A realistic Oxycodone dosage?

Written by

Thu, November 05, 2009

Additional Posts

I've got a question - and a complaint - about Oxycodone dosages. I'll have to give you some context here I guess.

I had to go onto long-term disability. For many years my primary care has been through the local VA clinic. The VA clinic told me it is their policy to NOT get involved in anything to do with disability claims; they won't do any of the paperwork required. So they told me I would have to go to another dr. office and find someone who would fill out the disability forms. So now I have to find someone at the last minute who will not only take me as a new patient, but also get me in to be seen immediately AND be willing to fill out the forms for disability. Well, luckily I found someone who would do all these things (I can't say enough good things about the staff and the doctor).

Here's where the trouble starts. At the VA clinic, I had just been switched from Vicodin to Oxycodone. I was maxed out on Vicodin and still in a lot of pain. The VA doc had prescribed me 5mg of Oxycodone, 3 times a day. It was not helping much. When I went to this new doc, he gave me a prescription for 20 mg of Oxycodone twice a day, to be taken in addition to the 5 mg scrip from the VA. I took the new scrip directly to the VA clinic, for one, to follow the rules about not getting narcotics from more than one doc, and two, because I'm a 60% disabled veteran, my prescriptions are free through the VA. I gave the new scrip to the narcotics nurse at the VA clinic and was told I could fill it locally and in about 10 days the VA pharmacy would mail me the pills. I fill the scrip locally and am getting some relief, not completely, but better than just the 5mg was giving. Then, after I've been taking these pills at this dosage for a couple weeks, I get a phone call from the clinic that says the doc won't approve or sign off on that high of a dosage and they are not going to fill the 20 mg scrip. They said the doc was very upset that I was given that high a dose. So, I try to make an appointment at the VA clinic and am told that my doc just started a 2 month vacation... So I make an appointment to see a different VA doc. I get the same reaction from her about the Oxycodone dose. She acts like more than 5 mg is outrageous, and says that no doctor in the VA would prescribe me more than that. I told her I had some relief at this dose and didn't seem to be suffering any bad side effects, but she wouldn't budge.

I then get another phone call from the VA narcotics nurse and am told that the doc said that since I am getting scrips from another doc, I can just fill them privately and that they will not fill Oxycodone for me at any dosage. Now remember, I was forced to see this other doc outside of the VA system because they wouldn't fill out my medical paperwork, and now they refuse to honor his course of treatment... I can't afford to pay the $220 or so it costs for these meds since I don't have private healthcare now.

< Page 1 | 2 Next >

Comments (12) | Add comment

Notify me when there are new comments

Nan from the Dunes

11/ 6/09 1:57pm

Jeff:

I recently was switched from norcote 10/325 tid(3xdaily) to oxy 10/650 tid(3x) I also have a pump. the oxy is for breakthru and pain in other areas i have problems with since the pump is for cervical area. I would check with major pharmacy's to see if they have any type of program you can belong too. as an example, in my area walgreens has a 20 bucks per year joining program which reduces cost. the state i live in belongs to a program in which all residents can get a card and get drugs at reduced cost. also check walmart....call around to price check. The cost under this una rx(state card for oxy20mg er 1 month is 110 , looked it up for you) See if your state has a unified type of drug card. Wait....I just looked up your profile...you live in indiana , so do I, go to this link....fill it out....check walgreens, cvs....walmart..for cost. Then get this card, it is free...follow link for meds and check prices in your area...it might save you some bucks for these meds you are going to need help with.....Who is your employer?... send m;e private message maybe i can really help you....been dealing with all this stuff for 5 + years. but first here is the link: http://indianadrugcard.com/index.php# I look forward to talking to you later

Jeff L

11/ 6/09 6:00pm

Hey Nan, thanks for the info - I'll send you a private message after this.

In browsing through other posts, I've run across references to a couple more sites: www.simplefill.com and www.pparx.org have you tried either of these? The one post said that the simplefill site filled out all paperwork and even gets refills automatically for $65 a month. Sounds too good to be true, but still probably worth checking out.

In your post you said you were switched to oxy 10/650 - is that 10mg oxy with 650 acetaminophen, like percocet?

