I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

I heard a couple doctors on Diane Rehm discussing this the other day. They were complete nuts, both of them - and they are both powerful. As I recall one was on the approval board of the FDA and the other was part of the insurance lobby, maybe?

Anyway, the whole thing struck me as useless fear mongering and a way for insurance companies to save money by requiring an over-the-counter medicine to be purchased out of pocket, to supplement a cheaper drug.

Not amused.

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?

forget it, there are already a million other combos out there
hydrocodone with (aspirin, ibuprofen, blah blah blah blah)

so people will have to switch ...
but probably wont be the end of the world

Benevolent Misanthrope: Anyway, the whole thing struck me as useless fear mongering and a way for insurance companies to save money by requiring an over-the-counter medicine to be purchased out of pocket, to supplement a cheaper drug.

The concern is the liver damage possible from use of acetaminophen, even in recommended dosages. If the FDA doesn't end up banning those combo drugs, some sue-happy shiathead will sue the pharma companies claiming, "You KNEW my liver would get farked, yet you left those killer combos on the market anyway..."

/tramadol ftw - far better for pain relief than vicodin

namatad: Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?

It is already available with ibuprofen or without any other analgesics at all, it is just most commonly prescribed with paracetamol - probably to attempt to minimize abuse.

I see this potential move by the FDA as more of a "protect people from themselves" kind of thing than a conspiracy.

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

As bad as that would be, if the FDA doesn't come up with a replacement for vicodin then I wish that everyone involved in removing that medication from the marketplace has 8 months of kidney stones.

I'll bet they find a way to reverse the ban after that.

I can't believe that the FDA is taking this horrible and unjustified action. It makes perfect sense to take a painkiller (oxycodone or hydrocodone) that can be expected to require increasing doses over time to remain effective, and combine it with another painkiller (acetaminophen) that inflicts horrible liver damage when used at high doses. The people behind this ban obviously just want to see people suffer.

Weaver95: As bad as that would be, if the FDA doesn't come up with a replacement for vicodin then I wish that everyone involved in removing that medication from the marketplace has 8 months of kidney stones.

I'll bet they find a way to reverse the ban after that.

Uh, what? Vicodin as sold is a danger to health because it forces you to take acetaminophen with it. Banning that form and forcing the production of an acetaminophen-free form, and you're naive as hell if you don't think that will happen, is a good thing. Once again, not all government intervention is bad.

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

Nailed it in one.

In my day all we had was a bottle of whiskey and a dirty bandanna for a tourniquet and a piece of leather to bite on. That's the way it was and we liked it.

namatad: and in all fairness, why is the acetaminophen there in the first place?

I always thought it was to keep people from using it as a recreational drug.

namatad: and in all fairness, why is the acetaminophen there in the first place?

My guess would be to make the new combination patentable.

Please leave Lortab alone..

Yeah, make the plain hydrocodone tablets. Those can probably be broken down easier. Bunch of dumbasses.

GAT_00: Weaver95: As bad as that would be, if the FDA doesn't come up with a replacement for vicodin then I wish that everyone involved in removing that medication from the marketplace has 8 months of kidney stones.

I'll bet they find a way to reverse the ban after that.

Uh, what? Vicodin as sold is a danger to health because it forces you to take acetaminophen with it. Banning that form and forcing the production of an acetaminophen-free form, and you're naive as hell if you don't think that will happen, is a good thing. Once again, not all government intervention is bad.

Is there not some medicine that doesn't have this combination? If so, why aren't the pharm companies exploiting that and, if there is some type of medication out there without this combination, why aren't doctors prescribing it?

I know a few people that are hooked on bars who won't give a rat's ass whether or not it's legal.

House in 3, very good, carry on.

Came for Hugh Laurie, leaving satisfied

Weaver95: As bad as that would be, if the FDA doesn't come up with a replacement for vicodin then I wish that everyone involved in removing that medication from the marketplace has 8 months of kidney stones.

Wait, you thought this ban would affect them too? Hahahah!

Just ban it. It would be terrible to just put the information out there and allow people to make an informed decision.

man the FDA and DEA are in bed together
sucking your country dry of cash
with their budgets and their bullshiat


ON JULY 4TH IT'S A GOOD TIME TO REMEMBER
what Thomas Jefferson said,

"If the people let government decide
what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny." - Thomas Jefferson

This has nothing to do with addiction but rather liver toxicity due to the acetaminophen component of the drug. Generic drug makers will likely be able to make percocet only or vicodin only pills that are just as cheap as the current combo-drugs.

shanrick: In my day all we had was a bottle of whiskey and a dirty bandanna for a tourniquet and a piece of leather to bite on. That's the way it was and we liked it.

Came here to say something like that.

Most folks I've ever known just pop those pills for fun. When you really need them, they suck.

/Hates pills.
//Likes whiskey.

SingletonFactory: Not amused.

So that is why he decided to go into rehab...

Acetaminophen is a messy drug and probably shouldn't have been approved in the first place. For those of us who regularly punish our livers, it's a really bad idea. Plus, acetaminophen doesn't work for shiat.

There are already plenty of other options, eg., Nurofen Plus (ibuprofen and codeine), or the aforementioned opiate + NSAID as separate pills. I don't know if Nurofen is already approved by the FDA (it *would* be very convenient if such approval somehow reactivated/renewed the patent and lined *somebody's* pockets).

I've seen people screwed up by "prescription" narcotics. I know that pain management is an issue for some people, but it's also true that these medicines are too much for some to handle, and they become addicted.

There has to be a better way.

cazman: Please leave Lortab alone..

I've been taking Lortab/Vicoden for about 15 years now. Of course, I also have to have monthly blood work done that my doctor monitors.

/rheumatoid arthritis.
//Enbrel,Methotrexate,Ketophrophen,Vicoden.
///hope my doc is willing to go with Oxy now.

this is good news...for heroin dealers

So, you'll get your ***codone formulated with something else in the pill instead of acetaminophen.

Big deal.

Hooray for my Dilaudid!

Stupid people are why we can't have nice things. Thanks stupid people.

Barbecue Bob: shanrick: In my day all we had was a bottle of whiskey and a dirty bandanna for a tourniquet and a piece of leather to bite on. That's the way it was and we liked it.

Came here to say something like that.

Most folks I've ever known just pop those pills for fun. When you really need them, they suck.

/Hates pills.
//Likes whiskey.

Vicodin never did a damn thing for me painwise anyway. What good is it if you're high out of your skull if you're still in pain?

That's funny, well not really funny, but all through the Bush years it was a mad rush to kill medical marijuana and promote more drug war nonsense. Now it's moving to take away prescription medicines, and the scuttle butt I heard was that they are going to go down hard on alternate/herbals and such next.

/why does it never, ever, occur to people in power that maybe. Just maybe MORE rules are not what we need, but rather less rules. Adults in control of their own bodies, what an alien concept!

Impudent Domain: That's funny, well not really funny, but all through the Bush years it was a mad rush to kill medical marijuana and promote more drug war nonsense. Now it's moving to take away prescription medicines, and the scuttle butt I heard was that they are going to go down hard on alternate/herbals and such next.

/why does it never, ever, occur to people in power that maybe. Just maybe MORE rules are not what we need, but rather less rules. Adults in control of their own bodies, what an alien concept!

Medical marijuana is less dangerous than opiate narcotics. Film at 11!

I'm going to present my intake of Vicodin, twice following a surgery (legally) and a few times in high school for fun, and lack of addiction to Vicodin as evidence that I am genetically superior to the lot of you. Prepare to be cuckolded.

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?


The Crips. They always seem to be ahead of the curve in pharmaceutical distribution.

Michael Jackson-related hype.

Impudent Domain: /why does it never, ever, occur to people in power that maybe. Just maybe MORE rules are not what we need, but rather less rules. Adults in control of their own bodies, what an alien concept!

It does occur to them, and if you had the power to choose your own medical treatments, with herbs that you can grow in your backyard, you'd take away the potential profits for the pharmaceutical industry.

A great many laws have been enacted for the sole purpose of reducing or eliminating competition, while being masqueraded as protecting people.

Oh, awesome, ban the combination pills so that the patients can be billed for two separate drugs. An how much do you want to bet that separate will cost more?

Ban acetaminophen.. problem solved.

Off to Tijuana!

so if tylenol/acetamenophin whatever is the liver killer, why not ban all forms of that including over the counter. got a headache, chew a piece of willow bark. nasty infection, eat some moldy bread. bad pain, smoke a big ole hog leg of some killer doobage. problem solved.

I'm thinking those aren't really intended for long term use anyway...I much prefer
Put it on for 3 days at a time...then replace....

SchlingFocker: So, you'll get your ***codone formulated with something else in the pill instead of acetaminophen.

Big deal.

This. A bunch of hype over nothing. They'll just start cutting it with ibuprofen instead, which is a better pain reliever, anyways.

namatad: Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?

"Combination analgesics are most likely to produce added efficacy or synergy, as each agent works on different sites in the pain matrix/network."

The more you know....

numb3r5ev3n: Vicodin never did a damn thing for me painwise anyway.

Vicodin didn't seem to do anything for me period. I was prescribed it after getting a very bad cut on my leg and it didn't seem to do anything more than extra strength Tylenol. No buzz, just a mild blunting of the pain.

namatad: forget it, there are already a million other combos out there
hydrocodone with (aspirin, ibuprofen, blah blah blah blah)

so people will have to switch ...
but probably wont be the end of the world

The problem with that is that many people, such as myself, are allergic to NSAIDs, so those combos are out of the picture for us.

This whole decision is such bullshiat. Like someone else said, I hope every person who voted in favor of this lives the rest of their lives with intractable pain and have nothing to take for it. fark 'em up the ass. Less than three percent of people given these meds abuse them. But now that hydro/oxycodone will need to be prescribed pure, the DEA will claim that abuse potential has just skyrocketed, and they'll be pulled off the market altogether. Just watch.

/bastards
//chronic pain is NOT fun

Why do we even have pain killers? Seriously, if you can't do the time, don't do the crime.

They'll ban them and attempt to pry them from my cold dead hands. fark off FDA - Mexico ain't too far away.

Hammurderer: numb3r5ev3n: Vicodin never did a damn thing for me painwise anyway.

Vicodin didn't seem to do anything for me period. I was prescribed it after getting a very bad cut on my leg and it didn't seem to do anything more than extra strength Tylenol. No buzz, just a mild blunting of the pain.

Same here. I was given it for migraines, and nothing happened at all except I was a little fuzzy headed. That's it. I went back to ibuprofen.

Thats great now people who suffer from stomach ulcers and gastric problems will have nothing to take. Everything else causes more problems that it solves.

I get a lot of my drugs off the Walmart price list. So my guess is that no new drug is needed to make Big Pharma a ton of money. Now prescriptions will go from $4 per month to $8 per month (two scripts.)

For the chronic pain sufferers, if your doctor is truly overseeing your pain management they will have your hydrocodone prepared by a compounding pharmacy with less acetaminophen. Mine has 80 mg per dose.

Hammurderer: numb3r5ev3n: Vicodin never did a damn thing for me painwise anyway.

Vicodin didn't seem to do anything for me period. I was prescribed it after getting a very bad cut on my leg and it didn't seem to do anything more than extra strength Tylenol. No buzz, just a mild blunting of the pain.

It barely does anything for me, either. It's better than nothing, but it's far from a "cure" for my pain. Percocet works a lot better, but it makes me unbearably itchy.

I wish I could still take NSAIDs. Advil worked great for me, but now I have colitis and it'll eat holes in my intestines.

sparkeyjames: Thats great now people who suffer from stomach ulcers and gastric problems will have nothing to take. Everything else causes more problems that it solves.



/hot like it's lit

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

Monsanto

There are already other combinations of both drugs(vicoprofen and percodan).

Darvocet and Tylenol #3 are probably just as prescribed and suffers the same hepatotoxic dangers.

Oxycontin has a higher street value and tends to rope in the masses.

The FDA is just a political whore spreading it's legs for the highest campaign contributor

As someone who worked for a pharma company I'm getting a kick...

Typical knee-jerk reaction. Before I was laid off we were in the middle of clinical trial for a new anti-radiation drug. The FDA consultant practically lived in my office. Any one of our test subjects got the sniffles and the study was shut down for a week while the consultant poured over the data. A 15 patient phase 1 trial ballooned to 100 patients in a matter of weeks. Not that I have a problem with the FDA you know, looking out for the best interests of the people. But come on guys, shutting down a whole study because one guy has a runny nose?

mruttan: Hooray for my Dilaudid!

THIS...Dilaudid (hydromorphone) works better than oxycontin or hydrocodone for me any old time.

If you NEED the acetaminophen with your hydrocodone (vicodin), just buy a $5 bottle of 200 acetaminophen and take two tabs with the generic version of hydrocodone that you can get for $8 for a month's supply (60) at Walmart.

Voila, homemade Vicodin!

This REALLY isn't a big deal.

sparkeyjames: Thats great now people who suffer from stomach ulcers and gastric problems will have nothing to take. Everything else causes more problems that it solves.

I manage chronic abdominal pain with ibuprofin and heat therapy. I kinda fear prescription drugs and don't wish to start with them.

Still, where will these patients turn now for respite? If these are such dangerous drugs, why where they approved without considerable trial and due diligence?

I think money. No one gives a shiat about the patient anymore. Not the FDA, not the drug companies and certainly not the criminal farks we call HMOs.

If you can kick the dependency, you'll be better off. Sadly, I haven't the foggiest notion what a good alternative would be.

Well, there is grass, but smoking that chit makes you some kind of Satan worshiper or something along those lines.

I barely got a damn thing out of vicodin when I had my wisdom teeth, but then again I barely get anything out of most meds :\

Ask your doctor if are right for you.

Crackers Are a Family Food: Hammurderer: numb3r5ev3n: Vicodin never did a damn thing for me painwise anyway.

Vicodin didn't seem to do anything for me period. I was prescribed it after getting a very bad cut on my leg and it didn't seem to do anything more than extra strength Tylenol. No buzz, just a mild blunting of the pain.

It barely does anything for me, either. It's better than nothing, but it's far from a "cure" for my pain. Percocet works a lot better, but it makes me unbearably itchy.

I wish I could still take NSAIDs. Advil worked great for me, but now I have colitis and it'll eat holes in my intestines.

D: Well, I understand that. Advil wrecks my stomach if I take it too much, but it's the only thing that works for me, and I try to space it out as far as I can.

Rush Limbaugh seen headed for the Mexican border, looking worried.

skinned: Ask your doctor if are right for you.

Did those bullets just give me the finger?

KickahaOta: I can't believe that the FDA is taking this horrible and unjustified action. It makes perfect sense to take a painkiller (oxycodone or hydrocodone) that can be expected to require increasing doses over time to remain effective, and combine it with another painkiller (acetaminophen) that inflicts horrible liver damage when used at high doses. The people behind this ban obviously just want to see people suffer.

+1

/Methinks your post is lost on many others

Gyrfalcon: Rush Limbaugh seen headed for the Mexican border, looking worried.

Not a chance in hell he'd make it in time.

Weaver95: Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

As bad as that would be, if the FDA doesn't come up with a replacement for vicodin then I wish that everyone involved in removing that medication from the marketplace has 8 months of kidney stones.

I'll bet they find a way to reverse the ban after that.

Calm down their chief. They aren't taking the drug off the market. They are taking the combination of acetaminophen and *codone off the market. You will still be able to get *codone, and combine it with another anti-inflamatory drug, maybe even acetaminophen.

The issue is that the drugs, for some reason are combined, so the doctors can't just perscribe *codone and cut down on the liver killing portion.

I'm seeing a lot of misinformation in this thread. Let me explain.

1. Vicodin/Percocet are not on patent. The reason that I like to prescribe oxycodone with acetaminophen is that it works better. You get more pain relief than with the oxycodone alone. If you are taking a few percocet a day, then you will have better pain relief, less drowsiness, less itchiness, etc. than a person with just oxycodone alone.

2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

3. The advisory panel isn't 100% full of crap (only 95%). Acetaminophen can be dangerous in high doses. If you need high doses of narcotics, I'm certainly not going to be prescribing percocet - I'm going to separate out the two drugs.

4. But the advisory panel is overly cautious. Physicians who are prescribing percocet and vicodin have a decent understanding of the dangers of acetaminophen. This is the proper job of the doctors, not of the government agencies.

/anesthesiologist

FloydA: Did those bullets just give me the finger?

And I was worried no one would pick up on it - such a fool I was :)

Riffington: 4. But the advisory panel is overly cautious. Physicians who are prescribing percocet and vicodin have a decent understanding of the dangers of acetaminophen. This is the proper job of the doctors, not of the government agencies.


Agreed, but many, many people buy the drugs on the street, not from the pharmacy, and certainly not prescribed by their MD / DO. Addicts often overuse Lortab, Percocet, Darvocet, etc... they will increase dosage due to needing more of the opiate, and not know the danger of the added acetaminophen.

/ophthalmologist
/thankfully don't have to deal with the stuff very often

Riffington: I'm seeing a lot of misinformation in this thread. Let me explain.

1. Vicodin/Percocet are not on patent. The reason that I like to prescribe oxycodone with acetaminophen is that it works better. You get more pain relief than with the oxycodone alone. If you are taking a few percocet a day, then you will have better pain relief, less drowsiness, less itchiness, etc. than a person with just oxycodone alone.

2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

3. The advisory panel isn't 100% full of crap (only 95%). Acetaminophen can be dangerous in high doses. If you need high doses of narcotics, I'm certainly not going to be prescribing percocet - I'm going to separate out the two drugs.

4. But the advisory panel is overly cautious. Physicians who are prescribing percocet and vicodin have a decent understanding of the dangers of acetaminophen. This is the proper job of the doctors, not of the government agencies.

/anesthesiologist

Very much appreciated, doc. Couple of questions, if you're keen.

Do you not think that prolonged use of these drugs -- or the combination of these drugs -- can, over time, increase the dangers of serious damage to the liver?

Also, when it comes to chronic pain, do you think there are other natural alternatives that may produce acceptable results?

I'm not speaking of the wild-eyed pain that cancer patients endure. I'm speaking of people with back worries, female problems, bowel disorder, etc.

Is there something else worth looking at?

Proud2B_American: I'm thinking those aren't really intended for long term use anyway...I much prefer
Put it on for 3 days at a time...then replace....

This! This! 1000x this!

I love those more than any other pain killer.

