Maintenance treatment in Netherlands

[Fertile]

The Dutch have robust support systems in place for Dutch citizens and those that have obtained a right to remain. If you aren't either, you have to pay all of the medical bills yourself.

 

[Arnold]

The Dutch have robust support systems in place for Dutch citizens and those that have obtained a right to remain. If you aren't either, you have to pay all of the medical bills yourself.

That's not quite true.
They all need to pay health insurance and you're covered then.

Hoe is de zorgverzekering in Nederland geregeld?

Iedereen die in Nederland woont of werkt moet een basisverzekering voor zorg (basispakket) afsluiten. Dat is medisch noodzakelijke zorg waar iedereen recht op heeft. De Rijksoverheid bepaalt wat er in het basispakket zit. Zorgverzekeraars bepalen zelf wat in aanvullende verzekeringen zit.

www.rijksoverheid.nl

 

[Fertile]

If you are a Dutch Citizen or have the right to remain - the tax is automatically taken out of your wage. Unless one is unemployed.

 

[emkee_reinvented]

Back to on-topic.

Any Dutch person here can tell about the maintenance treatment in NETHERLANDS. Would be extremely grateful

Well I know someone who is and its no Strawberry field. Your at will of your dr. specialized in addiction. Never asked if he got blood work done regularly to look for drug use, or to check his vital sign's.

But he is on Methadon, the easy option as you can take that home. He was also offered pharmaceutical Dia-Morphine/ Heroine. But that has to be taken on site so not an option he chose.

Besides that they pump him with med's. Promethazine/ Diazepam and various Anti-depressant's. But no dr. ever checks for possible interaction's. Or realizes sudden cessation of Benzodiazepine can be deadly. He also takes these on the side, things like Flunitrazepam.

For health insurance the benzo's are the biggest problem as they are not covered. Except if you have a very willing doc. I like my independence, he is dependent. Not only on the drugs but also on the dr. who prescribes them. And if there are changes in our private healthcare system, which sucks, he is the one who pays the price.

 

[Fertile]

Dutch health care is not heap and the Dutch being a Calvinist society does not like handing out anxiolytics or opioids. I managed to get 5 x 2mg alprazolam out of the doctor after being involved with a large explosion (2 days later HR was still over 160). As for pain - well tramadol is still seen as a potent analgesic only suitable for severe pain.

BTW did anyone try O-desmethyl tramadol? My calculations show it's supposed to be M-range potent, but I haven't seen any amazing reports.

 

[izo]

Odmt is sort of okay, not the best opioid but good enough for some to stay with it it seems. Contrary to tramadol you can feel somewhat of a nmda antagonist action that seems so be masked by the methoxy ether. It lacks any serotonergic activity though.

 

[Fertile]

I seem to remember that in QSAR trials, the example in which the tertiary -OH was swapped for an -F increased potency by a factor of 5......

But I do not think we will see clandestine labs working with fluorinating agents (well, not for long). DAST is one of the more friendly ones and it isn't friendly.

Sad that MT-45 is still about but U-47700 homologues have gone. a pity because U4 was discovered by one of Dan L.'s staff and both Dan and myself realized that their is a legal U4 derivative some x23 M......

 

[izo]

i seem to remember that in QSAR trials, the example in which the tertiary -OH was swapped for an -F increased potency by a factor of 5......

Right, I had a pdf once where such fluorinated tramadol derivatives were discussed. Some information were inconclusive, seems I’ve lost that pdf.

 

[izo]

Ot: Ok, found it:

Tramadol Derivatives pharmacology.pdf

drive.google.com

 

[Fertile]

I'm glad you found that. So deprotecting the phenol and swapping the tertiary hydroxyl for a fluoro results in a compound some x10 more potent.

Over the last few years I have found patents that show that about 1/3rd of all patented opioids were not covered by WIki. People may laugh but I spend MONTHS finding the original patents for over 2500 drugs and over the next few months.... most of the patents disappeared.

On a related topic, if you take a look at picenadol (specificially 3R,4R) & tapentadol, you will notice that the latter is a fragment of the former. What is odd is that having an N-propyl side-chain at the benzylic carbon (like picendaol) then it's a full agonist. Having an ethyl side-chain at the benzylic carbon means the product will be a partial agonist (or mixed agonist/antagonist). There are examples with methyl side-chains - these are ALL antagonists.

So with the connection between picenadol and tapentadol exposed, I guess the OBVIOUS thing to do is to make the N-propyl homologue. You would have thought that with the hundreds of patents and tens of thousands of compounds, different side-chains would have been tested. No. You might also assume that other amines (besides the N,N-dimethyl in tapentadol) would be part of that huge tide. Nope, not one.

It looks like Grünenthal went to extreme lengths to avoid having to calculate and admit to a dependence liability (although I believe a few people like them).

 

[emkee_reinvented]

Dutch health care is not heap and the Dutch being a Calvinist society does not like handing out anxiolytics or opioids. I managed to get 5 x 2mg alprazolam out of the doctor after being involved with a large explosion (2 days later HR was still over 160). As for pain - well tramadol is still seen as a potent analgesic only suitable for severe pain.

BTW did anyone try O-desmethyl tramadol? My calculations show it's supposed to be M-range potent, but I haven't seen any amazing reports.

Indeed on the contrary its so expensive people with low/ minimum income get an surchange to compensate the unrealistically high contribution. My individual amount, of surchange that i receive, is 2/ 3 of what I pay to the insurance.

o-DSMT is ok. Lots of itching though and it effect's the libido. Looses its effectivenes fast. Would it have been just as available I would choose Kratom. As it overal seems better.

And dr. 's will have you suffering, as long as they don't have to prescribe Benzo's or Opoid's. That is not Calvinistic btw, these guy's and girls were happy people, so they say, not into suffering at all. Its just the Dutch themselves.

 

[emkee_reinvented]

Well i guess I am living in rich land. Even the poor get surchange for all kinda of stuff. No clue if that is the right word for individual subsidie's. There is one for kids, health-care and rent. Now we have one for energie, a one kind thing, but an considerable amount of money. For the most some effort is required but once on the bandwagon the rest goes a lot easier.

And there already were some like for people unemployed for a long time and even one that cover's part of your internet cost's. Their reasoning that it was and a necessity and broadens your possibility's.

 

[emkee_reinvented]

Indeed on the contrary its so expensive people with low/ minimum income get an surchange to compensate the unrealistically high contribution. My individual amount, of surchange that i receive, is 2/ 3 of what I pay to the insurance.

o-DSMT is ok. Lots of itching though and it effect's the libido. Looses its effectivenes fast. Would it have been just as available I would choose Kratom. As it overal seems better.

And dr. 's will have you suffering, as long as they don't have to prescribe Benzo's or Opoid's. That is not Calvinistic btw, these guy's and girls were happy people, so they say, not into suffering at all. Its just the Dutch themselves.

To bad I have nothing to compare it with. It is def better then Tramadol. More like an Opioid.

More euphoric then Codeine going from my limited experience with it. Kratom is the only other Opioid I used big time. Would I compare the two o-DSMT is the sleepy noddy of the two, Kratom is way more functional.