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Thread: Oxycodone versus hydrocodone

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    Default Oxycodone versus hydrocodone

    I recently moved out of state and my new pm doctor continued with giving me oxycodone 5 mg. or .5. But I was really feeling lethargic a lot and I remember a few yrs. back taking hydros and not feeling as tired. So I asked him to switch and he was ok with it. But he gave me 5/500 of the hydros and with the max of 4 a day. Well now I find the oxys were better and stronger and I had to take 2 of the hydros together to get the relief and by early evening I already took my required amount. A few times I had woken up and took another one or 2 . I called my doctor back and told him I think I was better off with what I had been taking as the hydros are not really working as good or as long. He said "ok fine, but I can't call it in, you will need to bring all your meds and come in" By the time i see him I will be out of the hydros as I have like 3 left and some days I took 4 and somedays 6. With the hurricane I ended up feeling the pain even more so. Do I tell him the truth or just say I forgot to bring in my meds? I know honesty pays but this will only be my 3rd visit to him. Any suggestions? Why do you think he wants to see all my meds? I do have 1 refill left but can't get it until another 5 days. Any suggestions would be appreciated. No preaching though as I know I should have tried to limit to 4 but I didn't know the 2 drugs were so much different in strength until after the fact. Thanks


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    Quote Originally Posted by Rockieroads View Post
    He said "ok fine, but I can't call it in, you will need to bring all your meds and come in" By the time i see him I will be out of the hydros as I have like 3 left and some days I took 4 and somedays 6. With the hurricane I ended up feeling the pain even more so. Do I tell him the truth or just say I forgot to bring in my meds?
    Those are both bad options, they either make you look like you're abusing your meds or trying to get more opiates than you need. In the latter case, the best scenario is that he'll just refuse to give you the oxys, or he'll give them to you on condition that you absolutely bring them in like the next day. It's very unlikely he'll be amiable about taking more than prescribed after the fact, and without having been up-front about it already :/

    It sounds like you're fairly near the end of your script anyway. Make some excuse as to why you can't come in, tell him you'll just finish out the hydro script, and then go to pick up/have him mail the oxy one.

    If you're not near the end of your script, it might be best to order some tramadol or something to hold you over. There are IOPs that ship express, or you could order some overnight from a US consult place (but be weary of the possibility of getting caught double-dipping on pain meds...). At this dosage 100-200mg of tramadol would work just as good, if not much better (I take 100mg doses of tramadol for moderate CP, and 5mg of oxy does practically nothing for me).

    Doctors are very careful about prescribing oxys these days because honestly they have to be. Be very careful if you think you'll be needing opiates from this doctor for any period of time
    Last edited by coachmcguirk; 11-04-2012 at 02:39 PM. Reason: added tramadol dose info

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    The best idea would be to replace the hydros with vitamins or some other pills that he look like them. There are all about the size of many different things, many over the counter. Just put the correct number of those in, and let him count the correct number. Its worked for me numerous times. Until I got lazy and got booted for over dosing myself.

    Be careful, they don't play with that, no matter what excuse you give them. They're used to dealing with lying junkies all day, so they won't believe anything you tell him.

    It really sucks.

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    Quote Originally Posted by shkdwnst View Post
    The best idea would be to replace the hydros with vitamins or some other pills that he look like them. There are all about the size of many different things, many over the counter. Just put the correct number of those in, and let him count the correct number. Its worked for me numerous times.
    OK, if this worked for you you're lucky, period. An incredibly bad idea, nowhere near the "best." Granted there are many different manufacturers for these meds, and no one knows what they all look like unless they study pill ID websites. But almost all US pharms have some kind of imprints on them, and most vitamins don't. Relying on your doctor's inattention and laziness is incredibly reckless if you're actually counting on meds for something other than getting high (and I guess it's still pretty reckless if you're counting on getting high...).

    Not trying to be preachy, but just pointing out some seriously bad advice
    Last edited by coachmcguirk; 11-04-2012 at 02:40 PM.

