vicodin or lortab in the UK.

[Fantasian]

it could be related to the back problems SWIYou've been having but its very important to get something like that checked out at the hospital. The hospital doctors might be more inclined to help you get prescribed something more suiting too.

IF your doctor is so unsypathetic then as mentioend above it might be worth trying a new GP. From SWIF's limited experience he'd say for something like you described NSAIDS are the way to go, diclofenac being a key choice. Im not sure if dictoflex is diclofenac as it's a brand name that we dont have in the UK however it does sound quite similar. NSAIDS have a variety of side effects but the majority are better than that of opiates in SWIF's humble oppinion.

[Lisa J]

SWIM has suffered from severe pain for many years and it's up to SWIY to scream for proper pain relief, SWIM told her GP she'd tried some buprenorphine from a friend and it worked so he then prescribed it instead of dihydrocodeine. SWIM cant use NSAIDS as she's allergic but tests suggest her problems are neurological now anyway so she wouldn't have benefited from them. If your GP wont listen then change, failing that a few out of hours call outs or hospital visits will do the trick, people in real pain kick up a fuss and thats what SWIY must do. SWIM progressed from buprenorphine to pethidine and then to fentanyl, she also uses gabapentin and the maximum dose of codeine/paracetamol, this HELPED with SWIM'S pain, for other reasons she started using heroin 3 months ago and now SWIM is pain free.

[Orchid_Suspiria]

Swim would still suggest trying to get another painkiller than vicodin or any that contains acetaminophen or any other nsaid.If swiy has chronic pain and is going to be on a medication for a long duration it would still be much better for swiy's health to have something with no acetaminophen.Swim wishes more people,more doctors would take the dangers of this stuff into account.There is not many things that sound more frightening or painful than acute liver failure.

[jon]

just for the record, Hydrocodone or dihydrocodeinone is available in the uk, but only for terminal care / via pain team. It is not mixed with APAP or paracetamol and used as a 'minor' opiate painkiller as in the states - vicodin.

[bloodred1889]

thanks for your help ppl.
at the moment doctor isnt budging, im just gonna have to see what the doctors at the hospital say.

[Fantasian]

Originally Posted by bloodred1889

thanks for your help ppl.
at the moment doctor isnt budging, im just gonna have to see what the doctors at the hospital say.

if you go to hospital ensure you go with an **acute** attack. Or they'll just reley you back to a GP. Even if the pain is chronic its important that its hurting particularly at that time.

[Herbal Healer 019]

Actually your all wrong dihydrocodeinone IS NOT the same as dihydrocodeine, in fact, it (dihydrocodeinone) is simply the chemical name for hydrocodone

[Laudaphun]

dihydrocodeinone is not the same thing as dihydrocodeine

dihydrocodeinone is a more technical term for hydrocodone
just like oxycodone = hydroxydihydrocodeinone

my chemistry is rusty so someone correct me if i'm not exact but when you take oxycodone or hydrocodone to a more technical name... the -codone on the end of the word becomes -codeinone

If you are currently being prescribed.... 10mg dihydrocodeine doses for real pain, hydrocodone or dihydrocodeinone as you call it would be much much better at pain relief as it is far more potent. SWIM is from the U.S. so she doesn't know much about how things work in the U.K. If it's that hard to get a Dr. to give you anything better for pain than codeine or dihydrocodeine then thankfully I do not live in the U.K. and suffer from chronic pain. Oxycodone and hydrocodone are terrific pain killers, and I'm talking medical purposes. Recreational purposes aren't the issue as you stated that you just seek pain relief.

[bloodred1889]

thankyou very much for the info on remedeine it will help alot.

[samuraigecko]

if Hydrocodone is not available to SWIyou in the UK and the analgesic list says that Oxycodone is then why not ask about the Oxycodone?

In SWIMs opinion it is far better than Hydrocodone anywway.

OxyContin or OxyNorm are the things to ask for.
Or Endone if SWIyou REALLY want the acetaminophen (paracetamol). Though one cannot see why SWIyou would want something with it in it when it is far easier to take something that actually works without it.
Neither OxyContin nor OxyNorm have acetaminophen in it.

