opiates for pain

drug_mentor said:

She isn't my usual doctor but I have seen her atleast once before and it is the same practise as my regular guy, he just wasn't there yesterday.

Sublimit cheers for the info on the doc shopping register, I wonder how long someone stays on for after being put up? I don't think diazepam is an authority script without repeats but I am not certain, I may have fit the criteria you listed when I was abusing a lot more benzo's but as I was using benzo's so often it can be hard to recall! haha.

Click to expand...

no worries mate. It gets updated monthly so if someone was on it and wasn't actively fitting the criteria then that person would eventually be automatically removed.

you're right, 1 script of diazepam isn't authority required, but the same script with a repeat is. Just an example of benzo's, with clonazepam under the PBS the only script you can get is for 200 tablets which is an authority script. Oxazepam(alepam) 30mg tablets comes in a bottle of 25 and 50... the 50 is an authority script, while the 25 isn't. I asked this when i was getting them because i wanted something that worked quicker and suggested lorazepam and clonazepam.... my GP(at the time) said he'd be happy to give me lorazepam, but not clonazepam saying that it is only for epilepsy8) I didn't go for lorazepam because it's not under the PBS, and didn't want to spend $40 at the time, so i just said i'll settle for the oxazepam and asked if it came in more than 25 and he said no... So i caught him in 2 lies... the epilepsy excuse was because he didn't want to authorise me a script for 200 clonazepam tablets, and the blatant outright lie of telling me that oxazepam was only available in 25 when i knew better... he was just avoiding giving me an authority script... i found that quite amusing actually.

Yeah I have a friend who gets ativan, they are pretty good but I don't think its worth paying 3or 4 times what my valium costs to fill.

I am surprised PBS only covers bottles of 200 clonaz. What a relief you can be taken off the doc shoppers register, that isn't quite as unfair as I thought if a person isn't blacklisted for life or anything. I still don't think past behaviours should be allowed to get in the way of medical treatment though.

For those that aren't so experienced in the matter, what is the difference between an authority script and a non-authority script?

Authority scripts are for medicines that are used to treat more specific conditions or when you need a higher dose than normal or repeat scripts. It just means they need approval from the Government basically, sometimes the doctor can put a code on the prescription to certify you meet eligibility requirements for that medicine, in other cases they get approval over the phone.

I think most of the more recreational medicines would be authority scripts but I am not sure. Like I said, I can go fill a one off for 50 5mg valiums and that doesn't qualify as an authority script, by contrast I am pretty sure that xanax bars are authority scripts but am not 100%.

^ An authority script needs to be... authorized by I think the TGA before it can be given to you.

http://www.medicareaustralia.gov.au/provider/pbs/education/pbs-and-you-manual/authority-required.jsp

That explains the differences.... if anyone's still wondering.

I've never had DXM before but just tried 180mg about an hour ago, and just had 20mg of oxycodone(chewed). I need to stretch out my oxy script and i've never really tried any potentiating except grapefruit juice. Not really expecting much, but we'll see. A friend of mine, my psychanaught buddy, had a bad experience with DXM once, and i've always been hesitant to use it recreationally... we'll see how this goes

I just had surgery for the exact same thing, a bucket-handle tear of my lateral meniscus, they gave me 80 hydro 10s and 60 hydro 5s and also 50 tramadol 50mgs x 3 refills

^^^^Oh really? Well i see a specialist in august and then will probably need surgery... and i'm not sure how long i'll have to wait, but i know it aint happening soon.

so how was your knee before the surgery? were you in a fair bit of pain? and how was the op? is it a basic kind of operation, or more complex?

keep me posted on how you're going with it Fatstep... i'd be really interested on your progress and would much appreciate any updates : )

Thanks for the link on authority meds Sublimit, I was prescribed some neuroleptic yesterday and for some reason it was an authority script, it was weird.

