percoset withdrawal

TCASII, ADN · Jul 29, 2005

How long they been on? A simple search on Google will give you the scoop, but I took Percs and then Vicodin for over a year for a serious injury. Getting off of them was not fun. Your blood pressure goes up, you become hypersensitive to things around you (hypervigilance), you are irritable and restless, you go from hot to cold, and so on. It's very uncomfortable to say the least, LOL. It takes about a week to 10 days. Most people will reach a point where they peak in withdrawal and it's awful. For me it was when the full effect of the norepinephrine was rushing back into it's pre-opioid state. My muscles were so strange feeling, it woke me up and I spent a few hours moving around trying to get my mind of it.

The worst is that you have a period of about 6 months after where you feel down and yucky. It's called protracted abstinence syndrome.

For the most part though, the symptoms and overall scope of the withdrawal is dependent on the amount, potency, and duration the individual has been on the opioid.

CharlieRN · Jul 29, 2005

We treat percocet withdrawal as opioid withdrawal with methadone or suboxone. I would think it was the prescribing MD's responsiblity to write a taper.

krisssy · Jul 29, 2005

The MD did write a taper. She is down to 4 a day and then 5 a day and then switching back to 4 a day. She had been taking 8 a day for pain after two abdominal surgeries-once in a while 10 a day if the pain was really severe. This has been going on for 9 months since she had the initial surgery. So she appears to be half way there. The most notable problems has been an inability to sleep and stomach cramps. She can tolerate the nervousness and restlessness, but the other two problems have been difficult especially the stomach cramps, because her stomach is already sensitive after the two surgeries. There have been orgaqnic changes, and she was given the percoset for this pain originally. The surgeon has found nothing wrong from a surgical perspective. Any other suggestins to ease the process would be helpful. She has tried Excedrin for the crampiness, and it seems to help a little. The Dr. also told her to take 0.5 Colonopin at bedtime and once during the day if she really needs it. It doesn't appear to help. Is that because the dose is so small? Thank you all for any experience you have had with this either personally or professionally and any suggestions to ease the process. I did a search. They tell the symptoms, but they don't offer any suggestions to ease the process. Maybe there are none. I don't know.

Whispera, MSN, RN · Jul 29, 2005

When a person is withdrawing from anything, their symptoms will be the opposite of what the drug does to them when they take it. So, someone withdrawing from Percocet would have pain, speeded GI motility, increased heart rate, resps, and BP, anxiety, etc. It's important to treat the symptoms. Clonidine deals with the VS's. Tylenol or Ibuprofen help with the pain. Bentyl might be prescribed for the cramping, and a benzo or vistaril might be prescribed for the anxiety.

krisssy · Jul 29, 2005

I suppose that is why he prescribed small doses of Clonozapin and I assume that is why the Excedrin takes the edge off. She gets scared when the cramps come, because she had to have a second surgery for adhesions.

krisssy · Jul 29, 2005

The doc has been hesitant about the Clonidine, but I am going to pursue that, because she had fast heart beat the other night.

TCASII, ADN · Jul 29, 2005

Clonidine really requires close supervision. I'm surprised it's not doing anything. Also, I don't agree with a benzo for the anxiety, I find antihistamines are better, but that's just my opinion. There's no reason to substitute an addictive drug for another one, and for percocet, I really don't feel 8 a day is a reason to prescribe another opioid agonist or antagonist.

Not trying to be mean, but often times patients will say things just to get another dose. She may say she wants off it, and may very well mean it, but the withdrawal can really be difficult.

krisssy · Jul 29, 2005

He never prescribed the Clonodine. Do you think he should? The Colonipin is a very small does 0.5 mg. She is not a drug addict-just was given Percoset for post op severe pain- I suppose that is why he saw no harm in the Colonopin in such small doses.

TCASII, ADN · Jul 30, 2005

Oh, I misread. Klonopin, not clonidine was given. 0.5 mg of clonazepam is about the same as 5 mg of diazepam (Valium). Some text even say it equal to 10 mgs of diazepam. I'm not surprised it didn't do much. Although I still don't feel it's worth messing with for someone in her condition, unless she has some other reason for the drug (e.g., seizure disorder). Also, if she takes it as part of her daily regimen, and part of her pre-op medication, then she shouldn't be missing a dose.

For a lot of people clonidine does help, simply because it'll reduce the sympathetic outflow and abrupt release of NE from certain tissue stores. Clonidine requires some close monitoring however, as it's fairly strong and can really lower blood pressure, it's main use in medicine.

She may not be a drug addict, but at 8 pills a day, and having what sounds like moderate withdrawal, I still think some symptoms are likely to occur and will decrease as the days progress. It's impossible to avoid all symptoms.

Ultimately, it's the doctors decision and he should know how to handle the situation. My opinions are just that, opinions. I would have tapered her down to at least 3 or 4 a day over a week, then started a very small dose of clonidine with 15 minute BP checks.

NoCrumping · Jul 30, 2005

Oh, I misread. Klonopin, not clonidine was given. 0.5 mg of clonazepam is about the same as 5 mg of diazepam (Valium). Some text even say it equal to 10 mgs of diazepam. I'm not surprised it didn't do much. Although I still don't feel it's worth messing with for someone in her condition, unless she has some other reason for the drug (e.g., seizure disorder). Also, if she takes it as part of her daily regimen, and part of her pre-op medication, then she shouldn't be missing a dose.
For a lot of people clonidine does help, simply because it'll reduce the sympathetic outflow and abrupt release of NE from certain tissue stores. Clonidine requires some close monitoring however, as it's fairly strong and can really lower blood pressure, it's main use in medicine.
She may not be a drug addict, but at 8 pills a day, and having what sounds like moderate withdrawal, I still think some symptoms are likely to occur and will decrease as the days progress. It's impossible to avoid all symptoms.
Ultimately, it's the doctors decision and he should know how to handle the situation. My opinions are just that, opinions. I would have tapered her down to at least 3 or 4 a day over a week, then started a very small dose of clonidine with 15 minute BP checks.

Ok, you guys... since we are talking about percocet, I have some questions, too......I have been on them for post op pain from bil carpal tunnel surgery. I find I need 2 a day, no more. Is this enough to give me withdrawal symptoms when I no longer need them? I have been taking them for about 6 months. I will admit, before I take them , I do get a lil aggitated, but I cant tell if its because I am in pain, or am I "withdrawing" allready? (as in when I wait til I am in alot of pain before I take them).and second....I want to go back to work soon..... but I dont really want to divulge to them I am on the percocet, if a drug test is done. I just dont want the stigma, I guess... my question is, how long do I have to be off of them for them to NOT show up in a drug test??? Thank in advance guys, I have been struggling with these 2 things, but didnt know where to post it!!!

Whispera, MSN, RN · Jul 30, 2005

I've worked in an addictions unit. We regularly gave clonidine 0.1 mg BID prn for BP greater than 140/90. Vitals were checked an hour after medication was given and at least 3 times a day.