Is opiate addiction really so bad?

[Nicomorphinist]

Dr. Nicomorphinist, what do you think of the comparative effectiveness of opiates for treating depression vs SSRIs?

The opioids for depression research being done recently with oxymorphone, morphine, and butorphanol is focussed upon treatment-resistant depression, with good reason, of course, and there are all sorts of pharmacological reasons for the anti-depressant action of narcotics. The various anti-depressants help many people as, when you get right down to, there are as many types of depression as there are patients, well, more actually, and there are the co-morbid conditions. I am fairly sure that many addicts and habitués self-medicating depression and other things, and what are the psychological components of withdrawal but depression and anxiety which go and hide for a few hours and comes back? And there are some people who are helped getting off of other drugs like C-Jam and alcohol by switching to narcotics and that was an official indication for them up to 1914 at least in the US and was commented upon by many doctors like Dr Freud.

I have noticed that people I know with depression have been helped with hydrocodone in particular to a degree which is greater than its relative analgesic strength to other narcotics, which is why I think that the 22. August 2014 reclassification of hydrocodone products of all kinds as Schedule II in the Controlled Substances Act 1970 in the United States was a particularly treacherous action called for by the rehab gangster establishment. Oxycodone also has stimulant effects which some including William S Burroughs and some of the inventors of it in Germany in the 1920s say are like that of Bolivian Marching Powder. That it lasts much longer might help with some things.

They certainly can have effects which reduce pain because all of the inter-connectedness of analgesia, anti-depressant effects, and euphoria -- they will never invent a non-euphoriant strong analgesic and only get halfway there with things like nefopam and narcotic-potentiator combinations like morphine and other narcotics with tripelennamine, nefopam, naproxen, and orphenadrine, which has been working for me practically since the various ingredients (well, not morphine, which was discovered as the main active ingredient in opium in 1804 in what is now Germany by Friedrich Wilhelm Adam Sertürner, or hydromorphone (Dilaudid®, 1922) and nicomorphine (Vilan® 1904, patented by Pongratz & Zirm in March 1957) and so forth.

And people keep doing something like relieving their pain because they like it. The use of narcotics as anti-depressants, anxiolytics, and sometimes as the kind of psych med that works by knocking someone on their arse for 18 hours from prehistory to very recently is for obvious reasons and has not been replaced in my humble opinion are self-medicating depression with narcotics and other drugs with the sought functions like gabapentinoids, anticholinergics, stimulants, dextromethorphan (structurally an opioid -- it is related to Levo-Dromoran®) benzodiazepines . . . many of which are historically psych meds or even now.

What I have heard from people who have been on one, the other, and both at different times, well, like other folks who have been on medications of the general type, firstly illustrates the complexity of Selective Serotonin Reuptake Inhibitors and the parts of the human body with which they interact very well and they are used for an incredibly complex affliction of a very large patient base . . . a favourite quote of mine from long ago about various political organisations, movements or whatever is that if one asked a certain question of 20 people they would get 36 answers, some of which are diametrically opposite . . . get 20 patients and the 5 most common SSRIs and a group of researchers will probably have several thousand results in a manner of speaking, some of them taking very long to manifest and staying around for even longer, others not so much.

Secondly, they are of course more complex than the Tri-Cyclic Anti-depressants, but there are things in common too. Thirdly, I do think that the very common situation where it takes many weeks to see if an anti-depressant works, finds out that it may not, then having to withdraw it and inaugurate the new one over several weeks is very concerning -- it is horrible for the patient, often with economic consequences, and something which can be trialled and ruled in or out quickly. Also since insomnia is a potential matter which contributes to depression, anxiety, and chronic pain.

Selective Serotonin Reuptake Inhibitors, like TCAs, are used along with morphine especially as potentiators such as Cymbalta (duloxetine), an SSRI which was designed on the basis of a commonality in the structure of some other drugs like antihistamines, with tripelennamine, chlorpheniramine, and diphenhydramine being the big antihistamines whose structures pointed out things to be used in SSRIs and other such drugs and doxylamine being a very close relative of some other psych meds. And those antihistamines and TCAs are often used as narcotic potentiators and many have their own analgesic potency which can be in the naproxen range. As are gabapentinoids . . . and there are drugs which lie in the zones of overlap, like the tricyclic skeletal muscle relaxant

I am still digesting the new theory that depression can linked to inflammation; it does make sense, of course . . . anyone who deals with depression and/or has loved ones who do knows that it hurts like the dickens in the emotional sense, is a condition which is often misunderstood, and the cost for humankind in general is very high and there is apparently nothing illusory about the apparent increase in incidence and prevalence all over the place in the past couple of decades.

 

[Cream Gravy?]

