Expert: Crystal - 7/9/2009

Question
QUESTION: I have been taking Lortabs for more that 2 years for cronic back pain. I have noticed they don't even help the pain anymore.  My last visit to the Dr they checked my Billirubens and they indicate something wrong with my liver.  I take over 100 lotabs a month and have been for a year straight. I know I am addicted because when I try not to take them I feel terrible. Could there possibly be severe liver damage from this?

ANSWER: Bobbie,

I have a couple of questions; first, is this doctor the one who is giving you the lortabs and are they prescribed? Second, what does your prescription say? The thing is, if you are taking these as prescribed and they are causing liver problems it is due to the acetaminaphen in them. Various things can cause elevated bilirubin levels. Do you exercise alot? Are you flushing your system regularly and thoroughly, by like drinking water and making sure you are staying hydrated? Do you consume alcohol at all and if so how much?

Also, it is common for so many to feel addicted to narcotics after a long period of taking them but if you are taking them as directed by a doctor and you are having side effects when you attempt to stop taking them, that is called dependence which is different and it doesn't make you an addict. Now if you are buying them off the street or something like that and you are taking them then yes that is addiction. Either way there is a way to titrate off of them but it has to be done slowly and over a period of time so that the body can ajust. But I cannot stress enough, make sure you are under the supervision of a physician and he knows what you are doing so that he can help you where help is needed. Make sense?

---------- FOLLOW-UP ----------

QUESTION: To answer some of your questions, No, I do not buy them off the street, they are prescribed Lotab 7.5/500 at 3xday or PRN. Sometimes I do take more depending on pain level. I feel like my body is dependant like you said.  I do not drink alcohol, maybe 1 beer a month. I do not drink plenty of water, my weight is 120.
All makes perfect sense!  I have Spondylolisthisis with severe scoliosis and I can't remamber the last day I had without pain.  I am now able to look into surgery and hopefully stop all this pain management. Can I develope Hep.C from all the acetaminaphen?

Answer
I hope you did not take offense to my questions, they are just things I need to know to better answer your questions.. You need to increase your water intake and maybe cranapple juice.
Sometimes, yes the side effect of excessive use of acetaminaphen can cause Hep C but it depends on different factors..
I hope surgery will work for you and give some relief. Good luck.