my suboxone to hydrocodone or percocet that even at very very high doses I would still suffer withdrawals as my tolerence is outrageous. I know that suboxone is 50 times more potent then morphine, so my dose equals about 800mg worth of morphine daily, kinda scary when I think of it that way. But like someone said ealier, if they where to actaully look at HOW to help the drug addicts instead of taking useful meds off the market I think it would in the end make life easier for CPPs. But It seems to me that too many people would rather turn a blind eye to them(addicts) then help them, and until they open their eyes, us CPPs are just oging to suffer more and more, I mean whats the next thing they're gonna do? We'll probably have to go to a clinic like a methadone clinic to receive our meds daily and have them watch us actually take and swallow the meds, I really hope they dont ever get to that point, but it wouldnt surprise me....

-hellokitty

Chronic Pain Moderator

Dx-Gallstones at age 14 that caused Fibromyalgia in 1998. Chronic Pancreatitis at age 15 from Pancreatic Divisum. Fell down cement basement stairs on my bottom in 2001. Got severe migraines after the epidural from my 2nd childbirth in 2002. Was rear-ended by a lady doing 55mph in 2004 then 2 months later rolled my car down a hill and did even more damage to my back. Depression caused by having chronic pain. Asthma from allergies.

meds- Suboxone for pain, Cymbalta for pain and depression, Lyrica for pain and migraines, Imitrex for migraines, Ibprofen for migraines, Ventolin Albuterol inhaler for asthma. Phenergan for nausea, Seroquel for sleep.

"I know God will not give me anything I can't handle. I just wish that He didn't trust me so much."         -Mother Teresa


Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 7/3/2009 4:41 PM (GMT -7)   
ALSO, I guess now they found some very strong sedative in MJ's place that is only suppose to be used in operating rooms, very scary....

-hellokitty

Chronic Pain Moderator

Dx-Gallstones at age 14 that caused Fibromyalgia in 1998. Chronic Pancreatitis at age 15 from Pancreatic Divisum. Fell down cement basement stairs on my bottom in 2001. Got severe migraines after the epidural from my 2nd childbirth in 2002. Was rear-ended by a lady doing 55mph in 2004 then 2 months later rolled my car down a hill and did even more damage to my back. Depression caused by having chronic pain. Asthma from allergies.

meds- Suboxone for pain, Cymbalta for pain and depression, Lyrica for pain and migraines, Imitrex for migraines, Ibprofen for migraines, Ventolin Albuterol inhaler for asthma. Phenergan for nausea, Seroquel for sleep.

"I know God will not give me anything I can't handle. I just wish that He didn't trust me so much."         -Mother Teresa

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