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I've been chronically ill for over 16 months now with symptoms ranging from constant severe discomfort to moderate pain. I've recently decided that it's in my best interest to start taking a medication for pain management because my condition has gotten to the point where I don't feel well enough to leave the house or do much of anything. Unfortunately I just turned 18 in the U.S, and although I can legally take these types of medication without parental consent, it seems the numerous doctors I see are still not taking me completely seriously (for example, when I told my doctor today that if someone didn't prescribe me something soon I was going to start taking heroin, he started cracking up).
Anyway, I requested he give me vicodin as I've heard a lot of good things about it and it seems to be the universal painkiller of choice. He wouldn't prescribe me vicodin, but prescribed me "Tramadol" instead. He said that it's not an opiate like Vicodin, but it fits into the opiate receptors, and thus gives the "exact same effect as Vicodin," without being as addictive. I had a feelin he was just telling me what I wanted to hear, but I was out of ideas so I took the prescription and hoped for the best.
I took 1 50mg tablet half an hour ago, and another one five minutes ago. I feel no symptom relief at all, no euphoria whatsoever, but I do feel sleepy, as well as really angry that this doctor apparently lied to me. I'm obviously no expert, but I thought opium turns to morphine in your body and becomes endorphins, or something like that? If Tramadol isn't an opiate, then how can it do that? And if it can't then how does it have the same effect as Vicodin?
Anyawy, for those who you don't feel like reading all of that:
How does Vicodin differ from Tramadol in terms of the effect? Do the two really give the user the exact same effect, like my doctor said?
And slightly off topic, If I can't get a doctor to prescribe me a painkiller that actually does something, is taking heroin orally in small doses a good alternative (because it seems like my only one at this point), or is there something else I could do?
Thanks a lot. Any help would be much appreciated as I'm in a very bad place right now and I can't deal with my health symptoms anymore without some sort of help.
well first of all I doubt you would want to use heroin.....perhaps swiy(someone who isnt you..read rules) might. honestly swim would go with the hydrocodone it seems tramadol has other effects besides pain relief from what i understand it is also a mild ssri. And honestly I highly doubt anyone would advise swiy to begin using heroin as this can lead to serious addiction.
Both of the substances do vastly different things. Doctors are just told to push tramadol I think. Vicodin(hydrocodone) is one of the weakest morphine derived opiate agonists(dihydrocodeine is the only one I can think of weaker, since codeine turns to morphine). Tramadol however, has a much more complex mechanism of action. It's pain relieving abilities have been confirmed to come some what from it's noradrenic activity. My back pain does not respond well to straight opiate agonists. Tramadol however, completely eliminated it for 3 months without increasing dose. I was even using it over oxycodone in severe flare ups. Sadly, it just kinda stop working one day and never has been as effective as it was at first. It still works for a once in awhile dose, but nothing compared to how good it was at first. So I would say ask if you can try both. Docs have no problems giving scrips for tramadol, since they can't get in trouble at all really.
Finally, I agree taking heroin is a bad idea. Heroin is much more euphoric than needed for pain. Different opiates have different doses for analgesic and euphoric effects. Morphine for instance needs to be in a pretty high dose for euphoria, but is effective at low doses for pain. Not the best, but just an example.
well for swim a vicodin isnt shit, he can od himself on them and still not feel pain relief or a high, tramadol always worked good for swim but it was realy addicting for him so he gots a huge tolerance to them now, but anyway besides all that i realy think tramadol is better as a pain killer but most people think its weak, i realy think it all depends on your body not the strenght
So in terms of painkilling strength and euphoria, which has more of which? And if vicodin isn't any stronger than Tramadol in terms of the two, then what other options am i left with to help with my pain? What IS really strong? I would take more of the tramadol but the package says not to take more than 2 during a 4 hour period
swim has never had anything that could take care of his pain like he hoped but tramadol works the best for him but remember hes talking in doses of 1000mg at a time on average just to get rid of the pain and plus the high.... swim does not recremend any1 taking this much, withdrawals from it are hard enough from 1000mg (sometimes more, sometimes less) a day usage but swim has now got past that but feels permently depressed since hes not taking the tramadol anymore..... oxycontin or percocet in small amounts of mg can get rid of pain alright if your saying vicodin doesnt work for you, and you said that the doctor wouldnt give you a script to vicodin? thats usally somthing a doctor will write out just as fast as tramadol around here
he actually wrote vicodin down a prescription, then asked about the details of my symptoms, and i tried to dramatize them a little bit since it seemed like no one was willing to give me anything, and then he got a new prescripting and wrote out tramadol and said it was the exact same, except not addictive because it's not an opiate?
