pain control?

[Perrotfish]

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Is there a good resource for learning about effective pain control in both acute and chronic pain? When do you give oxycodone vs hydrocodone vs hydromorphone? I've had a lot of patients ask me about Vicoden vs Percoset for pain control and I honestly don't know the answer.

 

[Rendar5]

look up opioid equivalency charts. vicodin v. percocet is honestly whatever the person prefers.

 

[xaelia]

Hydromorphone and the oxycodone-containing preparations (e.g., Percocet) are Schedule II narcotics, while hydrocodone combination products are Schedule III, so, when possible, I write for those (which is basically all the time).

I also write fewer narcotic prescriptions and for fewer pills at a time than most of my classmates.

And it really irritates me when my classmates write our high-risk abuse population for tramadol as if it's a safe drug without abuse potential. At least I haven't seen anyone writing for tapentadol yet....

 

[EctopicFetus]

One thing to consider even though I believe this may have been changed is most of the Vicodin, Lortab etc have 500 mg of APAP which is a lot.

I like the 5 mg Percs or straight oxy. I give most people 12 tabs (harder to forge) unless someone has a real finding then ill give them more.

Personally, I am dont being a narc nazi though I honor our pain management protocol at my job.

One of the few things we can do is alleviate suffering. I do think most of the people who come in with a ton of visits are less likely to get meds from me.

 

[Painter1]

Hydromorphone and the oxycodone-containing preparations (e.g., Percocet) are Schedule II narcotics, while hydrocodone combination products are Schedule III, so, when possible, I write for those (which is basically all the time).

I also write fewer narcotic prescriptions and for fewer pills at a time than most of my classmates.

And it really irritates me when my classmates write our high-risk abuse population for tramadol as if it's a safe drug without abuse potential. At least I haven't seen anyone writing for tapentadol yet....

i've never had anyone come drug-seeking for tramadol. in fact, a good number of drug-seekers are now presenting with allergies to "tramadol" aside from their typical ibuprofen, toradol and morphine allergies.

 

[Greenbbs]

One thing to consider even though I believe this may have been changed is most of the Vicodin, Lortab etc have 500 mg of APAP which is a lot.

I like the 5 mg Percs or straight oxy. I give most people 12 tabs (harder to forge) unless someone has a real finding then ill give them more.

Personally, I am dont being a narc nazi though I honor our pain management protocol at my job.

One of the few things we can do is alleviate suffering. I do think most of the people who come in with a ton of visits are less likely to get meds from me.

Try Norco. Its Vicodin with less apap....325mg instead of 500.

 

[lucky_deadman]

i've never had anyone come drug-seeking for tramadol. in fact, a good number of drug-seekers are now presenting with allergies to "tramadol" aside from their typical ibuprofen, toradol and morphine allergies.

Tramadol gives a buzz when taken in higher quantities. It's becoming one of the fastest growing drugs of abuse (definitely in my local area). This is why it was recently made a Schedule drug by the DEA.

 

[DrMom]

i've never had anyone come drug-seeking for tramadol. in fact, a good number of drug-seekers are now presenting with allergies to "tramadol" aside from their typical ibuprofen, toradol and morphine allergies.

I've definitely seen tramadol drug seekers. My father does some counseling and has encountered a couple of people who admitted to drug seeking for tramadol.

It certainly isn't as prevalent as narcotic-seeking, but it's there.

 

[danzman]

I've definitely seen tramadol drug seekers. My father does some counseling and has encountered a couple of people who admitted to drug seeking for tramadol.

It certainly isn't as prevalent as narcotic-seeking, but it's there.

On a personal note, I find tramadol to be a superior product when compared to most any other narc. Was recently laid up with an injury and was given some. I find that they have a lot less of the nausea/constipation as compared to hydro/oxy and were just as effective with pain. For the life of me, I cant understand how anyone can get hooked on narcs, they all just make me sick and unable to sleep. I dont get it.

 

[deleted109597]

At my medical school, one of the attendings went to rehab secondary to ultram abuse. All he said was you have to take more of them to get the buzz.