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View Full Version : Percocet and Lortab being banned? Finally a possibility?



insaneike
07-01-2009, 08:58 AM
http://www.npr.org/templates/story/story.php?storyId=106134002

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/30/AR2009063004228.html

or just type in "banning acetaminophen containing drugs" into google.

Last night I heard on TV something about trying to ban Percocet and Lortab, or acetaminophen containing prescription drugs in general. Or at least lowering the dose of acetaminophen. I'm hoping maybe they finally see what so much acetaminophen can do to a liver! Hell I have personally been prescribed 11 Norco(hydrocodo/apap) 10/325mg a day, 330 tabs a month, for well over a year! Which is a fair bit of acetaminophen! I of course didn't take that many(as if hydroco would help me in the least to start with) but the docs sure intended on me taking said amount.. I also know MANY ppl who receive scripts from their pain dr.s like this, At the moment I know at least 3ppl who receive 10 hydrocodo/apap 10/325mg tabs a day, and that is too much acetaminophen in one day, EVERY DAY to me. It would be fine for most ppl now n then, but every single day can't be good over a couple years!

I'm just praying they finally remove percs n lortab from pharmacies. Plus half the time those fucking drugs give pain docs a reason to say "well we gave you a scheduled narcotic for your pain, what more do you want". Maybe if they were banned them docs couldn't throw percs at us thinking "well we give you a narcotic for your pain, we can't do nothing else".and maybe just maybe start giving ppl who really need releif something besides a couple fucking percocet everyday! I can only hope the pharms of America could some day be ridded of acetaminophen filled 'narcotic' meds. Plus oxycodone WITHOUT acetaminophen gives me more releif than with acetaminop-hen, I've tried taking OTC tylenol on many occasions with my Roxis and didn't notice the slightest increase in analgesic effects!
If a Dr. truely thinks that the patient would get signifigant pain releif from taking acetaminophen along with their CII opioid meds, then send them to the store and get a damn bottle of Tylenol!

Well I'm sure hoping they ban all these damn acetaminophen containing script 'narcotics' like percs and lortab. But if they're worried about the dangers, what about Darvocet/Propoxyphene??? That shit is just plain out bad if you ask me. It's literally no more effective at relieving pain than Aleve, it is quiet toxic at the doses it would take for propoxyphene to be effective, and the amount of acetaminophen is just crazy seeing as you would need multiple tabs for any real relief! This whole ban is probably more so about 'get percs off the streets and away from our kids' than they are worried about our health from too much acetaminophen over the years..

later

mikey5string
07-01-2009, 09:05 AM
im looking forward to blowing hydrocodone.

Synack
07-01-2009, 09:18 AM
If a Dr. truely thinks that the patient would get signifigant pain releif from taking acetaminophen along with their CII opioid meds, then send them to the store and get a damn bottle of Tylenol!





My first ever pain doc - when I told him I was already taking several grams of tylenol a day (I wasn't) - he agreed to switch to to a med w/o it.. he said he'd have to up it because I'd be losing the 'synergistic' effects of the combo.... that's how I went from perc 7.5s to roxi 15's...

Duckfeet
07-01-2009, 09:21 AM
I don't know, Ike: my experience is, that they always drift towards *more* control, and *less* actual opiates...this seems like it could work hand in hand with the attempt by the dea/gov to just let us live in fucking pain, and junkies? Nobody w/any power gives a shit about us...

I came of age before tylenol was the big new wonderdrug, and most of the pills we got--other than k4's which were trickier to obtain--were either percodans (oxycodone w/aspirin) empirin 3/s (codeine + aspirin) or some sort of darvon/darvocet which they had everywhere from here to Argentina, and had propoxyphene, caffeine, and aspirin...

docshopping lowlifes--like me--usually were disappointed if we didn't get percodans, tho sometimes we'd get demerol...which sucked, IMHO...dilaudids you had to kind of know doc, etc..

Then, docs got all excited and started pushing *tylox* (same as percocets) since elizabeth taylor made a big production about being strung out on percodans, and celebrity dope fiends always fuck it up for us plebes...and then, of course, they started w/the hydros w/tylenol...then oxycontin got invented and pushed, which got all the little "nice kids" good and strung out too...

