Re: Avinza - Detox

[Guest guest]

Jeff wrote:

<snipped>

I thought I'd pass this along to anyone that cares. Avinza is a

relatively new drug and from what I can determine, is much easy to wean off then

say Oxy or Fentenyl.

JEF,,

Thank you for posting that. I did find that interesting.

Later,

MT

[Guest guest]

has anyone here ever taken neurontin *cp ..for pain.if you have did it

help and what side affects did you have if any .

[Guest guest]

Jeff wrote:

> Phil - I understand what you're saying - but I'm just amazed at this point

> that I don't feel as bad as I thought I would. I took 3 60 mg avinza's

> daily. Last Thursday I cut one out and went on till Monday this week.

> Monday I cut it down to only 60mg and while I feel achy and somewhat sickly,

> I don't feel as bad as I thought I would cutting back in such a short time.

That's actually fairly moderate according to the books, so I guess I'm

not that surprised that it worked for you. Some references suggest

cutting it as fast as 20% every day. I think that's too fast based on my

own experiences about a year ago when I decided to stop all meds to see

what I really needed. I tapered over just a few days. The acute

withdrawal was very unpleasant but tolerable because it only lasted a

week or so. It was much like having a really bad flu. The bigger problem

was the " protracted " withdrawal consisting of moderate depression and

insomnia that dragged on for weeks until I started the antidepressant

Wellbutrin. This is the same drug as Zyban, used to help cigarette

smokers quit, and I can personally report that it really works on

protracted opioid withdrawal too. (Nicotine is not an opioid, but many

of its effects on the brain are surprisingly similar).

> I am thinking about cutting back to 30 and I have a call into my doctor for

> his opinion. Do you think it will be much harder cuttiing it back to 30?

> I'm interested in your opinion on this one since this is the first time I've

> had to cut back. Also - I have a great doctor and I know he wouldn't let me

> run out of medicine. I've been very lucky in that aspect.

I don't know how you'll feel (remember, I'm just another patient, I'm

not a doctor) but I do suggest that you not just drop from 60 to 30.

Although you've gone down by 30 mg before, this is now a bigger

percentage decrease (50%) than before (33%). I'd try cutting it from 30

to 20, which would be a 1/3 reduction just as when you went from 3 to 2

of the 60s every day. In other words, make each reduction a constant

fraction of your *current* dose. That is mathematically how you get a

decaying exponential.

I'm curious to know if your doctor gave any specific reason for

suggesting that you cut back before surgery, as I've never read that

anywhere. If you don't need as much for pain, then by all means cut

back, but I don't understand why you should subject yourself to

unnecessary pain and stress before surgery. Yes, you'll be more tolerant

and dependent on the larger dose, but the anesthesiologist can easily

compensate for that with additional opioids.

That brings up a good point, make absolutely sure the anesthesiologist

knows you're on pain medication: both what and how much. Not only will

he need to compensate for your tolerance, he may use opioid antagonists

(blockers) like Narcan to reverse the effects of the opioids he'll

administer during surgery. Since you're opioid-dependent, giving you too

much of an antagonist could trigger severe withdrawal and pain. If he

knows you're dependent he'll be extremely careful in his use of Narcan.

I mentioned tapering when you discover you're short on medicine because

there have been cases reported here where a patient had his medication

repeatedly stolen and his doctor would not replace it. Instead of

immediately beginning a taper to conserve, he prepared for a hospital

admission on the day he expected to run out. That's simply not

necessary. (I also couldn't understand why the guy could not buy and use

a good home safe to store his meds.)

Phil

[Guest guest]

Extraneous Text deleted by Moderator

Hello,

I take Neurontin. 600mg three times a day..

it does help with my neuropathic pain. Believe me, when it is time

for another dose, I know it..

There are of course going to be side effects....My Doc's tried other

things and combinations of drugs but I was sensitive to them,

especially trileptal...

The neurontin makes you drowsy, at higher doses and I believe weight

gain is common, You need to have your liver function followed, I

don't know all else, I have been taking it since October of 2001 I

think Memory is affected also...I don't know if it is the neurontin

or the illness..

So if you have questions, I could try to answer them, some of the

other people on this list are better suited to answer questions about

medications.

God Bless,

Daphne

[Guest guest]

Extraneous Text deleted by Moderator

Hello,

I take Neurontin. 600mg three times a day..

it does help with my neuropathic pain. Believe me, when it is time

for another dose, I know it..