I went to the site and got the Indiana drug card. That was easy. Thanks again

Jeff

Nan from the Dunes

11/ 6/09 8:39pm

Jeff:

oxy is 10mg with 650 mg as you guessed. I have not tried the other options out there because I still had coverage and do have coverage until 12/13/09 with my employer, The State of Indiana. It is after I have to purchase my own. Will let you know other details later.

Kathleen

11/14/09 6:28pm

Hey Nan, I came across your comment while looking at information regarding Oxycodone and Oxycontin. I too am on this medication (among 10 or so other meds per day). The reason I wanted to contact you is because you seem to be in a similar situation as I am. I worked for the State of Colorado for 20 years and have recently gone on Disability Retirement. I did not pay into Social Security, so I am not elligible for Medicare or Medicaid (I'm 49 years old). Right now I am using COBRA insurance, with the reducation from Obama's stimulus package. So my premium is only $139 a month. In January that goes up to $397 a month!!! I only make $1807 in PERA Disability, so its going to be tough. Do you know of any other optioins for health insurance coverage for State employees?

Thanks for your consideration of my question.

Kathleen

Nan from the Dunes

11/14/09 10:19pm

Kathleen:

Having paid into medicare, I really wouldn't know what to do in your situation. Does Colorodo have a retired employees association that you can contact for suggestions? This situation of yours leaves me at a loss, other than working with drug companies for cost reduced or free medication assistance I really don't know what direction to point you in. I would discuss this with as many people in your state, for direction and guidance. If fact this kinda blows me away that this option was even availiable to you(if an option) talk, talk, talk, to other state retiree's to get some suggestions.

Have a great week!

I am sorry I cannot point you in any other directions.

Scooter

11/11/09 5:49pm

The amount you are taking is NOT a high dose at all. Ten years ago I started out at 20mg three times a day with 5mg in between for breakthru pain. Now, I'm up to 80mg twice a day and 40mg once a day with 5mg for breakthru pain. My doctor told me he would encrease the doses if I needed it. Of coarse it costs a fortune. Oxycontin has a bad reputation because so many people abuse it and there are a lot of doctors who won't prescribe it. I wish you the best with many low pain days. Scooter

Jeff L

11/11/09 9:54pm

Hey Scooter, thanks. I kinda figured the dose was pretty low, especially after my internet searches...

I just can't figure out the doc's attitude about this stuff and why they say a total of 55 mg a day is ridiculously huge.

I get the same type of effects as I had with Vicodin - the drug helps with pain, but I don't have any kind of feelings or anything that would make me want to take it recreationally. The VA clinic also makes me take frequent blood tests to ensure that not only am I taking my drugs, but also that I'm not taking any recreational drugs. They know I have real pain for several conditions, but act like every prescription they write is gonna come out of their own paycheck. I guess I'm paying for all the other peoples' abuses of this drug...

Jeff

wingsovgrace

1/ 9/10 12:07am

It is my undersanding that Oxycontin is extended release taken 1 x 12 hrs. The Oxycodone is short acting taken every 4-6hrs. (According to my pharmacist)

My doctor and I have been experimenting to find an adequate dose and combination to cover pain and minimize side effects. The following are the doses and drug he prescribed. 15mg-30mg Oxycodone. 40mg Oxycontin. Certainly not all at once and he is trying it in combination with another med but these are some of the doses I have been prescribed.

I am 56 yrs, 4'11" and 101 lbs. Experience moderate to severe pain.

You be the judge.

This is my first post on the sight. Hope it was helpful.

BrokenSailor

12/15/10 4:14pm

Hi,

I am a VA patient also in Chronic pain. You can get your disability papers filled out by the VA by bringing them to the Release of Information department. They will take the paperwork and have a doctor fill it out for you. You cannot go to the doctors directly.

At 60% you need to work the VA system better. I suggest you join the DAV. It is non-profit and will file your petition for increases and new disabilities such as PTS due to pain and Insomnia. This gives you a Mental Health disabilty wich will give you another 10%. Also if you have ringing in the ears from using weapons and or machinery (Tinitus) that is another 10% and they cannot prove you don't have it. You need to have one injury at 40% and three at 10% for a total of 70% and you can file for unemployability with the VA. This will then make you 100%. Since you are over 50% all medical issues are covered for you. I am assuming service connected...

