Addictive prescription drugs
Discussion
About 20 years ago my wife was prescribed Seroxat (Paroxetine) and when she wanted to stop taking it found out that it wasn't easy.
With a bit of research we found out the it's addictive, the patient information leaflet (PIL) didn't say that but said if you stop taking this drug you must consult you doctor first.
Later we find that the drug company (GFK if I remember correctly) were taken to court over the drug.
Fast forward 20 years and we find ourselves in the same position.
Wife takes Tramadol and last Friday she ran out*, over the weekend she felt odd, very hot for 30 seconds then very cold, mood swings, etc.
Spoke to our GP today and he said that Tramadol is a addictive drug and her symptoms are just as he would expect if she'd not taken Tramadol for a couple of days.
He also said that the Government were considering classing Tramadol class C - he didn't explain what that meant but I'd guess it would be like Morphine, ie a CD.
So a couple of questions/point for debate:
If it's necessary to prescribe addictive drugs should the patient be given more information by the doctor rather than expecting the patient to read the PIL?
After the problems with the Seroxat we look at the PIL and but found no indication that it was/could be addictive so.
Should the drug companies be more open about the addictive qualities of the the drugs?
With a bit of research we found out the it's addictive, the patient information leaflet (PIL) didn't say that but said if you stop taking this drug you must consult you doctor first.
Later we find that the drug company (GFK if I remember correctly) were taken to court over the drug.
Fast forward 20 years and we find ourselves in the same position.
Wife takes Tramadol and last Friday she ran out*, over the weekend she felt odd, very hot for 30 seconds then very cold, mood swings, etc.
Spoke to our GP today and he said that Tramadol is a addictive drug and her symptoms are just as he would expect if she'd not taken Tramadol for a couple of days.
He also said that the Government were considering classing Tramadol class C - he didn't explain what that meant but I'd guess it would be like Morphine, ie a CD.
So a couple of questions/point for debate:
If it's necessary to prescribe addictive drugs should the patient be given more information by the doctor rather than expecting the patient to read the PIL?
After the problems with the Seroxat we look at the PIL and but found no indication that it was/could be addictive so.
Should the drug companies be more open about the addictive qualities of the the drugs?
- Wife had a Carpal tunnel op under a local anaesthetic. When discharging her the nurse noted her current pain medication (including Tramadol and Morphine) and told her to take more Tramadol if necessary, so she ran out. She's got a couple of months worth of another drug but not enough Tramadol!
She's on tramadol and morphine?
To begin with that's odd and to be prescribed a (ableit very weak synthetic) opioid without being told it's addictive is odd, but then if she's on morphine then i wouldn't expect tramadol to do anything and stopping taking it shouldn't cause withdrawals as when she's taking it the affinity of the morphine is greater than tramadol anyway.
To begin with that's odd and to be prescribed a (ableit very weak synthetic) opioid without being told it's addictive is odd, but then if she's on morphine then i wouldn't expect tramadol to do anything and stopping taking it shouldn't cause withdrawals as when she's taking it the affinity of the morphine is greater than tramadol anyway.
Silent, the morphine is in a patch changed weekly and the tramadol is twice daily 150mg.
Both were prescribed by a pain management consultant who did mention that the morphine was for life as coming off it wouldn't be an option.
It was her GP that told her it was withdrawal symptoms she was experiencing. Today she has had them and is fine so I think he was correct!
Andy, yes the PIL did (I've not read it latly) say there could be side effect if you stopped taking the tramadol but my point is that I think any drug is addictive if you suffer withdrawal symptoms when you stop taking it.
My wife also highly rates tramadol!
I think the drug companies should make it a lot clearer about any possibility of withdrawal symptoms and not hide it in tiny print on the PIL.
I also think that doctors should take the time to explain a lot more to the patient about drugs they are prescribing.
Both were prescribed by a pain management consultant who did mention that the morphine was for life as coming off it wouldn't be an option.
It was her GP that told her it was withdrawal symptoms she was experiencing. Today she has had them and is fine so I think he was correct!
Andy, yes the PIL did (I've not read it latly) say there could be side effect if you stopped taking the tramadol but my point is that I think any drug is addictive if you suffer withdrawal symptoms when you stop taking it.
My wife also highly rates tramadol!
I think the drug companies should make it a lot clearer about any possibility of withdrawal symptoms and not hide it in tiny print on the PIL.
I also think that doctors should take the time to explain a lot more to the patient about drugs they are prescribing.
Is she on buprenorphine patches?
As i can't think of a true morphine patch and fentanyl patches are 72 hours (i'm on them)
I'm just really surprised she's getting withdrawals from tramadol, they never did anything for me but even on people that they do work on they're so weak that i wouldn't have thought they would have an effect, but then i've got no experience of buprenorphine alone or with other opioids.
