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Have taken Hydros for YRS. now DOC wants me to go on BUTRANS? HELP I am scared?
  1. #1
    mkan54 is offline Junior Member
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    Default Have taken Hydros for YRS. now DOC wants me to go on BUTRANS? HELP I am scared?

    Long story, and it has prob. been told a million times in other ways -

    I am 59, and have had 5 major lumbar surgeries, and am fused from L5 thru L2 with hardware. One other lumbar surgery after #5 to relieve all the fluid.

    I had lung cancer in 2013, and had the upper right lobe of my lung removed. Did chemo, now am cancer free, have had 3 clean scans since then, the last one June 2014.

    I fell Dec. 2013 and broke / shattered 5 ribs in my lower left back (on ice, hit a concrete step)..

    Soooo, needless & I will honestly state that I am addicted to opiates, hydrocodone, largely due to all my years of surgeries, etc.....

    The current doctor I have (which is a family doc - in his 1st yr. in his own practice out of med school, not a pain specialist) practices in a small town where last month "another doctor" got her narcotics license taken away due to not appropriately RX-ing pain meds. I saw him today and he told me he has had a huge influx of patients coming from her to him, due to her loss of her RX license....

    He had been talking to me about Butrans Patch for the past (prob. 6-9 months), but because I had cancer, and then also lost my 35 yr.old daughter to an accidental drowning on July 6, 2013, he kept refilling my RX, knowing any "different" change in my meds might through me into a tizzy. He openly admits that he doesn't want to disrupt my life by commanding a major change to my meds....

    I also take 150 mg time release Wellbutrin for anxiety and depression and I also take Klonapen to help me sleep at night - just 1 mg at bedtime.

    Sooo today I go to see him for a "checkup" and he was adamant, (largely due to the other doctor getting into trouble) that I needed to try Butrans.... He said that he rec'd patients from this other doc, that had been taking 30 pills per day!!! I replied that I do NOT take them that way, but he still insists that I try Butrans....

    I asked him, "So, are you saying that you won't fill my hydros? I need to go with this Butrans Patch or nothing?" And he just said, "yeah, I want you to try it."

    I have sooo many questions... so many that I can't type them all in this one post. I am sure I will continue to post to this main thread.

    He thinks that Butrans will help with my w/d's.... and that it will take care of my pain. He is also willing to give me a backup RX for break through pain, but I can't imagine it will be many... maybe like 10-20 pills.

    I will admit, that over the years and years of taking hydrocodone my tolerance is up there.... higher. And yes, I do also drink...who wouldn't drink after all I have been through with the surgeries, cancer, and then losing my beloved daughter?????

    I am just afraid if I strap one of those patches on, you can't really control how much is going into you at any given moment, right? I feel like once I stick one of those patches on, I had better stop drinking any alcohol and be on the up and up, or I could die??

    If I DO try to get OFF the opiates, will it help with detox symptoms if I am not getting the mg's I am used to getting by taking the oral pills? How will he/I know what mcg patch I need? Although, he did say the first week I would need to be in touch with his office every few days to see how I am doing..............

    Will I use the backup / breakthrough meds that he IS going to also RX me, TOO much and end up dead of respiratory failure? I just don't like the idea of not being able to control what med you are taking into your body....something strapped on to you that you can't control the output going into yourself (???)

    Any input would be appreciated, from someone who has been there and done that. I guess the ultimate would be to get off the opiates for GOOD and just have a beer once in a while... but I don't know how I"ll get there and am afraid.
    By the way = I am now raising my g-daughter, although some days I really dont' care if I live or die, but my worse fear would be that she would find me dead in the bed of a morning due to respiratory failure...

    NOOO, I don't know what mcg he is starting me out at. He is basing his decision off my normal RX and I hate to tell him, but I prob. have been taking MORE than what he has been RX-ing me...

  2. #2
    iloerose is offline Platinum Member
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    MK: welcome to the boards! It seems as if you are in a difficult situation. Because of abuse, docs are running scared concerning the use of opiates to treat chronic pain. If as you state, you are addicted and using the opiates because of emotional reasons (same as drinking along with them), you do need to find a way off of these. It is disturbing in that you are A. Drinking while taking hydrocodone (the acetaminophen alone is a big worry with alcohol and liver function) IS a BIG worry. You CAN die from that alone. B. If you are taking more than you need to beyond your pain level and script, where are you getting extra? C. You can also DIE from taking the k-pin, drinking and the hydro, I don't know about the wellbutrin.

    You have every reason to believe you are an addict and perhaps need to do something else for your pain.

    Butrans patches or the use of (bupenorphine) is becoming a way to manage long term pain. You need to ask your doctor about applying the patch directly, I mean before you have been off of the hydro's. My feeling is that you should be in moderate to severe w/d from the hydro before you start the butrans. I'll explain a bit about that. Bupenorphine is the drug in suboxone used to treat opiate addiction, if you start too early on the suboxone you can go into "precipitated w/d" which is like regular w/d on steroids. I would read all I can about this, your doctor may not even be aware of this. The butrans is much more potent than the hydrocodone for one thing. Really, Really do your homework here.

