Is that a monkey on your back or are you happy to see me?
December 13, 2016 3:07 PM   Subscribe

Well crap. I think I've become physically dependent on painkillers. Now what?

tldr; I've been on on oxycodone for 3 weeks, and when I stop taking them, I feel weird and awful and can't stop thinking about taking one to make me stop feeling weird and awful.

I've never really had a history with narcotics. When I had thyroid surgery some years ago, they gave me morphine pills. I took them for 2 days and switched to tylenol. When I had knee surgery 4 years ago, they gave me oxycodone. I took it for 3 days. I felt sick and awful for about 24 hours after, but was fine after.

I went to the ER for severe knee pain, the day after Thanksgiving. They shot me up with "the strongest narcotic we have", gave me a prescription for oxycodone w/ acetaminophen. - 5/325, and told me to see an orthopedist. I tried going without the oxycodone, but the pain was too intense (I have a very high tolerance for pain, but OMFG it was bad). I had been taking it 3 times/day. A week later, still in pain, still taking oxycodone, I saw the orthopedist, had an MRI, and scheduled for knee surgery 5 days later. Still taking oxycodone for the pain. Had the surgery, the surgeon gives me a prescription for oxy/acetaminophen 10/325. He jokingly says, "I'm going to give you a lot!" And he did. 60 tabs. He said I could double up if the pain was very bad. I did, twice.

Here we are a week later. Up until this past Saturday, I had been taking the 10/325 tabs 3x/day. I decided to skip Sunday because the pain had lessened. I took 10mg at 8pm Saturday night. I woke up at 10am on Sunday with an awful headache. By 2pm, I was really jittery and sweating really bad. Also had bad stomach cramps. There was some legit knee pain as well. So I take a tablet, and the sweating and headache stop. Around midnight, I take another to get me through the night.

Monday morning, I woke up with a bad headache again. I decide to try and wean, so I took one of the 5mg tabs. That makes the headache and cramps go away, but I was anxious the rest of the day. The headache returned in the evening, so I took another 5mg around 10pm.

I woke up this morning, sweating, bad headache, jittery, irritated, crampy. It's my first day back to work in a couple of weeks. I didn't take any pills in the morning. About a half hour after I got to work, the headache was worse, I was more shaky and agitated, sweat pouring down me. My vision feels blurred. I brought a single 5mg tab with me to try and get through the day. I took it, and within a half hour, I'm functional again.

So I think I'm dependent. To what degree, I don't know. What I do know is that when I go more than 8 hours without taking a pill, I start to feel awful. And when I take a pill, all the awful stops. There's no joy in it, no euphoria, but the awfulness stopping. I'm taking them to feel normal.

No where along the line did anyone ask me if I had a history of addiction to narcotics (I never have before). They just threw all these pills at me and even -encouraged- me to use them liberally. No wonder so many people are addicted to painkillers!

I don't even know where to start stopping this. I can continue weaning, but my brain keeps telling me, "please don't do that. just take the meds for one more day." Even quitting smoking felt very different from this. I keep thinking about taking these goddamned pills. When I get home, I'm going to take one. I'm sitting here at work, and all I've been able to think about is taking one. This is freaking me out, and I don't know where to start to make this stop. Outside of cigarettes, I've never experienced anything like this. Does anyone out there have any advice? Am I blowing this out of proportion?
posted by Cat Pie Hurts to Health & Fitness (21 answers total) 6 users marked this as a favorite
First thing to do is cut your pills in half and see if you can do at least one dose per day where you only use the half pill. If you can do that, start doing that with your other doses. Also know that the sweating and feeling clammy is just a side effect of the acetomenephin, not the opioid. (Assuming you're taking something like Norco.) Knowing that might help you feel less anxious when those symptoms appear. It's just your body's reaction to Tylenol, not some big sign of addiction.

Also know that these drugs cause anxiety and panic attacks, especially if you try to go cold turkey, so that's why I suggest the halved pills method above.

*IANYDoctor, just someone who's been on a lot of opioids for cancer this year.
posted by MsMolly at 3:16 PM on December 13, 2016 [7 favorites]

Your doctor got you hooked on the pills. Go talk to him about getting you off them.
posted by humboldt32 at 3:19 PM on December 13, 2016 [7 favorites]

Physical dependence - the signs you describe - and addiction are two separate things. Addiction is characterized by destructive behaviours and euphoria-seeking. You have not described addiction.

You can wean down from your current dose. Your doc will likely be happy to help you figure out a specific schedule, but basically, increase the time between doses each time, or slowly diminish the doses. The unpleasantness will fade. I promise.
posted by Dashy at 3:28 PM on December 13, 2016 [32 favorites]

It kind of seems like you're catastrophising. You were in pain, and you took pain pills. That is how it should work, especially after surgery.

Now you're in less pain, and should continue the efforts you've already started to wean off them (MsMolly's suggestions about half pills is a great one!). And you should talk to your doctors if you still feel this way after a few days of half-doses.

If it's really freaking you out, ask them to switch you to a different pain management program ASAP. There are forms of pain relief that are not as addictive/dependency-building as oxycodone.

Also remember that keeping yourself pain-free helps your body recover from the trauma of knee surgery. Adding even a small level of chronic pain is not ideal in getting your body through recovery. I would also suggest that blaming doctors for their patients becoming addicted to pills perpetuates negative stereotypes that affect millions of people with serious chronic pain. It's already becoming much more difficult for chronic pain patients to keep access to pain medication. Please be aware and sensitive to that as much as you can. While your pain is temporary and your body is physically dependent, there are tons of people for whom the pain is permanent and life-changing.

Good luck.
posted by guster4lovers at 3:31 PM on December 13, 2016 [37 favorites]

It's probably worth noting that this is unlikely to be a long-term problem. Physical withdrawal is only one of the diagnostic criteria for substance use disorders for good reason: most of the really difficult issues are psychological, not physiological. You have had an entirely healthy and appropriate psychological response to the symptoms you're experiencing, and you are taking action to address them.

The actual practical advice is very basic: speak to your doctor, although probably initially your usual doctor, who is familiar with your general history, rather than the specialist. Please don't worry that you're responsible for this. You are experiencing the side effect of a medication, and appropriately scheduled cessation of that medication, under supervision, will stop the side effect.

I'm sorry it's making you feel sick in the meantime though! Feel better soon.
posted by howfar at 3:31 PM on December 13, 2016 [2 favorites]

30mg isn't too much, you can kick cold turkey in 2-3 days, followed by a couple weeks of low energy and mild depression. You're alright... just don't talk yourself into increasing your dose to chase the high and you'll be fine.
posted by skintension at 3:35 PM on December 13, 2016 [1 favorite]

What helped me is 1) cutting the pills in half and 2) setting up a list on my phone, and writing down every. single. pill. When, what time, half or whole pill, and exact symptoms. It gave me at least an illusion of control, and I didn't have to think "too much don't take any more" but instead "I can wait two hours, even if I feel shitty." The time between pills lengthened, and I began to skip a day here and there, and looking at the list and seeing that gave me a really good feeling.

An important thing is to be kind to yourself while you're cutting down/then off. It's damn hard, and you can't be brave all the time. But you can pull away, and one day you haven't taken any for days. !!

Wishing you the best.
posted by kestralwing at 3:39 PM on December 13, 2016 [10 favorites]

I would do a controlled taper if I were you. I know some people use high doses of cannabis edibles to help with withdrawal symptoms, which will be particularly helpful if you find you can't do a controlled taper on your own, or that the withdrawals are still pretty terrible even with the taper.

I also might consult with a different doctor -- chucking oxy at someone in a cavalier fashion without being diligent about the risk of dependency is, um, not inspiring confidence.

You'll be ok. Opiod withdrawals suck, but they don't suck for that long.
posted by schadenfrau at 4:18 PM on December 13, 2016 [1 favorite]

I'm in the same boat right now, although I've been on them for 3 months post-surgery. I just saw my doc today and asked for a taper schedule for when I'm ready to get off them. FWIW< I took oxy a few years ago after surgery and was able to get off after a few weeks with just some basic tapering.

Agree that there is a difference between "addicted" and "dependent." You just need to step down slowly. You can't go from 30 to 0, or even 30 to 10, in 1 day. Don't beat yourself up! You're not like, about to start freebasing heroin in a crack house. Your brain is physically dependent on the meds, and you need to wean off slowly. You should ask your doctor about a schedule for stepping down.