i think doctors characterize me as drug seeking. i've never had an addiction problem in my life but yeah i am drug seeking. i want something to make me feel better of course i am. anyway, who's swim? is that like forum code for "i?"
anyway, so does tramadol give the same euphoric effects as vicodin?
and someone111- the bottle says it's only safe to take 100mg every 4-6 hours. is that bullshit? i mean you're taking muchmuchmuch more than that. how much can you actually take without causing damage to your organs or ODing?
Angry, SWIM has been known to take up to 200mg in a single dose, however, be mindful that in excessive doses tramadol DOES and WILL cause seizures. They are usually not life-threatening, but should they happen with when driving or another similar act, well, use your imagination. Do take this risk into consideration and assess SWIY's tolerance before increasing the dose. SWIM's doctor has prescribed him tramadol in 100mg doses, but said that should his pain increase, he can take another, but not to exceed 400mg per day.
It should be noted that for SWIM, tramadol does hold a similar euphoria, but is more speedy and more subtle. However, should SWIM take 1-2 tablets of Vicodin, he would feel less due to his opiate tolerance, so pill-for-pill, tramadol is stronger for him. SWIM needs roughly 10 tablets (CWE'd due to Acetomiphen content) to produce a nice hydrocodone high. Always be mindful about acetomiphen content, and one sure advantage of tramadol is that it contains none usually (unless branded as Ultracet).
A good doctor, will, however change your prescription if you are getting no pain relief. A word to the wise is play drug-stupid, and NEVER ask for anything by name- thats a sure-fire way to be labeled a drug seeker. Be straight up with the doctor, and tell him it doesn't help your pain, is there something else you can try. In SWIM's experience, doctor's like making decisions, so let them. Its better to play the game for a little bit until you get a medication that works, than to get labeled a seeker from day 1. Also, please note that I'm not saying the above doses are safe, please don't attempt them. SWIM has a very high opioid tolerance, and he knows what is safe for him. An opiate-naive person could easily die from too much tramadol, and definately from 10 tablets of Vicodin/hydrocodone. Please be careful.
SWIM is new to this forum, and doesn't understand where doctors are prescribing vicodin or percocets to people unless they have serious and verifiable pain illnesses- he has tried going to the doctor for "back" or "neck" pain and followed the basic rules of not mentioning drugs by name or requesting them, and the best SWIM ever gets is tramadol or darvocet, IF that. SWIM doesn't know what he's doing wrong or where everyone finds these wonderful drugs. SWIM had surgery once last year and had percocet and loved it, but that was the only time he got to experience it. His doctors never give it out!
And actually when SWIM first went to this particular doctor and asked for a painkiller, he was prescribed neurontin, which is a rather useless drug. SWIM realized the neurontin was useless, then immediately emailed the doctor saying that SWIM didn't feel his pain was being taken seriously, that the neurontin was useless, and that he wanted something else. A week later the doctor's assistant emailed SWIM back saying "Dr.xxxx hopes the neurontin is helping. Take Care."
SWIM then emailed again, VERY angrily, stating that the assistant and the doctor should go back and actually read SWIM's first email, and then prescribe SWIM something. This still got SWIM nothing, so in his next appointment, SWIM requested vicodin, and threatened to start using heroin if the doctor didn't prescribe him anything. The doctor then cracked up, so SWIM said he wasn't joking because heroin is the only opiate SWIM thought he could find on the street. The doctor then told SWIM that he wouldn't give him vicodin, but that he would give SWIM tramadol because it's "the same as vicodin, just not addictive."
Moral of the story: doctors suck, and there's more than one way to get drugs like tramadol that don't even do that much and aren't really worth the effort put into getting them.
Angry, SWIM is fearful that you fucked yourself with the asking for Vicodin by name, and with the heroin comment. SWIM thinks a new doc is in order- and try everything willingly. You are medicine-stupid, remember, just a menial patient. Try everything eagerly, and if its crap, call back and say you need another appointment. Then at the appointment, explain that it helped 'some' but your still in pain. Pain is a medical condition, so being straight up with the doctor is best, no threats of heroin, no anger, he's trying to weigh the possibility of addiction with treating pain. To their credit, SWIM knows the hell of opiate addiction all too well, and it all started with, yes, Vicodin. That, too, is a medical condition, however its far more daunting than simple, acute pain.
