The War on Vicodin Abuse and the Collateral Damage it Causes

dr house vicodin

Thanks to FDA ,the State of Ohio, and lawsuit-fearing medical practitioners, my pain medication now has less acetaminophen in it and costs 125% more.  Until this year, my doctor was able to write me a prescription for Vicodin with a 7.5/750 strength. If I take four of these a day, I am still 1,000 milligrams under the FDA’s recommended maximum daily dose of acetaminophen. The maximum dose my doctor can now prescribe is 7.5/325.

As you may know, we have an opioid epidemic in this country. Well, actually that is not correct. We have an Acetaminophen (Tylenol) epidemic. When people hear of someone overdosing on Vicodin and dying, they wrongly assume that the death was caused by the Hydrocodone part of the prescription. While taking too much Hydrocodone can suppress a person’s respiratory system and kill them, it is often the Acetaminophen that actually kills them.

If you watched Dr. House, you know that Gregory House (Hugh Laurie) was addicted to Vicodin, He was shown taking the drug by the handful. Every time I saw House down a handful of Vicodin I would laugh, knowing that in real life if he made a habit of downing that much Vicodin (along the booze he loved to drink) his liver would have quickly failed and he would have died.

People like me, who are chronically ill and have to deal with chronic, unrelenting pain on a daily basis, are often frustrated by our doctors and government treating us like we are drug addicts. We don’t abuse the drugs, we don’t pharmacy shop, we take them as prescribed, yet, because pill popping junkies are killing themselves, we have to suffer the consequences.

My doctor prescribes both of my narcotic medications with one refill. This means I have to go to his office every two months to get my prescriptions refilled. When I factor in the cost of the cost of the office visit, I am actually  paying $225 for a two month supply of two cheap generic pain medications.

This is how life works, isn’t it? Those who play by the rules and act responsibly end up paying for those who won’t. I recognize that opiates need to be regulated and controlled. I know they are, in the wrong hands, dangerous drugs that can kill someone if they are abused or misused. But must everyone be treated like they are an addict looking to score some vikes/hydros? In this modern day of technology and digitized medical records, surely pharmacies and doctors can track opioid use and easily know who is abusing the drugs and who is not.

Comments (18)

  1. Becky Rogers Wiren

    My son Henry can’t get any good pain killers. Even though he has been diagnosed with fibromyalgia, he is “too young.” Never mind that if he was out of pain he might be functional. Oh, and they are willing to perform a procedure that costs $20,000 to burn nerves, but not give him pain meds! Come on. All chronic pain sufferers are paying for this. Sorry to hear this about you Bruce. :(

    Reply
    1. Bruce Gerencser (Post author)

      One of the problems with Fibromyalgia is that “experts’ say that narcotics don’t help Fibromyalgia sufferers. This become an accepted “fact’ so doctors refuse to prescribe the drugs. I had the same problem with the dentist, needing more Novocaine than most people to totally numb a tooth. I’d say, look I take a lot more Novocain than most people. Dentist ignores Bruce, Bruce hollers because tooth is not numb, dentist gives Bruce more Novocaine. I later found a study that had been done that showed people with red hair often require more Novocain, anesthesia, etc. Printed it off for the dentist and now the top of my chart says, patient requires more Novocain than normal. :) I wanted to write, No shit, Sherlock! :)

      These human bodies of ours are quite complex and what works for one may not work for others. This is why medical professionals need to try different things, be creative, even when the status quo says it won’t work. It took me years to get a proper drug regimen worked out. It works.

      Reply
  2. john

    Hello Bruce , actually there is a way for pharmacies to track opioid abuse and early refills , at least in Texas and Louisiana (the 2 states in which I own a license). Price shop for pharmacies for a better price on 7.5/325 , I wasn’t aware the price had increased that much. And more bad news— the dea has made hydrocodone a Cii.(don’t know when that starts) So at a future time it will be even harder for doctors to prescribe.

    Reply
    1. Bruce Gerencser (Post author)

      Yeah, I saw that. :(

      Reply
  3. amimental

    I have been on a prescription pain medication for a few years thanks to a failed ACL replacement… the pain has been the cartilage of my knee wearing away day by day. My doctor prescribed it. I take as little as possible. I refill when I run out. And because Oregon has a prescription drug monitoring program, there’s a little blurb on the bottom of the printout that comes with my refill every month. “Apparent misuse.”

    Okay. Prescribed by doc. Taken as directed.

    I’m so tired of stupid people thinking they know what’s better for us than we do. “Affordable” care act, ‘war’ on drugs.

    Yeah. Fuck those guys.