^You're a well read scholar my friend. I agree that the current assumption that SSRIs are a cure all answer to depression and anxiety is a shot in the dark at best and dangerously debilitating /given to increased suicide rates at worst. I know from personal experience that they are dangerous and for that reason I won't even see a psychiatrist any more for anxiety or depression. They all insist I need an SSRI/SNRI but neglect the fact that I've tried many and they only hurt me, increase my insomnia, and have a pension to increase the pain in my gut I have due to multiple forms of IBS.

Opioids and BZDs and occasionally cannabis along with dissociatives in general are the only drugs I have found effective at relieving any of my pain/IBS/depression/anxiety symptoms. Yes, they probably do it by making me feel good. Is that so evil? Did God put me here to suffer when he helped mankind to create so many alternatives to pain?

 

[wizardknight17]

I'm not sure what has and hasn't been said yet but to throw an opinion in.

Opioid addiction IS really so bad.

Opioid dependence however has the opportunity to not be.

I was on norco, oxy , fent patches, and tons of other shit for years with no real problems. The problem starts when you switch from being dependent to being addicted.

I made it about 4 years up to about 450-500 MME before my real problems began. You don't really notice the down side until you reach the breaking point of not being able to keep up the habit.

 

[xaddictx]

I think it's also important to note that the physical toll it puts on your body is not nearly as comparable to other things (like meth, cocaine, alcohol), so perpetual use doesn't seem to cause nasty side effects like the others allowing users to hide their lifestyle for a long time. I've heard that the brain is altered, but returns to normal after quitting completely? Only in severe heroin addiction cases have I heard that the brain does not in fact return fully, but I don't know much about that subject.

Seed tea would be much harder of an addiction to maintain, as people literally avoid going on vacations or traveling because of the withdrawal being so crippling severe. I've decided to stay away from that stuff also because my tolerance isn't the largest and it could easily become dangerous for me to dabble in.



I'm sorry to hear that. I totally understand how it can get out of hand on the stronger ones. Hope you're doing well these days. What is O-DSMT?

O-Desmethyl-tramadol

 

[Nicomorphinist]

There is some degree of co-morbidity of depression and addiction which could be for the reasons I discuss above, and also the flip side of the basal hedonic tone issue is that this important set-point seems to be on a bell curve normal distribution so there are ostensibly an equal number of people with a bright or even morphine-y default outlook as I seem to have, which also would be something which may make the person less addiction-prone in a number of ways . . . Maybe the GP and pain doctors would not have let out as great a length of leash when it came to prescriptions and so forth, but I certainly can visualise a situation at least abstractly that being on high doses of strong narcotics which make an obvious difference in the pain level round the clock can go off the rails for some people too, as can anything . . .but even that requires a supply bottleneck to create the problems that create the visible narcotics addict, otherwise it is merely the physical dependence and tolerance. One thing which would be good to determine is what exactly may be a clear-cut answer as to is the best way to turn an existing addiction into the more benign habituation which is the lot of nearly all people who take opioids and the like round the clock.

This is something which may be simple and already done in some cases as there are indications for using methadone, and in some countries levomethadone, and slow-release morphine, dihydrocodeine, dextropropoxyphene, hydromorphone, and/or tramadol, for maintenance treatment of addicts with a diagnosed chronic pain condition -- not, as some people want propagandists want people think, taking the patient off of all narcotics. Dimenoxadole is the subcategory prototype for the phenaloxam benzylic acid derivative methadone-type open-chain opioids, still used in some countries as Estocin, which I think could be a good agent for switching over as well for people allergic to morphine derivatives. The analgesic action of methadone and levomethadone goes away much more quickly than the cravings suppression and other effects sought for detoxification of course, and can be as short as four hours, so methadone is not perfect and the advantage of levomethadone has more to do with cardiac effects like QT lengthening and to some extent neurotoxicity as well. Another subcategory prototype, dipipanone (Pipadone, with cyclizine as Diconal), could be used to counter cravings in these folks too and the dimeoxadole used for the round the clock maintenance, especially if they could make a sublingual tablet with dipipanone plus hydroxyzine, an antihistamine which is a stronger relative of cyclizine often used clinically as a narcotic potentiator. Phenadoxone is very similar to dipipanone and an existing often sublingual medication already in existence is a fairly close relative, dextromoramide, sold as Palfium and Jetrium in various countries, as is phenadoxone.

This all seems to be the missing piece in benzodiazepine habituation and addiction apart from the physical dependence and/or rebound probability of benzodiazepines and similar drugs to varying extents about which I have always been wondering. Other sedatives, gabapentinoids, dopaminergic stimulants, as well some anticholinergics, first-generation antihistamines and other psychotropic medications could follow a pattern with elements of both that and narcotic habituation . . . The difference in benzodiazepine addiction rates in one country versus another could have something to do with the average stress level in those locales as well. The statistic that 57 per cent of US residents cannot handle a $500 in surprise expenses and 76 per cent could not come up with $1000 without making some other kind of arrangement is an example of something which would probably send me over the top with anxiety more or less daily . . . the 83 to 87 per cent of US residents and maybe some degree of a majority in other countries who hate what they do jobwise is maybe an even better example, especially when the answer to making the situation better is more like "Well, we could replace you people with a machine or outsource the department to North Sentinel Island or wherever" and certainly for people who have already had that happen to them . . . I know people who were out of work when the offices and factories closed for those reasons who simply ate themselves to death and others who had mental difficulties develop or suddenly surface and when even the patient misunderstands what is happening, it is an extremely thorny matter with which to deal for all involved.

