Currently it is very legal in all but three states in the U.S. to recieve Schedule lll narcotics (primarily hydrocodone) via the Internet (IOPs-Internet Online Pharmacies). According to recent federal tightening of the law, you are supposed to have submitted your medical records, proof of ID by fax, and spoke with an MD by phone; that of course is not always the case. The various sites follow the letter of the law with wide variation. While 11 states are currently in the process of formulating laws to try to ban the practice, state
law(s) thus far have had little overall effect on Internet businesses who evade state laws, not just IOPs.
Hydrocodone is now the fastest growing substance for which people in the U.S. seek detox and longer in-patient treatment; growing, according to the U.S. gov's own statistics, up 111% over the past four years. Numerous articles in NEJM, National Institute of Drug Abuse, and a host of others are trying to raise public alarm with only moderate success. It dosn't, of course, take a genius to figure out what part the IOP's play in this pandemic occurance. In the age of the information highway, doctor shopping is no longer required to maintain an addiction; for computer savy individuals with money to spend.
DB - Was there a recent announcement in the federal register that I missed? I thought Dihydrocodeine was a schedule II, meaning a written script is needed. I think there are loopholes in the CFR that currently allow internet sales in the USA. As long as a person has a license to dispense and drafts a script for schedules I and II (III's can be written or oral), keeps records for 2 years, and does not break any interstate commerce laws, it must be legal.
Eddie;
Hydrocodone, as a lone substance, which is not used here is the U.S., is a Schedule ll controlled drug. When hydrocodone is prescribed as a combination drug, i.e. along with Tylenol (Norco, Vicoden), or Ibuprophen (Vicoprophen) etc...which all are the most commonly prescribed current forms in the U.S., it is Scheduled as a C-lll substance, which allows it to skirt the much more stringent requirements of C-ll drugs. There is however, which you may be referring to, some legislation in Congress, which has not passed yet, (due to protest from you can imagine who) that would make even these combo drugs Schedule ll, much like oxycodone combo's are (Tylox, Percodan, Percocette, etc.) It remains to be seen who will win out on this one, but for the time being, they remain ( the hydro combo's) at the less regulated C-lll level. Making them eligible for IOP's to continue selling-for right know.
Thanks for the question.
Hydrocodone, as a lone substance, which is not used here is the U.S., is a Schedule ll controlled drug. When hydrocodone is prescribed as a combination drug, i.e. along with Tylenol (Norco, Vicoden), or Ibuprophen (Vicoprophen) etc...which all are the most commonly prescribed current forms in the U.S., it is Scheduled as a C-lll substance, which allows it to skirt the much more stringent requirements of C-ll drugs. There is however, which you may be referring to, some legislation in Congress, which has not passed yet, (due to protest from you can imagine who) that would make even these combo drugs Schedule ll, much like oxycodone combo's are (Tylox, Percodan, Percocette, etc.) It remains to be seen who will win out on this one, but for the time being, they remain ( the hydro combo's) at the less regulated C-lll level. Making them eligible for IOP's to continue selling-for right know.
Thanks for the question.
Dr. Bob,
I am just curious...have you ever been addicted to hydrocodone? I ask, in the most unsarcastic manner that I can. There is no sarcasm intended. I just am curious, because the hydro left me like a sick puppy. I don't fault the dr; I had an addiction. But I also have chronic pain. I must admit, though, the hydro left me pretty mentally shot after I got clean. I honestly feel like a fourth of what I was mentally, and I was on them for 3 years.
Can you please offer your medical opinion on this??
Do you have any medical opinion as to when I am going to feel like myself?
Kerry
I am just curious...have you ever been addicted to hydrocodone? I ask, in the most unsarcastic manner that I can. There is no sarcasm intended. I just am curious, because the hydro left me like a sick puppy. I don't fault the dr; I had an addiction. But I also have chronic pain. I must admit, though, the hydro left me pretty mentally shot after I got clean. I honestly feel like a fourth of what I was mentally, and I was on them for 3 years.
Can you please offer your medical opinion on this??
Do you have any medical opinion as to when I am going to feel like myself?