Hope this has been of help

[bloodred1889]

it is fucking sad that doctors dont give out opioids as much for the people who really need it.

[Fantasian]

Originally Posted by bloodred1889

it is fucking sad that doctors dont give out opioids as much for the people who really need it.

True, but in their defense it's a great thing that doctors dont give out opioids to people who think they need it but dont. After you see and experience opiate addiction, you can see why doctors are hesitant.

[Lisa J]

It's very important that SWIY really gets the message across that the pain is getting worse and she can't cope anymore, seeing the doc once a month when the previous script runs out wont do because the doc will just think SWIY managed for the last month so will be ok for the next. Go in once or twice a week and don't pre book the visit, make sure it's an emergency one, lay on a few tears and tell the doc you can't cope with this any more, call the doc out late at night too, they hate out of hours call outs and this should get you better pain management, if this fails then change your GP. Don't get obsessed with types of pain relief SWIY has never tried, tramadol, fentanyl or pethidine give many people in severe pain good pain management. If SWIY is suffering from nerve pain in the legs ask your GP if you can try Gabapentin too, it wont stop the back pain but is very good for tingling or electric shock type sensations. For a couple of hundred pounds SWIY can see a consultant privately and this will save considerable time and show how desperate you are. Good luck & SWIM thanks her lucky stars her GP gives her good pain management.

[wearestardust]

Bloodred;
If SWIY wants Vicodin then you're not very well up on your opiates. That is one of the worst brands it is possible to get, being only 5mg hydro and 500mg paracetamol. In fact, all US-made hydrocodone (dihydrocodeinone, and not just in the UK, EVERYWHERE! The name 'hydrocodone' specifically appears in Schedule II of the MDA 1971) products must be compounded with a non-narcotic analgesic, normally the extremely dangerous paracetamol. To get a really effectuive dose of Vicodin brand you would be putting your liver at risk. In Europe it is available only in Spain (compounded, brand 'VIKODIN' as used to be sold by a couple of Indian Pharmacies.) and Germany, where it is PURE and comes in 5 and 10mg tabs made by Knoll/Abbott. It is NOT SOLD AS AN ANALGESIC! It is an antitussive. You would have no chance whatever of a script for pain!
On the other hand, if you need strong pain relief, then go to your doctor and ask for Oxycodone, which is freely available on the NHS. SWIWAS has been prescribed it for a long time and it is MUCH stronger than hydrocodone which is only for moderate pain and not all that strong. However DICODID 10mg is a great antitussive but you will pay about £5/tablet. IF you can get any German doctor to prescribe it. It is not available in any other country at all.
Hell, go for Oxy or Fentanyl if you have bad pain. FREE on the NHS.
WAS

[Politicalchalk]

It's fascinating, the differences between US and UK doctors in relation to this drug. Funnily enough, a hydrocodone containing cough-syrup is available here under the brand Tussionex. It, too, is quite expensive, as a brand-name anyways.

So, have you been to the hospital yet? How'd it go? Pain management?

One thing swim's been thinking about is asking specifically for dihydrocodinone. It's true, it's not used often except with us opioid nerds. And, in addition to outright asking for a specific narcotic (even if legit) is a red flag, and so is being randomly technical. I'm not saying your pain isn't legit or recommending how to treat it or anything, just saying that, due to hysteria, doctors often look for signs of drug-seeking behavior -- even when they're not there.

As for shipping it in from a friend in the US, wouldn't that violate some sort of drug-import laws? One supposes one could send a script to America to have it filled, possibly in bulk, if you can hook up that kind of arrangement with your doctor. It follows that you'd need a really understanding doctor to go through all the extra blah blah blah.

Finally, let's say you do go to Germany to see such and such a doctor in hopes that he'll Rx Dicodid...if you state that you've had prior attacks (let's say with, chronic bronchitis), and your regular doc usually gives you such and such a drug, namely Dicodid. Wouldn't one be inclined to stick with what works? In the US anyways, if one does a little research, opting from codeine to hydrocodone isn't too far a jump.

