FDA panel wants to eliminate Vicodin and Percocet!!

[Striker8440]

I find this troubling because of a chronic pain condition I have, I take vicodin on a daily basis just to survive. I can understand the reasoning behind this, its not the Vicodin/Percocet but the acetaminophen that is used as a filler.

This would also affect over the counter tylenol, Nyquil and Theraflu. The issue is the affects on the liver of too much of this med in your system and the damage it does to the liver. I personally have a full bloodwork done including liver panel twice a year to monitor my liver function and so far so good.

I dont know if this is goverment meddling or a good thing, I just hope if they do ban vicodin and percocet that something else equally as effective is developed and put out on the market.

Here is the link that I was able to find:
http://health.msn.com/medications/articlepage.aspx?cp-documentid=100241255&gt1=31036

Also from my local newspaper:
http://www.columbusdispatch.com/live/content/national_world/stories/2009/07/01/fda_tylenol_safety.ART_ART_07-01-09_A1_C7EBI56.html?sid=101

[MrShotShot]

My understanding is that they would do a reformulation of the drug to remove the acetaminophen.

[Dr. Funkenstein]

But Klippel added that the vote to make the 1,000-milligram dose of acetaminophen available by prescription only would overburden the health-care system. "Given the massive number of people who rely on this drug for pain control, making the maximum dose requiring a prescription, I think, is going to place undo burden on the health-care system," he said.

Teperman disagreed.

"The 1,000 milligram pill should never be at the patient's discretion. It should only be prescribed by a physician," Teperman said. "If you took an entire bottle of Tylenol Extra Strength, three days later you would be in a coma and needing a liver transplant."

Yeah...I'm pretty ****ing sure if someone took an entire bottle of Extra Strength Tylenol, that was their damn goal.

:wall:

[5thIDSoldier]

This reminds me of the whole sacharin scare a few years back.

"If we give a rat 5000 times the normal amount consumed by a human, it gets cancer! Bam Sacharin!"

[Dr. Funkenstein]

This reminds me of the whole sacharin scare a few years back.

"If we give a rat 5000 times the normal amount consumed by a human, it gets cancer! Bam Sacharin!"
Actually no...but that was pretty stupid back then. Along with the "red dye #5" scare.

The issue here is that apparently there has been an alarming increase in the number of liver poisonings caused by people OD'ing on acetominaphen in the last few years they studied. It went from 28% in '98 to 53% in '03.

[5thIDSoldier]

Actually no...but that was pretty stupid back then. Along with the "red dye #5" scare.

The issue here is that apparently there has been an alarming increase in the number of liver poisonings caused by people OD'ing on acetominaphen in the last few years they studied. It went from 28% in '98 to 53% in '03.


That is quite an increase. But the regulators dont realize that the people popping the pills will simply take more of the reduced dosage pills until they reach the desired dosage. For example, to reach 1000mg right now they take 2 500 pills. At 325mg, they will take 3 to reach the 1000 threshold.

I think the better approach is better public education about the dangers of exceeding the recomended dosages.

[Dr. Funkenstein]

That is quite an increase. But the regulators dont realize that the people popping the pills will simply take more of the reduced dosage pills until they reach the desired dosage. For example, to reach 1000mg right now they take 2 500 pills. At 325mg, they will take 3 to reach the 1000 threshold.

I think the better approach is better public education about the dangers of exceeding the recomended dosages.
I don't disagree with you...I was just explaining the impetus.

[ressurectedUltraSaiyanUSA]

THANK GOD!!!

2 of the most troublesome medications I've ever had to deal with and the most easily abused!!!

if the government is just going to put more and more regulations/restrictions on these kinds of medications, better just eliminate it altogether and ban it!!!

[EmmanuelGoldstein]

I find this troubling because of a chronic pain condition I have, I take vicodin on a daily basis just to survive. I can understand the reasoning behind this, its not the Vicodin/Percocet but the acetaminophen that is used as a filler.

This would also affect over the counter tylenol, Nyquil and Theraflu. The issue is the affects on the liver of too much of this med in your system and the damage it does to the liver. I personally have a full bloodwork done including liver panel twice a year to monitor my liver function and so far so good.

I dont know if this is goverment meddling or a good thing, I just hope if they do ban vicodin and percocet that something else equally as effective is developed and put out on the market.

Here is the link that I was able to find:
http://health.msn.com/medications/articlepage.aspx?cp-documentid=100241255&gt1=31036

Also from my local newspaper:
http://www.columbusdispatch.com/live/content/national_world/stories/2009/07/01/fda_tylenol_safety.ART_ART_07-01-09_A1_C7EBI56.html?sid=101
The advisers voted against other safety restrictions for other over-the-counter drugs such as NyQuil or Theraflu, which contain acetaminophen and other ingredients that treat cough and runny nose.

