Tapering off Lortab to Tramadol... Need Advice

[thehollowclown]

Hello, my name is Becca. I am fairly new to this site and this community, so forgive me if this question has been asked before.
I have been taking Lortab 7.5, four times a day, for several months to ease my Fibromyalgia and arthritis symptoms. I've recently began tapering off (not of my own will), and I'm down to one daily, starting today, with enough left for three days. I've got an old Tramadol prescription sitting around, and I've heard they are used to ease the withdrawals. My symptoms are always severe when I stop the Lortabs, so I'm sure I'll end up taking the Tramadol one way or another.
Here's my question, now that I'm down to one Lortab daily, would it be safe to take that in the morning, and Tramadol in the evening?  What would be the proper dosage to ease my symptoms and possibly help the pain? How long should I take the Tramadol, and how often?
I've read somewhere that Tramadol can cause serotonin syndrome? Is this true? If so, how and why? I am on 20 mg Paxil daily, and due to a bout with serotonin syndrome in my past, I am definitely overly cautious. Should I avoid things like Robotussin while on the Tramadol?
In all honesty, I will probably end up taking the Tramadol one way or another. I have a slight substance abuse problem, and the withdrawals from Lortabs will surely leave me reaching for whatever I get my hands on. If someone here can set up some safe protocols for me, it's more likely I won't abuse it but rather, take it properly to avoid pain in the long-run. Hope someone here has some wise words for me. :)

[nick30]

Jan is absolutely right. all of us long term chronic pain people know without doubt that opiates are the absolute last resort. if you use them for reasons other than pain(even just a little)then you are really endangering yourself. I hate to sound like an old fart but these drugs really do have the potential to mess up a persons life COMPLETELY.
You are too young to let your life go to ruin over these meds. Please chat with some of the folks on the substance abuse forums, I'm sure they can tell you the full terror of what these drugs are capable of. If you would prefer to talk with one of them privately I will arrange for one of the wiser heads to chat with you.
When you say these drugs make you feel normal that really is a massive warning sign that no-one on this forum would miss. And by all means, keep in touch with us. It's also perfectly ok to post on both forums if you want to.
Even though you're young, you still have responsibility for your own welfare. You need to make the right choices here. A wrong choice could have terrible implications for you in the long term.
If we can help you make the right choices that would be great, but this is really something that you need to get on top of for yourself.
Take care,
Regards,

Nick.

[thehollowclown]

Sorry for the brief post but I'm in a bit of a hurry:
You guys are right.. I do have some underlying issues with my meds. I have said this before; I felt like absolute **** my whole life until I had my first Lortab. I could live with the pain if I was forced to, but it seems that if I'm not medicated, I have no joy in my life, and cannot stand to be around anyone, w/d or not.
My prescription is refilled on the 17th, which is less than two weeks away.
Thanks for the advice. I do understand that if I'm on pain meds now, it can only get worse from here. I have been taking all of my alternative meds just as the doctor prescribed, and they do seem to help.. the keyword here is 'seem.'

[BOK2Bjan]

I have a great deal of sympathy for you.  Since you admit to having had problems with substance abuse in the past, it sounds like you have a genetic propensity for it.  My son, 18, started stealing my opiates (at first for pain) and quickly became addicted.  He's battled it for over a year and I've been left with only 1/2 my meds many months.  But I try to take the least possible anyway, and often don't take the amount prescribed, so I was OK, but his problem - that's a different story.  To be so young and already have this tendency, I'd run, not walk, from these drugs IF it's possible.  I use them - have for years due to serious pain, and no matter what age, if you need them - you need them.  But if you can manage somehow without - trust me - do it.  Tolerance is a terrible thing!!  Because I take opiates on a regular basis, if anything, like surgery, or a serious injury comes along, the amount of drug I need for pain control is through the roof.  For that reason, I haven't upped my dose for years.  It's not easy, but you have to treat these drugs with great respect.  If your condition continues, by the time you're 45, you'll be taking a massive dose, and then what?  Those of us in this situation against our wishes, know it's the most unfortunate feature of the drugs - the tolerance.

Your question - if you are going to take the ultram anyway (ama), look up the comparable dose.  Keep the amount you take as low as possible - don't take vicodin in am and ultram in the pm, just take the ultram after your other is gone, and keep the dose once a day, and as close to the amt of pain relief you get with the one 7.5.  I used to take ultram years ago, and it raises your serotonin levels.  Mine are low, so it wasn't a problem.  If you're taking SSRIs AND ultram, you can end up with too much serotonin and get the syndrome.  That's another reason to keep your dose low.  It's not as strong as vicodin, though, and also it's chemically very different.  What dose pills do you have?  How many days till your refill?