If she's needing the tramadol on a regular basis it may be better for her to increase the patch strength and not use the tramadol as really it should be used for breakthrough pain only and by doing that she would probably find things a lot easier.
As i can't think of a true morphine patch and fentanyl patches are 72 hours (i'm on them)
I'm just really surprised she's getting withdrawals from tramadol, they never did anything for me but even on people that they do work on they're so weak that i wouldn't have thought they would have an effect, but then i've got no experience of buprenorphine alone or with other opioids.
If she's needing the tramadol on a regular basis it may be better for her to increase the patch strength and not use the tramadol as really it should be used for breakthrough pain only and by doing that she would probably find things a lot easier.
It's a tricky balance. The stigma of 'addiction' (more truly I think usually dependance for pain control, not at all the same thing) is so strong already that there are a huge HUGE number of people suffering terrible pain who are absolutely terrified of taking opioids/opiates lest they become 'addicted'. I think that real harm could be done if a much bigger deal were made of it, by way of increasing the number of people who do not take desperately needed pain medication, or who withhold it from a cared-for adult or child who needs it for the same reason. I've seen it happen and it's terrible. Had problems myself with nurses who had developed some of the same attitude but were then attempting to control access to pain relief (ignoring prescriptions in the process) and believed they were helping.
If the source of the pain is removed or improved then it's perfectly possible to reduce doses and come off morphine, fentanyl or anything else. I'm now on about a third of the amount of morphine I was taking 5 years ago. I'm relatively unlikely to get all the way off it but improved care, good equipment and physical positioning have solved a lot of what drugs were barely touching. It's more likely that it was suggested that the patches would be for life because any other way to relieve/remove the pain is not currently on the cards.
If the source of the pain is removed or improved then it's perfectly possible to reduce doses and come off morphine, fentanyl or anything else. I'm now on about a third of the amount of morphine I was taking 5 years ago. I'm relatively unlikely to get all the way off it but improved care, good equipment and physical positioning have solved a lot of what drugs were barely touching. It's more likely that it was suggested that the patches would be for life because any other way to relieve/remove the pain is not currently on the cards.
I was on buprenorphine patches for a couple of years and came off them slowly over a couple of months. Was also on Tramadol for a period of time...not at same time as the patches...and came off them over a period of time.
Most perscribed painkillers are addictive as a lot are opiate based but I think by speaking with the gp/pain clinic and getting a reductions programme drawn it can be done safely.
I've been on dihydrocodine now for over 3 years and don't particularly look forward to the day I try stop them...don't feel addicted I take as when but how do I know I'm not addicted? Who knows. The gp has never declined my monthly repeat persciption and when I last spoke to her she said the amount I take is not at a harmful level...but still who knows.
I imagine if you take any painkiller for long enough there will be some level of dependancy.
Hope everything works out well for you and your wife.
Most perscribed painkillers are addictive as a lot are opiate based but I think by speaking with the gp/pain clinic and getting a reductions programme drawn it can be done safely.
I've been on dihydrocodine now for over 3 years and don't particularly look forward to the day I try stop them...don't feel addicted I take as when but how do I know I'm not addicted? Who knows. The gp has never declined my monthly repeat persciption and when I last spoke to her she said the amount I take is not at a harmful level...but still who knows.
I imagine if you take any painkiller for long enough there will be some level of dependancy.
Hope everything works out well for you and your wife.
I must be honest - I had max dose of tramadol for about 3 months and altho it made me feel awful and didn't really hit the pain I had no problems coming off it. I know take sr hydro morphine in doses to suit me as I am - sometimes that's 2mg slow release twice daily, and it has been as high as 6 - I just jiggle according to my needs and sometimes come off completely, as well a staking break thru when I need it - and that usually ends up being 2 * 2.6mg at shortish intervals. I do find the pregabalin more awkward to juggle but only cos it does my head in and then I feel I can't drive. I think it's horses for courses to be honest with heavy pain relief - some will suit you, some won't - it took 3 different morphines for me to settle - and I think it's the same with withdrawal - some can and some can't.
What I am scared of is coming off - not that its likely to happen - my 120mg pd duloxetine - normal max is 60 which didn't hack it so its gone up to 120mg and I cope quite well there, but the problem is so many drug interactions mean one day IO maight have to change - now that scares me!! Then real me on the loose!!
What I am scared of is coming off - not that its likely to happen - my 120mg pd duloxetine - normal max is 60 which didn't hack it so its gone up to 120mg and I cope quite well there, but the problem is so many drug interactions mean one day IO maight have to change - now that scares me!! Then real me on the loose!!