The narcotic component of vicodin and percocet would still be available. They just want to remove the tylenol, and I agree with that.

[ressurectedUltraSaiyanUSA]

in my opinion two of the factors:

1. patient abuse.
2. a lot of regulation/restriction.

on one hand, these kinds of narcotics are regulated and restricted and then on the other, these are the most asked for meds by patients suffering with pain. it is ridiculous. even with patient-assisted analgesics, in some patients it still won't be enough and would ask for stronger and stronger pain medication/dosages.

but then if it is abused by patients, the risk of developing adverse reactions and side effects become higher and could lead to death.

knowing those factors, then, yes, it's better to ban these medications, because then, you will always be on the safe side. i for one don't completely understand why if everyone wants to be safe, safe, safe, safe, why in the hell should still be around. would it not be better to just do away with it if you want everything to be "SAFE"!

[Calibabe]

Actually no...but that was pretty stupid back then. Along with the "red dye #5" scare.

The issue here is that apparently there has been an alarming increase in the number of liver poisonings caused by people OD'ing on acetominaphen in the last few years they studied. It went from 28% in '98 to 53% in '03.


The researchers need to find out if these people were consuming alcoholic beverages along with their Tylenol.

I have been on an acetominaphen based analgesic for 6 years. However I have liver function testing done every 3-6 months to make sure that there are no unforseen problems going on. I also keep my daily consumption to less than what the prescription is written for. I had a former friend who however drank like a fish and was "eating" about 15-20 tabs per day. I told her she needed to go to rehab and henceforth the "former" friend title.

I will be watching this closely, however. It does make me a little more concerned about what they will replace Vicodin or Percocet with if they do indeed remove it from the market. I haven't heard anything about them replacing either drug with a reformulated version.

Again, this is something that the government should not be involved in. It should be between patient and doctor.

[5thIDSoldier]

I will be watching this closely, however. It does make me a little more concerned about what they will replace Vicodin or Percocet with if they do indeed remove it from the market. I haven't heard anything about them replacing either drug with a reformulated version.

Again, this is something that the government should not be involved in. It should be between patient and doctor.

Watch them do something really stupid like replacing it with Oxyconten.....morons.....

[mysticbeauty_nbeast]

Watch them do something really stupid like replacing it with Oxyconten.....morons.....

Now that is scary! :eek:

I believe what they (The FDA) will do is simply lower the acetaminophen levels in medications and OTC to 'safe' levels...which mean 325 mgs. or under per pill or less. NorCo has nearly taken over Vicoden/Percocet prescriptions already. Norco...which has a base hydrocodone main ingredient, has a very low acetaminophen carrier within it. So those who take these medication for chronic conditions need not fear. It will be merely 're-formulated to suit the new standards.

The larger point that we are not hearing is 'why'? Why now after all these years? Why the big push to regulate something that has been OTC for literally decades now? Do the pharmaceutical companies want us to have a scrip for acetaminophen now? Who is going to benifit from this new change? To me, this has money all over it...someone stands to make a fortune. ;)


~Mysty

[Striker8440]

Now that is scary! :eek:

I believe what they (The FDA) will do is simply lower the acetaminophen levels in medications and OTC to 'safe' levels...which mean 325 mgs. or under per pill or less. NorCo has nearly taken over Vicoden/Percocet prescriptions already. Norco...which has a base hydrocodone main ingredient, has a very low acetaminophen carrier within it. So those who take these medication for chronic conditions need not fear. It will be merely 're-formulated to suit the new standards.

The larger point that we are not hearing is 'why'? Why now after all these years? Why the big push to regulate something that has been OTC for literally decades now? Do the pharmaceutical companies want us to have a scrip for acetaminophen now? Who is going to benifit from this new change? To me, this has money all over it...someone stands to make a fortune. ;)


~Mysty

NorCo is EXACTLY the med I take right now for my pain, its not too bad overall if taken on a regular schedule. If you just take some at night instead of 1 or 2 every 6 hours then they are not that good. The key is to get on top of it and stay there, otherwise your just wasting your money.

[EmmanuelGoldstein]

Watch them do something really stupid like replacing it with Oxyconten.....morons.....

Oxycodone is the narcotic in percocet...

[mysticbeauty_nbeast]

NorCo is EXACTLY the med I take right now for my pain, its not too bad overall if taken on a regular schedule. If you just take some at night instead of 1 or 2 every 6 hours then they are not that good. The key is to get on top of it and stay there, otherwise your just wasting your money.

Your exactly right. Chronic pain is one of those fields that is now being looked at in a more critical light. There are those conditions that medicine simply can not correct. Long term medication regimens along with physical therapy and diet are the only ways in which modern day medicine can give some relief to those who suffer with chronic conditions. Keeping atop a pain cycle means a regimen of pain medications. If a patient allows his or her pain to escalate; it then takes twice as long to get atop said pain to become functional and within a comfort zone once again. As long as there is 'pain', the medication won't have a altering affect on the mind. Not enough pain and too much medication...you've got a walking zombie.

