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Addiction and Substance Abuse

Problem with Vicodin

01/22/2007

Question:

hi. My girlfriend has been dealing with an addiction to Vicodin. She only uses it at bedtime, but she started because of breaking her foot and she alsop has degenerative arthritis in her back, but now she needs it to feel ok, and not lay in bed sluggish. My problem is that she went through gastric bypass surgery and she can not take anything else in a pill form, any aspirin or ibuprofrin, as they all are part of the dont list after this surgery. I dont know what to do because this is the only thing she can take for pain. I really need to talk with someone but I dont want to risk her losing the ability to get pain meds in the future. We are planning to be married in a yr. and I want to help her because this is now affecting our everyday life. Please help

Answer:

Thanks you for the question. It sounds like a difficult situation. I cannot give specific advice on a case, but can give some general recommendations. Vicodin is a strong opioid (hydrocodone) combined with acetaminophen ("Tylenol"). It is very good for acute, self-limited pain situations that will heal and go away by themselves (like a broken foot). It is not generally thought to be a good medicine to take over a prolonged period of time, or for sleep, or every night for a chronic condition like arthritis in the back.

There are many other "non-medication" approaches that can help with long term back pain.  For example:

Medication should be reserved for only occasional use and for specific "bad-days," rather than every night. Also, there are many other medications that can be used instead of Hydrocodone containing products ... reserving the Hydrocodone for occasional use on "bad-days". Many of these medications, if taken occasionally or intermittently rather than regularly "around the clock", can help with pain, but not be a risk for a person who has had gastric surgery.

By using alternatives (physical and medications), this can avoid the development of tolerance, or the need to use more and more medication to get the same result, to the opioid (Hydrocodone). Also it can avoid the development of physical dependence, with withdrawal symptoms including bad pain and anxiety when the medication is abruptly stopped, to the opioid(Hydrocodone).

Hope this helps.

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Response by:

Ted   Parran, MD Ted Parran, MD
Associate Professor of General Medical Sciences
School of Medicine
Case Western Reserve University