There are of course going to be side effects....My Doc's tried other

things and combinations of drugs but I was sensitive to them,

especially trileptal...

The neurontin makes you drowsy, at higher doses and I believe weight

gain is common, You need to have your liver function followed, I

don't know all else, I have been taking it since October of 2001 I

think Memory is affected also...I don't know if it is the neurontin

or the illness..

So if you have questions, I could try to answer them, some of the

other people on this list are better suited to answer questions about

medications.

God Bless,

Daphne

[Guest guest]

Extraneous Text deleted by Moderator

Hello,

I take Neurontin. 600mg three times a day..

it does help with my neuropathic pain. Believe me, when it is time

for another dose, I know it..

There are of course going to be side effects....My Doc's tried other

things and combinations of drugs but I was sensitive to them,

especially trileptal...

The neurontin makes you drowsy, at higher doses and I believe weight

gain is common, You need to have your liver function followed, I

don't know all else, I have been taking it since October of 2001 I

think Memory is affected also...I don't know if it is the neurontin

or the illness..

So if you have questions, I could try to answer them, some of the

other people on this list are better suited to answer questions about

medications.

God Bless,

Daphne

[Guest guest]

Daphne Fernandez wrote:

> The neurontin makes you drowsy, at higher doses and I believe weight

> gain is common, You need to have your liver function followed, I

> don't know all else, I have been taking it since October of 2001 I

> think Memory is affected also...I don't know if it is the neurontin

> or the illness..

I've used quite a bit of Neurontin also. It doesn't make me drowsy so

much as it makes me dizzy and lightheaded. My vision can also blur a

little because it makes your eyes tremor slightly. It does help my

neuropathic pain, but the effects are rather subtle and require pretty

large doses that I have to work up to gradually to minimize the side

effects. It does seem to work better in combination with an opioid.

Until I started methadone, I could barely get any relief at all unless I

used both Neurontin and an opioid like oxycodone or fentanyl. Now the

methadone alone is starting to give me more relief than I've had in a

very long time.

Neurontin has become very popular for neuropathic pain. There are a few

reasons. One, the manufacturer pushed it hard a few years ago. That got

them in trouble with the FDA since neuropathic pain was not yet an

approved use. Two, it's a very safe drug. They couldn't even determine a

lethal dose in rats because even massive doses wouldn't bother them!

Three, it's one of the very few drugs that the body doesn't metabolize;

it comes out as the same drug that went in, meaning that drug

interactions aren't a problem.

I'm pretty sure Neurontin doesn't require liver monitoring either; this

*was* true for many of the older anticonvulsants that it is now

replacing, especially carbamazepine (Tegretol).

For a long time, Neurontin's mechanism of action was unknown. It was

thought to be a GABA analogue (hence its generic name of gabapentin) but

a bunch of papers have come out saying it works on the calcium channel.

Phil

[Guest guest]

Daphne Fernandez wrote:

> The neurontin makes you drowsy, at higher doses and I believe weight

> gain is common, You need to have your liver function followed, I

> don't know all else, I have been taking it since October of 2001 I

> think Memory is affected also...I don't know if it is the neurontin

> or the illness..

I've used quite a bit of Neurontin also. It doesn't make me drowsy so

much as it makes me dizzy and lightheaded. My vision can also blur a

little because it makes your eyes tremor slightly. It does help my

neuropathic pain, but the effects are rather subtle and require pretty

large doses that I have to work up to gradually to minimize the side

effects. It does seem to work better in combination with an opioid.

Until I started methadone, I could barely get any relief at all unless I

used both Neurontin and an opioid like oxycodone or fentanyl. Now the

methadone alone is starting to give me more relief than I've had in a

very long time.

Neurontin has become very popular for neuropathic pain. There are a few

reasons. One, the manufacturer pushed it hard a few years ago. That got

them in trouble with the FDA since neuropathic pain was not yet an

approved use. Two, it's a very safe drug. They couldn't even determine a

lethal dose in rats because even massive doses wouldn't bother them!

Three, it's one of the very few drugs that the body doesn't metabolize;

it comes out as the same drug that went in, meaning that drug

interactions aren't a problem.

I'm pretty sure Neurontin doesn't require liver monitoring either; this

*was* true for many of the older anticonvulsants that it is now

replacing, especially carbamazepine (Tegretol).

For a long time, Neurontin's mechanism of action was unknown. It was

thought to be a GABA analogue (hence its generic name of gabapentin) but

a bunch of papers have come out saying it works on the calcium channel.

