opiates for pain

heya sublimit, you are heading into treacherous territory with your pain management. Froim my experience with GP's they are not specialists in pain management, see if you could get a referral to a pain management specialist.

Running out of your medication early is not necessarily a good thing, plus it shows you are on your way with buidling a tolerance. This will impact your ability to access breakthrough pain medication. Ask for a referral to a pain management/addiction medicine specialist for review. They generally understand opiates better than any GP i've come across.

theres a line that many people on prescription opiates cross between addiction and effective pain management without seeing it. where effective pain management becomes dependance and addictogenic like behaviours

Australian trends in opioid prescribing for chronic non-cancer pain, 1986-1996
The clinical impression is that dose escalation may be more likely in patients taking the potent, short-acting drug dextromoramide, and less likely in those taking low potency codeine or long-acting methadone. Despite the small numbers (see Box), the difference in the proportion of patients taking these different drug types whose opioid dose escalated approached significance (P = 0.053).

Thirty-three patients (32.4%; 95% CI, 23.4%-42.3%) were still receiving S8 opioids five years later (although many were receiving a different S8 opioid in 1996).

Twenty-six of the 102 patients (25.5%; 95% CI, 17.4%-35.1%) received escalating doses of opioids: 21 of the 33 patients who were still receiving opioids on authority in 1996, and five of the 69 people not receiving opioids on authority in 1996 (chi-squared = 44.69; 1df; P < 0.005). Patients receiving opioids for the full five years were more likely to escalate their dose (odds ratio, 22.4; 95% CI, 7.1-71.0). It is unlikely that escalation was simply a function of patients beginning with a low initial dose of opioid. Converting initial doses to equivalents of oral morphine, the group whose doses did not escalate began with a mean dose of 80 mg of oral morphine per day, while the group whose doses did escalate began with a mean dose of 87 mg per day.

Thought these might be some handy numbers for people, if you want a referral to a pain/addiction specialist in your area; it might be worth contacting these S8 licencing bodies to find out where the major addiction/pain specialist clinics are.

Prescribing drugs of dependence: State and territory contacts

ACT Pharmaceutical Services Section, ACT Health: 02 6207 3974
ACT Opiate Treatment Service ACT Health: 02 6244 2591

NSW Pharmaceutical Services Branch, NSW Health: 02 9879 3214

NT Poisons Control Unit, Department of Health and Community Services: 08 8922 7341, www.health.nt.gov.au

QLD Drugs of Dependence Unit, Queensland Health: 07 3896 3900

SA Drugs of Dependence Unit, Drug and Alcohol Services, Department of Health: 1300 652 584

TAS Pharmaceutical Services Branch, Department of Health and Human Services: 03 6233 2064

VIC Drugs and Poisons Unit, Department of Human Services: 1300 364 545, www.health.vic.gov.au/dpu

WA Drugs of Dependence Unit, Department of Health: 08 9388 4985

madmick19 said:

heya sublimit, you are heading into treacherous territory with your pain management. Froim my experience with GP's they are not specialists in pain management, see if you could get a referral to a pain management specialist.

Running out of your medication early is not necessarily a good thing, plus it shows you are on your way with buidling a tolerance. This will impact your ability to access breakthrough pain medication. Ask for a referral to a pain management/addiction medicine specialist for review. They generally understand opiates better than any GP i've come across.

theres a line that many people on prescription opiates cross between addiction and effective pain management without seeing it. where effective pain management becomes dependance and addictogenic like behaviours

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i appreciate your advise very much Madmick, but it's not a case of running out(this time) as the 60 20mg oxycodone was sufficient in managing my pain, but i lost 40 of them due to someone stealing them... and all i wanted was a temporary solution until i'm due to see my regular doctor. i didn't want to go back to my doctor and tell him this because it would be possible that he wouldn't believe me and i don't want that to happen

before i saw this doctor, the 2 previous ones knew about my past H addiction and wouldn't prescribe me any opiates apart from tramadol and codeine which didn't suffice at all, so i went to my current doc and said i had a drinking problem and showed him my diagnostic report of my knee that i had an mri for several years ago, which i re injured and have subsequently booked myself in for another scan which i'm going for this monday, and he's happy to prescribe accordingly, first went from 60 5mg and now i'm on 20mg oxy twice daily.