So "getting rid of tylenol" probably won't improve matters...many of us already have tried to get "less buffer" and to most docs, that is a junky tip off....

Mulch
07-01-2009, 09:48 AM
^^
You said it man, very happy to see that they are finally acknowledging the dangers of APAP, but I agree with what you said. It's just going to shift the scene a little, BUT swim won't be complaining when the "filler pills" go away :-). And to Mikey5string, getting some compound less hydro would be awesome:D.

Sweater Ruin
07-01-2009, 05:37 PM
I read a similar article in the New York Times this morning. I quoted the first paragraph which summarizes the situation.
A federal advisory panel voted narrowly on Tuesday to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver. ~~NYTIMES

According to the article, the FDA's advisory panel has recommended the ban. Percocet and Vicodin are not outright done for, and they may never be.

This is an interesting situation. When I read the headline, my initial thought was that the ban was another attempt to exterminate opiate use. I was surprised to read that it was for a legitimate health concern. It appears that acetominophen is being reevaluated as more harmful than originally thought.

I can see this possibly working in everyone's favor, junkies and patients alike.
Straight hydrocodone and oxycodone substitutes could materialize to fill the gap if APAP filler is banned, and consequently become more easily available.

Say goodbye to liver damage and cold water extraction.
And if someone has a legitimate need to take these medications on a daily basis, they are at less risk of damage to the liver.

Duckfeet
07-01-2009, 05:48 PM
Yeah: we'll see...I know most docshoppers will be scrambling to their docs, trying to get purer opiates...but then, we've been doing that forever anyway...mostly I get depressed that we now expect/assume the FDA getting involved in *anything* is a good thing...feds need to stay out of doctor's offices, but I know, that is beginning to sound like a guy who wants to go back to horses rather than cars...all I really see is more control coming, and everybody--including docs--is under a big microscope when it comes to opiate use...and what do you *think* docs are really going to do with this one: give you pure hydrodone or pure oxycodone or pure--I hit the lottery!--hydromorphone? Nah, they'll find some new talwin like shit that supposedly gets rid of pain, but doesn't give you a buzz...probably some kind of crappy bupe combo...fuck...

Maybe some *very* lucky longterm pain patients might get a play...but I can just see the look on my doc's face when I bring this up: they've heard all this before: hell, anybody who finds out they've got hepC, immediately angles for "no buffer" dope--I know I did, way back in '95, and I got knoll dilaudids...but he was new to this country, and I could tell I was his first junky, and I rode that poor kindly buddhist indian doc right into the fucking ground and burnt him out: people like me usually do...hand in hand with this is the FDA and DEA saying docs need to prescribe *less* opiates...and that's also often in the news...good luck...



I read a similar article in the New York Times this morning. I quoted the first paragraph which summarizes the situation.
A federal advisory panel voted narrowly on Tuesday to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver. ~~NYTIMES

According to the article, the FDA's advisory panel has recommended the ban. Percocet and Vicodin are not outright done for, and they may never be.

This is an interesting situation. When I read the headline, my initial thought was that the ban was another attempt to exterminate opiate use. I was surprised to read that it was for a legitimate health concern. It appears that acetominophen is being reevaluated as more harmful than originally thought.

I can see this possibly working in everyone's favor, junkies and patients alike.
Straight hydrocodone and oxycodone substitutes could materialize to fill the gap if APAP filler is banned, and consequently become more easily available.

Say goodbye to liver damage and cold water extraction.
And if someone has a legitimate need to take these medications on a daily basis, they are at less risk of damage to the liver.

roxi*stardust
07-01-2009, 09:46 PM
http://www.emedicinehealth.com/script/main/art.asp?articlekey=101618

Sweater Ruin
07-03-2009, 04:06 PM
mostly I get depressed that we now expect/assume the FDA getting involved in *anything* is a good thing...feds need to stay out of doctor's offices. Nah, they'll find some new talwin like shit that supposedly gets rid of pain, but doesn't give you a buzz...probably some kind of crappy bupe combo...fuck...
...

