Stretching the Effective Time of Vicodin / Norco / Opiates

OK, this might seem like a druggie/abuser question, but…

Are there supplements or herbs that can safely extend the effectiveness of opiates? I don’t mean the euphoric feeling, but the pain relief effect.

I’m asking because when I have a bad couple of day’s I use more than my “normal” allowance and end up shorting myself before my scheduled refill. My PCP (though generous and sympathetic), will not allow me more than a certain amount every month.

Now that I’m working again (in a wood shop with saws, routers, and planers screaming all day), I’m reaching for the meds as soon as I get home.

Currently I’m taking a multi-vitamin, fish oil, niacin, and milk thistle.

Any ideas?

I hear you. Pain meds don't work for me anymore. I wind up taking them later than sooner now. Also, now when I get home I have a joint waiting for me if it is bad enough. I guess marijuana is a herb.

Congrats on the new job.

Oh My! Yes, congrats on the job, but I am sure it is noisy in there!! I don't know of any herbs. The Marijuana I tried about twice, and really it made my head throb harder and I was paranoid when that started to happen, but that is just me. I am wondering what you take, I am wondering if there is any way to stagger, conserve, stagger, conserve. I used to take my dosage, and a bit later add in a half dose. It seemed to work, there were days when I didn't need to do that and days I Needed way more.

I take oxycodone. I can't do the percocet deal because I have a reaction with the acetmenophen in it. Don't know why just a crazy deal. This may sound dumb, but I have added Ibuprofen about a half hour after taking my pill, when My pill is not quashing it enough. Amazingly enough it has been working well. IN the past Ibuprofen has done absolutely nothing. I really didn't think it would do anything, but I had my gall bladder removed a while back and my surgeon let me take my oxycodone for pain and said to add Ibuprofen to it. I honestly was amazed how well it worked for the migraine! (I also have botos, so not sure there).

I think your question is a great one, and I will continue to watch and see if there are more posts, I am pretty curious. thanks.

My specialist (neuro & pain) says the Ketamine he prescribes me decreases my tolerance to pain medications. I use Ketamine nasal spray that I get through a compounding pharmacy.

Dan,

I fight this battle every month. I am fighting it now for I do not get my refill until Tuesday. Two things I have done in the past that has helped me...

If I already have the migraine/headache and the pill did not relieve my headache I may chase it down (about 20 minutes later) after I have reliezed that one pill was not doing it, with strong coffee. Sometimes this helps.

If I am low on meds I will take Ibuprofen before I even feel a headache coming on and it will keep it at bay and I normally do not get one. This helps me get through the day without taking any painkillers. I start this when I only have a few pills left for that month.

Hope this helped. I am also looking forward to other options. I think a lot of us have this very problem. I hate the problem because I know I am looking at a few days of headache in front of me before I get my refills.

kimsmom

Dan, my doctor told me to add a Tylenol to my oxycodone which will provide a booster effect. So instead of needing two, I will only take one Oxy with one or two Tylenol. My other doctor told me to take an Aleve with the Oxy, but I did not notice that help much. Sorry, I havent found any natural substances that helped with the pain.

I do hope you are wearing good earplugs all day in that noisy environment. An ounce of prevention is worth a pound of cure.

Thanks everyone for the responses.

My PCP recommended I add IBP to my Norco for the inflammatory benefits. But when the thumper's hit nothing works except the high power stuff. I actually have my own cocktail for bad ones: A Norco, two Ibuprofen and a Latte' or other form of strong coffee. It knocks the thumping down, but it's a one shot remedy.

Well if anyone stumbles across something please post it.

BTW - Funny isn't it? I guy with chronic daily headaches finds a job in one of the most loudest, noisy shops there is!
But I work inside an office (on the factory floor), and I have a pair of professional grade ear plugs. The little foam plugs they have at work don't do much for me.

Dan, I was having a similar problem, but more of having mini withdrawals during the day since I take opioids daily. An hour before it was time for the next dose I'd be hurting and watching the clock, and my tummy would start cramping.

My Dr. added extended release Oxycontin 20 mg three times a day. So, it boosted the effectiveness of the norco (obviously) and also kept my pain levels from fluctuating so much during the day.

I never feel buzzed from it, and in fact on good pain days forget to take it.

You say your Dr is sympathetic, perhaps he would consider that option. BUT, the Oxycontin alone does not cut it, I use it in addition to the Norco. A combination of slower acting long term pain control, with fast acting short term pain control.