I agree with the idea that doctors should have a duty of care on behalf of their patients. At the end of the day, they are there to assist you. You are paying for a service, and unless you make it extremely obvious that you are a drug addict looking for stonger meds, I don't see how it should be up to the GP's discretion to decide whether or not to treat your pain in the proper manner.

The guy I'm now seeing is very understanding when it comes to pain management. My tooth/exposed nerve ending condition has worsened since the temporary filling fell out, and more of the same tooth broke off. Basically, because the nerves are exposed now, anything that touches the affected area causes overwhelmingly sharp pain - including eating, drinking fluids and even air when I breathe in. To top it off, an abcess has formed underneath the said tooth. So whenever any downward pressure is applied it pushes down on the abcess, meaning more pain. The filling broke off this morning, around 6.00am. Woke up screaming at the top of my lungs, declined to go to the ER because I can't afford the time off work. Instead, drove to my Aunts' place. She's an RN and has had tounge cancer, poor thing. Anyway, she had a bottle of oral morphine (unsure of the concentration) and gave me two teaspoons. To date, this was the most effective relief I've had. I'm going to ask the doctor if there is some kind of derivative similar to but not as strong as that oral solution. Because it has given me substantial relief for coming up on 5 hours now.

I've got a decent relationship with this guy so I've booked in to see him this afternoon. Just going to explain what has happened since the last visit and ask him straight up what options I have. As explained in one of my previous posts, there is a 4-week wait leading up to my appointment with the specialist. All I'm after is a temporary solution until I can get it looked at professionally.

Sublimit said:

http://www.medicareaustralia.gov.au/provider/pbs/education/pbs-and-you-manual/authority-required.jsp

Click to expand...

Thanks for the link dude. Really helpful!

Apparently morphine hydrochloride/sulphate and oxycodone hydro/sulph are both listed in the restricted category; meaning, to quote from the page:

"Medicine which can only be prescribed through the PBS if the prescriber is satisfied that the patient’s clinical condition matches the approved therapeutic uses as determined by the PBAC (this medicine will be identified in the Schedule as a restricted benefit)."

After further exploring the PBS site, I came across the latest schedule (effective as of 1st June 2010), and it seems the conditions more or less have to be the same for both oxycodone and morphine.

Here's an excerpt from the latest PBS schedule regarding the conditions for prescribing them:

Morphine: Restricted benefit. Severe disabling pain not responding to non-narcotic analgesics. Authorities for increased maximum quantities and/or repeats will be granted only for:

(i) severe disabling pain associated with proven malignant neoplasia; or


(ii) chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months; or


(iii) first application for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner, and the clinical need for continuing narcotic analgesic treatment has been confirmed. The date of the consultation must be no more than 3 months prior to the application for a PBS authority. The full name of the medical practitioner consulted and the date of consultation are to be provided at the time of application; or


(iv) subsequent application for treatment of chronic severe disabling pain not responding to non-narcotic analgesics where a PBS authority prescription for treatment beyond 12 months has previously been issued for this patient.

Oxycodone: Restricted benefit. Chronic severe disabling pain not responding to non-narcotic analgesics.

Points (i) to (iv) are identical to above.

So I guess based on this information, one could assume if a doctor prescribes someone with oxycodone tablets and they are not responding to it or other non-narcotic pain relievers, he/she is entitled to reach higher up the opioid chain...for example, morphine sulphate IR or SR tablets. Or vice-versa of course. In other words, they don't have to jump through any extra hoops to have access to stronger classes of opioids? Hmmmm I doubt this is the case, and I'm sure I've misread or skipped something in there!

What do you guys think?

^^^^ no worries mate.

thats an interesting subject.... the first application for treatment beyond 12 months is something i need to familiarise myself with.

its a matter of what the doctors first line opiate of choice is relative to the type of pain/injury/illness a patient has imo. I want to find out what my doctors 2nd choice is and ask about the benefits of cross tolerance in a suggestive way. i have no idea of knowing what his opinion on morphine is, but we were talking a little bit about oxycodone and how it was like morphine and heroin, and now i feel i can come back and ask him more specific questions and also add my own bit of knowledge. I could tell him that i read that oxycodone is stronger than morphine, and that i want to switch opiates for a positive effect on my tolerance.