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    Forgive me but that's terrible advice..either being honest or stalling would be better than clearly lying and replacing with vitamins. What about imprint codes? Brands? Scoring, color?
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    I would tell the truth. It is very comen and most doctors should understand that switching from oxy to hydros for many patients will leave something to be desired in the pain department. If he switched you and had any clue what he was doing, he should have switched you to 10mg hydros from the 5mg percocet, main reason being is that oxy is a tad stronger than hydro, so of course you would have had to take more to get your normal pain relief. Mention perhaps you did some research and suggest you would be open to trying a stronger dose of the hydro in replacement of the oxy as you understand or have heard that oxy is more effective/ stronger buy a small amount. He should understand, and be familiar with the equivalency charts. Even though their is not HUGE difference between the two, 5mg of oxy just is not going to be quite as strong as 5mg of hydro, close but no cigar. I would say honesty as it is always the best policy (usually anyway) also doctors for the most part are used to working with patients and makng the neccesary adjustments when they are switching medications. I wouldn't worry about it.
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    @dingleberry : There certainly are doctors out there who are just regular people, and might not be phased by what we understand to be a very reasonable departure from usage as directed. But in my experience (and I've had more than most people twice my age) these kind of doctors are the minority. If RR just started seeing this guy, it's probably a bad start to the relationship, or at least a bad thing to bet against. Even if you could easily replace these with tramadol, the words "drug seeker" are not what any of us want written in our medical records ;_;

    And you're quite correct that oxy and hydrocodone are not equipotent. I think the conservative equivalence is 5mg oxy = 7.5mg hydro, though 2x might be closer in practice (hydro never did that much for me). As you say, a competent doctor should have known this, but "you don't know what you're doing so I just upped my dose of opiates" probably isn't that ingratiating ;3
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  8. #8
    Quote Originally Posted by shkdwnst View Post
    The best idea would be to replace the hydros with vitamins or some other pills that he look like them. There are all about the size of many different things, many over the counter. Just put the correct number of those in, and let him count the correct number. Its worked for me numerous times. Until I got lazy and got booted for over dosing myself.

    Be careful, they don't play with that, no matter what excuse you give them. They're used to dealing with lying junkies all day, so they won't believe anything you tell him.

    It really sucks.
    This is completely counterproductive to what the OP wants. The idea is for the doctor to not believe the meds are being abused, or at most "only suspect" that the meds are abused. By replacing the meds with other pills, the doctor will "absolutely know" that the meds are being abused.

    I do agree that, while this situation is bad, the safest (and most painful) course of action would be to postpone seeing the doc until your script is done. Get your refill and see him then. Hang in there.

    Also, I have found that when I was switched from oxycodone to hydrocodone (for just this reason, so I didn't have to go in as often), that the dosage I needed for comparable relief was about 2/1 of hydro to oxy. I don't recall exactly, but I think literature suggests that the actual ratio in potency is 1.5/1. I know of others who feel the same, that the official dosage ratio is lower than what most people really need for the same relief.

    "IF" you want to take the chance, discuss the ratio issue with your doctor. I know it's only your third visit, so be very cautious if you do consider bringing this up. I only mentioned this to my doc after we had a more open relationship, and I ended up switching back to oxy, as they tend to give me more energy than hydro, at a comparable pain relieving dosage.

    I am sorry and I sympathize with you for the problems the hurricane has brought on us. It has definitely been a rough couple weeks.
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    Yes, the option you mentioned was the one I was thinking of doing is wait until my next refill is do and then go. He actually said to me why change something that is working and seemed to think I should keep with the oxys but I thought they were a bit strong but perhaps when he asked me what strength hydros (he said keep it the same?) like a question, I figured yeah, why not. I really didn't think there would be that much difference. It is so crazy how you have to watch everything you say. I do have tramadol that is old but will take to hold me over until I can get in there. I appreciate your response and rethought it today and went with the option of waiting for my next refill.

