Percocet & Vicodin

Hello Everyone,

I read on one of the pain newsletters last night that the feds had a little vote to stop making percocet and vicodin and it passed 20/17. Their concerns are over the the Acetomenophen overdoses resulting in liver damage. They gave stats of 400 people died from liver related problems and some 240,000 needed medical care last year. So, I guess rather than finding a way to educate the consumers its just easier to stop making it. Its not in concrete yet that this will happen, but they said the FDA usually goes along with their recommendations.

It will be interesting to see how this pans out.

I think a simple label change for Vicoden and Percocet and any medication that contains acetaminophen would be good enough. When you buy the generic version of these meds it say exactly what they are and how much of each drug is in them. The name brands usually don't.

If this does go into effect I wouldn't worry too much about any shortages. Companies that make these drugs in either the name brand or generic versions will be able to step up production of the straight narcotic without any trouble.

It is frustrating though. People will have to go through some BS because a handful of idiots in and out of the medical community. At least it won't be as bad as it was/has been over the children's OTC cold medicine bit caused by the same reason.

Kitty,
You're way more trusting of those making these decisions than I am. Maybe it's your youth.

Removing the APAP from the percocet in essence turns it into oxycodone IR. But for some of us, the combination of that together in the same pill may prove to be more effective than the oxycodone plus tylenol.

It's pretty siimple; insurance companies already regulate how many pills of various meds they'll allow in a month. So they make sure the MDD is enforced in dispensing these, with serious warnings about taking extra tylenol, and a list of common OTC meds like NyQuil and such containing acetomenophen can be easily included in all the other stuff they give us. Other than that, can't protect people from their own stupidity.

Sorry, guess I feel pretty strongly about this one because I DON'T trust that they know what they're doing in terms of the effect on CP patients. In general, it's pretty well been shown by the actions of the DEA, FDA, and even doctor's overreactions that the needs and concerns of CPP's are no where near the top of the priority list.

PaLady

I take Percocet without Acetomenophen. Does this mean I can't get that? No more Perocet in any form if this passes?

Here is the link to the MSN report on this decision by a panel of experts advising the FDA on the Acetaminophen issues, including, but not limited to, banning Vicoden & Percocet.
http://today.msnbc.msn.com/id/31664450/ns/health-more_health_news/?ns=health-more_health_news

The link to the notes from the FDA panel are available at:
http://www.fda.gov/AdvisoryCommittees/Calendar/ucm143083.htm

To provide feedback to the FDA about these recommendations, you can go to the FDA's website through September 30, 2009 and post comments. Here is that website:
http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm165107.htm


I do think we need to be cognizant of the facts surrounding this issue. First, on April 28, 2009, the FDA approved a new regulation requiring additional labeling on OTC acetaminophen products warning of the dangers of overdose, combination with various prescription drugs (not only narcotics, but other meds like warafin) & combination with alcohol.
The panel addresses a number of issues, but the topics it addresses do not seem to be the ones referenced here. Abuse does not refer to addiction, but rather to those taking it to attempt suicide, which results in half of the serious cases of acetaminophen overdose cases in the U.S. The other half of the cases the panel labels as "unintentional overdoses" where the user was not aware that there was acetaminophen in the product. Their goal in pulling prescription products with acet. in them is to force patients to have 2 prescriptions to where they would be more likely to realize that they are consuming both the narcotic & acet.
Lastly, and perhaps most importantly, they discuss that they feel that an educational campaign would be prohibitively expensive. They tried a small campaign in 2004 & it had almost no effect.

I only mention these issues b/c if we are to write letters that have any chance of making a difference, I think they need to address the actual concerns of the FDA. It appears that addicts abusing vicoden/percocet is not a concern of the FDA at this point. Honestly, I'm not really sure how educating the American public could be made cost effective. Americans seem unbelievably careless with OTC meds. The vast majority of stores where those meds are sold have a licensed pharmacist on staff, yet many people do not discuss those issues even with a pharmacist.

Really, the only thing I can even think of that might work is implementing the same policy that was implemented with the Sudafed type drugs. The moved them behind the pharmacy counter. Maybe then pharmacists could offer counseling to every patient who purchases OTC meds with acet. in them. I don't know. I'm kinda with all of you. I'm tired of stupid people making it harder for those who really need treatment for CP. Between the stupid people who want pain meds just "to relax", crazy people who say things like "I wish I could get surgical anesthetic every night so I could sleep" -- MJ certainly wasn't the first time I ever heard someone say something like that, dumb people who refuse to consult with their doctors or pharmacists b/c they would rather self-treat, etc., etc., etc. I am starting to feel that maybe refusing everyone access to any of these meds really may be the only option to keep stupid people from accidentally killing themselves. UUUUGGGHH! So frustrating! I feel for you all. Fortunately, this round I'm safe with my meds (I have an extensive family history of cirrhosis so I avoid all acet. products like the plague), but I imagine the stupid people will find a way to ruin my meds given the chance so I figure it's just a matter of time. :(


peace,
Frances

The report I read only related to the issues of the liver that was their big concern. They also mentioned lowering the dosages of the OTC Acetomenophen. This article never mentioned anything about addictions issues, it was strictly talking about the liver issues.