I have no complaints about oxycodone though and i'm not sure if my reasons will be enough to warrant having my medication changed. will be interesting to see if my doctor indulges me or not

Edit: 100 posts.... Go Australia!

What kind of things are oxycontin 80s perscribed for? Cause they're pretty fucking strong and i thought they'd be rare but they seem to the only pharm opiates I find.

Doctors are way scared of perscribing opiates especially with the crackdowns that happen. Just talking to a doctor I know there's alot of bullshit everytime a decent opiate is perscrbed. Also many docotors are ignorant and Overstate the negative effects eg. Saying codine is terribly strong and addctive. Some of the shit they say in my medical science course makes me laugh at how overstated it is

Sublimit said:

^^^ hey Leftwing, just using a basic opiate converter which says 32mg of HM a day is the same as around 130mg of morphine a day(both orally)... does that seem accurate? Anyway, yeah i appreciate having knowledgeable discussions with a GP. It really does show that they have you in their best interests, and they're not just going through the motions to get you back out the door for the next patient.

Click to expand...

that seems about right, i hadn't bothered to check myself to be honest. my point was not liking my overall larger opiate tolerance. i've decided to cut morphine out of my meds as of 2 weeks ago; i've been getting stabilised and comfortable with a tramadol and oxy combo, along with valium and baclofen for muscle spasms and relaxation as well as anxieties.

Sustanon said:

Just wondering has anyone ever tried to IM OC's before? Is it prepared in a similar way to IV? Dont really want to go down that path at all. Also just out of curiosity how would one make rackable powder out of morphine vials? Same method as K? Just evaporate?

Click to expand...

fuck no, man. don't ever IM any kind of pill even if it has been passed through a micron filter. that's asking for an abscess at least. the insoluble particulates are likely to contract an infection.

skatkid said:

What kind of things are oxycontin 80s perscribed for? Cause they're pretty fucking strong and i thought they'd be rare but they seem to the only pharm opiates I find.

Click to expand...

as it says just above, chronic pain. whether that be a spinal condition (me) or cancer or whatever. you have to be in a substantial amount of pain and have proof. ie - xrays, mri's, etc

only 4 more months until i see a specialist and pm doc again

Sublimit said:

^^^^ no worries mate.


I have no complaints about oxycodone though and i'm not sure if my reasons will be enough to warrant having my medication changed. will be interesting to see if my doctor indulges me or not

Click to expand...

I tried 100mg of oxycodone the other day (medium opioid tolerance) and wasn't really that fussed with the buzz to be honest. I found it was completely different to the high obtained from a ~400mg codeine hit (or a 40mg oral morphine hit) from a CWE.

The oxy high felt like a warm blanket over my whole body, took a while to come on and lasted for around 2 hours. Didn't feel very heady, it was more like my body felt lighter - but it also felt somewhat cleaner than a codeine buzz.

IMO after that I still definitely prefer the morphine/codeine over oxycodone. Thinking about it, the reasons could be:

* The fact that morphine and oxycodone are metabolised by two different enzymes; namely the cytochrome P450 system for oxy and UDP-glucuronosyl transferase-2B7 for morphine (UGT2B7).

*One is a naturally-occurring opioid, the other is semi-synthetic.

*Morphine has a higher binding affinity for the Mu opioid receptor than oxy and is faster-acting on these receptors.

*Morphine exerts its effects mainly in the central nervous system and the spine whereas oxycodones metabolites are distributed to skeletal muscle, the liver, intestinal tract, lungs, spleen, and brain.

The effects of oxy were enjoyable and it felt like I was floating on air whilst walking around. For me it seemed to focus less on the brain and more on the body as a whole

^ Was it continuous release? If so and you didn't break the time release, that may be why it took a while to come on but it would last a while as well.