/degenerative bone disease 5 years running limping

Shrew2u:
/tramadol ftw - far better for pain relief than vicodin

That stuff never touched any pain I had, they gave it to me when I hurt my foot. Vicodin helped a bit, but not in the small doses they prescribed, and since it was apap, I was very hesitant to take a higher dosage, just for the selfish reason of being able to walk to the bathroom.

I never take tylenol, but it is about impossible to find a lot of common drugs without it. I'd rather find a cough/cold medicine without it and pop a few ibuprofen.

As a fark user, I prefer to damage my liver in only very specific ways. Tonight it is Captain Morgan, not tylenol.

Barakku: I barely got a damn thing out of vicodin when I had my wisdom teeth, but then again I barely get anything out of most meds :\

I had oxycodone for an oral surgery, and I didn't know how much it helped until day 3 when I ran out.

The feds push doctors to prescribe the combination with tylenol they think it is harder for people to abuse due to the liver toxicity of the tylenol. So they ban the tylenol combination. Cue feds harassing the crap out of any doctor prescribing the same med without tylenol after they ban tylenol. This sounds like the end result may be no more hydrocodone. I don't take it but it is next on the list if what I do take ever stops working so I am a bit concerned. The fark heads at the FDA need to live for a few months in chronic pain with no medication before they start banning pain drugs.

I am so sick of being treated like a criminal because some idiot takes pain meds for entertainment.

I'm lucky. I have both GI and liver problems, so neither ibuprofen nor acetaminophen are really good choices for me. I had to have major abdominal surgery at the beginning of this year, and when I first got out of the hospital they put me on Vicodin, then Percocet, then Darvocet (knowing I had severe liver damage, mind you, because they are the ones who saw it during my colostomy). Most recently, my GP switched me to 5mg oxycodone tabs.

Why didn't the surgeon put me on that to begin with? I have a wild theory, that doctors are hesitant to prescribe the straight-up oxycodone because of its popularity for recreational use/abuse. The same thing goes for 'nerve pills'. There's nothing like going to the ER with a legitimate health crisis (diverticulitis with perforation) and waiting for hours in agony while the staff deals with people asking, "Can't you just give me some Xanax/Ativan/Vicodin/Percocet/wtf-ever?", when those people wouldn't even be there if they could just go to their corner store and buy a bag of weed.

PS: The GP also prescribed gabapentin, generic for Neurontin; it's mainly used as an anti-convulsant for epilepsy, but for some reason is also prescribed for chronic nerve pain, like with shingles. So far it does seem to reduce my need for other pain meds.

The whole article is misleading on many levels.

All of these patent pain-killers have one thing in common: They are not as effective as opium based analgesics.

In general, they cause more side-effects, they have a higher tendency to cause addiction, and they can become positively deadly when mixed with other drugs; alcohol and barbituates for example, can be fatal even at very low doses.

Opium-based pain killers share none of these drawbacks, but they are indeed habit-forming, not usually as much so as the newer pain-killers.

Unfortunately they are not patentable, so there are no big profits in prescribing them; it pays better to administer a medication which is much more dangerous, but much more profitable.

Bohemian: The feds push doctors to prescribe the combination with tylenol they think it is harder for people to abuse due to the liver toxicity of the tylenol. So they ban the tylenol combination. Cue feds harassing the crap out of any doctor prescribing the same med without tylenol after they ban tylenol. This sounds like the end result may be no more hydrocodone. I don't take it but it is next on the list if what I do take ever stops working so I am a bit concerned. The fark heads at the FDA need to live for a few months in chronic pain with no medication before they start banning pain drugs.

I am so sick of being treated like a criminal because some idiot takes pain meds for entertainment.

Yeah, I think there is a little bit of tin-foil going on here. As Riffington pointed out, the combo drugs are popular because they work well... unfortunately the acetaminophen portion is dangerous at high dosages.

For that matter, ibuprofen and acetaminophen work well in combination too... they aren't addictive, hence little abuse. Of course, GI and liver side effects are common if taken too much.

If they follow through on this, they'll just be creating a new 'Meth'-style homemade drug.

/Unintended Consequences are the Liberal's Kryptonite.

So people will taken Vicuprofen and Lorcet (hydro/ibuprofen) instead of Vicodin and Lortab. Personally, I prefer Advil to Tylenol anyway.

Percocet will be replaced by OxyIR (just oxycodone instant release) or Combunox (oxy/Ibu). I don't know why percodan (oxy/aspirin) became unpopular, so I don't know if it'll make a comeback.

FTR, oxycodone and hydrocodone are combined with the acetaminophen because there is a clinically-proven "booster" effect.

SingletonFactory: probably to attempt to minimize abuse.

more to make abuse much more dangerous than to prevent it.

In other news, they are considering pulling NyQuil from the market. Assholes.

Opiates are Bad Drugs. There are no good Bad Drugs. All Bad Drugs are Bad. It doesn't matter if some responsible people use Bad Drugs because they need them for real chronic pain; because there are some stupid idiots who abuse Bad Drugs, all Bad Drugs have to be criminalized, taken off-market, or made hard to get. Because they are Bad Drugs, and we can't be seen as promoting Bad Drugs in any way.

Bad Drugs get people addicted, and addicts are Bad People. Bad Drugs make Bad People, so they are Bad. Bad! Bad! Bad!

olddinosaur: Unfortunately they are not patentable, so there are no big profits in prescribing them; it pays better to administer a medication which is much more dangerous, but much more profitable.

Profits for who? Do you think Lortab, Percocet, etc make money for the prescribing physician? They are both available generic, dirt cheap. Not too sure what you're getting at here.

Acetaminophen makes me vomit, so I taught myself the coffee-filter treatment when I got my wisdom teeth out. I'm pretty sure that, if the US weren't on par with third-world countries in terms of elementary education, I'd probably be a rocket scientist.

alywa: olddinosaur: Unfortunately they are not patentable, so there are no big profits in prescribing them; it pays better to administer a medication which is much more dangerous, but much more profitable.

Profits for who? Do you think Lortab, Percocet, etc make money for the prescribing physician? They are both available generic, dirt cheap. Not too sure what you're getting at here.

Not all doctors follow the pattern, but the drug companies tend to push their newest, and thus patented and higher cost margin, drugs to doctors, usually with an extensive list they've come up with why they are better than the old drug they were harping the year before, which suddenly isn't as good once it has gone off patent.

Enough doctors fall into the trap, and enough patients want the newest and "best", that the drugs with no generic equivalent get prescribed at a high level.

Riffington: 2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

that is why this policy change is a good thing. the current state of affairs puts idiots who don't follow directions (taking other APAP containing drugs at the same time) in physical danger. the new policy will mean idiots who don't follow directions just give themselves less effective pain therapy.

"alywa:" I have studied the situation for many years, and find that any medication which is new, must be profitable, or it will be driven off the market.

Examples would be vitamins, intravenous Vitamin C for cancer, hydrazine sulfate, dimethyl sulfoxide, aspirin, colloidal minerals and especially hemp, a medication with which mahy Farkers are familiar.

All of these medications are effective if used properly; few cause any serious side-effects even if grossly misused, but all can be administered for pennies a dose---and none can be patented, hence there is no profit.

The pharmaceutical industry and the medical industry walk hand in hand, in the direction of the money.

phenn:
Do you not think that prolonged use of these drugs -- or the combination of these drugs -- can, over time, increase the dangers of serious damage to the liver?

Also, when it comes to chronic pain, do you think there are other natural alternatives that may produce acceptable results?

Moderate doses of acetaminophen are safe over prolonged periods, unless there's something else going on. High doses are not, and people using a large number of pills should really not be getting acetaminophen put in them.

There are a number of alternatives (natural and manufactured) to opioids for chronic pain. Far too many to describe in one thread, but it could range from massage to gabapentin to steroid injections to breathing techniques. Opioids and acetaminophen are powerful and valuable tools. They shouldn't be the only things a physician offers for pain, but they should certainly remain available.

Regarding abuse: I assure you all that the toxicity of acetaminophen is purely a negative effect. We do not put silent and dangerous things (like tylenol) in our drugs to avoid abuse: they don't prevent abuse very well, and we aren't trying to murder people. The fact that vicodin is sold to abusers is certainly an argument against putting tylenol in it... just not a good enough argument considering the benefits to patients who use it appropriately.

evilgreg: So people will taken Vicuprofen and Lorcet (hydro/ibuprofen) instead of Vicodin and Lortab. Personally, I prefer Advil to Tylenol anyway.

Percocet will be replaced by OxyIR (just oxycodone instant release) or Combunox (oxy/Ibu). I don't know why percodan (oxy/aspirin) became unpopular, so I don't know if it'll make a comeback.

FTR, oxycodone and hydrocodone are combined with the acetaminophen because there is a clinically-proven "booster" effect.

This is what I will have to do. I currently take Norco because I am in constant pain. It lets me go outside, play with my kid and have a somewhat normal life. Every month I get my blood levels checked and take my medicine like I should. Now this happens because a few dumb-asses cant follow directions.

Percocet and Vicodin just plain don't work nearly as well as marijuana for pain relief.

/motorcycle accident
//not just talking out of my ass

Riffington: I'm seeing a lot of misinformation in this thread. Let me explain.

1. Vicodin/Percocet are not on patent. The reason that I like to prescribe oxycodone with acetaminophen is that it works better. You get more pain relief than with the oxycodone alone. If you are taking a few percocet a day, then you will have better pain relief, less drowsiness, less itchiness, etc. than a person with just oxycodone alone.
/anesthesiologist

I didn't know that was a major side effect. I always thought it was just that I was allergic to something in the mix. I'm still taking benadryl with my percoset tonight though. I've got bad enough allergies tonight without the mad itchies.

It was a whole lot worse on non-generic percodan, which I was on several years ago.

/Once broke out in hives because I was allergic to my allergy medicine

LavenderWolf: Percocet and Vicodin just plain don't work nearly as well as marijuana for pain relief.

/motorcycle accident
//not just talking out of my ass

That is why I chew Lotus leaves.

I would prefer not to look like a drug seeker when asking for drugs without acetaminophen in them. I got enough probing questions last time I was in the ER on day 8 of a migraine.

I prefer to get as many of my drugs separate and just take what I need at that time, which has become enough of a pain in the arse with pseudoephedrine, and having to get a two weeks supply at a time from the pharmacist.

phenn:
Also, when it comes to chronic pain, do you think there are other natural alternatives that may produce acceptable results?

I'm not speaking of the wild-eyed pain that cancer patients endure. I'm speaking of people with back worries, female problems, bowel disorder, etc.

Is there something else worth looking at?

"Natural"??? Given that opium is a plant derivative, how much more "natural" do you want it to be?????

Aspirin is derived from salicylic acid--which is derived from a tree bark; arsenic is a heavy metal. Good god I'm so sick of people wanting "natural" alternatives to "drugs" when most drugs are, in fact, totally natural.

For your female problems, cramps and what not, why not try Kagel exercises, more water, less chocolate, and asking your OB/GYN about hormone therapy? (Hormones: body chemicals: natural) Or have her see if you have ovarian cysts that need removing. SHeesh.

Gyrfalcon: Opiates are Bad Drugs. There are no good Bad Drugs. All Bad Drugs are Bad. It doesn't matter if some responsible people use Bad Drugs because they need them for real chronic pain; because there are some stupid idiots who abuse Bad Drugs, all Bad Drugs have to be criminalized, taken off-market, or made hard to get. Because they are Bad Drugs, and we can't be seen as promoting Bad Drugs in any way.

Bad Drugs get people addicted, and addicts are Bad People. Bad Drugs make Bad People, so they are Bad. Bad! Bad! Bad!

Wow. That's bad.

Lehk: Riffington: 2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

that is why this policy change is a good thing. the current state of affairs puts idiots who don't follow directions (taking other APAP containing drugs at the same time) in physical danger. the new policy will mean idiots who don't follow directions just give themselves less effective pain therapy.

That would make almost perfect sense if patients could be placed into a convenient dichotomy of "smart people who take medications properly" and "idiots who use drugs in crazy ways". However, patient compliance is a lot more complicated than this. There are a huge number of people who will avoid taking medicine if you tell them not to, but will also skip medicines sometimes (more often if they don't see much benefit). I say almost, because if they take too much oxycodone (more likely without the acetaminophen to help), they can hurt/kill themselves that way too.

It's important to know your patients. The FDA can't know them for you.

Lifeless: the coffee-filter treatment

say what now?

Riffington: I'm seeing a lot of misinformation in this thread. Let me explain.

1. Vicodin/Percocet are not on patent. The reason that I like to prescribe oxycodone with acetaminophen is that it works better. You get more pain relief than with the oxycodone alone. If you are taking a few percocet a day, then you will have better pain relief, less drowsiness, less itchiness, etc. than a person with just oxycodone alone.

2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

3. The advisory panel isn't 100% full of crap (only 95%). Acetaminophen can be dangerous in high doses. If you need high doses of narcotics, I'm certainly not going to be prescribing percocet - I'm going to separate out the two drugs.

4. But the advisory panel is overly cautious. Physicians who are prescribing percocet and vicodin have a decent understanding of the dangers of acetaminophen. This is the proper job of the doctors, not of the government agencies.

/anesthesiologist

Still doesn't help the patients that take vicodin then take a over the counter cold medicine that happens to be laced with ace, dumb sure but the point being that behavior is out of the control of doctors.

Besides the advisory panel makes their recommendations off the numbers, we can complain all we want about skewed results but ultimately they can only make the best recommendation based on the information placed in front of them.

Certainly if you can recommend taking a combo drug, you can also recommend the taking of the pure version and a ace addition and achieve the same results.

On one hand you seem to support the drug decision making on the doctor and the patient, then turn around and claim that it's best patients take the combo drug because they may not follow your directions anyways? Your opinion seems to be at odds with each other or at least it would seem your saying YOU deserve the power of med recommendation not the FDA, when I'd argue that decision should be in the patients hands and not in your or the FDA's ultimately.

So for me the panel decision seems thoroughly thought out, and there is no loss here to the patient as long as they follow their doctors direction to also take ace. Nothing to see here.

ArgentCorvid: Lifeless: the coffee-filter treatment

say what now?

Are coffee filters fine enough to strain out the acetaminophen from the narcotic in solution?

Just a bit of additional info to augment what the MD said upthread:

Yes, they'll probably just put hydrocodone into a pill alone and prescribe it. But there's a problem, and it's the same situation as with oxycodone -- hydrocodone alone is C-II. That means no phone prescriptions, no refills. You have to have a paper scrip for each bottle of it. While this might be interesting to some doctors (more office visits, more $, yo), it will mean that the tens of thousands of people who need narcotics for a period of time will have to get themselves to their doctors offices (or, for a lot of them, I fear, they'll gum up the emergency departments). Additionally, doctors will be pressured, overtly or not, to write larger prescriptions, which tends to increase the chance that some people will increase their dosages. The pills will also have substantially more value as smuggled goods (5-10 mgs of drug are quite a bit smaller than 5-10 mgs bundled with 500 mgs of APAP -- more pills, less space, better contraband).

Don't get me wrong -- it's probably not the worst idea in the world to do this. However, there's a bunch more people out there than you think who are dependent on hydrocodone. This will cause LOTS of people to freak the hell out.

/recovering hydrocodone addict
//criminologist
///you'd think I'd know better

Shrew2u: The concern is the liver damage possible from use of acetaminophen, even in recommended dosages. If the FDA doesn't end up banning those combo drugs, some sue-happy shiathead will sue the pharma companies claiming, "You KNEW my liver would get farked, yet you left those killer combos on the market anyway..."

/tramadol ftw - far better for pain relief than vicodin

Ultram (Tramadol) also causes liver damage, but not as quickly, just FYI.

/Daily Tramadol user

Gyrfalcon: Aspirin is derived from salicylic acid--which is derived from a tree bark; arsenic is a heavy metal. Good god I'm so sick of people wanting "natural" alternatives to "drugs" when most drugs are, in fact, totally natural.

One of my favorite T-shirts evar was one that said "Drink up, Socrates, it's all natural!"

otterrr: A bunch of hype over nothing. They'll just start cutting it with ibuprofen instead, which is a better pain reliever, anyways.


Ibuprophen burns a hole through my stomach, thank you very much.

I've been on all the NSAIDS, and I know that some react badly with patients' stomachs. Acetaminophen (Tylenol) on the other hand is pretty universally harmless on the stomach lining, which is why it's mixed with everything on a lot of combo analgesic-painkiller meds.

That having been said... combo pills are idiotic, and I don't approve of them, unless it's a mandatory combination treatment regimen. Some AIDS treatments have set ratios of drugs, and combo pills there simplify things for people. (Instead of three different pills at different times and dosages, just one pill X times a day.)

However, painkillers, muscle relaxants, antinauseants and analgesics should be sold individually to avoid problems with one or the other.

Both Oxycontin and Hydrocodone are off patent by now, so some generic outfit will start producing their variety of the stand alone medications, and will likely make a nice few dollars over it too.

I perfer the old fashioned Codeine pills for pain emergencies. Don't need no prescription for 'em either here in Canada.

So let's summarize. The government prefers to reduce painkiller abuse rather than reduce pain suffering.

kidsizedcoffin: Shrew2u:
/tramadol ftw - far better for pain relief than vicodin

That stuff never touched any pain I had, they gave it to me when I hurt my foot. Vicodin helped a bit, but not in the small doses they prescribed...

It's the opposite for me and Mr. Shrew. He injured his back 30 years ago and still deals with flare-ups of pain. He switched from vicodin to tramadol because he'd gotten to a point where vicodin made him feel fuzzy without touching the pain. When I threw my back out toting the kids around recently, I found the same applied to me - my vicodin did nothing but made me a drooling zombie, while the tramadol addressed the pain without the fuzzy-headedness.

dahmers love zombie: Just a bit of additional info to augment what the MD said upthread:

Yes, they'll probably just put hydrocodone into a pill alone and prescribe it. But there's a problem, and it's the same situation as with oxycodone -- hydrocodone alone is C-II. That means no phone prescriptions, no refills. You have to have a paper scrip for each bottle of it. While this might be interesting to some doctors (more office visits, more $, yo), it will mean that the tens of thousands of people who need narcotics for a period of time will have to get themselves to their doctors offices (or, for a lot of them, I fear, they'll gum up the emergency departments). Additionally, doctors will be pressured, overtly or not, to write larger prescriptions, which tends to increase the chance that some people will increase their dosages.

Does this apply to the new e-scripts? Seems like that could be as easily authenticated as a paper script. If that were the case, the patient could still call their doctor for a refill, and thus the doctor can monitor when the patient is running out of his Rx.

