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Can I Withdraw Percoset Slowly Inspite Of Having Spine Pain?

Posted on Tue, 29 Apr 2014

Question: Have multiple herniated discs. Begine tumor in spine at T1 T2. Nedless to say I have had much pain. I refuse (as I mentioned in prior posts) to go on any of the "pain meds". I am on Percoset for about 10 years now was taking about 3 a day up to 2 weeks ago when I went down to 2 a day. One in eve one in am. The dose is 5/325. I have 3 conflicting medical recommendations to go off these totally. This moning after the 2 weeks of 2 a day I broke the am pill in half and will take the other half this evening. I DO NOT WANT ANY SIDE EFFECTS!! Am I going too fast? I was thinking of taking the half in am half in pm for 2 weeks, then go to 1/2 once a day for 2 weeks then off. How does this sound. I need to mention that in addition I take Xanax for anxiety from the pain 2 mg at bedtime one in the am. After I get off the Percocets the Xanax is next. But first things first. Please help. Many thanks.

Answered by Dr. Preeti Parakh (7 hours later)

Brief Answer: Taper off at a rate that is comfortable to you. Detailed Answer: Hi, Welcome to Healthcare Magic! First of all, let me congratulate you on having a very good pain tolerance. You have done exceptionally well in never letting opioids take control of you and having the courage to think of stopping these completely. In my opinion, you can make the process of quitting even easier. Percocet contains two medicines, oxycodone and paracetamol. Both are analgesics but only oxycodone, being an opioid, has the ability to cause dependence and withdrawal. While you are quitting Percocet, you can continue to take paracetamol, either in the same dose or more, if needed, to control the pain. Paracetamol is available as Tylenol over the counter. The 500 mg tablet taken 2 to 3 times a day should be able to sufficiently control the pain so that you are not much discomfited by the reduction in dose of oxycodone. Regarding the speed in which you are reducing the Percocet, the bottom line is that it should be done as per your comfort. For some people, this rate of reduction would be fine, and for some, it will not. This is because of the huge individual variability in receptor profile. So, there is no perfect rate of tapering off. For you, in my opinion, it will be more prudent to reduce only one of the am or pm doses by half for a couple of weeks and then to halve the other dose as well. This will be easier for your body to handle. If there is any increase in pain, you can take Tylenol as and when required. I do not expect any other opioid withdrawal symptoms at this dose. You are right in deciding not to alter the dose of Xanax at present. Two drugs should not be tapered off at one time. I hope this helps you. Please feel free to ask in case you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Preeti Parakh (6 hours later)

As I understand you. This is day 2. Yesterday I took 1/2 in the am and 1/2 in the pm. Today I should go back to taking 1 whole at night for example and 1/2 in the am for the two weeks. Then reduce the whole to 1/2 for two weeks. Then what? Once I am on 1/2 in both am and pm for the two weeks do I go to 1/2 a day for two weeks? End game please. Thanks you have been helpful in clearing this up. With having 3 different opinions I just was not comfortable. They were so extreme.

Answered by Dr. Preeti Parakh (22 minutes later)

Brief Answer: As below. Detailed Answer: Hi, If you are so far comfortable and your body has not started complaining about the reduction in dose, then you need not hike up to one full tab in evening. Since oxycodone is very short acting, by now, you would be technically in withdrawal. Do this as per your own body's requirements. You need not torture yourself. Continue with your present dosage if you find it easy to do so. If you, at any moment, feel that it cannot be managed in spite of taking additional paracetamol, then take one full tab at night. If you have to do so, do not feel guilty about it. Try to reduce again after a week or two, when the timing is correct. The timing is correct when your body has been comfortable on the current dose for a few days and when there are no stressful events coming up which demand a lot of physical activity. Once you are on half tab twice a day for around two weeks, go down to just half tab a day. After two more weeks, tell yourself that you will now take half tab only when you find it absolutely necessary. Do not tell yourself that you are stopping it completely from the next day. Then let it be a day to day decision. If you need to take it occasionally, you should not feel bad about it. Please do not worry. You will find that this goes off very smoothly. There are no hard and fast rules. Just listen to your body. Take care. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Preeti Parakh (26 hours later)

Been having a very dry throat and mt geographical tongue is acting up. Could this be part of withdrawal or allergies. Just had all allery testing, no alleries found except for molds. Throat always feels dry. And last 3 nights been woken up with SEVERE body cramps, pains and aches. I am in 1/2 pill at night 1/2 in am on the percoset and it is day 3. Is this withdrawal? I am not doing anything to cause the pain. Our plan is this dose for one month. Will I soon start feeling relief? Was it because I have been on for so long? But not giving up VERY determined to get OFF all. Thanks.

Answered by Dr. Preeti Parakh (2 hours later)

Brief Answer: As below. Detailed Answer: Hi, The dry throat is unlikely to be due to withdrawal. In opioid withdrawal, the secretions from all parts of the body increase. So people usually have running nose, watering from eyes and diarrhea. The increased body aches and cramps are likely to be due to withdrawal. If you are finding it difficult to tolerate, then do take Tylenol or other non-opioid analgesics to control the pain. Otherwise you can hike up Percocet to half in morning and one at night. The pain should gradually start reducing and be gone by the end of a week. You are right in saying that these problems are because of having been on the drug for long. But please also keep in mind that some of the pain is due to your back condition, which had so far been kept under check by analgesics. Please do not worry. You will manage to be off medicines as you wish. Best wishes. Dr Preeti Parakh MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Preeti Parakh (2 hours later)

I am so sorry to keep bothering you but I forgot to mention that when during the last 3 nights I get the very bad pain. My blood pressure is normal but my pulse is a bit off. My daughter is an asthmatic so I have for her a monitor that cn give me her blood oxygen level and pulse. I (each time) put it on my finger and my pulse goes 10 beats skips one then 10 again, etc. I am and have been under the care of a cardiologist and just had by my MD an EKG last week all was well. I am under the care of the cardiologist because at times the pain gets so bad my blood pressure shoots up to stroke level. But I have been working on that with rexalation methods and stress reduction mental therapy. My blood pressure has been GREAT but I am a bit concerned about the pulse skipping. Could this be just stress or from the pain? I am due to see mt cardio in 2 weeks. I have been cardiac tested so many times, even he says I am not acadiac patient but sees me about every 9 months.

Answered by Dr. Preeti Parakh (8 hours later)

Brief Answer: Due to pain, anxiety and withdrawal. Detailed Answer: Hi, Please do not feel bad about having questions. Regarding fluctuations in the heart rate, it is common in both anxiety and withdrawal. Moreover pain causes anxiety. You will notice that relaxation helps normalize the pulse. Since all your check ups, especially the last one, have been fine, in my opinion, you need not worry at present. As you start feeling better, you will find that your pulse also becomes normal. Please do not worry. Best wishes. Dr Preeti Parakh MD Psychiatry

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar