when and how to ask for an increase in meds?

[katomic]

Hay
i have a codeine script 30mg up to 4 times a day I get 56 at a time now iv been on these for a month now and well I usually don’t take them as I am supposed too.
I don’t want to push it as docs round hear are basterds but when should I ask for an increase? And any tips on asking?
ta
K-atomic

[Zoop]

After a month, even if you were taking it as prescribed, you'd be running into some tolerance to the analgesic effects.

So, a doctor should be aware of that. If the medication is for some type of chronic pain condition, if you'll be taking it for a long period of time, then an increase would be in order even if you were on the straight and narrow.

I would tell the doc that the dose prescribed is just not cutting it anymore. Say it's wearing off after like 2 hours now, and you want to take it more often, but the directions say you shouldn't, so you just tolerate the pain. That will make you sound like a goodie-two-shoes type guy. Mention that "a friend" of yours or some elderly relative has ___ (whatever med you're shootin' for) for his/her pain and it seems to work really really well for him/her, and could you try it too please?

I think the key will be to say that it is just wearing off faster than it used to.

[katomic]

Thanks zoop man your a star i will try it today for dihydrocodiene

[JoyDivision]

Strong dihydrocodeine would be nice here. but we only have codox soluble which has 7.5mg of dhc and 300mg aspirin and the stuff is really soluble and really tastes like shit. I haven't tried it but I don't think doing a CWE would make any difference. So I usually just combine like 4 or 8 of them with some nurofen plus (12.8mg codeine + 200mg ibuprofen). Sucks. You can't split the ibuprofen out of the new nurofen plus packs. And you get sludge crap when doing CWE's. I really hate doing CWE's. I feel that I'm losing some of the goodies.

I ran out of Oxy so my doc prescribed 100 x Panadeine Forte (30mg Codeine Phos. + 500mg APAP) with 2 repeats. So that's a total of 300. I try to stick to the dose of 8 per day so 12.5 days per 100. It's bad enough taking 4g of APAP a day let alone taking more. And doing CWE's on them just means I won't have any pain relief when they are all gone. Unless I use OTC shit or poppy seeds. Good thing I see my pain doc next week. I've been off Oxy for quite a while now after being on it for 6 months and soon hopefully I'll have a dose increase. But having not used it for so long will make the next dose worthwhile.

56 at a time blows. See if you can get Tylenol #4's instead. We don't have them here but they are 60mg codeine phos. per pill. Then just take 1-2 4 times daily. 120mg of Codeine phos. is a really effective dose. But since you're on 30mg 4 times a day start with just 1 unless you can handle 2 30mg tablets.
Personally I think anything more than 256mg is a waste because 300-400mg will just make you sick. I did 300mg once and I have a huge tolerance to codeine and I felt shitty. And this was with split nurofen plus pills. Not heaps of codeine + apap crap.

I reckon just take grapefruit juice with them if the current dose isn't doing the job. Trust me. It works.
Drink like 1 - 2 250ml cups at least 1 hr before you take it. Check out www.coldwaterworld.com then click on potentiators and read everything it says about enhancing codeine. A small dose of DXM works wonders. Start low though. Even 30mg of DXM with 120mg of Codeine put me to sleep once. So start with about 10mg then titrate up. Above all be careful 400mg of Codeine might be fine for a seasoned opiate addict but not for someone who is just on 30mg of codeine 4 times a day.

30mg 4 times a day wouldn't even touch the sides for me. I wish we had T 4's! I'd take 2 4 times a day. That would be nice indeed.

Another idea is to switch over to propoxyphene hcl I have no idea what you call them over there. We get them in 32.5mg + 325mg apap combination pills and capsules and also 100mg propoxyphene napsylate capsules. The napsylate salt sucks. I believe you can get 65mg propoxyphene hcl pills in the states. See if you can get some of those then start with 1 every 4 hours. 32.5mg is about 2/3 the strength of 30mg of codeine. However since propoxphene hcl works differently than codeine and metabolises to something different it will work great. Before I got Oxy I'd switch between codeine and propoxyphene hcl & napsylate all the time. Then there's Tramadol. The only probs I've had with propoxyphene in both forms is I get dizziness and nausea if I use them for too long. And I feel like killing myself when I come off from Tramadol. We have really stupid quantity regulations for tramadol even though technically it's not a narcotic and works better than codeine. I wish I could get 100 Tramadol 50mg's. Then to come off I could just take one a day or something to wean myself off them without feeling suicidal.