Frances hit on a very good subject of lack of people asking the pharmacist info on OTC products they buy. I think most people are of the mind set it's there on the shelf so it must be an ok product, most never read past the dosage. But, that's very true with precription medication, people will not ask questions. They will not read their print-out sheets given on every rx they buy, people come here and ask us questions on side effects that they should have asked the pharmacit when they picked their meds up. Or if they had read their print-out they would know what can be a possible side effect. How many times have we seen it someone posts the dr changed their medication and they just picked it up and want us to give them info that is at their fingertips!!!!Can anyone explain that one? We have too many tools at our hands now not to be educated when it comes to medication and even medical information.

Frances, thank you for taking the time to type all that out. I wanted to last night, but I was too tired.

ETA: Even though the generics are interchangeable with hydrocodone, the Norco brand only has 325mg of tylenol, while regular Vicodin has 500 (regular), ES has 750, and HP has 660.

Post Edited (BionicWoman) : 7/14/2009 8:10:23 AM (GMT-6)

Susie,
I could try to answer the question you pose about "Can anyone explain that one?" but you'd have to edit my answer!!

PaLady

Susie,
Ok, don't beat me up but no, the bed's not elevated. I'm still debating about it. Have been reading on the GERD forum, plus the nexium is helping. And I spent today starting my taxes, and investigating the partnership for prescription assistance program website. BTW that's pretty good, although you have to go back and forth between various links for each drug. It does APPEAR I may be able to get the nexium at no cost if I meet their application requirements. Found a couple places that look like I can get my neurontin - and maybe even lyrica. But of course the pain meds are the challenge. No one lists percocet or oxycodone IR. Possibly oxycontin, but that requires a complicated application process and I've never even tried it before.

I just know elevating the bed is going to cause problems with my neck and possibly spine. It's been a delicate balance for many years, and still is. I am making huge changes in my diet. No more friend foods. No more caffeine. No chocolate. No eating for 3 hrs. before bedtime (a hard one). I guess there's just so much I can do at once, you know?

I applied to my retirement annuity for an exception to their rules. That was last week's project. Finally got the, out a 3 page letter. It's just one thing after another. Please understand, I'm dancing as fast as I can.

PaLady
p.s. I forgot to add the continuing tooth pain where the new crown was placed. I'm about half way through the antibiotic, but I already know that I'm going to need a root canal. So yesterday I called around about prices for that. Around $800-900, and most all dentists want their money up front. I wake up every morning with that tooth aching. I have so had it with pain!

Post Edited (PAlady) : 7/14/2009 6:03:26 PM (GMT-6)

White Beard,
Nope you didn't miss anything. In my view the dentist screwed up. But he's not admitting it. Said he didn't see any evidence of it when he was doing the work or looking at the X-ray. So guess what? They get to drill through the new crown! No, they don't have to replace it, but wiil have to put a filling in. I've called around to several dentists and evidently drilling through a crown is relatively common. But you're right he should have caught it. I will talk to him again after I'm finished with the antibiotic and see what he'd charge to do the root canal; had he done it when he was doing the crown, I'd still have had my dental insurance. Probably would have cost me another couple hundred, but not the full load. I can tell this dentist is moving toward the "it's not my fault and here what it's going to cost you" BS. But one thing I don't want is an angry dentist drilling through my tooth, so I won't get pissed at him until later. If he gives me a deal on the root canal - including a payment plan - I may have no choice but to let him do it. But at the moment I don't have the money, plain and simple. My cousin just loaned me a little bit more but I have to get my car inspected this month too!!!

I'll take all the prayers and positive energy anyone wants to send, even though I'm not religious (but am spiritual).

Ok I don't want to hijack this thread any more than I already have!

Thanks, WB,

PaLady

Thanks, Bill!

Most people won't know what we're talking about (well, Susie and WB do!) but Bill has helped me out a lot on the GERD forum and he also has Barrett's esophagus. I may try to borrow a wedge or something and just see if it makes things any better at night. But honestly, I also get the acid in my throat and mouth during the day, too.

I know this belongs on the GERD forum. Sorry, Susie!

PaLady

I agree with Susie about raising my bed not affecting my neck & the only reason it caused probs. for my back was b/c I was dumb enough the first time to try to raise my bed without any help. Not my best idea :). Once my dad & brother came & raised it for me I was fine.
My idiot allergist dx'ed me with Silent GERD. Turns out I had a rampant infection that had eaten a hole through my sinuses. It showed up on my CT & that's why my neuro referred me to an ENT, but the ENT was too dumb & told me that if I was weak enough to "want" Actiq for my back pain that there was no way I could handle such a severe infection while on a drug holiday. Idiot! The infection spread throughout my entire body. but that's beside the point -- my neck (which is super sensitive & I can't even sleep w/ a regular pillow) and back were not bothered in the least by raising my bed. :)

Hope you feel better soon & if you do decide to raise the head of your bed ... get some help! ;) hee, hee, hee

peace,
frances

PAlady, does your dentist have a brother who is a PMS and recently moved to Oregon?