i don't understand the links you posted regarding the vic drugs and poisons unit DHS... it doesn't have any reference to any pain specialist(not that i can see anyway), besides you need a reference from a doctor, who i'm going to see about that anyway.

good points sublimit,

yes you do need a referral to see a pain specialist, but knowing who they are and where they are can spped up that process for you. Ididnt find the pain managment clinics numbers for each state, but i know that when people are prescribed S8 Drugs the GP should need to have authorisation ( a simple process by Fax) from the state and territory bodies who i listed above. If you call them you would get an idea where the pain clinics are more generally in your state, or who are alternative doctors you may also be able to see. i wasnt able to finad a nice listing like this for aus more generally

Once you got the details it is possible to ask your GP for a referral to see them for a second opinion. Just to ensure that you are getting the best availble treatment for what you have.

Also im a big believer in having open and frank discussion with doctors, they in the end are there to service us- not the other way around. hopefully you can build a good relationship with your GP where you can tell him about your previous heroin use. Should it not be a problem than there are various physical indicators which would actually confirm this during his examinations of you.

also since this is a harm reduction and holistic based websit i though it worthwhile chcking a copy of the Pain management page taken from the better health webiste talks about the additional things you can do without drugs . In counselling for addiction and pain meditation and mindfulness practices can achieve massive gains for people.

The main causes of pain include medical conditions (such as cancer, arthritis and back problems), injuries and surgery. Sometimes, the cause of the pain can't be found or there are no available treatments for it. In other cases, the cause may be remedied, but the associated pain lingers on. Chronic pain is defined as pain that persists for longer than three months. At any given time, around one third of Australians are in pain. Management strategies include pain-killing medications, and complementary therapies (such as acupuncture and massage). Studies suggest that a person's outlook and the way they emotionally cope with chronic pain influence their quality of life. It has been shown that people who learn self-management skills lower their levels of felt pain. It is important to learn these skills, and to deal with the associated stress and depression in constructive ways.

The epidemiology of pain
A Brisbane study in 1986 found that certain groups are more likely to suffer chronic pain than others. The findings of this study were similar to research findings from other countries. Selected statistics include:

* The incidence of pain rises with advancing age.
* Women are more likely to be in pain than men.
* The most commonly reported pain is back pain.
* The most severe pains include those of the back, head, neck and leg.
* The pain is constant for around one fifth of people.
* The cause is unknown in around one third of cases.
* One fifth of cases were caused by work-related accidents.
* Most people surveyed had suffered chronic pain for longer than three years.
* Seven out of 10 people sought professional help.
* The most common source of professional help was the family doctor (80 per cent).

Pain-killing medications
The type of medication you are prescribed depends on your pain. The issues you need to discuss with your health care professional include: the location, intensity and type of pain; which activities ease or exacerbate it; the impact your pain has on lifestyle factors, such as appetite and quality of sleep. Medications for chronic pain are best taken regularly. If your pain is well managed, you are less likely to take large doses of painkillers, and the risk of side effects is reduced.

The medications available for the management of chronic pain include:

* Aspirin and aspirin-like drugs
* Paracetamol
* Opioid drugs, such as codeine and morphine
* Local anaesthetics.

Long term use of some medications can have side effects which affect a person's quality of life. They may also lose their ability to reduce pain. Some studies have shown that medication can undermine the value of developing self-management skills. This occurs because the person believes they are coping better with pain due to the medication, not because they may have learnt effective coping skills.

Complementary therapies
Numerous studies have found that certain complementary therapies are effective in pain management. Some of these therapies include:

* Acupuncture - a component of traditional Chinese medicine. Acupuncture involves the insertion of slender needles into specific points on the skin.
* Massage - better suited to soft tissue injuries and should be avoided if the pain originates in the joints.
* Relaxation techniques - including meditation and yoga.
* Transcutaneous electrical nerve stimulation (TENS) therapy - a minute electrical current is passed through the skin via electrodes, prompting a pain-killing response from the body.
* Cognitive-behavioural therapy - this is a process of learning to change how you think and, in turn, how you feel and behave about pain. It is part of a process of self-management of chronic pain.

