Pain Pill Mistakes that may lead to a Ketamine Infusion

As regular readers know, about 3 weeks ago, I had a ketamine infusion. Part of the reason for this was I was addicted to codeine-based painkillers. I was unable to go cold-turkey and undertook the infusion to avoid all those horrible withdrawal symptoms.

Basically, this addiction came about because I made some pretty common pain pill mistakes.

Mistake No.1: If 1 Is Good, 2 Must Be Better

Doctors prescribe pain pills at the doses they believe will offer the greatest benefit at the least risk. Doubling or tripling that dose won’t speed relief. But it can easily speed the onset of harmful side effects.

“The first dose of a pain medication may not work in five minutes the way you want. But this does not mean you should take five more,” Kristen A. Binaso, RPh, spokeswoman for the American Pharmacists Association, says. “With some pain drugs, if you take additional doses, it makes the first dose not work as well. And with others, you end up in the emergency room.”

If you’ve given your pain medication time to work, and it still does not control your pain, don’t double down. See your doctor about why you’re still hurting (and, hopefully, there is something that will help more).

pills“This ‘one is good so two must be better’ thing is a common problem,” says pain specialist Eric R. Haynes, MD, founder of Comprehensive Pain Management Partners in Trinity, Fla. “Patients should follow the instructions their doctor gives. Ask before leaving the office: Can I take an extra pill if I still hurt? What is the upper limit for this medication?”

Another bad idea is trying to boost the effect of one kind of pain pill by taking another.

“There may be Advil, Tylenol, Aleve, and ibuprofen in the house, and a person may take them all,” Binaso says.

This can escalate into a very bad situation, Haynes says – welcome to a fast-forward approach to end up with a cannula in your arm and a week worth of ketamine!

Mistake No. 2: Duplication Overdose

People often take over-the-counter pain drugs – and even prescription pain drugs – without reading the label. Never a good idea – it means that you often don’t know which drugs you’re taking.

And if you take another over-the-counter drug – for any reason – you could wind up in a hospital ER with an overdose. That’s because many OTC drugs are combination pills that carry a full dose of pain pill ingredients.

Mistake No. 3: Drinking While Taking Pain Drugs

Pain medications and alcohol generally enhance each other’s effect. That’s why many of these prescription medications carry a “no alcohol” sticker.

“A common misperception is people see that sticker and think, ‘I’m OK as long as I don’t drink liquor – I can have a beer.’ But no alcohol means no alcohol,” Binaso says.

“The patient should heed that alcohol warning, because it can be a major problem if they do not,” Haynes says. “Alcohol can make you inebriated, and some pain medications can make you have that feeling as well. You can easily get yourself into trouble.”

Drinking alcohol can be a problem even with over-the-counter pain drugs.

Mistake No. 4: Drug Interactions

PILLSBefore taking any pain pill, think about what other medicines, herbal remedies, and supplements you are taking. Some of these drugs and supplements may interact with pain medications or increase the risk of side effects.

I suggest you try a drug interaction checker, if in doubt; and/or keep an updated list of your medications on your phone or computer so you can give your doctor a complete list of all the drugs, herbs, and supplements you take – before getting any prescription.

If buying over-the-counter medications, Binaso recommends showing a list of everything else you’re taking to the pharmacist.

Mistake No. 5: Drugged Driving

Pain medications can make you drowsy. Different people react differently to different drugs.

“How I react to a pain medication is different from how you react,” Binaso says. “It may not make me drowsy, but may make you drowsy. So I recommend trying it at home first, and see how you feel. Don’t take two pills and go out driving.”

Mistake No. 6: Sharing Prescription Medicines

Unfortunately, it’s very common for people to share prescription medications with friends, relatives, and co-workers. Not smart, Haynes and Binaso say – particularly when it comes to pain medications.

“If a fairly healthy person is taking a medicine because she is in pain, and wants to give some pills to Uncle Joe because he is hurting – well, this is a potential problem,” Haynes says. “Uncle Joe may have a problem that keeps his body from eliminating the drug, or he may have an allergic reaction, or the drug may interact with a medication he is taking, with life-threatening results.”

Mistake No. 7: Not Talking to the Pharmacist

22. pillIt’s not easy to read drug labels, even if you can make out the small print. If you have a question about either a prescription or OTC drug, ask the pharmacist.

“That’s why I’m in the store,” Binaso says. “You may have to wait a couple of minutes for me to finish what I’m doing. But you’ll get the information you need to take the right medicine the right way. Just say, ‘Tell me about this medicine; what should I be on the lookout for?'”

Mistake No. 8: Hoarding Dead Drugs

Pills stored at home start breaking down soon after their expiration date. That’s especially true of drugs kept in the moist environment of the bathroom medicine cabinet.

“People say, “That drug is only a year past its expiration date; isn’t it good?” But if you take a pill that’s broken down, it may not work – or you may end up in the emergency room because of reaction to a breakdown product. That is really common,” Binaso says.

Another reason that it’s dangerous to hoard is that the drugs may tempt someone else (your son or daughter?) into making a very bad choice.

Mistake No. 9: Breaking Unbreakable Pills

Pills are actually little drug-delivery machines. They don’t work the way they’re supposed to when taken apart the wrong way.

“Scored pills should be cut only across the line,” Binaso says. Those without scoring should not be cut at all, unless you’re specifically instructed to do so.

“When you start chopping up pills like that, the pill may not work,” she says. “We find more and more people are doing this. And then they say, “Oh, that pill had a really bad taste. That is because they cut away the coating.”

Just Lovin’ This (NOT!)

Day 3 – Spent the morning with The Kid, until after we both had a nap.

