June 16, 2008 - 5:55pm
I am having an issue. I don't want a class II narcotic. However, it takes at least 80 to 100 mg of hydrocodone to get me by everyday. Any less and I get sick and start to have pains. I have several questions. They are as follows:
1. What is a MAX qty per day of 350 mg Soma (24 hrs)?
2. What is a MAX qty of 10/325 Hydrocodone per day (24 hrs)?
I am SICK of weekly appointments. I want to find a pain clinic that my insurance will cover that will take care of ALL of my needs on a once a month basis.
Is it unheard of to be RX'ed up to 11 norco a day?
Is it unheard of to br RX'ed over 3 Soma a day?
Where can this information be found?
I need at least 8 to 10 NORCO AND 8 TO 10 Soma a day along with two or three .5 mg Xanax a day to get by.
Is this an unlikly daily RX qty to get from one Dr.? I want to go to ONE PLACE that is safe and file it under my insurance and be done with it.
Am I crazy or can this type of RX be found?
Do I need to go class II?
My condition is getting worse and I am getting worn out.
I just paid $75.00 for an office visit and my rx was $205.00. I got 120 Norco, 90 350mg Soma & 60 800mg Ibuprofen. I can't keep this up on a weekly basis. It is killing me and will only get worse in the future because I have Degenerative Disc Diesease in late phase two entering phase three.
What should I do?
(edited by admin)
June 16, 2008 - 6:56pm
#2
It is not unheard of to be
It is not unheard of to be prescribed 8 Norco per day as long as the doc knows you have built up a tolerance. I highly doubt a new doctor would just presribe 8-10 a day starting out. Also I am pretty sure you cant go over 12 a day due to tylenol intake. As far as the somas go I have never seen anyone prescribed more than 4 per day so 8-10 of those seem a little high for any doc to prescribe. My suggestion is to at least try the schedule II drugs because they will work better and u could take less pills. Yes they are a little more addictive but they are still opiates. Is there any specific reason why you dont want to go to schedule II? Obvioulsy the schedule III hydrocodone isn't cutting it. If all else fails or your insurance wont cover pain management clinic or something then i would suggest methadone clinic because its only like 400-500 a month or so i've heard and you get dosed everyday and methadone lasts for a very long time.
June 16, 2008 - 11:41pm
#3
I do not know much or have
I do not know much or have much experience with soma or benxos so I cannot offer advice with that, but I do know quite a bit about hydrocodone.
First, let me give you some basic information that you may or may not know. The highest recommended daily intake of acetaminophen/tylenol is 4000mg. When it comes to 10/325 Norcos, this means you could take up to 12 pills per day and still be safe. This limit of 12 pills/day is because of the tylenol not due to the hydrocodone. Doctors do not always like to prescribe this much because when someone needs this much pain meds they usually raise them to at least an oxycodone med such as percocet.
You said you do not want to take a class II drug- is there a reason why? Many people are more afraid of the label, and believe there is more abuse/addiction potential with these stronger drugs, but that is not the case. Percocet is only about 1.5x stronger than hydrocodone, and would probably serve you better than hydrocodone. Now, that being said...
doctors can and will at times prescribe the doses of medication you asked about, but only at their own discretion and when they feel it is needed. I currently am prescribed 11 10/325 Norco per day, along with Fentanyl 50mcg/hr patches. Each patch lasts 3 days. So, on a daily basis I always have this 50mcg/hr patch and take 11 Norco. When the pain gets bad I also wear non-narcotic lidoderm patches, and when it gets extremely bad I take the lowest dose of Lyrica.
You just need to talk with your doctor about all your concerns, or try to find a doctor who is more comfortable prescribing these kind of meds. Why, if you don't mind me asking, do you not take an extended release medication? What is your medication history?
I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.
June 17, 2008 - 9:11am
#4
Class II scares me
I do not plan on taking these meds forever. I am waiting for my condition to go into a full blown phase three. When this happens I plan on going to Methodist Hospital here in Houston for an evaluation to see if I qualify for the new robotic bone/disc replacement procedure they are doing. I don't want to advance to a Class II because I don't want to end up in a drug re-hab center when the time comes to kick the drugs. I guess I am just trying to get by at this point with limited treatment. I have been under the care of a Chiropractor for a year and it helped alot. However he said I am now at a point where he can lo longer help me anymore. My PCP won't prescribe enough Class III meds and neither will my PM Doc's. I am not using more than 4G of APAP a day. the only thing I seem to be over the limit on is Soma and thats only due to the fact that the relief it provides is second to no other pill I have ever used and when my muscles knot up Soma is the only thing that works. I guess I just need to find a PM Doc that will take better care of me. I use the benzo's to keep my hydrocodone intake down. I know I am dependant/addicted to them and when I feel the urge/need to take them and am not necessarily for pain I take .5mg of xanax and it removes the anxious feelings I get and allows me to limit my Norco intake. I never use more than .5mg at a time and never more than 1mg a day. I am basically "self medicating" at this point and I am getting VERY tired of it.