I've had my go-arounds with Vicodin and its equivalents. I honestly don't understand how anyone can get addicted to it. Other than the obvious benefits, the downside for me has been horrible constipation and really bizarre dreams. Really strange, off the chart strange. When the need is gone, I'm off of it at the first opportunity.

Gyrfalcon

"Natural"??? Given that opium is a plant derivative, how much more "natural" do you want it to be?????

I would like to point out that Dogshiat is both all natural, and 100% organic.

Impudent Domain: Gyrfalcon

"Natural"??? Given that opium is a plant derivative, how much more "natural" do you want it to be?????

I would like to point out that Dogshiat is both all natural, and 100% organic.

I also would like to point out that tigers are all-natural, and can eat you.

Common Sense Advice From A Man Who has Been There And Done That:

When I broke my shoulder in a motorcycle accident, I told the doctor: "--make sure anything you prescribe doesn't react adversely with alcohol, I drink a lot of whiskey and beer."

He nodded knowingly and proceeded to prescribe opium-based narcotics for my pain, well aware I would keep drinking anyway. . . but also aware, alcohol dulls the performance of opiates, which is why junkies never drink.

I found I could manage the pain if I took about four times the dosage he prescribed, and I kept a four-ounce glass of whiskey on the nightstand, so I would have the remedy handy just in case I overdosed.

Worked out fine, but I was a little jittery when I ran out of drugs; predictable.

If Michael Jackson had cured his insomnia with a double-shot of brandy and a stick of Vancouver's finest, he would be alive today.

Shrew2u: kidsizedcoffin: Shrew2u:
/tramadol ftw - far better for pain relief than vicodin

That stuff never touched any pain I had, they gave it to me when I hurt my foot. Vicodin helped a bit, but not in the small doses they prescribed...

It's the opposite for me and Mr. Shrew. He injured his back 30 years ago and still deals with flare-ups of pain. He switched from vicodin to tramadol because he'd gotten to a point where vicodin made him feel fuzzy without touching the pain. When I threw my back out toting the kids around recently, I found the same applied to me - my vicodin did nothing but made me a drooling zombie, while the tramadol addressed the pain without the fuzzy-headedness.

It just may be the amounts prescribed, I have an unusually high tolerance for a lot of drugs. I get the fuzzy feeling fairly easily of vicodin, which can help take my mind off the pain, but the pain killing effects of a lot of drugs don't kick in at lower doses for me.

Last time I went in for surgery, to remove a tumor from my side, they didn't completely knock me out, but for the first 10 minutes of the surgery, I'm fairly certain they were tired of me saying ouch, and thus them having to try to numb me further. I have the same problem at the dentist.

Unfortunately morphine gives me migraines.

All of you farking nancies that are taking pills to cope with your pain grow up and quit being pathetic little biatches. Yes, I realize that pain is relative but you are not in pain. You are experiencing mild discomfort.

Weaver95:
As bad as that would be, if the FDA doesn't come up with a replacement for vicodin then I wish that everyone involved in removing that medication from the marketplace has 8 months of kidney stones.

I'll bet they find a way to reverse the ban after that.

I find myself heartily agreeing with you on this one.

ArmoredFelix: All of you farking nancies that are taking pills to cope with your pain grow up and quit being pathetic little biatches. Yes, I realize that pain is relative but you are not in pain. You are experiencing mild discomfort.

3/10 Nice try.

I'm currently on post surgery 'Vicodin', so I'm really getting a kick out of these responses.

The FDA will NOT be taking the ACTIVE PAIN KILLING INGREDIENT off the market. Hydrocodone and Oxycodone will remain. The APAP (aka Tylenol) is the chemical at issue with the FDA.

5mg Norco and 5mg Vicodin have the same strength of hydrocodone. IIRC, Norco holds their APAP steady at 325mg no matter what the Hydrocodone level, while Vicodin varies the APAP with the strength of the hydrocodone. So if they remove Vicodin, there is still Norco.

If some people are too stupid or lazy to find out what they are putting in their mouths....SCREW THEM.

Gyrfalcon: Aspirin is derived from salicylic acid--which is derived from a tree bark; arsenic is a heavy metal. Good god I'm so sick of people wanting "natural" alternatives to "drugs" when most drugs are, in fact, totally natural.

I think people have a problem with being prescribed medications that the doctor is paid(or otherwise enticed) to prescribe. Medications with horrible side effects. Medications where, when the patent has expired, the drug company fiddles with a molecule chain a bit, and rereleases it under a new name and a new patent and full price. Medicines that haven't been properly tested, or when they are tested, negative side effects are marginalized or ignored.

ArmoredFelix: All of you farking nancies that are taking pills to cope with your pain grow up and quit being pathetic little biatches. Yes, I realize that pain is relative but you are not in pain. You are experiencing mild discomfort.

Come on by and bring a chainsaw and I'll introduce you to my pain. Since it's mild discomfort, you should have no problem with it.

dahmers love zombie: /recovering hydrocodone addict

Please oh please tell me how you kicked this crap. My PM doctor thinks I'm not addicted because I don't take more than he prescribes and I don't do it for fun.

phenn: Also, when it comes to chronic pain, do you think there are other natural alternatives that may produce acceptable results?

I'm not speaking of the wild-eyed pain that cancer patients endure. I'm speaking of people with back worries, female problems, bowel disorder, etc.

There's a growing consensus among chronic pain physicians that the use of opiates for the treatment of non-cancer chronic pain is inappropriate and ultimately counterproductive. Opiates simply carry too much baggage and really don't work well for very long without escalating the dose - and then the patient is narcotic tolerant/dependent and still in pain.

Our clinic, for example, uses NO opiates for non-cancer pain. If there's an acute exacerbation of a chronic problem, sure, for a few days, but that's it. This pisses some patients off, especially if they were accustomed to getting narcs from other sources. It's hard to convince a person in pain that you have their best interest in mind when you're taking away their oxycodone.

One of the most frustrating things we deal with are patients who come in to us after failing therapy with their primary care provider, who has them on daily narcotics. The fibromyalgia patients on fentanyl patches always made me want to go find the prescriber and kick him in the nads.

The best long term results usually come from a multimodal approach involving non-narcotic medications - NSAIDs like ibuprofen, Tylenol, anticonvulsants like Neurontin, Elavil, Cymbalta (a serotonin/norepi reuptake inhibitor), sometimes muscle relaxants ...

... and psych assistance, if the patients are willing to accept that kind of help. (Chronic pain has profound mental health effects, and even a couple visits with a psychologist can do wonders for their coping mechanisms and help with their quality of life.)

... and lifestyle changes (especially weight loss) on the rare occasions when patients are willing to make them.


/ also an anesthesiologist

quantum_jellyroll: I've had my go-arounds with Vicodin and its equivalents. I honestly don't understand how anyone can get addicted to it. Other than the obvious benefits, the downside for me has been horrible constipation and really bizarre dreams. Really strange, off the chart strange. When the need is gone, I'm off of it at the first opportunity.

I have the same experiences with Vicodin as you do. I think you and I just don't have addictive personalities. If my wife took the same drugs I am currently taking for post surgery pain, she'd be hooked in no time because she DOES have an addictive personality.

This is all just lead up to the creation and introduction of Soma, isn't it? And I'm not talking about the muscle relaxer, I'm talking about the Brave New World stuff. They'll take away every damn useful drug and pain reliever we have, then all of the sudden "discover" this miracle cure-all drug that has no nasty side effects, other than sapping your will.

/OK I'll take my tin foil hat off now.

kidsizedcoffin: ArgentCorvid: Lifeless: the coffee-filter treatment

say what now?

Are coffee filters fine enough to strain out the acetaminophen from the narcotic in solution?

kidsizedcoffin: ArgentCorvid: Lifeless: the coffee-filter treatment

say what now?

Are coffee filters fine enough to strain out the acetaminophen from the narcotic in solution?

Acetaminophen dissolves very poorly in cold water and crystallizes if you dissolve it in boiling water and then cool it rapidly; so if you crush the vicodin, dissolve it in boiling water, put it in the freezer, then strain it with a coffee filter, you remove ~90% of the acetaminophen. YMMV, IANAD, but it kept me from puking all over my stitches.

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

One that gave huge amounts of campaign/lobbyist money to Obaqma and the democrats?

Benevolent Misanthrope: I heard a couple doctors on Diane Rehm discussing this the other day. They were complete nuts, both of them - and they are both powerful. As I recall one was on the approval board of the FDA and the other was part of the insurance lobby, maybe?

Anyway, the whole thing struck me as useless fear mongering and a way for insurance companies to save money by requiring an over-the-counter medicine to be purchased out of pocket, to supplement a cheaper drug.

Seems unlikely since vicodin is dirt cheap if you have a prescription.

WFern: Michael Jackson-related hype.

Not even close. Its due to the fact Tylenol kills people far more rapidly than all illicit drugs combined.

As someone who takes 3 hydrcodone daily for pain I am not getting a kick out of these replies.

jayhawk88: then all of the sudden "discover" this miracle cure-all drug that has no nasty side effects, other than sapping your will.

I think you just described marijuana.

As mentioned by other posters, hydrocodone itself is a schedule 2 drug. Getting a sched 2 drug rx'd for moderate pain? Hmm. I wonder if instead doctors will choose to rx higher doses of NSAIDs instead of dealing with all the restrictions and dea presence sched II drugs entail.

Cap Ten Oblivious: was to keep people from using it as a recreational drug.

Bingo! Vicodin is less restricted that hydrocodone because it is more dangerous. Banning vicodin will not make hydrocodone alone easier to get it will be just as restricted.

Proud2B_American: I'm thinking those aren't really intended for long term use anyway...I much prefer
Put it on for 3 days at a time...then replace....

Duragesic? Smoke it... very very carefully.

Mylan? Isopropyl extraction, then smoke it.

Enjoy your vicodins and your percocets, that what got me started. Now onto it's much more cost-effective big brother.



/Require 1,000mg of oxycodone daily.
//Not dicksizing, actually have a 2g/day iv diamorph habit.

This article is so full of shiat that it is not even amusing. They are only considering removing certain types of vicodin and percocet. Namely crap like Vicodin ES which contains more tylenol per tablet than anyone should take at one time. Instead of taking hydrocodone 10/650, they would rather people take 10/325. Oh noes!

Now, what IS going to suck is when they remove all of the tylenol containing products from over the counter. I cannot wait to here the QQ of people when they have to buy tylenol and cold medicine separately. I am sorry, but there are one to many farktards out there who think they can give their kids tylenol without reading the label on the tylenol containing cold syrup they just fed her.

Crackers Are a Family Food: The problem with that is that many people, such as myself, are allergic to NSAIDs, so those combos are out of the picture for us.

Oh yes, this. Also sensitive to pretty much any medication out there, even if I'm not allergic to it. I take a single Tylenol when I need it, and it works just as well or better than two does for other people.

I'm sure they'd love to take acetaminophen off the market completely for fear of the whole liver thing, but fark em. If you take it and are dumb enough to take enough to fark up your liver, you deserve what you get. Sadly, this crappy lawsuit-happy society of ours (that is in serious need of complete and total repair) would rather blame others than take personal responsibility.

Let me correct the article:

Oxycodone is available without the acetaminophen as OxyCodone, with brand names such as Roxicodone. I should know, I take it daily.
I have in the past taken Oxycontin (the time release version of Oxycodone) but switched to Fentanyl patches for long lasting pain control instead.

kidsizedcoffin: Last time I went in for surgery, to remove a tumor from my side, they didn't completely knock me out, but for the first 10 minutes of the surgery, I'm fairly certain they were tired of me saying ouch, and thus them having to try to numb me further. I have the same problem at the dentist.

Mr. Shrew has the same "slow to numb" problem. He made an agreement with his dentist - his dentist shoots him up as normal, then hubby sits in the waiting room reading a magazine until he's actually numb. It's usually 30-40 minutes before he's numb enough for dental work. Me, I have a high pain tolerance and low drug threshhold, so my dentist loves me - in, numb and out quick, never make a peep (just drool alot).

Cap Ten Oblivious: namatad: and in all fairness, why is the acetaminophen there in the first place?

I always thought it was to keep people from using it as a recreational drug.

Your user name is bang on target! If APAP is so dangerous then why not just ban all of it?

Obama is not in touch with Americans. He does not feel my pain like Clinton did.

namatad: no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?

It was put in there ostensibly to provide fever relief along with pain relief. I'm of the opinion that it was put there to allay the fears of the opiophobics in the medical machine that feared that someone might become "addicted".

Cap Ten Oblivious: namatad: and in all fairness, why is the acetaminophen there in the first place?

I always thought it was to keep people from using it as a recreational drug.

I owe you an apology for the previous post (I should read posts more carefully): I thought it said "Captain Obvious"

Shrew2u: /tramadol ftw - far better for pain relief than vicodin

Really? I'm not up to speed on the latest and greatest drugs, but I have taken Tramadol. It sorta sucks. In recommended dosages it's (to me) no better than a couple ibuprofen. The hydros or oxys actually eliminate or mitigate the pain in their prescribed amounts. I have to take so much Tramadol that I'm high as a kite (which is sorta awesome, don't get me wrong).

This is stupid. There is NO drug without side effects. As long as they are known, the decision is between you and your physician, not some huge government tumor.

As soon as VIOXX was taken off the market, I knew we'd be in for more of this shiat. Yes, it can cause complications with some people, but for many, it was really the best option.

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

Phizer? Bayer? Diet and exercise?

Filth and Disease Administration

Famine and Death Administration


Food and Drug Administration just doesn't cut it anymore, sorry!

abiigdog:
On one hand you seem to support the drug decision making on the doctor and the patient, then turn around and claim that it's best patients take the combo drug because they may not follow your directions anyways? Your opinion seems to be at odds with each other or at least it would seem your saying YOU deserve the power of med recommendation not the FDA, when I'd argue that decision should be in the patients hands and not in your or the FDA's ultimately.

A big part of prescription is knowing your patients, and helping them to find a medication (or combination) that will work for them. There are a large number of patients (probably a majority of the patients who have taken oxycodone) for whom a combination of acetaminophen/oxycodone is the best drug. For those patients, that's what they should be prescribed. Other patients should not.

But yes, the FDA (if it adopted this) would be overstepping its bounds. The FDA is there to make sure that drugs do what they say they do. The doctors are there to help patients get the medications most appropriate for them. Ultimately, the patient is the one taking the medication, so obviously they have the final say.

Even if it were shown that the practice of combining acetaminophen and opiates should stop (it has not), the FDA should not be the group making that recommendation. The American Academy of Pain Medicine is a more credible and less political organization, with a better understanding of the issues and the science.

Alacritous: Gyrfalcon: Aspirin is derived from salicylic acid--which is derived from a tree bark; arsenic is a heavy metal. Good god I'm so sick of people wanting "natural" alternatives to "drugs" when most drugs are, in fact, totally natural.

I think people have a problem with being prescribed medications that the doctor is paid(or otherwise enticed) to prescribe. Medications with horrible side effects. Medications where, when the patent has expired, the drug company fiddles with a molecule chain a bit, and rereleases it under a new name and a new patent and full price. Medicines that haven't been properly tested, or when they are tested, negative side effects are marginalized or ignored.

Which specific medications are you referring to? None of the dozens that had been mentioned on this thread, I hope.

Shrew2u:

/tramadol ftw - far better for pain relief than vicodin

You're a farking idiot if you think that. Period, no discussion.

I am in pain from getting a kick from all of these replies.

As a result, I will self medicate.

Riffington: Which specific medications are you referring to? None of the dozens that had been mentioned on this thread, I hope.

Vioxx (new window) is one that immediately springs to mind. There are others.

mattknows: Shrew2u:

/tramadol ftw - far better for pain relief than vicodin

You're a farking idiot if you think that. Period, no discussion.

I think it depends on the person. My GF has a cyst and the vicodin doesn't do jack for it. She took some tramadol, and it made her pain lessen and she was able to sleep. Different pain meds can bet better for different people and conditions.

drp:
Our clinic, for example, uses NO opiates for non-cancer pain.

I strongly support multimodal therapy, and trying to avoid opiates for fibromyalgia (the one noncancer pain you mention). But your clinic works well because other clinics are available for those patients who do benefit greatly from opioids. Bad osteoarthritis, for example.

space_cadet_28: So let's summarize. The government prefers to reduce painkiller abuse rather than reduce pain suffering.

exactly...don't even talk to me about the new restrictions on liquid morphine and liquid oxycodone.

/Hospice nurse
//government has recently made my job a WHOLE lot more difficu,to keep my patient's pain controlled when they can't swallow anymore.
///fark them

This is good news .... for Canada.

Marley: Gyrfalcon: Opiates are Bad Drugs. There are no good Bad Drugs. All Bad Drugs are Bad. It doesn't matter if some responsible people use Bad Drugs because they need them for real chronic pain; because there are some stupid idiots who abuse Bad Drugs, all Bad Drugs have to be criminalized, taken off-market, or made hard to get. Because they are Bad Drugs, and we can't be seen as promoting Bad Drugs in any way.

Bad Drugs get people addicted, and addicts are Bad People. Bad Drugs make Bad People, so they are Bad. Bad! Bad! Bad!

Wow. That's bad.

Who's bad?

Marley

Please oh please tell me how you kicked this crap. My PM doctor thinks I'm
not addicted because I don't take more than he prescribes and I don't do
it for fun.

Another former *codone addict here (lortab, percoset, dilaudid and morphine), several years ago, broke my wrist severely and the doctor was one of those who gave me a refill of 200 Lortab 10's about every 2 weeks.
Ended up taking 10-15 or more every day for several months, and when I finally ran out, had to get off of it cold turkey.
Not fun, and not the way I recommend getting off of those.
Took about 4 days of sweating, cramps, fever, "itchy blood sydrome" and insomnia to get off the physical part of the withdrawal, the mental/emotional withdrawal, however, is a lot more complicated and can take years to recover from depending on the severity of the addiction.

Vicodin is a combination of hydrocodone and acetaminophen; Percocet is oxycodone and acetaminophen. While oxycodone is available without the acetaminophen (as OxyContin) hydrocodone is not available alone in the United States. A ban would be problematic for patients and doctors alike.

FAIL

Vicoprofen has been around for years. I guess it's only problematic for those who are allergic to ibuprofen.

Let me just weigh in for a second.

1) According to UpToDate, Acetaminophen toxicity is the #1 cause of acute liver failure in the US;

2) Tylenol is so benign at its normal doses that the general public does not understand the potential consequences of taking too much;

3) Death from tylenol poisoning (intentional or accidental) is horrific. Often, the liver damage (and imminent death) is irreversible, but patients are awake and lucid for a day or two before their body really begins to fail. They have to be told sometimes that they have less than a week to live.