    You are caught in the hard place of being an addict (hydro), drinking. I would get off of the hydro and assess your pain levels before you do anything else and remember that during w/d your pain may be more acute than after you are clean from hydro. You may be pleasantly surprised concerning what you really need to control your pain. The use of opiates, drinking and the klonipin usage ca also lead to suicidal depression. You need to consult a good addiction specialist as well as a good pain doc.

    Peace,

    Iloerose

  3. #3
    mkan54 is offline Junior Member
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    You are correct in many areas - thank you for caring.

    My doctor doesn't know anything about P/W's.... He said he was actually going to also give me a small script for hydro to take supplementally while I start the Bup. I have no idea which m/g he is going to start me out on, I mean, the strength of the patch. I have not been to the pharmacy yet to see what he sent over there. (If he sent it yet at all, he is horrible at follow through, plus I am switching to a new pharmacy, for unrelated reasons).

    On my drive home from the doctor, it's kinda funny, but I actually thought to myself - what I need to do, is finish taking any pills I might have, and THEN take the Bup. I already "naturally" sort of knew how to do it.... I have Googled a lot already about P/W's and it sounds bad and not something I want to go through.

    My normal withdrawals are usually deep sneezing, runny nose, chills, coughing with lots of phlegm, not being able to sleep, eventually diarrhea - and I guess that's about as deep as I have gotten into w/d's until I was able to get a pill or pills to take. These symptoms usually come on in about 18-24 hrs. after my last dose of hydro. I have never went - say like, 2-4 days without anything so I have no idea how bad I would get.

    I am familiar with the COWS scale and have it bookmarked. So, are you essentially saying that I should take whatever pills I have, start to w/d, rate myself on COWS and then start the Bup? I have some time here to get a plan together. I do want to stop taking the hydros. I am done with them, completely DONE..... I want off of them. If this Bup patch will work for me and prevent w/d's then I'm all for it, but I want to be successful in how I use it. Obviously, I am going to have to look to others (like you) to figure out how to treat myself as he doesn't know what he is doing.

    Where I live, there are only like 2 doctors that have Suboxone licenses in the entire STATE. Insurance does NOT pay for it, and it is very expensive, from what I understand. I have a girl friend acquaintance, that went on Sub and had to drive over 3 hrs. one way to get to this doctor every MONTH to get her Sub. and I think she is still doing it. From what I have read, you can get just as addicted to Sub as the Opiates, correct?

    I will find out what is at the pharmacy (mg -wise) and how many hydro pills he prescribed me and then I'll report back if you are willing to help me figure this out. I will trust you and others to get me through this. Like I said, I have some time, maybe like 1-2 wks to start the Bup, so hopefully I'll have enough good info by that time that I can make this a successful transition.

    Thank you so much for telling me about P/W's. I had no idea. I am a bit on the naive side when it comes to this type of thing. I have taken them a long time due to all the health issues I have went through and basically am a doctor induced addict I guess. Life is just so much simpler to keep taking the pills to feel "normal" but I know there has to come a time when I STOP.

    Will you and others help and advise me? Thank you.
    Last edited by Anonymous; 07-23-2014 at 05:36 AM.

  4. #4
    mkan54 is offline Junior Member
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    Got a call from the pharmacy today and he sent over a 10 mg Bu Trans RX and 60 -10 mg Hydros. Doesn't that seem counter-productive? Or hypocritical? I mean, even a non-health care prof like me, after reading up on this can realize this is not the way to get off opiates, right?

    My questions, (at this time, there may be MORE), would be, if I began a taper, with the pills I have and THEN put on a patch what would be my risk...?

    OR, what if I quit the pills entirely, like on a Thursday evening, then worked Friday, started into detox, then sometime later on Saturday evening, maybe - then do the patch. Would that be enough time from Thurs night til Sat. night to get the opiate receptors cleaned off before I introduced the Bu Trans? How much time (in either hours or days) would it take to get those receptors cleaned out before I would be safe using the Bu Trans and not go into P/W? Is it based on your daily intake of Opiates, or the years you have been on them, or the half-life of the drug (what time of day it was you took your last pill)???

    I am super intelligent (well, sounding dumb right now to be in this position), and analytical, so I think I can figure this out and get off this blood suckers. Reading some of the posts on this forum makes me really want to kick it - as I see how much better they feel being opiate free.

    One other personal thing I have to consider - I am the sole care provider for my 12 yr. old g-daughter, so I can't like die, or go into seizures or something with P/W's. I think I can get by with not going into work for a while by declaring the HIPAA LAW/RULES, as I work for a large corporation where I don't have to declare why I am off work due to a medical condition.

    Like I asked earlier, is there anyone here that will help me? Advise me like Iloerose did last night? Or Iloerose will you help me?

    Thanks for reading.