Broomsticklady said:
I must be honest - I had max dose of tramadol for about 3 months and altho it made me feel awful and didn't really hit the pain I had no problems coming off it. I know take sr hydro morphine in doses to suit me as I am - sometimes that's 2mg slow release twice daily, and it has been as high as 6 - I just jiggle according to my needs and sometimes come off completely, as well a staking break thru when I need it - and that usually ends up being 2 * 2.6mg at shortish intervals. I do find the pregabalin more awkward to juggle but only cos it does my head in and then I feel I can't drive. I think it's horses for courses to be honest with heavy pain relief - some will suit you, some won't - it took 3 different morphines for me to settle - and I think it's the same with withdrawal - some can and some can't.
What I am scared of is coming off - not that its likely to happen - my 120mg pd duloxetine - normal max is 60 which didn't hack it so its gone up to 120mg and I cope quite well there, but the problem is so many drug interactions mean one day IO maight have to change - now that scares me!! Then real me on the loose!!
You are right broome...horses for courses. I've been on pregabalin for yrs now also. For me it's good and don't think I'd like to be without it. best sticking with what works for you and play with levels when you need to. What I am scared of is coming off - not that its likely to happen - my 120mg pd duloxetine - normal max is 60 which didn't hack it so its gone up to 120mg and I cope quite well there, but the problem is so many drug interactions mean one day IO maight have to change - now that scares me!! Then real me on the loose!!
I just guess that I'm not dependant on any...but who knows ! So long as gp's are OK then i guess I'm happy.
i hope you are doing well broome.
Seroxat is nasty stuff.
It isn't 'addictive' in the classical sense, but the effects following stopping it are rather unpleasant.
The main ones for me were dizziness and constant ringing in the ears. However this did pass - after about a month of feeling dreadful during which I was convinced I'd be stuck with it for for life.
Hope this helps.
It isn't 'addictive' in the classical sense, but the effects following stopping it are rather unpleasant.
The main ones for me were dizziness and constant ringing in the ears. However this did pass - after about a month of feeling dreadful during which I was convinced I'd be stuck with it for for life.
Hope this helps.
Mobile Chicane said:
Seroxat is nasty stuff.
It isn't 'addictive' in the classical sense, but the effects following stopping it are rather unpleasant.
The main ones for me were dizziness and constant ringing in the ears. However this did pass - after about a month of feeling dreadful during which I was convinced I'd be stuck with it for for life.
Hope this helps.
the SSRIs and SNRIs are well known for this It isn't 'addictive' in the classical sense, but the effects following stopping it are rather unpleasant.
The main ones for me were dizziness and constant ringing in the ears. However this did pass - after about a month of feeling dreadful during which I was convinced I'd be stuck with it for for life.
Hope this helps.
Pothole, hindsight is a wonderful thing 
Silent, the patches are Buprenorphine transdermal patches 5 microgram/hour. She changes them once a week. When she was first given them we had to sign to say that we'd keep them in a secure place and have to sign separately when they are dispensed.
I mention about upping the does and dropping the tramadol - thanks for the advice.
BVD, you make a very good point about the stigma of addiction but I didn't mean to put anyone of taking a drug that can help them cope with pain.
But I think that the drug companies and the doctors should give the patient much more information maybe something like:
'taking this drug will help you and in my opinion you should take it but when you have/need to stop please talk to me and I will make sure it is a easy as possible but we must work together'
Totally agree that more effort should be treat the source of the pain but in my wifes case it's not possible, well one day back transplants might be possible!
I suggested to one doctor that her back problems are made worse by her being over weight due to her not being able to walk very far. He agreed but when I asked about more pain killers so she could walk easier/further/do some exercise he waffled on about her diabetes etc.
But I got the impression that it was more about the cost of the drugs than anything else.
Sorry about the long post, I'm very grateful for all the replies and will reply to the other posted later.
Silent, the patches are Buprenorphine transdermal patches 5 microgram/hour. She changes them once a week. When she was first given them we had to sign to say that we'd keep them in a secure place and have to sign separately when they are dispensed.
I mention about upping the does and dropping the tramadol - thanks for the advice.
BVD, you make a very good point about the stigma of addiction but I didn't mean to put anyone of taking a drug that can help them cope with pain.
But I think that the drug companies and the doctors should give the patient much more information maybe something like:
'taking this drug will help you and in my opinion you should take it but when you have/need to stop please talk to me and I will make sure it is a easy as possible but we must work together'
Totally agree that more effort should be treat the source of the pain but in my wifes case it's not possible, well one day back transplants might be possible!
I suggested to one doctor that her back problems are made worse by her being over weight due to her not being able to walk very far. He agreed but when I asked about more pain killers so she could walk easier/further/do some exercise he waffled on about her diabetes etc.
But I got the impression that it was more about the cost of the drugs than anything else.
Sorry about the long post, I'm very grateful for all the replies and will reply to the other posted later.