America sucks in that you got stronger dihydrocodeine & propoxyphene & tramadol pills. And you got shit we don't even have like Carisprodol, Cyclobenzaprine for muscle relaxants (I get bad muscle spasms and can only take diazepam but only temporarily and can't take orphenadrine citrate cause it makes me sick and pretty much doesn't work) then you got hydrocodone, hydromorphone and oxymorphone. And heaps of other stuff we don't have. Yet you have doctors without the balls to prescribe the stuff for people in genuine pain. If I were you. I'd get all my drugs from Mexico or Canada :-). Or off the net.
Oh and then you can get pods off ebay. All I can get is seeds for poppies off ebay.

Land of the free, home of the brave, doctors without testicles, expensive drugs, extreme pain killers which most can't seem to get.

You'd think the Government would prefer a doped out, vegetated, apolitical population.

[Zoop]

Well, to be sure, there are doctors here in the U.S. that don't have the balls to prescribe strong painkillers to people when they're needed. But, if you're talking about hydromorphone, oxymorphone, high-dose oxycodone, fentanyl, et cetera, no doctor worth his salt is just going to write for any of that shit just because some schmoe walks in with a headache or a sprained ankle. That's why we have pain specialists.

Sometimes, it's a bit of a trick for those people who are in serious chronic pain to get the meds they need, but a little perseverance and they usually end up getting them.

It is very very easy, on the other hand to get a hold of hydrocodone, percocet (5mg oxycodone per tab), carisoprodol, propoxyphene and the like (cyclobenzaprine by the way totally doesn't do shit, you're not missing anything there...) .

So, it's not quite as bad as you make it out to be. I mean after all, I live here. And the reason why we have some of the better meds? That is because we don't have a socialized health care system. Canada has waiting lists for months for people who need life saving surgery. People who could benefit from cutting-edge medicine are given the cheap, less-effective stuff instead to save money.

In the U.S., we have extensive welfare programs for those who are the most in need. It is relatively easy to apply for and receive benefits. These programs, despite the wailing of all those wanna-be "Che" Guevera's crying wolf, are not going anywhere.

Socialism is a hazard to the health.

[paesan]

Originally Posted by JoyDivision

I reckon just take grapefruit juice with them if the current dose isn't doing the job. Trust me. It works.
Drink like 1 - 2 250ml cups at least 1 hr before you take it. Check out www.coldwaterworld.com then click on potentiators and read everything it says about enhancing codeine. A small dose of DXM works wonders. Start low though. Even 30mg of DXM with 120mg of Codeine put me to sleep once. So start with about 10mg then titrate up. Above all be careful 400mg of Codeine might be fine for a seasoned opiate addict but not for someone who is just on 30mg of codeine 4 times a day.

Yo JD, not to be a dick but P450 inhibitors such as Grapefruit juice and tagament both should not be used with codeine. This is due to the fact that they impair codeine from metabolizing into morphine which is it's course of action (in other words that's how codeine works)... So by drinking grapefruit juice or taking a tagament you're effectively killing the dose of codeine you took, not potentiating it. So either you have a strange liver or you're experencing a placebo effect bro... DXM on the other hand should help to potentiate, just make sure to take it 30-60 minutes before you take your codeine...

[paesan]

Please Delete Post...

[katomic]

The result
well first I asked for an increase in amount cos we have to pay a set amount for each medication on the script and 56 is expensive so I got it up to 112 (but for 4 weeks so the same amount of tabs) but I dident ask for dihydro as I thort I would be pushing my luck because he looked at me real suspiciously

but next time i will go for dihydro or an increase

at least its cheaper now.

[roxyrob]

....................

[roxyrob]

Don't say anything to make him examine your chart or something..... if you been on the same dose for awhile, just tell her that your taking them as prescribed, and its still hurting in your work and personal life. You can't live off disability and you need to work.....

[GMorris]

Originally Posted by JoyDivision

All I can get is seeds for poppies off ebay.

Any particular reason why? Worried about customs or are you just not able to order the pods at all for reason?

Originally Posted by JoyDivision

Land of the free, home of the brave, doctors without testicles, expensive drugs, extreme pain killers which most can't seem to get.

You'd think the Government would prefer a doped out, vegetated, apolitical population.

It's true that it is often difficult to get a good doctor that will have the nerve to treat pain like it should be. However, that doesn't mean that it's impossible by any means. Over the years I've known many disabled people, some in wheelchairs, who got killer meds all the time. Hell, if it hadn't been for them needing cash more than the pills sometimes, I'd have never tried most of the good pharmaceuticals I've had over the years. I tried to get a pain specialist because of my bad back, but just because of things I said (even though it WAS the truth), the guy never believed I was in enough pain. I honestly think that he never had any intention of ever giving me a prescription for narcotics, and after three visits he wanted to (instead of narcotics) do a steroid injection into my spine at which point I never went for THAT appointment! On the other hand, my signifigant other has Multiple Sclerosis and the doctor knows that disease comes with serious pain so she can pretty much get whatever she wants from him. Given that, I'd definitely not say that nobody can get the good stuff, you just have to be careful not to come across as a drug seeker and have some kind of painful or potentially painful disorder. But, If you try to fake it or make it out to be so much worse than it is, they'll usually catch on real quick, unless you're a real pro at conning doctors.