  5. #5
    Thisweekforsure is offline Advanced Member
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    First... calm down. You are right, you are very analytical and you will figure this out. It's not as bad as you feel right now but I understand it feels very, very bad and confusing.

    I am going to drop a bomb that might get me kicked off the forum or something, but I'm not completely sure you are an addict in the true sense of the word. Not saying you are NOT either. Depends on how much alcohol you drink (one beer a week? several a night?) and just how often you dose more than prescribed and are you in fact a victim of being under treated for your pain.

    Before I'm blasted for disagreeing with your statement that you are honestly addicted to hydrocodone, I clarify that you are definitely physically dependent. But do you have the psychological underlying personality that led you further into uncontrolled use for a "high"? Or were you suffering ongoing physical pain that you were attempting to get ahead of but never could quite?

    Your history is EXTREME. My God... multiple fusions, cancer, broken ribs. And the year 2013 was for you a complete nightmare of repeated shocks - blows to your body and mind. Cancer, chemo, broken ribs and the sudden unexpected death of your young daughter, after which you presumably immediately took in your granddaughter - all of this within a 12 month timeframe.

    The demeanor of your own doctor is that you are NOT an addict but rather a very deserving pain patient, and he understands how extreme trauma can affect physical pain. He is reluctant to rock the boat with you (but he must) because he sees you are in a very delicate state. You have NOT had enough time to recover your balance from all the shocks of the past year; you are extremely traumatized.

    The doctor has (appropriately in his mind) helped you by putting you on an antidepressant and giving you a benzo for sleep. And you are self-treating with some (amounts?) alcohol. These additional substances are complicating your state of mind. (Paradoxically the first two might help in the short run) however it is clear that your doctor is treating you with multiple pharmaceuticals for what he sees as a very severe need, and that he is not viewing you as a drug seeking addict.

    I take issue with him though in that in your case you have no business being on hydrocodone (is it Vicodin with tylenol?) you should have been on OxyContin or slow release morphine, if you were going to take them daily because you would have gotten a smoother release and much better control. The short acting pills have you obsessing over the next dose probably an hour after you take it, am I right? The pain killing action is gone pretty quick.

    But at this point, I get from your messages that YOU WANT OFF these pills, you see that maybe they are becoming more of a problem than a solution and (very intelligently) you do not see the Butrans as the solution.

    IF YOUR LIFE IS BEGINNING TO STABILIZE.... the cancer is gone, the ribs are healing, the acute agony of the death is receding a little, the grandchild has settled in... now it is time for you to assess your medication situation and reduce your dependence on all of these medications.

    Your doctor is doing his very best to give you quality of life - because he is attempting to treat pain despite the addiction hysteria in your town. He is right to put you on a long acting opiate BUT that would only be if you were still in severe pain and did not want to be free of opiates. If you want to be free of them and think your life is stable enough that your pain can be managed in non-drug ways, then the LAST thing you want to do is start a long acting opiate. This would apply to OxyContin or morphine but this Butrans Patch is in a league of its own... its a mixed agonist-antagonist, if it were me I would avoid it like the plague.

    I sense that you have anxiety about all these meds and you don't really want to be on them anymore (at least the "addictive" ones.... you may discover that the antidepressant and the Klonipin are also "addcitive" and hard to quit but don't worry about them right now.... one thing at a time!)

    Your situation with doctors - this is not your fault - the legal situation has thrown this chaos into your life - you are being forced suddenly to decide whether to start a major long acting opiate patch or nothing... no more pills... that's what the one doctor has decreed for his own legal reasons having everything to do with the local sheriff and the DEA and NOTHING whatsoever to do with what is best for you!

    You do have the option of traveling to another doctor for a more appropriate medication. A classic opiate in slow release form. But I get the idea you at heart don't want to be held prisoner with any opiate, so you also have the option of getting off it now. I don't know your current daily dose or how many pills you have, but you could design a taper plan to get you off them, or you could bite the bullet and do a week of "cold turkey".

    I would admonish you that from your very recent history of multiple, severe, devastating shocks, that you do nothing to indicate to anyone you are an "addict". The last thing you need is misinformation in your record. (Now if you are downing a gallon of vodka per night that would be another matter - you decide.)

    Only 2013 is far too recent for you to come to permanent conclusions about all of this. You might consider looking for a very professional treatment center for continued control of your pain in ways that are truly appropriate to your case, and not driven by harassment of your local doctors.

    Keep researching and learning all you can about these meds. You are on the right track and the answers will come.

    PS edit deepest sympathies on the death of your daughter
    Last edited by Anonymous; 07-23-2014 at 04:47 PM.
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  6. #6
    mkan54 is offline Junior Member
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    really quick...

    i have read your post two times... i will read it several more times and then respond to each point...

    first and foremost.... i am crying...at the things you typed to me... how is that you understand me and yet we have never met...

    let me cry for a while then i'll be back...
    thank you is inadequate right now.

    i'll be back

  7. #7
    mkan54 is offline Junior Member
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    I am attempting to send you a private message "Thisweekforsure" and I think I need to add you as a friend first? feeling my way through this idea... I sent you a add as friend thingy I think...

