Expert: Charles I. - 8/27/2009

Question
QUESTION: Hello, my husband was taking prescription lortabs and benzos perscribed by his doctor because of a screw in his foot and anxiety aswell as insomnia for 5 years, after awhile it became an addiction to the lortabs. He was very violent on the lortabs, he has now has of 5 years decided to put it all down cold turkey to keep us together. He is totally different now being off his medication. His doctor does not know he has quit taking his medicine. I am very concerned about him, it's been almost 2 weeks now he is taking nothing to come off the pills, no kind of medicine. But, he also suffers with anxiety and insomnia and quit taking his benzos, they were not a problem, the lortabs were the problem, he hates to talk about it, he doesn't sleep well at all and has lots of muscle pains, twitches and bad dreams is this part of the withdrawals? What do I do to help him through this he's quit cold turkey, without notitifing doctor or taking any medicine at all. Please help me what is your opinion and advice on what I have told you and asked?

ANSWER: Hi Rachel,

The biggest thing that concerned me was the fact that he cold turkey the benzos after five years of use. That can be dangerous. Abruptly stopping benzo use, especially after considerable time of use, can lead to seizures. The withdrawal from benzos are very similar to the withdrawal from alcohol and it should usually be a medically assisted detox. But if it has been two weeks, the probability of this occurring is minimal. The anxiety and insomnia he is suffering from sounds right on target and should be expected; it will get better over time, but it will take some time.
I really believe your husband should let the doctor know that he wants off these meds and allow him to assist your husband through this. Unless he is some pill-pushing doctor he should be willing to assist your husband through this. Opiate withdrawal he is experiencing (physically) should be wrapping up and he shouldn't have so much muscle pain and discomfort. He can take an over the counter analgesic to help a little with this discomfort. Other than that if he is adamant about doing this himself and not involving his physician there isn't a whole lot more he can do. A couple things he could try to help the process along is trying to do some moderate exercise (walking, swimming, biking...whatever he can physically do). this will assist some with any mood swings or depression he may be experiencing, as well as may assist him with a little better sleep. He should also take a good vitamin supplement to ensure that his body is receiving proper nutrients.
By not involving his doctor, he has really taken the tough road to get through this. If he has a good rapport with his physician I don't understand why he wouldn't allow him or her to help. On the other hand, if he feels like his physician is trying to keep him on the meds he should really be looking for another doctor that is willing to work with him. There are other ways to deal with pain such as alternative pain therapy which uses different techniques to help the patient deal with pain issues other than just by meds. I know this reply to your question is a bit rambling and I do apologize...but as I said earlier, the road your husband has decided to take is a tough one. I'll once again strongly suggest that your husband tries to work with his physician to get through this successfully. Good luck.

Charles

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

QUESTION: Hi Charles, sorry to bother you again but you seem to be helping me here. If for say my husband was to take the Oxycodone capusals would he be most likely to want to start taking lortabs again? By the way he's doing really well... he has cravings but like I said he's more strong welled than most! Hopefull you can answer this one.

Answer
Hi Rachel,

Forgive me for not answering sooner...I had some issues arise that have kept me away. I don't think the oxycodone is such a good idea. It would kinda be like jumping from the fire into the frying pan. Your husband is trying to leave the Lortabs behind...Lortabs are acetaminophen and hydrocodone combined...same thing as a Vicodin. To switch from hydrocodone to oxycodone is really no change...both are extremely addictive and have very similar effects. I would really recommend he receive some professional substance use disorder counseling so he can start learning about the behavioral changes he needs to make to help him deal with this. Switching one substance to another is just substituting...the addiction is still getting fed. Once again I would recommend he talk to his physician about this. If his doctor only wants to treat him with pain meds, then he may consider getting a second opinion and possibly try to find a doctor that can work with him on alternative pain therapy techniques. Hope this helps.

Charles