M30s(fent)+Benzos+Lyrica - Which & How to properly take?

[Kalahad]

Hello, new here; hope this is right sub-forum to post this. If not feel free to move it.
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I am a sufferer of a debilitating neuro disorder that hit me exactly 10 years ago to the day, which came with a slew of symptoms including fight or flight(adrenal glands) being stuck on 100% of the time, so horrific physical+mental anxiety, traditional, nerve, and other pain/suffering of all types even those I can't explain. All I know is that benzos and oxys are all that seemed to help it at all, so even in spite of the side effects, I have been taking them. Lyrica and other meds have helped as well, but with so many meds "on my desk" so to speak, now, I am unsure exactly how to take them for max benefit. Perhaps some here can help. I will explain further. FYI I've never shot up, I've never done actual heroin, nor marijuana, never drank, etc. In fact, I never did any substance of any kind before this illness hit me 10 yrs ago, at which point they began prescribing these meds to me. I had a great life, my own IT business, played tennis weekly with a group of doctors, ironically, and aside from main computer work did, on the side, landscaping, small engine mechanics, snow removal, gardening, bought out contractors low sold high on craigslist/bay, etc. Hobbies included fishing, tennis, nitro powered r/c vehicles, computer games/designing websites, fixing other mechanical devices like printers/phones for both clients and friends/family, and tending to my own garden. There's more, but that's a condensed portrait of my life pre-illness. The day the illness hit, it took merely a day for it to disable me, and although I could walk, it would fatigue me to the extreme, felt sick all the time in a way I can't even put into words - a strange feeling of horrible unwellness - no matter what(until i discovered opiods/benzos which almost miraculously cut down that feeling and the overall suffering 70% or so, + gave me energy to get out of bed, lest I'd be bedridden right now.)
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Now, 10 years later, after having been trialed on 100+ meds, 99% of which don't work, I do know what works. Even on the meds, I have a very hard time even getting outside or moving around much now. They discovered fatty liver recently, but are not sure what caused it, as I have never drank, and they are not sure if it's from an autoimmune component of my illness, or some other component of it. I fear it is from the high doses of opiates and other drugs I have been on, but I can't be sure.
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To break it down into specifics:
I am a roughly an ~8 year user of benzos(mostly kpins 1-2mg, sometimes xanax 1-2 mg, occasionally a bar.) Neither Xanax or Valium do as much for me as Klonopin, no idea why; it just works without snowing me.
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I'm a 5 yr user of opiates(went through the whole pain clinic ordeal here in shit Massachusetts); told pain clinic my issues after I was diagnosed, they begrudgingly agreed to RX opiates in small doses, tried to push all kinds of other "pain killers" on me that did not help, such as patches of low dose fent that they would not go up on, methadone that didnt do much, etc. I finally told them firmly that oxycodone was what worked, please just prescribe what works, I am in agony. They finally RX'd oxys, beginning in low doses and eventually increases to 4x 10mg QR pills and 3x 20mg extended release a day, equaling 100mg/day for almost 3 yrs. All was well 'til they found a microdose of buprenorphine (just bup, not sub) in my system I tried from a friend, not knowing at all it would void the opioid contract, and instead of explaining it to me or showing me the most minute sympathy, they completely fucked me and kicked me out over this one trace of it on the spot. They were already afraid/unsure of how to help me - even though if they were in my body they would have known they were helping me greatly - since my illness is rare and they were basically going off my word alone that opiates were helping. When they left me hanging dry at this point with NO opiods, I had to go elsewhere, and you can guess where I went to find a replacement, in the form of M30 blues.
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In the past 1 year or so my neurologist trialed me on Lyrica and it actually helped as well. As you know, once it first builds up active levels in your blood system for the first time, you feel unnaturally/unusually happy, giddy, etc, for a couple days, then it seems to go away, but still helps with the nerve pain greatly, and possibly my mood too; not sure on that. I was on 75mg 3x a day, 'til he just upped it to 100mg 3x a day after a visit to him in Boston. He is a powerful, well respected neuro that I would like to keep in my corner. I doubt he will ever prescribe or even refer to pain clinic, but hes good for what he is good for, and doesn't ask many questions.
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The main issue at this point is tolerance and overall confusion to a degree of what to take and how/how much of it to take. I don't believe the Lyrica is interfering with the other meds, or blocking/being blocked by them, from what I have read. I know the kpins are a potentiator of opiods, and always keep that in mind when taking them. The kpins certainly help add a calming and anti-anxiety effect to the opiods which are already calming in a more physical way.
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The main questions/problems I have revolve around tolerance and what/how to use each.
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My meds are as follows:
*Prednisone, prescribed, 2mg each morning to help adrenal glands counter illness' effect on them.
*1-2mg kpins
* Clonidine, prescribed, and sometimes take this at night before my last dose of opiods, as I've heard they can potentiate it, as well as the fact that the clonidine is prescribed to be taken at night to help w/sleep+anxiety. I don't feel it helping w/anxiety, but it does reduce BP, and mine runs a little high, so it helps, but I am careful with it.
*The opiates - Normally, 2-3 M30 blue opiate pills per dose, 2x doses a day, due to how short it lasts, sometimes 3x doses a day, all taken orally. I have snorted a couple before, but didn't feel much a difference, unless I had a full stomach, then snorting helped bypass all the food. - these M30s - which from everything I've heard are fent not oxy - they do "work", but they tend to either not be quite "enough", or too much. Meaning, each one is supposed to be = to 30mg oxy, so I take 2-3 M30s at a time with 1-2mg of kpin, as well as my Lyrica throughout the day, and this 3x M30 +1-2mg kpin combination will sometimes "work" sometimes not, but I've had to take 4 M30s several times to feel a strong enough opiate effect, but at that point it doesn't make me nod, or have a softer, pleasant euphoria like the oxycodone I took so long ago did, rather it just knocks me out - often while still in my chair - within 15-20 min, and I wake up in 1-2 hours later very hungry. Now, I know fent is a cheaper high, but these M30s certainly aren't cheap pills, trust me. I have heard of people on this forum paying something like $20 for a "bag" of heroin/fent, but I don't know if they're talking about pills or powder or heroin or fent or what, and I assume they're shooting it, not swallowing a pill. If I did not have access to a moderate amount of money, I do not know what I would do, as these pills are extremely expensive, and I fear for my future.
*Lyrica - 100mg 3x a day. Certainly helps with nerve pain, especially in hands/feet, just hope it is not causing any problems being taken with these other meds. From what I've read, it isn't, but it's just a lot of pills to take each day.
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I would like to know if I am taking anything incorrectly, and also if there is a way to get back to the nice euphoric feeling I had years ago when I was first on oxys, for the first few years. I would take 30-50mg of actual RX'd oxys, and I could use the "energy" from it to go outside and garden a bit, or I could sit at computer and listen to music, feeling a beautiful euphoria come on within ~10 min, last ~20-30 min, then slowly taper off, lasting about an hour. It was not a "knockout" like these much higher opiate dose M30s give, and I'm not sure if that's because they are apparently fent, or because of my much higher tolerance now, or what. I also have no idea of the Lyrica is preventing the effects of the opiates, but I don't think so, as I didn't feel a change in the effects of the M30s when I got on the Lyrica.
I just am not sure what to do regarding the opiates I am on, how long I can afford them, what I can/should switch to, etc. It has been several years since pain clinic ejected me, and I have a new primary physician, and she suggests I try a new pain clinic again, as it has been awhile and I look "clean" on paper and in real life. She does not know I am still using opiates.
If it would mean experiencing that euphoric, longer lasting comparing to fent experience of true oxys, I would get off the M30 fents temporarily(I have a few legally prescribed suboxone boxes), just to be able to be tested as clean at a new pain clinic, just to have a chance to get on real oxys again, if they actually would bring back that cleaner, warmer, longer lasting euphoria, compared to the cold knockout of the M30 fents which don't last as long, either. I'm just not sure how much my tolerance plays a part, how long I'd have to be off M30sfor tolerance to go down low enough to "feel" the oxys, and how quickly, even if I got real oxys, my tolerance would go back up, and if at that point I would not feel much of that coveted euphoria again, then no more euphoria, then feel the need for the more powerful M30s again, etc...vicious cycle.
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Sorry for the long post. If you want it broken up, condensed, moved to another sub-forum, just tell me. Thank you.