All of this, of course, is why when they have bled the fake opioid cri$i$ dry that benzodiazepines and gabapentinoids, psych meds and/or CNS agent meds all, are probably next, and I could even imagine a general war on insomnia medications as we saw with the change in controlled status of carisoprodol in a number of countries from 2005 to 2015 or so, something every bit as wicked (in a bad way) as the foolishness surrounding narcotics, as we all know. I am not sure what English word denotes the boundary land betwixt greed-driven tomfoolery and wretched treacherous sadism, but it describes the effort against carisoprodol and carbamate sedative-hypnotics well in my opinion as well. It has ignorant, outright mistaken, and informed variants to it like anything requiring public policy changes. The same three-headed monster is what is behind drugs testing of employees I think, as there is no straightforward accounting rationale for it. The only possible benefit from drugs testing comes from the fact that unquestionably a zero per cent accident rate is imperative for aeroplane pilots and some other professions where close does not count, though even that also has its public relations, personnel, and political components to it as well. The outright mistaken part of it has some connexion to the absolutist school of opposition to anti-depressants as well. Whatever problems they can cause, and the lack of clear superiority to the drugs which preceded them, all psych meds help at least a moderately large group of people percentagewise and in absolute numbers or they would not be sold, much less sold as being psych meds. The extremely involved and prolonged and expensive approval process for all drugs in practically all locales are a major reason for the expense involved for everyone in the process, though I would think that experimental medications should be easier for doctors and academics to obtain and give to patients who give informed consent, as would be, for example, the off-license prescribing process for uncommonly used and esoteric medications which are or have in the past been used for the conditions. There is a capsule of one of the SSRIs and maybe other prescription drugs of the same general type by now too which sends a message via to smart phones and computers when it is in the stomach which are one of most expensive drugs of all, something like €50+ and US$50 to $125 a dose.

A good relationship with one's doctors and pharmacists (open communication being the big thing) and thorough documentation on the part of doctors is the most effective means of preventing most of the iatrogenic addiction (physical habituation occurs just as surely as swallowing Syrup of Ipecac will make the patient blow chunks) which does occur. Iatrogenic addiction is much less common than the propaganda these days says, and my guess is that it follows more of a pareto distribution instead . . . also, both patients with pain and addiction (and any number of other things -- I have had great results with chasing down allergies, such as that which causes hives from yellow food dyes, and in my case seem to have a moderately strong correlation with gastric reflux at high doses, for instance) definitely can be helped by keeping a combination medication log and daily journal of the symptoms and signs.

I have never seen "euphoriant" as a drug category in monographs, package inserts and so on alongside antihistamine, anti-emetic, antibiotic, antacid and so forth, but euphoriants really help all sorts of people, don't they? opioids in particular come from a poppy which is certainly renewable, and the synthetics have precursors which originate in plants as well, so there is no economic reason to deny people this assistance. People have a human right to freedom from pain, and if it medications are part of the equation, why not? Aside from people who make their money on more people being in drugs rehabilitation, who does it hurt?

 

[GetMeOutOfThisCRAP]

I'm not sure what has and hasn't been said yet but to throw an opinion in.

Opioid addiction IS really so bad.

Opioid dependence however has the opportunity to not be.

I was on norco, oxy , fent patches, and tons of other shit for years with no real problems. The problem starts when you switch from being dependent to being addicted.

I made it about 4 years up to about 450-500 MME before my real problems began. You don't really notice the down side until you reach the breaking point of not being able to keep up the habit.

It's tricky because I think any addiction has viable pros and cons and hence addicts struggle with quitting because of the beneficial parts of whatever substance(s), obviously the negative side effects are just considered a toll for using them. 4 years is a pretty long time because some users can ruin their lives with opiates in less than that time. Out of curiosity, what was the breaking point for you?

Opiates are a fantastic antidepressant at times but on the flip side they seem to cause depression with perpetual use, maybe because of some sort of physical aspect of how it affects the brain. I've seen several people say that it's the only antidepressant that works for them out of everything in existence. But sometimes it can be beneficial to feel good even for a brief moment because then you feel refreshed, and can go back to fighting whatever is going on in your life. Relapsing during withdrawals in a way gave me a good break so I can build my spirit up again for fighting how long it is. I think with perpetual use it comes down to balancing out your life. Obviously the times I just stayed indoors on substances not really being productive I became quite depressed. It's hard to gauge when a substances is ruining your life but there are always key moments where it's a slap in the face. I think for the lifestyle to work for someone with opiates you'd need to be able to back off at the right time, and that's something that can be really hard to do at that point. But for sure some people have the lifestyle figured out and won't face consequences even with something ultra potent like heroin. Those users might be the ones that are quite active in life and are able to balance out work versus pleasure. The thing about opiates is like anything--if it's the only thing you're doing it will start to become baseline and suck, so you'll be taking more when it only makes your situation worse. It can become quite dark if the only thing you're looking forward to when you wake up in the morning is medicating yourself. That's when they become your entire life as opposed to "enhancing it." I think if I was on harder things, I'd probably have an opposite opinion. I just don't want to take it to the next level and live with something unmanageable.