Coming to terms with chronic pain
Sometimes, chronic pain cannot be relieved. Suggestions on how to emotionally handle this difficult and distressing situation include the following:

* If all medical avenues have been exhausted, don't raise false hopes by searching fruitlessly for a cure.
* Accept that your pain may not go away and that flare-ups may occur. Talk yourself through these times.
* Find out as much as you can about your condition so that you don't fret or worry unnecessarily about the pain. Fear makes cowards of us all!
* Take steps to prevent or ease depression by any means that work for you, including talking to friends or professionals.
* If painkillers can't ease the pain, don't increase the dose - take fewer or none at all, in consultation with your doctor.
* Improve your physical fitness, eat healthy foods and ensure you get all the rest you need.
* Don't allow the pain to curtail your life more than necessary - if you miss activities you used to do before the pain, try reintroducing those activities in a gently paced way. You may need to cut back on these activities if pain flare-ups occur, but it will be possible to increase slowly again as you did before.
* Concentrate your efforts on finding fun and rewarding activities that don't exacerbate your pain.
* Seek advice on new coping strategies and skills from an occupational therapist.

Where to get help

* Your doctor
* Occupational therapist.

Things to remember

* At any given time, around one third of Australians are in pain.
* Management strategies for chronic pain include pain-killing medications, and complementary therapies (such as acupuncture and massage).
* Studies suggest that a person's quality of life is influenced by their outlook, and by the way they emotionally cope with chronic pain.
* Seek advice on new coping strategies and skills from an occupational therapist.

You might also be interested in:
Acupuncture.
Cancer pain management.
Fibromyalgia.
Headache - treatment options.
Headache and medications.
Massage.
Pain-killing drugs.
Physiotherapy.

madmick19 said:

good points sublimit,

but i know that when people are prescribed S8 Drugs the GP should need to have authorisation ( a simple process by Fax) from the state and territory bodies who i listed above.ly

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i thought there was a difference when it comes to schedule 8 drugs as in the GP needs to get "authorising" of an "authority script" but with regards to a "restricted script" on the PBS all the GP needs to do is be essentially satisfied to prescribe it when necessary, without any authorisation of any kind, afaik.

I asked earlier and got confirmation from Leftwing about endone aka 5mg oxycodone and if one prescribed pack would need to be authorised as an authority scrip, but apparently only a months supply would fall under an authority script, but one pack falls under "restricted benifit"http://www.pbs.gov.au/html/consumer/product/restrictions?publication=GE&code=8464L&brand=OxyNorm

i am still a little confused about the whole criteria for prescribing and medicare and the pbs's exact procedure, but it is interesting to learn about it non the less

madmick19 said:

Also im a big believer in having open and frank discussion with doctors, they in the end are there to service us- not the other way around. hopefully you can build a good relationship with your GP where you can tell him about your previous heroin use. Should it not be a problem than there are various physical indicators which would actually confirm this during his examinations of you.

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i would like to agree with you on that one Madmick and generally i am an honest person, i pride myself on honesty and it's a quality i look for in people, but when it comes to doctors and being honest well i personally think it depends on the doctor, but a lot of the time it has gone against me in the worst way were one doctor has even outright lied to me.... recently, when i injured my knee, i went to a doctor that someone recommended to me for being understanding when it came to pain management, and also the practice was close to the box hill hospital, which i was going there with my pending reference from what i though was a good gp... so i come in on crutches, with a diagnostic report of an mri i had 7 years ago when i first injured my knee, as well as the actual mri images in my backpack, and told her that i'm in a lot of pain can you give me a referral so i can take it to the ER room, oh and i have an ongoing H addiction that i've managed to overcome recently. would you be able to manage my pain sufficiently? my answer was "it would be illegal for me to give you anything because you have a history of heroin abuse" i was shocked and asked her if that was discrimination. she mumbled a few things trying to tell me that it wasn't discrimination and sent me on my way with a referral.