  10. #10
    Quote Originally Posted by Rockieroads View Post
    By the time i see him I will be out of the hydros as I have like 3 left and some days I took 4 and somedays 6. With the hurricane I ended up feeling the pain even more so. Do I tell him the truth or just say I forgot to bring in my meds?
    Honestly you don't think the doctor is stupid? You tell him the truth. If you work with him, given what you've said, he'll work with you. Otherwise, when you walk out of his office, don't expect to return.
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    No of course I don't think he is stupid!!! Do you think though every one remembers to bring all their meds? I have never been asked before by him or my old dr. so this is new to me. If he or the nurse mentioned it prior to my very first visit, I would have brought them but I don't recall any messages of the sort. That is what I said in my original post about being upfront, if I knew there would be such a big difference, I would have dealt with the tiredness much easier than dealing with the pain. It was probably better to have gotten a higher miligram for the hydros but it is trial and error. He also could have suggested it.

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    Aw thanks. I had a lot of damage due to 3 huge trees that came down and I had some one cut them all up and take them away but I will still need to do the work myself of raking, cleaning up the debris, getting new gutters etc. My husband is going to try to make it down but we have his sons living with us. Believe me if I could afford to hire someone to do this I would. I find just doing any type of bending, raking, gardening, is painful. Those days of working in the yard all afternoon on weekends are now long gone. Just baby steps now. Thanks for your advice as well..

    *This post was auto-merged. The following text was added 18 minutes after the last post:*

    Quote Originally Posted by dingleberry View Post
    I would tell the truth. It is very comen and most doctors should understand that switching from oxy to hydros for many patients will leave something to be desired in the pain department. If he switched you and had any clue what he was doing, he should have switched you to 10mg hydros from the 5mg percocet, main reason being is that oxy is a tad stronger than hydro, so of course you would have had to take more to get your normal pain relief. Mention perhaps you did some research and suggest you would be open to trying a stronger dose of the hydro in replacement of the oxy as you understand or have heard that oxy is more effective/ stronger buy a small amount. He should understand, and be familiar with the equivalency charts. Even though their is not HUGE difference between the two, 5mg of oxy just is not going to be quite as strong as 5mg of hydro, close but no cigar. I would say honesty as it is always the best policy (usually anyway) also doctors for the most part are used to working with patients and makng the neccesary adjustments when they are switching medications. I wouldn't worry about it.
    - M.D. (Massive Dingleberry)
    Yes you are right. I would have thought he would have figured to bring me closer to the higher miligram instead, he kind of asked me "same miligrams"? And I said I guess so, yeah. But the way I read some responses you have to really watch what you say or you can be labeled. He has all my reports so it is not like I am lying about the discs, stenosis, etc. You know I read where they the senators of certain states want the doctors to stop prescribing vicodin/hydrocodone as it is out in the streets so much. But yet I was told by my previous pharmacist in another state that they had to fire the entire pharmacy staff as they were stealing pain medication. When I asked for a particular manufacturer once, I was told they don't carry that brand in their warehouse but would order it. So if it comes from a warehouse of some sort I am sure some employees have figured out a way to get some out the door. I was really surprised when I heard the whole staff was fired, I always said they had a quick turnover and that could be another reason so many pain meds are out in the street. Granted some doctors may over prescribe but it tends to make sense a lot is leaking out as well. I once worked for a pharmacist and I remember he gave me this huge box of smashed bottles, broken ones, pills that were loose and I had to do a basic count and inventory. I asked him what happens to these broken bottles, crushed etc and he said he gets a partial credit for them. I recall seeing valium, amphetamines and thinking how easy it would be for someone to just take a few as this box sat for a long time in the storage room. These senators don't have to deal with pain yet, but when and if they do, they'll understand what is needed to function, Sorry for the rambling here. Thanks again.
    Last edited by Rockieroads; 11-05-2012 at 02:48 AM.
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    The fact that I wanted a pain medicine that didn't make me lethargic and wanted a less potent one should show I am not in it for the high or drug seeking. But now I rather deal with feeling tired than in pain. Not only does my back hurt, I feel achy all over. I am going to tell him I thought it was a good idea but after a month of taking them, I should go back to what works. I am surprised he even asked me what does for the hydros....he said "keep it the same" and I said yes but like someone posted here, it takes 2 of hydros to feel the equivalent of 1 perc. For me that is. There is so much paranoia about Doctors and Pain drs. and people are worried they will be lableld but if you have a genuine injury and have medical documents to support it and if you feel paranoid by asking a doctor for something better or less, then he is not the doctor for you. No one should feel that way when discussing their pain level with a pain management doctor. This man seemed nice enough and willing to help with whatever I thought would make me less tired. If I was asking for oxycotin off the bat on the first visit, I would say not a good idea but I was going for a lesser pain pill not stronger. Yes in my case I am going to be upfront and honest and see how it goes. I thank all of your for the support. We just need to remember we are the ones living with the injury, not them.