 

[Nicomorphinist]

That's right -- the cases everyone hears about are of cases of addiction which becomes visible for reasons related to what separates the addict's case from benign habituation, such as crime or economic problems stemming from have to source a drug through a clandestine channel . . . there are others who do not have trouble getting their narcotics and may be even slightly less prone to violent crime than the general population because of the sedative effects of narcotics and not wanting to encounter the law . . . other than that, basically track marks from old re-used equipment or poor technique is what shows up, as well as constricted pupils, but I would think 80 per cent of the population cannot keep straight whether it is constricted or dilated pupils which are caused by narcotics . . .

But we also have the fact that if someone is in pain which is not being treated correctly, of course they will want to seek out a means of dealing with it, the most efficient is usually a comprehensive approach which has narcotics as one of the spokes on a wheel. There is morbid seek orientation for drugs, and there is seek orientation which is not morbid, and which disappears when the pain is correctly treated. And many people don't know enough to be able to distinguish that, especially politicians and media people. The first cause and highest source of the misinformation are wretched and evil disinformation peddlers who often have a financial interest in one part or another of the whole thing . . .

 

[GetMeOutOfThisCRAP]

I think it's important to note that different drugs cause different people to lose control. I've always feared and respected opiates since the very beginning because of their monstrous stigma and the frequent rate of overdoses. My tolerance never raised too much because of this, and also my span of using has not been the longest in comparison to some people. Not taking a holier than thou approach whatsoever--totally not my intention. I made this thread with having in mind wanting to hear real experiences from real users and how their lives have been positively or negatively impacted. Opiates are a highly complex topic with so many outcomes.

Everyone has a unique reason for delving into the opiate world. Some people legitimately have crippling chronic pain while others use them for euphoria/their anti-depressive properties. But for example, I have no desire to ever use benzos again and I can't remember how long it has been since I've touched alcohol. However, stimulant pills make me absolutely mad. I'll take 20 mg with the mindset of keeping it there for the entire day and end up gobbling a crap load just in time to be zombied out before something important. I can't control my stimulant usage and I simply can't find a reason why I always take it to extremes, and it doesn't seem like I abuse them for a lack of something within myself. I simply become obsessed with redosing and the need to constantly feel good. My two love affairs are opoids and pharma stimulants. I've actually found painkillers up to this point in my life a way more manageable addiction than stimulants for unknown reasons, while most would probably find opioids to be a lot more compelling/addicting. I hope that I can find the willpower to control my stim addiction or finally grow up and breakup with stimulants. I will never touch meth I swear to god. . . I'm glad I have limited access to stims so I run out very quickly and then live the rest of the month like a normal functional person.

Sorry I got off topic. I guess my point was that redosing with opiates is different for the individual too. Adderall consistently feels good to redose on but for some reason there's a pleasure threshold for me with opiates so if I redose there's usually no point since I barely gain euphoria. Not sure where these addictions will take me--probably nowhere good. One has been able to remain hidden but the other is way less frequent and much harder for me to hide. Hopefully one day I will not need any substances at all, tis my end goal.

 

[Nicomorphinist]

It is possible for a narcotic bender to cause an intermission for a few hours because the user would fall asleep, which of course does not happen with stimulants, which is why stimulant benders end when the stimulant is gone and even those experiments where mice and rats and monkeys redose themselves with C-Jam or Crank until they fatally overdose themselves with them. Oxycodone may have enough of a central stimulant effect on some people to give it some of the same qualities, but the phrase "narcotic bender" is not one that one sees very often. Alcohol has enough stimulant effect to cause binge drinking although some people seem to go on benders specifically to black out . . .

 

[Olivia Nicole]

That's right -- the cases everyone hears about are of cases of addiction which becomes visible for reasons related to what separates the addict's case from benign habituation, such as crime or economic problems stemming from have to source a drug through a clandestine channel . . .

Assuming a change in the law that allowed for legally prescribed heroin, why should anyone be put on methadone and not given their necessary dosage of heroin.

I was on methadone maintenance treatment twice, the first time when I was pregnant. The doctors/nurses never explained to me why it would be preferable from a medical/scientific perspective for my daughter to be born possibly addicted to methadone rather than possibly addicted to heroin, (she turned out incredibly healthy and beautiful; going to be 6 years old in two weeks!)