And to say that all doctors suck, well thats not true. SWIM gets prescribed Hycodan (off label- its for cough, but is prescribed for pain), which is a Hydrocodone medication like Vicodin that has no tylenol. 90 per month for his chronic basilar artery migraine, along with 30 fioricet (a barbitute) and 30 tramadol for breakthrough pain. This wansn't overnight, you have to prove pain, and if SWIY has legitamate pain, then keep trying with a new doctor. It may take several visits, but the life of not having pain kicks ass. You may walk away with tramadol, neurontin, cymbalta, amatryptolene or other total garb, however, be patient and look eager to try everything. If it doesn't work, you can always go back. Also, considering the DEA right now, doctors aren't only worried about addiction, but DEA action as well- doctors ARE being prosecuted for overprescribing controlled meds. Don't think badly of them, many of them are good people, some more sympathetic than others.
And Percocet is Oxycodone/Tylenol, a similar product to Vicodin which is Hydrocodone/Tylenol. Slightly stronger, but harder to get prescribed.
I think you may learn a bit from the above. Going in with acute pain (i.e. threw out your back) may get your Darvocet or Vicodin, but not very many. If you go to an emergency room, your chances for Vicodin or Percocet increase. However, Percocet is even more controlled than Vicodin, so don't hold your breath on that. If you are ever asking for a chronic prescription, expect to "work your way up", so to speak.
Angry, SWIM does understand your dilemma all to well. You've been given some very good advice from the good folks here so there's not really much more I can add except to tell you that opiate seeking is a tricky game.
No disrespect but your first mistake was telling the doc that "heroin was the only opiate you could find on the street." Big red flag right there. You should probably take the advice of the person here who said to try a different doc because SWIM can pretty much guarantee that your not going to get anything out of this doc now.
SWIM used to play this game some years ago and found that it is beneficial to come across as not having to much knowledge about pain meds. And yes, you will have to be patient and work your way up to the good stuff. Be assertive but not aggressive about getting what your after.
SWIM had been out of the game so to speak for many years and recently started having pain in her neck and shoulder, along with severe headaches.
Sounds crazy but she was actually paranoid about going to the doc to get something for pain because she was afraid of being thought of as a seeker because that's what she had done in the past. Even though she had legit pain. The doc told her that she was just having tension headaches and prescribed skelaxin, (a muscle relaxer). Well her pain continued to worsen and after a couple more doc visits, one of which it was recommended that she try massage therapy, yeah right, the doc finally ordered an MRI and found that she had 3 ruptured discs in her neck. Now she gets 40 vikes a month.
Please excuse the lengthy post. The point SWIM is trying to make is that if you have legit pain you will eventually get what you need. But if you're just looking to get high you may have to seek an alternative source.
So good luck and I hope you get what you're looking for.
Oh yeah, BTW IMO tramadol can be very affective but it does affect people differently. SWIM couldn't tolerate it. It made her feel very agitated and nauseous.
swim takes doses way over the bottle with no harm as far as he nos because of his tolerance.... as swim said before no1 should ever take up to 1000mg at once like swim because it could be life threating.... if tramadol isnt working with the dose thats safe then you should switch to something else, swim just thinks tramadol has the best nod ever
actually, in a weird kind, swiy's doctor is right. Tramadol is NOT an opiate. opiate is a name exclusive to natural opioids. Tramadol is an opioid. Tramadol is also a weak opioid, in fact, the weakest there is. in a lot of countries, it's not even scheduled.
tramadol has also a serotonergic effect in its repertoire, acting as an slight anti-depressant. however, tramadol has also a very high rate of so called non responders (people on who tramadol has little to no effect). tramadol has about the same/slightly higher pain killing strength as codeine (morphine is about 10x as strong, a and codeine is converted to morphine on a 10:1 basis). Tramadol has a low binding affinity to receptors, and has virtually no binding affinity to receptors causing breathing depression. Tramadol also carries the very low risk of a serotonergic syndrome if combined with any other serotonergic drug.
