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Suggest Treatment To Manage Pain While Weaning Off Vicodin
Posted on
Sat, 26 Nov 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 26 Nov 2016
Answered on
Fri, 23 Dec 2016
Last reviewed on
Question : My "pain Dr" that I have to see has to ween me off Vicodin because of Obamacare strictness on opiates. I have been on that regimen for 10 yrs of 3/day 7.5/325 and it works well for my RA pain. However, since i drink wine, there is alcohol and he can't prescribe Vicodin anymore. The chIorzoxazone he prescribed made me like a zombie the first one I took, I could not get off the couch for 4 hrs after walking my 4.5 miles in the morning (5:30am) and the one 300mg tablet took 8 hours to wear off. I cannot foresee that working. He also prescribed Gabapentin 300mg for the nite (I already take Requip for restless leg and Flexeril for sleeping). Medicare is denying an MRI for C4/C5 because my arms go to sleep during the night, and sometimes go numb during the day. He is a young Dr, and I suspect he isn't writing enough or the correct information on the MRI request. I had an EMG on my arms and neck, and do have issues, probably complications from my osteoarthritis, and Medicare denied pain blocking injections. I feel I am caught in a sinking web, and think I either 1: have to change insurance AGAIN, or 2: find a new pain Dr.... Any input?
Brief Answer:
It's all wrong.
Detailed Answer:
There are not restrictions on opiates from Obamacare. First of all, when did these "restrictions" start, sounds like within the last 2 years. When did Obamacare start ? that was about 7 years ago. So, that is exactly as likely as legistlative cooperation between Obama and the Congress.
No.
The guidelines were out of a panic from a narcotic epidemic. They are for increasing concern over increasing narcotics. The LOWEST category is more than what you are on (30 mg versus 22 mg). You are not on a level that would be a concern from anyone.
More dangerous drugs than 22 of hydrocodone are perhaps a better drug for RA, however. Every inflammatory rheumatoid arthritis patient should be considered for:
1) an aspirin like drug. There are at least 5 different categories of them chemically and while they all act the same, people respond to them differently. All of them can affect the kidney. Most of them can cause ulcer. All of them are longer acting and potentially stronger than 22 mg vicodin a day.
2) a disease modifying agent that lowers the action of the blood cells that cause rheumatoid. Some, like plaquinil, do not kill cells and are not toxic. While its action of gumming up RA cells can also gum up the eyes, that takes years to decades to occur. and in the short term it is entirely safe, mild, takes weeks to months to see if it works. But this can help the joints from falling apart and the other drugs discussed cannot.
There are many, stronger, and expensive rheumatoid drugs that more or less are chemotherapy for blood cancer. They all can injure organs with increasing risk over time. If the joints are truly falling apart, the low risk of serious problems from them is very worth it. If the joints just ache but do not have issues of falling apart, then they are not worth it.
3) physical therapy. Also ballroom dance.
So, first a rheumatoid patient needs a competant primary care doctor and a rheumatologist. You have neither.
It's all wrong.
Detailed Answer:
There are not restrictions on opiates from Obamacare. First of all, when did these "restrictions" start, sounds like within the last 2 years. When did Obamacare start ? that was about 7 years ago. So, that is exactly as likely as legistlative cooperation between Obama and the Congress.
No.
The guidelines were out of a panic from a narcotic epidemic. They are for increasing concern over increasing narcotics. The LOWEST category is more than what you are on (30 mg versus 22 mg). You are not on a level that would be a concern from anyone.
More dangerous drugs than 22 of hydrocodone are perhaps a better drug for RA, however. Every inflammatory rheumatoid arthritis patient should be considered for:
1) an aspirin like drug. There are at least 5 different categories of them chemically and while they all act the same, people respond to them differently. All of them can affect the kidney. Most of them can cause ulcer. All of them are longer acting and potentially stronger than 22 mg vicodin a day.
2) a disease modifying agent that lowers the action of the blood cells that cause rheumatoid. Some, like plaquinil, do not kill cells and are not toxic. While its action of gumming up RA cells can also gum up the eyes, that takes years to decades to occur. and in the short term it is entirely safe, mild, takes weeks to months to see if it works. But this can help the joints from falling apart and the other drugs discussed cannot.
There are many, stronger, and expensive rheumatoid drugs that more or less are chemotherapy for blood cancer. They all can injure organs with increasing risk over time. If the joints are truly falling apart, the low risk of serious problems from them is very worth it. If the joints just ache but do not have issues of falling apart, then they are not worth it.
3) physical therapy. Also ballroom dance.
So, first a rheumatoid patient needs a competant primary care doctor and a rheumatologist. You have neither.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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