I would like to encourage you to try every alternative treatment possible also, and count yourself fortunate to have found a Dr. who is willing to Rx narcotics, but look for other means of pain relief as well.  As said above, if it doesn't work, you have other options down the line.

Blessings, Jan

[sandee1818]

Hi,
I am sorry your in so much pain. You are a person dealing with pain and so yes you are in the right place. So many people do have problems with the addiction issues that come along with this drug. If you are taking it for strictly pain then your fine, if you feel you are addicted or becoming addicted then you may have a problem. I do appreciate your honesty and think if you are willing to work with thus new doctor you will be okay. Not all doctors believe in pain medicine for chronic pain and they will suggest other options and it is my suggestion that you try those option first and give it your all and then go from there. If those options do not work then it is time to look for a new doctor who will work with you on your pain and addiction issues.
The tramadol will be hard to detox from too so be very careful with it and at high doses it causes seizures.

[nick30]

Hi there,

I think Mollyrae is right. you will probably benefit from talking to the folks on the substance abuse forum. They are well versed in the kind of issues you are going through. I'm not saying that you don't belong here though, by all means stay in this forum if you want to, but just be aware that people won't judge you badly if you think you need to visit the other forum.
Seeing as you're so young it is probably a good idea for you to get on top of this before it gets out of control. Please don't get used to liking these drugs so much. The way you talk about it is indicative of someone with an addiction moreso than pain. I'm not saying that you don't have pain, i'm saying that i think there are other things going on.
If I'm wrong then i apologise, however I think that deep down you probably know that you don't take these meds purely for pain. And that's a big red flag.
Take care of yourself,

Nick

[thehollowclown]

Thanks for your response.
Yes, I am short on Lortab for this month. I've started seeing a new doctor: I have no insurance and through a mutual friend he has agreed to see me for a minimal amount. He's really big on natural healing, and herbal supplements, which I think is great, but he doesn't agree with me being on pain pills at such a young age (I'm 24) and now I'm only getting 45 pills a month. I don't think he understands the pain I am in, but I can no longer afford to see my previous doctor.
My usual agenda is Lyrica (100 mg 2x daily), Soma (30 mg 2x daily), and of course the Lortab. I still have all I need of the two aforementioned. It's only the Lortab w/d I fear. Aside from Paxil that's the only medication I take, and rarely more than I'm prescribed. I would not describe my behaviors as 'abuse' though I have had problems with it in the past.
I've tried many meds and nothing makes me feel 'normal' quite like the Lortab does. I have been told that you don't really get addicted if you are only taking them for pain, but I disagree. I have been thru the w/d's once; I was horribly nauseous, depressed, and my body felt like it weighed 10,000 lbs for about a week. I was so low, and in so much pain that I became violent, which is unlike me. Not to mention that I have bipolar disorder and I'm afraid it could trigger a depressive episode.
I know that I will live through the withdrawals, and when I get my prescription refilled I plan on taking them as prescribed, no matter how much I disagree. I am more worried about my family, and my job, than I am myself. I may not have many Lortabs but I still have a life to live and work to be done, and all I can see is looming disaster without the medicine I'm so used to having.
If you still think this is a better question for the Substance Abuse forum, then I will take your advice. It's possible I am in denial.

[FeCielo]

I have been on Lortab 7.5 four times daily for several years now. I have had occasions where I have run out early.....due to theft of my meds....and while the W/D symptoms can be uncomfortable they should be fairly mild and gone within a few days. As far as the rest of your question, I can't really answer I just suffered through until my refill date and took precautions to make sure no one could steal my meds again.

[Mollyrae]

Hi Becca:

First of all, why are you having to stop the Vicodin??Are you short this month?? Doctor making you quit??  I usually don't answer these types of questions and leave them up to the Substance Abuse Forum because that is where you should really be but I will tell you what I think.

You should be alright without taking additional medications. You are not on a very high dose and your w/d symptoms should be quite easy. I wouldn't imagine that you would feel crappy any longer than 3-4 days.

I have this feeling that you are on a few more pills than what you tell of and I'm wondering if you aren't looking for a way to ease the wickedness of full blown W/D. Am I right??

The Substance Abuse Forum deal with issues you might have during the w/d process. I suggest that you hop on over there and post your issues.

Take care,
Mollyrae