Working in the ER, I found what nurses and doctors used as a litmus test to 'pain'. Two patients enter the ER claiming horrific pain. Give both a 25 mg shot of Demerol. One will zonk out into a deep sleep...which tells you that patient had drug seeking behavior....the other will actually sigh in relief out loud and become lucid and verbal...that's the patient with pain.

So many in our Nation abuse prescription drugs; so much so that it has made chronic pain suffers run the gambit of proof to ensure doctors are not creating another abuse situation. In many ways, this makes the whole experiance of the medical field and chronic pain suffers juxtaposed.

~Mysty

[Slowburn]

Hydrocodone is the #1 abused and illegally diverted controlled substance in the United States. It causes more deaths and injuries than every illegal drug on the streets combined. It definitely needs to be reschedules to a Scheduled 2 drug like morphine and demerol to place tighter controls on it.

[kanaskat]

Your exactly right. Chronic pain is one of those fields that is now being looked at in a more critical light. There are those conditions that medicine simply can not correct. Long term medication regimens along with physical therapy and diet are the only ways in which modern day medicine can give some relief to those who suffer with chronic conditions. Keeping atop a pain cycle means a regimen of pain medications. If a patient allows his or her pain to escalate; it then takes twice as long to get atop said pain to become functional and within a comfort zone once again. As long as there is 'pain', the medication won't have a altering affect on the mind. Not enough pain and too much medication...you've got a walking zombie.

Working in the ER, I found what nurses and doctors used as a litmus test to 'pain'. Two patients enter the ER claiming horrific pain. Give both a 25 mg shot of Demerol. One will zonk out into a deep sleep...which tells you that patient had drug seeking behavior....the other will actually sigh in relief out loud and become lucid and verbal...that's the patient with pain.

So many in our Nation abuse prescription drugs; so much so that it has made chronic pain suffers run the gambit of proof to ensure doctors are not creating another abuse situation. In many ways, this makes the whole experiance of the medical field and chronic pain suffers juxtaposed.

~Mysty

this makes no sense to me. i take 250mg of a tylenol knock off that i get at the dollar store to help me sleep at nite. the directions call for 1000mg but I choose not to be groggy all the next day. you can get acetaminophen anywhere in may different forms. if folks are killing themselves with this ingredient then i think that education is what's needed. to cut off people for whom vidadin and percocet has become a great relief because of a few seems wrong. people who abuse substances of any kind are going to do it no matter what. when a patient first fills a prescription for painkillers they are probably not particularly receptive to the education offered. if a patient begins to need those painkillers as a mainenance drug that is when the doctor should TAKE THE TIME to explain the dangers of certain ingredients and what they could do - then if the patient chooses to abuse the drug it's on them - not the drug itself......

[EmmanuelGoldstein]

As long as there is 'pain', the medication won't have a altering affect on the mind. Not enough pain and too much medication...you've got a walking zombie.

Working in the ER, I found what nurses and doctors used as a litmus test to 'pain'. Two patients enter the ER claiming horrific pain. Give both a 25 mg shot of Demerol. One will zonk out into a deep sleep...which tells you that patient had drug seeking behavior....the other will actually sigh in relief out loud and become lucid and verbal...that's the patient with pain.


I strongly disagree.

[EmmanuelGoldstein]

this makes no sense to me. i take 250mg of a tylenol knock off that i get at the dollar store to help me sleep at nite. the directions call for 1000mg but I choose not to be groggy all the next day.

?

Are you talking about plain tylenol? Nothing else?

[psyko kat]

I find this troubling because of a chronic pain condition I have, I take vicodin on a daily basis just to survive. I can understand the reasoning behind this, its not the Vicodin/Percocet but the acetaminophen that is used as a filler.

This would also affect over the counter tylenol, Nyquil and Theraflu. The issue is the affects on the liver of too much of this med in your system and the damage it does to the liver. I personally have a full bloodwork done including liver panel twice a year to monitor my liver function and so far so good.

I dont know if this is goverment meddling or a good thing, I just hope if they do ban vicodin and percocet that something else equally as effective is developed and put out on the market.

Here is the link that I was able to find:
http://health.msn.com/medications/articlepage.aspx?cp-documentid=100241255&gt1=31036

Also from my local newspaper:
http://www.columbusdispatch.com/live/content/national_world/stories/2009/07/01/fda_tylenol_safety.ART_ART_07-01-09_A1_C7EBI56.html?sid=101

Iv have taken both, vicodin and percocet, for -after surgery, pain...
neither one had any affect at all/
so I stayed with using tylonal, or just plain aspirin.

[captusa]

I find this troubling because of a chronic pain condition I have, I take vicodin on a daily basis just to survive. I can understand the reasoning behind this, its not the Vicodin/Percocet but the acetaminophen that is used as a filler.