  8. #8
    mkan54 is offline Junior Member
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    I am getting ready to go the pharmacy and pick up my RX's... I am not saying I am going to take the BuTrans, but am going to pick them up. When I called the pharmacy they told me that the BuTrans had to have a pre-authorization before insurance would pay for it. How much will that cost?

    Hang in, I am still going to respond to Thisweekforsure's Post... I am so shaken by that post I have to collect my thoughts and address each thing. .. This person took the time to write to me so personally, so intimately... I can't begin to express how touched I am by that.

    I will get back here and report when I find at the pharmacy regarding cost of the BuTrans Patch... am prepared for the worst. If it is TOO high ? I will not even pick it up.

  9. #9
    Thisweekforsure is offline Advanced Member
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    That sounds like a good plan, if it is too high, you know you don't want to be stuck with that expense every month. It's also okay to call the doctor and tell him you cannot afford that patch. What else does he recommend that is cheap and generic?

    I don't know if I can do messages, I think there is a restriction that you have to make 100 posts before you can message. One or both of us probably doesn't have that yet.

  10. #10
    Thisweekforsure is offline Advanced Member
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    Oh one more thing, I don't disagree with Rose's post even though it sounds like I do. What she says about you are an addict may be true, again, YOU need to evaluate your situation and decide, no one on the internet can tell you whether you are or are not.

    Listen carefully to what she says about the concurrent dangers of these drugs and alcohol because she is correct, and also, what she says about P/W and transferring to the patch if you decide to do that. I bet she is spot on about the doctors not even fully understanding that issue.

  11. #11
    mkan54 is offline Junior Member
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    I am afraid to do a public post with how I really feel and what is going on with me.

    I just had a huge thing written up and then I deleted all of it.

    If I can't PM you guys that are trying to help me, I don't know what I shall do??

  12. #12
    iloerose is offline Platinum Member
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    I would not be afraid to post here. You can spill it here. If not, use my user name and gmail.com. I have others who post to me. Can keep twfs in the loop as well. (no hard feelings, differing opinions maybe but not enough to make an issue out of it and you've brought up some really good points)

    One of the things that doctors worry about is the effect of the acetaminophen in the vicoden and the effect on the liver, long term. Drinking exacerbates that and is a very bad idea to drink and take hydro.

    The signs of addiction: taking more than needed and for reasons other than pain such as coping with life.

    As far as the Butrans, I have no idea how well it works to relieve chronic pain. I have seen yes and no. Because the buprenorphine takes over your receptors, I'm not sure how the hydro will work for break through pain. But I've seen some very positive reviews of how butrans is working for others (cursory glance)

    What I would do is get completely off the hydrocodone if possible. Like go the whole ten yards through w/d process either by tapering or an all out c/t. Give it a week or two and honestly assess your pain level.

    If you don't want to do that and try the butrans (may take some the hydro w/d away, but it will make quitting harder down the road) Google a COWS chart and when you hit a 26 (non-negotiable on the COWS), then apply your patch and see how you do.

    Keep posting and let us know.

    Peace,

    Iloerose
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    mkan54 is offline Junior Member
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    Here is what I had typed up last night, so I'll go ahead and post it this morning. If I am going to try to taper first can either one of you (or anyone else) give me a regime that will work with the least amount of withdrawals so I can possibly keep working & functioning, or is that not possible? Here is what i was going to post last night. I have to work today so won't be able to ck this til later tonight.

    I just got back from the pharmacy... he gave me 5/325 Vikes... 60 of them. So going from 10/325's @ a rate of 5 per day to 5/325, with the patch added...

    I am at a juncture / a crossroads. I must do something. Raise to the occasion! Figure something out, right? What shall it be?

    I am thinking at this point in time, I may as well try a taper first, and the go cold. Cold Turkey... get them outta my system. Like I said earlier, my work can't ask "why" I'm off work... they cannot, due to privacy laws, in the States here.

    The pharmacy did not have the pre-authorization back yet and she couldn't tell me how much the BuTrans would cost "me". I have had 2 CT Scans with Contrast for my Lung Cancer in this year: 2014, and 2 app'ts with my Onc. Dr., as well as the doctor I reference in this post (and radiology & follow up app't regarding my broken ribs from Dec. 2013, into 2014) so I may well have reached my MAX out of pocket for this Medical Year = 2014... So, everything may be paid for by now - split out between about 6 or more different Medical Providers, and all of them want and expect a monthly payment... that sucks... That is IF I want to try to go with the BuTrans Patch and it is indeed expensive. It might be covered 100% by insurance…. I don’t know yet. I don’t know if I want to even try that route.