 

[negrogesic]

You are unlikely to recapture those early experiences with oxycodone, particularly with said fake M30 tablets.

Taking those M30 tablets regularly is a bit of a russian roulette. Especially given the benzos involved. I think i recall hearing that these days street M30's contain on average a bit under 2mg per pill, though a good proportion do contain over 2mg. That 2mg figure is what is often reported to be a lethal dose, but this is quite inaccurate, and seems to be based on an extrapolation of equianalgesic equivalency to morphine, and would be only for intravenous administration. But morphine is actually more likely to produce overdose at those high equianalgesic doses due to more profound respiratory depression. The human LD50 figure is probably closer to 3mg. In any event, with oral administration, bioavailability is low (i believe something like 20-30%), so if a pill contains on average say 1.5mg of fentanyl, you might be getting 450 micrograms into the blood stream when taken orally, which is around 45mg of morphine, which funny enough, is indeed equal to around 30mg of oxycodone. This would make them fairly accurately dosed fake 30mg oxycodone tablets, but only when taken orally.

Problem is, quality control is low, and I've heard of single tablets containing something like 16mg of fentanyl. You mentioned you've consumed up to 4 tablets at a time -- imagine if those 4 tablets came from a particular hot batch that contained 10mg+ each tablet. That, combined with the klonopin, may have resulted in fatal overdose.

In any event, the M30's are likely unsustainable. I would recommend methadone in your case. Far more enjoyable than fentanyl too. In fact methadone is one of my all time favorite opioids.

If you do keep consuming the M30s I'd recommend buying it in as large quantities as possible and then crushing them into a fine, well mixed powder, then dosing using a milligram scale. This will reduce the risk of hotspots. Even better would be dissolve in propylene glycol and dose volumetrically as a liquid.

 

[Kalahad]

You are unlikely to recapture those early experiences with oxycodone, particularly with said fake M30 tablets.

Taking those M30 tablets regularly is a bit of a russian roulette. Especially given the benzos involved. I think i recall hearing that these days street M30's contain on average a bit under 2mg per pill, though a good proportion do contain over 2mg. That 2mg figure is what is often reported to be a lethal dose, but this is quite inaccurate, and seems to be based on an extrapolation of equianalgesic equivalency to morphine, and would be only for intravenous administration. But morphine is actually more likely to produce overdose at those high equianalgesic doses due to more profound respiratory depression. The human LD50 figure is probably closer to 3mg. In any event, with oral administration, bioavailability is low (i believe something like 20-30%), so if a pill contains on average say 1.5mg of fentanyl, you might be getting 450 micrograms into the blood stream when taken orally, which is around 45mg of morphine, which funny enough, is indeed equal to around 30mg of oxycodone. This would make them fairly accurately dosed fake 30mg oxycodone tablets, but only when taken orally.

Problem is, quality control is low, and I've heard of single tablets containing something like 16mg of fentanyl. You mentioned you've consumed up to 4 tablets at a time -- imagine if those 4 tablets came from a particular hot batch that contained 10mg+ each tablet. That, combined with the klonopin, may have resulted in fatal overdose.

In any event, the M30's are likely unsustainable. I would recommend methadone in your case. Far more enjoyable than fentanyl too. In fact methadone is one of my all time favorite opioids.

If you do keep consuming the M30s I'd recommend buying it in as large quantities as possible and then crushing them into a fine, well mixed powder, then dosing using a milligram scale. This will reduce the risk of hotspots. Even better would be dissolve in propylene glycol and dose volumetrically as a liquid.

Thank you for this informative reply.
Why are the M30s unsustainable, in your opinion? And re: a "hot batch", a pill that could be 16mg as you say, a possible lethal dose, I really don't care at this point in my life - I've not been "living" for a decade+ now, just existing. I'm not saying I want suicide, I just don't mind if I don't wake up, as long as it's not waking up with brain damage. That would be a real nightmare, beyond the one I'm in now even.

When you say buy in large quantity, what do you mean? How many pills? They are phenomenally expensive here in MA, like $15-30 a pill depending on who you know, how much you buy, how long you've been buying, etc.

And if I crushed them into a fine powder as you say, how would I then ingest them? Are you talking needles? I've never used needles and really hate them.

If an M30 is snorted, is more of the bio-availability going to go into your bloodstream? Meaning, a higher dosage than just eating it? Also I've never heard of propylene glycol and will have to research it.

Also, re: methadone - I've tried it extensively w/this illness - and it doesn't cut through the sick feeling associated w/it. I feel sick all the time w/this illness due to it's unique/rare symptoms, and only strong full agonist opiods like oxy, fent, etc., seem to cut through it and give me peace. Also, they used propofol once for a procedure, which i know is a barbituate, but it worked as well. I'm not sure how else to explain; if methadone worked well enough, or suboxone, I'd be taking it. I did try buprenorphine pills once, just a few, and they worked OK(no naloxone in them), better than the methadone, but still felt the illness. It's only the stronger opiates, especially combined w/benzos, that really knock the symptoms away and give me the ability to physically/mentally rest. A symptom of illness if restless body, not just restless leg syndrome, so w/out the opiates my body is just twitching all over the place, It's scary to think what I would be like without the opiates/benzos with how far the illness has progressed over the past 10 years, and how far I've degenerated. I used to be able to still work physically even with chainsaw, lawn mower etc, when it first hit, for a few years, then year 4 could only use tractor, then year 6 couldnt do anything but light gardening in chair outside, then year 8 - 2 yrs ago - I couldnt even do that anymore. So, I am stuck inside 99% of the time, besides Dr. appointments, and without these meds I'm in a living hell. Sorry if I come across long-winded, just trying to explain the situation. I would love my health back, I'd throw these pills out the window in a millisecond and go back to living, but that's not an option.

 

[Señor Moreno]

Hello Kalahad, sorry to hear you are in that situation.
I also suffer from nerve pain and know about it. I think opiates and benzos won't help you in the long run, not for nerve pain. It's not the kind of pain that can be totally numbed by using such drugs.
I 100% get your need to feel better, and opis&benzos can do that just fine, but, as your suffering stems from your pain, you should study another ways to fight it. I am sure Lyrica isn't your favourite med, you sure prefer oxy, but Lyrica is by far the best nerve pain med out of all you have been prescribed.
You should learn and ask your doctors about alternative treatments that are giving good results all around the world . You can ask about botulinum toxin, or for meds made from a sea crab called Conus regio, such as Ziconotide and others, you can google it and find scientific reports on the subject.
You might ask your doctors about ketamine, it's useful for nerve pain as part of certain combos, and it very likely will improve your mood. Often, even at discrete doses, it provides you with a useful perspective towards pain and your perception of it
Also I noticed that you said that you get more relief from kpins than xanax or diaz. While all of them are benzos, kpin is a superior anticolvunsant, so if you benefite from that property, you very well could try another anticolvunsant meds like carbomazepine, in order to avoid a huge benzo intake.
Other meds are also used, like topimarate, memantine... hell, even baclofen and phenibut can sometimes be useful.

I honestly think you should not limit yourself to the belief of only opis and benzos being able to help you, because that's not only not true, but you are jeopardizing your future chances of managing your condition more or less successfully.
Pain patients will never solve their problems by buying fucking fentanyl pills on the street, no one will. Try another paths before you get too deep into the wrong one.

 

[Kalahad]

Hello Kalahad, sorry to hear you are in that situation.
I also suffer from nerve pain and know about it. I think opiates and benzos won't help you in the long run, not for nerve pain. It's not the kind of pain that can be totally numbed by using such drugs.
I 100% get your need to feel better, and opis&benzos can do that just fine, but, as your suffering stems from your pain, you should study another ways to fight it. I am sure Lyrica isn't your favourite med, you sure prefer oxy, but Lyrica is by far the best nerve pain med out of all you have been prescribed.
You should learn and ask your doctors about alternative treatments that are giving good results all around the world . You can ask about botulinum toxin, or for meds made from a sea crab called Conus regio, such as Ziconotide and others, you can google it and find scientific reports on the subject.
You might ask your doctors about ketamine, it's useful for nerve pain as part of certain combos, and it very likely will improve your mood. Often, even at discrete doses, it provides you with a useful perspective towards pain and your perception of it
Also I noticed that you said that you get more relief from kpins than xanax or diaz. While all of them are benzos, kpin is a superior anticolvunsant, so if you benefite from that property, you very well could try another anticolvunsant meds like carbomazepine, in order to avoid a huge benzo intake.
Other meds are also used, like topimarate, memantine... hell, even baclofen and phenibut can sometimes be useful.

I honestly think you should not limit yourself to the belief of only opis and benzos being able to help you, because that's not only not true, but you are jeopardizing your future chances of managing your condition more or less successfully.
Pain patients will never solve their problems by buying fucking fentanyl pills on the street, no one will. Try another paths before you get too deep into the wrong one.

I read every word you said, thank you. I've never heard of any of those meds you listed. I think if I brought them up w/PcP her head would explode, especially sea crab one hah, but I will save them all in a file. Perhaps something like a pain clinic is best place to bring them up? I don't know. I want to get back in with a pain clinic, as literally no one of the doctors I see is willing to prescribe anything r/t pain.

How do I explain, this is such a hard illness to describe. I will just go ahead and start with it's name: Hyperadrenergic POTS(Postural Orthostatic Tachycardia Syndrome), with Myalgic Encelphalomyelitis. It sounds like it's just a cardio or mainly a cardio illness, but that is only one component of it; I wish the only one. When first attempting to diagnose me, they did skin biopsies a few months after illness hit me, tested one punch biopsy here at MGH Boston, send other 2 punch biopsies to a NYC Cornell/NY Presbyterian super-doc pathologist, and both found the same thing: eccrine coils denervated. So, there was already nerve damage in my extremities(at least) before the illness hit, since that kind of damage doesn't happen in a few months.

They are not sure if illness is connected to nerve dmg, but let me get back to the illness.

I was playing tennis June 22, 2013 exactly 10 yrs ago and I had been feeling lousy all day, but not horrible. By tennis time, 7:30 pm, I was really feeling horrible; fatigued and just overall sick/unwell. I barely made it through the match with ironically doctors who I'd played with/known for 10 yrs since 17 yrs old, and quickly said thanks and went home. As I drove home, the warm air of the near-summer blew over my body through the window, which usually felt great, but now it felt strange, uncomfortable. I had to pull my arm in the window. I later learned a symptom of this illness is that all senses are heightened to the point of being painful, including touch. It's like living in an alternate world all the time, so hard to describe this. The sound of even a truck going by outside my house is so loud I have to cover my ears. I have found, though, that if I keep music playing all the while I'm awake, even loud, my ears/brain can handle it and even get used to it as ambient noise, which helps block out otherwise loud external painful noise. I have had 10 years to find ways around parts of this illness, and I've used every trick I could. Anyway, when I got home that night 10 years ago, I knew this wasn't just a cold, or cancer, or anything like that; it was something serious, yes, but something strange, rare. Without even being told, I already knew that and had the strongest feeling my life as I knew it was over. That night before bed, I also felt a cluster of lymph nodes in left upper part of my jaw swell up, and figured some kind of infection/cold, went to sleep.