now i don't like the word junkie, but i look like a normal person and wear respectable clothes and i'd like to think that i'm well spoken.... my doctor thats known me for most of my life is a great doctor and he know everything about me, but i knew that i would be better off seeing a brand new doctor because of my last experience... so the day after i went to the hospital i had a search on the net and i noticed a lot of people saying good things about a doctor that was close to where i live... so i managed to make an appointment that day, came in with my crutches and my referral from the hospital and with my 7 year old diagnostic report.

now because i hate dishonesty i felt to tell him i had an addiction of some sort that i'm wanting to overcome. i told him that i had an alcohol problem, and he gave me 50 valium lol, but i also said that when i was in the hospital they gave me endone(which was on the report) and i even said to him" the endone worked well but i doubt you'll give me that" well he smiled and subsequently wrote me a script for a pack to my surprise and delight, so i go back a week later and say i need another, but this time he said it would be my last because i have an addictive personality,,, well in the mean time i went back to the hospital and booked myself in for an mri which was to be 5 weeks time. so sure enough i go back to him and confidently say i need you to manage my pain, i deserve quality of life, my addiction is behind me etc. and he subsequently gave me 60 5mg oxy's, 2 and ahlf weeks later i go back and ask to increase the dose. bang! 60 10mg oxy's and then again now i'm on 20's, but this time he said he won't want me to go higher,

but now that i had 2 of those packs stolen, i'm thinking about either just asking him to slightly increase the dose and just wait it out, or tell him the truth which i'm reluctant to do because of obvious reasons)i'm sure they get story's like that everyday) or, see another doctor and get small scripts(restricted benefit) to hold me until i'm due to see my regular gb.... i know it's risky business to see another doctor, and hypothetically if i get an authority script(which i doubt because it would be my first visit) then i'd be in a lot of trouble, but i don't see the harm in seeing another doctor if he was to prescribe me a pack of endone... even if it was tramadol, i wouldn't run the risk of being labelled a doctor shopper and i wouldn't have to put up with WD symptoms, pain on the other hand i would

bit of a catch 22, or a double edged sword

What are peoples experiences with GP compared to pain management specialists for PM???

wooo only 5 posts away from the coveted bluelighter status WOOO

Yup, the sad fact is that the medical system discriminates hugely against drug users, past and present, and even when the treatment is absolutely necessary, having any kind of controlled substance prescribed becomes a thousand times harder if a doctor knows about your drug use. Not to mention the fact that a lot of doctors look down upon, or straight up disrespect or are rude to, drug users. I'd say anyone is well within their rights to lie about their drug use when talking to a doctor, you have to do what you can when you're working with a broken system.

Crankinit said:

Yup, the sad fact is that the medical system discriminates hugely against drug users, past and present, and even when the treatment is absolutely necessary, having any kind of controlled substance prescribed becomes a thousand times harder if a doctor knows about your drug use. Not to mention the fact that a lot of doctors look down upon, or straight up disrespect or are rude to, drug users. I'd say anyone is well within their rights to lie about their drug use when talking to a doctor, you have to do what you can when you're working with a broken system.

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well i'm glad i'm not alone in that respect, i think it must be a taboo for doctors to prescribe opiates to people who admit that they had an addiction to them in the past... it's like they feel liable, or assume the patient is going straight to the street to sell them???

why would anyone thats in pain being prescribed pharmaceutical grade opiates sell them for money or heroin.... i guess there is a minority of drug seekers that con doctors into getting drugs for that purpose, but it ruins it for everyone else and the majority of legitimate people that need PM are suffering and finding it harder and harder to get sufficient analgesia.

when i was using H regularly, not once was i offered any pharmaceutical opiates except for bupe, and benzo's(which are sold very cheap afaik)

Sublimit said:

but now that i had 2 of those packs stolen, i'm thinking about either just asking him to slightly increase the dose and just wait it out, or tell him the truth which i'm reluctant to do because of obvious reasons)i'm sure they get story's like that everyday) or, see another doctor and get small scripts(restricted benefit) to hold me until i'm due to see my regular gb.... i know it's risky business to see another doctor, and hypothetically if i get an authority script(which i doubt because it would be my first visit) then i'd be in a lot of trouble, but i don't see the harm in seeing another doctor if he was to prescribe me a pack of endone... even if it was tramadol, i wouldn't run the risk of being labelled a doctor shopper and i wouldn't have to put up with WD symptoms, pain on the other hand i would

bit of a catch 22, or a double edged sword

What are peoples experiences with GP compared to pain management specialists for PM???