vicodin is acutally a pretty strong painkiller (hydrocodone), however, it comes in low dosages for recreational (= euphoric) value and also combined with NSAID's, which further kills the maximum dosage.
vicodin/hydrocodone and tramadol do only have in common that they're opiods and share some basic opiod qualities. other than that, they are in no way the same drug.
if you actually need the opiods for real pain killing and not mainly for euphoria (trust SWIH, as you're taking your pain killers daily, the euphoria diminishes VERY quickly!), start out low.
the "I do not know anything about pain killers" attitude can work well. SWIH did another route, started a pain diary and informed himself alot in the internet and bought himself professional books about medicine study, and taking the diary and those books to his doc. SWIH talked out with his doc which would be the best pain killer and also they set up a plan on dosage, renewing prescriptions and that.
Also, SWIH was honest to him and was willing to try out different strategies. Actually his doc pointed out that SWIH's suggestion of acupuncture (something the doc would actually get more money directly from!) was not that good as SWIH does not have a type of chronic pain which usually doesn't responds well to acupuncture.
also, SWIH's doc was responsible enough to prescibe SWIH opiods from the lower end of strength to swap it out for SWIH's daily usage of several grams of ibuprofen and metamizole as SWIH had not that good kidneys and the stomach was damaged as well.
His doctor pointed out that addiction is not an issue in responsible patients which do need it to manage pain. Do not start thinking that addiction and dependence are the same.
A good MD can tell you the difference without even needing to think about. Dependence is NOT an issue as there are good ways out of it.
Find a responsible MD which has at least some qualification in pain managment and is willing to actually work WITH you and not AGAINST your health just to calm his conscience out of an unjustified prejudice of opioids caused by lack of knowledge. Unfortunately, these are the minority of docs, and, despite the drug politics having the most guilt in this, drug seeking behaviour of a lot of people made it's part in this as well.
Im probobly repeating what others have said, but if a doctor writes you a script and you reply "this isnt going to work!" without even trying hes not going to take you seriously. IE: he knows youre seeking.
SWIM has had the same problems of unexplained pain. But it took many years and a chance ER visit to finally get oxy. SWIM asked for pain releif and was given Trammadol, and it only worked for him at its highest dose. (200 mgs in the morning and another 150 - 200 at night)
Also even tho SWIM smokes marijuanna he no longer gives this info away to his doctor. Doctors have guidelines to adhere to and a reputation. If a doctor sees that someone is a drug user then he will be less inclined to give you pills that you can use to get high.
Also, since it seems you have a long term problem a doctor most likely wont perscribe something like Vicodin. The amount of AP/AP (Tylenol) in Vicodins make it very dangerous for long term use. There is no AP/AP in Trammadols so in a sense they are much easier on your system.
What ISWIM would do (what SWIM has done because hes been in your shoes for the last 8 years.) is keep on the trammies. Just tell him SWIY thinks SWIY needs a higher dose or maybe the instant release trammadols might help. Lie, tell him they kinda work. He may up your dose. Keep taking it and keep telling him they kinda work, while every 3 months or so tell him they just dont work like they used to.
If SWIY is like SWIM and has to go to the ER frequently on a visit see if you can see the in house pain specialist. Youre already there and it will be free. Let him/her know the situation, how trammadol kinda works but SWIY is taking up to 400mgs a day and feels there has to be something out there that will work about the same as trammadol with much less of the active drug.
These are the steps that it took SWIM to finally get releif. And some pills that get him a little high every now and then to boot.
Just a word of caution. If SWIY really are looking for releif from serious pain try and stay away from getting "high" on the pain meds. In the end it only boosts SWIYours tolerance and before SWIY know it SWIY is feeling the pain of the illness and the pain of withdrawls because SWIYs script ran out early.
Also I wanted to say that you have to look at it from the doctors perspective. He wants to help and cure you most likely. Giving you strong pain med right away migh aleviate the pain sure, but then its just masking the problem. Pain from the inside is a signal that something is wrong. If you dont feel that pain anymore then you feel like nothing is wrong any longer. And that most surley isnt the case.
Im willing to bet most doctors would feel better curing your ailment then just covering up till its too late and out of control.
The fact that your 18 doesnt help either. Sure you think youre a responsible adult but starting a pill adicction now will lead to some serious issues way earlier in your life then you want em. Not to mention thats about the age people are going to college. The land of over excess and debauchery. amiright?