Next morning, all symptoms of illness were in full swing, and it hit me just like chronic fatigue syndrome hits people - which is another illness I've been diagnosed with - since it hit textbook chronic fatigue style and I was instantly lethargic and tired all the time, regardless of how much sleep I got. I was in a panic, with this inherent anxiety and horrible physical and mental restlessness. I didn't know what to do, neither did parents. I also felt incredibly sick, at a core level, but no one knew what it was or what to do. There are many theories as to this "sick/unwell" feeling rt: POTS, but no one is sure exactly what it is/what causes it. Lack of overall blood volume is a theory w/POTS and would certainly make someone feel horrible, but there are many, many theories. Bottom line was, even as I was setting up appointments and getting spinal taps, bone barrow biopsies, pints of blood taken, etc, I knew I could NOT live with this illness as it is without something to block the default feeling it leaves you with every millisecond of every day+night 24/7/365, including horrific dreams since the hyperadrenergic component keeps your body in fight-or-flight all the time. You're basically trying to tranquilize your body all the time. Ultimately, after it hit, I got into a local hospital and spent 7 days inpatient there. They could not figure it out. I spent another week at home suffering, then went into "town' (Boston) to Mass General Hospital, which is about 45 min from me on avg - a hard ride w/this illness - and they took me inpatient and figured it out in 4 days. It took a team of doctors and searching through their medical encyclopedia(heard/saw them doing it) to find out what I have might be, basically through deductive reasoning. Their ultimate diagnosis was "We think you have POTS", but they provided me w/no neurologist or referral to one. Basically just a "your life will never be the same good luck" speech.

At some point around this time, I had a lymphadenopathy on one of those nodes under my upper left jaw that was still, several months later, inflamed, and could often be felt by palpating. The chief vascular surgeon felt them, and performed the cervical lymphadenopathy. I actually woke up part way through the operation with my neck cut open, so that wasn't pleasant, but they knocked me out again with a little more propofol. When finished, this is when I realized propfol ha the same properties as the oxy or most other full agonist opiods; it massive euphoria and it numbed the most agonizing symptoms of the illness. Yes I know propofol is not an opiate. Anyway, the results came back from the surgery, and the extracted lymph node was clear of everything, but they did find antibodies for EBV, the mono disease. They said this means nothing, and majority of people have it, but it just makes me wonder, could EBV or some other virus somehow have gotten into only one side of my head, and affected only that side of nodes? I've never heard of it happening. Since then, I've had many scans on both that area of my neck/jaw/head, as well as brain, ultrasound, CT and MRI, and nothing harmful stuck out on the imaging.

Continuing the story of my illness post-MGH partial diagnosis, I had to find my own neuro, and did, but it took 6 months to get in to see him. In fact, it took years to get good doctors on board for all specialties, which is needed w/this illness. During this time, I developed horrible insomnia due to the hyperadrenergic flight or fight component, and eventually, within 3-4 months, I was up for 4 days, and couldnt sleep still. Worried, I went to the ER, and a doctor there listened closely to my situation, thankfully, and eventually prescribed valium, which allowed me to sleep, thankfully, and was beginning of benzo use and prescription by PcP of 10mg valium which eventually turned into 1mg kpin . For about 3 yrs I didn't need more than that or kpins, no opiates. The neuro I found and saw was at Beth Israel Deaconess in Boston and specialized in peripheral and autonomic nervous system disorders; a very intelligent, extremely well educated man, but the type you see for 5 minutes then talk to his fellow for 45 min. Anyway, this neurologist, who is also one of Michael J. Fox's doctors, he did tilt table testing, and communication w/my other doctors, ultimately confirming what MGH diagnosed(POTS) but adding greatly to it classifying it as secondary Hyperadrenergic POTS. I asked him what could be done, any meds for symptomatic relief, etc, he said no. They tried me on nonsense drugs like florinef, but it/they did nothing, which is common w/my kind of POTS. After I left his office with only a follow-up appointment and no sign of relief to speak of in any form, I felt completely hopeless, since he was the guru supposedly and could not help rid of me of any of the suffering from this illness.

I'll explain how I found out that opiates worked to quell the worst symptoms of this illness. As I mentioned in earlier post, I was still able to garden for the first half of the illness, and I one summer was so happy that the first fig ripened on my fig trees, I pulled it, observed it, saw no bird dropping or anything else on it, and ate it. It was great. Unfortunately, there were invisible bird dropping remnants on it, as it gave me campylobacter, and had to go to the ER due to extreme abdominal pain from the infection. They tested my stool for it and sure enough, campylobacter jejuni. They gave me a 3-pill antibiotic pack, but I was in extreme stabbing pain still. The young asian female doctor tending to me, who could see I was in pain, listened to me when I asked for something for pain. She gave me a shot of morphine, I believe 4 mg. It dulled the infection pain immensely, but more amazingly, it took away that sick feeling associated with the illness for the first time. My mother, an ex-head nurse for 40+ yrs, noticed it as well - it had a paradoxical effect. It didn't snow me, or make me feel sick. It allowed me to get up, whether out of bed or chair, gave me energy (as opiates do), but most importantly took that sick feeling in my head/brain away, as well as relaxing my body and mind. Near miracle drug, as many have thought I'm sure when they first experienced opiates. I immediately got referred to a pain clinic, and they did prescribe oxys as well as triald other meds like fent patches and methadone, ultimately landing back on oxy for 2.5 yrs or so, and they worked great, but as I said they fucked me over a trace dose of a drug not prescribed by them. They knew I wasn't abusing drugs, which at the time I was not; they just wanted me out - they didn't understand the illness and I don't believe they believed I was truly benefiting from it, when in reality it was the most important med in my life. They were also probably scared due to insurance reasons or whatever explanation they would have felt like giving on that day. The whole pain clinic system here (in MA, USA anyway) is a joke. I was taking what I was prescribed, and just tried one pill of something a friend gave me to see if it could help, not knowing it would a) be in my blood still when tested at pain clinic, and b) result in being kicked out instantly for it. That's when things got very hairy. Without the opiates I could no longer even get out of bed, and was extremely ill, all the time, even after opiates were out of my system. I've been on suboxone too, so I know the feeling of naloxone instantly blocking the full agonist opioids, and god it's horrible. The agony of the illness floods in like a broken dam, and the tiny dose of buprenorphine in it does nothing to stop it; in fact I can barely feel the bup.

