Hey guys (and gals),

I have a possible need for Vicodin for some miniscus knee tear,...

They may not give it to me but if they do,...whats the protocol,....do you have to wait a few days after the Vicodin in order to avoid the severe withdrawl? I'm imagining a day later I could start Vicodin but restarting NAL I think is the dicier issue,...and I may just deal with teh pain,..suggestions please...BEst, Jim

JC -- I forget: Does your md know you take naltrexone? If so, of course you will want to discuss this with her. Noone here is in a position to give medical advice.

A few of us do have experience with this. Waiting to Exhale had a skiing accident -- broken collarbone etc. You may want to search her posts. She was going to tough it out with ibuprofen but that did not work for her. She went off the nal for a few days to take the pain meds. I recall others mentioning going off briefly -- a few days' window off the nal and then off the opiate before resuming the nal -- and this worked fine. It's not ideal but we do what we must. I've read that effective pain management is an important part of the healing process. Knee surgery, even minor, is not fun.

My experience is unique: I was in the hospital for a couple of weeks last year at this time, with IV morphine the entire time. When I got home, I went off the pain med for a day in order to have a nal/glass of wine. I had a VERY bad reaction. I thought the worst that could happen was the pain med wouldn't work. I was wrong. I guess I had been on the opiate too long. I don't know exactly what it was, as my medical treaters did not know about the naltrexone. I went off the nal for a while in anticipation of a second, scheduled surgery which was delayed a couple of times. I suspect that interlude of non-nal drinking for a few weeks may have something to do with the fact that, now, I'm just not quite where I'd like to be with TSM.

Others will chime in with their experience. I expect you'll hear that they found that a few short non-nal days is not the end of the world. Best wishes as you make your decision, and here's hoping for a smooth healing process.

Thanks Lena,

I realize nobody is qualified to give advice but would you all like Lena did, kindly share your experiences and I will extrapolate what I need....

Thanks so much,...They kicked the first scrip back but they re-sent it.....

I will check in on it,...but I may just put it aside for future and deal with pain,....

I just wish I didn't have to deal with this right now on such a beautiful day....Sunny and almost 70

Hi Jim,
About a year ago, I had to go off nal for some minor outpatient surgery. I stopped taking it about a week before the scheduled event. (And yeah, I still drank.) I only had a day of being on something -- vicodin, I think it was -- so I can't answer to more extensive usage. But I went right back to the nal the day after. You may want to inform your dr that you are taking it, just in case.

I responded to an email that Jim sent me offlist about this, but I'd like to repeat some of what I said to him here. Like Lena and H4B, I was put on opiate pain meds right in the middle of my TSM treatment.

Taken from discussions with my Dr, Pharmacist, and personal experience: The risk of nasty side effects of mixing Nal with opiates is really only a concern if you take the two within hours of one another or if you are consuming ALOT of opiates or have been taking them over a long period of time and have come somewhat dependent on them (My guess is that Lena was in this category). Taking NAL within a day or two after taking low doses of opiates isn't going to hurt you and the Nal will be 100% effective. However, the converse is a much different story. Nal takes a good 5-7 days to completely wash out of your system. During this time, opiates will have no to little effect on you. The risk here is that if you really need them, they simply won't work because the Nal is blocking the opiate receptors.

The other issue here is AL cravings while on the opiate meds. In my experience, switching to a stronger opiate med mostly got rid of my cravings and allowed me to recover without drinking. In my case, I switched from Vicodin to Percocete. There is an issue with asking your Dr. for this switch and saying you are doing so because you have a drinking problem -- most will think you are just being a typical addict and say no. What I said was "Vicodin just isn't working for me. I need Percocete."

Finally, don't be surprised when going on pain meds sets your TSM progress back. All of us that had to go on pain meds during our TSM treatment seemed to have experienced a backslide.

Good luck.

Q

On either end, this isn't a process to be taken lightly. Hence the importance of the medic alert card or bracelet or something. I think Q may be right about my case. I never would have thought that two weeks on IV morphine would have put me in the opiate "dependent" category, but based on my reaction, it may very well have, for naltrexone purposes. Fortunately(??), I was sufficiently ill before the surgery that nal/al was not an issue for several days prior to the first surgery.

An additional word of caution: Both vicodin and percocet are opiate/acetaminophen combinations. Acetaminophen is VERY dangerous to take with alcohol, because the two can cause acute liver toxicity. This can and does happen. Please read up on this.

Some day soon these issues will be in the rear-view mirror.

Jim,

I had to suspend nal two weeks ago in anticipation of a tooth extraction. I took my last nal on Sat. prior to the Wed. proceedure. I took my last pain med (Vicodin) the morning of the day I went back on nal (at about 6:00p), and had no problems.

This is an interesting thread. I was feeling a bit bummed that my units went up a bit last week. Maybe it was just a little backslide from stopping nal for a few days the week before. I'm hoping that next week will be better.

By the way, stopping nal for a few days was interesting. Up-regulation of opiod sites caused pharcological enhancement of all sorts of endorphin-supported activities. For example, food tasted fantastic, and the Vicodin felt real good.

Good luck with your knee.

-wort

Thank you aLL...as it stands,..I have the Vicodin,..but I am not taking it....

I'm listening to Queen live in Montreal and having a drink....much better combo I think,...

BTW I gigged tonight,...no jones,..but had about 7-8 units over 8 hours....No drunkeness...

God Bless Freddie Mercury,..Jim

one other thing..

the pharmacist told me this...

48 hours after last nal should be fine for opiod meds and as well 48 hours after last vicodin you should be able to start nal again.

this is what he told me but again my pain has subsided and I feel as though I want to continue with nal because I think I'm closer than I realize... best Jim

I tore a my bicep working out ... Dum S#*T! Anyway the orthopedic prescribed some painkillers (Narco). I am not planning to take them if I can avoid it. However I was wondering if anyone had any more up to date info on this thread or some experience with Nal and pain killers.

Thanks,