I also agree with kestralwing that keeping track is really helpful. I am already using the MySymptom app to track other stuff, so I use it to track my oxy too.
posted by radioamy at 4:31 PM on December 13, 2016 [4 favorites]

From an anonymous commenter:
If it helps you feel better: I have chronic pain relating to a couple of conditions. I have been on round the clock opiates for a couple of years now for them, including a patch and breakthrough pain pills.

I have withdrawal if I quit cold turkey, sure. That's just a thing that happens. But I have not ruined my life or lost my job or any of that. Now, the thought of going through withdrawal? And knowing that if I just take the pill the symptoms will ease? I know that.

You can wean yourself off this stuff little by little. But since you are under the care of a doctor, who prescribed them, you should talk to them for help cutting down. As mentioned above, it may still be necessary for you to take them; pain will make healing take longer and being in constant pain is really not good for your body.

Try not to let the current opioid panic get to you too much. There are reasons to use these drugs. And know that yeah, just stopping taking them cold turkey right now is bound to be miserable, and probably not great for you. I hope you heal well and are able to get off the meds soon!
posted by restless_nomad at 4:31 PM on December 13, 2016 [22 favorites]

What's your caffeine intake like? If you have cut back, either purposefully or inadvertently, maybe now isn't the time. A lot of those symptoms are ones I get when I try to go caffeine-free cold turkey.

But otherwise, you'll get there. It'll suck a bit for a while but tapering down will help and one day you'll be through it. Best wishes for a speedy recovery.
posted by kitten magic at 6:17 PM on December 13, 2016

My dad is a doctor, and he says that the vast majority of patients taking opiates for pain do not get addicted, they are able to stop the medication when the pain has ended. You said your pain had lessened on the first day that you tried to quit cold turkey, so, I take that to mean you were still in pain? When my mother had knee replacement surgery, she tried cutting back on the pain med earlier than the doctor had prescribed (because of the side-effects of fuzzy-head/nausea/whatever) and the surgeon admonished her for it since her being sore was interfering with how much physical therapy she could do and added to her recovery time in getting released from the rehab hospital.

So, I agree with everyone saying you need to talk to your doctor about how to taper off, or getting a prescription for a different drug, not just up and quit out of nowhere, especially if you're still in pain.
posted by oh yeah! at 6:20 PM on December 13, 2016 [2 favorites]

Please contact your doctor. At the very least s/he should know about this - at the most s/he can recommend what to do to make it stop.
posted by Toddles at 9:15 PM on December 13, 2016

If I read your post correctly you are one week out from surgery. You really need to contact the prescribing physician/ surgeon about this. You are basically treating yourself at this point, and you're not doing a great job. Just because a Doctor gives you 60 pills doesn't mean they are being blasé about pain meds. You may need everyone of those pills to recover fully.

Please call your Doctor and talk to them about your concerns. Let them help you.
posted by cairnoflore at 10:47 PM on December 13, 2016 [6 favorites]

I just had knee surgery two months ago, and was careful with pain meds so I only have one suggestion. Are you drinking turmeric tea, by any chance? Because that shit almost sent me to the ER, thinking I had accidentally overdosed myself.
posted by raisingsand at 7:35 AM on December 14, 2016

This is a little off topic, but since doctors don't really explain anything about narcotics to their patients...they tend to make you horribly constipated. MiraLAX is the med you want to take.
posted by radioamy at 9:05 AM on December 14, 2016

Thank you, everyone, for all of the stories and advice; they are all very helpful. I'm a little less frantic this morning. Perhaps I am catastrophizing, as guster4lovers suggested. But this is a frightening experience for me, and what better place to do that AND get solid answers than the community that I trust most! Also, this stuff makes me incredibly hyper and amps my already existent anxiety.

For the record, I'm not beating myself up or feeling any shame. I don't think I'm "chasing a high". Who knows. My pain is minimal, with a few flareups that I expect ibuprofen to handle.

It also seems that I've used the terminology for addiction and dependance incorrectly. Now I know.

As for other meds, etc, I take levothyroxine and lamatrogine daily. I haven't changed my caffeine intake, and I don't take any non-standard supplements. In the first few pain days before the oxy, I had been using CBD to try to control the pain, to no avail. Going the high dose cannabis route won't work for me, because it makes me extremely hyper (I'm not a regular consumer of cannabis for that reason). I've tried all sorts of blends suggested to me by the friendly neighborhood collective.

radioamy - I really wish he had explained that to me. I deserve a trophy for my regularity. These drugs have thrown (what feels like) a wrench into things, to say the least!