Kerry
Ok now that my secret is out to my Dr its ok for me to actually talk about this now.He asked me yesterday how many ultram I was takin per mth.I asked him legally?He looked at me and said"Come on know me its OK"So I told him he gives me sripts for 240+ I was buying 120 off line every month.Thats alot of freaking pills.He than asked what I pay online and I told him about 90.00 he asked how much I paid for his and I said .50 which is pretty messed huh????mj
Littlejean;
Yes, unfortunately I have "been there-done that!" Hydro is a real bear because in the begining w/ it you actually feel better; i.e more energy, no depression, mood swings, loss a little weight, choleseterol levels go down, and if your'e prone to alcohol, that tends to fade away too. Miracle drug, right?? Not quite. The bad part part comes later. Of course, the dose has to keep going up; at this point it is best to try to switch to Norco 10/325 (in the U.S., the least toxic combo available) to minimize to toxic effects from the Tylenol upon the liver, however that is not always an option for those not "closely aligned" w/ a MD, (unless you utilize Internet Pharmacies) Mental "clouding sets in, along with a slow shut down of bodily operations ( too long to mention-unless you up want details, it varys, rather male or female) and instead of percieved mental sharpness and physical aquity, the opposite ocurrs and the merry-go-round of maintianing an adequate supply to keep the addiction "comfortable" becomes paramount.
In my own case briefly, I moved on to morphine and the horrors associated with heavy use there. But, that is all over now, and I like to ckeck in from time to time on this board, and if there is some input I can offer to clear up some misconceptions, I like to do that. The main point is: opiate w/d will not kill you-it is not fun by any means, but it can be overcome, and their are several mechanisms, including medications (non-opiate), that can be implemented to assist w/ you success. There are also rather safe alternative out there for those living w/ pain that need to be addressed. Have you consulted a pain specialist (mentioning of course your addictive nature?)
I don't know what state you are in, but I hope this little microcosim of info helps, and let me know if I can be of any assistance-take care!
Yes, unfortunately I have "been there-done that!" Hydro is a real bear because in the begining w/ it you actually feel better; i.e more energy, no depression, mood swings, loss a little weight, choleseterol levels go down, and if your'e prone to alcohol, that tends to fade away too. Miracle drug, right?? Not quite. The bad part part comes later. Of course, the dose has to keep going up; at this point it is best to try to switch to Norco 10/325 (in the U.S., the least toxic combo available) to minimize to toxic effects from the Tylenol upon the liver, however that is not always an option for those not "closely aligned" w/ a MD, (unless you utilize Internet Pharmacies) Mental "clouding sets in, along with a slow shut down of bodily operations ( too long to mention-unless you up want details, it varys, rather male or female) and instead of percieved mental sharpness and physical aquity, the opposite ocurrs and the merry-go-round of maintianing an adequate supply to keep the addiction "comfortable" becomes paramount.
In my own case briefly, I moved on to morphine and the horrors associated with heavy use there. But, that is all over now, and I like to ckeck in from time to time on this board, and if there is some input I can offer to clear up some misconceptions, I like to do that. The main point is: opiate w/d will not kill you-it is not fun by any means, but it can be overcome, and their are several mechanisms, including medications (non-opiate), that can be implemented to assist w/ you success. There are also rather safe alternative out there for those living w/ pain that need to be addressed. Have you consulted a pain specialist (mentioning of course your addictive nature?)
I don't know what state you are in, but I hope this little microcosim of info helps, and let me know if I can be of any assistance-take care!
Hey Dr.Bob.
I was just wondering if you have heard of Xodol. It is even less toxic than Norco. It is 10mg of hydro and 300mg of tylenol. It is new and I know someone who takes it. Just wondering if you had heard of it. You are right hydro withdrawl isn't going to kill you but it is a bit*h coming off of. What medications do you think are good (non-opiate) to help with vicodin withdrawl???? Any suggestions? Rae
I was just wondering if you have heard of Xodol. It is even less toxic than Norco. It is 10mg of hydro and 300mg of tylenol. It is new and I know someone who takes it. Just wondering if you had heard of it. You are right hydro withdrawl isn't going to kill you but it is a bit*h coming off of. What medications do you think are good (non-opiate) to help with vicodin withdrawl???? Any suggestions? Rae
Dear Dr Bob can you give me any info on suboxone?I start it Monday and I'm trying to get as much info as I can....mj
Dr. Bob - I think you opened up "pandora's box" for yourself. Start an internet physician consulting service and you would make a mint.
Thanks for the info.
Thanks for the info.
Dr Bob, if you are really, truly a doctor, you may just become the most popular person on this website!! LOL
You could help so many people on here and would be doing such a good thing by offering advice and knowledge to others going through this rough time.
You could help so many people on here and would be doing such a good thing by offering advice and knowledge to others going through this rough time.
