The People's Perspective on Medicine

Show 970: Health News Update on Hydrocodone and Vitamin D

Hydrocodone containing pain medicines have been reclassified to make them more difficult to access. How will this affect patients?
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Health News Update on Hydrocodone and Vitamin D

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Hydrocodone Painkillers

Last month, the Drug Enforcement Administration changed its classification of hydrocodone containing pain relievers. The new rules will make it more difficult for some patients to get their medications. What will they mean for you?

Movember

By now, everyone is pretty well aware that October is colored pink to draw attention to breast cancer. The idea is to raise money for research and awareness for screening.

November isn’t pink…but have you noticed a number of men in your circle growing mustaches? They may be participating in Movember, a movement to raise awareness of prostate and testicular cancer and men’s health.

Vitamin D

As we head into winter, people in most parts of the country will not be able to make vitamin D by exposing their skin to sunlight. The sun is too low in the sky, and anyway it is too cold to bare very much skin. So how do we get vitamin D and why should we care?

Call in your questions and comments at 888-472-3366 or email radio@peoplespharmacy.com between 7 and 8 am EDT. Or reach us via Twitter: @peoplespharmacy

This Week’s Guests:

David Kroll, PhD, is a pharmacologist and medical writer in the Research Triangle Park area of North Carolina. He blogs at Forbes.com and has written about the hydrocodone rule changes. The photograph is of Dr. Kroll.

Tieraona Low Dog, MD, is director of Fellowship for the Arizona Center for Integrative Medicine at the University of Arizona, and one of the country’s leading experts on the science of dietary supplements. Her latest book is Healthy at Home: Get Well and Stay Well without Prescriptions.

Listen to the Podcast

This show will first be broadcast on Saturday, November 15, 2014. The podcast of this program will be available on Monday, November 17, 2014. The show can be streamed online from this site and podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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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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I have been unable to obtain my prescription for hydrocodone-ibuprofen for 2 months now. Supposedly the manufacturer has it on backorder? B.S. They were probably threatened by the feds for making too much of it.
My pain specialist says it is the only drug that will help me. So I’m relegated to live in pain! TENS? been there, done that….USELESS. Biofeedback? Gimme a break.

Of course after 2 months there is no residual opiod in my system and my pain grows greater every day.

Thanks for nothing FDA!

have listened to your radio programs for many years. As far as sharing my problems, that will take some time – – will do so when I have the time. thanks for your great programs.

I am a big fan of your show and often refer patients, friends, and family to your site. However, I think the reporting on hydrocodone products going CII was biased.

Acute pain management should not be compromised by HCPs going to CII. You get a script for a 2 week supply as you leave the dentist, surgery center, or hospital, and take it to the pharmacy to be filled. Acute pain should not be treated with opiates for more than a month or so anyway. No issues there.

If a patient is in chronic pain and on long-term opiates, they need to be transitioned to a long-acting opiate, which have all been CII since they were put on the market. They also need to be seeing a pain specialist and looking at alternatives to opiate therapy, like biofeedback or TENS. This is basic stuff that we learned in medical and pharmacy school.

The main reason that the US dispenses so many more opiates that European contries is not because we have more chronic pain patients – it is due to diversion and abuse, pure and simple. As a hospital pharmacist, I cannot tell you how many problems I’ve seen with Lortab, Norco, Percocet, etc. It’s a scourge.

As one of my retail friend said on October 16th – I predict heroin sales will skyrocket!

When people do seek treatment for addiction, many of them are put on long-term opiate maintenance therapy, like methadone or Suboxone. I’m not sure that’s really a viable plan for the rest of a person’s life.

Interesting reading: “Previous research has shown that regional variation in use of prescriptions cannot be explained by the underlying health status of the population.”
http://www.cdc.gov/media/releases/2014/p0701-opioid-painkiller.html

Alternatives like TENS and biofeedback should be pursued is “basic stuff” that you “learned in medical and pharmacy school?” How can you be so sure that what you were taught was even remotely true? If you wish to get a sense of what I’m talking about, look for the interview on The People’s Pharmacy with Steve Feldman (a dermatologist). He’s also on the tube speaking at Forsyth Medical Center. As someone who lived with severe CNCP for 1.5 years, I can’t tell you how infuriating it is to be told that I need to “Butch up” (the LEO who called in).

I was equally infuriated when I heard this from Show 972: New Pathways to Overcome Chronic Back Pain (Dec. 4, 2014). The guest is Dr. Hanscom, an orthopedic surgeon who completed his residency in 1984. This is an orthopedic surgeon, mind you! 9 minutes in, he has this to say: “it was absolutely the most miserable experience of my life… it was a very, very humbling experience… I never could understand why people with back problems complained so much, and I really got humbled on that one.” Again, this is an orthopedic surgeon with over 30 years experience.