Click to expand...

you need to file a report with the police. i've had a motel maid with sticky fingers who took painkillers and benzos from me. doctors will only tolerate this once off. if you need relief in the mean time it is worth seeing and explaining your position to your doctor, failing that go to an ER.

i see a GP for my PM script and have no complaints at all. it's the specialists who have been bad experiences - ortho surgeons and other specialists who told me nothing more than the MRI lady and my GP at an exorbitant price for a 15min consultation.

i am glad to have been with my GP for about 4 years now, building a solid relationship with him.

leftwing said:

you need to file a report with the police. i've had a motel maid with sticky fingers who took painkillers and benzos from me. doctors will only tolerate this once off.

i see a GP for my PM script and have no complaints at all. it's the specialists who have been bad experiences - ortho surgeons and other specialists who told me nothing more than the MRI lady and my GP at an exponential price for a 15min consultation.

i am glad to have been with my GP for about 4 years now, building a solid relationship with him.

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so in your experience a gp(good one with good relationship) is better than any pain specialist you've ever seen? i'm i aloud to ask how much a consultation with a pain specialist would be?

thanks for your advise about contacting the police... what would that process be? i go in and make a report and they would write that in a summery and then i could take that to my doctor as proof of the stolen medication? even if it happened a few days ago.. wouldn't that be a bit late to go to the police and make a report?

oh and did you ask your gp about jurnista when you saw him?

i've never had to show proof of a police report but it's a good way to have yourself covered legally in case someone else happens to fill those scripts. but yes, go into your local cop shop and file a report. better late than never.

no i didn't mention jurnista to my doc yet, i've been having a hard enough time twisting valium from him still i'm more than pleased with morphine, tramadol and codeine for breakthrough when needed.

oh my specialist appointments have cost me up to $500, but there is a medicare rebate. it's the repeat consultations which add up and travelling whereas i have a doctor here in town who's licensed to prescribe me what i get and he even bulk bills!

edit - i have let it be known to my doctor that i have filed the reports.

^^^ hey thanks for that advise... i'm still not sure if i wont to break it to my doctor though, but i'm sure if i went and got a police report he'd have to assume that i was being sincere and not hold anything against me or hold any suspicion towards me, thats what i want to avoid the most, because like you say; gaining a good relationship with your GP is absolutely vital, and thats more important for me than anything because i've only started to build one with my GP (4 months) and it has already become an understanding and friendly relationship. well i have a few days to decide what to do anyway. but regardless i'm going to the police station tomorrow to make the report.

Wow $500, yeah i think i might forget about the pain specialist for PM at the moment, as especially as i'm not working due to my injury being this bad.

yeah i know that gp's are reluctant to prescribe valium with opiates, funny thing is that opiates make me(and i'm guessing most people) find it difficult to sleep, i want to be careful, but i've had good results asking for a benzo with a long half life for sleep issues, but use it for anxiety purposes and not necessarily for sleep i find hypnotic benzo's don't make me drowsy, in fact i find diazepam makes me drowsy

i'm sorry about your condition, but i like your regime! so 60mg of ms-contin is like a 40mg ocycodone, pretty much identical by the sounds of it(time-release wise). sorry about all the questions, but how do you find morphine compared to oxycodone? and you use tramadol for breakthrough pain? i've found that to take a long time to work for me, like 1:30mins to work from a 100mg dose. and do you find that baclofen is as effective as valium or is that more effective for your back... i have mild chronic back pain and i'm wondering if that would help for my back,

I guess the point of this thread is purely for information about PM, but it's been very interesting and just to be aware of what people have experienced from getting pain management has made me realise a lot of thinks i can talk to my doctor about and in turn get better understanding and better pain management

i would agree that the medical system discriminates against drug users but there are ways that you can actually change that by starting a good relationship with your doc. At the same time i know that doctors are people who are just as prejudice if not moreso sometimes because of the class background that most doctors are pulled from.

You have great authority in your relationship with your doc & could teach them a thing or two, pity you are not in a public health system where you could ask for a social worker to advocate on your behalf, maybe there is a way that you could write your doc a letter including a voluntary undertaking to maintain your treatment where it is untill furhter medical information comes to hand.