This would also affect over the counter tylenol, Nyquil and Theraflu. The issue is the affects on the liver of too much of this med in your system and the damage it does to the liver. I personally have a full bloodwork done including liver panel twice a year to monitor my liver function and so far so good.

I dont know if this is goverment meddling or a good thing, I just hope if they do ban vicodin and percocet that something else equally as effective is developed and put out on the market.

Here is the link that I was able to find:
http://health.msn.com/medications/articlepage.aspx?cp-documentid=100241255&gt1=31036

Also from my local newspaper:
http://www.columbusdispatch.com/live/content/national_world/stories/2009/07/01/fda_tylenol_safety.ART_ART_07-01-09_A1_C7EBI56.html?sid=101

The easiest thing would be to take acetominophen out of vicodin and percocet and just make a hydrocodone tablet.

[psyko kat]

This reminds me of the whole sacharin scare a few years back.

"If we give a rat 5000 times the normal amount consumed by a human, it gets cancer! Bam Sacharin!"

I remember that,from a long time ago...lol.

[psyko kat]

The researchers need to find out if these people were consuming alcoholic beverages along with their Tylenol.

I have been on an acetominaphen based analgesic for 6 years. However I have liver function testing done every 3-6 months to make sure that there are no unforseen problems going on. I also keep my daily consumption to less than what the prescription is written for. I had a former friend who however drank like a fish and was "eating" about 15-20 tabs per day. I told her she needed to go to rehab and henceforth the "former" friend title.

I will be watching this closely, however. It does make me a little more concerned about what they will replace Vicodin or Percocet with if they do indeed remove it from the market. I haven't heard anything about them replacing either drug with a reformulated version.

Again, this is something that the government should not be involved in. It should be between patient and doctor.

when we were kids in school, we would put an aspirin in our coke.

[traditional_woman]

Iv have taken both, vicodin and percocet, for -after surgery, pain...
neither one had any affect at all/
so I stayed with using tylonal, or just plain aspirin.

I was gonna say the same thing!! I've had both percocet and demeral a few times after surgery, or dental work, and neither did a thing for me. I don't see how ppl can get addicted to it. I do think i felt a little loopy/tired after taking percocet, maybe that's the draw for some?

[psyko kat]

I was gonna say the same thing!! I've had both percocet and demeral a few times after surgery, or dental work, and neither did a thing for me. I don't see how ppl can get addicted to it. I do think i felt a little loopy/tired after taking percocet, maybe that's the draw for some?

I had taken darvacet too, before they made it OTC....

[traditional_woman]

Come to think of it, I've had morphine that didn't even touch my aftrebrth pains,it only made me sick. The ONLY thing that DID work was tramadol. That stuff was the bomb!!

[psyko kat]

Come to think of it, I've had morphine that didn't even touch my aftrebrth pains,it only made me sick. The ONLY thing that DID work was tramadol. That stuff was the bomb!!

I had morphine too, after my hysterectomy, then within 6hours ,being rushed back to surgery for a ruptured appendix...

[jwil59]

Are there not Lortab brands that do not contain acetaminophen? I don't see why they cannot do the same thing with Vicodin.

For chronic pain, the fentanyl patches work very well from what I understand.

[5thIDSoldier]

Oxycodone is the narcotic in percocet...

Ya learn something new everyday......thanks Emma..

[captusa]

Iv have taken both, vicodin and percocet, for -after surgery, pain...
neither one had any affect at all/
so I stayed with using tylonal, or just plain aspirin.

That would indicate thast acetomeniphene (tylonol) is a more effective pain killer than hyrocodone.
Many would disagree with you.

[psyko kat]

That would indicate thast acetomeniphene (tylonol) is a more effective pain killer than hyrocodone.
Many would disagree with you.

the prescription meds just didn't work for me...

[captusa]

Watch them do something really stupid like replacing it with Oxyconten.....morons.....

Vicodin and the others are a mixture of hydrocone and acetaminophen
Most if not all of the oxycotin tablets available are mixtures of oxycotin and acetaminophen.

[Striker8440]

Come to think of it, I've had morphine that didn't even touch my aftrebrth pains,it only made me sick. The ONLY thing that DID work was tramadol. That stuff was the bomb!!

When my appendix ruptured after my surgery I was being given 3mg every 3 hours because they had to cut me open to clean out the mess. I would get my dose and right away get up and start walking. It helped some but didnt knock me out and tramadol is freaking candy to me LOL doesnt do a damn thing, doesnt touch the pain at all in my case.

[Striker8440]

Glad I started this thread, I personally have learned quite a bit reading the replys.

Thanks folks for the replys.

