Tramadol Isn’t As Safe As You Think

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tramadolTramadol is a synthetic opioid drug, similar to natural opioids derived from poppy seeds, such as morphine. It is marketed under names such as Ultram, Ultracet, ConZip, Ryzolt, Rybix ODT, Zydol and Zamadol. Are you using Tramadol for pancreatitis pain? You may want to reconsider or at least be extremely careful using it because …

When John Bowker left his 57-year-old wife, Lizz, alone in their bedroom, she seemed to be in perfectly good health yet when he returned just six minutes later, she was dead. And her death wasn’t caused by a sudden heart attack, stroke or aneurysm. In just six minutes she had become another victim of Tramadol, a dangerous opiate pain med that’s so cheap and widely prescribed that you or someone you love could be taking it right now.

Tramadol is sending patients, many of them seniors, to emergency rooms in record numbers, and death rates have tripled in just a few short years. Experts are warning that if you don’t quit the drug fast, it could trigger a serious brain condition and potentially lethal event know as serotonin syndrome that’s often nearly impossible to spot. It can turn fatal in a hurry.

When the FDA approved Tramadol 20 years ago, it was supposed to be less addictive and cause fewer stomach problems than the other long-term painkillers on the market.

But in reality, Tramadol (Ultram, Ultracet, ConZip, Ryzolt and Rybix ODT) has proven to be a living nightmare for many of those to whom it was prescribed.

The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has found that Tramadol is sending at least 27,000 people a year to the ER, a number that’s increased 145 percent since 2005. And research on Tramadol use in Florida found that deaths linked to the drug have tripled since 2003.

And Tramadol seems to pose the greatest danger to seniors, the very people the drug most intended to help. One of those victims was an 84-year-old woman whose doctor prescribed Tramadol for lower back pain. Before long, she was suffering from common side effects like shortness of breath, confusion, depression, anxiety, loss of appetite, and very high blood pressure, which eventually landed her in the ER. Read the rest of the story here.

Keep in mind it may not be affecting only seniors. From what little research I have done while writing this post it doesn’t seem to discriminate between age, and, the usage of antidepressants, which many pancreatitis sufferers are prescribed, dramatically increases the risk for both seizures and serotonin syndrome.

187 thoughts on “Tramadol Isn’t As Safe As You Think”

  1. I have been using Tramadol retard for 10 years because of fibromyalgia and osteoarthritis. The doctors in Germany discourage use of Ibuprofen ,Exedrin etc., because of damage to kidneys, liver etc.
    The last 2 years the doctor switched me to Tilidin retard because of nausea. According to WHO opoids and morphine are much better for stomach ! Retard form will not make one addicted.
    But thanks for all the info, very helpful. Been living with first gallstones since 2000 and after the removal of the gallbladder suffer from chronic pancreatitis. It first started again by 2009.
    Greetings, C.Carsrud

    1. Hi Christina – Just because the WHO thinks opioids are better for the stomach (yep that’s why they make many people puke) or your doctor is worried about bleeding, kidney failure, liver damage (all extremely rare) doesn’t mean Ibuprofen or other NSAIDS aren’t the answer. Tramadol, Tilidin, Tylenol, opioids and most likely your next door neighbors spring tonic don’t do diddly squat for inflammation. Pancreatitis IS inflammation. It’s inflammation of the pancreas. If you don’t address that inflammation the result is unnecessary suffering. PLUS large numbers of people die EVERY year from overdosing on opioids. A lot less die from NSAID usageage. It’s your life and you, like everyone else, has to choose their own course. Thanks for your comment I appreciate your views.

        1. No… You are wrong.. Ibuprofen IS NSAID Tylenol is not… However… You might want to recheck your numbers on NSAID deaths… As celebrex,Vioxx, have high numbers of death associated with them… As well as motrin, and Advil…. More than tramadol…

          1. Lbc – First of all the commentor SD-PN is not me. I know Ibuprofen is an NSAID. I also know that NSAIDS (including aspirin) cause more deaths and this is to be expected due to the fact that Ibuprofen, Naproxen and aspirin are extensively used, abused and easily obtained OTC. NSAIDS can cause serious gastrointestinal issues (bleeding) and most (not aspirin) can cause blood pressure spikes and heart attack. THAT fact is exactly why I have told people who use Ibuprofen to stop pancreatitis pain and acute pancreatitis to be cautious. Ibuprofen does knock out pancreas inflammation but it comes with risk. The percentage of deaths due to NSAIDS is relatively low about .02% most likely far lower than that of Tramadol due to more NSAID users than Tramadol users.