You also need to get into a VA chronic Pain clinic. You need to get a consult from your primary care doc and then see the chronic Pain clinic. There are too different clinics. Anathesia Pain Management and Pain Management and Rehab (PMNR). Anathesia pain management will give you trigger point injections, Beir Blocks, Spinal blocks, etc. PMNR will get you into a medication regime. They can also get you canes, walkers, wheel chairs, ramps, etc. Talk to the Vietnam vets hanging out to be picked up by transportation and you will learn a lot. You can also have your primary care doctor request that your receive free transportation to the VA facility at your rate. This will help, since driving on meds and in pain is not advisable. This also builds your case. You need to play the game to get the service you deserve.

I would suggest that you inquire about a Fentynal Patch and use Oxycodone for breakthrough. They may try to start you on Morphine Sulfate as this is much cheaper. Get a not from somone that you cannot function or have severe side effects and they will move you to the Fentynal patch. The Morphine really messes with your GI...constipation.

I am currently on 75 ug/hr of fentanyl with 5 mg/8 hours for breakthrough. The breakthrough is not cutting it and the doctor is not budging on the this. They are likely to move me up on my patch.

I have been through many needles over many years and many different meds. So far this is the best. I have a paralyzed siatic nerve plus other damage, missing part of my leg.

Jeff L

12/15/10 5:14pm

Hey BrokenSailor, thanks for the good advice – I know it’s good because I’ve already done most of the things you suggest =]

Yup, I’m service connected. I became a Lifetime Member of the DAV years ago and gave them Power of Attorney to represent me with my VA claims. I turned in claims for my back, PTSD and unemployability which were, of course, denied – the DAV is appealing, but I’m sure you know how long that process can be. I have since had to suck it up and go back to work – if I didn’t, I would’ve lost everything and been on the streets… I have cut back on my meds so that I’m not so drugged up anymore, but the pain is so bad that I’m nearly out of my head anyway, kinda stuck in bad catch-22 thing there…

I do have a bad case of tinnitus in both ears from weapons firing, aircraft and such, and am at 10% for that. I am also rated for both ankles and both knees. Had a botched reconstruction of my Rt ankle while active duty that left me with nerve damage and a limp.

I’ve been to the pain clinic in Indy, and won’t go back – they injected my spine and made it worse – the meds wore off the next night and I was literally left in the fetal position unable to do anything but scream and cry – got a nice ambulance ride to the local ER where it took 2 shots of morphine to un-curl me… I’ve never experienced that kind of pain before – it was all consuming. I was almost totally unaware of my surroundings, and don’t even remember the paramedics or the trip to the ER – just came back to reality once they pumped me full of morphine.

They offered me morphine before the Oxycontin, but I turned it down – it scares me. 30 mins after the shots of morphine in the ER, I was twitching and scratchin like a junkie, my skin crawling and shaking… I can see how people get strung out on that stuff.

It sounds like you’ve been run through the same VA ringer I have – I feel for ya. It truly sucks. I hope that you are able to keep your chin up and that you get some relief.

Jeff

BrokenSailor

12/17/10 6:37pm

Great,

Long reply, but it may help others... Sounds like you are on the right path. I have four herniated disks also and use a muscle relaxer Cyclobenzaprine HCL. You can't drive on it, whacks you out, but I got used to it and now I am better and can drive short miles. I have been on pain management for 20 years. I spent two years in a cast and almost three years in a Naval Hospital. After I learned to walk again (2 years...my leg was the size of my arm) I went through 10 years of Vocational Rehab and got my college degree on the VA dime and then went to work for the US DOE. They just forced me out when my back froze up at work and with the new meds, too much to be safe at work. I applied for unemployability and got it. I am also receiving Social Security Disability and extra money for my child. The VA is now paying for my wife to go back and get her masters and my son has his college paid for.

It seems like we are indeed in a similar boat. I think that for your back you should see the doc about muscle spasms. When my back hurts it is from the nerves, which in turn causes the muscles to clamp up. My experience was similar to yours...fetal position, screaming, no memory and such. I was treated for a heart attack at the local ER. Went to the VA ER the next day and a very good doctor figured out that my muscles were spasming from a back x-ray. This could be your problem and solution. Took me two weeks on the above med to get me right. Now every now and then, but I am home in a recliner with a heat and massager. I cannot do much at all.