[ConstitutionHugger]

I find this troubling because of a chronic pain condition I have, I take vicodin on a daily basis just to survive. I can understand the reasoning behind this, its not the Vicodin/Percocet but the acetaminophen that is used as a filler.

This would also affect over the counter tylenol, Nyquil and Theraflu. The issue is the affects on the liver of too much of this med in your system and the damage it does to the liver. I personally have a full bloodwork done including liver panel twice a year to monitor my liver function and so far so good.

I dont know if this is goverment meddling or a good thing, I just hope if they do ban vicodin and percocet that something else equally as effective is developed and put out on the market.

Here is the link that I was able to find:
http://health.msn.com/medications/articlepage.aspx?cp-documentid=100241255&gt1=31036

Also from my local newspaper:
http://www.columbusdispatch.com/live/content/national_world/stories/2009/07/01/fda_tylenol_safety.ART_ART_07-01-09_A1_C7EBI56.html?sid=101

The level of idiocy shown by the govt never ceases to amaze me!.
I have taken Vicodin, before but it is just a brand name of Hydrocodone/Acetaminophen Which is the most common prescription pain killer, and very safe. I accidently OD'd on the syrup form one day before College Football practice (used the wrong spoon) and had no ill effects. only thing that happened is that i got a bit goofyer than usual.
Looks like we are headed for a total Nanny state at warp speed.

Ignorence is CLEARLY the dominant gene in the govt

[ConstitutionHugger]

Are there not Lortab brands that do not contain acetaminophen? I don't see why they cannot do the same thing with Vicodin.

For chronic pain, the fentanyl patches work very well from what I understand.

Emma Correct me if I'm wrong, but If i remember correctly from my days as a Pharmacy tech Vicodin and Lortab are the same thing just different brands.

[gdoane]

If the FDA does this, won't the overall effect be to drive patients to buy the "banned" pills in Mexico and Canada where the FDA has no jurisdiction?

This seems like prime fodder for the law of unintended consequences. Driving patients to places where drugs are outside of the safety of American control cannot lead to any good. The answer should be consumer education, not driving consumers to cross the border.

[captusa]

Emma Correct me if I'm wrong, but If i remember correctly from my days as a Pharmacy tech Vicodin and Lortab are the same thing just different brands.
I just checked.
Both are hydrocodone and acetaminophem.
Lortab seems to have 500mg of acetaminophen for all strengths of hydrocodone while vicodin has more acetaminophen as the hydrocodone dose increases.
I am prescribed Norco (I get a generic) but my dosage is 10mg hydrocodone to 350mg acetaminophen while a vicodin with 10mg hyrocodone contains 660mg acetaminophen.
When I got my script I asked if there was any pill with less acetaminophen and was told there wasn't.

[captusa]

If the FDA does this, won't the overall effect be to drive patients to buy the "banned" pills in Mexico and Canada where the FDA has no jurisdiction?

This seems like prime fodder for the law of unintended consequences. Driving patients to places where drugs are outside of the safety of American control cannot lead to any good. The answer should be consumer education, not driving consumers to cross the border.

The irony is that the dangerous component is an over the counter drug.
They suggest banning the presciption compound while only putting a warning on the harmful over the counter component.

[EmmanuelGoldstein]

Vicodin and the others are a mixture of hydrocone and acetaminophen
Most if not all of the oxycotin tablets available are mixtures of oxycotin and acetaminophen.

Almost but not quite.

Oxycontin is a sustained release oxycodone, which is the narcotic (in immediate release form) in percocet (combined with tylenol). Oxycontin doesn't contain any tylenol.

[EmmanuelGoldstein]

Emma Correct me if I'm wrong, but If i remember correctly from my days as a Pharmacy tech Vicodin and Lortab are the same thing just different brands.
Yes.

[EmmanuelGoldstein]

I just checked.
Both are hydrocodone and acetaminophem.
Lortab seems to have 500mg of acetaminophen for all strengths of hydrocodone while vicodin has more acetaminophen as the hydrocodone dose increases.
I am prescribed Norco (I get a generic) but my dosage is 10mg hydrocodone to 350mg acetaminophen while a vicodin with 10mg hyrocodone contains 660mg acetaminophen.
When I got my script I asked if there was any pill with less acetaminophen and was told there wasn't.

Well, that's another problem with the med. Depending on the manufacturer and dose of narcotic, the amount of tylenol differs. Some have up to 750 mg tylenol. The ones we give out at the hospital contain either 325 or 650 per tab.

[EmmanuelGoldstein]

The irony is that the dangerous component is an over the counter drug.
They suggest banning the presciption compound while only putting a warning on the harmful over the counter component.

I don't believe they are banning the narcotic, rather the combination.

[captusa]

I don't believe they are banning the narcotic, rather the combination.

Isn't it stupid to bann the combination which ideally can only be gotten through a doctor and only put a warning on the part of the combination that causes the problem ?