If the people in your house have taken the medications better to have that conversation with your doc but also show that you have some way to change those circumstances. When clients are prescribed takeaway opiate pharmacotherapies i have known doctors to suggest the purchase of a lockable box in which the S8 meds can be kept. that way you have taken resonable action toward changing the circumstance and the docs fears of abuse may be slightly allayed, but also that you are an active participant.

Docs do get very suspicious when people present for opiates again and again, and the research litrature that informs addiction doctors suggests that opiate users once they have a dependence have heightened risk for abuse for the rest of their lives, while this may be true in many cases it is not the rule. Simply it is a body of research taken fromk a specific opinion (medicine) and baseline success is permanent abstinance (which is highly unlikey for previously addicted indv, but one use after leaving treatment=fail.

Again, i appreciate your sentiments Madmick. I've decided not to make a report and go through the hassle and process of it, but the other reason why is that i don't want to hit my doctor with it.... i hear what your saying about the mutual benefit of having a completely open relationship with a GP, and it's something i'd be defiantly considering, but over time.. the last thing i want to tell him now is the fact i lost 2 packs of meds, no matter how unfortunate, because i'm still kind of new to him, i've only seen him in the last 4 months or so, due to not being satisfied with any other GP willing to manage my pain, to to point where i was being discriminated for my honesty.

So how do i eventually come clean about that fact that my addiction was H and not alcohol? I know in my mind that i should be able to justify it to him. i really like him personally, he seems genuine and i do want to have a completely open relationship with him, just need to be careful of how i go about it.

I'm using what i have left, one tablet 20mg of oxy a day, but had my last one today. i've halved ,my dose for several days now and i don't think it will be much of a withdrawal if i use some codeine and diyhdrocodeine tomorrow and the next day it should be ok, but i'm more worried about the pain and being able to get around ok. iwas really considering seeing another doctor for some pain relief(i know a doctor whose known me most my life would give me endone, but he'd also probably wonder why i didn't see him about my knee) i know i could easily see a walk-in gp and get tramadol, but because i'm on an authority script with my current doctor i'm very reluctant try and get extra pain meds from another gp.(i don't want to be identified under the prescription shopping program) seeing multiple doctors is part of the criteria, within a 3 month period, updated monthly.

So i think the best thing i should do is go back and see my doctor and tell him that for around the clock pm i need to take 20mg oxycodone 3 times daily. I've read that the ER on the pill can vary from 8-12 hours, and i've noticed this when i first started on the 5mg one's. he's never had a problem in the past refilling early, and up'ing the dose, but this time i think i should see him soon and let him know that ive been taking 3 a day. i was scripted last on the 10th so at 3 pills a day im due for a refill in late May.

When i go for my next visit i can talk to him about additional medication, for breakthrough pain. are doctors likely to prescribe extra IR pain meds whilst on around the clock PM? I found 20mg 3x daily to give me great around the clock pain, but on a few occasions i've been in sever pain due to putting too much pressure on my knee or slipping. is this enough for him to prescribe for breakthrough pain? either way i'm going to feel awkward, because of the increased oxy amount. maybe i should wait and suffer a bit... for around 9 days : ) i'd jump up and down if he gave me hydromorphone

leftwing said:

i'm prescribed baclofen as a muscle relaxant in combination with valium on top of my morphine and tramadol for my spinal condition. i don't have a bad word to say about, unless you go taking absurd amount trying to get high - its not recreational in the least; it will leave you knocked out, motor skills wiped out, and just a down right disgusting feeling altogether. it's also an extremely effective anti-anxiety medicine too, on par with valium imo.

you're right that it'sb een trialled in alcohol replacment, that's the main literature i found on it when researching before having it prescribed. it's not an analgesic, its a muscle relaxant.

FWIW - i've never experienced any withdrawal symptoms upon ceasing it.

here's MIMS info, it's long so i put it in NSFW

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Cheers for the input man. Decided to give it a shot after benzos didn't work out (never did like them outside of getting some sleep post-binge), they're definately effective, can still feel the pain but it's dulled noticeably and much easier to ignore. Will see how they hold up over the next week or two though, that list of potential side effects is quite extensive.