Phil

[Guest guest]

Daphne Fernandez wrote:

> The neurontin makes you drowsy, at higher doses and I believe weight

> gain is common, You need to have your liver function followed, I

> don't know all else, I have been taking it since October of 2001 I

> think Memory is affected also...I don't know if it is the neurontin

> or the illness..

I've used quite a bit of Neurontin also. It doesn't make me drowsy so

much as it makes me dizzy and lightheaded. My vision can also blur a

little because it makes your eyes tremor slightly. It does help my

neuropathic pain, but the effects are rather subtle and require pretty

large doses that I have to work up to gradually to minimize the side

effects. It does seem to work better in combination with an opioid.

Until I started methadone, I could barely get any relief at all unless I

used both Neurontin and an opioid like oxycodone or fentanyl. Now the

methadone alone is starting to give me more relief than I've had in a

very long time.

Neurontin has become very popular for neuropathic pain. There are a few

reasons. One, the manufacturer pushed it hard a few years ago. That got

them in trouble with the FDA since neuropathic pain was not yet an

approved use. Two, it's a very safe drug. They couldn't even determine a

lethal dose in rats because even massive doses wouldn't bother them!

Three, it's one of the very few drugs that the body doesn't metabolize;

it comes out as the same drug that went in, meaning that drug

interactions aren't a problem.

I'm pretty sure Neurontin doesn't require liver monitoring either; this

*was* true for many of the older anticonvulsants that it is now

replacing, especially carbamazepine (Tegretol).

For a long time, Neurontin's mechanism of action was unknown. It was

thought to be a GABA analogue (hence its generic name of gabapentin) but

a bunch of papers have come out saying it works on the calcium channel.

Phil

[Guest guest]

Extraneous Text deleted by Moderator

I was going to comment on this as well. I read her post, and she

said she had stopped the Avinza but she said nothing about

stoping the Hydro's. For true withdrawl to start, one must stop

all opiods....if one is still taking hydro there would be barely

any withdrawl or none at all.

I thought her doc said to cut down and not to quit Avinza...am i

wrong? It is very dagerous just to stop taking a medication

like that. I wasn't sure if the Doctor had said " Quit taking

Avinza " or " Taper it. " Most doctors would never say quit taking

a medication....but, sense she is still taking Hydro's then i

supose in her case it wouldn't be to dangerous to quit Avinza

all together.

I hope my doctor does the Tappering things when it comes time to

stop taking my Vicodin hp 10/660. If he does just stop me some

day, say when i am recovered...i am going to have a talk with

him and explain how i know that quiting a medication can be very

dangerous. I hear such horror stories about medications being

stopped.

I have seen addiction and withdrawl first hand, and i undrestand

how opiods work. I had a friend go through it and i read up on

everything i could find. Thankfully they are doing great..but,

this was lord.... 10 years ago.

Anyway, just thought i would comment on her post via your reply

lol

Anyway, this wasn't a criticism, just an observation of her

post.

[Guest guest]

hey how much pain tablets dose it take to have withdrawl ,nuerotion never

even work on me i felt no diffrence at all i was just wonerding if you knew

phil you so knowlegable about meds .im on

prozac but for pain davastte think im going back to vicdon its better longer

acting i do not take everyday but usally twice most the time to sleep we all

know how pericous it is.the only way i can sleep is on my billy with hand

under my chest its the modt conforable poatison,i can fine.for my spelling,i

have iq of 137 but cannot spell or script good.i did 3.4 in medcaicl school

but could not finish what a shame. enyway hoping you can answer me.

>

>Reply-To: chronic_pain

>To: chronic_pain

>Subject: Re: Avinza - Detox

[Guest guest]

hey how much pain tablets dose it take to have withdrawl ,nuerotion never

even work on me i felt no diffrence at all i was just wonerding if you knew

phil you so knowlegable about meds .im on

prozac but for pain davastte think im going back to vicdon its better longer

acting i do not take everyday but usally twice most the time to sleep we all

know how pericous it is.the only way i can sleep is on my billy with hand

under my chest its the modt conforable poatison,i can fine.for my spelling,i

have iq of 137 but cannot spell or script good.i did 3.4 in medcaicl school

but could not finish what a shame. enyway hoping you can answer me.