[wearestardust]

Correct. Hydrocodone is for moderate pain and is probably the most overpriced weak narcotic analgesic on the market. The 'analgesia gap' which is so apparent in the UK can be filled by larger doses of dihydrocodeine, which is actually a lot stronger than many of you have appeared to imply - probably, because like hydrocodone, in the USA it must be compounded with a non-narcotic. However I stand by my statement(s) that SWIBR should go for oxycodone rather than hydrocodone. It is a proper opiate and not a weak excuse for one. As SWIWAS has said, he has been on 40mg b.d. for two years, having cut from 80mg b.d., and finds that it is perfectly adequate, especially since he takes it along with diclofenac, a ery potent NSAID, branded VOLTAROL or ARTHROTEC (which contains a stomach-protector, diclofenac not exactly being the best thing for one's tummy.)
If oxycodone (normally given in its m/r form of OxyContin) isn't strong enough, which I seriously doubt, then there is always the Durogesic D-trans patch, which delivers 25, 50, 75, or 100mcg fentanyl per hour over a period of three days per patch. That is the strongest opiate on the market. In between the two is hydromorphone, branded PALLADONE, which is available in i/r strengths of 1.3 and 2.6mg, and s/r strengths of 2, 4, 8, and I THINK they still produce the 16mg version. Known in the USA under brand-name DILAUDID, it's a highly potent opiate and very rarely prescribed. SWIWAS' advice though is to stay with the idea of oxycodone, a much stronger and effective analgesic than hydrocodone, which is the most expensive disappointment of a painkiller yet devised.
WAS

[Lisa J]

SWIM is currently prescribed fentanyl & methadone, SWIM wants to change the methadone over to oxycontin, do any other SWIMmers have any experience of how well oxycontin will control pain compared to methadone. SWIM'S GP is quite happy for her to stay on methadone or try oxycodone but is waiting for the ok from the neurologist.

[johnny27bt]

I know you said you have tried dihydrocodeine for the pain, was it a compounded brand with paracetemol? If it was, ask for DF118's, its got no paracetamol, and it comes in alot higher dosages than the usual DHC UK tablets Co-Drydramol. I think i have seen 120mg DF118 Tablets, or 100 and something miligrams. Plus DHC has'nt got a low ceiling effect like codeine, i have taken as much as 600mg of DHC at a time, but DHC is'nt very effective if you have a tolerance, hence the 600mg dosage. As i recall, i ordered that load of DHC from a pharmacy in spain, it was a 30ml liquid bottle, containing 300mg of DHC, was'nt actually listed for pain relief but as a anti-tissuive tincture. It was cherry flavour but its still bitter as hell.
If the GP definetly is'nt budging on perscribing stronger opies, then ask for the DF118 tablets, preferably 60mg tablets or upwards.
Of course you could always resort to buying subutex from friends/dealers or whatever, it would probaly help the pain more the codeine or DHC, but be very careful on dosing untill you know you tolerance. England espically seems to have lots of subutex available on the street. And when i say be careful with dosage, i mean start of with 0.2mg, and see how that feels, remember subutex tabs are high dosages, 2mg (of which you only want 0.2mg to start) 8mg tabs, and only ever rarely seen is 0.4mg.
You could use Temgesic which are 0.2 but they are'nt as popular as they where on the streets during late 80's early 90's, you more than likely won't be able to buy them. Hope some of this might help with the pain.

[wearestardust]

UK doctors seem reluctant toprescribe Temgesic these days, but as I noted, they appear quite happy to take somebody directly from dihydrocodeine (pure) to OxyContin if the pain levels merit it. And as for strength, oxy is, mg for mg, much more effective than methadone and does not produce the nightmarish withdrawal symptoms that methadone is renowned for. SWIWAS has posted on another thread that he is worried by the current trend of US physicians to prescribe very large doses of methadone for pain, considering the problems associated with that particular drug. He had a most terrible time quitting methadone... it has to be the worst choice of analgesic a doctor could make. Leave it for those who wish to be maintained on an opiate dose due to habituation - it's not a good drug for withdrawing from opiates either, since it has such a long half-life and is so difficult to cut down on comfortably.
WAS