Hi All:
Unfortunately, (or fortunately!) I have neither the time or the inclination to make a mint off of people's suffering, but I have had a few days away from "work," and personal experience w/ this medical problem (that's what it is) so I will try to answer a couple of the questions.
*The first drug you mention w/ the 10/300 combo of Hydro/Tylenol is another "attempt" by the industry to reduce the toxic effects of liver damage associated with long-term high doses of Tylenol, by those w/ addiction problems. It differs little from Norco 10/325. By federal law here in the US, an MD can write an order for a "formulated" dose so long it that contains at least 15mgs of another drug, per 100mg of Hydro, usually Tylenol along w/ the Hydro, but that is rarely done
*The most common anti-withdrawal drug utilized by detox centers and those knowledgable folks at home is still Catapres or clonidine (generic name), a rarely used blood pressure med from the 1940's. It was discovered in the 60's (they still don't know why) to block many of the major effects of opiate withdrawal in humans. This generally is used in conjunction w/ other meds to support the patient during the worst of it; about 7-10 days for hydro, oxy, & morphine, and up to 21 days for methadone.
*Suboxone and Subutex (C-lll) are newly approved (2002) meds for opiate withdrawal that contain an active opiate (Subutex, has only an opiate agonist and is used only in the first few days) and Suboxone (used afterwards for detox and maintainence) also contains a drug called naloxone hydrochloride, a narcotic antagonist; in other words it blocks the effects of the agonist narcotic drug if you take too much of it, or try to inject it, with rather unpleassant effects.
Naloxone can be prescribe independently to well motivated patients as well. It is non-addicting, non-psychoactive, and serves to block the effects of narcotics if you "slip." Brand name is Revia, and it was also approved in the 1990's for alcohol addiction. It does not block the effects of alcohol like it does narcotics, but people tend to experience much less pleasure from the ingestion of alcohol, thus tend to drink less. It operates in the "pleasure/reward" center of the brain.
If you have no real serious pain issues, total abstainence ffrom opiates is probably the ultimate goal, but if you do, or have failed repeatedly to quit completly this may be the route to go. I would not recommend Methadone Maintenance except as a last resort. Only licensed Addictionologists (or approved others) can prescribe Subutex or Suboxone. Check your yellow pages (or Web-search for "Suboxone Physician Locator") for "Addictionology" under medical specilaties. (I am not certified as such, just a plain old Dr.) Be forwarned however, that they (Addictionologists) are not common, and many have long waiting lists; access to them maybe best accomplished via licensed medical detox hospitals in your area.
Good luck-it can be done, and is every day!!
Unfortunately, (or fortunately!) I have neither the time or the inclination to make a mint off of people's suffering, but I have had a few days away from "work," and personal experience w/ this medical problem (that's what it is) so I will try to answer a couple of the questions.
*The first drug you mention w/ the 10/300 combo of Hydro/Tylenol is another "attempt" by the industry to reduce the toxic effects of liver damage associated with long-term high doses of Tylenol, by those w/ addiction problems. It differs little from Norco 10/325. By federal law here in the US, an MD can write an order for a "formulated" dose so long it that contains at least 15mgs of another drug, per 100mg of Hydro, usually Tylenol along w/ the Hydro, but that is rarely done
*The most common anti-withdrawal drug utilized by detox centers and those knowledgable folks at home is still Catapres or clonidine (generic name), a rarely used blood pressure med from the 1940's. It was discovered in the 60's (they still don't know why) to block many of the major effects of opiate withdrawal in humans. This generally is used in conjunction w/ other meds to support the patient during the worst of it; about 7-10 days for hydro, oxy, & morphine, and up to 21 days for methadone.
*Suboxone and Subutex (C-lll) are newly approved (2002) meds for opiate withdrawal that contain an active opiate (Subutex, has only an opiate agonist and is used only in the first few days) and Suboxone (used afterwards for detox and maintainence) also contains a drug called naloxone hydrochloride, a narcotic antagonist; in other words it blocks the effects of the agonist narcotic drug if you take too much of it, or try to inject it, with rather unpleassant effects.
Naloxone can be prescribe independently to well motivated patients as well. It is non-addicting, non-psychoactive, and serves to block the effects of narcotics if you "slip." Brand name is Revia, and it was also approved in the 1990's for alcohol addiction. It does not block the effects of alcohol like it does narcotics, but people tend to experience much less pleasure from the ingestion of alcohol, thus tend to drink less. It operates in the "pleasure/reward" center of the brain.