4) The headline is a bastardization of the article and subby is a douche.

And lets not forget Bayer, after being forbidden to sell it in North America proceeding to sell AIDS contaminated drugs (new window) in Europe and Africa

Alacritous: Riffington: Which specific medications are you referring to? None of the dozens that had been mentioned on this thread, I hope.

Vioxx (new window) is one that immediately springs to mind. There are others.

Doctors didn't prescribe Vioxx for patients because they were paid off, they prescribed it because it was a wonderful pain medicine that didn't cause much GI Bleed. There was always a question whether it actually could lead to an increase in cardiac events, or whether it simply wasn't cardioprotective like NSAIDS. When that question was finally answered, the drug was removed from the market. It took a long time to properly answer it because a tiny increase in a very common event is hard to pin down. It's actually quite unfortunate that it was removed from the market rather than just given a black box warning, because it was a good drug for certain people.

This is a pain in the ass for pharmacies because if you plan to sell plain hydrocone (without APAP combined) it becomes a schedule 2 drug. Which makes a lot more paperwork and time to dispense. This whole thing is a load of BS, there are so many different strength combinations that doctors have a lot of choices for the patients anyways.

/drunk slashies
//prefers alcohol mediated liver toxicity

namatad: Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?

So that you would develop a liver that needs servicing. You know, the General Motors plan.

We need to add a new class of labels to medications:

"Take at your own risk"

Simply put: if you suffer harm, no matter how obvious or severe, you can't sue, nor can your family should you die.

And no, a company can't just put it on there. The FDA must mandate it. Once mandated it's required in order for the medication to be sold.

No lawsuits, no class actions, no appeals. Should be defined in the constitution so nobody can argue it. No exceptions, none. Even if it was made of 100% rat poison.

Everyone wins.

Riffington: There was always a question whether it actually could lead to an increase in cardiac events

That's when you should be doing more testing, not marketing it full speed ahead.

Riffington: I strongly support multimodal therapy, and trying to avoid opiates for fibromyalgia (the one noncancer pain you mention). But your clinic works well because other clinics are available for those patients who do benefit greatly from opioids. Bad osteoarthritis, for example.

It's true, some patients who we decline to give narcs to will go elsewhere. Chronic pain patients tend to have high doctor turnover, at least until they find a plan that's working for them.

The sad fact is that the overwhelming majority of these patients never reach a pain-free state. We can help their symptoms become livable, but most will be on some lifelong polypharmacy regimen. Given that, we feel that lifelong daily opiates, with their side effects, tolerance and withdrawal characteristics, are better off avoided in almost every case.

To tell the truth, I always had more trouble convincing a patient to go see the pain psychologist ("What, you think it's all in my head?") than to give up or forgo the narcs. Most don't want to be on narcs any more than I want to prescribe them ...

Riffington: Alacritous: Riffington: Which specific medications are you referring to? None of the dozens that had been mentioned on this thread, I hope.

Vioxx (new window) is one that immediately springs to mind. There are others.

Doctors didn't prescribe Vioxx for patients because they were paid off, they prescribed it because it was a wonderful pain medicine that didn't cause much GI Bleed. There was always a question whether it actually could lead to an increase in cardiac events, or whether it simply wasn't cardioprotective like NSAIDS. When that question was finally answered, the drug was removed from the market. It took a long time to properly answer it because a tiny increase in a very common event is hard to pin down. It's actually quite unfortunate that it was removed from the market rather than just given a black box warning, because it was a good drug for certain people.

I felt freaking great on the third day taking Vioxx, well until the crushing chest pain started. More pissed at the stupid doctor that gave it to me for a minor shoulder injury and passed it off as "better than tylenol" without mentioning any risks.

BOZ: THIS...Dilaudid (hydromorphone) works better than oxycontin or hydrocodone for me any old time.

Dilaudid is a short-acting pain killer. It acts quickly and lasts for four to six hours. So is hyrdocodone.

Oxycodone is longer-lasting narcotic.

Different drugs, different uses. I take both because one alone doesn't fill the need.

MOHWowbagger: Let me just weigh in for a second.

1) According to UpToDate, Acetaminophen toxicity is the #1 cause of acute liver failure in the US;

2) Tylenol is so benign at its normal doses that the general public does not understand the potential consequences of taking too much;

3) Death from tylenol poisoning (intentional or accidental) is horrific. Often, the liver damage (and imminent death) is irreversible, but patients are awake and lucid for a day or two before their body really begins to fail. They have to be told sometimes that they have less than a week to live.

4) The headline is a bastardization of the article and subby is a douche.

This reminds me of the episode of house where Amber takes some flu medication that can't be metabolized out of her system and is slowly dying of organ failure. Oh and the whole House messed up on Vicodin season finale.

It makes me wonder if the people writing it have some sort of bombshell agenda to be revealed and the FDA is trying to get a jump on the PR side of it by banning tylenol now so they look less stupid.

Bohemian: I felt freaking great on the third day taking Vioxx, well until the crushing chest pain started. More pissed at the stupid doctor that gave it to me for a minor shoulder injury and passed it off as "better than tylenol" without mentioning any risks.

As a patient, you do have a responsibility to yourself to read the label, the drug information sheet mandated to be bundled with the medication... of freaking google it.

Yea the doctor ideally should say something... but if you didn't make any effort to know what your taking, I'd argue your worse than the doctor.

drp: The sad fact is that the overwhelming majority of these patients never reach a pain-free state. We can help their symptoms become livable, but most will be on some lifelong polypharmacy regimen. Given that, we feel that lifelong daily opiates, with their side effects, tolerance and withdrawal characteristics, are better off avoided in almost every case.

What area of medicine are you in? Serious question.

This has nothing to do with addiction. The FDA met about Vicodin,Percocet,and Tylenol. They were meeting to discuss the labeling being changed because of liver failure. Then it turned in to a just ban it. Soooo. ANYWAY.

MOHWowbagger: Let me just weigh in for a second.

1) According to UpToDate, Acetaminophen toxicity is the #1 cause of acute liver failure in the US;

2) Tylenol is so benign at its normal doses that the general public does not understand the potential consequences of taking too much;

3) Death from tylenol poisoning (intentional or accidental) is horrific. Often, the liver damage (and imminent death) is irreversible, but patients are awake and lucid for a day or two before their body really begins to fail. They have to be told sometimes that they have less than a week to live.

4) The headline is a bastardization of the article and subby is a douche.

Do you know why it's the number one cause of acute liver failure? It's not because Mavis and Harvey took too much to kill a headache. It's the number one cause because if you walk into an ER room in this country during an 18 hour shift, there is some dumbshiat who swallowed an entire bottle in the attempts to kill themselves.

Subby isn't a douche. People who read simplistic conclusions without any real knowledge behind the data are misinformed, and use their tiny amount of information as a battering ram and call other people douches are in fact far douchier.

Alacritous: That's when you should be doing more testing, not marketing it full speed ahead.

The problem is that some adverse effects are so rare that it's statistically, mathematically impossible for premarket drug testing to prove them safe.

These are problems that become evident after many patients take the drugs over a long time. This is why all new drugs are carefully surveilled after approval. Now, some drug companies may deliberately conceal bad data during drug development, and that's inexcusable.

But just because a drug is found to have a harmful effect after its approval doesn't mean that either the testing was inadequate, or even that more testing would have revealed the effect.

Believe it or not, the FDA is pretty conservative when it comes to approving new drugs. Sometimes excessively so.

/ lookin' at you, Sugammadex

ArmoredFelix: All of you farking nancies that are taking pills to cope with your pain grow up and quit being pathetic little biatches. Yes, I realize that pain is relative but you are not in pain. You are experiencing mild discomfort.

You're like my idiot section commander.

Yes, mild discomfort is something many people call pain.

When my farking hand is crushed from a motorcycle accident it isn't mild discomfort, my bones were split down the farking middle.

drp: Believe it or not, the FDA is pretty conservative when it comes to approving new drugs. Sometimes excessively so.

There were known problems with Vioxx, and the FDA actually helped them cover it up. Read the article I linked. there's more information available.

Stay Cool Babylon: Shrew2u: /tramadol ftw - far better for pain relief than vicodin

Really? I'm not up to speed on the latest and greatest drugs, but I have taken Tramadol. It sorta sucks. In recommended dosages it's (to me) no better than a couple ibuprofen. The hydros or oxys actually eliminate or mitigate the pain in their prescribed amounts. I have to take so much Tramadol that I'm high as a kite (which is sorta awesome, don't get me wrong).

I should have stuck a disclaimer on that "ftw" - more like "ftw for me", since X level of pain relief for many people can take so many different forms, even for the same general type of pain. Mr. Shrew and I are similar in that vicodin does diddly squat except make us fuzzy-headed anymore (NTTAWWT, we did enjoy the buzz), while tramadol gives fast and lasting actual pain relief without the fuzzy head feeling.

Stay Cool Babylon: Shrew2u: /tramadol ftw - far better for pain relief than vicodin

Really? I'm not up to speed on the latest and greatest drugs, but I have taken Tramadol. It sorta sucks. In recommended dosages it's (to me) no better than a couple ibuprofen. The hydros or oxys actually eliminate or mitigate the pain in their prescribed amounts. I have to take so much Tramadol that I'm high as a kite (which is sorta awesome, don't get me wrong).

Tramadol has its uses so don't knock it. I use it for break through pain and would much prefer it to having to use something that is more of an opioid. Tramadol also doesn't make you massively high or out of it. What works for one person won't work for another.

LavenderWolf: When my farking hand is crushed from a motorcycle accident it isn't mild discomfort, my bones were split down the farking middle.

OWOWOWOWOWOWOWOWOWOWOW shiat!

So, what did you take for THAT undoubtedly massive pain?

cacophony_lo: What area of medicine are you in? Serious question.

Anesthesiology.

Several months of chronic pain clinic and interventional pain are part of all anesthesiologists' residency training. Some go on to do a yearlong fellowship in chronic pain and make that the focus of their practice. I didn't, but I'm reasonably comfortable with most chronic pain management. I wouldn't do radiofrequency ablation procedures, neurolytic blocks, and a few other things, but the rest of it's within my scope of practice.

That said, I don't plan on doing much chronic pain management in the future because, frankly, the non-procedural stuff doesn't pay anywhere near as well as passing gas for surgery.

America chugs cock for a living. What a pathetic country.

IANAD and all that, but Tramadol can be some nasty stuff long term. The first pass metabolite is about 100 times more active than the tramadol itself. Toss in the SSRI effects it has, and it's a ugly beast to break from.

/in the process of dropping a Tramadol dependence
//it sucks
///alot

kidsizedcoffin: mattknows: Shrew2u:

/tramadol ftw - far better for pain relief than vicodin

You're a farking idiot if you think that. Period, no discussion.

I think it depends on the person. My GF has a cyst and the vicodin doesn't do jack for it. She took some tramadol, and it made her pain lessen and she was able to sleep. Different pain meds can bet better for different people and conditions.

However, you made it a blanket statement that it was "far better for pain relief...", when the opposite is, for the majority, the truth.

Oh and if she has a cyst causing that much pain, sounds like it needs to get drained. A ruptured cyst is not something she wants.

Did anyone read the !@#$%^ article? The reason they're banning Vicodin is that it consists of a drug which works, combined with a LARGE dose of Tylenol designed to cause liver damage in people who would otherwise abuse Vicodin... now they're just taking the tylenol out of the vicodin so that legit patients don't get liver damage. If you actually WANT vicodin, you can just take hydrocodone and over-the-counter tylenol pills together and get the EXACT SAME THING.

So, in other words, this "ban" is a ban on taking choices away from patients. Hard to see how that's a bad thing.

Great. Now I have to go back to using PCP and tequila as a pain killer. It does the job but you usually end up hurting more the next day.

nuclear_asshat: MOHWowbagger: Let me just weigh in for a second.

1) According to UpToDate, Acetaminophen toxicity is the #1 cause of acute liver failure in the US;

2) Tylenol is so benign at its normal doses that the general public does not understand the potential consequences of taking too much;

3) Death from tylenol poisoning (intentional or accidental) is horrific. Often, the liver damage (and imminent death) is irreversible, but patients are awake and lucid for a day or two before their body really begins to fail. They have to be told sometimes that they have less than a week to live.

4) The headline is a bastardization of the article and subby is a douche.

Do you know why it's the number one cause of acute liver failure? It's not because Mavis and Harvey took too much to kill a headache. It's the number one cause because if you walk into an ER room in this country during an 18 hour shift, there is some dumbshiat who swallowed an entire bottle in the attempts to kill themselves.

Subby isn't a douche. People who read simplistic conclusions without any real knowledge behind the data are misinformed, and use their tiny amount of information as a battering ram and call other people douches are in fact far douchier.

After reading your sweeping generalization, I've decided to refrain from calling you a douchebag as well, and instead I'll refer you to the following journal, which says that intentional and unintentional overdoses account for EQUAL incidences of tylenol-induced liver failure each year.

Title: Acetaminophen and the U.S. Acute Liver Failure Study Group: lowering the risks of hepatic failure
Author: Lee WM
Journal: Hepatology 2004 Jul;40(1):6-9

It's not people taking too much tylenol "to kill a headache" (usually), but people with chronic pain problems who try to avoid taking narcotics and think it's safe to just keep taking more tylenol. Or, commonly, people with preexisting liver disease whose threshhold for tylenol-induced injury is lower.

JerkyMeat: America chugs cock for a living. What a pathetic country.

Says the dude hanging out on an American-centric site on July 4th.

Sick people should just die, you're a burden on our failed health system. It's the humane and profitable thing to do.

madblader

Your family m,embers first.

IsThatYourFinalAnswer: IANAD and all that, but Tramadol can be some nasty stuff long term. The first pass metabolite is about 100 times more active than the tramadol itself. Toss in the SSRI effects it has, and it's a ugly beast to break from.

/in the process of dropping a Tramadol dependence
//it sucks
///alot

And there's the rub for any really good pain reliever, really - possibility of addiction and nasty long-term side effects. Which is why I won't take but a single tramadol per day, at bedtime, so I can get some solid shut-eye. If I took it to control the near-constant pain I've been in since Tuesday, I'd probably develop a definite and scary liking for it.

drp:
Our clinic, for example, uses NO opiates for non-cancer pain. If there's an acute exacerbation of a chronic problem, sure, for a few days, but that's it. This pisses some patients off, especially if they were accustomed to getting narcs from other sources. It's hard to convince a person in pain that you have their best interest in mind when you're taking away their oxycodone.

Heh, I can attest to that personally. I recently finished a month-long "boot camp" at a pain rehab clinic for fibromyalgia (yes I may be one of the few people who actually does have it and is not a frigging lazyass drugseeker), and this was their stance, too. I was pretty upset in the middle of a flare when they wouldn't give me anything beyond Celebrex, but when that had passed and everything else they were teaching started to work, I could see they had the right of it--for my condition, at least. Too many of the other patients there were dealing with chronic illness/pain and addiction issues, and christ just one of those is enough. A regime of exercise, stress reduction, meditation, support therapy, massage, muscle relaxants, non-narc non-opiate meds works far better in the long run (and the occasional bit of prescribed medical marijuana when literally nothing else works and I'm climbing the walls). Of course, that's not nearly as easy to keep up with as popping a few pills a day.

And I can see that for the brief period of time I did have a vicodin prescription--which never worked very well to begin with--it was all too easy to become so desperate from the pain that I didn't care about potential liver damage from the ace if a higher dose helped. That kind of pain makes it awfully hard to make rational decisions, imo.

/my $0.02

Dear submittard, I hope your liver fails from toxic overuse of acetominophen. RTFA.

Well hey, when it comes to healthcare, who knows better than the government. Just ask any Fark intellectual.

mattknows: kidsizedcoffin: mattknows: Shrew2u:

/tramadol ftw - far better for pain relief than vicodin

You're a farking idiot if you think that. Period, no discussion.

I think it depends on the person. My GF has a cyst and the vicodin doesn't do jack for it. She took some tramadol, and it made her pain lessen and she was able to sleep. Different pain meds can bet better for different people and conditions.

However, you Shrew2u made it a blanket statement that it was "far better for pain relief...", when the opposite is, for the majority, the truth.

FTFY - kid didn't make that statement, I did. And I later modified my statement, if you care to read the thread that far.

namatad: Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?


So it can be a one pill miracle.

I was sick as hell last month. Coughed so much my teeth farking hurt. It hurt to breath because the muscles had spasmed so much. Perkocet killed the cough and the pain. No over the counter medecine could help and I tried them all. Thanks, meth assholes.

Sorry -- don't have time to read all the comments -- but let me just suggest that Percocet without tylenol (good old oxycodone) and Vicodin without tylenol (good old pure hydrocodone) are EVEN MORE DANGEROUS. When I was hooked on opiates (I'm over 9 months clean) I would have LOVED to find some pure oxy or hydrocodone. Easier to snort, shoot, etc.

This is a bad idea.

Oh but keep those cigs and booze coming. They're harmless.

People that don't think non-cancer pain and cancer pain aren't the same really piss me off. PAIN IS PAIN. There is an EPIDEMIC of under-treated chronic pain in the US itself.

Chronic use of acetaminophen or NSAIDs is BAD. PERIOD. There is NOT a consensus of chronic pain doctors that think opiates for non-cancer pain is a bad way to go, in fact it's quite the opposite. Here and here. Read it yourself. Tylenol and Ibuprofen can lead to liver damage, stroke, bleeding ulcers, etc. Opiates don't. OPEN YOUR EYES, "DOCTORS."

Primum non nocere. Still remember that part?

Corectorium

People that think non-cancer pain and cancer pain aren't the same really piss me off.

Proof-read, remember that part, me?

This is stupid. NSAIDS (like Ibuprofen) cause more injury and death than acetominophen, overall.
The gut ulcers, the kidney damage - and you can expect that to get worse.

FDA had better satisfy itself with a black box or it is going to find that its usefulness as an agency is past it's shelf life, and it gets pulled. Enough nannying Tell us what's in the medicine, ensure what's on the label is what is in the product, and does what it claims. perhaps record adverse events.- that's what the FDA is for.

Physicians pharmacists and patients decide whether and what to risk. They pick. Not you.

I wake up in the recovery room after having surgery for a ruptured disc. I have my own attendant with a syringe full of morphine at the ready if I simply groan a bit.

A few beds down, some clown is crying, begging for more painkillers. I mumble something about "give it a frigging rest, some of us are actually in pain. You just want some dope". My attendant laughs a little, and says "oh, I see you noticed that too. By the way, would you like some more morphine?"