I’m guessing it had more to do with the danger of withdrawal during pregnancy. There is essentially no risk of withdrawal on methadone.

 

[Nicomorphinist]

Assuming a change in the law that allowed for legally prescribed heroin, why should anyone be put on methadone and not given their necessary dosage of heroin.

I was on methadone maintenance treatment twice, the first time when I was pregnant. The doctors/nurses never explained to me why it would be preferable from a medical/scientific perspective for my daughter to be born possibly addicted to methadone rather than possibly addicted to heroin, (she turned out incredibly healthy and beautiful; going to be 6 years old in two weeks!)

I’m guessing it had more to do with the danger of withdrawal during pregnancy. There is essentially no risk of withdrawal on methadone.

One rationale would be that the cravings suppression is for much longer than the analgesia from methadone which is 4 to 9 hours, and indeed the up and down cycle from short-acting narcotics can be debilitating but people on methadone and levomethadone still have cravings anyways . . . One other rationale is that methadone can effectively be administered orally and there are a lot of experts who say that breaking the needle fixation is important, but of course, there are non-injecting heroin users, and it is possible to do injectable prescriptions, even IV ones, so they can make sure the injecting user has the best possible injection technique.

I may be mistaken, but I have not heard of methadone doctors complaining about heroin prescription in the UK, Canada, or Switzerland the way rehab racketeers are always squalling. There are people who do better with methadone or levomethadone and certainly it should remain an option, but I would think that if one is going to maintain or detoxify someone from opioids that they should give the patient their drug of choice then transfer over to the long-term agent, and unquestionably they can make an 8, 12, 18, 24-hour tablet of heroin for people who want it. Even with it being metabolised in minutes to morphine, users of all types can tell morphine and heroin apart -- heroin is an ester of morphine as is nicomorphine, which is obvious on injection as not being morphine as there is not anywhere near the itching and flushing from nicomorphine as there is with morphine, and IV, IM, SC, PO, SL, or PR (suppository) or in the form of insufflation powder or nasal spray I know it is nicomorphine and not morphine; years ago I did a taste test of sorts under laboratory conditions of another ester (acetylpropionylmorphine) heroin (known for medicinal use as diacetylmorphine or diamorphine) morphine, dihydromorphine, hydromorphone, hydromorphinol, metopon, oxycodone and oxymorphone and I could tell all those apart too. Of course the experimental medication (acetylpropionylmorphine) felt a lot like both the diamorphine and they both felt a lot like nicomorphine,, which I was taking orally for pain at that point, did feel a lot like nicomorphine . . . and smack may be what floats their boat the best. I was later able to distinguish amongst morphine, diamorphine, diacetyldihydromorphine, and acetylmorphone as well. It wasn't ESP. There are just myriad objective and subjective effects of narcotics and they add up to a different gestalt and so forth.

Really the whole idea of Opioid Substitution Therapy should be on changing the economic equation for the user and improving their health. I actually remember that Dole and Nyswander and early methadone doctors said that there is euphoria from methadone and it is beside the point, the point is to stabilise the patient, not make them feel dysphoric or neutral . . .

The risks of withdrawal during pregnancy for both the mother and the baby are substantial, and in the United States, it is still illegal to use morphine for maintaining habitués and addicts from the Harrison Narcotics Act 1914, and of course heroin is still in Schedule I of the Controlled Substances Act, although a common protocol for habituated infants is to switch to Deodourised Tincture of Opium (laudanum) and taper that down as it comes in drops, whereas even liquid methadone, which does of course come in liquid form, three different concentrations in some countries for detox/maintenance, pain, and coughing, is harder to dose to an extent which perhaps makes it dangerous, and there is so much variability in metabolism of methadone that it is certainly more marked for someone who weighs 3-4 kilos or so. Oral morphine, which comes in at least six different concentrations of seven salts of morphine (not all 42 in one place as far as I know) is 10 times stronger than DTO. Women I have known who had babies who have been on, under medical supervision for pain, morphine, hydromorphone, thebacon, phenadoxone, and medicinal opium, and more of them had babies who were detoxified with DTO than were the mothers' prescribed painkiller (phenadoxone, morphine, and hydromorphone) or liquid morphine, which when it had been used was mixed up by pharmacists in the dispensary with compounding powder or diluting the 1 mg/ml liquid which comes in smallish bottles and has sugar in it and sometimes orange, lemon, strawberry, or cherry flavouring, though the dispensary has flavourings as well.

 

[GetMeOutOfThisCRAP]

It is possible for a narcotic bender to cause an intermission for a few hours because the user would fall asleep, which of course does not happen with stimulants, which is why stimulant benders end when the stimulant is gone and even those experiments where mice and rats and monkeys redose themselves with C-Jam or Crank until they fatally overdose themselves with them. Oxycodone may have enough of a central stimulant effect on some people to give it some of the same qualities, but the phrase "narcotic bender" is not one that one sees very often. Alcohol has enough stimulant effect to cause binge drinking although some people seem to go on benders specifically to black out . . .