        2. What? Ibuprofen absolutely IS an NSAID, just like Tylenol. And, it’s the most widely used NSAID. Do you know your meds?

          1. Yes ibuprofen aka motrin, advil, etc. is an nsaid (nonsteroidal anti inflammatory drug) acetaminophen aka tylenol is not an nsaid………Paula, RN

        3. Ibuprofen IS an NSAID which stands for non steroidal anti inflammatory drug. Tylenol (if taken in large doses is bad on your liver) IS the safest pain killer out there. Moderation is the key. If you need something everyday, you have something underlying going on and need to see your dr. None of these drugs, opiate based or OTC should be taken daily for any long period of time. NSAIDS destroy your stomach ( colitis and other serious stomach problems) Tylenol destroys your liver. Opiates are highly addictive. Tramadol causes seizures as well as a host of other problems. Of the above mentioned, there are no good choices but living in pain in not a choice either. So I guess what it boils down to is each individual deciding which side effect is worth taking one of these meds for. Each to his own I guess. There is no magic pill. All drugs have some type of side effect and each individual’s body can respond differently to all of them.

          1. Inconstantpain, thank u,I’ve been on tramadol sense 2012 from back and foot surgery, I knew the side affects n the side affects of other pain pills, I choose tramadol because it’s nowhere near like percacets and OxyContin which is what they wanted me to take, I lost my brother in 2008 from OxyContin and I just lost my baby brother in March of this year to overdose of percacets so I choose tramadol it helps me with my pain, my dr. also sat me down n talk to me about all the pain killers that we’re out there, I think it’s very very important for dr.s to take the time like they use to n talk to there patient about the pros n cons of pain killers n it is the patients decision as to which one they chose, thank u again for ur comment.

        4. SD-PN. I regret to inform you that Tylenol is not an NSAID, it is Acetaminophen. Ibuprofen, ie, Advil, Motrin, Anaprox (Naproxen), are all NSAIDs, and are all anti-inflammatory drugs. Call and ask a pharmacist! I have been in the medical field for 35 years, the last 5 in Orthopedics and can tell you this is true!

        5. SD-PN – Ibuprofen IS an NSAID. Tylenol isn’t. I think you need to learn your medicine. I know as I’m allergic to all NSAIDs

        6. Ibprofin is an nsaid Tylenol is NOT thats why pregnant women can only take Tylenol because nsaids can cause Rye Syndrome in infants!! Google it

        7. Tylenol is not a NSAID, Ibuprofen is. I’m allergic to NSAID’S incld ibuprofen, naproxen, aspirin etc. Do you know your drugs?? Do your research before you bash someone else!!!

          1. my dr gave me xr tramadol today im scared he said its better than perocet

        8. Tylenol is an antipyretic which is use for fevers and a pain. Ibuprofen is an nsaid use for inflammation just like aleve advil. Please know your stuff before calling other idiots. I am a nurse.

          1. I was in nursing 28 yrs,and I take Tramadol.I have had no side effects for the past 20 yrs.I’ m allergic to everything and this helps me,I guess we all have to choose our own way!

        9. Actually, it’s the opposite. Ibuprofen is a NSAID (NON-STEROIDAL ANTI INFLAMMATORY DRUG). Tylenol is not. That’s why it’s not used alone to treat any disease with inflammation (rheumatoid arthritis, pancreatitis, etc)

        10. You’re a darned uneducated idiot. Please research and know your facts before expressing your viewpoint.

        11. Do your research please before posting wrong information. Ibuprofen IS an NSAID. Tylenol is NOT.

      1. As one who has damage of kidneys I could tell you how much ibuprofen / Tylenol I’ve taken, and now how much Kidney function I have left. I’m just one. We never know what these meds are doing to the other organs until the damage is done..

        1. Hi Cindy – I’m sorry to hear you have damaged kidneys. NSAIDS can and do cause organ damage and death. I agree. ALL drugs can be dangerous. Some are worse than others. Thank you for sharing.