This is a good point. I could also see the situation going the other way with a lame replacement drug.

Without Viocdin or Percocet, they might just short change people after minor surgeries such as the removal of wisdom teeth or tonsils. Instead of those two medications, the doctor will politely ask the patient to stop being a punk ass bitch and toss in a cliche one liner: "no pain, no gain son!"

Paregoric Kid
07-03-2009, 10:37 PM
if they actually do get rid of them instead of just adding a black box warning, they will probably start prescribing tramadol, codeine, vicoprofen (hydrocodone+ibuprofen), and percodan (oxycodone+aspirin) instead. hydrocodone and oxycodone only products are CII so I doubt most doctors will be as willing to hand them out like they did vicodin and percocet.

youwonhundred
07-04-2009, 02:53 AM
I don't see how banning ANYTHING is ever good for us. Sure APAP sucks, but it will just be replaced by something even less fun.

Duckfeet
07-04-2009, 07:45 AM
Yep: the only thing this country hates more than having a bunch of junkies floating around...is having a bunch of *happy* junkies floating around...it's that old puritan ethic thing, deep within every trueblue american's guts, which just think we should be punished for our sins...I've never seen prescribed drugs get "better" only worse. With one exception in my life, and that was oxycontin, which came out well after they'd started realizing how addictive oxycodone was, and were constantly finding weirder drugs, and weirder buffers....and how *that* one slid by, I can only guess that lotsa money was at stake...but other than that, banking on this governent to "make it better" for us, is just wishful thinking...

jersey_emt
07-04-2009, 10:10 AM
if they actually do get rid of them instead of just adding a black box warning, they will probably start prescribing tramadol, codeine, vicoprofen (hydrocodone+ibuprofen), and percodan (oxycodone+aspirin) instead. hydrocodone and oxycodone only products are CII so I doubt most doctors will be as willing to hand them out like they did vicodin and percocet.

Percocet is CII. Anything with oxycodone (including combination drugs) is CII.

Hydrocodone and codeine are the only opioids that are not CII in certain preparations.

Paregoric Kid
07-04-2009, 10:40 AM
yeah you're right about oxycodone, don't know how I ended up typing that. codeine and hydrocodone as well as dihydrocodeine, morphine, ethylmorphine, and opium are CII substances that are also CIII in certain concentrations.
there are some other oddities in the CSA, like how the opioid difenoxin is schedule I by itself but when mixed with atropine its schedule IV!

HandMeSomeOpiates
07-04-2009, 12:34 PM
Yeah, actually I think they are taking or have taken darvocet off the market as well ike.

The only problem I see with this, is it being harder to get rx'd pain meds since CIII's would be non existent. For situations like mine of course where my pain isn't bad enough for CII pain meds (or so my doc thinks) Right now I get 180 Norco every 25 days. Wonder what would happen if they pulled Norco. Wishful thinking comes into play and has me imagining the Doc giving me 180 roxi 15's instead.... YUMMMMMYYYYYY my favorite!! As I said.....wishful thinking

Paregoric Kid
07-04-2009, 10:08 PM
darvocet is still on the market, but they were talking about adding a black box warning or discontinuing darvocet months before this. it will be a long time before these drugs actually disappear from use, the FDA hasn't even made a final decision about any of this yet.