Reputation Comments on this post:

answered my question

[Lisa J]

Thanks WAS, SWIM was prescribed methadone for heroin addiction but it has become part of her pain meds now, SWIM'S GP is considering oxycodone but is worried it wont be strong enough for the pain or wont be strong enough to prevent withdrawal when SWIM stops methadone. He doesn't want SWIM to relapse for either reason so he is waiting and getting advice from the pain clinic on dosage etc. SWIM gets on really well with methadone for pain but still feels like a smackhead, also her methadone intake is going up rather than down due to tolerance as a painkiller, this makes her feel like she's going backwards even though it's a painkiller not a substitute. SWIM thinks it would be better to try another drug and reduce the mess in her head.

[Politicalchalk]

In the US, buprenorphine (temgesic, subutex, suboxone) and methadone are used far more for quelling addiction than pain, though methadone for pain does seem to be becoming more popular. Swim was on 16mg Suboxone for the former, and it def. helped quench w/d symptoms, but didn't do much in the pain dept (although Swim has no chronic pain per se). Be careful with buprenorphine, at least when other opiates are involved....once you've been on the bupe a week, it becomes quite the competitive little bugger, and forms a buprenorphine blockade....in other words, once your stable on it, other opiates (are supposed to) have little to no effect, if not forcing outright withdrawl. Swim, however, has verified (via the package insert) that, like methadone, you can shoot the ball "over the rainbow."

...For situations requiring opiate analgesia -- doses of narcotics may be higher than those normally prescribed for analgesia for patients on buprenorphine. See blockade information on page X. Buprenorphine is a mixed agonist/antagonist opioid.

Also note that buprenorphine has a ceiling efect at about 32mg. Doesn't seem very high, but considering the lowest dose swim's heard of is .2 or .4, it's important to bear in mind.

[ConcertaXL]

darvon or darvocet is absolutely NOT Dihydrocodeine. It is co-proxamol which is a mixture of Dextropropoxyphene and Paracetamol which is now banned completely in the UK. There was a big issue about this, it was even mentioned in Parliament, but the MHRA would not change their minds. Private doctors can still prescribe Co-proxamol under schedule 4 conditions or Dihydrocodeinone (Hydrocodone) under schedule 2 CD conditions but good luck finding a person who will or a pharmacy to dispense it!

The best solution for chronic pain, and the usual one in the UK, is sustained release morphine sulphate (MXL, MST Continus, Zomorph, Filnarine, Oramorph SR- the first two brands are far more common than the others). An NHS GP should prescribe this or if not ask for referral to a pain specialist.

[hamsterdam]

to the op:

why don't you just get oxycodone if hydrocodone for whatever stupid reason isn't available in the UK? (unless that's also not available).

It's essentially the same thing.

btw, swim likes hydrocodone/apap and has a good time with it. CWEd of course, since he has 7.5/500s and 7.5/750s (!).

Dunno why they'd even make formulations with that much apap, it almost seems like it's designed to cause liver failure in unsuspecting people.

Oh, swim would also like to note, that hydrocodone does NOTHING as an analgesic for him. If he's sore from the gym, he's just as sore after taking 30mg of hydrocodone then he was before. Sure.. it'll be less noticeable since you're going to be halfway out of your mind after an hour, but a normal therapeutic dose would probably do nothing for swim.

So if you're after the analgesia.. don't go for hydrocodone.

[Politicalchalk]

Actually, in the US anyways, in palliative care or extreme chronic pain, special preperations (which have to be made by the pharmacist before hand) can be made with hydrocodone in whatever strength the prescriber wishes. Swim's heard of up to 50mg w/o the associated APAP (paracetamol). It is an extended-release formulation

[Dr_Janus]

Just to clarify for people who are confused Paramol® (In the UK) is NOT in any way the same as Vicodin. Paramol contains dihydrocodeine and paracetamol, Vicodin contains hydrocodone and paracetamol. They are totally different.