/2 ruptured disc, two surgeries, nearly two years of pain management
//glad to be off the opiates

Note that they're not trying to ban painkillers.
Note that they're not trying to ban the restricted chemicals in the Vic and Perc.

The issue here is that acetaminophen is in so many different medications that people are f'ing themselves up by taking too much of it.

Answer to problem: Release Hydrocodone tablets. Doctors can now prescribe either Hydrocodone and Acetaminophen or Oxycodone and Acetaminophen instead of being forced to prescribe combination drugs.

People who have problems get the exact same amount of the exact same drugs as they are now; just without the excessive levels of Acetaminophen from having Acetaminophen in everything.

Bonus: Pure -codone!

MOHWowbagger: After reading your sweeping generalization, I've decided to refrain from calling you a douchebag as well, and instead I'll refer you to the following journal, which says that intentional and unintentional overdoses account for EQUAL incidences of tylenol-induced liver failure each year.

Title: Acetaminophen and the U.S. Acute Liver Failure Study Group: lowering the risks of hepatic failure
Author: Lee WM
Journal: Hepatology 2004 Jul;40(1):6-9

It's not people taking too much tylenol "to kill a headache" (usually), but people with chronic pain problems who try to avoid taking narcotics and think it's safe to just keep taking more tylenol. Or, commonly, people with preexisting liver disease whose threshhold for tylenol-induced injury is lower.

So about 1/2 of the cases are suicide attempts. Of the other half, most of them were already taking the drug and took more than the amount directed by their attending physician.

Your point was that this was some huge dangerous substance and the FDA as doing us a favor. You break the numbers down and clearly it's not an EVERYBODY PANIC!!!! drug. 1/2 tried to kill themselves and the other half are popping pills like crazy. That's hardly a reason to remove a safe drug from the public for what will likely be replaced with a substitute from a pharma company with a lot less research data.

The FDA is clearly overstating the problem .

no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?

The apap potentiates the painkilling of the oxy or hydro making a 5mg oxy work as well as a 20 or so.

Yeah, vicoden doesn't give me any kind of high at all, and its pain relieving ability is maybe just a bit better than a double dose of naproxen. Thankfully I've never been in a medical situation where I needed pain relief, because I worry that the stronger related meds might also be ineffective.

And for all the people talking about legalizing pot for pain relief, I have a question. Several years ago, I distinctly remember a friend of mine who said she had a prescription for something called Marinol, which is basically purified THC. So, if Marionl can be legally prescribed, then why is it necessary for pot to be legalized? To me this situation is similar, though not entirely analogous, to opium being illegal, but we have tons of drugs derived from it that can be legally obtained and used by prescription.

Just for the record, I'm actually in favor of marijuana legalization, but I still have a few questions, I guess.

Shrew2u:

And there's the rub for any really good pain reliever, really - possibility of addiction and nasty long-term side effects. Which is why I won't take but a single tramadol per day, at bedtime, so I can get some solid shut-eye. If I took it to control the near-constant pain I've been in since Tuesday, I'd probably develop a definite and scary liking for it.

Well, just be careful with that stuff. I started the exact same way. One for bed...then two for bed....then three for bed, wake up at midnight, pop another two. I'd gotten to the point to where I was taking 200mg of tramadol every 4 hours just to function, no buzz at all. Never noticed it as an addiction, and my doc (vet affairs, course) has the "Not scheduled, not addictive" mentality. Decided last week I had a problem, stopped my refills, and staggered down. I'm on Day 4 of no Tramadol, and it's a true bastid.

For some reason, Aleve helps, along with Seroquel.

MrHappyRotter: Yeah, vicoden doesn't give me any kind of high at all, and its pain relieving ability is maybe just a bit better than a double dose of naproxen. Thankfully I've never been in a medical situation where I needed pain relief, because I worry that the stronger related meds might also be ineffective.

And for all the people talking about legalizing pot for pain relief, I have a question. Several years ago, I distinctly remember a friend of mine who said she had a prescription for something called Marinol, which is basically purified THC. So, if Marionl can be legally prescribed, then why is it necessary for pot to be legalized? To me this situation is similar, though not entirely analogous, to opium being illegal, but we have tons of drugs derived from it that can be legally obtained and used by prescription.

Just for the record, I'm actually in favor of marijuana legalization, but I still have a few questions, I guess.

Marinol is a synthetic version of THC and its affects vary person to person. By most accounts (anecdotal in my case) it doesn't work so well.

Most people that truly use cannabis for pain relief don't smoke it, they ingest it, as it works way better and lasts longer than just smoking it.

MrHappyRotter: And for all the people talking about legalizing pot for pain relief, I have a question. Several years ago, I distinctly remember a friend of mine who said she had a prescription for something called Marinol, which is basically purified THC. So, if Marionl can be legally prescribed, then why is it necessary for pot to be legalized? To me this situation is similar, though not entirely analogous, to opium being illegal, but we have tons of drugs derived from it that can be legally obtained and used by prescription.

Two cancer patients have told me that Marinol does not provide the pain relief that smoking a joint does, and it does not ease the nausea of chemotherapy or enable the patient to actually eat.

I admit that's a ridiculously small sample, but it's all the terminal cancer patients I knew. And even if ordinary adults have to be "protected" from the eee-vil weed, why on earth are we depriving terminal cancer patients?

Actually, hydrocodone is sold alone in it's polystyrex form as Tussionex®, a delicious, pineapple-flavored cough medicine which gives one a very pleasant buzz (better than vicodin!). I am sure someone else has mentioned this by now but I am not about to read through 205+ comments just to say that. It is late (23:24 EDT) and I am tired. Have a good night, y'all!

abiigdog: Your opinion seems to be at odds with each other or at least it would seem your saying YOU deserve the power of med recommendation not the FDA, when I'd argue that decision should be in the patients hands and not in your or the FDA's ultimately.

You shouldn't take options away from either the doctors or the patients.

Taking options away from the FDA, OTOH, is fine by me, as long as all parties are informed. Acetaminophen isn't exactly thalidomide, is it?

The PROBLEM isn't the acetaminophen. The PROBLEM is the fact that people are abusing them. And they will continue to abuse them, especially if these pills are "pure".

Do you know how happy I would have been to find pure hydrocodone when I was all junked out? Do you know how excited I was everytime I found pure oxycodone?

This is a baaaaad idea.

I have both Vicodin and Percocet on my shelf, so I'm getting a kick ETC.

/Fentanyl is evil stuff
//was on it for a month and a half
///rather have a tooth pulled out of the top of my head without anesthetic rather than go through that withdrawal again
//Demerol, however, rocks
/BYO laxatives

Marley:

Two cancer patients have told me that Marinol does not provide the pain relief that smoking a joint does, and it does not ease the nausea of chemotherapy or enable the patient to actually eat.

I admit that's a ridiculously small sample, but it's all the terminal cancer patients I knew. And even if ordinary adults have to be "protected" from the eee-vil weed, why on earth are we depriving terminal cancer patients?

Okay, and keep in mind that I'm playing devil's advocate, but what if the same is true for opium vs its legal derivatives? I'm wouldn't be surprised if you'd find people that say pure opium works on their pain better than any of the opiate drugs.

nuclear_asshat: MOHWowbagger: After reading your sweeping generalization, I've decided to refrain from calling you a douchebag as well, and instead I'll refer you to the following journal, which says that intentional and unintentional overdoses account for EQUAL incidences of tylenol-induced liver failure each year.

Title: Acetaminophen and the U.S. Acute Liver Failure Study Group: lowering the risks of hepatic failure
Author: Lee WM
Journal: Hepatology 2004 Jul;40(1):6-9

It's not people taking too much tylenol "to kill a headache" (usually), but people with chronic pain problems who try to avoid taking narcotics and think it's safe to just keep taking more tylenol. Or, commonly, people with preexisting liver disease whose threshhold for tylenol-induced injury is lower.

So about 1/2 of the cases are suicide attempts. Of the other half, most of them were already taking the drug and took more than the amount directed by their attending physician.

Your point was that this was some huge dangerous substance and the FDA as doing us a favor. You break the numbers down and clearly it's not an EVERYBODY PANIC!!!! drug. 1/2 tried to kill themselves and the other half are popping pills like crazy. That's hardly a reason to remove a safe drug from the public for what will likely be replaced with a substitute from a pharma company with a lot less research data.

The FDA is clearly overstating the problem .

Are you being serious? They're not removing tylenol from the public. They're removing it from two combination meds in an effort to prevent accidental toxicity. Both drugs will still be available to use or abuse as much as you want. You're screaming conspiracy because you'll now have to take an oxycodone AND a tylenol instead of one combination pill?

vertiaset: You can get a natural, longer lasting high from exercise and meditation. Plus, you get the added benefit of ... you know ... not dying.

Pussy.

IsThatYourFinalAnswer: Shrew2u:

And there's the rub for any really good pain reliever, really - possibility of addiction and nasty long-term side effects. Which is why I won't take but a single tramadol per day, at bedtime, so I can get some solid shut-eye. If I took it to control the near-constant pain I've been in since Tuesday, I'd probably develop a definite and scary liking for it.

Well, just be careful with that stuff. I started the exact same way.

Roger Wilco. Last night was probably my last tramadol, since I've been able to walk upright without yelping today. Hope so - the pain relief is nice, but I'd rather be able to have a nice glass of chardonnay before bedtime!

"Combo" drugs are actually one of the major causes of liver failure, and not usually because of intentional drug abuse. I see nothing wrong with forcing the drugs to be sold separately (and more cheaply too).

Riffington: Alacritous: Riffington: Which specific medications are you referring to? None of the dozens that had been mentioned on this thread, I hope.

Vioxx (new window) is one that immediately springs to mind. There are others.

Doctors didn't prescribe Vioxx for patients because they were paid off, they prescribed it because it was a wonderful pain medicine that didn't cause much GI Bleed. There was always a question whether it actually could lead to an increase in cardiac events, or whether it simply wasn't cardioprotective like NSAIDS. When that question was finally answered, the drug was removed from the market. It took a long time to properly answer it because a tiny increase in a very common event is hard to pin down. It's actually quite unfortunate that it was removed from the market rather than just given a black box warning, because it was a good drug for certain people.

Viox was great for my back, I really miss it :(

MrHappyRotter: Okay, and keep in mind that I'm playing devil's advocate, but what if the same is true for opium vs its legal derivatives? I'm wouldn't be surprised if you'd find people that say pure opium works on their pain better than any of the opiate drugs.

I'm not sure I understand the question. (Too much Vicoprofen, I guess.) You're asking if pure opioids work better than narcotics/APAP combination should we use that instead?

My understanding is that in terms of pain relief, it doesn't. I have no experience, so I'm talking out of my ass, but I'm told that the APAP or ibuprofen enhance the effect of the narcotic. Plus there's that whole "harder to snort" thing.

It's the APAP that's cooked my liver, though. Switching to Vicoprofen, which only comes in lower dose tablets, was horrific.

preshrink: Acetaminophen is a messy drug and probably shouldn't have been approved in the first place. For those of us who regularly punish our livers, it's a really bad idea. Plus, acetaminophen doesn't work for shiat.

There are already plenty of other options, eg., Nurofen Plus (ibuprofen and codeine), or the aforementioned opiate + NSAID as separate pills. I don't know if Nurofen is already approved by the FDA (it *would* be very convenient if such approval somehow reactivated/renewed the patent and lined *somebody's* pockets).

Unless you're married to someone with a diagnosed NSAID allergy, chronic pain, and trying NOT to develop an addiction.

duuuuuude: People that think non-cancer pain and cancer pain aren't the same really piss me off.

Pain is pain, but not all pain should be treated the same way.

The first article you cited is not a set of practice guidelines or even a consensus statement. It's a review article with some recommendations - and even it specifically states that opiates should never be first-line treatment for chronic pain. I could also cherrypick similar articles advocating non-opiate approaches.

The second article included the bit "There is currently no nationally accepted consensus for the treatment of chronic pain not due to cancer" and I have to agree with this. I am by no means suggesting that it is inappropriate to prescribe opioids for non-cancer pain - indeed, in this very thread there's another anesthesiologist who does.

Chronic use of acetaminophen or NSAIDs is BAD. PERIOD.

Why are you so willing to make this (incorrect) blanket statement, but so angry when I say that chronic use of opiates usually works out poorly?

Primum non nocere. Still remember that part?

Primum non nocere is precisely why I avoid prescribing narcotics to certain subsets of patients. My education, training, and experience have led me to conclude that in the long run, most find that their quality of life is scarcely improved by chronic opiate use but instead they've added opiate tolerance and dependence to the equation (note that tolerance & dependence are not the same thing as addiction, which is actually rare in chronic pain patients taking opioids).

1.61803399: Dear submittard, I hope your liver fails from toxic overuse of acetominophen. RTFA.

time to think up yet another alt

ttc2301: I have both Vicodin and Percocet on my shelf, so I'm getting a kick ETC.

/Fentanyl is evil stuff
//was on it for a month and a half
///rather have a tooth pulled out of the top of my head without anesthetic rather than go through that withdrawal again
//Demerol, however, rocks
/BYO laxatives

Yes, Fentanyl is very bad, but, when front line opiates just aren't cutting it...you gotta do what you gotta do.

/Spinal cord tumors and several spinal surgeries...The thing is, I don't feel a buzz at all. I get a better buzz from a Mojito. But do not mix the two...

If pain management was simple anyone could do it.

Unfortunately, it's not. In part because we're not completely sure what pain really is or how it works.

I'd be thrilled to find something that works for my arthritis but doesn't mess with my Crohn's. NSAIDS are trouble because of GI irritation; acetaminophen is an extra worry because I take a potentially nasty hepatotoxic immunosuppressive; and codeine-derived drugs screw up intestinal motility.

Vioxx was marginally useful while it lasted.

I'm (probably) not drug-seeky as I've never finished any opioid prescription.

I conclude that it would be nice to live in a medical marijuana state.

MrHappyRotter: Yeah, vicoden doesn't give me any kind of high at all, and its pain relieving ability is maybe just a bit better than a double dose of naproxen. Thankfully I've never been in a medical situation where I needed pain relief, because I worry that the stronger related meds might also be ineffective.

And for all the people talking about legalizing pot for pain relief, I have a question. Several years ago, I distinctly remember a friend of mine who said she had a prescription for something called Marinol, which is basically purified THC. So, if Marionl can be legally prescribed, then why is it necessary for pot to be legalized? To me this situation is similar, though not entirely analogous, to opium being illegal, but we have tons of drugs derived from it that can be legally obtained and used by prescription.

Just for the record, I'm actually in favor of marijuana legalization, but I still have a few questions, I guess.

Marinol is worthless, take it from a hospice nurse

i have to say that tramodol does very well for my chronic back pain. i have 3 herniated discs in my lower back. most docs are scared to death to prescribe the stuff that is safe and that works because of all the publicity of abuse.

i would be just fine with a decent hydro/oxy script, but no doc will do it. in the meantime, i will continue to humor my doc by going to physical therapy, chiro, massage, and everything else they suggest but i really just wish they'd give me what works instead of having to maintain some pretty shady contacts to get the meds i need.

/have insurance
//people w/o insurance seem to get better care when it comes to pain

Littleturtle: Marinol is worthless, take it from a hospice nurse

Doesn't do jack-sh*t for nystagmus, either, while cannabis does. But I will never be able to conduct a real (i.e. N>1) study or publish the results.

numb3r5ev3n: I've seen people screwed up by "prescription" narcotics. I know that pain management is an issue for some people, but it's also true that these medicines are too much for some to handle, and they become addicted.

There has to be a better way.

There isn't. Everyone who takes narcotics becomes addicted. That's what narcotics do.

In fact, there's nothing wrong with a little opiate addiction in those who suffer chronic pain. Ask anyone who takes vicodin if they'd rather have regular bowel movements or suffer the excruciating pain that the vicodin relieves. Constipation sucks, they'll tell you, but the pain is worse.

The ridiculous part is when morphine drips for the terminally ill are cut back to reduce risk of addiction, causing them to suffer needlessly.

And a hydrocodone-only pill better be on the market the moment vicodin is yanked, because I don't want to see one of my loved ones try to make it through the day without one.

I like how they said 'Bad news for Dr Greg House!' Because for those of us that follow the show (sadly) that's the first farking thought that popped into our sad little minds.

"Oh no! Poor Dr House!"

A BIG vote here for Celebrex. It's the ONLY pain reliever I've ever used that works. All the others might as well have been sugar pills. Plus, it is safe as houses, compared to most other NSAIDs.

Crackers Are a Family Food: namatad: forget it, there are already a million other combos out there
hydrocodone with (aspirin, ibuprofen, blah blah blah blah)

so people will have to switch ...
but probably wont be the end of the world

The problem with that is that many people, such as myself, are allergic to NSAIDs, so those combos are out of the picture for us.

This whole decision is such bullshiat. Like someone else said, I hope every person who voted in favor of this lives the rest of their lives with intractable pain and have nothing to take for it. fark 'em up the ass. Less than three percent of people given these meds abuse them. But now that hydro/oxycodone will need to be prescribed pure, the DEA will claim that abuse potential has just skyrocketed, and they'll be pulled off the market altogether. Just watch.

/bastards
//chronic pain is NOT fun

THIS THIS THIS FARKING THIS

/Media will eat those stories from the DEA up
//STOP listening to the media!!

My favorite post-op med is dilaudid...but it's really not a long term drug. And I would never want to feel like it makes me feel just for fun...I lost an entire week after the last spinal surgery. I remember pretty much NOTHING...

I have to agree that Dilaudid is prob the best drug out there, for in hospital pain control. I was hospitalized with Meningitis a couple of years ago and the headache/neck pain was atrocious. @ mg IV Dilaudid q 3 hours did the trick.

First dose and I understood how easy it is to get addicted to herion.
(IIAC, Dilaudid is only a molecule or 2 off from heroin)

How farking hard is this. If you are on X drugs, do not take Tylenol.

It's the same with drinking. I can't tell you how many idiots I knew that decided Tylenol before bed or Tylenol in the moring was the best thing for a hang over. Go fark you liver.

I'm on my 4th ACL and God Damn those Percosets were farking awesome. I love me some opiates.

/Durnk.

As someone who struggled for several years with an addiction to opiate painkillers, I would like to apologize to everyone who will legitimately suffer if this ban becomes official. It's selfish and stupid people like myself that screw things up for people that truly need help.

Sorry.