      2. NSAIDS actually kill more people than any other class of drugs. In addition many people suffer from the damaging effects of these drugs, kidney failure, liver damage, hemorrhages, etc. Another thing you may not be aware of, which is opioid overdoses are lumped together into the same category as illegal drug overdoses. For example, fentanyl is a fairly cheap drug on the street and it is often substituted for heroin by many drug dealers. Keep in mind that fentanyl is at least 10 times stronger than heroin. When a toxicology report is done on a person who has overdosed on this, they are counted as an overdose from prescription drugs when in fact the person was not a patient, but an illegal user. This happens a great deal. A chronic pain patient rarely becomes addicted to opioid drugs. Statistics show that between 95% – 99% of chronic pain patients do not become addicts. Opioids give many a better quality of life.

        1. Hi Howard – not sure where you get your info especially on the chronic pain patient numbers/% but you should do more research. I can tell you from over 3 years of talking with pancreatitis patients that quite a few become addicted to pain meds. Thanks for sharing your opinion and visiting. 🙂

          1. Sorry Health Guy, there is a huge difference between dependency and addiction. I personally have 4 autoimmune diseases which includes chronic pain. When it comes to chronic illnesses, most NEED pain management. Just as we (the chronically ill) need medications like methetrexate or predisone our pain must be addressed as well. Yes we are dependent on pain meds but also just as dependent on our biologics, steroids, etc. Addiction in chronic pain patients with legitimate, diagnosed illnesses do not suffer as much addiction as you would have folks believe. It is the undiagnosed, those that are suffering pain and Dr’s can no longer provide pain management because they cannot find whats wrong, or find the patient should be healed; these are the folks that end up becoming addicts. They are cut off instead of weaned and at this point labeled a drug seeker. Which they very well may become- unless they are lucky enough to find a Dr. willing to run tests to actually find the problem. It took me 3 years to be diagnosed with Rheumatoid disease, 10 years from time of dx until I finally gave in to pain meds. I was lucky I had a good Dr., but also that I was sero positive for RA factor in my blood work. Many are sero neg.; meaning they need a group of diagnostic tests to determine RA including x-rays, mri and blood work- many Dr’s don’t bother and assume it’s lifestyle choices that are causing symptoms. So these folks suffer for years, changing doctors, meanwhile in severe pain. This isn’t exclusive to RA- most autoimmune diseases are on the rise yet it still can take years for a proper dx and that includes lupus, stills, RA, POTS, Fibro…and even worse diseases like RA can be severe enough to not just cause perm. damage to joints, but also soft tissues and organs- these diseases have had a rise in mortality, yes you can die from these diseases even with treatment. So before you make a blanket statement re: chronic pain diseases and addiction, maybe understand the addiction process and how people with legitimate pain and dx’s get treated like drug-seekers even though it has been well documented that pain meds are necessary.

          2. Hi Chailine – Everybody has their own opinion regarding certain things and you are either right in your opinion or wrong. You happen to be wrong. Dependency is NOT different from addiction and I’ll give you a real easy way to understand that addiction and dependency when talking DRUGS is the same. You yourself mentioned “They are cut off instead of weaned.” If you aren’t addicted (physically or mentally dependent) there is no reason to be weaned. I can take aspirin every day for 6 months and abruptly stop and have ZERO effects. That is NOT possible with Tramadol or any other narcotic drug. Do you understand why? BECAUSE your body has become dependent upon the drug, addicted. A rose by any other name is still a rose! But feel free to believe your own wrong opinion. 🙂

          3. Feeling worried now. Have been on tramadol for around ten years for pancreas pain as it’s the only one that works. Should I be stopping it. Advice please thankyou ?

          4. Christy – If Tramadol is working for you and it’s the only pain med that does and you’ve never had a problem you’re probably ok. I didn’t write this short post to instill fear, just to make those who suffer from pancreatitis and use it to be aware of possible side effects. IF it were me I’d call my pharmacist and ask him/her about the drug. They know way more than me about possible side effects, interactions with other drugs etc.