    Reply
  4. Kat

    Those who play by the rules and act responsibly end up paying for those who won’t. I recognize that opiates need to be regulated and controlled. I know they are, in the wrong hands, dangerous drugs that can kill someone if they are abused or misused. (My emphasis.)

    I understand the anger directed at the “few bad apples” that spoil the barrel for everyone else — I have several friends/family members who suffer from chronic pain, and it can be very frustrating for them to get what they need. I also had a friend who had chronic, crippling, migraines, who did anything and everything possible to avoid going to the ER, but sometimes she just had to go…and was treated like a criminal for requesting narcotics. Never mind what her doctor wrote in her charts…

    But what most people don’t understand is that opioid “junkies” are overwhelmingly not weak-willed, lazy hedonists that are just looking for their next high for fun. They have an actual physiological disorder of the brain — substances many people can take responsibly and safely are addictive poison to them. Their brain receptors are overwhelmed by the chemicals that provide relief/pleasure, which causes their brains to produce less of its natural pleasure neurotransmitters, causing the crash when the drug wears off. They need more to achieve the same level of relief/pleasure, and the stress of the crash actually seems to affect which centers of the brain are triggered in the craving/searching for the drug that will provide relief, switching the decision from the frontal lobes (the more evolved section of our brain usually involved in decision making) to the amygdala, sometimes known as “lizard brain,” which is part of our more primitive flight/fight/freeze response. When a person has become addicted to a substance, they are literally not thinking right when they seek out the next fix.

    I encourage everyone to read the article linked below, to gain a better understanding of addiction in general and the people prone to it.

    http://debbiebayerblog.com/2014/02/04/phillip-seymour-hoffman-did-not-have-choice-or-free-will-and-neither-do-you/

    The above is a blog post, written, initially, for the blogger’s friends, so does not have footnotes or links (Though she is thinking of re-writing it in a more scholarly form now that it’s gone viral). For articles from scientific or medical sites, see:
    http://www.drugabuse.gov/publications/topics-in-brief/drugs-brains-behavior-science-addiction
    http://www.helpguide.org/harvard/addiction_hijacks_brain.htm
    http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1695257

    Reply
    1. Bruce Gerencser (Post author)

      Thank you for mentioning this. When I wrote this post, I thought, this is going to sound like I am attacking drug addicts. I didn’t mean to do so, after all my Mom was a prescription drug addict for many years, as was one of my sons. I know what these drugs did to them. But, at the same time, I am frustrated that I am being treated like a drug addict, when nothing in my behavior gives them reason to do so.My wife has a similar problem at work. An employee does _______________ and pretty soon her boss puts a notice castigating EVERYONE for what one person did. I think this is what is going on with narcotics. Yes, we have a problem, but rather than deal with the problem and get the addicts help, we make things harder for those who use the drugs as prescribed.I readily admit, after years of taking pain meds, that I am physically dependent on the drugs. Every so often, I will stop taking the drugs so my body can reset itself. Not taking the drugs for a week can be hell. Ironically, stopping Tramadol is much harder on me than stopping Vicodin.

      Reply
      1. Kat

        Hey, Bruce: It looks like my comments are being moderated again. Is this a mistake, or did I overstep some bounds and didn’t know it? :-(

        Reply
        1. Kat

          Or maybe it happens when I post a lot of links? I noticed this post isn’t being moderated. Oops… ^_^;

          Reply
        2. Bruce Gerencser (Post author)

          Nope. You are definitely on my good list. :) You had four links. Any post with more than three links goes to moderation.

          Reply
          1. kat is dreaming

            Heh. I will remember that. Sorry — I get link-happy sometimes. ;-)

          2. Bruce Gerencser (Post author)

            It is OK to have more links, it just means there will be a delay in the comment showing up. Ismellarat’s comments end up in moderate quite frequently due to this. :)

  5. gimpi

    Most of these well-meaning but harmful regulations are written by healthy people who just don’t understand diseases that can be managed, but not cured. Pain can sometimes be controlled, not eliminated. But our puritan ethics are uncomfortable with just easing pain. If the treatment doesn’t cure the underlaying condition, it’s regarded with suspicion.

    I’ve had people express dismay that I take a couple of drugs (Enbrel and Methotrexate) to control the damage from my rheumatoid arthritis. These drugs don’t cure the disease. They don’t even manage the pain. They (hopefully) prevent some of the joint-damage that RA causes. And people just don’t get it. They ask when I’ll be “cured.” They call my medication “an addiction.” (They are especially wigged out because these medications are taken by self-injection in my case. I’m “shooting-up.”) They regard any treatment that does not eliminate the disease as “a crutch.” My response, “My mother need crutches. They allowed her to walk for years. What’s wrong with a crutch, if it helps you?”