    I have a bit of time to figure out what I shall do... I have a 2nd daughter that I did not raise, but yet gave her up for adoption at birth in 1973. We got reunited in 2000 and have built a close relationship. She comes here to visit from California and will be here again on August 9th for about 10 days. She is a CA Girl, pure, organic, Yoga-filled and does want me to quit the pills – quit drinking, quit everything. She is right… regretfully I say that..  I plan on taking some vaca. time when she is here, so maybe she can be here for me if I start to do a taper and then get off.
    I am a very strong woman…. When I don’t think about it, I don’t really realize how strong I truly am. But then – when I DO think about it, I realize I am strong and from that strength I must draw… right???
    I am sure I am an addict and need to quit everything. IF I want to live, but sometimes, due to my daughter’s death (that I raised), sometimes, I don’t really care what happens to me. And yes, yes, I know my granddaughter needs me, but when you pull yourself BACK and look at everything in the big picture you painfully realize that “life goes on” whether you are here OR NOT. I am NOT suicidal or anything like that, and I can say that statement with 100% confidence.

    IF my cancer comes back, IF it comes back in any way, shape or form – it shall be in my brain. I had “Small Cell Lung Cancer” and it most often comes back in your brain. I did do the followup Chemo after removing the upper portion of my right lung, but chemotherapy does not permeate the brain. I chose to NOT have the preventive radiation treatments to my brain. My late daughter recommended before she lost her life, that I NOT have the PCI treatments. So, IF it come back in my brain, I will NOT choose treatment. The radiation treatment can kill you in and of itself. I would rather just lay down and go to sleep on morphine or whatever they would give you to slow your respiration down enough for you to just go to sleep. Morbid thought I know..

    My case is quite complicated and I wish I could just keep taking my pills and not have this to disrupt my life to a major extent, but if this is how it shall be, then I have to figure it out.

    Please, please don’t think this post is some kind of suicide threat, because it is not. I do not want to die yet… to differentiate – I have to say / note, I am not afraid to die any longer. I feel by my 35 yr. old daughter dying before me has given the ultimate sacrifice and making it OK for me to leave here, “the Earth” …. I pray and hope I will see her hand outstretched there, somewhere.

    Let me think about this for a week or so and then I’ll make a plan.

    By the way – I do not take an exorbitant amount of pills per day – only about 4-6 per day… it’s just that my RX-ing doc feels like he under the microscope so is taking it out on me. Why do I drink? Hello? I am obviously upset by the blows that life has dealt me…. I know I should deal with it in another way and maybe this whole thing is forcing me to figure it out and clean up my >>>>.

    I will be back and please help me, as I just don’t know what to do… here…. Not kidding.. my life depends upon this stuff.

    Thanks again for helping me.

  14. #14
    Thisweekforsure is offline Advanced Member
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    I'm glad you posted although I really hear you about not wanting to put your personal stuff up for the public to see. If it makes you feel any better, I think it might help people come to an awareness of the great amounts of suffering that a whole lot of folks are undergoing.

    Reading between the lines I think it seems your drug of choice is alcohol. Your hydocodone use is pretty under control but you don't mention how much you drink exactly which is fine, the important thing is your awareness. Rose is exactly correct about the tylenol part of the hydro, and about alcohol, that is a deadly combination for the liver.

    Because of that and because you feel very supported by your daughter in CA, it sounds as if you have a lot of reasons to go ahead and get off the hydro. If your DOC (drug of choice) is alcohol, you might find getting off the pills relatively easy but stopping the alcohol more challenging.

    Your benzodiazepine. This class of drug affects the GABA receptors and withdrawal from it can be dangerous, it can cause seizures. So can withdrawal from alcohol. If you are physically dependent on alcohol you need to be very careful and it is a great idea to have your daughter come to help you navigate these decisions. In my case I found that withdrawal from the benzo much more difficult than withdrawal from the opiate. You are taking klonopin daily, right? Like I said above, one thing at a time, I would not quit that cold turkey or even reduce it at this time. Straighten out your painkiller question first.

    But right now you need a plan to get off the hydros. You are taking about 5 10 mg per day which is only 50 mg total per day. This is not a huge amount at all. Now they've given you 5 mg so you are down to 25 mg per day. That is a 50% cut and if you do not add the patch, you will feel withdrawals but I bet they will not be severe. If I were in your situation, I would go ahead and start the new dose right away. You will have maybe 4-5 days of feeling pretty under the weather, but hopefully will be functional enough to manage. Something that helped me a lot when I did a big cut like that is to cut your pills in half and instead of taking them 5 times a day, take them 10 times a day. Or if you want to get really extreme, cut them in quarters and take them every hour. That way you are not so "up and down" but rather keeping more consistent blood levels. It makes the drop down much easier in my experience.

    If it were me, I would stay on that dose for a week, then decide either to make another drastic cut, or start deleting a pill per day for the next week, or go cold turkey from 25 mg per day. I went cold turkey from 20 mg oxycodone and that is a stronger drug than hydro, and it was not that bad. I never vomited. It was 5 days of feeling bad and then rapid improvement. I think you would not undergo anything worse. If you are able to take a few days off work, you can very easily do this.