The nerve pain almost seems like a different illness entirely, one that's certainly gotten worse over time and is helped by the Lyrica, but the Lyrica does not seem to help with the main illness' symptoms, not the primary/strongest ones. Whether nerve pain is entirely another illness, connected or not, it's as if treating that w/Lyrica(or anything) is treating a secondary symptom; that's how bad the sick feeling from the illness is. I have explained this sick feeling to many, many doctors, npr's, nurses, etc. A few doctors brought in psych thinking that's what it was. Bastards. Psych always cleared me of everything, but they had only to look at my history to know I had no psych issues, they just didn't believe the words coming out of my mouth describing the symptoms related to agony of illness. It's almost like a venom is dripping down your brain all the time. That is literally how it feels w/no meds or weak meds. Try saying that to a doctor that doesn't understand this illness, and he'll look at you sideways and call psych in.

Once again, I apologize for the long posts; I am just trying to be very clear about everything, which with my condition, takes deeper explanation than most. I am trying to format the posts properly as well as use proper grammar/spelling to make it as easy/fast to read as possible.

Thank you very much.

 

[Señor Moreno]

You are more than welcome, mate.
I didn't hear of your condition before, or not under its English name at least.
I can relate to that unability of yours to bare noises, it happens to me also during my bad days, when those days are specially terrible, it's not only the noise but the smell, the entire world, people, myself, air and everything stinks so badly that I barely can cope with it all.
Reading the meds I told you I noticed that I forgot an important one: there are certain lidocaine delivering devices that work for many nerve pain patients and any pain doctor worthing such name should know about them.
I also get you on the propofol matter, that milky looking thing is fantastic, you awake after your surgery in such a great mood, often after having lovely dirty dreams lol.
I don't know to what degree propofol and ketamine are related, but I found them both to have a very nice and notorious afterglow, I honestly thing that ketamine could be helpful for you.
I know from what I read that the whole pain management in the US sucks, just like the addiction treatment policies. It all seem to be about profit and stigma. I go to a huge hospital wich has its own pain clinic and its own addictive behaviour unity were they treat your most harcore junkie but also your young lady who wants to quit cigs as she learned she is pregnat, people with sex, shopping, gambling problems, etc (all council services, all free).... so I don't know if a regular US pain clinic would help you or not. I don't advise you to join a methadone clinic, as you would end up both with a massive tolerance and a massive stigma on you.
But I 100% tell you to learn about all the options I have listed, and please read on the sea scrub subject, it is terribly promissing, with studies reporting it being 1000 times more efective than morphine in some cases. Please, read. I refuse to think that doctors in the know aren't to be found there, maybe not near your town, but they have to exist in your state or neiughboring ones, you are in the US, it may suck in many regards but it's also the place where fantastic medical improvements are made.

I wish you all the best. My advise is clear: no one will take your pain an it's treatment as seroiusly as you. Read, study, learn, ask and don't let your doctors rest for a second till you see them 100% fighting your corner.

Good look, amigo/ amiga.

 

[Señor Moreno]

Oh, Kalahad, just an obious tip: you know how (90%) of doctors are. You need to approach them the right way, understanding their mentality.
I gave you a good list of options to try, but under no circunstances you should tell them you read about that info online, let alone you did it in a HR- drug related site, as they won't pay you the slightest attention, as they know so much better than you or your internet reads.
You just tell them you do have a close friend, or a relative in Europe who is a nerve pain patient and those are the meds he/she has been prescribed during these years. This way their unsecure mind will release a kind of complex on them that will made them listen to you and look for the information you are requesting

 

[Kalahad]

Oh, Kalahad, just an obious tip: you know how (90%) of doctors are. You need to approach them the right way, understanding their mentality.
I gave you a good list of options to try, but under no circunstances you should tell them you read about that info online, let alone you did it in a HR- drug related site, as they won't pay you the slightest attention, as they know so much better than you or your internet reads.
You just tell them you do have a close friend, or a relative in Europe who is a nerve pain patient and those are the meds he/she has been prescribed during these years. This way their unsecure mind will release a kind of complex on them that will made them listen to you and look for the information you are requesting

Yes the doctors certainly know it all don't they. :-\ I have to talk to them in a way that massages their ego or at least appeals to their feelings, not just conveys facts, or they get offended/pushed away/disinterested. And of course I'd never mention where I got the names of the meds or info related to them, and never mention this forum or any forum like it, naturally. The "close friend" line is a good one, thank you.
And yes those were my thoughts exactly re: methadone clinic. It would be ridiculous for me to even enter one. It's not as if I chose these meds to "party hardy and have fun, yay". And I'm sure it would be chaos in there, + the stigma like you said. Someone else mentioned that to me awhile ago, "try a methadone clinic" etc., and it was like audible depression hitting my ears; I felt like walking into a methadone clinic would just be walking into the river styx and getting on the boat.

I read all those meds off you listed to my mother(RN) and she knew most of them and kinda scoffed at them, even the ketamine due to the fact that a doctor once wanted to administer it but required that we come in like every few days or a week(cant remember) for injections. I am far too weak w/this illness to drive to a place every week and get injections, otherwise I would try ketamine. There must be some other way to take it, and some other doctor that would prescribe it, somewhere. I have yet to research the other meds but will, and my mother is not the end all be all in decision making, I just run things by her first, and phrased it to her as "medications I found researching on the internet", very vaguely.

I just want to get to a place where A) I'm not having to drain massive funds to buy the meds(opiates) I need, and B) Some doctor(s) somewhere "get it" and prescribe at least opiates, preferably oxys, or something that truly helps, so my insurance will pay for it again and I don't have to dish out a small fortune making mexican cartels/chinese rich(er).