[captusa]

Well, that's another problem with the med. Depending on the manufacturer and dose of narcotic, the amount of tylenol differs. Some have up to 750 mg tylenol. The ones we give out at the hospital contain either 325 or 650 per tab.

I went to a pill identifying website to get the specific information on the tablets available.(I think you have to pay at the PDR site)
The combinations were different for the 3 brands (Norco, Lortab and vicodin) and the ratios differred by brand.
I was originally prescribed norco. The generic is labeled hydrocodone 325/10 with the fact that it is a substitute for norco.
If it had been a generic for the corresponding vicodin it would have been 660/10hydrocodone.
Fortunately in the hospital you don't have to go to the PDR to know what the combination is since you use generics..

[gdoane]

Isn't it stupid to bann the combination which ideally can only be gotten through a doctor and only put a warning on the part of the combination that causes the problem ?

If drugs were only kept for prescription and "ideally only gotten through a doctor" that might be stupid to ban the drug but medicine cabinets tend to be like scrapyards full of old junk pills.

A few months ago, I was in the odd position of going through a medicine cabinet trying to figure out what a guy who'd just had a stroke was taking. Obviously he was no help, being half comatose and all, and I'm hitting up my laptop trying to figure out what the heck some of this stuff is.

One of the bottles turned out to be generic Vicodin, pills labeled "M360" and I didn't want any part of it. Worse, it was expired and not by a little bit, I'm talking three years.

I wouldn't even eat a tic-tac three years past the expiration date and people have this junk in their medicine cabinets like the pills might be useful to future generations or something.

Two things came to light. First of all, I don't know what the heck kind of pill I'm facing as a layman unless I sic Runabout (my laptop PC is named Runabout) on the issue and secondly, there are a LOT of prescriptions from years gone by sitting in medicine cabinets completely out of control of any responsible party.

If it's stupid to make the ban, it's mainly the same kind of stupid you get when you close the barn door after the horses ran out.

[Dual867PowerMac]

They should eliminate aspartame. :evil:

[EmmanuelGoldstein]

Isn't it stupid to bann the combination which ideally can only be gotten through a doctor and only put a warning on the part of the combination that causes the problem ?

No. You can still be treated with the actual narcotic without concern for chronic tylenol use.

Even recommended dosages of tylenol have been shown to cause liver damage:

http://www.medicalnewstoday.com/articles/46607.php

The new trial involved 145 healthy volunteers. They were divided into three groups. The first group received a acetaminophen/opioid combination, the second acetaminophen alone, and the third group received a placebo. They were on their medication(s) or placebo for 14 days. The acetaminophen only group received the maximum recommended daily dosage.

The maximum ALT measurements for each group were as follows:
How many had a maximum ALT measurement 3 times higher than the upper limit of normal:

-- Placebo group - 0%
-- Combination acetaminophen/opioid group - 31% to 44%
-- Acetaminophen only group - 31% to 44%

These results indicate that it was the Acetaminophen, rather than the opioid, that was having the effect.

[mysticbeauty_nbeast]

I strongly disagree.

You strongly disagree with what exactly? The litmus test I posted (25 mg's Demerol) given to those patients who claim to have pain or the patient who is in actual pain? or..that medication when given in the presence of pain doesn't have the 'high' effect' that it has on those without pain?

I wasn't speaking to long term use of pain medication itself Emma..nor was I stating some people don't receive a side effect of some sort from their long term meds. I was speaking to the use of a litmus test to determine a patient in pain verses those patients who present verbally with pain but are looking for a fix. UCD used this method to ensure proper diagnosis in the patient with pain verses the patient who was malingering/abusing/drug seeking behaviors. You dont' agree with their litmus? You don't have too. It works none the less.

Take that to the next level and look at chronic pain patients. Those patients who are malingering/abusing do look for the 'high' and tend more toward abuse of their pain meds. Those who are in true chronic pain are looking for relief..and rarely, when prescribed the correct dosage and type of pain med, receive that same high; nor do they go looking for it.

NorCo, Vicoden, Percocete and their companion drugs do give some relief to those who suffer with conditions that are ongoing/chronic. However, those are rarely the only drugs that the patients are given...nor are they solely effective for long term use without a companion drug used in conjunction with said drugs. Dependent upon the condition that presents pain, a physician may use any combination of drugs in order to bring relief to his or her patients. These patients function day to day due to the effectiveness of those drug interactions. Long term, that means low levels of acetaminophen (usually the filler or booster for another compainion med) or other like active ingredients that can have long lasting side effects. Long term use of 'pain medication' can be accomplished safely and effectively, just as easily as they can be grossly abused.