    So yeah if I were in your situation, I'd start with the 5's as prescribed, cutting them into pieces to keep a steady blood level, now you will NEVER feel "good" doing it that way but you will never go into real withdrawal either. After several days your body will adjust and you will begin to feel "normal" at that dose. Then if you go back to taking a whole pill five times per day, you will again feel "good" right after taking that pill, you will have down regulated your brain receptors. At that point, again if it were me, I'd just jump cold turkey. Then you will feel the withdrawals, and it may be a pretty difficult couple days but only 2 really bad days then a few more blah days but after a week you will be free of them and on the way to improvement.

    Once you clear the opiate out you can address the other substances. For the Klonopin, a very slow taper is recommended, maybe over months or a year depending on your dose. Also, doctors will give you benzodiazepine to treat alcohol withdrawal, if you want to address your true addiction, that is a whole ball game I have no experience with except to say I don't believe long term use of a benzodiazepine can possibly be helpful in alcoholics and it's best to avoid them altogether unless you have a seizure disorder.

    Often we are given benzos for anxiety and sleep when we have an extreme crisis... and there is no more extreme crisis than losing your child. But the best use for them is only a week or so. When you take them for months or years, they mess up your brain's receptors pretty bad. Anti-depressants can do the same, and also need to be weaned slowly. But I am getting ahead of you. You cannot jump off all those meds and I'm not qualified to tell you that you should. I would keep everything else exactly even right now, no big changes in anything while you get off the hydro.

    Because you are a pain patient you need to keep watch over your pain while doing this. You will have increased pain. It is part of the withdrawal process. But in time that settles out. Don't think the amount of pain you are in the first week will be permanent. I don't want you to go ahead with the patch based on that because it will not, your brain's natural painkiller production will ramp back up in time. If it were me, I'd wait at least two weeks before deciding what my baseline pain level is.

    No I did not feel your post indicated suicidal thoughts at all. It's very clear you don't want to die. You are suffering and you have an extreme amount of stuff on your plate. You had the equivalent of at least two nuclear bombs detonate in your life and there will be shockwaves and fallout for at least another year, and that is assuming you don't get hit by another. Emotional and physical repercussions are ongoing and they feed on each other. Recovery from this is a one step forward, two steps back process but the overall trend is toward stability. Your goal is that you want to be able to enjoy life again, just in the moment. Just each day as it comes. You want to do that for your granddaughter and to enjoy what life you have left however long or short it may be. Truly without brain-altering substances it is easier to do that, the substances numb you and cycle you up and down too much, and distract you with their demanding schedule. You can choose to be free of that.

  15. #15
    mkan54 is offline Junior Member
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    Thank you so much…..
    A couple of things – right off the top of my head – and I will write more later, please check back…..

    One benefit of having cancer is that every 6 months they do a complete blood work up to include liver function. For some reason – my liver function has remained good through the chemo and all I continually put it through. I do drink, but in retrospect, my old pain doctor that had for about 5-6 years would give me the high-test Acetaminophen of 500 mg per tablet!!!!!!!!! What was he thinking??? Didn’t he know they made 7.5 mg hydros with only 325 of Acetaminophen? Anyway, got over that and got the new doctor and he was at least smart enough to give me the Hydro with 325 of Acetaminophen….

    The taper … Good plan.. I like it… I agree with all you said Thisweekforsure. The taper plan you laid out is what I will do… I just have to put it on my calendar and then do it. Problem or (situation) is that I have enough meds right now to make a decision a while from now.. maybe like 2-3 wks. But that is good, right? I have enough time to really, really, truly TAPER…. So I should have NO w/d symptoms at all. I just have to come to grips with the fact I am going to TAPER and get off of them. I CAN’T WAIT! I spoke to my son in law tonight on the phone (he is in prison - please don't draw un-needed conclusions, I am not a predispositioned addict) and he is ALL for me getting off of them, but he is worried about my “mental state” to STAY off them. I asked him if I should go to meetings, because he (and my daughter) were both meth addicts and they went to N/A meetings, so I am wondering if I should start going to meetings? But also, as you had said, you and HE, are not sure I am a true addict, but rather a victim of my back surgeries, cancer surgery, broken ribs in Dec. 2013, etc. It seems like a lot of my pain presently, is IN my rib location, as well as my spine of course....

    Oh and then the Klonopin that you talked so much about – I only take it at night, never EVER during the daytime hours where I am working, etc. They are 1 mg and I ONLY take it to sleep, but actually it only keeps me asleep about 4 hrs, then I am wide awake. I do not feel that I am addicted to them at all, even remotely, they are only related for sleeping, and they don't even work right that way?? I can take them or leave them, it’s just the ONE pill at bedtime that most time helps me sleep about 4 hrs. and shuts my mind down, or maybe the other things do as well.. I never ever take them during the day… although I think I might have taken one or two when my daughter died/drowned, but it is not the norm for me.