[liberty boy]

I bought 32 co-codamol 8mg/500 and did a cold water extraction on twenty tablets and it didn't do shit. Is this normal?

[reddragon3668]

Originally Posted by Zoop

Well, to be sure, there are doctors here in the U.S. that don't have the balls to prescribe strong painkillers to people when they're needed. But, if you're talking about hydromorphone, oxymorphone, high-dose oxycodone, fentanyl, et cetera, no doctor worth his salt is just going to write for any of that shit just because some schmoe walks in with a headache or a sprained ankle. That's why we have pain specialists.

Sometimes, it's a bit of a trick for those people who are in serious chronic pain to get the meds they need, but a little perseverance and they usually end up getting them.

It is very very easy, on the other hand to get a hold of hydrocodone, percocet (5mg oxycodone per tab), carisoprodol, propoxyphene and the like (cyclobenzaprine by the way totally doesn't do shit, you're not missing anything there...) .

So, it's not quite as bad as you make it out to be. I mean after all, I live here. And the reason why we have some of the better meds? That is because we don't have a socialized health care system. Canada has waiting lists for months for people who need life saving surgery. People who could benefit from cutting-edge medicine are given the cheap, less-effective stuff instead to save money.

In the U.S., we have extensive welfare programs for those who are the most in need. It is relatively easy to apply for and receive benefits. These programs, despite the wailing of all those wanna-be "Che" Guevera's crying wolf, are not going anywhere.

Socialism is a hazard to the health.

I agree and disagree. While you can get prescriptions for these meds, oftentimes they are so expensive that someone without insurance can not afford them. A script that I can not afford to get filled is not worth much. I would much rather have someone give me a less strengh pain reliever for free than a peice of paper I could afford to get filled.

With that said, I don't think there is any argument that the quality of healthcare in America is better because of our free enterprise. Of course, even this is being compromised due to the escalation and often unmanageable cost of liability insurance for doctors.

While social programs are available, the ones that provide health care and medicine are difficult to qualify for.

Originally Posted by GMorris

I tried to get a pain specialist because of my bad back, but just because of things I said (even though it WAS the truth), the guy never believed I was in enough pain. I honestly think that he never had any intention of ever giving me a prescription for narcotics, and after three visits he wanted to (instead of narcotics) do a steroid injection into my spine at which point I never went for THAT appointment!

My brother had this same problem with a Pain Specialist. He would hardly take pain meds, but would if he really needed him. He hurt his back on the job and workers comp sent him to a local pain doctor. He had been on Vicotin for like four months, and had only went through 2 60 pill prescriptions. When he went to the Pain specialist because he needed another script, the pain specialist gave him 30 but told him he would not give him anymore. I know how bad he hates to take them, so it really pissed me off. There is no reason why a person should ever have to live in pain like that. I suspect the doctor looked at my brother and because he happens to have some tatoos on him arms, he thought he was a biker or something and just stereotyped him, which is ridiculous.

[insaneike]

Find anotehr doc man, beleive me! My orthopedic surgeon is like that, hes thinks hydrocodone and peroccet are fkn precious gems! Asshat. So does pain management. They ae good and staait up no BS places but god damn idiots. After some shit and shit I got fed up with not having meds that helped me. I couldn't get but morph 15s ONE TIME from asshat doc. I was on lorab 10s and percs msotly from the ho.

SO i went to a local walk-in doc and he didn't even look at my MRI and wrote me DURAGESIC FENTANYL 25mch/hr and 2.5mg total. ALONG WITH Soma 3x day and lortab 10s 2-4x a day
Talk about being one surprised mofo! I had to strain from smiling as he was giving duragesic samples! annd telling about soma lol. It was great. Shoulda seen me walk out fo the pharmacy with 10 Duragesic Fentanyl, 90 soma, 90 Lortab 10s, some other crap muscle relexer nomutone or somehting, and scripts ig ot filled form my 'crazy' doc: 90, 1mg kpins, 30 50mg trazodone, and celexa. I don't take he celexa or trazodone, I hoenstly dont need it ;p

Hope i hepled some... go to them tiny local foreighn preferably docs

later

[antony]

I think a lot people here would be happy going to look for new docs if we weren't afraid of getting blacklisted. I think thats whats keeping people at a codeine level