If you have no real serious pain issues, total abstainence ffrom opiates is probably the ultimate goal, but if you do, or have failed repeatedly to quit completly this may be the route to go. I would not recommend Methadone Maintenance except as a last resort. Only licensed Addictionologists (or approved others) can prescribe Subutex or Suboxone. Check your yellow pages (or Web-search for "Suboxone Physician Locator") for "Addictionology" under medical specilaties. (I am not certified as such, just a plain old Dr.) Be forwarned however, that they (Addictionologists) are not common, and many have long waiting lists; access to them maybe best accomplished via licensed medical detox hospitals in your area.
Good luck-it can be done, and is every day!!
FYI Dr Bob for me the suboxone is my final hope.I am up to 15-16-17 ultram per day.I have fought with myself everyday for the last 2-3 years.You know all those excuses we make...I'll start tapering tomarrow etc.I just(dahhhhh)realized how close I am comming to deaths door and I'm not willing to die.37 is too darn young!!!!Thank you for the info.I have to star Tuesday because the pharmacy I use doesn't get any in until late mon nite.Take care..mj
It is incredibly easy to buy pain meds online. In fact, that's when my spiral into physical and financial hell began.
About 5 years ago, my sister told me to go to some sites that sell pain meds. I've been ordering ever since, to the tune of a $15,000 credit card bill.
Not all of it is for pain meds, a bunch of it is from shopping when high and buying stupid crap I didn't even need.
About 5 years ago, my sister told me to go to some sites that sell pain meds. I've been ordering ever since, to the tune of a $15,000 credit card bill.
Not all of it is for pain meds, a bunch of it is from shopping when high and buying stupid crap I didn't even need.
Addict Mom.......LMAO........I can so relate! When I was high, also on pills bought online, I loved to shop. And I loved everything I saw so I bought VERY MUCH. When I got clean and looked around my house and in my closet I was disguisted!! Had no idea where all the useless crap came from. I have given away more stuff to Goodwill in past 6 weeks than ever in my life. LOL!! My husband knows that just one of the many benefits of my recovery is that the shopping will curtail dramatically.
Nice to meet you. Welcome to the board. I have only been here a few weeks but have gained very much from the people here. I wish you much luck if you are trying to quit. You have come to the right place for help and support! Let me know if I can be of help.
Dr. Bob,
I'm glad you came and cleared some of that stuff up. Thanks for
your info. I, like some others, am having my times with Oxy
and Vicodin. My doc wants me to take Oxy scheduled bid and Vicodin for breakthrough pain tid. He is happy to raise the dose to whatever I need.
The last time he saw me he wrote scripts for 3 months and it was Thanksgiving and I lost them. I have had a stroke and my memory is not so good at times. He knows this. When I called him he refused to write the scripts again and told me I'd just have to withdrawl and go to er if I had problems. The thing that got me was I really did lose them. I know that is bad but it was an honest mistake. I have been his patient for 2 years. Plus I have never ever abused them or my scripts. Luckily I had my primary care doc who doesn't write for my pain meds. think he was insane and definately did not want me to go through withdrawl because I lost my meds. ... so she wrote for me until I go back to him.
I've played pain control his way for awhile and had the worst withdrawls ever when I just decided I wasn't taking them anymore. I never got high on my meds. but my withdrawls were brutal. Twice.
So now I have been taking the Vicodin not the Oxy and of course my body wants more. I take up to 3/day. I would take more but I know the outcome. I even tried taking an Oxy here and there and no Vicodin and I just felt tired.
My pain control is not controlled and I'm trying to look at all the alternatives for this most frustrating experience. I have neurogenic pain and hypersensitivity from the stroke but I also can barely walk at times from an accident which demolished my right leg. I've had about 5 surgeries to reconstruct.
I wish my docs could have given me Catapress when I withdrew for my Htn. I saw them as it was out of control and they knew why. Instead I ended up chasing it with what I was taking and that was virtually impossible because they were long acting meds. I also took HCTZ but that wasn't so great cuz I was dehydrated already. I learned the hard way. So next time I will be fully armed for withdrawl. I thank you for taking the time to help us. The information might help me when I try to find a new pain doc to assist me.
I'm also interested in Cymbalta for the neuro pain. So we will see. I long for the day we can take something effective and nonaddictive to help with pain.
Thanks,
PM
I'm glad you came and cleared some of that stuff up. Thanks for
your info. I, like some others, am having my times with Oxy
and Vicodin. My doc wants me to take Oxy scheduled bid and Vicodin for breakthrough pain tid. He is happy to raise the dose to whatever I need.