    When I was going thru chemo with my Oncologist, she wanted to switch me to Ativan from Klonopin.. I tried that for a while, but it just did not do a good enough job keeping me asleep. It is also given for nausea, which you get with the extreme chemo regime I had to undergo. (my chemicals were especially bad: etoposide and cisplatin). I did become bald, … well, I kept cutting my hair shorter; down to 1” long, then ¼’ long, then basically, a buzz cut. When it was shelling off like rain, I went into a Walmart hair joint and asked her to remove her guard and take it down to 0. She did and then wigs were forever my friend. I have hair now…and it is out of control curly and growing. I just don’t want to cut it quite yet…. But it is messy and crazy.

    Anyway, so I hear all you are saying and you are just getting to know me and my personal situation which is good.

    I feel like it is just to set a date on the calendar, start tapering and there you go. It’s just that I don’t want to do it, but I KNOW I MUST DO IT… I am sure I’ll become better on the other side.

    More later……….. Thank you to everyone who is following my journey.

    I am a normal human just trying to live a life, that is now messed up. Not gonna swear here, cause I know they will bleep it out. It’s all c r a p…. but whatever…

    you can see me in real life on You Tube, probably, and view my entire channel if you search out Small Cell Lung Cancer or some stuff about Cancer and wigs. I am sure I will come up… especially if you take my user name on this site into consideration...... Have made a ton of videos there, like 67 or something like that, with videos of myself during my cancer journey and some of my granddaughter after my daughter died when I rec’d guardianship.
    Love to you all… Keep posting for me and I will do the same… have to make a plan, have to make a plan…

  16. #16
    mkan54 is offline Junior Member
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    It's on page 3 if you search out: small center lung cancer wigs

  17. #17
    Thisweekforsure is offline Advanced Member
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    I'm really glad you have a plan and are motivated to do it. During the taper I don't promise you will have no withdrawal symptoms but they should be minimal and controllable. The challenge with taper is that you don't ever really feel that great and it's kind of like BLAH all during the taper. But it should be manageable unless you succumb to updosing.

    The klonopin, unfortunately you sound exactly like me. I was taking Ativan just like you only at bedtime for sleep never during the day and thought I was not dependent on it at all because I never craved it and it was such a small dose (only 1 mg). Well come to find out that these drugs come in small doses, but they are actually big doses. 1 mg of Ativan is moderately large. One day I said, "this isn't helping me that much I'll just not take it". Well boy did I find out... brain zaps... great anxiety. I had to get back on it and then taper off really slowly. It took me 6 months to get from 1 mg to zero. I don't want to scare you, some people never notice withdrawals from benzos.

    I can't say whether you should go to meetings. Rose and I have two different views of your situation but it is likely we are both right. Two people can look at the front and back end of an elephant and they look completely different but it's the same elephant. My perspective is that of a pain patient. It seems most others here have the perspective of being addicts. So we are both seeing things in you that resonate with both of us. You are truly a pain patient who does not abuse your meds. At the same time you admit you think you drink too much alcohol. However but, it's a result of these extreme tragedies in your life. True, however, no matter the reason you start, if you spend enough time using these substances, your brain chemistry changes to expect it and you can insidiously develop an addiction that you did not really start off with. So once again, you must evaluate yourself. Everyone's opinion (mine, Rose, your son, your daughter, your doctor) are all interesting, but not ultimately relevant. You're the captain of your ship.
    iloerose likes this.

  18. #18
    mkan54 is offline Junior Member
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    Okay, so big BUMP here…. UPDATE UPDATE ~

    A week ago yesterday, on July 22nd my doctor prescribed me the BuTrans Patch AND 60 – 5 mg/325 hydros. Sooo, I go to pick up the RX’s and the pharmacy tells me they had to send in a Pre-Authorization for the Bu Trans to my insurance company. Okay, so I go along with my whopping 5 mg hydros, being cut back from 10’s…. and call them today wondering about the Pre-Authorization. NOPE, they still have not rec’d the pre-auth. back, so NO Bu Trans…. In the meantime, I am running out of the 5’s and wondering what to do next.

    I put in a call and leave a voice message with my doctor’s nurse telling her of the situation…. First off – how dare they “lump me in with” all the other major opiate abusers that came from the “other” doctor’s office? Geez, compare apples to apples, right? AND I can’t even GET the patch IF it’s the way I decide to go, which I am not sure yet.

    I don’t know what to do…. I can still try a taper with some “additional” meds I have on hand (yah, yah, I do until I figure out how to handle this and do it the right way..) … I suppose I should start the taper like SOON, early next week, or perhaps this weekend to taper, so I can sort of stabilize before I have to go to work on Monday.

    What a frickin’ mess.

    OH and by the way - on my voice message I left for the nurse, I asked her to ask HIM if had ever heard of Precipitated Withdrawals???
    I also belong to an Opiate sub-group on Facebook and one guy on there is telling me it doesn't make any difference when I switch from Hydros to the BuTrans... he said I would not have P.W.'s.... (?) So, who do you believe? You guys here, or this guy there? I am so confused...
    Last edited by Anonymous; 07-30-2014 at 04:54 PM.

