Expert: Sherrie Sweet - 10/4/2011

Question
QUESTION: Two years ago (October 2009) I had Shoulder surgery (rotator cuff)that left me in severe pain. There was some nerve damage that somehow aggravated into my trigeminal neuralgia. I was sent to pain management In order to control this severe pain. I was prescribed Hydrocodone 10mg 3x daily Soma 350mg 1x daily and Gabapentin 100mg x3 daily. In August 2009  I ended up in the emergency when my Neurologist added Celexa to all this. I began lowering all my medications till now that I I am almost medication free.  for the last six months I have been taking 5mg of Hydrocodone (the last medication) at night that I cant seem to stop. Is there any way I can pass this wall and stop completely. If not is this amount safe to continue taking.

ANSWER: Hello,
Congrats for reducing your use of medications. I am assuming that you are unable to stop the last dose of hydrocodone due to withdrawal symptoms. Stopping abruptly may cause some low level symptoms even at this small dosage. If you do stop the symptoms should last about a week to ten days. If pain is the reason you are unable to stop, I recommend that you speak with your physician about alternatives for relief.
I can not recommend that you continue taking this nightly. Long term use of opioids and acetaminophen do have long term effects on both the brain and the liver.
Good luck to you,
Sherrie

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

QUESTION: Sherrie,

Follow up Questions.
1) What type of test should I request to determine if any liver damage has occurred,and if so is this reversible?
2) I have also been suffering from severe Tinnitus, can this be related to this medication?
3) I developed severe anxiety when I tried to stop completely, any suggestion?

Answer
Speak with your physician about doing some blood work that includes a liver profile and enzymes. The results of this test will give your doctor preliminary information about the health of your liver. Tinnitus is not a known side effect of long term opiate use, however it is common in someone who takes large amounts of aspirin. I would also be curious if it is being caused a a result of your shoulder injury, i.e. possible nerve damage?
Lastly, anxiety is a common withdrawal symptom associated with withdrawal from opiates. It will dissipate over time. Many people obtain prescriptions for anti anxiety medications rather than seeking treatment for addiction and withdrawal. It is important to note, that anti anxiety meds are also habit forming, and are widely used by individuals who have become dependent on opiates.
There are medications that can be used to assist with the withdrawal symptoms of opiates. They also block cravings for use and in some cases have pain relieving qualities. You can learn more about this medication at www.suboxone.com.
I hope this information was helpful to you
Sherrie