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Patient in Severe Pain Suddenly Cut Off from Vicodin

Has the pendulum swung too far in the war on opioid pain relievers? Some docs are beginning to question what happens when a patient is cut off from Vicodin.

Much has been written over the last several months about the abuse of opioid narcotics. The FDA, CDC, DEA and other federal agencies have all been warning about opioid overdoses and deaths. But over the last three years opioid prescriptions have dropped in 49 states. What is rarely mentioned is what happens when patients in severe pain are cut off from Vicodin or other pain medication they have been relying on for years. Here is one such sad story:

Q. After much trial and error, my doctor and I finally found a medication (Vicodin) that helps my severe neck arthritis as well as my debilitating migraines. I had to change doctors when mine retired. The new one initially had no problem prescribing the Vicodin that I have been using cautiously for at least five years.

Then out of the blue, with no explanation, he said he would not give me any additional scripts for Vicodin and I had to find someone else who would.

I went to a rheumatologist who won’t give me Vicodin but is injecting me with cortisone and has given me three more prescriptions that I never had before and do not work. I have never abused Vicodin in any way. I feel that, like so many others, I am suffering because of the ones who do abuse opioids.

A. We have heard from hundreds of people like you who are in chronic pain that was well controlled on an opioid medication like hydrocodone (Lortab, Norco, Vicodin). When the DEA moved such medications from Schedule III to Schedule II it became far more difficult for people to get these pain relievers. Some found they were suddenly cut off from Vicodin or another hydrocodone-containing pain reliever because such drugs became too much of a hassle for some doctors.

Unintended Consequences of the War on Opioids:

The goal was noble: to prevent abuse and deaths from narcotic overdose. Other federal agencies have also come out against long-term opioid use for chronic pain.

As a result, many physicians have become reluctant to prescribe these drugs, even when patients are in excruciating pain.

What Happens When You Are Cut Off from Vicodin?

Unfortunately, there are not a lot of alternatives. NSAIDs like ibuprofen or naproxen can be useful in some cases but may not alleviate severe pain. They also come with their own serious side effects such as high blood pressure, heart attacks, strokes, kidney damage, fluid retention, heart failure, headache, dizziness, drowsiness, ringing in the ears and aggravation of asthma. It is not clear how many people die each year from NSAIDs but we would not be surprised if the number was substantially higher than that from opioid overdose.

Cortisone has its own complications. Osteonecrosis (death of bone) can cause severe disability. Such injections can also cause weakening of bones (osteoporosis) and tendon rupture. Pain and inflammation around a joint sometimes gets worse before it gets better.

Some Doctors Are Asking Questions About the Opioid Panic:

An article in SCIENCE WORLD REPORT notes that some people in severe pain have used opioid analgesics responsibly to ease their agony:

“Dr. Daniel Carr, the director of Tufts Medical School’s program on pain research education and policy said that the climate has definitely shifted. He explained that is now one of averseness, fear of consequences and impediment with administrative hurdles. He added that a lot of patients who need opioids have been caught up in that response.”

You may need to consult a pain specialist to see if there is a strategy that can help you function.

To read more about the problems other people have experienced because of the crackdown on opioid prescriptions, check out this link.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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