The last time he saw me he wrote scripts for 3 months and it was Thanksgiving and I lost them. I have had a stroke and my memory is not so good at times. He knows this. When I called him he refused to write the scripts again and told me I'd just have to withdrawl and go to er if I had problems. The thing that got me was I really did lose them. I know that is bad but it was an honest mistake. I have been his patient for 2 years. Plus I have never ever abused them or my scripts. Luckily I had my primary care doc who doesn't write for my pain meds. think he was insane and definately did not want me to go through withdrawl because I lost my meds. ... so she wrote for me until I go back to him.
I've played pain control his way for awhile and had the worst withdrawls ever when I just decided I wasn't taking them anymore. I never got high on my meds. but my withdrawls were brutal. Twice.
So now I have been taking the Vicodin not the Oxy and of course my body wants more. I take up to 3/day. I would take more but I know the outcome. I even tried taking an Oxy here and there and no Vicodin and I just felt tired.
My pain control is not controlled and I'm trying to look at all the alternatives for this most frustrating experience. I have neurogenic pain and hypersensitivity from the stroke but I also can barely walk at times from an accident which demolished my right leg. I've had about 5 surgeries to reconstruct.
I wish my docs could have given me Catapress when I withdrew for my Htn. I saw them as it was out of control and they knew why. Instead I ended up chasing it with what I was taking and that was virtually impossible because they were long acting meds. I also took HCTZ but that wasn't so great cuz I was dehydrated already. I learned the hard way. So next time I will be fully armed for withdrawl. I thank you for taking the time to help us. The information might help me when I try to find a new pain doc to assist me.
I'm also interested in Cymbalta for the neuro pain. So we will see. I long for the day we can take something effective and nonaddictive to help with pain.
Thanks,
PM
PM,
Hey I was just reading your story, sounds like you have been through a lot with pain and meds.I hope you will find something that will work better for you oneday! I saw where you said you wished you had catapress patches to help for your withdrawl. Well everytime I have withdrawn from either Methadone or hydro I have had catapress(clonodine). I personally really don't think it really helped that much. It may have kept my blood pressure stable after withdrawling from the methadone and all but I never thought it really took a way any pain. Although they have catapress 1,2 and 3 and I usually had the #1 and 2. Boy they are expensive too. Anyway just thought I would say that. Hope you have a great New Year. Rae
Hey I was just reading your story, sounds like you have been through a lot with pain and meds.I hope you will find something that will work better for you oneday! I saw where you said you wished you had catapress patches to help for your withdrawl. Well everytime I have withdrawn from either Methadone or hydro I have had catapress(clonodine). I personally really don't think it really helped that much. It may have kept my blood pressure stable after withdrawling from the methadone and all but I never thought it really took a way any pain. Although they have catapress 1,2 and 3 and I usually had the #1 and 2. Boy they are expensive too. Anyway just thought I would say that. Hope you have a great New Year. Rae
Hey Rae, and how are you today?
Danny "see, it rhymed" OB343
Danny "see, it rhymed" OB343
Hey Danny,how is your new years day going? A couple of friend are coming over and we are going to cook-out and play some 90's trivia. So that is about it. I have to go to TIA tomorrow to pick up my daughter, she is flying home from her visit in Ohio with her other side of the family. So one more night of peace before the teenager gets home,LOL. I'll be back on later this evening. Talk with ya later!!! Rae-
Ps. Yeah your a poet and didn't know it!!!!ha-ha
Ps. Yeah your a poet and didn't know it!!!!ha-ha
Hey Rae,
Thanks. I don't think the Catapress would help the pain much unfortunately. For me though my bp was through the roof! I really should have gone to detox or the ER cuz my bp was like 190/120 and higher. It was horrid as I already have HTN. In my case, with my hx, I was really sort of stupid cuz I put my life at risk. Thank God for Sharon, Kat, Carrie, and Rus who were always asking me about it and watching it with me.
Love,
PM
Thanks. I don't think the Catapress would help the pain much unfortunately. For me though my bp was through the roof! I really should have gone to detox or the ER cuz my bp was like 190/120 and higher. It was horrid as I already have HTN. In my case, with my hx, I was really sort of stupid cuz I put my life at risk. Thank God for Sharon, Kat, Carrie, and Rus who were always asking me about it and watching it with me.
Love,
PM
Rae- I'm a poet and didn't know it and my feet are Longfellows!