          5. I lost my pancreas and spleen to pancreatitis and I have been going to pain management for 4 years now. She says you become dependent on the drugs for relief. But that is different from addiction. She can bring me off them slowly with no side affects. I live in pain every day from the surgery and the pain is from scar tissue. I do not feel well any day of the week but I am alive and I am grateful for the pain relief. I suffered so bad the first year of the pancreas attacks I was hospitalized 8 times in one year. The attacks destroys my pancreas it started destroying the other organs and the spleen was destroyed. In the 3 years I fought the attacks I was in hospital about 15 to 16 times. I wish I had known about this site then. It might have saved me from the last 5 years.

          6. Hi Kels Mom – I’m sorry to hear you’ve had such a rotten experience. You are way worse off than me (more damaged). I can’t say I know your pain cuz I don’t – oh ya I KNOW the pain but not yours with that amount of damage. There are others who “stalk” this site lol who have similar damage as you. I have a forum too where you can set up a profile, meet others, swap stories, even chat in real time (I think lol). The forum has not caught on yet, only a few members have posted etc. BUT I’m hoping the other couple hundred who have signed up will begin to participate 🙂

        2. Howard, a voice of reason! Amen! Chronic pain sufferers will become psychically dependent on opiods after long term treatment but that is a far cry from being an addict. There is a distinct difference, Health Guy. I’m a member of many chronic pain support groups and have suffered chronic pain myself for 23 years. Chronic pain sufferers just want to feel normal, addicts just wants to feel high.
          BTW, do people read these posts? I ask because how many people does it take to tell one person that Ibuprofen is an Nsaid. Still giggling.

          1. Hi Andi – Yep you and Howard should get together and become best buddies lol. Being physically dependent on a drug isn’t the same as an addiction? What do you think an addiction is exactly? You can be a member of all the support groups you want but that doesn’t make you intelligent, knowledgeable or correct. Thanks for stopping by 🙂

          2. I just can’t believe food spend all this time writing stuff!
            Just feel good be well and listen to The Health Guy! With all the people this man has helped including myself for anyone to feel it necessary to give this man a hard time should take a look at them themselves in the mirror and ask why?? Why?? Why?? This gentlemen is only good! Only good things! He is a true blessing! In fact if you looked up the word BLESSING in the dictionary his picture should be one of the pictures next to the definition. BTW Paul, Health Guy, thank you for getting all that info to me on the vitamin D. Have got had an episode since I stopped taking it in that large quantity. Now I get it in 5000 unit measures in a capsule open it up and put it right into my Protein Shake every morning!
            Thanks so much for all you do! If u are ever in Arizona please come to my restaurant called Chompies…let me know and I will make sure to take care of you first hand. Thanks Neal

          3. Hey Neil! I am glad to hear you are feeling better. 50,000 units of Vitamin D daily is a boatload. I’m sure your doc put you on that amount because you were so low in D but shazam! that was a full toxic load! I am glad to hear 5,000 units is working better and that lowering your Vitamin D dose has stopped your acute pancreatitis attacks. Thank you so much for the kind words. If I am ever back in AZ again I will let you know. Take care and stay well 🙂

      3. NSAIDS CAUSE ULCERS AND GERDS terrible! Tylenol causes 80,000 deaths a yr, far more than anything the lady before me knows or the opioid faked stats even per yr…u know the “big epidemic but where are they” kinda,thing.. Unless you have the addiction gene, you take your opioid pain medication as prescribed less than 2% become addicted (due to said gene) & unless you plan on snorting it or injecting, taking it with alcohol it IS SAFER TO TAKE. WHO IS CORRECT. Propaganda instills fear and poor judgment. I’m sorry your having all these issues. I’m listening to knowledge w/o propaganda myself. Ps. Ultram/Tramadol withdrawal is said to be worse than heroin withdrawal, it’s bad news all the way around.

        1. TRAMADOL IS HORRIBLE TO GET OFF OF! WORSE THAN HEROIN! I am living proof! Was absolutely horrible for me

        1. Hi Janet – all drugs have side effects. Even aspirin will kill a person if enough is taken. Some drugs are worse than others. All this article was intended to do was to let people know that Tramadol has some side effects.

      4. WORLDWIDE OPIOID FEAR of the 21st century. Now, heroin is included in opioids as many drug addiction reports, programs, clinics and so on do not just say heroin, now it’s opioid or opiates when it’s largely, almost exclusively heroin as the problem and issues of most all addictions, overdoses, and deaths. Opioid was never an issue until the 21st century when it was decided to include heroin in all reports concerning opioid or opiates.