Good luck!

I used to take the Oxycontin as well. It seemed to help things level out, but I still needed medication for "break through" pain. I didn't notice any sort of buzziness or anything from it, it was low dose, and extended release, so it didn't really 'hit' you. I didn't have any addiction issues, or dependency, but I tapered off of it when I stopped taking it, I am sure without the taper I would have had withdrawl effects, I took it a long time.

Steph,

So many epoeple don't understand the difference between addiction and physical dependency. I've been on these for so long that my body goes through withdrawal w/o it. But I've never had addiction issues either. In fact the studies I did before I took this route indicated that used properly for pain management, addiction rates are quite low. I don't have cravings for anything, I don't wake up in the morning reaching for my pills, and on low pain days I actually forget to take the pills.

Guess, I'm not a very good addict, no matter what ER staff thinks.

Oh I hope you didn't take that the wrong way. I totally understand the difference. I won't do mail order prescriptions anymore because three times in the past they were too slow. I was left without medication, that I took on a daily basis, and went through actual withdrawl. In my opinion, that can almost be as bad as a migraine. The first time I didn't know what was happening, and it was hours into it that I figured it out. I ended up slapping a fentanyl patch on my arm, it was a low dose, just to get out of the withdrawl. I was desperate.

The second and third times, I was just pissed. Never again will I do mail order for those 3 reasons. I just never noticed any dependence on the Oxycontin ER because I tapered off of it, and I am sure I would have if I had just stopped it, the previous withdrawls are exactly why I didn't just quit it.

I didn't mean to offend anyone. I really didn't think that I had. Sorry.

Oh Steph, no...I didn't take as a insult at all. I was agreeing with you. I was thrilled that you knew and understood the difference!! So many folks don't, even nurses and other healthcare professionals.

No, no, no, nothing to apologize for, I knew exactly what you were saying. I'm sorry I gave the impression that I was offended!

I had to go through a three day withdrawal because if a insurance mix up. I was miserable. I always refill early and make sure I have some stashed away in case it happens again.

I'm sorry if I made you worry...We're good

Now, time to Night, all.

OH GOOD, I was a little confused and in fact re-read your post after I posted and was like, well...hmmm. I wasn't sure!

I reread it too and can see why you were confused. If I would have added a simple "so glad you understand".... instead it comes off like I'm lecturing you. Sorry!!

So hard on line when you can't hear tone of voice or inflections.

Yeah! I know, it is like texting! I am always such a smartass and I TRY tone stuff down, but I can't so I always wonder if I come off snarky!!

Ha ha. We can be the misunderstood snarky sisters.

Enigma wrote:I hear you. Pain meds don't work for me anymore. I wind up taking them later than sooner now. Also, now when I get home I have a joint waiting for me if it is bad enough. I guess marijuana is a herb.

Congrats on the new job.

I second the marijuana options for extended relief. However, I am in California and here it is a medical aid. It is clean, pesticide free very high quality which means I don't have any of the weird mental stuff. If I have a pain scale 3 migraine, I can take 15mg of an opiate and then a tiny bit of marijuana and it offers the same relief as if I took two pills without being too "high". But it only lasts for about two hrs so I usually do that before bed. It also helps counter act the problems with lack of appetite, nervousness and overall bad mood.

My Dr said this was fine and that there were no problems as long as I wasn't too out of it.

However, it really doesn't help on it's own. If I have a bad migraine, it doesn't help at all. Everyone is different though.

I always wondered if medical marijuana would offer ant relief for migraines. In Michigan it's been legalized on paper, but law enforcement has there undies in a knot over it. Nobody can agree on what the law actually say's!

This area is SO conservative that even medical use would brand you as a doper or pot head.

Closed and judgmental minds suck...

02R96 wrote:I always wondered if medical marijuana would offer ant relief for migraines. In Michigan it's been legalized on paper, but law enforcement has there undies in a knot over it. Nobody can agree on what the law actually say's!

This area is SO conservative that even medical use would brand you as a doper or pot head.

Closed and judgmental minds suck...

Oh I've had my fair share of judgement towards ANY medication I take for the migraines. My husband and many of his friends come from a very conservative place about it. I just chalk it up to a lack of understanding and as you say conservative thinking.