>

>Reply-To: chronic_pain

>To: chronic_pain

>Subject: Re: Avinza - Detox

[Guest guest]

thanks for the info I started the neurontin yesterday and it has helped

the pain a lot but like you said it makes me drowsy and kind of light

headed but to be free of pain for a couple of hours I will deal with it.

[Guest guest]

thanks for the info I started the neurontin yesterday and it has helped

the pain a lot but like you said it makes me drowsy and kind of light

headed but to be free of pain for a couple of hours I will deal with it.

[Guest guest]

thanks for the info I started the neurontin yesterday and it has helped

the pain a lot but like you said it makes me drowsy and kind of light

headed but to be free of pain for a couple of hours I will deal with it.

[Guest guest]

It was a " He " and the Surgeon asked me to cut down on my Avinza.

While it's true I continued to take the hydro - I went from 180 Avinza to 60

Avinza in about a weeks time and am still holding in there.

-Jeff

wrote:

> I thought her doc said to cut down and not to quit Avinza...am i

> wrong?

[Guest guest]

Jeff wrote:

> Phil,

>

> You bring up a good question that I did not think to ask.

This why you should always ask questions!

> Anyway - I think I'm going to stay where I'm at. I got down to 60 mg and I

> take hydro every 4 hours. That should be good enough.

What's " good enough " is whatever level that controls your pain

reasonably well without terribly annoying side effects. This could be a

small dose or a large one, it depends entirely on your specific situation.

> I'm also going to

> ask for a Pain Management Specialist to be present after my surgery so that

> I get proper pain control.

Hopefully you'll get a PCA, Patient Controlled Analgesia. This is a

morphine pump feeding the IV that you control yourself. It has a " basal "

rate, i.e., a slow continuous amount that comes out automatically, and

you can push a button whenever you need an additional dose. They're

becoming quite popular in hospitals and hospices. Since the patient can

get almost immediate relief without having to wait for a nurse, the

patient is much more comfortable and often use much *less* total drug.

Personally, I don't think you'll need a pain management specialist there

if you have an enlightened surgeon who really understands opioid

pharmacology and the need for good pain control. Attitudes among doctors

and nurses are changing fast on this subject, and thankfully in the

right direction.

Since you're so concerned about it, you should definitely discuss this

with your doctor before surgery. If he can't address your concerns to

your satisfaction, cancel it and look for a better surgeon.

Phil

[Guest guest]

Oops, sorry Jeff, i always type He/She Vice Verce along with

other words LOL

Hang in their, you're doing great!

--- Jeff wrote:

> It was a " He " and the Surgeon asked me to cut down on

> my Avinza.

> While it's true I continued to take the hydro - I went from

> 180 Avinza to 60

> Avinza in about a weeks time and am still holding in there.

>

> -Jeff

>

>

> wrote:

>

> > I thought her doc said to cut down and not to quit

> Avinza...am i

> > wrong?

>

>

=====

[Guest guest]

Phil wrote:

> Since you're so concerned about it, you should definitely discuss this

> with your doctor before surgery. If he can't address your concerns to

> your satisfaction, cancel it and look for a better surgeon.

>

> Phil

Phil - I'm going to s Hopkins because I've been everywhere else in

Pennsylvania. All the good Dr.'s have left here because of malpractice

insurance. Hopkins is my last choice. I have an appointment on the 29th to

discuss my surgery. I will bring these concerns up during that visit.

Thanks for your suggestions,

-Jeff

[Guest guest]

Phil wrote:

> Since you're so concerned about it, you should definitely discuss this

> with your doctor before surgery. If he can't address your concerns to

> your satisfaction, cancel it and look for a better surgeon.

>

> Phil

Phil - I'm going to s Hopkins because I've been everywhere else in

Pennsylvania. All the good Dr.'s have left here because of malpractice

insurance. Hopkins is my last choice. I have an appointment on the 29th to

discuss my surgery. I will bring these concerns up during that visit.

Thanks for your suggestions,

-Jeff

[Guest guest]

Thanks Phil - I appreciated your advice. I'll let you know how it goes.

It's coming up quickly - may forth. I also just found out that I'll be

giving a bone graft. I hear that hurts worse than the back surgery. We'll

find out.

Take care,

-Jeff

Phil wrote:

> s Hopkins is a good place. It's in my home town, btw. I just can't

> imagine you should have a problem getting good pain control after your

> surgery. Unlike chronic, non-cancer pain, opioids for post-operative

> pain have *never* been controversial so I can't imagine that you won't

> get whatever you need. Good luck.