While browsing online, I was pretty amazed by how many addictive prescription drugs you could buy illegally. The websites said, "comes in a discrete package," and "nobody needs to know!" I understand that sometimes people are recommended drugs that are embarassing to be on… but dangers here are misuse, addiction, and overdose.

If I can beat an old drum for a minute, drugs should be prescribed by doctors, and chinese herbs by acupuncturist/herbalists. As you know from your experience, it's dangerous to treat yourself- even doctors shouldn't do that.

However, there are some legitimate websites that allow you to buy your prescriptions online. They require a doctor's prescription, as they should. The main advantage of using an online pharmacy is much lower prices than your local drugstore. Check out Imported Drugs.com.

It's not my place to recommend what to do with meds that are already being taken... even though it's a little different when you're taking self-prescribed, illegally-purchased meds. It's best to work with an MD and an acupuncturist/herbalist. What literature suggests is:

Quitting Ultram One should TAPER off Ultram rather than just suddenly stopping. That means reducing dosage gradually over a number of days or weeks.

Herbs and Acupuncture for Withdrawal from Addictive Drugs NADA (the proven ear acupuncture detox protocol - more about that in my article on Acupuncture and Addiction) could make withdrawal period easier. So would formulas:

Chai Hu Long Gu Mu Li Tang (Bupleurum Dragon Bone and Oyster Shell) and Xiao Chai Hu Tang (Minor Bupleurum)

The first one (Chai Hu Long Gu Mu Li Tang) would be better for someone with a tremor disorder. Neither formula should be taken longer than a couple of months.

Instead of Painkilling Drugs... Your prospects in future for treating aches and pains and tremor would be great with acupuncture and chinese herbs. I would suggest you find an acupuncturist in your area and see them for at least a few months.

Anything else you need, please let me know!

All best, Brian

1. Pain Medications Sometimes herbs and acupuncture can neutralize effect of pain drugs. For example, patients on neurontin or morphine need to be treated differently. Acupuncture in these patients should be of shorter duration with less stimulation and subtler point selections (like eight extra points, e.g.). Moxibustion is a helpful alternative.

2. Chinese Licorice Gan cao (chinese licorice) is sometimes problematic… it is in many herb formulas, but in low dosages. Higher dosages can lead to fluid retention. Gan cao can also reduce absorption of oral tetracycline and some other meds, and can offset pharmacological effect of spironolactone. The rule of separating dosage times of herbs and drugs solves this problem.

3. Tannins Tannins are insoluble with antibiotics. A few herbs such as Da Huang (rhubarb), He Zi, and Mo Yao (Myrrh) contain tannins. Tannic acids may inhibit absorption of iron.

4. Glycosides Glycosides, which are active ingredients in many herbs, are neutralized by acidic drugs. That means that, for example, Vitamin C (ascorbic acid) and nicotinic acid could prevent your herbs from working.

5. Blood-thinners Patients on warfarin (coumadin) are most at risk for problems from drug-herb interactions. Warfarin is given to thin blood, thus preventing likelihood of clots blocking blood vessels in heart, lungs, or brain. Warfarin's dosage needs to be quite exact to work, so we don't want any herbs affecting it. Herbs and herbal formulas that contain blood movers must be avoided. This includes, among others, herbs dan shen (salvia), dang gui (angelica), and yan hu suo (corydalis), and herb formulas like xue fu zhu yu tang, di dan tang, and tao he cheng qi tang. Feverfew, garlic, Ginkgo, ginger, and ginseng may alter bleeding time, and so they also should be avoided by patients on warfarin.

6. Dan Shen (Salvia) Salvia (see #5) can also reduce effectiveness of anti-ulcer drugs.

7. Surgery and Herbs It's a good idea to stop taking herbs 5 days before surgery, and then after surgery take herbs only to rebuild body.

8. Drugs for Heart Ma Huang (ephedra) should not be taken (even in an herbal formula) if your are on digitalis or any other heart drugs. It also reduces effectiveness of anti-anxiety and sedative drugs, and increases cardiovascular effects of caffeine. Kyushin, gan cao (licorice), plantain, uzara root, shan zha (hawthorn), and ren shen (ginseng) may interfere with digoxin.

9. St. John's Wort Studies have shown that patients who take St. John's Wort while on a Selective Serotonin Re-uptake Inhibiting (SSRI) anti-depressant end up with varying blood levels of drugs. This means it interferes with effectiveness of your anti-depressant. Because its mode of action is not understood, it should be avoided with monoamine oxidase inhibitors and SSRI's.

It also appears to reduce blood levels of cyclosporin, a drug taken to prevent body's rejection of transplanted organs. And it reduces effectiveness of AIDS drug indinavir. It's not yet clear whether it interferes with metabolism of all drugs, or just some. It may be difficult for your medications to work effectively if you take St. John's Wort.

10. Ginseng Ginseng plus phenelzine sulfate may cause headache, tremulousness, and manic episodes. Ginseng should not be used with estrogens or corticosteroids.

Continued in Part 2!