Riffington: abiigdog:
On one hand you seem to support the drug decision making on the doctor and the patient, then turn around and claim that it's best patients take the combo drug because they may not follow your directions anyways? Your opinion seems to be at odds with each other or at least it would seem your saying YOU deserve the power of med recommendation not the FDA, when I'd argue that decision should be in the patients hands and not in your or the FDA's ultimately.

A big part of prescription is knowing your patients, and helping them to find a medication (or combination) that will work for them. There are a large number of patients (probably a majority of the patients who have taken oxycodone) for whom a combination of acetaminophen/oxycodone is the best drug. For those patients, that's what they should be prescribed. Other patients should not.

But yes, the FDA (if it adopted this) would be overstepping its bounds. The FDA is there to make sure that drugs do what they say they do. The doctors are there to help patients get the medications most appropriate for them. Ultimately, the patient is the one taking the medication, so obviously they have the final say.

Even if it were shown that the practice of combining acetaminophen and opiates should stop (it has not), the FDA should not be the group making that recommendation. The American Academy of Pain Medicine is a more credible and less political organization, with a better understanding of the issues and the science.

Alacritous: Gyrfalcon: Aspirin is derived from salicylic acid--which is derived from a tree bark; arsenic is a heavy metal. Good god I'm so sick of people wanting "natural" alternatives to "drugs" when most drugs are, in fact, totally natural.

I think people have a problem with being prescribed medications that the doctor is paid(or otherwise enticed) to prescribe. Medications with horrible side effects. Medications where, when the patent has expired, the drug company fiddles with a molecule chain a bit, and rereleases it under a new name and a new patent and full price. Medicines that haven't been properly tested, or when they are tested, negative side effects are marginalized or ignored.

Which specific medications are you referring to? None of the dozens that had been mentioned on this thread, I hope.



Yeah but come on who are we fooling, that ass in the president seat wants to be making ALL MEDICAL decisions for you, or err at least the ones that cost money, it don't get any more political then government ran health care. This ruling is a tea cup of water on a drowning mans head.

I'm on narcotic paint killers right now, so I'm getting a kick out of these posts... :-)

/for real -- 15mg oxy -- no apap.
// :-) :-)
/// what's not to smile about when the pain is gone, and the opiates make you feel good.

P.S. to all you holier than thou types who think it's better to be in chronic pain than addicted to opiates, I suggest you try the pain for a few weeks -- you'd change your tune in a hurry. It's *far* better to be addicted to oxy or it's ilk than experience ongoing severe pain 24/7.

medic2731: I have to agree that Dilaudid is prob the best drug out there, for in hospital pain control. I was hospitalized with Meningitis a couple of years ago and the headache/neck pain was atrocious. @ mg IV Dilaudid q 3 hours did the trick.

First dose and I understood how easy it is to get addicted to herion.
(IIAC, Dilaudid is only a molecule or 2 off from heroin)

Dilaudid is the only drug that ever really controlled the pain after the surgeries...I totally agree with you about understanding how easy it would be to get addicted to heroin. The dilaudid is nasty stuff, but I am glad it is there when it's needed.

Jesus, this is like reading the notes and letters in the back of Naked Lunch. Too bad ole Billy Burroughs is dead.

kermit_the_frog:

P.S. to all you holier than thou types who think it's better to be in chronic pain than addicted to opiates, I suggest you try the pain for a few weeks -- you'd change your tune in a hurry. It's *far* better to be addicted to oxy or it's ilk than experience ongoing severe pain 24/7.

/I couldn't agree more!

Lumi: numb3r5ev3n: I've seen people screwed up by "prescription" narcotics. I know that pain management is an issue for some people, but it's also true that these medicines are too much for some to handle, and they become addicted.

There has to be a better way.

There isn't. Everyone who takes narcotics becomes addicted. That's what narcotics do.

In fact, there's nothing wrong with a little opiate addiction in those who suffer chronic pain. Ask anyone who takes vicodin if they'd rather have regular bowel movements or suffer the excruciating pain that the vicodin relieves. Constipation sucks, they'll tell you, but the pain is worse.

The ridiculous part is when morphine drips for the terminally ill are cut back to reduce risk of addiction, causing them to suffer needlessly.

And a hydrocodone-only pill better be on the market the moment vicodin is yanked, because I don't want to see one of my loved ones try to make it through the day without one.

Sorry, you're wrong on one major point. Not everyone that takes narcotic pain relievers becomes addicted. They will more than likely become dependent. There's a major difference between the two, addiction is for fun, dependence is a medical condition. Please look up the difference between the two.

co-conspirator: Doesn't do jack-sh*t for nystagmus, either, while cannabis does.

It helps nystagmus?? Does it also help with balance issues?

/TBI

Oh man papa bear Rush is going to be stocking up now.

abiigdog: Yeah but come on who are we fooling, that ass in the president seat wants to be making ALL MEDICAL decisions for you, or err at least the ones that cost money, it don't get any more political then government ran health care. This ruling is a tea cup of water on a drowning mans head.

So... how's that paint huffing been working out for you? At least it's over the counter.

/"Take two Krylon and call me in the morning."

MrHappyRotter:
And for all the people talking about legalizing pot for pain relief, I have a question. Several years ago, I distinctly remember a friend of mine who said she had a prescription for something called Marinol, which is basically purified THC. So, if Marionl can be legally prescribed, then why is it necessary for pot to be legalized?

Marinol is synthetic THC that is patented. I have heard it cost about $30 a pill and most people need to take a few to make it work. And it does not work as well as real pot.

RancidOne: Lumi: Sorry, you're wrong on one major point. Not everyone that takes narcotic pain relievers becomes addicted. They will more than likely become dependent. There's a major difference between the two, addiction is for fun, dependence is a medical condition. Please look up the difference between the two.

From a neuropsychopharmacological standpoint there is no difference between dependence and addiction. The chemical mechanisms are identical.

The distinction between "dependence" and "addiction" is a lay one, not a medical one, and "dependence" is simply a nice way to reassure people they aren't filthy addicts. Or something.

Marley: It helps nystagmus?? Does it also help with balance issues?

Some forms, such as infantile nystagmus syndrome (used to be known as "congenital nystagnus")

I suspect it would be a problem to add on top of acquired forms such as vestibular, as there are other issues, such as trauma, involved. But it's vanishingly unlikely I'd get approval to do such a study...

Have another pill, pillhead.

co-conspirator: Some forms, such as infantile nystagmus syndrome (used to be known as "congenital nystagnus")

I suspect it would be a problem to add on top of acquired forms such as vestibular, as there are other issues, such as trauma, involved. But it's vanishingly unlikely I'd get approval to do such a study...

When you do that study, look me up, please. My neurologist told me "It'll just take time." Isn't two years enough?

As someone with a pocket full of Norco whose liver just exploded all over the god damned cat, kicks and so forth.

My father did was a doctor providing chemo to cancer patients 10-15 years ago, he said it was not unusual for patients to come in reeking of pot, partly for the pain, partly for the nausea, he never made a big deal of it, he was happy if they found something to make them feel better. Nevermind it has now been shown to stunt or reduce some tumor growth. We have his chemo chair in our living room now, great conversation piece once someone is situated in it.

And thanks Shrew2u for clearing up the way above misconception about my post.

It is not asinine, it is needed. I work in the insurance field and doctors prescribe it for non-acute, non-cancer pain for far too long. I've had people on my caseload die from too much. The doctors that do this eventually lose their license, but that doesn't bring the dead people back.

I got an Rx for Percocet when I dislocated my shoulder, twelve years ago. Honest to God, that stuff just knocked me on my ass. I was just groggy the whole time, no fun at all for me. I cut the pills in half. Still just made me want to sleep. After two days, I just said "fark it!" and stuck with four Advils. That killed the pain, but I was alert.

Vicoprofen to the rescue.

Marley: My neurologist told me "It'll just take time." Isn't two years enough?

I am not an MD, I am a PhD who researches eye-movement disorders (but there are several neurologists in our lab from whom I have learned a bit here and there).

Some neurologists have prescribed gabapentin to treat acquired nystagmus, especially if it is associated with oscillopsia (visual perception that the world is moving).

The best drug in the world is the one that makes you feel better but doesn't get you better... then you are a lifelong customer.

This is the goal of all pharma companies. They're not out to cure anything.

These companies are also in bed with the "food" companies that stock your grocery shelves with poisonous non-food product in flashy packaging, which makes you sick so you have to take their pills.

The FDA is a joke. If you trust what the FDA tells you, you deserve what you get.

Oxymorphone 5mg IR


Oxymorphone 10mg IR


Oxymorphone 40mg ER


Only the finest pharmaceutical opioid in existence hotlinked.

Diamorphine might be considered pharmaceutical, won't bother hotlinking vials. Holy grail is good enough.

Really you pussies, it's just pain. Cry all you want about your motorcycle wrecks or your bleach blanket bingo rug burns, it's just farking pain. It's capable of being mastered by anyone with an intellect superior to a llama's. You people with your drugs are the reason that white people should be destroyed.

kermit_the_frog: I'm on narcotic paint killers right now, so I'm getting a kick out of these posts... :-)

/for real -- 15mg oxy -- no apap.
// :-) :-)
/// what's not to smile about when the pain is gone, and the opiates make you feel good.

P.S. to all you holier than thou types who think it's better to be in chronic pain than addicted to opiates, I suggest you try the pain for a few weeks -- you'd change your tune in a hurry. It's *far* better to be addicted to oxy or it's ilk than experience ongoing severe pain 24/7.

You sicken me. That a human should fall so low and be so unable to control themselves.............

ArmoredFelix: Really you pussies, it's just pain. Cry all you want about your motorcycle wrecks or your bleach blanket bingo rug burns, it's just farking pain. It's capable of being mastered by anyone with an intellect superior to a llama's. You people with your drugs are the reason that white people should be destroyed.

God? Is that you? It's me, Margaret.

re: The FDA is a joke. If you trust what the FDA tells you, you deserve what you get.

no. the fda isn't a joke. you're a joke ya farking simpleton.

So long I can still drink whiskey

Lumi: RancidOne: Lumi: Sorry, you're wrong on one major point. Not everyone that takes narcotic pain relievers becomes addicted. They will more than likely become dependent. There's a major difference between the two, addiction is for fun, dependence is a medical condition. Please look up the difference between the two.

From a neuropsychopharmacological standpoint there is no difference between dependence and addiction. The chemical mechanisms are identical.

The distinction between "dependence" and "addiction" is a lay one, not a medical one, and "dependence" is simply a nice way to reassure people they aren't filthy addicts. Or something.

addiction and physical dependence are not interchangable terms. addiction may encompass physical dependence but physical dependence doesn't itself describe the phenomena of addiction.

twidgetfitch: Oxymorphone 5mg IR


Oxymorphone 10mg IR


Oxymorphone 40mg ER


Only the finest pharmaceutical opioid in existence hotlinked.

Diamorphine might be considered pharmaceutical, won't bother hotlinking vials. Holy grail is good enough.

And all this time I thought you weren't allowed to post porn on Fark!

Marley: Two cancer patients have told me that Marinol does not provide the pain relief that smoking a joint does, and it does not ease the nausea of chemotherapy or enable the patient to actually eat.

I've also been told from a Marinol patient that smoking a joint gives him better control over the dosage. He found the pill form too much to handle.

twidgetfitch: Oxymorphone 5mg IR


Oxymorphone 10mg IR


Oxymorphone 40mg ER


Only the finest pharmaceutical opioid in existence hotlinked.

Diamorphine might be considered pharmaceutical, won't bother hotlinking vials. Holy grail is good enough.

mscontin was a lot of fun for me for a while...withdraw sucked ass.

cutting open deregesic patches and eating the gel was also a blast.

ArmoredFelix: kermit_the_frog: I'm on narcotic paint killers right now, so I'm getting a kick out of these posts... :-)

/for real -- 15mg oxy -- no apap.
// :-) :-)
/// what's not to smile about when the pain is gone, and the opiates make you feel good.

P.S. to all you holier than thou types who think it's better to be in chronic pain than addicted to opiates, I suggest you try the pain for a few weeks -- you'd change your tune in a hurry. It's *far* better to be addicted to oxy or it's ilk than experience ongoing severe pain 24/7.

You sicken me. That a human should fall so low and be so unable to control themselves.............

I take it that you sing the loudest in your church choir.

So next time I have an abcessing molar and cant get an extraction for 3 weeks I should just blow my brains out, I mean if all they can give me is asprin now?

I can just continue to get my painkillers from Canada, cheaper, better, made by people you can trust. Honestly I should just cut out the middleman and save myself the postage by moving the whole family north.

How's the tech jobs in Toronto?

/Palins gonna flush this country down the shiatter after 2012 anyways.

The FDA needs to be abolished (or its legal authority severely limited). It can easily be handled just like consumer reports handles products or Underwriters Laboratories handles the certification of electrical devices.
The FDA has NO LAWFUL RIGHT to deny ANYONE of ANY drug they wish to take. What body of citizens would ever grant them such vast authority as to regulate what everyone in the whole country can or cannot take?
At the very least, if the FDA has the final say on what's safe and what's not, then THEY should be the ones who take the blame when tainted foods hit the market and when people die from not receiving the drugs they wished to take. If they're good enough to tell us what's what, they're good enough to handle the consequences.

Link

This thread is the land of the Lotus Eaters.

Cap Ten Oblivious: I always thought it was to keep people from using it as a recreational drug.

I've heard this before, sounds like BS but I'm open minded. Is there a source?

namatad: Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

no bet
but yah, there will soon be a hydrocodone only type pill
and in all fairness, why is the acetaminophen there in the first place?

Exactly.

Acetaminophen is really a toxic drug that doesn't do much.

Aspirin would be better for most human beings.

I'm so glad Fark is full of medical doctors and pharmaceutical experts! Thank goodness we have everyone in here to turn to for guidance, since we wouldn't want to listen to medical experts like those advisers for the FDA. I keep forgetting that ANYTHING ever related to the government is evil and a part of a giant conspiracy (oh, and done entirely, 100% solely for the profit of the big drug companies, and absolutely never for public health). Certainly, there's no way that more recent studies have revealed that, just perhaps, previous maximum recommendations for acetaminophen may have been too high.

/ Sincere thanks to those the limited few who actually ARE well-read and educated in the medicine and drug fields
// I'm not either, but I don't trot around pretending to be

namatad:
and in all fairness, why is the acetaminophen there in the first place?

Hydrocodone or Oxycodone mixed with tylenol is considered a schedule 3 drug, while Hydrocodone or Oxycodone by themselves are CIIs. Schedule 3s are still considered controlled meds, but CII is a category of "OMG This shiat is serious business, we must track every prescription, treat the providers like criminals and the patients like addicts". It's pretty stupid really. I guess they figure the added tylenol will limit the amount of abuse, because once you hit a certain level you start damaging your liver. That is pretty farked up when you think about it. To purposely put something in a medication to poison you if you take more than the government thinks you should have.

Bacontastesgood: Cap Ten Oblivious: I always thought it was to keep people from using it as a recreational drug.

I've heard this before, sounds like BS but I'm open minded. Is there a source?

hydrocodone alone = sched II.

hydrocodone mixed with APAP = sched III.

a plausible theory could then pop up that the APAP is there to limit abuse, thus the lower designation on the DEA scale of scheduling.

Drugs are for sucks

Gyrfalcon: Opiates are Bad Fun Drugs. There are no good Bad Fun Drugs. All Bad Fun Drugs are Bad Fun. It doesn't matter if some responsible people use Bad Fun Drugs because they need them for real chronic pain; because there are some stupid idiots who abuse Bad Fun Drugs, all Bad Fun Drugs have to be criminalized, taken off-market, or made hard to get. Because they are Bad Fun Drugs, and we can't be seen as promoting Bad Fun Drugs in any way.

Bad Fun Drugs get people addicted, and addicts are Bad Fun People. Bad Fun Drugs make V People, so they are Bad Fun. Bad Fun! Bad Fun! Bad Fun!

FTFY

Let's hear it for the Puritan ethos of "if it feels good, it's bad for you".

I hope the FDA gets shot, gets a serious fever, or their kids break a farking hip bone.

I can't take anything with aspirin in it, which severely lowers the choices available to me for painkillers.

I broke my back seven years ago. Not a year ago I found out that they forgot to check my neck, and I have been walking around with pretty much a broken neck this whole time. I have nothing but severe pain 24/7. I can't get vicodin, ocycodone/oxycontin, or any of the narcotics anymore. Not because I was addicted or anything like that, but because doctors think I am a junkie.

I was on a cocktail of just about every painkiller you can name except methadone. (They offered it, I refused.) Tramadol, Baclofen, oxycontin, oxycodone, vicodin, percocet, my stomach looked like a screen shot from Dr. Mario. All of these could plus a morphine drip could barely keep the pain at bay.

I finally had a surgery 1.5 years after breaking my back (work comp case which I had to sue to get the MRI that proved my back was broken, nevermind the physical indications) that alleviated a good amount of the pain, but they did that wrong. They did a fusion with two rods and six screws at L4, L5, S1. They put the rods too low and they sit on my tailbone, constant pressure. No fix except to do it again.

I had complications. Spinal fluid leak, DVTs, death three times, etcetera and up to the broken neck. I have massive migraines almost all day everyday. I live in a body that has hellfire running through it from the pain. I can't remember a single day of my life now that hasn't been lived without severe pain.

Now, the one drug ingredient that I can use to help alleviate that pain they want to take away? Yes, I get it, it is bad for my liver. I know this. I knew this when I went to the doctor and they told me that. When I went to get the prescription filled and the pharmacist told me not to mix it with anything else unless prescribed by my doctor. When I picked up the script and the mandatory consult said not to mix it. The massive amounts of paperwork stapled to the drugs saying not to mix it, and the labels on the pill bottle itself saying not to mix it.

The study they are using to advise taking acetaminophen away is based on a ten year period. That period of time showed less than 500 deaths due to mixing of drugs, barely 53,000 overdoses due to mixing of the drugs. This was in ten years, not one year, not one month, but TEN YEARS. Then they tacked on the liver damage to it to make it seem like a worthwhile move.

What gets poured around in the media? "Liver damage, mixing of drugs, liver damage, and deaths from overdoses." Not the fact that the people who overdosed from it were the ones grasping for Darwin Awards for being too farking stupid to listen to the doctor, pharmacist, to read to the pamphlets or the pill bottles. If anything this is natural selection.

So what am I left with after they take it away? I can't legally use marijuana in this state, even though I have a lifetime prescription for it in California. I can't take aspirin at all, and ibuprofen is like sugar pills to me; it doesn't do a damned thing for the pain. I get to live my life "drug free" but in even more severe pain than I have now with my low dosage of OTC Tylenol.