Regarding the Pain Treatment...20 yrs. I have more experience at pain management than many of my doctors have been practicing....and I let them know it! I too went through a bunch of needles...trigger point injections (I have three nueroma sites ...bundled nerve endings where my leg was cut off ...missing two inches in my shin area. They saved my leg.) I did 10 injections every three days foro four years, and finally gave up on that. I also did spinals like you and Beir blocks...where they put a tourniquet up on my thigh, and lidocane and steroids into an IV in my foot. That is Anesthesia Pain Management. If it works it is better than being on Opioids. I also tried Nuerontin for many years...non narcotic meds... Now I am on the Fentynal patch which is 10 times more powerful than heroin, but it is time released and I change the patch every two days. They don't work for three days as advertised. They are the best thing I have found. No ups and downs like morphine pills. You should try to get into the Pain Management Clinic. I am in NY and go to the Northport VA. I have nothing but good things to say about everything the VA has done for me. Once you are seen and put on a regiment that works for you, your meds are then handled by your primary care doctor.

As for PTSD....I was not sure if you got rated for it or not? You can get PTSD for the Pain from a service connected injury. In other words, you have have mental problems from dealing with the pain. Also if you have insomnia...due to social issues caused by pain...you can get 30%. Do not directly relate the insomnia to the pain, relate it to the problems you have at home...frustration, anxiety, depression, etc...

Unemployability... You have to have one issue that is 40%. Do you have this? If not, you need to build your case on your main injury. Nerve involvement at the injury site will do this for you. You need to document this. The DAV is great for handling your claim.

This is my best advise...go see your Congressman. No shit, do it. I have been to his office four times, and they have an aide that is usually assigned for dealing with just Vets. They can expedite your case. Once you have a Congressman looking at your case, things start happening. My Congressman is Tim Bishop (D) and his staff is Great! There was a liaison at the VA for SSD. This is not welfare, it is social security disability and you paid in for it, so you deserve it. I filed my case with the VA liaison at the VA hospital, and he took it directly to the SS office, but the Congressman can point you to one. He helped me fill out the forms...took one week. I went to Records Release at the VA and got a copy of the last year of my medical records, attached it and that was that. Then I went to the Congressman and he had it expedite.

They have a separate staff member to help you with that. I went to one physical and saw a Haji doctor dressed in white pajamas. Guy was like 80 years old. He had me perform some function tests....using a zipper, buttons...nothing for my leg....got an X-ray and was done. Had my SSD in three months. Took six months for the VA to grant me unemployability. They back pay you. Most important thing I did for my case was get the Congressman involved.

I am now fighting for my mortgage, since I couldn't make payments while waiting for my VA and SSD. I have a separate congressional aide that has filed a complaint, and now I deal directly with the Presidential office at Wells Fargo and have a direct phone number to one person. Still taking forever... it is a Freddy Mac Loan. Looks like it is going OK, but it has been 14 months now since I got hurt and 8 months since I filed under the new mortgage act. 4 Months since the congressman got involved. They call me back almost weekly at this point. I have little else to do. All said and done... the VA pays out 2900, SSD 1600 plus kid 800. You can live well on that. I had a long term disability policy that I paid into at DOE with Prudential. They said I could still work, even with decisions from the VA, SSD, and letters from the DOE doctor at the OMC clinic. Prudential SUCKS!

After I settle my mortgage, I plan on selling and moving to a warmer climate where my bone pain won't hurt as much. On the pain score I aim for a seven and hit a nine three days a week. Sometimes I can get lower. My 10 year old has to watch my cry and scream from the pain, until meds kick in. It is very sad and upsets me very much. Thank the VA his college is paid for due to my sacrifice. This is important to document at the VA. Never say you are less than a seven. You might feel better than that with meds, but give them the score before meds. They use this number heavily when looking at your case. You have to get into pain management at the VA to bolster you case. Have patience....it took me three years just to figure out I had a nerve problem....then many years and tests to get treatment. I have been through a lot but I am sitting well now.

Overall it sounds like you need to really focus on putting in your time at the VA hospital to get develop your case better and get into a pain management clinic. The Fentynal patch is the best thing I have found for quality of life opioid treatment. I also use 2 lidocane patch directly on my leg...wound site to kill some surface pain. They work well, but the VA has discontinued them. So my VA doc writes the script and I get it locally. I have asked twice for exception, but have been denied.