Can I ask how are you so knowledgable on these topics/are you in the medical field? You don't have to answer if that's an invasive question though ;p Out of curiosity, what do those who suffer from depression say about stimulants in regards to improving or hurting their lives? Are there clinical trials that you know of about stimulants in this manner?

 

[Nicomorphinist]

Can I ask how are you so knowledgable on these topics/are you in the medical field? You don't have to answer if that's an invasive question though ;p Out of curiosity, what do those who suffer from depression say about stimulants in regards to improving or hurting their lives? Are there clinical trials that you know of about stimulants in this manner?

I come to it more from the pharmacology, toxicology, pharmacy & medicinal chemistry side academic and otherwise, and have been a chronic pain patient for several decades . . . There have always been oodles of doctors, nurses, radiologists, pharmacists, organic chemists, and veterinarians in my family and amongst friends, associates, and so forth, and also I started working in one of the family businesses which was sort of betwixt a set of regular and compounding pharmacies and little pharma perhaps which were in different locations first as a technician and then as what in today's business parlance would be called a compliance officer with a lawyer, scientist, and General Practitioner being the rest of that department, and amongst the usually four of us spoke and read something like 20 languages making it possible to keep on top of the academic, legal, and general purpose news and documentation. This was starting right as the Single Convention On Narcotic Drugs 1961 and a number of new national drugs laws were being formulated.

So with that what I did was research and development I guess as we also, along with several of the pharmacists and chemists, worked on efforts to find and work with inventors and others who had new ideas -- I kept up with the current regulatory laws and so forth in the old West Germany and East Germany, Switzerland, pre-EU-accession Austria, and the former Yugoslavia, and later the United States, Canada and Argentina. In my semi-retirement over the last 15 years or so I have amongst other things been getting degrees in history, politics, and journalism (after working my way through school as a statistician, actuary, translator, and newspaper reporter and editor back when they taught the latter on the job. The history of science, history of pharmacology, and philosophy and politics of science and medicine have always been things for which I could never get enough, partially because it is not a genre about which not a lot has been written so far.

I was already nearly crippled by arthritis in multiple forms when I was fairly young, so my six months compulsory military service was nine months working in hospitals, universities, firms and so forth, originally helping design studies and doing research. One place kept me on at the end of the nine months . . .

Back then, what we now know as Post-Traumatic Stress Disorder was something very common even in the general population so I always had protocols and medications as well as the politics of the whole thing amongst my interests, in addition to pain, of course. The increase in incidence and prevalence of depression and bi-polar conditions is of course very alarming too. People always said I should become a psychologist on account of the knowledge I already had and temperament and being a good listener and so forth, but there was something I didn't like about the way the profession seemed to be headed on both sides of the Iron Curtain by that point. There were the power dynamics, some corruption, and trouble with government meddling, such as what they did to Dr Wilhem Reich and the fashion for calling people with whom they disagree mentally ill and so on. There are the same kind of problems as with calling everybody a troll now, on top of the fact that the public and even in some cases professional and certainly governmental knowledge about mental health is abysmal and I don't think it is improving, so people who want to change something in that part of their life have stigma, defamation, superstition and misinformation making the situation for them so much worse, pretty much no matter what it is.

Addiction in my definition is the acquired endocrine and metabolic changes coming from repeated narcotic administration, which by itself is not that serious and almost pre-ordained with narcotics because of how they work, and it happens with many drugs, especially hormones, TCAs, the various selective reuptake inhibitors, yet also beta blockers, benzodiazepines, gabapentinoids, stimulants and many others -- on top of a phobia and anxiety about potential withdrawal which leads to distress and trouble for the patient which causes a morbid seek orientation for the drug(s), which is to say they are willing to do what they need to do in order to get the substance, and not do things they have to do perhaps, and all in a way that causes trouble for them. It doesn't magically happen by itself because of the presence of a substance, and is often forced on the person by pain coming back and undergoing withdrawal because of doctors being afraid or ignorant. When one is in pain, damn straight they are "drug seekers" -- and X-Ray seekers, MRI seekers, diathermy seekers, and of course information seekers, and many do not want narcotics if at all possible, even if refusing them is a foolish choice that comes back to haunt them in the short term.

All of which is to say that ⅔ of the condition of narcotic addiction, and all of narcotic habituation are medical matters -- endocrine, metabolic, neurological to some extent, and gastrointestinal -- not psychiatric. There are other addictions which are much less physiological than is narcotic addiction just because of the way the drugs work, although the endocrine part is generally always there at least due to the dopamine reward for dosing and the norepinephrine disturbances associated with many kinds of withdrawal. Although, then again, people take drugs repeatedly because it makes them feel good so that is why they do it again. Ending withdrawal symptoms, or a rebound as from some stimulants, makes the person feel better. That is why they do it. Christ, I imagine every thing from the amoeba or paramecium up in the animal kingdom is in that boat, and who knows about plants, fungi, bacteria, protists, viruses, computer programmes, and spirits and so forth? Maybe even DNA itself?

