Darsh
Pre-Flight
I was given and injection of hydromorphone, trade name dilaudid, at the hospital today to ease pain from a recent injury. Does anyone know how long it will take to be legal to fly?
Hydromorphone and wait time before flight?
- Thread starter Darsh
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bbchien
Touchdown! Greaser!
If you had pain requiring dilaudid, dilaudid is the least of your worries.
Dilaudid is terribly- the most addictive one we have, but last short- about 3 hours. That's why it's so addictive.
Assuming none of that happens, 48 hours will do.
Dilaudid is terribly- the most addictive one we have, but last short- about 3 hours. That's why it's so addictive.
Assuming none of that happens, 48 hours will do.
Is there a list with technical guidance on this? I always figured that after I wake up from the sleep I take after the effects of what I was taking wore off, I was good to go, and I pretty much always felt that way too.
bbchien
Touchdown! Greaser!
FAA is never going to publish that Henning. But having spent Feb there, that's the consensus of the docs. This falls into the "judgement" zone, no 8110 on this one.
Darsh
Pre-Flight
Thanks everyone for your feedback!
Darsh
Pre-Flight
New update: They also put me on Norco in addition to the dilaudid. Will this effect the decision. I apologize if none of this makes sense,, I'm heavily medicated as we speak.
Dude, at this point, don't even worry about it, it's nothing to concern about. It'll be a few days after pain killers. If you have real pain, you need real pain killers. The bad part is you're gonna have to come off them and that can be a bit of a process in itself. If you're asking out of consideration of a flight in the next 72 hrs, at this point I would say you wouldn't be ready even if you didn't take another dose. So just take care of whatever is requiring the pills, and after you get off them for a few days you see how you feel. If you feel up to it you go. That's the way I always understood it and I've had enough injuries where I needed them and asked the same questions you're asking now. In the end, it is up to you to medically qualify yourself between medicals. It's pretty much on the honor system really. The whole medical thing is for that matter when it comes to small GA.
In the end, you say whether you're ok using the guidelines set forth, and as you've noticed, the guidelines are really loose. There are specifics "Can't do while", but outside of those mostly medical conditions, with injuries it's pretty different. You can't while you're on the pain killers is a "can't", but to saw how long after that is up to you. When you feel clean, fit and capable. Where you are now, 48 hrs wouldn't be enough lol, I been there. You've got one full day of comin down coming your way. BTW, there's 2 ways you can go about that in the first few weeks. You can lessen the intensity of the misery by stretching it out with a 1/3rd strength of the last dose. I don't think it's worth the extra day though. If you're on them for more than 2 weeks, or get into heavy dosing for severe pain then you're gonna have to stretch it out or you can be in serious trouble. I've personally been amazed at how little medical aftercare one gets for this btw. You get to DT it out on your own, they don't keep you around long enough to detox in the hospital. Now, Here is where it all goes wrong for so many people. You are now surgically cured of your pain and since the hospital doesn't want to deal with your detox and find out what your pain level is, they send you home with a bottle of your pain killer and you don't quit taking them. If you're in pain, you need them for your brain to function. If you're not in pain...the nod is nice.... Easy to be seduced, happens to a lot of people....
In the end, you say whether you're ok using the guidelines set forth, and as you've noticed, the guidelines are really loose. There are specifics "Can't do while", but outside of those mostly medical conditions, with injuries it's pretty different. You can't while you're on the pain killers is a "can't", but to saw how long after that is up to you. When you feel clean, fit and capable. Where you are now, 48 hrs wouldn't be enough lol, I been there. You've got one full day of comin down coming your way. BTW, there's 2 ways you can go about that in the first few weeks. You can lessen the intensity of the misery by stretching it out with a 1/3rd strength of the last dose. I don't think it's worth the extra day though. If you're on them for more than 2 weeks, or get into heavy dosing for severe pain then you're gonna have to stretch it out or you can be in serious trouble. I've personally been amazed at how little medical aftercare one gets for this btw. You get to DT it out on your own, they don't keep you around long enough to detox in the hospital. Now, Here is where it all goes wrong for so many people. You are now surgically cured of your pain and since the hospital doesn't want to deal with your detox and find out what your pain level is, they send you home with a bottle of your pain killer and you don't quit taking them. If you're in pain, you need them for your brain to function. If you're not in pain...the nod is nice.... Easy to be seduced, happens to a lot of people....
Darsh
Pre-Flight
The delaudid is injection only, so i won't need to worry about that. The norco howver is prescription and take home.
Norco isn't that bad, it's same as a Tylenol 3 or Vicadin, it's acetaminophen with hydrocodone (Codine). oxycodone is considerably more powerful, more like heroin, but none the less has withdrawal issues. I don't like them if I know I'm gonna take them for a while because the acetaminophen gives me terrible headaches when I take it more than a couple of days, and it's not real good on the kidneys either. Just give me clean oxycodone....
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Gary F
Final Approach
Hydrocodone is stronger than codeine. Hydrocodone and oxycodone are mixed with acetaminophen to make it harder for addicts to convert oral pain meds to intravenous use. Narcotics without acetaminophen are more tightly controlled than straight narcotics. Some physicians would like it if narcotics were made OTC just to keep all of the addicts from constantly abusing the medical system in order to get their fix.
Darsh
Pre-Flight
I think norco is a little stronger than vicodin if i remember right.
AcroBoy
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Jim N
Hydrocodone (Vicodin, Norco) is stronger than codeine, but less than oxycodone. They are generally used in combination with acetaminophen since together the pain relievers have a greater effect. The formulation is not to prevent iv use.
bbchien
Touchdown! Greaser!
Gadzooks I can't believe you are dumb enough (yes, I said it) to even think about flying when any of that stuff is in your blood.
The more I hear the longer I think you need to be clean.