No change in medication today but severe nausea (only after nap). Mommy asked if it was because of the change in medication? How would I know – it could be the FM itself, the medication, something I ate, etc. Don’t you just love this condition!

And now my tummy (and bottom) are very upset! Hmm…too much information?

Pharmaceutical Finances

The mortar and pestle, one of the internationa...

The mortar and pestle, one of the internationally recognized symbols to represent the pharmacy profession (Photo credit: Wikipedia)

If you think you’re spending a lot of money on prescription drugs, you’re probably right. In 2008, American patients and insurance companies spent more than $234 billion on prescriptions, up from $40 million in 1990. According to a study by the University of Western Australia’s School of Population Health, spending on medicines was rising rapidly in Australia. This was in line with trends in most other industrialised countries; however, spending in Australia was fourth highest among comparable countries –  spending on publicly subsidised medicines by Australian patients increased from $16 per person in 1971 to $62 (which when adjusted for inflation equals $134) in 2007. Only Finland, Denmark and Poland ranked higher.So, any way for us to save money on this money drain?

5 Good Ways to Save Money on Medicine

1.  Ask About Generic Options

“In most cases, generic drugs can save a great deal of money,” says Corey Sawaya, RPh, a pharmacist in Stow, Ohio. Almost 80% of FDA-approved drugs have generic alternatives that cost an average of four times less than the brand-name versions.

2. Look Into Splitting Higher-Dose Pills

Pill splitting is based on the fact that many pills cost about the same even if they contain twice as much medication. An 80 mg pill is often close in price to a pill with 40 mg of the same drug. Ask your doctor or pharmacist if your medication is safe for pill splitting. If so, ask your doctor to prescribe twice the dosage you really need, so you can split your pills in half.

Be aware, many pills are not safe to split, including time-released drugs, coated pills, and capsules, says Richard Sagall, MD, president and co-founder of NeedyMeds, a non-profit organization in Gloucester, Mass, that provides information about financial assistance programs for prescription drugs.

“The best person to ask whether it’s safe to split a pill is the pharmacist,” he says.

3. Talk Openly With Your Doctor

Your health care provider may not know how much you’re paying for the drugs he or she prescribes. “Patients should talk with their doctors so they can consider less expensive options,” says Sawaya. It also helps to review all your medications with your health care provider from time to time. If you’ve been taking a drug for a long time, it’s possible you no longer need it or could switch to something cheaper.

4. Shop Around

“Prices at pharmacies are fluid,” says Sagall, who recommends negotiating with your pharmacist. If one pharmacy has the best prices in town on all but one of the medications you’re taking, let the pharmacist know and see if she can give you a discount or price match on that one drug. “Many pharmacies want relationships. They want to keep you as a patient, and this is one way they do it,” says Sagall.

5. Look Into Patient Assistance Programs

Many pharmaceutical companies have programs that provide their drugs at deep discounts or even free for people in need. If you have a prescription for a high-cost drug, check out the company’s web site to see if they offer assistance. You can also look up patient assistance programs on the NeedyMeds website , which provides information on almost 6,000 programs.

5 Bad Ways to Try to Cut Drug Costs

1. Do NOT Use a Friend’s Medicine Cabinet

“Taking other people’s medications is a really bad way to save money,” says Sagall. The drugs you find in your friend’s stash may be expired, may be the wrong dose, and may react with something else you’re taking. Plus, taking someone else’s prescriptions is illegal. “There are usually specific reasons why a doctor prescribes pill A and not pill B to their patient,” says Sagall.

2. Do NOT Insist on Brand Name Drugs

In the old days, drug companies sent information to physicians, who then decided what drugs to prescribe to their patients. Now television and magazine ads use images of active grandparents or amorous couples to promote prescription drugs directly to patients. No matter how attractive the models, the advertised drug may not be the best match for your particular condition. And there’s probably a less expensive alternative to the drug advertised on TV.

3. Do NOT Assume Herbal Supplements Are Safe or Adequate

Because they’re natural, it’s easy to equate herbal supplements with a green, leafy salad. In fact, herbal supplements are not regulated like medications, and some could pose a real danger. “Some of the herbals have the same drug interactions and possibility of adverse reactions as prescription medicines,” says Sawaya. “Those things need to be monitored by a doctor.”

4. Do NOT Keep Switching Pharmacies

You might switch pharmacies to get a better deal, but doing so repeatedly undermines the checks and balances meant to protect your safety. The history of your prescriptions creates a profile of your health in a pharmacy’s computer system. Pharmacy computers are programmed to catch errors such as potential drug interactions so the pharmacist can intervene. “If you’re moving around from pharmacy to pharmacy, the computer system is less likely to catch things like that,” says Sawaya.

5. Do NOT Buy Drugs from “Rogue” Internet Pharmacies

Online sales of counterfeit prescription drugs is a booming global business. By operating under the radar, groups posing as legitimate pharmacies get away with selling fake drugs, expired drugs, or the wrong drug in the name of a buck.

Officials are starting to come down hard on counterfeit drug operations. In 2011, the U.S. and 80 other countries launched a worldwide operation targeting rogue Internet pharmacies. Within 10 days, almost 13,500 web sites were shut down and 2.4 million illegal and counterfeit pills from 48 countries were confiscated. This is good news for consumers, but don’t let down your guard too soon. It’s safe to assume rogue pharmacies will be online for some time to come.

(As you might remember, in my financial desperation, I ordered Lyrica from a Canadian pharmaceutical company – so far, all seems to be going well. I checked with my doctor and pharmacist prior to starting the ‘imported’ product and let Mommy know, in case weird things began to happen. They haven’t (YET)!)

Related articles

Website Lets You Shop and Compare Prescription Drugs (fox4kc.com)