 

[Señor Moreno]

Sure, your wellbeing cant rely on those dirty fent pills.
Ketamine could be useful, but don't focus only on it, as you said ketamine is abusable and can easily rise doubts about why you really want it for. Lidocaine is not, neither is memantine, carbomazepine and other things. Ask your mon, get her into reading something about lidocaine devices and Ziconotide& other meds from that Conus regius sea scrab.
Remember, the less psicoactive a substance is, the more comfortable your family and docs will be with it

 

[Skorpio]

Thank you for this informative reply.
Why are the M30s unsustainable, in your opinion? And re: a "hot batch", a pill that could be 16mg as you say, a possible lethal dose, I really don't care at this point in my life - I've not been "living" for a decade+ now, just existing. I'm not saying I want suicide, I just don't mind if I don't wake up, as long as it's not waking up with brain damage. That would be a real nightmare, beyond the one I'm in now even.

When you say buy in large quantity, what do you mean? How many pills? They are phenomenally expensive here in MA, like $15-30 a pill depending on who you know, how much you buy, how long you've been buying, etc.

And if I crushed them into a fine powder as you say, how would I then ingest them? Are you talking needles? I've never used needles and really hate them.

If an M30 is snorted, is more of the bio-availability going to go into your bloodstream? Meaning, a higher dosage than just eating it? Also I've never heard of propylene glycol and will have to research it.

Also, re: methadone - I've tried it extensively w/this illness - and it doesn't cut through the sick feeling associated w/it. I feel sick all the time w/this illness due to it's unique/rare symptoms, and only strong full agonist opiods like oxy, fent, etc., seem to cut through it and give me peace. Also, they used propofol once for a procedure, which i know is a barbituate, but it worked as well. I'm not sure how else to explain; if methadone worked well enough, or suboxone, I'd be taking it. I did try buprenorphine pills once, just a few, and they worked OK(no naloxone in them), better than the methadone, but still felt the illness. It's only the stronger opiates, especially combined w/benzos, that really knock the symptoms away and give me the ability to physically/mentally rest. A symptom of illness if restless body, not just restless leg syndrome, so w/out the opiates my body is just twitching all over the place, It's scary to think what I would be like without the opiates/benzos with how far the illness has progressed over the past 10 years, and how far I've degenerated. I used to be able to still work physically even with chainsaw, lawn mower etc, when it first hit, for a few years, then year 4 could only use tractor, then year 6 couldnt do anything but light gardening in chair outside, then year 8 - 2 yrs ago - I couldnt even do that anymore. So, I am stuck inside 99% of the time, besides Dr. appointments, and without these meds I'm in a living hell. Sorry if I come across long-winded, just trying to explain the situation. I would love my health back, I'd throw these pills out the window in a millisecond and go back to living, but that's not an option.

I think Negrogesic's advice regarding the dirty 30s is spot on.

You would buy say a week or two supply of the pills (say 10 or 20). Then you would grind them up, and dissolve them in propylene glycol (a known amount, say 10 or 20 ml). Then you will use an oral syringe to measure out doses of the fent-propylene glycol solution and eat them. The first dose you take, you should shoot a bit low, and then you can increase to a comfortable dose. This method ensures that you get a week or two of consistent doses, and one particularly strong pill will get averaged with the rest, and its danger diluted.

Fentanyl should be soluble in water or ethanol, but with water you might want to filter or keep some of your working solution in the fridge or freezer so microbes don't grow and make you lose your batch.

Sounds like you are in a rough spot and I am sorry to hear that.

 

[negrogesic]

Thank you for this informative reply.
Why are the M30s unsustainable, in your opinion?

Unsustainable due to cost, availability issues and inconsistency of the product itself.

When you say buy in large quantity, what do you mean? How many pills? They are phenomenally expensive here in MA, like $15-30 a pill depending on who you know, how much you buy, how long you've been buying, etc.

I can't advise you on how many pills to buy, but by buying larger quantities at one time one can presumably drive down the price, and more importantly, if one were grind all the pills up homogeneously, it can reduce the risk of unexpectedly consuming a "hot" pill.

And if I crushed them into a fine powder as you say, how would I then ingest them? Are you talking needles? I've never used needles and really hate them.

No needles, i was recommending that you consume the powder orally.

But what you really need is to see a doctor about pain contol options.

 

[Señor Moreno]

But what you really need is to see a doctor about pain contol options.

No more, no less.
Pain control, specially nerve pain control, isn't only about " funny" meds, there are other options indeed.
Nothing wrong with getting high, don't get me wrong, but what you really need isn't a glow, it's pain treatment in the most efective and safe form you may find and afford

 

[Señor Moreno]

And yes those were my thoughts exactly re: methadone clinic. It would be ridiculous for me to even enter one. It's not as if I chose these meds to "party hardy and have fun, yay". And I'm sure it would be chaos in there, + the stigma like you said. Someone else mentioned that to me awhile ago, "try a methadone clinic" etc., and it was like audible depression hitting my ears; I felt like walking into a methadone clinic would just be walking into the river styx and getting on the boat.

Sure, Kalahad, avoid methadone, specially US mdone clinics. Just avoid it.

Now, that said, if somehow you were to end up needing methadone for any reason (like the unsustainability of fent or oxy purchasing in the long run), you must know that you should not take it once daily, as they want you to do at the clinic, you must split your daily intake in at least three doses, otherwise it won't work for pain 24 hours, it only will keep you wd free for that time.
If you make the terrible mistake of only dosing once a day and then just keep raising your dose to get pain relief, instead of splitting your original dose, you will end up in a dark place, with a massive tolerance and a poor pain management.
Also, if you push your mdone intake over certain given levels, you would be making other opiates practically useless, and you would be minimizing your chances of pain relief to a level that you wouldn't believe.
Happened to me years ago after some serious surgery. Hard time, believe me

 

[Keif' Richards]

Hey @Kalahad

You've got a complicated situation no doubt. I'm not a doctor so I'm not gonna try to touch on anything too, too specific here. I think at the end of the day, you're a person who is in pain and we're discussing how to best use different substances together, strategically to reduce your pain as much and for as long as possible.

I am pretty against using Street Fentanyl for folks with legitimate, chronic pain conditions. There is something about taking a drug thrice daily that is familiar and ingrained within us. We stop to eat three meals a day (generally). A meal is a time where we are generally allowed to stop and have time to ourselves. To slip in some medications with your meal at the same time is really no inconvenience. When you start talking about Fentanyl, especially whatever exactly is out on the street, it's much more common to dose 5-6 times per day, as you're experiencing. This can lead to confusion. How many times have I dosed today? Well, I'm feeling kind of bad, must be time for another. Then 6 becomes 7, 7 becomes 8 and pretty soon you're totally off the rails.