insaneike
07-05-2009, 01:27 PM
I can see how this could turn out worse for some pain patients, if docs stopped writing meds because they don't like the idea of said patient receiving opioid only containing medications, but I honestly don't think it would be like that if the ban or whatever does go through.. I think it will be for the best if it goes through..
If it does happen, chances are they will just reduce the amount of acetaminophen in the opioid/acetaminophen containing meds. As a lot of these ppls probably would not like the only weaker opioid medications available being opioid only meds, as it would be more tempting to fix up and thus creating more 'junkies'. So I think they will just reduce the amount of Acetaminophen, which I think would be in our, the pain patients, favor still. BUT if they just reduce the amount of acetaminophen instead of removing, then I could see some docs keeping some pain patients on these weak meds(percs, lortabs) for longer periods instead of switching them to something stronger/more effective. As there is less acetaminophen in the meds, the Dr. scan write more tabs per dose/day instead of moving the patient onto something stronger. Like now I've known so many ppl whose docs kept them on fucking percs(oxycodo-apap) n norcos(hydrocodo-apap) up until they were prescribed 10-11 tabs a day before the Dr. switched them to a more effective opioid medication! It's fucking stupid.
Though this could also happen if the acetaminophen was removed, then I bet there would be a good bit of Dr.s keeping patients on hydrocodo and oxycodo for a very long period of time before switching to something more effective since the dangers of exceeding the max daily amount of acetaminophen is no longer there..

Though I also think if they removed acetaminophen from all the opioid/acetaminophen combination meds that would also be in we pain patients favor. Cause they would still produce oxycodone and hydrocodone in the same strengths as they did with the acetaminophen combo meds probably. I don't see docs just strait out stop writing the really weak scripts for opioids just because they are opioid only meds.. I mean yeah of course a couple will if the patient comes off as someone who could potentially abuse the meds, but in general, I don't think the removal of acetaminophen from percocets and lortabs/vicodins will result in a dramastic decrease in Dr.s prescribing said meds..

It could easily go either way though if this lil 'ban' goes through so who knows.

Hopefully it turns out in our favor(pain patients) though. Not that I'm on percs anymore, not get the least bit of releif from them, I know many ppl who are on them and do get decent releif from them as their breakthrough med with oxycodo, fent, or somethin for around the clock opioid dosing.

later

Lu_cid
07-17-2009, 02:07 AM
thats nuts my doc was talking about that today.

Restharrow
07-17-2009, 01:02 PM
My impression is that that taking tylenol combo products off the market, will be combined with REDUCED ACESS to the purer formula's.

I doubt this will help anyone here.

Will

Narkotikon
07-17-2009, 01:12 PM
I think the thing on the news a few weeks ago was for APAP in general. Some doctors / agency wants to lower the maximum daily dose from 4 grams to something else. Vicodin and Percs got mentioned because they contain APAP too, but I don't think it was targeting them specifically, rather just APAP.

Personally, I think it would be foolish on their part to outlaw / get rid of Vicodin / Lorcet / Lortab or Percocet just for the APAP thing. I mean, lower the dose in the pills instead, put a black-label box warning, something.

Now, if you notice, the new commercials for Aleve (naproxen sodoium) is stating how if you take Tylenol, and take 8 pills a day (which is the maximum dose I think), you'd be taking 80 pills in a ten day period, whereas if you took Aleve it would be only 20 pills in a ten day period. I don't see the point in that. Granted, I think APAP sucks, and have never really taken Aleve before (I usually take Advil / Ibuprofen when I have a headache because I think it works better for me), but what's it matter how many pills you take?

But, yeah, I don't think it was targeting Vics or Percs specifically, but rather the APAP instead;

Opiyum
07-17-2009, 01:19 PM
, which got all the little "nice kids" good and strung out too...

I'm flattered Mr. Feet. I didn't know you thought of me that way.

Restharrow
07-17-2009, 01:26 PM
But, yeah, I don't think it was targeting Vics or Percs specifically, but rather the APAP instead;
^^^^^^^^^^^^^^^^^^^^
I think thats the real deal -- the gov. wants to reduce total APAP intake, and wants doctors to be more aware of the dangers of tylenol combo products taking a patient over the 4 gram (or lowered) maximam.

Paregoric Kid
07-17-2009, 01:49 PM
tylenol can be dangerous but anything can be dangerous at the right dose. I have no doubt that vicoprofen and percodan will replace vicodin and percocet if they go as far as to actually ban them. some people get nasty side effects from ibuprofen and aspirin but don't have many/any problems with tylenol. less choice is bad.

some doctors may start prescribing 5 and 10mg oxycodone IR instead of percodan but not all will. there is also the chance that darvon will hang on and darvocet will be taken off the market.

upstate_007
07-17-2009, 02:10 PM
some doctors may start prescribing 5 and 10mg oxycodone IR instead of percodan but not all will. there is also the chance that darvon will hang on and darvocet will be taken off the market.