  19. #19
    iloerose is offline Platinum Member
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    MK: I tend to agree more with TWFS on the "addict" part. I should have asked how many you take in a day and if you're ramping that up. 50mg. of norco is not all that much. It is definitely not fair for me to judge you so. I just took a differing take from your original post.

    You have been through quite a lot of mess with this doctor. Your doctor should be pushing for the authorization.

    First off, what additional meds do you have and how much? How many 5mg do you have left? Let's take a look at that and then go back to the post that TWFS made about tapering. Take a look at what you CAN do.

    Meanwhile I'm going to make a post in the sub forum and ask there about the transfer from hydro to the bupenorphine patch. I will let you know what I find there. Since you can't get the butrans right now, let's focus on the hydro problem.

    You certainly do NOT deserve this aggravation. Take a deep breath and let's figure this out.

    Peace,

    Iloerose
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  20. #20
    Thisweekforsure is offline Advanced Member
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    I'm glad you posted, I was wondering how you are doing. I can't answer the question about whether the patch would put you in precipitated withdrawals.

    I don't really know what to say because you still seem to be kind of stuck in indecision. Do you want to stop the opiates? Do you have an alcohol problem? (which makes taking opiates not really safe). Are you in pain to where stopping the opiates is not really advisable right now? The only thing I feel certain about is that the doctors have thrown a monkey wrench into this by switching your meds. It seems you were not really ready to face discontinuing the opiate altogether at this time but it has become something you are considering because they've messed with your routine and you don't really trust the Butrans patch.

    PS, Rose has got this, just saw her post.
    Last edited by Anonymous; 07-30-2014 at 06:09 PM.

  21. #21
    mkan54 is offline Junior Member
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    yes, yes, and more yeses......

    I called and left a huge voicemail this afternoon for my doc's nurse. She did call me back and said she could not address it today, but she would tomorrow. Just the mere fact that I cannot even GET the Bu Patch and then looking at the RX he gave me - 5's... 60 of them.. coming off an RX that was 4.5 - 10 mg, per day. Obviously, he thought I could cut everything in half once I got that patch on me, but here it is 8 days later and I don't even have it in my possession!?!?!?!

    I WILL admit, freely, that I have/had taken more than the 4.5 per day of the former RX that I legitimately had gotten... I would take more - especially if I mowed the grass, stayed up late (no sleep the next a.m.). took the dog for a walk, needed a pick-me-up, etc. etc. Soooo. I was always running out before the RX would refill. And yes, I have my friends who would help me out so I didn't go into D.T.'s.... Not my "pure and righteous" choice, by any means, but what can I do? GET OFF OF THEM, for sure right???

    Drinking, yah, I need to quit doing that too. I basically need an overhaul. I had to quit everything last February before my lung surgery so I am almost sure I can do it again.. Well, I quit the smoking with the patch and E Cigs, then got rid of all the alcohol.... gone, outta here. Just up and quit.

    I wanna post this up and then regroup... my g-daughter just left the house with her friends and I have to make sure she is okay and safe.. might have to stalk her... LOL! But I know one thing for sure, I don't get enough sleep so have to get things ready so I can go to bed in about an hour...

    Thanks to both of you.. I will be back with more details if you think you can help me because the Good Lord knows I need help = I am sure my daughter is up there saying, "God, can you please help my mom?" She was one of the strongest people and sooo smart. If there's anyway to influence your place once you go UP, she is trying to do that. Both of you be Blessed in that you are now involved with my recovery and life and I JUST KNOWWWW my "late" daughter is trying to help me from UP THERE! She brings me and others together by fate... there are no such things as coincidences.
    Last edited by Anonymous; 07-30-2014 at 06:53 PM.

  22. #22
    iloerose is offline Platinum Member
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    Wondering how you are, MK. What new developments from your doc? Hope you are hanging in there and wishing you well.

    About the Butrans: since the active drug is bupenorphine and that is the active drug in suboxone therapy, I would definitely go with the COWS and the 26 before you put the patch on. You may not hit a 26, but get as close as you can. I would think around 36-48 hours would be safe. You need to be in moderate to severe w/d to avoid precipitated w/d.

    Anyhow, wishing you well.

    Peace,

    Iloerose

  23. #23
    mkan54 is offline Junior Member
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    OMGGGGGGGGGG

    you would never believe what is happening to me RE.: my doctor.......

    More on that tomorrow.
    Thank you for caring...

  24. #24
    Thisweekforsure is offline Advanced Member
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    Well I hope you read my post, I think your and my last posts vanished. Not sure why. Hope you can work this out with your doc. I might not be around much more so I wish you luck if I don't post again. I did go to your youtube and saw some of your remembrances of your daughter. You are obviously a very caring and heartbroken mother and I'm glad you have the love your granddaughter and have stepped in to care for her. Bless you and I hope your health and life improves from this point forward.
    mkan54 likes this.

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