Note: I was never addicted to the narcotics/painkillers. I hated and continue to hate them. They put a fog on my brain that I am still having side-effects from. I hated not being able to think at a higher level because I was stoned out of my farking mind 24/7 for four years. I hated taking them and the day I finally said, on my own accord, that I couldn't live with that fog anymore and said "no more" I was happy. I went six months without any painkillers, trying to get my body used to the pain so that I could live without taking one more farking pill. My body won, it seriously hurts too much. When the first thing a doctor says to me is "How are you still alive? With that amount of pain I would have killed myself a long time ago" then I know even more that the amount of pain I am in is too severe to live a productive life without a painkiller.

I abhor painkillers. I wish I didn't need to have them to operate at any level of normalcy. I sincerely hope that the surgery I am going to have to fix my neck will alleviate more of the pain that I am in so that I need fewer painkillers than I take now. Is my liver shot? No. Will it be? Most likely. I don't drink alcohol either, so I get a nice second-hand liver failure.

So, fark you FDA. Thank you so much for taking away the only painkiller strong enough from OTC that can help me be a productive member of society. The only painkiller from OTC that I can take for the pain. I hope you all burn in hell. I'll be thinking really nasty thoughts your way as I writhe on the floor in pain, shiatting myself because I couldn't even walk to the bathroom. I'll be thinking of you as I get admitted to a care facility because all I can do is scream during my waking moments, like I did 95% of the time the 1.5 years of a broken back and two years following the surgery. I hope the screams keep you up at night. I hope they haunt your every waking moment.

Did I miss the post where someone wrote that since Marinol is in pill form, if your illness or related condition causes upset stomach (re: chemo), you might not be able to keep it down long enough for it to take effect?

Plus, the state of fluids in your digestive system (stomach acid ph level) would probably affect how well it's absorbed.

If you smoke pot, it bypasses the stomach and gets straight into the bloodstream via the lungs.

justoneznot: namatad:
and in all fairness, why is the acetaminophen there in the first place?

Hydrocodone or Oxycodone mixed with tylenol is considered a schedule 3 drug, while Hydrocodone or Oxycodone by themselves are CIIs. Schedule 3s are still considered controlled meds, but CII is a category of "OMG This shiat is serious business, we must track every prescription, treat the providers like criminals and the patients like addicts". It's pretty stupid really. I guess they figure the added tylenol will limit the amount of abuse, because once you hit a certain level you start damaging your liver. That is pretty farked up when you think about it. To purposely put something in a medication to poison you if you take more than the government thinks you should have.

indeed, and sorry my post went through without me realizing someone posted a similarly themed reply. I just wonder what effect a ruling by the fda on this would have in respect to prescribing painkillers which are stronger than OTC nsaids.

Shrew2u: LavenderWolf: When my farking hand is crushed from a motorcycle accident it isn't mild discomfort, my bones were split down the farking middle.

OWOWOWOWOWOWOWOWOWOWOW shiat!

So, what did you take for THAT undoubtedly massive pain?

The doctor prescribed farking codeine of all things, which I happen to react badly to. After about a week of vomiting and no pain relief, I started smoking pot medicinally.

Twidgetfitch: I have a prescription for those sitting at the pharmacy for chronic pain. They don't work as well as morphine and costs $500 a month, why are they so good to you? On the addiction scale how bad are they? I didn't notice any real dependency until after I started taking them after a year of various opiates.

Everyone who thinks this stuff shouldn't be on the market has probably never experienced real pain on a long-term basis. Simple question, if the pain is bad enough you want to kill yourself and suicide becomes an option, does it really matter if you medicate with something this strong? I've only caught a buzz twice in a year, including a major surgery. Real pain cuts the buzz completely and you get back to life. There's a lot of people out there who can't take NSAID's, and not all of us want to get high. Alcohol is so much more fun, and I can't drink anymore since I take pain pills, that I miss.

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

it is possible
they've know for years (decades) that acetaminophen is a liver killer
now with pain meds containing it and on the marked for decades, long enough that there are low cost generic equivalents available are banned.
New meds that are patented and not subject to generics for years and years that are very expensive will come to market
And people in pain will have to pay for relief

Postal Penguin: This has nothing to do with addiction but rather liver toxicity due to the acetaminophen component of the drug. Generic drug makers will likely be able to make percocet only or vicodin only pills that are just as cheap as the current combo-drugs.

Sure they will. It's just a coincidence that 5mg oxycodone has been out of stock for six months because the FDA shut down a couple of the generic factories, but didn't bother to increase quotas for those left operating. Just a coincidence.

Your government loves you.

spidermann: I hope the FDA gets shot, gets a serious fever, or their kids break a farking hip bone.

You do realize that they are NOT banning acetaminophen, right? They are just removing those drugs that are actually combos that contain acetaminophen to help prevent acetaminophen overdoses. Many folks have received liver damage or had liver failure as a result of taking these drugs AND extra acetaminophen tablets on the side (i.e. ending up taking too much acetaminophen). As such, they're just removing the acetaminophen from combo drugs like vicoden. You can still combine your non-mixed drug with a Tylenol if you want the combo (and have the go ahead from your doctor!). Tylenol and generic brands of acetaminophen will still be around; it's just been decided that that previous max recommendation was actually too high and too close to the point of liver damage in many folks, so they're adjusting it down a bit.

Take a breath, man.

Few realise that once combo drugs like Percocet and Vicodin disappear, it's not as if docs are simply going to prescribe a pure pill instead. They are far more reluctant to write for pure opioids, citing the usual fear of addiction.

Upshot is that, yes, the pure forms are and will be available, but as they are all CII (with all that that entails regarding refills and calling in), they will be extremely hard to get, even for excruciating pain. Not to mention the DEA monitor every single CII pill prescribed, every patient and every prescribing physician like hawks.

ArmoredFelix: Really you pussies, it's just pain. Cry all you want about your motorcycle wrecks or your bleach blanket bingo rug burns, it's just farking pain. It's capable of being mastered by anyone with an intellect superior to a llama's. You people with your drugs are the reason that white people should be destroyed.

+1/10

/no points for originality

Spiderman-you should have tried the methadone. I am not in the same league as you, but have had five proceedures/three ruptured discs. I became quite addicted as I was having surgeries on my right hand as well and could do very little except think about the pain. My pain management Dr. suggest I try the methadone and over about two years I was able to cut my painkiller consumption down to 5mg of methadone and one 7.5 Lortab at night, mostly to sleep. The methadone is a good,cheap and long lasting painkiller. It lets me use much less of the lortab. I think a lot of people turn their noses up at it because of its' association with heroin addicts; I put up with attitude from the pharmacy clerks because it works.
I know you will never be pain free, but think about at least giving it a try. Good Luck and God Bless

Shrew2u: Benevolent Misanthrope: Anyway, the whole thing struck me as useless fear mongering and a way for insurance companies to save money by requiring an over-the-counter medicine to be purchased out of pocket, to supplement a cheaper drug.

The concern is the liver damage possible from use of acetaminophen, even in recommended dosages. If the FDA doesn't end up banning those combo drugs, some sue-happy shiathead will sue the pharma companies claiming, "You KNEW my liver would get farked, yet you left those killer combos on the market anyway..."

/tramadol ftw - far better for pain relief than vicodin

If people are too stupid to actually look at the literature that comes with their prescriptions, and see that, hey, there's acetaminophen in this stuff, then that's there own problem. There's a reason the pharmacist/pharmacy tech says "Do you have any questions?" once you make your purchase. Anybody with half a brain should know that too much of ANYTHING is bad for you, and should alter their medicinal intake appropriately. Even if they're popping percoset or whatever just to get high, ease up on the Tylenol! People who are in chronic pain and know WTF they're doing when taking medications shouldn't have to pay for other people's inability to read up on the stuff they are putting in their systems.

I've taken acetaminophen religiously for every type of pain I've had since I was 13 (within recommended dosages), and my liver is just fine. If I ended up with a liver problem, I'd either severely cut back or quit acetaminophen altogether, and risk the stomach ulcers that ibuprofen would bring.

/Tramadol FTW
//just like Vicodin, but I don't get loopy

A potential future alternative is Acurox, a drug co-developed by King and Acura and currently under review by the FDA. Acurox is a single-dose tablet containing the opiate oxycodone - which is sold separately as OxyContin and other brands - plus the drug niacin. It's designed to deter abuse by causing unpleasant effects if it's crushed or taken excessively.

"The wave of the future is to move toward these abuse-deterrent systems," said Natixis Bleichroeder analyst Corey Davis. "The news here is the FDA is now really hell-bent on protecting against [acetaminophen]-induced liver toxicities. Acurox has abuse deterrence and it doesn't have acetaminophen."

ehhhhhhhhhhhh, from a quick google search.

Link

/just linkin
//i didn't know b3 was a drug

ubertwit: re: The FDA is a joke. If you trust what the FDA tells you, you deserve what you get.

no. the fda isn't a joke. you're a joke ya farking simpleton.

Yes, the FDA is a joke. It took the hiring and firing of 10 FDA chiefs before they found one that would approve aspartame for human consumption... and that chief just happened to be Donald Rumsfeld who had a monetary interest in aspartame... you know... coming from Monsanto and all. There is now overwhelming evidence that aspartame is a neuro-toxin and carcinogen, yet it is still on the market.

The FDA is controlled by pharma, fast-tracking untested medications so they can be tested on the public. The FDA has one responsibility which is to protect the public from dangerous food and drugs... There isn't a single thing in a typical grocery store that is safe for human consumption and drug regulations are practically nil.

The current head of the FDA is a numbskull. He recently wrote a book about food and thinks he's a genius because he figured out that the combination of fat, sugar and cheese create morphine-like reactions and addictions in the human body. This is something that has been known for quite some time. He talks like he's on horse tranquilizers.

Go ahead and trust the FDA. My guess is you're fat and/or sick.

Who's the simpleton, moran? Read-up, it might do you some good.

Umm this is a good thing. Vicodin and pecocett are brand names for the combined medication. Hydrocodone will then be available by itself.

Like said above... this is a GOOD thing. There is no reason for the combo drugs. If you happen to need both, then take a Tylenol along with your hydrocodone.

Dumbasses.

twidgetfitch: \
//Not dicksizing, actually have a 2g/day iv diamorph habit.


Ouch - how do you afford that?

They should more strictly regulate all these types of drugs, if only because the welfare patients who wind up in maternity clinics will say anything and do anything to get their hands on more of them to sell on the streets.

The nurses have to ask stupid questions like, "Oh a scale of 1 to 10, how is your pain?" And of course most people respond by throwing a fit that they dare even ASK about how pained they are.

People who have "chronic pain" usually (USUALLY) need to lose some weight because they've been in a car wreck and have just been lazing around on pain meds for a few years. The government should have some kind of yoga class available for them. Get off your fat ass, quit feeling sorry for yourself, quit collecting unemployment and watching football or daytime TV, and go stretch those muscles to build strength and pull yourself back into health. It's getting so that I just don't feel sorry for people with "chronic pain," I don't care how big a sob story you're toting around.

sombreradoraloca: They should more strictly regulate all these types of drugs, if only because the welfare patients who wind up in maternity clinics will say anything and do anything to get their hands on more of them to sell on the streets.

The nurses have to ask stupid questions like, "Oh a scale of 1 to 10, how is your pain?" And of course most people respond by throwing a fit that they dare even ASK about how pained they are.

People who have "chronic pain" usually (USUALLY) need to lose some weight because they've been in a car wreck and have just been lazing around on pain meds for a few years. The government should have some kind of yoga class available for them. Get off your fat ass, quit feeling sorry for yourself, quit collecting unemployment and watching football or daytime TV, and go stretch those muscles to build strength and pull yourself back into health. It's getting so that I just don't feel sorry for people with "chronic pain," I don't care how big a sob story you're toting around.

Hey now.... lemme tell you a story.

There's this man I know, who has CHRONIC shoulder pain due to a run-in with a ladder (more like the ladder toppled, and he would have fallen had it not been for the arm grabbing the ladder, which in turn tore a lot of ligaments in his shoulder). He takes prescription codeine for the pain (could get vicoden or percocet, but he wanted to work). He stayed productive til he retired at 62, 10 years after the accident, thanks to codeine. He works even still thanks to it.

While I will say there are those who want to be lazy, this man is not. He's a perfect example of pain regulation through meds. So please, don't figure all on prescription pain pills are taking them for the rush and the high.

Glad I'm not affected by this.

Pot, it does a body good.BobaFeet: There isn't a single thing in a typical grocery store that is safe for human consumption

There isn't a single thing in a typical grocery store that is safe for human consumption

So you say while I sip on this bottle of Arrowhead distilled water.

Moron.

chicagorefugee: ArmoredFelix: Really you pussies, it's just pain. Cry all you want about your motorcycle wrecks or your bleach blanket bingo rug burns, it's just farking pain. It's capable of being mastered by anyone with an intellect superior to a llama's. You people with your drugs are the reason that white people should be destroyed.

+1/10

/no points for originality

Well, he *is* from TX. Concessions must be made.

Dear all you "but I need my pain medication" whiners,

(yes, this is a troll, but in trollus veritas)

why the hell is it that the american per-capita consumption of painkillers dwarfs all other countries? Ok ok - I know - YOU are the farking exception because you have a Real Condition(tm). It's all those OTHER farking loser pill-poppers.

At what point do some of you people wake up and realize that you are part of the problem?

America - nation of hypochondriacs.

509boatman55: Spiderman-you should have tried the methadone. I am not in the same league as you, but have had five proceedures/three ruptured discs. I became quite addicted as I was having surgeries on my right hand as well and could do very little except think about the pain. My pain management Dr. suggest I try the methadone and over about two years I was able to cut my painkiller consumption down to 5mg of methadone and one 7.5 Lortab at night, mostly to sleep. The methadone is a good,cheap and long lasting painkiller. It lets me use much less of the lortab. I think a lot of people turn their noses up at it because of its' association with heroin addicts; I put up with attitude from the pharmacy clerks because it works.

Methadone is an excellent, underutilized drug - partly because of the stigma that only addicts take it. Unlike other opioids, it also has some NMDA receptor activity. Not a lot of drugs touch the NMDA receptors (ketamine & dextromethorphan being the major other two) so often you can get more mileage out of methadone than other opioids ... the result being a reduction in opioid needs.

For chronic pain patients having surgery (related or unrelated to their pain) I always incorporate ketamine into their anesthetic; for spine cases I'll use methadone too.

For outpatients, it's not without its own drawbacks and dangers though. Nothing that can't be safely overcome with some caution and a smart cooperative patient ... but it's not rx & forget.

SU: Lumi: RancidOne: Lumi: Sorry, you're wrong on one major point. Not everyone that takes narcotic pain relievers becomes addicted. They will more than likely become dependent. There's a major difference between the two, addiction is for fun, dependence is a medical condition. Please look up the difference between the two.

From a neuropsychopharmacological standpoint there is no difference between dependence and addiction. The chemical mechanisms are identical.

The distinction between "dependence" and "addiction" is a lay one, not a medical one, and "dependence" is simply a nice way to reassure people they aren't filthy addicts. Or something.

addiction and physical dependence are not interchangable terms. addiction may encompass physical dependence but physical dependence doesn't itself describe the phenomena of addiction.

And what are these special phenomena of addiction? Jonesing, bad behaviors used to attain the drug of abuse, being mean to people, really wanting to use the drug? That kind of stuff?

From the body's standpoint, people who are "dependent" on a drug looks exactly the same as people who are "addicted" to a drug.

Just because "addiction" has had additional behavioral attributes attached to it in the past 15 years since I received my GED in psychopharm doesn't mean there is any physical difference between the two.

Why are people so adamant on this point? Are they so reluctant to admit they are addicted to their painkillers? Or do they just want some way to differentiate themself from the "bad" people who go about getting their fix the wrong way (illegally, not to help with pain, etc.)?

"Me? Oh, I do admit I've developed a dependence on my Vicodin. Doc says it can't be helped...oh no, I'm not addicted [laughs]. I'm no Rush Limbaugh [both laugh]!"

Bomb Head Mohammed: Dear all you "but I need my pain medication" whiners,

(yes, this is a troll, but in trollus veritas)

why the hell is it that the american per-capita consumption of painkillers dwarfs all other countries? Ok ok - I know - YOU are the farking exception because you have a Real Condition(tm). It's all those OTHER farking loser pill-poppers.

At what point do some of you people wake up and realize that you are part of the problem?

America - nation of hypochondriacs.

I'll address this assertion. America sanctions violence in sporting events and has automobile drivers far more than any other country in the world (except maybe those nationalities that play polo with goat carcasses, etc---minus the car part). There is an enormous residue of musculo-skeletal mayhem that is a byproduct of having extra-large mouth-breathing head-butting tard-like bullies smashing their bodies into smaller and less physically mature opponents. (A significant percentage of these "sporting" injuries are actually criminal physical batteries masked under the guise of the sporting event.) Add in the enormous number of auto collisions, criminal assaults, and truly innocent accidents that produce the same said injuries, and, voila, there you have the chronic pain patient demographic.

Don't think, for a minute, that childhood, adolescent, and adult vertebral, shoulder, and other peripheral joint injuries just go away after the initial traumatic damage. They stay, and they stay, often, for life.

Personally, I have a herniated T4 vertebra that, if you GIS, will show itself to be both fairly rare and particularly pernicious and disruptive to daily activity. Open rotator-cuff surgery also has been done for a cuff tear that was bad, along with removal of a large benign tumor off of my right shoulder (that has left a big flesh divot in that shoulder). I am quite functional, owning and running a successful white-collar business, when taking 10/650 hydrocodone 4 times a day. Without a significant pain-killer, the nature of my chronic injury pain causes me to just sit at my desk while calculating the pain variable of every outward reach of my arms and shoulders. De pain, de pain....

As for the criminal addicts who rob pharmacies to get "Roxy" or whatever, well, the historical dustbin awaits their eventual demise. Sad cases, criminal cases; case after case of misguided youth gone awry.

//P.S. Meth- a hell of a drug for which all bets are off
///along with a few other illicits that are useless trash
//peace out, Lashawnda

Lumi: SU: Lumi: RancidOne: Lumi: Sorry, you're wrong on one major point. Not everyone that takes narcotic pain relievers becomes addicted. They will more than likely become dependent. There's a major difference between the two, addiction is for fun, dependence is a medical condition. Please look up the difference between the two.

From a neuropsychopharmacological standpoint there is no difference between dependence and addiction. The chemical mechanisms are identical.