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    Well as I thought about it more, if I should not in the least eel paranoid about asking for a lower dose and then finding it didn't work as good as the percs,, You know if a doctor makes you feel paranoid, then he is not the right doctor for you. I am looking for a better quality of life, not tired all the time, but yet have the pain manageable. This is something that their getting paid for to help and listen to what the patient is saying. The more time I had to think it over, I did nothing wrong with wanting a less potent medicine.

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    You're lucky he never called you out on it by looking for an imprint or checking a website real quick. I see what you are saying as he probably was looking for a count but what would you do if he just took one and went to look up the name or imprint or saw nothing on it? I thought it was funny but I wouldn't want to get caught doing something that can be easily researched real fast.
    Last edited by Rockieroads; 11-09-2012 at 03:06 AM.

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    Quote Originally Posted by coachmcguirk View Post
    Those are both bad options, they either make you look like you're abusing your meds or trying to get more opiates than you need. In the latter case, the best scenario is that he'll just refuse to give you the oxys, or he'll give them to you on condition that you absolutely bring them in like the next day. It's very unlikely he'll be amiable about taking more than prescribed after the fact, and without having been up-front about it already :/

    It sounds like you're fairly near the end of your script anyway. Make some excuse as to why you can't come in, tell him you'll just finish out the hydro script, and then go to pick up/have him mail the oxy one.

    If you're not near the end of your script, it might be best to order some tramadol or something to hold you over. There are IOPs that ship express, or you could order some overnight from a US consult place (but be weary of the possibility of getting caught double-dipping on pain meds...). At this dosage 100-200mg of tramadol would work just as good, if not much better (I take 100mg doses of tramadol for moderate CP, and 5mg of oxy does practically nothing for me).

    Doctors are very careful about prescribing oxys these days because honestly they have to be. Be very careful if you think you'll be needing opiates from this doctor for any period of time
    Thanks for your advice. I am a bit late with responses as I was out of state due to the damage done to a house I own and then I stayed through Thanksgiving. But before I left the nice pharmacist I deal with let me know my pain meds 3-4 days earlier. When I got back my pain dr. voice mail says to call a week before you run out of meds. Wouldn't you know some nurse called and realized I got them 3 days earlier so I explained that I was out of state and would be gone for close to 3 weeks and didn't want to run out. She was ok with it but I swear they make you feel like you are doing something sneaky when I have been too honest. Told him to take me off percs as I was tired. I saw him a days before I left and told him that I should have had stayed with percs as the lower dose of hydros is not working as well and now I can't get him to raise the dose. Me and my big mouth, should have left things they way they were. I just felt tired a lot from the percs. Probably got him in not so good of a mood. He keeps pushing for those spinal shots and I had them a few times. The first one worked good and the 2nd time, I hurt from the actual shot and it did not last anywhere as long as I was told. Oh well.. But thanks again for your information.


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