People in my town I know who use the Fentanyl out on the street and have been using for some time will typically have an end stage to their addiction looking like taking a hit of Fentanyl, falling uconscious for 1-1.5 hours, waking up and doing more, repeating the process. When they run out, they're already sick as fuck within 4-5 hours and jonesing like a fucking fiend by the 12 hour mark.

Next, we need to talk about Xylazine. Xylazine is a dissociative anesthetic most commonly used in veterinary medicine that has found its way into the illicit Opioid supply over the past 5 or so years. It was added to give the drug a bigger "bang". It also apparently causes dependence and has a withdrawal syndrome of its own characterized by extreme anxiety and confusion among other physical symptoms. A great deal of the illicit Fentanyl out on the street right now contains Xylazine. You need to be aware of that.

If you want my advice, you need to do your very best right now to be done with the Fentanyl and try to maintain with your licit prescription. It will not be easy. It's worth it though, as I believe you are on a short time limit regarding the effectiveness of these Fentanyl tablets.


-----------------------------------------------------------------------------------------------------

Benzodiazepines your usage is not astronomical. I don't think it's a huge problem. Taking into account the fact that you are suffering, I don't see an urgent need to correct anything here. Just don't increase your dosage. Keep your usage to as low as you possibly can and you can probably maintain efficacy for some time.

Clonidine (Catapres) Clonidine is a great medication for mild sedation, anxiolysis and of course, sleep. The way I see it, if you're sleeping, you're not in pain. If you can use something more mild to maintain proper sleep, you can use less Opioids. Perhaps try taking a little more Clonidine in place of one of your Fentanyl pills and see how you feel. Clonidine definitely will potentiate your other sedative medications. We don't want you to be all jammed up or anything, but you're in pain, so I feel this is all in the spirit of the good.

Pregabalin (Lyrica) also works in concert with your other medications. Really, all of the medications we've listed here are going to interact pretty significantly with one another. Pregabalin is often used in conjunction with Opioids for this reason. When used properly, Pregabalin has been demonstrated to reduce the overall need for Opioid medications. This is kind of the theme of this whole thread.

The biggest immediate issue with Pregabalin is that is is known to produce tolerance at a pretty quick clip. If you want to maintain efficacy long term, you need to get creative with the dosage and frequency of your usage. We have been discussing this issue in a number of other threads just this morning. I"m going to include a link to another thread specifically regarding Pregabalin tolerance for you to check out as well.

Pregbalin

since my wife died ,(last month 19thmay) ive having some issues .I can't sleep and i use pregabalin 600mg like 3 times a week But about 2:30hrs ago i took 1200 mg and i haven't feel not much.Im amazed that tolerance can go up in a mater of weeks..Even though i only took it 3 times a week .And...

bluelight.org

I feel this is a good amount of information with which to start. I don't want to overload you. Read up and let us know if you have any questions. We will be happy to sort you out.

 

[Keif' Richards]

@Señor Moreno I know you're averse to the idea of attending a Methadone Clinic. I can understand why. It's really not bad though if you're being honest. In my state you can be picking up Methadone every 7 days (weekly) after 3 months of clean UA's. You'll likely begin every other day dosing after 2-4 weeks of making appointments and clean UA's. The clinic is a harsh mistress. If you're really trying to better yourself, it's great. If you are walking into the clinic without any other ideas for improving yourself, you'll just end up with a massive Methadone dependency and all of the other problems you started with.

My second point is that if you keep using Street Fentanyl you will likely keep raising your tolerance and put yourself in an even worse position. For various reasons, namely dubious purity from batch to batch, this can't be used effectively, long-term for analgesia. If you keep doing the Fentanyl, you will eventually hit a brick wall. Once your prescriber catches on, you better believe they will drop you like a bag of dirt with no recourse.

It makes me very sad. I see more and more grannies coming through the clinic. You realize that these old people were in pain, messed up somehow with their prescription and then had no choice but to attend the clinic. I've been through addiction to medications with my own grandmother. She was addicted to Benzodiazepines. She asked for her refill too early and the doctor immediately cut her off with no taper or plan of any kind. The takeaway here is that more and more folks are being send through the clinic as prescribers worry more about themselves and their careers than about you.

Opioids can only be used long-term if you're totally responsible, use as little as possible and also by taking short breaks from the medication. When you start taking more, you get a process of diminishing returns. This is why I say you absolutely should try to get back to relying on your prescription. If you're in pain and suffering, this is my honest, best advice. If you need anything let us know.

 

[Señor Moreno]

@Señor Moreno I know you're averse to the idea of attending a Methadone Clinic. I can understand why. It's really not bad though if you're being honest. In my state you can be picking up Methadone every 7 days (weekly) after 3 months of clean UA's. You'll likely begin every other day dosing after 2-4 weeks of making appointments and clean UA's. The clinic is a harsh mistress. If you're really trying to better yourself, it's great. If you are walking into the clinic without any other ideas for improving yourself, you'll just end up with a massive Methadone dependency and all of the other problems you started with.

Hey, @Keif' Richards
I think we both agree in how we see the op's options, but sometimes I fail in trying to make my points 100% clear in English.
I told the op that no nerve pain patient will fix his/ her problem by buying fent pills. And, like you, I see the street fent use as the biggest danger here, something that has to be cut, even if op needs a methadone clinic. Mdone over street fent, allways
Now, I am happy to learn that in your área methadone treatments are provided in those rational terms,
But, and again we do agree, I think that in the op's case, nerve pain, opiates aren't the best option. They can be very useful in combo with other meds, but the main part of the treatment should not rely on their use. That's why I suggested to the op a lot of other options that I use, have used and I'm meant to use in a future

 

[Señor Moreno]

Hey @Kalahad , How are you mate? What did you do, then. You got more benzos, did you got medical help?
Just tell us something if your ok, please

 

[Señor Moreno]

Oh, shit, sorry @Kalahad that^ post was meant for another thread

 

[Kalahad]

Fentanyl, especially whatever exactly is out on the street, it's much more common to dose 5-6 times per day, as you're experiencing. This can lead to confusion. How many times have I dosed today? Well, I'm feeling kind of bad, must be time for another. Then 6 becomes 7, 7 becomes 8 and pretty soon you're totally off the rails.

People in my town I know who use the Fentanyl out on the street and have been using for some time will typically have an end stage to their addiction looking like taking a hit of Fentanyl, falling uconscious for 1-1.5 hours, waking up and doing more, repeating the process. When they run out, they're already sick as fuck within 4-5 hours and jonesing like a fucking fiend by the 12 hour mark.