~Mysty

[EmmanuelGoldstein]

I don't agree that should be a 'litmus test' to determine if someone is actually in pain. We all handle it differently. Myself, the more pain I'm in the more I withdraw. I lie still, even try to sleep to escape it. Even if I'm not actually asleep, I appear to be to others. I drove myself to the ER with an incarcerated/strangulated bowel. I came very close to a colostomy with that one. I knew what was wrong (I could feel the loops of caught bowel just under the skin) and I calmly told the registration and triage people what was going on. I sat quietly, albeit a bit hunched over, while I waited for over an hour to be taken back for an exam. Even then, I could see they didn't believe me. It wasn't until I reacted to the rebound on exam that they begun to think maybe something was up, and took me for an emergent CT. I heard the surgeon mutter 'holy ****' while reading it. Only then did they offer me anything for pain.

Working with patients in pain over the years, I don't have a 'litmus test' to determine if it's real or not. And yeah, I've seen plenty of chronic pain patients get 'high' from meds, go to sleep when they receive it and all sorts of reactions.

I don't deny there are drug seekers. Of course there are, but I also have a problem with nurses and doctors who use that term. Too often it's applied inappropriately, and besides that--- chronic pain patients are 'drug seekers' too. Most anyone in pain is. Nothing wrong with seeking relief from pain.

I've found over the years that the behaviour of these patients can be abated by simply acknowledging their pain and letting them know I will medicate them as ordered. I think a lot of the behaviour we see is fear that no one will take them seriously or treat their pain.

My own personal pet peeve is how patients in sickle crises are treated. Whenever I hear someone call them "drug seekers" I go off.

[mysticbeauty_nbeast]

I don't agree that should be a 'litmus test' to determine if someone is actually in pain. We all handle it differently. Myself, the more pain I'm in the more I withdraw. I lie still, even try to sleep to escape it. Even if I'm not actually asleep, I appear to be to others. I drove myself to the ER with an incarcerated/strangulated bowel. I came very close to a colostomy with that one. I knew what was wrong (I could feel the loops of caught bowel just under the skin) and I calmly told the registration and triage people what was going on. I sat quietly, albeit a bit hunched over, while I waited for over an hour to be taken back for an exam. Even then, I could see they didn't believe me. It wasn't until I reacted to the rebound on exam that they begun to think maybe something was up, and took me for an emergent CT. I heard the surgeon mutter 'holy ****' while reading it. Only then did they offer me anything for pain.

:eek::eek::eek: Holy you know what is right! Dear Lord...what an experiance! Thank God you survived Em...frighting to be sure.

Been there and done that myself. Near ruptured appy...sat in the ER for two hours before anyone even laid eyes on me. :rolleyes: I too crawl into a silence...and wait. I got the same reaction that you did from the doctors when they figured out what was going on. You and I are not the norm however.

I've also been in the ER for RSD crises..which is very similar to sickle cell/ms crises symptoms. After 6 hours I was told to go home, take an aspirin..that the pain was all in my head. :rolleyes: My pain was so escalated I was barely able to speak, much less remain lucid for any length of time; my body shaking involuntarily due to sever muscle spasms and contractual pain. I think falling flat on the floor trying to walk out of the ER is what got them to relaize something more was going on. I hate ER's...such a nightmare.

Working with patients in pain over the years, I don't have a 'litmus test' to determine if it's real or not. And yeah, I've seen plenty of chronic pain patients get 'high' from meds, go to sleep when they receive it and all sorts of reactions.

I should have been more specific and clear in what point I was posting too.:redface: I was making the point that for patients who enters the ER expressing verbal pain..and how that specific hospital dealt with deciphering who was malingering and who was in actual pain. Once on the floor, different litmus is used by the standards of that floor. One thing I know for sure...sever pain when first relived is visually present in the relaxed/relaxing facial features of the patient and usually accompanied with an audible sigh of relief/stated relief.

I don't deny there are drug seekers. Of course there are, but I also have a problem with nurses and doctors who use that term. Too often it's applied inappropriately, and besides that--- chronic pain patients are 'drug seekers' too. Most anyone in pain is. Nothing wrong with seeking relief from pain.

I agree the term 'drug seeking behavior' is too broad brush. If one is in pain, then of course your seeking to relive it. I believe medical professionals use the term as a way to identify those who are not in actual pain,; yet are looking for/seeking narcotics. Makes it darn hard for those who are actually in pain to meet the criteria to prove out said pain.

I've found over the years that the behaviour of these patients can be abated by simply acknowledging their pain and letting them know I will medicate them as ordered. I think a lot of the behaviour we see is fear that no one will take them seriously or treat their pain.

I agree...In floor nursing this is especially true.

My own personal pet peeve is how patients in sickle crises are treated. Whenever I hear someone call them "drug seekers" I go off.

Western Medicine hardly has a handle on the ever growing population with chronic pain. Having had a chronic nerve pain condition for 14 years, I've run the gambit of every school of thought there is in the treatment (or non treatment) of said condition. It's maddening to be sure. The situation is only made worse by those who do abuse narcotics. California thought they had the situation beat by linking up all narcotic prescriptions vis a vie pharmacy data uplink...and in this, doctor shopping and multiple prescriptions for schedule 2 and 3 drugs would be reduced. Unfortunately, it hasn't put much of a dent in the problem.