And probably more Tramadol too.

HandMeSomeOpiates
07-17-2009, 02:15 PM
And probably more Tramadol too.
exactly what I was thinking....Oh joy more trams.....

PiLL CLiNToN
07-17-2009, 02:34 PM
And probably more Tramadol too.


Yup 2 doctors recently switched me to oxycodone i.r 15's from getting the 10mg percs and switching fucking my 3 vicodin es's to 1 soma and 3 30mg codeines pssshhhh im like no no codeine nooo thanks so i lucked out and got 2 vicoprofens insted and also some tram 50mg 30 of em just for extra relief and swims buddy was getting 2x of 60mg oxycodone er and switched em to 2x 40mg oc and 5mg valiums 3x of em so i guess he aint that pissed but the 60s were way better than 40's i also know another guy who was getting like 5 80's a day and got switched to 100mg morphine 3 of em and he also got i think like 15mg oxycodone ir and a cousin got cut off from demerol to methadone so alot of changes are being made i know lots of heads on done its crazy but id def say the biggest switch is less rx'es of the ole normal percs and vicodins to vicoprofens,tramadol,differnt muscle relaxants and codeine based pills bullshit for alot of pepole....:mad:

PiLL CLiNToN
07-17-2009, 02:39 PM
:(
but honestly i highly doubt they will just stop producing them i just think theyre cracking down more and want less potent pills out nowadays in light of doctors like bein in entourages with celebs n MJ shit is hitting the fan in alot of places damn i wish we could just keep it old school and get the good shit not all these back up bullshit pills

Paregoric Kid
07-17-2009, 05:36 PM
yeah I can definitely see tramadol and codeine (without tylenol) becoming more widely used. but I'm guessing that for the most part if they do end up banning them that it will cause a mass switchover of patients from being on percocet to percodan and vicodin to vicoprofen. they aren't really causing any changes that increase safety because the same types of problems are present in aspirin and ibuprofen + opioid combos. these problems aren't even an issue for people who take these medicines with tylenol (or aspirin, or ibuprofen) responsibly or follow their doctors orders. and they aren't helping people in pain and doctors, they all need as many choices as possible so that people can get the medicine that works best for them.

Duckfeet
07-17-2009, 06:51 PM
My fear, as I've stated, is that docs can do all this now: why are the feds getting involved? But you're right: nobody I know, even serious pain patients, ever wanted the switch from percodans (aspirin) to percocets (tylenol) but at least back then, it was *doctors* who made these decisions, and I feel they were often swayed by the pharmaceutical reps--like the oxycontin pushers--but all the freaked out parents made the feds realize there was *finally* a huge voting block they could tap into, and thus began another downward spiral...

And I won't even get started on the whole "scheduling" fiasco, that I think began around the time the DEA got created...before that it was BNDD and Class A's etc...but to a ruffian like me, that was a *good* thing, since pharmacies kept it simple by locking up all their Class A's in one easy-to-find area ;)

Until they didn't. :(



yeah I can definitely see tramadol and codeine (without tylenol) becoming more widely used. but I'm guessing that for the most part if they do end up banning them that it will cause a mass switchover of patients from being on percocet to percodan and vicodin to vicoprofen. they aren't really causing any changes that increase safety because the same types of problems are present in aspirin and ibuprofen + opioid combos. these problems aren't even an issue for people who take these medicines with tylenol (or aspirin, or ibuprofen) responsibly or follow their doctors orders. and they aren't helping people in pain and doctors, they all need as many choices as possible so that people can get the medicine that works best for them.

JonnyM
07-17-2009, 07:41 PM
Im scared shitless that if this goes through codeine and trams are what will be available.