        1. Duffy feel free. If you think writing opinion backed up by scholar articles is dangerous hop to it. By the way the FCC won’t do anything. If you were half as intelligent as you think you are you’d at least know to report me to my state’s AG. Try that too. Nothing there either. Hey I have an idea, why don’t you go do something to yourself that is physically impossible. 🙂

    2. I’ve taken Tramadol off and on since the late ’90’s for back pain. I’m taking it now 100 mg. 1 to 2 X a day PRN. I have taken heavy opioids when my back was in worse shape and was bouncing off walls from being doped up. I started seeing a very good chiropractor who helped me to feel better without heavy medication. I’m not advocating chiropractic. It just worked for me. To help my pain at this time, Tramadol continues to work for me. I am not afraid of it due to my long term use and results. It’s too bad that others suffer from it. I still maintain that patients look into further research before deciding to toss it out as an option for pain management.

      1. Hi Brenda – Thank you for commenting and sharing. You have voiced one of the best comments so far and you make perfect sense. Nothing is perfect, especially when it comes to pain management. Drugs, ALL drugs are dangerous. The pharma industry has a knack for creating drugs that kill more people per year than wars. If they took a completely harmless, natural and necessary vitamin like vitamin C and turned it into a presription drug I am almost certain it would harm or kill people. But again your thoughts and recommendation regarding patients who use Tramadol is spot on. Thanks for visiting 🙂

      2. I agree I have been taking it for several years. I need it to get through working and I only take it when I work.. Who writes this nonsense… All meds have the potential to kill anyone as does 95% of the food we ingest daily…

    3. Christina Carsrud, I too had my gallbladder removed and then suffered from chronic pancreatitis. My gas to enter I logo at later found stones in my common bile duct. After removing them I am fine and pancreatitis is gone. Just thought I would share this information it may help. Good luck

    4. I was going to comment on the complete lack of replacement ideas (after saying, “don’t take …”) but I now see how F’d up this goofball is and am happy to have him pretend he is smarter than our stable genious leader, I think they are tied!

      1. Hey Duffy LOL Nice name! Did you know that low IQ people tend to swear, revile, and try to elevate themselves above others because they feel so inadequate that shame follows them like a continuous stench?

  2. No author!! If someone is not willing to put their name and reputation on the line, I would be very wary of any thing stated. And, all the misspelled words leads me to believe that the anonymous author is uneducated.

    1. Hey JR You must be simply magnificient! A legend in your own mind. And a spelling expert to boot! Hot damn sam! If you don’t like my info don’t read it! And if you are taking Tramadol good luck to you. I usually don’t approve turd comments but in your case I thought I’d make an exception 🙂

  3. ive been taking tranadol for 4 years now for restless legs and its the only thing that works for me i take one pill at bedtime which is 75mg and thats all i take and it doesnt do nothing to me but stop my pain in my knees from OA and stop the legs from hurting and going crazy i got off of it for a year and no side effects then i started it again cuz nothing would stop my legs from being restless i have no problem with it

      1. Mike – not true.

        Tramadol Hydrochloride Extended-Release is available in 100 mg, 200 mg and 300 mg extended-release capsules.

        100 mg Capsules: White capsule imprinted with blue ink “G 252” on cap and “100” between lines on the body

        200 mg Capsules: White capsule imprinted with violet ink “G 253” on cap and “200” between lines on the body

        300 mg Capsules: White capsule imprinted with red ink “G 254” on cap and “300” between lines on the body

        You can find more about Tramadol here.

    1. bonnie have you tried Indian Tonic Water for your restless leg syndrome i have and find it really good sometimes just a good drink can sort it long enough for me to get to sleep, has to be INDIAN tonic water, hope it helps,

        1. My mom also suffers from RLS. She just uses normal tonic water and mixes it with grape juice or grapefruit juice. It is a stout drink, but has been off all meds for 7 yes.

    1. Mary Ann – THAT is a great question. IF you ever doubt the harm prescriptopn drugs do just ask yourself: “Why would personal injury attorneys, who work on a commission basis (usually 30% of the take), are willing to pay all expenses (including TV ads) etc in order to have an opportunity to win IF there weren’t good cases to litigate?” Then of course there are articles like these (buried but there) that tell the story. I quote: “106000 (76000-137000) had fatal ADRs, making these reactions between the fourth and sixth leading cause of death.” Read the whole study here. I’m thinkin “follow the money.” Drugs are HUGE business.