There is the political portion, which is huge, of the fake opioid cri$i$ in the United States which seems to be getting even worse which has lots of effects which spill into Canada . . . when I was shown the letter that they sent to all the doctors prescribing over 90 mg morphine base equivalent per 24 hours, I just decided that after the next time I came to Austria I would just not go back, and I know of others including doctors doing or having done the same thing, but not a lot of people have that option. I have been a chronic pain patient for almost 50 years, and on the dose of morphine sulphate ER and oxycodone IR I was on for 17 now, which is much lower than in the past actually -- so just what were these pig fucking demon snake Communist shithead gangster terrorists doing that endangered me so much. It turned out that Centres for Disease Control had to correct these attorneys general and so forth, but new shit is still happening. So what I have to figure out in April and November of 2020 is whether or not I have the Intent To Return to call back to the county clerk office where I used to live and get a ballot and send it back, or if I am cancelling out the vote of someone else who is physically and spiritually there. I am still undecided on that. On the local level, as they mail out the same ballot everyone else has, there is not much hope as a great deal of ground has been lost on this and the Republicans, MNIP, Greens, and DFL all seem to be singing from the same satanic hymn book on the fake opioid cri$i$. Codeine cough syrup was moved to Schedule II in the state implementation of the Controlled Substances Act 1970 for Christ's sake. The next state over got it even worse and there is nobody speaking out about it and is bi-partisan in that case too. Banning kratom and tianeptine was part of it all over the place too. It's pretty damn obvious what is going on

Stimulants, especially dopaminergic ones like methylphenidate, mazindol, amphetamines were also used to treat depression in the same time frame from after the isolation of ephedrine in the 1880s to the advent of tricyclic anti-anti-depressants,, and cocaine until 1910 or so, as they all worked on serotonin, norepinephrine, dopamine and so on, and the TCAs and SSRIs can interact with other things to case serotonin syndrome. So the neurotransmitter levels probably make stimulants useful and conservative doses with narcotics even more so.

On the other hand, there is always the possibility of a stimulant making someone more aware of their depression or other condition which they are trying to treat, so especially if it is feeling overwhelmed and having depression with a predominantly discoverable cause (one can point to what is making them depressed) so that is another reason to use stimulants along with narcotics like oncologists and other doctors treating severe pain do when they do, mainly to counter the drowsiness from especially a rapidly-escalating dose. Cancer, previous amputations, and the patient having lots of trouble with both orthostatic hypotension and drowsiness is the most common indication I have seen, mainly for using methylphenidate and dextroamphetamine as both treatments for the two problems and as narcotic potentiators. And of course there is Brompton Cocktail, originally with smack or morphine, cocaine and/or an amphetamine or methylphenidate, cannabis tincture or another anti-emetic, gin or reagent-grade ethanol, and chloroform water with distilled water and cherry syrup.

 

[wizardknight17]

Out of curiosity, what was the breaking point for you?

Sorry I've been trying to get back here for days but I've got a migraine that won't go away and though I can write just fine today, there's just too much for my brain to read on this post right now. Haha

And I know it SOUNDS simple but the real turning point for me was when I realized...

1. that it's impossible for me to get high enough to help my problems.

2. Understanding on a deep level that no matter how many drugs I take what goes up, must come down. And after extensive use, the DOWN part will 100% without fail ALWAYS be worse than the up part is good.

3. Living with massive chronic pain I had to learn the difference between taking pills to escape physical pain and taking them for mental pain. Mental pain has always won in the past and (it's believed) that's where addiction comes from. I had to learn how to be honest with myself and accept that I was taking them to escape reality more than physical pain.

Where to go from there I'm still not sure but I went from 8 meds including 3 separate opioids (fentanyl, oxy, norco) at about 400-500 MME a day to cold Turkey withdrawal that makes hell seem like a resort. I got clean (minus MMJ) for about 6 months to make sure I was a different person then started a pain management program again once I felt I had total control.

I know I could still slip back to where I was and know I have to watch it carefully but so far I'm doing much better than a year ago (as far as taking more than prescribed goes) in fact I'm actively trying my hardest to take LESS than prescribed and for the first time in my life I'm accomplishing it.

 

[BeachBum4u]

you know, i went from being a 2+ gram a day high quality hash smoker to not smoking at all, and i didn't really ever think about it, never could figure out why either, i never made a decision not to smoke anymore it just happened ^^

I bet you're probably wondering where did all this money come from. Although legal, in my state at least, a habit like that can be quite expensive.

 

[somnilicious]

Opiate addiction sucks. That's all I've got to say about that.... Lost a lot of good friends. It eventually steals your vitality and traps you in the land of that great , last ditched kick to escape the abyss forever that never came world... Bad news from experience. Lost a lot of good friends.