I don't see how being metabolized by a different enzyme would affect the high for you, and for your information morphine is metabolized by the P450 system as well. In fact, all the methods for prolonging a morphine high pretty much work on inhibiting this metabolic system of the liver.

Naturally occurring shouldn't make much of a difference either.

A higher affinity sure could make a difference, and morphines greater histamine action probably has something to do with morphine's effects on how it makes your body feel and why you prefer it and codeine.

As for distribution through the body, where did you find this information? All drugs are distributed through the body via the blood stream, they have effects where they can find receptors to bind and there are opioid receptors throughout the body. As I stated though, oxycodone does have less of an affinity for the histamine receptors then morphine.

As for coming on, I always though oxycodone and morphine took roughly the same amount of time to come on. You could try plugging if it took too long for you.

Cr1spy: What strength oxy was it? Ur supposed to lick the coating off it totally if one would be using it other than pain management. I usually keep it in my mouth until the pill is white with no green color on it (80mg). The effects wear off quite quick tho. Few hours and thats it. I usually dose at nite then i just fall asleep (nod) after.

^the coating on oxycontin tablets have nothing to do with the time release matrix.

^ leftwing, come on MSN! :D

Cr1spy said:

I tried 100mg of oxycodone the other day (medium opioid tolerance) and wasn't really that fussed with the buzz to be honest. I found it was completely different to the high obtained from a ~400mg codeine hit (or a 40mg oral morphine hit) from a CWE.

The oxy high felt like a warm blanket over my whole body, took a while to come on and lasted for around 2 hours. Didn't feel very heady, it was more like my body felt lighter - but it also felt somewhat cleaner than a codeine buzz.

The effects of oxy were enjoyable and it felt like I was floating on air whilst walking around. For me it seemed to focus less on the brain and more on the body as a whole

Click to expand...

in my experiance to really compare different opiates you need to use them quite a few times and not go off a few experiances.

like others have asked, did you take 100mg of oxycodone orally and did you crush it up or chew it to make it instant release as opposed to continuous? that would be a big difference, but even so a 100mg ocycontin taken whole should be way more recreational than either 400mg of codeine and 40mg of morphine. when i chew a 20mg oxycontin i find it very similar to taking 2 20mg whole albeit it takes slightly longer to kick in. Taking IR oxycontin orally is like clockwork... 45-50 minutes empty or full stomach doesnt make a difference to me it seems. I'm starting to enjoy the whole oral process very much now. If i wasn't IV'ing them i'd have to snort them, but now i'm getting used to taking them orally and would never go back to snorting them.

It's funny because i'd say i'd get the same euphoria with codeine and oxy... both nice warm fuzzy feeling in my head, but codeine euphoria lasts way less than oxycodone. I'd say that 160mg of codeine is similar to 20mg of oxycodone euphoria wise, but when it comes to body load, analgesia and duration, oxycodone is far superior IMO. Morphine i can't really comment about because i've only ever had it when my liver converts 10% of codeine to morphine.

I ran out of oxycontin a few days ago and i'm not due to see my GP for a refill, which should have lasted me a month, until mid next week. I'm seeing him on friday to talk to him about increasing the dose and maybe adding another opiate for breakthrough pain. I tried to kick cold turkey, reducing from 20mg of oxycodone 3 times a day to 10mg twice a day and day 1 was pretty bad, and on day 2 I had had enough and started to think about going to the chemist and get some rikodeine and panadine... but then i just decided to get on and score some H, just one hit worth.... man even though it was the size of 3 match heads it was one of the best tastes i've ever had... i could feel the endorphins rushing to my lower back and the relief from WD and pain in my back and knee was a godsend... I saw a walk in GP and got some tramadol, then bought some panadine and rikodine and today I had 300mg of trams and just before i had my usual 160mg of codeine... It's completely masked the H/oxycodone WD as well as analgesia so i should be right for friday.