As to the FDA considering taking out acetaminophen as a filler from NorCo, Vicoden, Percocet and other hydrocodone base meds is like trying to take aspirin off the shelves as an OTC. Tends to make me wonder what the FDA is trying to produce as an affect. I would think harsher restrictions on opiates would be a higher priority then regulating acetaminophen? Or even revamping our chronic conditions lists to support or weed out those who abuse scheduled drugs. I think about Anna Nicole Smith and recently Michal Jackson...the meds they were on with unscrupulous doctors writing for just about anything under the pharmaceutical sun...doing so for the money....now that seems more prevalent then deaths related to over consumption of acetaminophen.

~Mysty

[EmmanuelGoldstein]

:eek::eek::eek: Holy you know what is right! Dear Lord...what an experiance! Thank God you survived Em...frighting to be sure.

Been there and done that myself. Near ruptured appy...sat in the ER for two hours before anyone even laid eyes on me. :rolleyes: I too crawl into a silence...and wait. I got the same reaction that you did from the doctors when they figured out what was going on. You and I are not the norm however.

I've also been in the ER for RSD crises..which is very similar to sickle cell/ms crises symptoms. After 6 hours I was told to go home, take an aspirin..that the pain was all in my head. :rolleyes: My pain was so escalated I was barely able to speak, much less remain lucid for any length of time; my body shaking involuntarily due to sever muscle spasms and contractual pain. I think falling flat on the floor trying to walk out of the ER is what got them to relaize something more was going on. I hate ER's...such a nightmare. :(

I'm sorry you are going through that. Yeah, what happened to me was scary; I suppose I could have wailed and carried on but that's just not how I handle pain. I have chronic pain issues, but I refuse to see anyone about it. I know how medical people view people with chronic pain and I'm not going to subject myself to that. I deal with it, although I would like to know what it would feel like to go through just one day without pain. It's been so long I don't even remember what it felt like NOT to have pain.



I should have been more specific and clear in what point I was posting too.:redface: I was making the point that for patients who enters the ER expressing verbal pain..and how that specific hospital dealt with deciphering who was malingering and who was in actual pain. Once on the floor, different litmus is used by the standards of that floor. One thing I know for sure...sever pain when first relived is visually present in the relaxed/relaxing facial features of the patient and usually accompanied with an audible sigh of relief/stated relief. True. If I'd worked the ED, I'm sure my take on all of this would be different. As it is, I know that true drug-seekers are extremely difficult to deal with. As an example, had a 30ish year old guy who was "disabled" (never did figure out why) and was on a multitude of pain meds, including dilaudid and percocets. I was doing his admission, and his prescriptions were all gone... 3 weeks before he should have run out. To top that off, he had placed yellow MENTOS in the dilaudid bottle and tried to tell me they were 4mg dilaudid tabs :lol:

So yeah, I understand where you're coming from.



I agree the term 'drug seeking behavior' is too broad brush. If one is in pain, then of course your seeking to relive it. I believe medical professionals use the term as a way to identify those who are not in actual pain,; yet are looking for/seeking narcotics. Makes it darn hard for those who are actually in pain to meet the criteria to prove out said pain.

Very hard. There ARE objective signs, but (as I explained with myself as an example) they are different in everyone and otherwise pain is purely subjective. So what do you do?


Western Medicine hardly has a handle on the ever growing population with chronic pain. Having had a chronic nerve pain condition for 14 years, I've run the gambit of every school of thought there is in the treatment (or non treatment) of said condition. It's maddening to be sure. The situation is only made worse by those who do abuse narcotics. California thought they had the situation beat by linking up all narcotic prescriptions vis a vie pharmacy data uplink...and in this, doctor shopping and multiple prescriptions for schedule 2 and 3 drugs would be reduced. Unfortunately, it hasn't put much of a dent in the problem.

As to the FDA considering taking out acetaminophen as a filler from NorCo, Vicoden, Percocet and other hydrocodone base meds is like trying to take aspirin off the shelves as an OTC. Tends to make me wonder what the FDA is trying to produce as an affect. I would think harsher restrictions on opiates would be a higher priority then regulating acetaminophen? Or even revamping our chronic conditions lists to support or weed out those who abuse scheduled drugs. I think about Anna Nicole Smith and recently Michal Jackson...the meds they were on with unscrupulous doctors writing for just about anything under the pharmaceutical sun...doing so for the money....now that seems more prevalent then deaths related to over consumption of acetaminophen.

~MystyWell, it's a mess. I don't see where making it a schedule II would place undue hardship on the patients that truly need the meds; it may be a bit more of a headache for the prescribers.