Amitriptyline that I took for nerve pain was quite bad to come off.
Even on it everything was just that bit lucid about it.
It did state that you should wean off,I'd had enough of it and stopped it dead.
Not a good idea at the time,for about 7-10 days my mental state was doing somersaults,mixed emotions and njust generally a bit of a head f
k.
Once over it everything was ok and back to normal.
Tramadol can be nasty as can Morphine.I had my other half throw away her last tramadol and repeat script she had.She'd been on them for around 6 months and taking them when she didn't really need to.
I have some tramadol knocking around too,the effects hit me quite hard so I only take one if I really feel the need for pain relief.
Liquid morphine had to go too,I always upped the dose a little and it was actually quite splendid stuff and one of my favourite pain reliefs.It's very easy to see how people could get addicted to the stuff.
Even on it everything was just that bit lucid about it.
It did state that you should wean off,I'd had enough of it and stopped it dead.
Not a good idea at the time,for about 7-10 days my mental state was doing somersaults,mixed emotions and njust generally a bit of a head f
k.Once over it everything was ok and back to normal.
Tramadol can be nasty as can Morphine.I had my other half throw away her last tramadol and repeat script she had.She'd been on them for around 6 months and taking them when she didn't really need to.
I have some tramadol knocking around too,the effects hit me quite hard so I only take one if I really feel the need for pain relief.
Liquid morphine had to go too,I always upped the dose a little and it was actually quite splendid stuff and one of my favourite pain reliefs.It's very easy to see how people could get addicted to the stuff.
Broomsticklady said:
.....I think it's horses for courses to be honest with heavy pain relief - some will suit you, some won't - it took 3 different morphines for me to settle - and I think it's the same with withdrawal - some can and some can't....
Very good point/s................
MC, Seroxat is addictive the drug company (no naming ans shaming but it was a 3 letters and is now 4 letters;)) admitted it a few years ago. They also changed the PIL after legal action.
Panda, you should never stop taking any drug without talking to your GP. As for morphine, it's well known to be very addictive.
Many thanks for all the replies and I hope that all the replies help other people.
One final thing I would say is always ask/question what your GP/doctor/other health professionally tells you, ask them why, ask them what will/could happen.
They won't mind, well most won't, but it's your right to know what they are doing to your body.
T used to take 800mg of Tramadol a day following release from hospital after neurosurgery some years ago. I was in hospital waiting to decide what to do about the spinal difficulty for six months before the decision to operate was taken. Much of that time I was on intravenous Morphine. Not good. The operation was successful but left me in 24 hour a day very severe pain initially. Hence the Tramadol.
Tramadol is a very effective painkiller. Hence the dosage. Tramadol is addictive and has serious side effects but is much less dangerous than the Morphine from which it was derived. I was fortunate that with gradual exercise and physiotherapy my spinal condition post op gradually settled and I reduced the Tramadol over a period of six months. I eventually reached the point some two years ago where I was off Tramadol and the only painkillers I was taking were and remain 1000 mg of Paracetamol a day.
I have an addictive personality and I am compulsive obsessive by nature. Over the years I have learned to a point to control those tendencies personally. For that reason I always research every medication doctors prescribe for me. I knew the risks of Tramadol but was in so much pain I had no choice other than to take the risk. I was fortunate in being able to stop taking Tramadol on a program designed to remove Tramadol from my system over time. It worked for me.
As others have said it is sensible to carry out your own research when offered any prescription drug. All prescription drugs have side effects and once informed you can make an informed decision. I wish your wife well and I suggest that she sees her consultant and follows his advice as to how to come down from the Tramadol. Everyone is different and their reactions to any opiate can vary significantly. Good luck to you both.
Tramadol is a very effective painkiller. Hence the dosage. Tramadol is addictive and has serious side effects but is much less dangerous than the Morphine from which it was derived. I was fortunate that with gradual exercise and physiotherapy my spinal condition post op gradually settled and I reduced the Tramadol over a period of six months. I eventually reached the point some two years ago where I was off Tramadol and the only painkillers I was taking were and remain 1000 mg of Paracetamol a day.
I have an addictive personality and I am compulsive obsessive by nature. Over the years I have learned to a point to control those tendencies personally. For that reason I always research every medication doctors prescribe for me. I knew the risks of Tramadol but was in so much pain I had no choice other than to take the risk. I was fortunate in being able to stop taking Tramadol on a program designed to remove Tramadol from my system over time. It worked for me.
As others have said it is sensible to carry out your own research when offered any prescription drug. All prescription drugs have side effects and once informed you can make an informed decision. I wish your wife well and I suggest that she sees her consultant and follows his advice as to how to come down from the Tramadol. Everyone is different and their reactions to any opiate can vary significantly. Good luck to you both.
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