Geesh, that was scary to read, particularly because that's either exactly or very close to the situation I'm in now. I don't know if it's because I just want to psychologically "check out" (via some form(s) of escapism) of what my life is/has become post-illness, or if the addictive aspect of the fent has pulled me so close to it that it demands I take an absurd amount, but that explanation is spot on to the state/stage I'm at. It's essentially wake up, take meds - which used to be 1x m30 but now is 2-3x m30s, then repeat this a few times throughout the day. My liver being recently diagnosed as "fatty liver disease" also worries me because though the illness, or slight weight gain, could be causing/have caused it, in my opinion it's the opiates, especially the M30s that I've been ingesting for a few years now. Q: Is it common for the M30s, or for fent/opiods in general, to hit the liver hard, even kill it? And in what time period?

Back to respond to what I quoted of your post, Keif', it was so timely(you saying that), that in fact, last night, I took my last dose, just happened to stare out my window since it was a nice dark summer night, looking out at the street/neighbor's house/trees etc., then was out and woke up 3 hours later in the exact same position, head and all. The area my head was resting on really hurt, but it would have hurt much more without the fent, I'm sure. If it had been day, neighbors would have wondered, "Why is he staring at me ... for 3 hours..without moving a millimeter?"

I'm not sure why I am even feeling the need to take it this often, to be honest. I remember 4-7 yrs ago - "the Oxycodone period" - I would take my licit 4x 10mg breakthrough pain pills, spaced out every couple hours, and the 3x 20mg extended release Oxys I'd usually make "expand" or "bloat" through soaking them in Gatorade or some other citric acid liquid in a small medicine cup for 1-2 hrs and then push down w/finger to flatten out as to create more surface space for faster ingestion - dont know if it worked but felt like it did; believe I read that here, before I joined. I would eat those just like the 10mg breakthrough's, usually in between the 10mg's, or, "pinks", as I called them since they were pink. I miss those, and even more the time in my life when they had an actual effect. So, at this point, the total a day was 100mg of Oxy, no fent, and never felt a need to take more in between, almost always got to sleep and in the morning repeat the aforementioned process, which, to me anyway was a long day to stretch out 100mg since that's, for me, about 15 hrs in a waking day. Now I don't even want to think about the amount of opiates(fent) I'm hitting myself with just to A) feel something, which quickly becomes knocked out and feeling nothing, ironically, and B) stave off the withdrawals. I do have a few packs of licit Suboxone, still, so if I was unable to get m30s for a period I could, in an emergency, take those to at least stave off the withdrawal symptoms, which I hope they would do, but god just to think of the illness hitting me full bore with nothing but a tiny amount of buprenorphine to help...I'd be in my bed like a worm on a hook, unable to sit still, banging into the wall, the bed, popping Zofran(Ondansetron) hoping it staves off the vomiting, hoping I get more 30s soon, etc. Even the benzos, kpins in my case, don't seem to help past a certain point; just make you feel out of it and a little sick. It's really a hellish situation, but I see no way out. Either suffer from this illness or suffer from the, as you guys have said, "unsustainable" downward spiral of opioid addiction. My mind always goes back to that bastard pain clinic owner that instead of working with me, worked against me over a trace dose of a med(bup), taken once from a friend who didn't tell me it was an opioid, therefore I blatantly honestly did not know that it was one. I was so "green' at the time re: "opiods, pain clinics and pills, oh my", I just didn't know the names of the meds.

This veterinarian drug "Xylazine", though; I'm not sure if it's in my m30s, or what else is in them, and what else in them might have their own withdrawal-like effects that my Suboxone would not halt. The Oxy's also felt very pleasurable, which wasn't what I was chasing - I'm just stating that there was a euphoric effect and it helped get through the day and life, period. I just wanted to be numb to the horrible symptoms of the illness. The m30s, as opposed to the Oxys of the past; they just knock me out, basically, with little to no euphoria. Feels more like anesthesia.
I wanted to post this short video for those unsure about the base illness I have (there are many types, but this is similar), but the young man they showcase at about 3:00 is nearly where I'm at in terms of progression of the illness, but not quite yet. It is a progressive, degenerative chronic neuro disorder, so, based on my symptoms worsening over the past decade since onset, I feel I'm maybe 80% there to where he is. If not for strong meds like opiates/benzos, I would almost certainly be fully bedridden, like him, perhaps even with permanent lines to my heart and vein - also like him - with minimal ability to speak. You can watch the entire video, as it's not very long, I just linked it to start at the most visual part, showcasing the young man's suffering, not far from my age when the illness hit me.



That is something else the opiates do for me; without them, I am bedridden and can barely even speak I am so weak; only in whispers, if even, and due to hyperadrenergic(fight-or-flight) component of illness(horrific), I am physically and mentally anxiety-ridden all the time, so even someone's footsteps walking to my door, nevermind them knocking on it, sends me into a panic, a terror, even. I often have to ask close relatives/friends to leave my room, or whatever room I'm in, due to the fear/anxiety of just having someone that close to me, even on meds. It's a horrible symptom of the illness that is unimaginably worse when off these strong opiates/benzos. After ~2 yrs into the illness, this got worse and the Klonopin was introducted to quell it, but after ~2-3 more years, nothing was helping much, and as I wrote in a previous post, a morphine shot for horrible food poisoning-related pain educated me to the fact that opioids quelled the horrible physical + mental anxiety of the illness that was making life miserable/unlivable with zero quality of life, as well as removing any traditional pain. At that time, even my mother was in tears and father near tears at seeing me in a state of physical+mental relief for the first time in years. I couldn't have known exactly where, how and when this path of pain "management" would have placed me, my parents, and my doctors, many of whom were trying to help, but simply did not either know how, of have the pull to prescribe what I wanted/needed, or were afraid due to insurance, or were simply limited due to regs, etc. I've gone on for too long, am tired now.

 

[Keif' Richards]

Hey @Kalahad I just want you to know that I'm working on a detailed response to your situation. I want to get it right and not overload you too much either intellectually or psychologically. It's all the same to us. We all speak the same language, if you catch my drift. Not to be overly poetic here. There are feelings that arise from being an Opioid user and more generally, an addict, that we know and feel viscerally.

Your situation is far from hopeless my friend. Here at Bluelight, I'm proud to say we've dug folks out of much deeper holes than yours, so don't lose faith. I will have a response for you today, hopefully in the next hour. Sit tight. We will get through this together.