I'm glad to hear that it's legalized on paper there, it would be worth a try if you have a clean source and know what it is and where it's from. One thing my Dr talked about was making sure it's not laced with anything, which can be dangerous. There are also different strains that offer different kinds of "high". I've had to try different kinds to find one that helps for pain and not just getting high. That to me is useless.

My sister also gets migraines and she prefers mm to any pharm options. It helps her tremendously.

I would love to see marijuana legalized in my state...not for pain relief, I get decent pain relief from my pain management regime, but for the nausea. All the pills in the world don't do any good if you throw them back up!

I would be tempted to try it but 1) would lose my job if caught, and 2) I signed a pain contract with my Dr. And he can refuse to treat me if illegal or drugs not prescribed by him are found in my urine test.

My Dr. and I have developed a great deal of trust, and he is the first Dr. that understood that it's impossible to work or live a life with chronic daily migraines. I don't want to take the chance of losing his trust and possibly being kicked out of his practice.

At : somebodyhealme
Question about your post on Fri Apr 01, 2011 10:22 pm
"My specialist (neuro & pain) says the Ketamine he prescribes me decreases my tolerance to pain medications. I use Ketamine nasal spray that I get through a compounding pharmacy."

I had heard of a research project using ketamine as an antidepressant/mood stabilizer. Is this what you take it for? I am very interested, and look forward to your reply.
- Big John

I'm not the original poster, but I can chime in on the use of Ketamine for chronic head pain. My neuro recently prescribed compounded Ketamine, first in a nasal spray then in capsules. I find it helpful for my NDPH headache.

Its short lived, but something at least. I take it in addition to opioid pain meds (and other treatments). The nasal spray kicked in quite strong but only lasted maybe 20 minutes. The capsules take about 30 minutes to kick in and last a couple hours of more steady relief (but still has a peak then decreases, like a short acting opioid).

Although I can definitely tell I've taken something, the only time I've felt impaired was for a very short period of time when I took them on an empty stomach. I actually take them at work when my pain is at its worst. I have the same experience with opioids--I never feel impaired, and actually focus much better when my pain is treated.

Unfortunately there isn't much evidence on the use of Ketamine for chronic pain and there is a stigma against it as it can be used recreationally. Hopefully they publish more studies so more doctors are comfortable prescribing it (few currently do).

Oddly enough its only Schedule III (vs. opioids which are mostly Schedule II), so it can even be faxed (often a mail order compounding pharmacy is used).

My pain doctor is ok with my neuro prescribing it (he could have claimed it would violate my opioid contract), but at this time wouldn't consider taking over the prescription...probably just too much liability for them.

Also, few insurance companies cover compounded meds, especially Ketamine. My prescription was $200, but it may last me 2 months. Hopefully it doesn't stop working, like has happened with many other meds. Apparently you aren't supposed to build tolerance though.

Ketamine can also be used in an IV more with the hope to break a pain cycle / reset the system (vs. when used orally or nasally it is similar to an opioid). I've heard of the nasal spray or capsules being used after an IV to try to extend the results.

Bioavailability is much higher intranasally, but a higher dose can be used orally. Ketamine is also used for depression (there is probably more info online right now about that use than for pain). Best wishes.

I know your said you have ear plugs, but you might look into the ear muff style, they seem to work better at noise reduction. Hubby is a gun enthusiast, and had me at the range so that I would knew how to use everything (safety thing), and I found that the plugs never did enough, but the muffs do. The one time he drug me there with a low grade migraine, I wore both!

Stretching out the useful ness of the meds, When I was working and was able to take Butalbitol I found that a single Tramadol would take me 4-5 hours instead of the 1 hour relief. I now have Norco and Butorphanol that the Tramadol will stretch out the useful life on. The 400mg Meperidine can be extended with a Norco within the first hour, but someone else has to be there and help, As well as making decision to give it to me at that time. Somewhat related, Cyclobenzaprine can be booted way up with the addition of a Beer or Glass of wine, my Ortho told me about that after I broke my back many years ago, it still holds true although I don't use it much.
This is year 20 dealing with the Migraines, I am pretty sure I have tried all available to me at this time. I had them as a kid and they stopped for almost 15 years after I was 19, then Boom one day at work it came on, of course I was alone in the Dept. that day... Some really good friends ran interference for me and we cleared the office, then they took me to the DR. and on came the Demorol and I got a ride home before he went back to work... Good people, I still help them when I can, They would do the same for me...
=BillH