If I was in a legalized marijuana state, I would probably try that. I understand I could cut down my opioid by 50% and increase my quality of life. Now that the VA will let you stay in a Pain Management clinic if you follow your state laws you can do this. In NY, we are still waiting. I don't know about your state, but look into it. I hear from other Vets with Nerve damage like mine, it would help, but I cannot risk it and break my PM contract with the VA. They do give you a Tox screening. I have had one in the beginning and now have one coming up next month. Otherwise not much of a problem. I don't smoke, or drink, and I am not addiction prone at all. If you smoke cigs, or drink they watch you more carefully. (Note to Everyone)

I called asking to many questions about my dosing of oxycodone, and the doctor put me in for one. I scheduled it for a month out....read between the lines. Presently they only allow me 5mg per 8 hour for breakthrough, and to get from a 9 to a 7, I need 15 mg, which they say is too much and will kill me. Well, it hasn't, but my questions raised a concern that I may be abusing my oxycodone to get high. Funny thing is, besides when I have increased from 12 to 25, 50, and 75 ug/hr of Fentynal I have never had any euphoric feeling ever from my meds. They are looking to raise my patch to 100 now. I have been on 75 for 2.5 years.

Regards

Jeff L

12/21/10 7:45am

BrokenSailor,

Sounds like we've been through a lot of the same treatments and meds, although it sounds like you have MUCH more serious injuries than I. I feel ashamed sometimes to even complain about my feet ankle and knee pain because I still have them attached, and there are so many others that have lost entire limbs.

Last year I was prescribed - and taking all at once - Oxycontin, Neurontin, Flexeril, tramadol, and was switched around on several different anti-depressants (they all made me REALLY depressed). I was maxed out on the dosage amounts - still am maxed out on the Flexeril. My mental state has suffered...The damn VA let my Neurontin script expire and wouldn't see me or return a phone call about what to do. I had to quit the Neurontin cold turkey, and I don't advise it. I had withdrawals for a month; non-stop nauseousness, throwing up, shakes, you name it. They finally called me back over three weeks into my withdrawals and I told them I didn't want the meds any more. I actually wanted to stop taking it because if I was an hour late with a dose, I'd have sweats and shakes and crawling skin. So of course they send me a three month supply after not having any for a month. I didn't start taking them again. My pain level is higher, but I'll accept that. I still have constant muscle spasms in my back and neck, but they say I can't take a higher dose of muscle relaxers than what I'm on.

In addition to the joint pain in knees, ankles, back and neck, my local VA primary care doc diagnosed me with fibromyalgia and PTSD. The regional VA, however, won't accept these diagnoses. They've turned me down on the PTSD because they say they can't document any of the things I've told the VA shrink I've been through... haven't told everything though, and may never speak of any of it again if possible. I just can't bring myself to fight them on that issue.

The pain mgt clinic at the Indy VA said that injections are the only thing they do, and since it didn't work for me, my only other option is to let them actually burn out the nerve and destroy it. While waiting for my last appt at the pain clinic, I was sitting next to a guy, with 2 crutches, and heard him telling another guy that he just had that nerve destruction thing done, and they did the wrong nerve! They totally destroyed sciatic nerve and left him on crutches... They didn't understand why I wouldn't agree to the procedure.

I wish that I could move to a warmer climate. Winter is hard on me too. Gotta stay here - my youngest is only ten, and I can't bear the thought of moving away from my kids. They live with their mother.

I currently take 20 mg of Oxycontin 3 times a day, and it isn't enough. I know what you mean about them acting suspicious. I had to fight them hard to get my dosage that high. But, like you, I never get any kind of high or buzz from the painkillers. I guess that means we're in too much pain to get any of the side effects that recreational users seem to like so much.

Well, here I am at the end of another sleepless night...

I gotta go, can't sit at this computer any longer. I type slow and my computer chair is one uncomfortable SOB. I had my girls all weekend and Monday, and I'm worn out and hurtin.

I wish you luck. Hope you have a Merry Christmas and Happy (less painfull) New Year.

Jeff

A realistic Oxycodone dosage?

Additional Posts

Ask a Question

Health Centers