    Pain medication is a necessary part of treating many conditions. And being treated with suspicion for needing that medicine makes the condition more painful.

    Reply
    1. Bruce Gerencser (Post author)

      Correct. I get soooo tired of people asking me if I am getting better. No, I am not and I will never be “better.” This is why it is called CHRONIC illness and pain. The best I can hope for is to manage the symptom so I can live as productive of a life as possible.

      Reply
  6. kittybrat

    You people have eloquently stated my own thoughts and experiences on the subject. Kat, for example, is spot on in her explanations about what is occurring inside the brain of a person who craves the opiates.

    That said, it is the people who need the medication for physical pain who are suffering as a result of the doctors over-prescribing these medicines, rather than providing them for those who need them. For example, after I had my hysterectomy, I was in a lot of pain. The physician prescribed Percocet. Although it helped me during the daytime, I cannot sleep on Percocet, so I asked for Darvocet at night. The doc kept arguing with me that it wasn’t as strong. I told him I didn’t care, because it was all I needed at night to sleep. The Tylenol PM was not doing it, and the Percocet kept me awake. He wanted to give me a stinger alternative. Finally, he gave in. You cannot even get Darvocet anymore, but it was one of the better, less addictive drugs. (I know, it was an acetaminophen problem, but don’t these other drugs have that same ingredient, as Bruce mentioned?)

    So, for chronic pain that does not get cured, these meds are vital. Yet, everyone is treated with suspicion, when, clearly, the addictions are due to a particular subset of the population not being able to handle them. A subset.

    The overdoses happen often because people are not remembering how many pills they took. I know when I am on heavy meds, I have to write them down or keep them in sectioned containers, because I forget that I have taken one and will go to take another, otherwise. So, even though these are prescribed for legitimate pain, those who take the pills on a temporary basis often are the ones who O.D.

    The prejudice of the profession making medical staff suspicious of people seeking pain relief causes deaths, too. My good friend, Johnnie Bee, had a lot of pain in his legs, which he attributed to arthritis. However, when it got really bad a few years back, he gathered up some money and saw a physician. Physician told him to take over the counter Motrin. Johnnie Bee has long hair, by the way. The pain got so bad, Johnnie found himself at the E.R. several times wracked in pain, but accused of drug seeking. He told the staff that he could find pain medications himself, on the street, but please find out what was causing the pain. After 5 or six times, he finally found a doc at the hospital clinic that was willing to do tests. He sent Johnnie to the hospital E.R., with instructions in the chart to admit. But the E.R. docs were about to send him home for seeking, when an intern spoke up and got them to heed the docs orders.

    Johnnie, it turns out, was suffering from bone cancer, and by the time it was finally diagnosed at this particular hospital stay, he was at stage 5. He wept for his poor mother, and within a few months, he died. Yeah, I know it’s a downer, you guys, but this is fucking serious. People are being ignored because of the medical profession’s high headedness in not taking pain seriously.

    OK, rant over.

    LOVE to you, Bruce, and all of you who need these medications to make life a little more bearable. We must fight back.

    Reply
  7. Dale

    I hear you, Bruce. I have to go to my doctor’s office every month to pick up a written prescription now. Until November 1 of last year in Okieland, the doc only had to call it in and as long as I went in for my DEA-mandated 90-day checkup, everything was fine and dandy. Shame on me for having a herniated disc, cervical bone spurs, and sciatica that wakes me up every morning around 3 am.

    Reply
  8. plutosdad

    I had the exact same problem with my pills for a kidney stone. I get frequent headaches and take excedrin, so I can’t take a bunch of acetaminophen for some chronic problem or else I can’t take the excedrin.
    When I asked for the hydrocodone with less acetaminophen they said “why do you want the STRONGER one?” I explained why and the nurse did not seem to believe me until I explained I did not want the STRONGER hydrocodone, but the WEAKER acetaminophen, and finally her response was “then don’t take any excedrin” Augh! No I can’t work if I have a horrible headache. i finally got the doctor to write the script I needed.

    it’s like there are people that think pain is good and purifying and just don’t want to help you avoid it, or they look down on you if you do want to avoid pain.

    Due to that, I am not sure we are paying for what addicts do. Rather we are paying for the disgust the average “moral” person holds for addicts. If we had a sympathetic view of addiction we might not have to jump through so many hoops, since we would not be so obsessed with stopping them via so many laws, or actually help them so addiction could be managed and less destructive. Or similarly if we did not practically worship pain in the West we might have fewer hoops as well.

    Reply
    1. Becky Rogers Wiren

      I think you’re right. Many, many of the people who don’t suffer make moral judgments on those of us who do. :(

      Reply

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