  4. I was taken for pancreatis an can no long take cuz know I have seizures all caused from this drug… I try to warn people of this but each to there own

      1. Ĺ)I was working when i “blacked out” and fell 14ft from my ladder. I crushed 3 vertebrae, broke 6 ribs (causing a punctured lung) and broke my right shoulder blade. I was out cold for about 30-45 mins before the customer found me and called 911. They brought me to the hospital where they had to do surgery to repair my broken back. I now have 2 rods and 12 screws in my back and attend physical therapy 3 times a week, until i am abIe to return to work. I am very lucky to be alive and not paralyzed. My ladder was still standing up-right when I fell which leads me to believe that the tramadol caused me to have a seizure. My mother was taking tramadol as well when she had a seizure too. Luckily she was at ground level when it happened.

          1. I also ended up having a seizure on tramadol. I end up falling and hitting my head on the driveway causing a concussion and had 15 stitches in my scalp. I also had a chronic pain specialist who refused to prescribe Tramadol after several of his patients went into kidney failure. A lot of doctors think that it’s the new pain pill and it’s so safe but like many medications you can have some real problems with it. For some people it works great but I don’t think it’s a real safe drug to take long term.

  5. Ive been taking this drug for almost a year now….. i have major low back pain and FAI….. basically chronic pain due to herniated discs and spinal stenosis and severe disc degenerative disease….. been dealing with those issues for 9 years now….. i am only just turned 31…. them had more tests done and found i have FAI…… dont know if anyone knows of tbos condition but it is impingements of the hips… and basically i was born with it and many dont realize they have it till its in the advance stages… went unnoticed for 30 years…. so basically have bone spurs on my hip bone ball joint sockets… cushioning between the joints and bone and have to have surgeries to have the bones shaved down……i am a waitress and have three children my options are limited….. i just know i have to keep moving and my doc….. has me on 168 50mg a month…… i want her to switch to somthimg else but i always get the same answer we dont want you to be addicted to pain pills cause i am so young…if you wede in you 40s or 50s she said she wouldnt mind but what do i do….. need input plz

    1. Low dose Norco !! It’s an opiod for pain but you can still function and it’s considered a happy drug for pain because of the serratonin !! Ask your pain management doctor about it !!

  6. I’ve been taking trams since 2008 after a severe car wreck. Lately they just make me sick anymore. They have me on 8 tablets daily 50 mg each. However I started having seizes and my anxiety is through the roof. So now I am taking 3 tablets a day and am slowly decreasing them ?? I might have a gastro problem too. My stomach is emptying slow. Thank you for this article

    1. Hi Kristy – sorry to hear you have had some rough times. It sounds like you are still having rough times. I hope you are able to feel healthier soon. Thank you for commenting 🙂

  7. I got this prescribed for a gunshot wound a week ago. But I haven’t taken it. And after reading this I don’t think I will. Its painful but bearable. So I don’t think I need it anyways.

  8. I am stage 4 cancer and doing well when I did have a problem they gave me oxys and stomache meds and meds for constipation. after seeing 3 different doctors, one finally listened to me when I told her that the narcotics left me hung over for 20 hrs, and I was taking half of the lowest dose. after hearing me she prescribed tramadol and it was a godsend for me. I am no longer needing it but for 3 weeks it left me in a functional state until I recovered and no longer needed it. on top of the cancer I had a bout with sciatica that was really bad thus the pain meds.

  9. My Dr. Put me on Tramadol for lower back and leg pain. 1 pill at bedtime but each time I take it my Stomach hurts like a Fury. I can’t handle the abdominal pain. It keeps me up all night and then I’m half dead all day.

    1. You have to eat before of when you take it. Try that. I have the same problem and eating helps. I’ve been on it for over two years and it’s not the wonder drug that doctors claim. Dont ever just stop taking it. I find if you replace it with a norco for a few days it helps to control my body from needing more to control the pain. That’s my biggest problem with this medication. After taking it for a long period of time it required me to take more to control pain which increases the side effects. Ive never had a seizure or anything close just alot of anxiety.

    1. Talk to your pain management Doctor about Norco for pain !! They have it in low dose , and different strengths as needed !!