I'm curious though dude, how do you find it combines with other drugs? Any interactions? Particularly meth and opiates. I figure the latter all I have to worry about is the mild CNS depression, but I'm not so sure about the former.

heya sublimit,

why not talk to him about methadone as a pain reliever?, it has a great potential to manage your pain via once a day doseage?. this could also facilitate the discusion around previous use f Heroin and other opiates in the long run.

while methadone miht not be as eaisly transportable across aus, it would make you medication management eaiser.

Howdy all.

There was a proposal in 2003 for a trial of Hydromorphone in the ACT. The advantages were 3 fold:

1/ Very similar feeling to heroin when injected.
2/ Hydromorphone already available. No need to re-legalise diacetylmorphine(heroin) which requires the OK from parliament and special conditions to import it.
3/ Much cheaper than heroin
Read more

It probably fizzled out because of the pressure from that low life, John Howard. Remember, his philosophy was that addicts should only be treated with recovery programs that he thinks is best. He obviously knew more because he was a career politician ... they were only doctors and experts.

Canada included Hydromorphone as part of their heroin trials and had excellent results.

Read more: Hydromorphone(NOTE: reverse order - start from the bottom of the page)


BTW, I am on 700mg of Slow Release Oral Morphine (SROM) for pain management, depression and OMT. I was on methadone and after a referral to a pharmacotherapist, he and my GP(methadone subscriber)applied to the health dept. for an authority for morphine. Quality of life is 152.85% better than what it was. Why SROM is not part of any countries OMT program is just ridiculous.

I wrote about my methadone to SROM experiences on my blog: The Australian Heroin Diaries
Also, try this: morphine vs methadone.

-
Regards

Terry Wright

Sublimit said:

i'm sorry about your condition, but i like your regime! so 60mg of ms-contin is like a 40mg ocycodone, pretty much identical by the sounds of it(time-release wise). sorry about all the questions, but how do you find morphine compared to oxycodone? and you use tramadol for breakthrough pain? i've found that to take a long time to work for me, like 1:30mins to work from a 100mg dose. and do you find that baclofen is as effective as valium or is that more effective for your back... i have mild chronic back pain and i'm wondering if that would help for my back,

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i prefer morphine. i don't necessarily like that stimulative effect oxy can produce, i can find it a hindrance.

the reason they that amount of time to start taking effect is because they're slow, continuous release pills. they've each got a wax matrix which releases the drug over a period of 12 hours. information on the matrix of each pill is easy to pull up with a simple google; i'm pretty sure the purdue (oxycontin brand) has the info on it's site for example.

i guess i say tramadol is a breakthrough pain med but it's not really, it just adds the extra pain relief i need as my doctor isn't willing to bump my morphine dose up any further at the moment. i mainly use the slow release tablets; codeine for proper breakthrough.

i find valium and baclofen just as effective as each other as a muscle relacant and for anxiety. just each has it's different side effects. if you suffer from muscle spasms then you'll find it useful.

Crankinit said:

Cheers for the input man. Decided to give it a shot after benzos didn't work out (never did like them outside of getting some sleep post-binge), they're definately effective, can still feel the pain but it's dulled noticeably and much easier to ignore. Will see how they hold up over the next week or two though, that list of potential side effects is quite extensive.

I'm curious though dude, how do you find it combines with other drugs? Any interactions? Particularly meth and opiates. I figure the latter all I have to worry about is the mild CNS depression, but I'm not so sure about the former.

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i find it's synergistic with opiates, benzos and alcohol at small doses. not recreational by itself at all, it's absolutely repulsive imo. i've never combined it with meth yet so i'm not sure about that.

i actually had some concern combining it with meth because it fits the profile of a β2-Receptor antagonist which mustn't be used in the case of a cocaine, amphetamine or any other alpha adrenergic stimulant overdose. now it says overdose, but what wiki refers to as an overdose isn't clarified, it could just be a larger dose for a tolerant person. and i haven't had a certain answer to it so i'm not risking it anyway, in the case of a meth comedown benzos would be much better; higher dosees can be taken without the awful feelings of a high dose of baclofen