Doctors like the idea that they can give pain medication that isnt scedule II to people with a tooth ache, or back pain.

the abuse potential of pure hydrocodone is just as immense as that of oxycodone... and may even cause a "scare"





"Hydrocodone a powerful derivative of heroin... blah blah blah." I can see the misinformation already.

samsong
07-17-2009, 08:01 PM
For the real PM clinics, I can't see this having too big of an impact on doctors rx'ing methodology--they know realtively easily when some one is in real pain and they know the trams and codeine and darvocets and all the other weaker opiates aren't going to help their patients. So, if you were a doc that owned your own clinic, and you need to keep people coming in the door, I would assume they would continue to rx the stronger opiates like roxis and OC and dilaudid and opana, and fent and morphine because if people can buy trams over the internet and not deal with the hassle and expense of going to see a doctor every month, there you go--they need to keep a steady stream of clients to stay in business.

On the other hand, the dentists and ERs and your family docs--I think that is where the patients are going to get screwed, unless of course as a few have stated they start to just rx the vicoprofen and other non-acetaminphen. I can easily see your family doc saying, sorry, your govt took these off he market, so nothing I can do but give you some trams or codeine--easy for them because most of their patients aren't pain patients like the PM clinics doctors.

The whole thing is ludicrous in the first place--the govt run FDA shouldn't even have the power in the first place to make the decisions of which medications can be marketed or not. Doctors should be able to advise their patients of which medications are suitable and then let patients make up their own mind of what they want and they shpuld have the power to go and purchase anything they want without an RX. if the meds are dangerous and kill people, then manufacturer executives should do time and be sued, regardless of their intent to market a dangerous product--that would insure even better testing than what is in place now. That would therefore eliminate the need for a govt oversight group like the FDA who fucks up all the time but are never punished for their fatal mistakes.

Tmac5150
07-28-2009, 09:34 AM
[URL] At the moment I know at least 3ppl who receive 10 hydrocodo/apap 10/325mg tabs a day, and that is too much acetaminophen in one day,



Very true. 4000 mg or 4 grams is s'posed to be the max amount of apap you're s'posed to take in a day. Which I'm sure that even that much is not good for you...

I'm sure most of you know that, and I know you know it Ike. I didn't see it in anyones post(unless I missed it), so I just thought I'd throw it out there for those that didn't know it... Take care...

Paregoric Kid
07-28-2009, 09:50 AM
I've seen people, some even with hep c, take close to or over 6-8 grams of tylenol a day and not even get sick. I'm sure its not good on the liver, and I'm sure there are a lot of people who can't even tolerate 2 grams much less 6 but I think some people must have iron livers.

OverDriven
08-10-2009, 01:22 PM
I've seen people, some even with hep c, take close to or over 6-8 grams of tylenol a day and not even get sick. I'm sure its not good on the liver, and I'm sure there are a lot of people who can't even tolerate 2 grams much less 6 but I think some people must have iron livers.

Yeah, from what I've read it's highly dependent upon the individual.

I really don't think anyone is going to be "blowing hydrocodone" any time soon. They will likely replace the tylenol in percocets/vicodin with something like ibprofen.

digby
08-10-2009, 10:36 PM
I think it is the chronic pain patients that will really feel the hurt if vicodin gets banned. I don't think doctors will have problems in writing one-up prescriptions for schedule 2's, but they won't like doing it every month for the same patient.

Way back when, I was simply taking vicodin along with a potentiator (soma or fioricet) for chronic pain issues and when I moved, my new doctor wasn't comfortable prescribing two abusable prescriptions each month for me - so get this, I had to settle for oxycontin or nothing. ??? WTF?
So I got 10 mg oxys, then in a few months 20's, then a some months later 40's because of tolerance issues. Then morphine liquid got added for breakthrough pain and I was off and running....and all I wanted was a few vicodins.

HandMeSomeOpiates
08-31-2009, 09:28 PM
They will likely replace the tylenol in percocets/vicodin with something like ibprofen.
Note to self: Buy Ibuprofen Stocks

CowboyDan
09-02-2009, 10:06 PM
It is a good thing for us opiophiles that commerce trumps conscience every time. As long as pharma companies can make money selling strong narcotics and as long as docters can keep patients coming in the door by prescribing strong narcotics they will continue to be on the market.