Given the startling ignorance displayed by Dr. Hanscom (until he experienced it for himself), and the epistemological problems that Dr. Feldman illustrates so amusingly, why should I trust the clinicians who treat me, much less you lecturing us about the “basic stuff” you learned in “medical and pharmacy school?”

I’m replying to Kevin regarding his buttock and leg pain. I suffered excruciating pain from this for months. After seeing many different doctors from many different specialties, I diagnosed the problem by doing a little internet research. It was something called Piriformis Muscle Syndrome. After several sessions of the correct Physical Therapy, I was pain free for the first time in months.

I am a registered nurse and am seeing first hand the frustrations of patients who need this medication, hydrocodone. According to your program there are 16,000 deaths per year from combined narcotic overdoses. However, again according to your program, there are 165 million prescriptions written for these each year. I am sorry for these deaths from overdoses, however compared to the scripts written, this isn’t that much of a problem. Obviously the DEA can not do math. The better option would have been to re-educate the prescriber (doctor).

I have been taking Vicodin for at least 15 years and have not needed to increase the dosage. If I do not take it, I have pain.

IS ANYONE taking Co Q10? I know it helped me (legs and mucles) a few years ago. If the person is older that 45, they should check with their doctor about this coenzime (it gives energy, protects the heart, and helps with legs and other areas of the body). also vitamin B12, Is just an idea, may be can help someone.

Last year I was having terrible pain in my left hip when I went to work as a substitute teacher. It was so bad that after about 6 hours I could barely walk, however the pain went away as soon as I went home and went to bed. I put up with this for about 6 months before I went to my internal medicine doctor and asked for help. Without doing any tests, he said it was bursitis, and told me to start taking one of the NSAIDS, which I was not willing to do. I asked if he could refer me for physical therapy and he did. I went and was diagnosed with bursitis and arthritis in my left hip.

After about 8 weeks of therapy Medicare stopped paying for the PT so I quit, but the inflammation was gone and it was summer. I am substituting again this year, but I have figured out how to prevent my pain. I began to realize that the pain was a result of sitting in hard chairs, so I finally bought a stability ball, which I use at my desk when online. I can sit for hours with no pain whatsoever. At work, I only sit in chairs with deep cushions and just bought an inflated portable disc cushion, that I take with me when I work.

Likewise, I have flat feet and have suffered miserably for years when taking long walks, longer than 1 mile. Nothing helped until this year when I saw Orthaheel shoes on TV. These have completely stopped the pain to the extent that on my vacation I was able to walk for hours with no pain. Now I only wear these shoes for all day use. BTW, I had even tried professionally made inserts and orthopedic shoes and they didn’t work at all.

I wonder if doctors and patients go to medications first before trying other methods of pain relief.

Why no discussion of Marijuana for pain?

I do not get to listen to your show until Sat. on WI public radio and so my comments do not make a difference. I have been on norco 7.5 325 for 7 years and I keep running out of my script because I have severe pain in my right buttocks and my right leg all the time. My point is I don’t think Drs. really care what your pain level is. I have lost two jobs in the last 5 years due to missed days work, and my marriage due to the constant complaining and me not keeping care of the family which I have five kids. So no I’m not leading a productive life because of pain.

I hope you know what is causing your pain. Is it from statin drugs to lower cholesterol or a back injury? I assume you are getting physical therapy or chiropractic care to alleviate the problem. But there are much simpler ways to get rid of the pain. All pain is caused by inflammation somewhere.
Try an enzyme supplement called “serrapeptase”. It literally eats up all the inflammation in your body, from carpel tunnel to severe arthritis. And it works. I noticed a difference in 3 days, but stay on it for a few months. You must take it on a completely empty stomach like 4 or 5am, but it was worth it. I am finally pain free. I still have the damage to my spine but there is no more pain. I am in pt now to get more mobility.

Listening to your show on the change in regulating pain meds. I am a patient in a pain clinic associated with a local hospital who gave myself a serious ulcer from taking OTC NSAIDs (ibuprofen) for my pain for years, it ended up putting me in the emergency room when it perforated. So NSAIDS really are not totally harmless. I have serious chronic 24/7 pain and am now taking a low dose opioid, NOT hydrocodone or oxycondone which by itself it’s not to effective but is effective when combined with Tylenol. So I am on that 24/7. I take pills becuase I can’t swallow capsules (long story having to do with the source of my pain) and they last about 5 hours so I have a scrip for about 90 a month.

Like one of the other callers, I am able to work because of this medicine, without it I couldn’t work. I have been on the same dose for a year and hope it will stay that way but realistically I know that the body will adjust to it so I will need a higher dose for it to work the same. That is a physiological process, it is not addiction, which is also a psychological craving. Believe me, I don’t crave this stuff and often keep working past when I’m supposed to take the next dose en end up in acute pain. I take it for pain. Period. I understand there is an addiction problem out there but there are also lots of people who need these medicines and take them responsibly and the meds are what make them functional!

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