The distinction between "dependence" and "addiction" is a lay one, not a medical one, and "dependence" is simply a nice way to reassure people they aren't filthy addicts. Or something.

addiction and physical dependence are not interchangable terms. addiction may encompass physical dependence but physical dependence doesn't itself describe the phenomena of addiction.

And what are these special phenomena of addiction? Jonesing, bad behaviors used to attain the drug of abuse, being mean to people, really wanting to use the drug? That kind of stuff?

From the body's standpoint, people who are "dependent" on a drug looks exactly the same as people who are "addicted" to a drug.

Just because "addiction" has had additional behavioral attributes attached to it in the past 15 years since I received my GED in psychopharm doesn't mean there is any physical difference between the two.

Why are people so adamant on this point? Are they so reluctant to admit they are addicted to their painkillers? Or do they just want some way to differentiate themself from the "bad" people who go about getting their fix the wrong way (illegally, not to help with pain, etc.)?

"Me? Oh, I do admit I've developed a dependence on my Vicodin. Doc says it can't be helped...oh no, I'm not addicted [laughs]. I'm no Rush Limbaugh [both laugh]!"

I have a fair amount of experience in the treatment of addiction. I've always understood "dependence" to be a situation where the drug is necessary and prescribed. "Addiction" is a similar or identical behavior set, but in someone who does NOT have a medical need for the drug(s) they are taking.

Anyway, if you look at the 12-step programs, addiction is a pattern of behavior characterized by obsession and compulsion with *having* certain things -- drugs, food, sex, clothes, etc. NA's definition of addiction is broad enough that it specifically says that addiction doesn't even refer to any specific drug -- just the behaviors of obsession and compulsion. The only reason drugs come into play is because addicts need to stop using drugs before they can correct the underlying behaviors. (honestly -- read the 12 steps of NA. There isn't a single reference to drugs.)

What sucks is that acetaminophen is one of the few painkillers that isn't also a blood thinner. So if you end up in pain after an injury and also on blood thinners (warfarin or heparin), now you are screwed.

bullock.: It is not asinine, it is needed. I work in the insurance field and doctors prescribe it for non-acute, non-cancer pain for far too long. I've had people on my caseload die from too much. The doctors that do this eventually lose their license, but that doesn't bring the dead people back.


What? They died because they took too much? They couldn't read the bottle or did the doctors prescribe too much? If the doctors are truly at fault and they lose their license the system is working.

If the people are taking too much and killing themselves, Darwin is working. I don't see how it's the doctor's fault.

Farking bean counters like you just don't have the concept of "acceptable loss." You're the farking reason I have to deal with tylenol after major mouth reconstruction surgery. Why the fark do we have the shiat at all if it's not doing to be prescribed? Christ, it's not like I'm asking for a morphine drip.

Ask for two days of oxy until the inflamation subsides and all of a sudden I'm a suspected junkie. Meanwhile the little old farking lady next to me is walking out with two months of oxy scrips for a pulled tooth.

No, you assholes are worse than the abusers. You've already got the doctors scared shiatless as it is.

co-conspirator: I am not an MD, I am a PhD who researches eye-movement disorders (but there are several neurologists in our lab from whom I have learned a bit here and there).

Some neurologists have prescribed gabapentin to treat acquired nystagmus, especially if it is associated with oscillopsia (visual perception that the world is moving).

How 'bout that, I've got to come to Fark for my education. I described oscillopsia exactly that way, and no one ever told me what it was called. I hated it.

After four treatments of the Epley maneuver and a couple of months of Brandt-Daroff exercises at home, I can bend over to pick something up without falling over or vomiting. But it's not a complete cure, and like the pharmacy techs who think I'm a criminal when I call about my prescriptions, the folks at the neurologist's office treated me like I was faking it.

I'm glad they figured it out, because it's such a thrill sitting up and lying down and making the whole world spin.

Nocens: bullock.: It is not asinine, it is needed. I work in the insurance field and doctors prescribe it for non-acute, non-cancer pain for far too long. I've had people on my caseload die from too much. The doctors that do this eventually lose their license, but that doesn't bring the dead people back.


What? They died because they took too much? They couldn't read the bottle or did the doctors prescribe too much? If the doctors are truly at fault and they lose their license the system is working.

If the people are taking too much and killing themselves, Darwin is working. I don't see how it's the doctor's fault.

Farking bean counters like you just don't have the concept of "acceptable loss." You're the farking reason I have to deal with tylenol after major mouth reconstruction surgery. Why the fark do we have the shiat at all if it's not doing to be prescribed? Christ, it's not like I'm asking for a morphine drip.

Ask for two days of oxy until the inflamation subsides and all of a sudden I'm a suspected junkie. Meanwhile the little old farking lady next to me is walking out with two months of oxy scrips for a pulled tooth.

No, you assholes are worse than the abusers. You've already got the doctors scared shiatless as it is.

I was pleased to see that a lot of people in this thread understand why these meds are dangerous. Which you apparently don't.

You should consider the fact that nothing will prevent you from taking tylenol and hydrocodone or oxycodone separately, so people can up their opioid dose without destroying their livers. This is just common sense, not protecting stupid people.

Stupid people are people who take one pill instead of two when the combination puts their liver at risk.

Approximately two years ago, Forest pharma was promoting the newest and bestest evar hydrocodone and ibuprofen combo. I just rolled my eyes wondering how much this "new" combo drug was going to cost the patient. Makes me wonder if they didn't see this coming and were planning accordingly.

The government is banning a habit forming product because people abuse it?

That's unpossible!

BobaFeet: ubertwit: re: The FDA is a joke. If you trust what the FDA tells you, you deserve what you get.

no. the fda isn't a joke. you're a joke ya farking simpleton.

Yes, the FDA is a joke. It took the hiring and firing of 10 FDA chiefs before they found one that would approve aspartame for human consumption... and that chief just happened to be Donald Rumsfeld who had a monetary interest in aspartame... you know... coming from Monsanto and all. There is now overwhelming evidence that aspartame is a neuro-toxin and carcinogen, yet it is still on the market.

The FDA is controlled by pharma, fast-tracking untested medications so they can be tested on the public. The FDA has one responsibility which is to protect the public from dangerous food and drugs... There isn't a single thing in a typical grocery store that is safe for human consumption and drug regulations are practically nil.

The current head of the FDA is a numbskull. He recently wrote a book about food and thinks he's a genius because he figured out that the combination of fat, sugar and cheese create morphine-like reactions and addictions in the human body. This is something that has been known for quite some time. He talks like he's on horse tranquilizers.

Go ahead and trust the FDA. My guess is you're fat and/or sick.

Who's the simpleton, moran? Read-up, it might do you some good.

The current head of the FDA is a she, Margaret Hamburg, and she's no numbskull. Instead of making random accusations about how pharma controls the FDA, why don't you come up with something specific?

The rest of your post displays a similar level of ignorance about what the FDA does, and how long medications take to be approved.

Animatronik: Nocens: bullock.: It is not asinine, it is needed. I work in the insurance field and doctors prescribe it for non-acute, non-cancer pain for far too long. I've had people on my caseload die from too much. The doctors that do this eventually lose their license, but that doesn't bring the dead people back.


What? They died because they took too much? They couldn't read the bottle or did the doctors prescribe too much? If the doctors are truly at fault and they lose their license the system is working.

If the people are taking too much and killing themselves, Darwin is working. I don't see how it's the doctor's fault.

Farking bean counters like you just don't have the concept of "acceptable loss." You're the farking reason I have to deal with tylenol after major mouth reconstruction surgery. Why the fark do we have the shiat at all if it's not doing to be prescribed? Christ, it's not like I'm asking for a morphine drip.

Ask for two days of oxy until the inflamation subsides and all of a sudden I'm a suspected junkie. Meanwhile the little old farking lady next to me is walking out with two months of oxy scrips for a pulled tooth.

No, you assholes are worse than the abusers. You've already got the doctors scared shiatless as it is.

I was pleased to see that a lot of people in this thread understand why these meds are dangerous. Which you apparently don't.

You should consider the fact that nothing will prevent you from taking tylenol and hydrocodone or oxycodone separately, so people can up their opioid dose without destroying their livers. This is just common sense, not protecting stupid people.

Stupid people are people who take one pill instead of two when the combination puts their liver at risk.



You missed my point entirely. Comprehend much?

Let me spell it out.

I don't give a fark if its mixed with another drug if I'm doubled over in pain and have no chance of getting something for it whether it's mixed or pure because of the abusers.

Two days of a mixed pain killer (four farking pills) is not putting my damned liver at much risk if any.

After a bad car wreck while I was stationed in Germany, the Army doc were giving me percocets like it was candy for about 6 weeks. Started getting dependent on it and after the medics said something along the lines of "U no can has more percocets. Not yours." I was having fits for a couple days until I dove into a bottle of Bacardi 151 to break the withdrawl from the pills. Since then, I've not touched the stuff. vicodin, oxycontin, percocet... I won't touch the stuff even after getting teeth pulled

Nocens: You missed my point entirely. Comprehend much?

Let me spell it out.

I don't give a fark if its mixed with another drug if I'm doubled over in pain and have no chance of getting something for it whether it's mixed or pure because of the abusers.

Two days of a mixed pain killer (four farking pills) is not putting my damned liver at much risk if any.

OK, I can see where you're coming from. Unfortunately, i think most people who take these drugs don't need them. They are extremely powerful and should ONLY be used by people with the worst pain.

I had surgery twice over the last few years and each time the pain afterward was severe and lasted for a week or two. I was given scrips for opioids both times, but I took ibuprofen instead because my fear of opioids was much greater than the pain. People need to fear these drugs, there are many addicts and many people who are addicts but don't realize it.

Alacritous: Riffington: There was always a question whether it actually could lead to an increase in cardiac events

That's when you should be doing more testing, not marketing it full speed ahead.

Further phase 3 testing would not have given any more information, since we were talking about a tiny increase in a common problem. The only way to detect that is via phase 4 surveillance, which is what happened, and what's appropriate. If you need a million people to actually measure an effect, then you need to just put the drug out there and market it and monitor it.

The sad part of this is that many people do take these medicines safely and appropriately. So the few bad apples spoil the whole bunch so to speak. The typical person has a wisdom tooth extracted, takes a couple of vicodins a day for 2 days then feels better and is not totally miserable for those two days. Perhaps there needs to be limits on how many can be purchased or something to limit how many a person can get at a time or something like that. Still I looked this up just now and it says that the average young person can take up to 4 grams of acetominophen a day safely. That would be the equivelent of 8 Vicodin a day...my guess is that if you need more than that then you are either addicted to it and are taking it for "fun" or you have developed tolerance to it and it probably is not working anyway in which case you probably need to be moved to a more potent analgesic or have some alternative treatment prescribed.

Personally I think this is just another example of the Obama effect. That is to say, we are going to run this country and now we are going to control every aspect of your lives. Next thing you know they will be taking my blood pressure medication away.

Riffington: The only way to detect that is via phase 4 surveillance, which is what happened, and what's appropriate.

There were over 30,000 cases of cardiac events or death from vioxx. You'd think something like that might have shown a glimmer of possiblity somewhere during the prerelease phases.

Alacritous: Riffington: The only way to detect that is via phase 4 surveillance, which is what happened, and what's appropriate.

There were over 30,000 cases of cardiac events or death from vioxx. You'd think something like that might have shown a glimmer of possiblity somewhere during the prerelease phases.

Not if 10 million people were taking the drug and 15,000 would have had cardiac events anyway if they weren't taking the drug (arthritis patients tend to be older and tend to have heart issues more than younger people). i pulled those numbers out of my ass, but his point that you need phase 4 studies is valid: the effect may have been small enough to not be detectable in Phase 3 trials.

Lumi:
Just because "addiction" has had additional behavioral attributes attached to it in the past 15 years since I received my GED in psychopharm doesn't mean there is any physical difference between the two.

Why are people so adamant on this point? Are they so reluctant to admit they are addicted to their painkillers? Or do they just want some way to differentiate themself from the "bad" people who go about getting their fix the wrong way (illegally, not to help with pain, etc.)?

Because there are important clinical differences. Let me describe two situations, and you tell me if you can spot the difference.

Patient 1 is prescribed opioids for worsening back pain. She uses them as prescribed, but after a few weeks discovers that she has to use her emergency "rescue" meds more often; I therefore go up a little on her dosage to account for the narcotic tolerance she is developing. Eventually, she has an operation that helps this back pain greatly. She is physically dependent on the opioids, so stopping them abruptly after she recovers from the operation makes her miserable for a few days. Afterwards, she does not really crave opioids, but uses them when appropriate (in above-average dosages).

Patient 2 is prescribed opiates for worsening back pain. She uses more than are prescribed, both to relieve pain and for the thrill, requiring higher and higher doses. Eventually, her physician accuses her of abusing them. He takes them away, leaving her in excruciating pain as well as withdrawal. She finds a new doctor to give her opioids, and the same thing happens. She is associating withdrawal with high pain levels, and even after she has an operation that helps the back pain, she still continues to crave the opioids. She finds three different physicians to prescribe her opiates, and also buys some from friends. She is fired after stealing some from a coworker. She visits a rehabilitation program, but four months later is again using medications illegally.

Doctors define addiction and physical dependence differently, because they affect human lives very differently. Physical dependence is unfortunate, but not nearly as unfortunate as poorly-treated pain. Addiction is a tragedy.

Animatronik: Alacritous: Riffington: The only way to detect that is via phase 4 surveillance, which is what happened, and what's appropriate.

There were over 30,000 cases of cardiac events or death from vioxx. You'd think something like that might have shown a glimmer of possiblity somewhere during the prerelease phases.

Not if 10 million people were taking the drug and 15,000 would have had cardiac events anyway if they weren't taking the drug (arthritis patients tend to be older and tend to have heart issues more than younger people). i pulled those numbers out of my ass, but his point that you need phase 4 studies is valid: the effect may have been small enough to not be detectable in Phase 3 trials.

As mentioned, there was more than a "glimmer of possibility": we knew it increased cardiac mortality over the NSAID rate. We just didn't know to what extent that was the NSAID protective factors vs Vioxx actually causing events. There was clear evidence that Vioxx reduced GI bleed (another major cause of morbidity and mortality) vs NSAIDS. That tradeoff appeared more favorable towards Vioxx in 1999 than it appeared in 2001.
It's easy to be a Monday-morning quarterback, of course.

Riffington: Animatronik: Alacritous: Riffington: The only way to detect that is via phase 4 surveillance, which is what happened, and what's appropriate.

There were over 30,000 cases of cardiac events or death from vioxx. You'd think something like that might have shown a glimmer of possiblity somewhere during the prerelease phases.

Not if 10 million people were taking the drug and 15,000 would have had cardiac events anyway if they weren't taking the drug (arthritis patients tend to be older and tend to have heart issues more than younger people). i pulled those numbers out of my ass, but his point that you need phase 4 studies is valid: the effect may have been small enough to not be detectable in Phase 3 trials.

As mentioned, there was more than a "glimmer of possibility": we knew it increased cardiac mortality over the NSAID rate. We just didn't know to what extent that was the NSAID protective factors vs Vioxx actually causing events. There was clear evidence that Vioxx reduced GI bleed (another major cause of morbidity and mortality) vs NSAIDS. That tradeoff appeared more favorable towards Vioxx in 1999 than it appeared in 2001.
It's easy to be a Monday-morning quarterback, of course.

Well, that's essentially saying that the apparent effect after Phase 3 was so small that risk-benefit arguments rendered it negligible. Which all changed when the risks becamore more apparent after it went to market. I am not familiar with the particulars of the Vioxx case.

Fact is that people need to be more aware of risks asociated with painkillers. If you have major arthritic pain, such that you can hardly move without a drug, you should be willing to take a riskier drug, because you will suffer health problems associated with lack of mobility (beyond the quality of life argument).

If however, you have an arthritic knee that causes occasional joint pain that is not crippling, a drug like Vioxx is obviously a bad choice. Unfortunately, marketing departments of bg pharma companies all too often work at promoting riskier uses of their drugs - a real problem. Hopefully, genomics will reduce the risk even further and make more medications available to people who need them.

Cap Ten Oblivious: namatad: and in all fairness, why is the acetaminophen there in the first place?

I always thought it was to keep people from using it as a recreational drug.

I haven't read the entire thread, but the acetaminophen or ibuprofen are added to improve pan relief without increasing the narcotic component.

museisluse: Cap Ten Oblivious: namatad: and in all fairness, why is the acetaminophen there in the first place?

I always thought it was to keep people from using it as a recreational drug.

I haven't read the entire thread, but the acetaminophen or ibuprofen are added to improve pan relief without increasing the narcotic component.

If I recall, a lot of the studies showed that pain relief was primarily from the non-narcotic component because the amount of avialable narcotic was limited to prevent respiratory depression and other significant complications of narcotic overdose. Stand-alone products will be limited in effectiveness because of this limitation as well.

Strong oral narcotics will never be used for routine pain control because of liability issues. Cancer patients and chronic pain patients get more powerful narcotics because of tolerance and other obvious reasons.

If your doctor is prescribing Dilaudid 4mg after your routine gallbladder surgery, you may want to think twice about taking it.

NeoBad: The sad part of this is that many people do take these medicines safely and appropriately. So the few bad apples spoil the whole bunch so to speak.

It's not a few bad apples screwing it up for everyone else. It's chronic pain patients who are suffering liver damage in spite of following doctor's orders. My doctor prescribed 10 mg Vicodin (650 mg APAP,) three times a day. I followed my doctor's instructions to the letter. I never took any other prescription or OTC med, other than what he prescribed. I never took more than he prescribed. I stopped drinking alcohol entirely. I did everything right. And a year after the accident I was diagnosed with liver failure.

I don't know what the right answer is. I'd rather not see FDA take Vicodin and Percocet off the market, but it would seem that prescribing them for long-term use is not advisable. Yet my doctor was very annoyed with me when I told him I'd been diagnosed with liver failure and we needed to find something else.

And switching people from Schedule III Vicodin to Schedule II hydrocodone (alone) will be a nightmare for everyone involved. And it will probably make hydrocodone easier for addicts to obtain.

Bestbank Tiger: Just ban it. It would be terrible to just put the information out there and allow people to make an informed decision.

you can't just ban something because it's dangerous. yeah, I have to take percocet daily for a busted knee (I have no insurance to get my knee fixed yet). I barely afford the percs. but I would rather take percs everyday and take that chance of damaging my liver than to not take it at all.

besides you can't just swtich from perc with to perc only. it definitely would be a nightmare.