Same advice as everyone above. On SWIM medical files SWIM is pretty sure he has some substance abuse issues on it from the teenage years. Now SWIM has REALLY REALLY REALLY bad GAD, stemming not only from his father side of the family(alcoholics, abuse,etc) but also very bad from his mothers side(most of his cousins are paranoid schizophrenics, and he isn't really able to talk to them). Even though it is apparent he would deffinately have some mental issues because his genetics, doctors would just not give him anything but SSRI's(which made him manic and psychotic) or very low doses of xanax, but only to help with the initial anxiety of SSRI's. He eventually had to get "jumped"(beat sensless by a gang because he was "talkin shit") and had a gun pulled on him(for the second time in his life), which gave him severely bad panic attacks multiple times a day. Now panic attacks were nothing new for SWIM, but his parents were seeing him have them all the time, and he wasn't leaving the house at all(except school, sometimes), and he wouldn't talk or eat. Even once he got the xanax and had been on it for a while, he said how it had lost its effectiveness, yet they wouldn't give him a higher dose(although he goes through psych's like air, because most of them are just pill company drones). Anyways the main point is that, if you are young, sound like you are trying to get high(or would rather enjoy the initial high from the pills), and mention "street drugs", or have "drug abuse" on your record, it may be a lot more difficult to get that prescription for the "good stuff". Just try doc shopping for a while, while I realize it can't be the same for you, as your pain is physical, if you find that right doc, your gold.
It's true that pain in general is a warning sign. However, there are also a lot of cases of chronic pain without any physical signs, in people who get medicated for their life and in the end die of something not related to the pain. This is only to make it clear that pain in general has a cause, but not every chronic pain disorder has a cause that can be masked by pain medication.
For example, Restless-Legs-Syndrome can be painful for extended periods of time (SWIH has RLS, which mainly occurs due nightly sleep and caused him to have sleeping problems for years due to waking up in the night when your leg feel like something is crawling up on them on the inside).
Doctor shopping may not be the best solution in the end. It's kinda not worth the high, and please think about that if you end up being caught, you'll have VERY serious pain out of the withdrawal (yes, opioid withdrawal actually HURTS physically) additionally to your pain that's there anyhow.
Docs are human, too, and they do a lot of stuff only out of believing their patients and trusting them. Trust is something that builds up over time. If the doc is good, the best way is to stay with him, and eventually, when he realizes that you have real pain issues, he'll prescribe you what you need.
Have heard many a report over at Erowid which compare the fine (narcotic) effect of tramadol most closely to the warm fuzzy effect of hydrocodone, mixed w/ low dose MDMA (and less to the speedy effect of oxycodone). Go over to Erowid's experience vault. Puts to rest any blastphemy that tramadol is a worthless drug. Tramadol, one of the very best.
How well tramadol works for an individual has everything to do with enzyme levels, mainly cyp2d6. Tramadol in itself is a completely benign opioid, but once it goes through your liver it becomes O-desmethyltramadol. Which is a much stronger opioid. For many with low cyp2d6 or none they receive minimal to no benefit. I myself can feel a pronounced opioid effect from it. Sedation, mild euphoria, itching and other effects. It comes down to your body chemistry.
The biggest difference between tye 2 is that Tramadol has anti-depressant properties and Vicodin doesn't.Vicodin is combined with APAP (Acetemonophen) and Tramadol doesn't.
Both have a limitation on dosing. You should never take more than 4,000mg of APAP in a 24 hour time span, taking too much can seriously damage the liver. Also, you should never take more than 400mg of Tramadol in a 24 hour time span to avoid a possible seizure.
Vicodin is more potent than Tramadol. Both are Opioids/Narcotics, to treat moderate to moderate severe pain.
Vicodin, aka Hydrocodone/APAP is a CII (Schedule 2) controlled substance/Narcotic. Which means it has a high potential for abuse and can cause severe withdrawal symptoms both physically and psychologically.
Tramadol is a CIV (Schedule 4) controlled substance/Narcotic. Which means it has potential for abuse. Like other Narcotics, Tramadol also can cause severe withdrawal symptoms. Some say Tramadol has worse withdrawal symptoms than other Narcotics due to its anti-depressant properties which effects serotonin in the brain which can lead to seizures.