You're up to needing 72 hours clean now in most AME's books and even then it's probably bad judgement. No wonder there is an FAA. When you head clears you'll reread this string and think, "what the H was I thinking?"
The more I hear the longer I think you need to be clean.
You're up to needing 72 hours clean now in most AME's books and even then it's probably bad judgement. No wonder there is an FAA. When you head clears you'll reread this string and think, "what the H was I thinking?"
JesseD
Line Up and Wait
Jesuchristo, how much are you on? I was on morphine, vic, and oxy after my bike accident. I didn't want to think about moving. Hell I didn't even want to think, much less anything else. Even after I got out, I wasn't allowed to stand for 2 months, and was just happy to sit in the hospital bed at home minus necessities / doc visits.
I'll say this: if you're on a cocktail of narcotics that strong for the pain, wait until the pain kicks in. I'd broken bones, et al., but until that day I didn't know what pain was. Even with several injections of this and that, they had to knock my a$$ out to get the X-rays.
I don't know what happened to you, but I'm going to offer you this advice:
Just wait.
Just wait.
Just wait.
Just wait.
See how you feel after your painkillers. I hope it's not bad.
I'll say this: if you're on a cocktail of narcotics that strong for the pain, wait until the pain kicks in. I'd broken bones, et al., but until that day I didn't know what pain was. Even with several injections of this and that, they had to knock my a$$ out to get the X-rays.
I don't know what happened to you, but I'm going to offer you this advice:
Just wait.
Just wait.
Just wait.
Just wait.
See how you feel after your painkillers. I hope it's not bad.
The only things worth taking that are legal are aspirin and oxycodone, but not mixed. The aspirin is constant dose limited by the stomach while the oxycodone is variable by need.
Darsh
Pre-Flight
Tell me about it. I got discharged from the hospital, and they prescribed me Norco as needed for pain. I'm sitting here with a 9 on the pain scale in my head, took two norco, and nothing happened. If this keeps up till 0500, back to the hospital for me.
AcroBoy
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Jim N
Whatever your injury, does it really sound like you could or would be capable of flying safely? Depending on the opiate, you could have detectable levels for days in the blood, urine, or stool.
Why go back to an ED? Didn't they give you the names of some docs to contact for follow-up?
Why go back to an ED? Didn't they give you the names of some docs to contact for follow-up?
Gary F
Final Approach
Not exactly. Codeine (9050), Hydrocodone (9193) are schedule II drugs but combination codeine with acetaminophen Tylenol#3 (9804), or hydrocodone with acetaminophen Anexsia, Lortab, Vicodin (9806) are schedule III, less restricted. Adding acetaminophen to a narcotic may have a small effect in terms of pain control but it is toxic to the liver in high doses making it less useful to narcotic abusers. You might be surprised what stuff people will inject. I saw a 22 y/o guy last week for a heart attack he had after injecting "white rush" bath salts intravenously.
http://www.justice.gov/dea/pubs/scheduling.html
http://www.8newsnow.com/story/13931292/bath-salts-becoming-popular-among-drug-abusers
AcroBoy
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Jim N
Thanks for the clarification, I write these all the time butwas unaware of the differences in class. We have gone to multimodal anaesthesia, so only use vicodin or Percocet later after discharge, and mostly long acting and gabapentin primarily. Most of our rxs now go electronically, no more paper scripts, and for all practicl purposes the class of drug does not seem to be too important. Electronic rxs do make refill requests easier, and no chance of getting scammed by someone who says they lost the paper.
Gary F
Final Approach
I may be showing my age. Years ago there was a special prescription form for certain pain meds. It was a real hassle to write for the stronger stuff.
http://www.deadiversion.usdoj.gov/schedules/index.html
Schedule II Controlled Substances
Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence.
Examples of single entity schedule II narcotics include morphine and opium. Other schedule II narcotic substances and their common name brand products include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®), and fentanyl (Sublimaze® or Duragesic®).
Examples of schedule II stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®). Other schedule II substances include: cocaine, amobarbital, glutethimide, and pentobarbital.
Schedule III Controlled SubstancesExamples of single entity schedule II narcotics include morphine and opium. Other schedule II narcotic substances and their common name brand products include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®), and fentanyl (Sublimaze® or Duragesic®).
Examples of schedule II stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®). Other schedule II substances include: cocaine, amobarbital, glutethimide, and pentobarbital.
Substances in this schedule have a potential for abuse less than substances in schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.
Examples of schedule III narcotics include combination products containing less than 15 milligrams of hydrocodone per dosage unit (Vicodin®) and products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with codeine®). Also included are buprenorphine products (Suboxone® and Subutex®) used to treat opioid addiction.
Examples of schedule III non-narcotics include benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such as oxandrolone (Oxandrin®).
Examples of schedule III narcotics include combination products containing less than 15 milligrams of hydrocodone per dosage unit (Vicodin®) and products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with codeine®). Also included are buprenorphine products (Suboxone® and Subutex®) used to treat opioid addiction.
Examples of schedule III non-narcotics include benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such as oxandrolone (Oxandrin®).
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Darsh
Pre-Flight
I definitely wouldn't fly in my current state. And my injury was barotrauma to my sinus. I was more concerned about the FAA's rules about these medications because I know certian meds have a wait period before you can be legal again.
And I'd go back to the ED just because that's what they told me to do. They said if the pain gets worse, which it has been, to call an ambulance and get back to the hospital ASAP.
bbchien
Touchdown! Greaser!
Darsh, it's been 3 days. Lots of baaaaddd stuff can happen well beyond "it hurts like heck" when you smash the wall of a sinus due to pressure- eye entrapment, loss of an eye, Cavernous sinus thrombosis, meningitis, death.....if you get the least bit of fever, get to some medical care.