Also, a methodone clinic is a dumb idea and OUT OF THE QUESTION! I am a proffesional at an engineering company here in Houston and most of what I am facing is secrete and will stay that way.
June 17, 2008 - 1:36pm
#5
Most doctors, myself
Most doctors, myself included will not write for 300 Norco a month, because of the risk of abuse and diversion, even if you do not have an addiction problem yourself. I am also a lot less comfortable replacing 300 norco when they get burned up in a fire, scipt blew out of the car while driving, got stolen, got dropped in the street and run over, fell into the toilet, etc.
I am not sure why you are reluctant to switch to a long acting medication, if your problem is not addiction. For someone on that high dosage long term, a long acting narcotic is the standard of care.
The usual dosage of Soma is 3-4 a day. It has never been proven to be effective in treating back pain in high quality randomized controlled studies. but is moderately sedating. Many doctors do not precribe it for pain, including myself.
Xanax O.5mg three times daily is appropriate for short term treatment of anxiety, and is sometimes used long term for certain types of anxiety and behavior disorders usually in conjuction with other medications. Many doctors prefer that a psychiatrist prescribe anything other than prn or short term doses of Xanax.
The maximum recommended dosage of Ibuprofen is 800mg three times daily, and this is safe for only short term use without regular monitoring of renal (kidney) function.
If the problem you have with lower doses of norco is that you get sick and have pains then you may simply be experiencing physical withdrawal and the norco is no longer doing anything for the pain (I assume) that it was originally prescribed for.
June 17, 2008 - 10:39pm
#6
I see what you mean, and
I see what you mean, and understand how you feel. You theories sound similar to what I have heard from several people, even from myself at times. I have said I do not want to switch to a stronger, higher class med unless it is absolutely necessary.
The big issue I see right now though with what you said is that you are currently taking soma, xanax, and hydrocodone. Pain meds, benzos, etc. When the time comes to get off the medication you will not only have to be tapered and withdraw you will have to deal with coming off not only a high level of pain meds, but also the benzos. You will have two different kind of substances to come off of. I also see that where you would take a Class II pain med (and essentially less meds), you are substituting this with more benzos. Benzos are often harder to come off of than pain meds.
You shouldn't be scared of the higher class med at this point because it would help you more in your situation. You do not know how long it may take for you to reach a level of qualifying for the procedure, and could be waiting years. In that time you WILL need a stronger pain med. Also, just because you switch to a class II it does automatically mean you will need a rehab center to get off the meds. If you take them as prescribed, and do not abuse or over medicate you should be able to taper down when the time comes with no problems, regardless of if you are taking a Class III or II. At this point it would be harder for you to come off the hydrocodone because you are using more and self medicating. Have you discussed these concerns with your doctor?
I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.
June 17, 2008 - 11:34pm
#7
I just wanted to say that if
I just wanted to say that if he is only taking 2 or 3 .5mg xanax per day any sudden stoppage will not make many side effects as thats a very low dose. Everyone is different but the opiate withdrawal will be a lot worse from the levels you take compared to the benzo although thats just my opinion.
June 18, 2008 - 2:09am
#8
I completely agree with the
I completely agree with the other posts to your question here, and would respectfully like to add that at the level of meds you are at now, you shouldn't hesitate to move to long acting drugs or CII, because you are already tolerant, and as 57 said, will have a heck of a time coming off CIII medications. I have suffered as you, and have withdrawn from both classes of meds prescribed, and legally taken, and I suffered equally with weening or withdrawing from both kinds of opiates. A scheduled III drug is no light matter, especially at high levels.
July 2, 2008 - 12:54am
#9
You can be Rx'd Bube for
You can be Rx'd Bube for pain- it works very well. It can be Rx'd by most pain management doctors and when its time for your surgery its alot easier to come off than Methadone or all your daily narcotic regime.
July 2, 2008 - 1:56pm
#10
Methadone
I am on methadone for chronic pain..I went from Vicodin to Vicodin ES to Lortab 10/500 to Percocet 10/325 to Oxycontin..etc etc Finally got on methadone and my life has changed the half life is SO long. If I had to I could go 24 hours with one dose and not go thru withdraw. I take it 3 x's a day in pill form. Plus I have noticed I don't have that pill craving like I did when I was on regular pain med's. Try and get on methadone find a pain management clinic in your area that way you can take it home. I think methadone clinics make you go every day or every few days and make you drink it in liquid form (that's what I have heard). I live in Tampa FL and many pain management clinics use methadone for chronic pain because its cheaper than Oxycontin and the half life is longer. Good luck. PS The acetaminophen (APAP) in the Norco is killing your liver.
Go to methadone clinic and tell them you have been taking opiates and you are addicted.... even if you are not... and get dosed everyday, you will never go thru w/d again and it is very good for pain!!
Nascar #88 GO JR!!