I'm seeing the surgeon for a followup tomorrow. I will ask him about a tapering schedule. In the meantime, I'm going to continue taking the meds. Thanks, all!
posted by Cat Pie Hurts at 9:15 AM on December 14, 2016 [1 favorite]

If you find it difficult to follow a tapering schedule all the way to the end on Percocet (oxy/apap), you may want to consider asking your doctor to switch you to Vicodin (hydrocodone/apap) for that last little bit. It is a somewhat weaker opioid that has correspondingly somewhat lesser withdrawal symptoms, so some people find it easier to take the last step to zero after switching.
posted by wierdo at 12:30 PM on December 14, 2016 [1 favorite]

Wow, I am going thru this exact same thing right now, and it is god-awful. Short-ish version of my story, I had extreme hip deterioration and in so much pain I couldn't walk (I ended up getting a cane, and then a walker, and then a wheelchair) and needed total replacement of both hips. After the first surgery, I developed a mild infection in the wound site and had to go on IV and then oral antibiotics. Because of that, I had to wait a full year before having the second hip replaced. In that year I was on a 25 mcg fentanyl patch. I finally had the second surgery done at the end of October, and this time rehab has been a breeze. Right after surgery I contacted my PCP for a tapering plan - she gave me one month Rx at half my previous dose and then one more month at half that again. She very offhandedly mentioned I was probably going to experience some withdrawal symptoms.

I'm now on about day 2 of removing the last patch and yesterday I thought I would die. Sweating and chills, naseau, diarrhea, super anxious, and if felt like I had a skull fracture. I spent the entire day shaking in bed, praying for sleep. I am determined to just power through this because I did read that although severe, symptoms should only last a few days. I have some 5mg oxycontin tabs and finally took two of them last night around 6 p.m., and within a half hour felt like a relatively normal person again. I just don't want to keep taking those, either. I want this junk out of my system.
posted by Bretley at 3:06 AM on December 15, 2016

So, interesting thing. I got home from last night and was feeling so sick and shaky that I just crawled into bed. I had about 10 hours of very fitful sleep. I woke pretty groggy this morning, and forgot to take a pill. I was kind of groggy and achy all day, but didn't really think of taking another pill. I told my SO that I must have just made a big deal about nothing.

On the way to my doctor appointment this afternoon, I was hit with awful, awful cramps, a terrible headache and what seemed like a flu from hell. And pain in my knee. The doc took one look at me and asked if I had stopped taking the oxycodone. I told him. He just kind of sighed and said that he was sorry, but I must be going through withdrawal. He gave me a prescription for 10mg hydrocodone with instructions to cut the dose in half every day or two until I can comfortably stop. Said it shouldn't take longer than a week. He was really apologetic for not discussing it with me.

So, perhaps I did blow this way, way up. I know there are many people out there who have to deal with these things on a much larger and longer scale. It's been an critical lesson for me, and if I ever have to go through anything like this again, I have better tools to deal. I still think that medical professionals should be more forthcoming about withdrawal expectations, though.
posted by Cat Pie Hurts at 8:05 PM on December 15, 2016 [2 favorites]

A couple of observations:

- a week out from surgery you may still need the painkiller. I went through some orthopedic trauma years ago and discovered that pain doesn't always show up where and how you expect it. Not trying to enable more painkiller use than you need, but be aware you're still healing up.

- Doctor's advice is good, and yeah, they're notorious about not discussing this in advance - how to stop. Tapering off.

When I went through a bunch of surgery because I was in a wreck I progressed from enough morphine to nearly kill me to an IV drip to a handful of pills a day and got down to one little pill a day. And went through all that wind down with no problems.

And then I took the last little pill. And in a day I remember calling my wife who had gone off to run an errand and kind of finding it hard not to cry because she wasn't back yet.

A few months out I decided I wasn't managing the pain really well and my doctor prescribed a low dose of Tramadol. He prescribed 2 a day, but I only took one of those a day for a couple of years until I realized a) that I felt really awful if I missed a dose and b) listened to a podcast where they described heroin withdrawal as a worse version of what I experienced. I also felt they were making me feel a little emotionally withdrawn and lazy.

So I started stretching those doses out 24, 36, 48 hours over the course of a few weeks and eventually stopped.

posted by randomkeystrike at 9:14 AM on December 16, 2016

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