Rheumatoid Arthritis Pain Relief
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How much pain medication is to much before it is considered an addiction?
My mom has been suffering from rheumatoid arthritis for years. As she gets older nothing seems to truly relieve the pain. She has tried everything from aspirin to Embrel without much success.
About 6 months ago her doctor prescribed Norco, or the generic Hydrocodone-APAP 10/325. She takes 3 to 4 Norco a day, depending on her arthritis pain, although the prescription allows her to take up to 6 a day. This is the first medication that truly has given her real pain relief in years.
Since she is feeling better, her moods have improved and she also has become more active on a daily basis. My concern is that hydrocodone can be extremely addictive. I guess my question is, actually how much hydrocodone does she have to take before she becomes addicted, or is she on a safe dose? Or, perhaps addiction is a better alternative than the pain of rheumatoid arthritis?
Thanks in advance for your responses!!
Woa Woa Woa… No where in the books does it say 60mgs of hydrocodone is the most you can take without becoming addicted!
It appears I got here just in time 
Addiction is defined as a craving for, and taking for the recreational purpose, a drug. End of sentence.
I think what is failing here is proper education about opioids. I will attempt to do this now.
In Pain Management we deal with three main things. Addiction, Tolerance and Dependence. Addiction I have already defined for you.
Dependence is a natural process of taking opioids, which means that if you stop them without a proper taper, you will experience withdrawal symptoms. If you experience withdrawal symptoms, does that mean you are addicted? Absolutely not. Tolerance simply means that over time, as a result of the bodys response to opioids, you may need to increase the dosage in order to obtain the same pain relief.
Now, firstly, I would not say that hydrocodone is EXTREMELY addictive. Something like Dilaudid or Actiq certain has a greater potential for abuse.
The behaviors you are describing that your mother is exhibiting is a pain specialists dream come true. Let me pose a scenario to you. If you come in to see me with low back pain and I prescribe you say, Lorcet 7.5/650 (hydrocodone 7.5/ APAP 650) and you come back in a month and tell me all you have gained is being able to lay in bed and not be in pain, I’ve not improved your quality of life. Treating pain is ALL about improving the quality of the patients life. If say, that same patient comes in next month and she tells me that she is now cleaning her house, going grocery shopping once a week and you’ve attented a PTA meeting for the first time in four years; I’m thrilled beyond relief. The medication has done exactly what I wanted it to. IMPROVE FUNCTION
Basically, in summary. Your mother is more than fine. Signs of addiction would include increasing the Norco above her daily prescribed amount, reports of taking it for non pain related issues and sorts of the like. It is wonderful that her mood has improved and that her activity has improved. Please report that to her health care provider when she see’s him/her next time. I’m sure they will be thrilled.
And finally, KUDOS for keeping such a close eye on moms. I went in to medicine so I could help take better care of my mother (although she’s not my patient) and I’ve always thought there is a special place in Heaven for those of us who honor our parents this way.
Rheumatoid Arthritis Pain Relief