 

[GetMeOutOfThisCRAP]

Damn, 3 months totally sober on only kratom then returned back to oxy for just a tiny bit. Ended up turning into a daily habit again for the past two weeks and my tolerance has skyrocketed.

I think I take this thread back. At least with kratom I don't feel guilty about not having chronic pain when so many addicts actually need painkillers to get out of bed in the morning.

 

[Nicomorphinist]

Damn, 3 months totally sober on only kratom then returned back to oxy for just a tiny bit. Ended up turning into a daily habit again for the past two weeks and my tolerance has skyrocketed.

I think I take this thread back. Should probably switch back to kratom again before the withdrawal from hell claims my soul. At least with kratom I don't feel guilty about not having chronic pain when so many addicts actually need painkillers to get out of bed in the morning, and I'm far more handsome when I don't look like a zombie. Why do I do drugs... sigh.

It is not a moral failure or anything like that as frustrating as it may be, just the beginning of the next step in recovering.

The habituation potential of oxycodone, as with hydrocodone, is actually more than its analgesic potency when compared to other narcotics. If you are wanting to taper off, is it possible to convert the oxycodone dose to another narcotic without the C-Jam-like stimulation such as codeine, dihydrocodeine, dionine, dextropropoxyphene or whichever? I would think that the 50 to 100 mg codeine hydrochloride tablets (Perduretas) would be the most helpful, and the 60-120 mg ER DHC, which is used in place of methadone some places,, and then taper that one. With oxycodone it really seems like there are weak narcotic, strong narcotic, and stimulant addictions to battle simultaneously, hence codeine being workable if you can obtain it

Well, the kratom and oxycodone are apparently doing something that is beneficial, which is why people take drugs. The question of course is whether or not it balances any damage the situation may have caused. I will point out the kind of absolute sobriety promoted by many is unnatural and, in the intermediate and long term, probably unhealthy. Even animals search for alcohol and opium, like the wallabies that eat poppies and hop in circles all night like it is a macropod discotechque . . .

 

[GetMeOutOfThisCRAP]

It is not a moral failure or anything like that as frustrating as it may be, just the beginning of the next step in recovering.

The habituation potential of oxycodone, as with hydrocodone, is actually more than its analgesic potency when compared to other narcotics. If you are wanting to taper off, is it possible to convert the oxycodone dose to another narcotic without the C-Jam-like stimulation such as codeine, dihydrocodeine, dionine, dextropropoxyphene or whichever? I would think that the 50 to 100 mg codeine hydrochloride tablets (Perduretas) would be the most helpful, and the 60-120 mg ER DHC, which is used in place of methadone some places,, and then taper that one. With oxycodone it really seems like there are weak narcotic, strong narcotic, and stimulant addictions to battle simultaneously, hence codeine being workable if you can obtain it

Well, the kratom and oxycodone are apparently doing something that is beneficial, which is why people take drugs. The question of course is whether or not it balances any damage the situation may have caused. I will point out the kind of absolute sobriety promoted by many is unnatural and, in the intermediate and long term, probably unhealthy. Even animals search for alcohol and opium, like the wallabies that eat poppies and hop in circles all night like it is a macropod discotechque . . .

Can you explain to me what the term C-Jam refers to? Right now I'm finishing up this doctoral program and my addictions have actually helped me deal with the stress of writing papers/and dealing with extracurricular things. I'm glad that you stated that sobriety can be somewhat unnatural. Last year my oxycodone usage was very irregular and I struggled to pass certain classes with my GPA lower than it's ever been, which seems counterproductive after how many people told me it would be for the best to sober up. I've actually been wondering if without my using I'd be able to handle the difficulty of the program

Off topic but my mother at one point was a heavy heroin addict. It took me a 10 mg percocet to feel the same euphoria that for my friend upon first time use felt from a 5 mg percocet. So some tolerance does carry through generations, and perhaps ability to function on certain substances? I know that for some opiates are stimulant and others they serve as a hardcore downer. That could be an interesting thing to look into. Why some never "nod off" and others perpetually become sleepy.

 

[Nicomorphinist]

C-Jam is cocaine hydrochloride as in Bolivian Marching Powder.

I am thinking it is the up and down oxycodone levels which could very set up everything that happens like that as I have had trouble with that as a student and since I know what is up with that, and I can recognise withdrawal signs of course so when that happened I have given a few Incompletes and allowed folks who had trouble on a test an opportunity to re-take it . . . in other cases which were more dire, if they can speak for 15 minutes on the course material and do 10 minutes of Q & A during office hours, I either threw out the obvious outliers at below -1.75 σ, or would consider a grade up to C+ based on the discussion. If they could take all of the examinations again in one sitting and write a 250 to 625 word description of the course material, I would boost the grade to A. Extra-credit papers on obscure and/or compelling topics presented to the class would raise the grade by one letter.