Good to see you hear Wilson! I always appreciate your posts.
Drug laws can be pretty asinine... like Cannabis being Federal Schedule 1 in the US, the highest level of scheduling alongside many psychedelics that are also touted as "having no medicinal value", yet legal in many states and the medicinal value of cannabis is now scientifically proven and indisputable. No logic. So many contradictions.
I am treated for adult ADD and dysthymia (treatment resistant) with dextroamphetamine in the form of Vyvanse 60mg capsule and have been for a few years now. I also have many legitimate chronic pain conditions and was a patient in a pain management clinic for some time. IME it's much easier to obtain stimulant medications than opioids of any kind.
There are some states that do sell codeine syrup with phenergan (schedule V) OTC but it is at the pharmacist's discretion. I know this is still legal in Washington state (I dont live there lol, but know people that do). However, it is pretty rare to obtain this way anymore. Certainly not like in the UK it sounds!
Idk what all the hype about oxy is. I mean, it's good, but not that good. I can think of at least 10 other prescription opioids I'd prefer.
Thanks man, appreciate it!
I do find it ironic that the US, which seems to be the strictest for enforcement of drug laws out of all the Western countries, is leading the way in medical and recreational cannabis legalisation.
What I mean when I say that is for example the UK is technically stricter in its laws since we have a blanket ban on all drugs that aren't government approved, crazy fucking law, but in reality that law is virtually unenforceable and police will generally turn a blind eye to most drug use as long as you are being subtle about it because they just don't give a fuck. Whereas I have heard many stories of people in the US having to go to court just for having a few pills in their pocket. Then there is the strictness around prescriptions, especially opiates, which I'll address in my reply to your next comment.
Vyvanse is good stuff, personally I have a preference for good old IR dex because the time release stims tend to cause me more side effects and vary in duration, especially Vyvanse since it's a prodrug rather than a traditional XR system. Some days it lasts a few hours, other days it lasts so long I can't sleep. IR dex is far more consistent.
Agreed about oxy too, I have always said it has a lot of strength but not nearly as much euphoria as other opiates. I honestly prefer oral morphine over oxy. Over here we have bottles of Oramorph 10mg/5ml liquid on prescription and I'd much rather have one of those than a box of OC80's. Ironically I can get OC80's much more easily on the black market which is basically the only reason I ever used oxy. If I had my choice of opiates I'd have used Oramorph or even Zomorph (time release) because they're still bloody nice and you can just open them up and crush the little balls to make them IR.
As an anecdote - Middle class, 30's, white male. Cant get an opioid prescription to save my life. Not even when I worked in a direct patient care in a large metropolitan hospital.
I think there are many factors at play in regards to narcotic prescribing patterns. I'm sure racism and classism both are involved. The biggest factor I have personally observed is provider fear of licensure revocation due to the extreme political climate surrounding opioids in the US and the pressure put on doctors not to utilize opioids.
I have had more than one doctor bluntly state that my pain conditions are mechanical in nature, thus most responsive to opioids as an effective treatment, though they refuse to prescribe them because, as they've said, "it's not worth losing my license over". The DEA has everyone terrified and is leaving so many people without treatment.
Age is another factor IME. For example, my mother is a patient at the same pain management clinic that booted me for testing positive for mitragynine and 7-HO. At the time I was only getting #30 50mg Tapentadol from them and was tested EVERY SINGLE TIME.
My mother is prescribed MS Contin and morphine sulfate IR daily and has been tested once in the past year. Same doctor. Go figure...
This seems to be the norm in the US now, as you say because of the DEA, and I find it crazy you can have a doctor tell you that opioids are the best treatment option for your pain but then refuse to prescribe them because he's worried about losing his license. Shit is crazy over there. A doctor signs the Hippocratic oath and leaving a patient in preventable pain seems like causing harm to me.
I'm in my 20's and I've had multiple opiate scripts, none of them were long-term but then I don't have a history of chronic pain. We tend to use weaker opiates here like codeine, DHC, tramadol, morphine instead of oxy, hydromorphone, etc but as a general rule if someone has a legitimate need for pain relief they get it. Due to the nature of our healthcare system being decentralised, some areas of the country are stricter than others with certain types of drugs, but generally that is how it goes.
Age is a definite factor though. Doctors will be less willing to write a repeat opiate prescription for someone my age than they would for my gran. Which makes sense as a rule, but in your case where you have a disorder causing chronic pain which is best treated by opiates, that's where doctors need to look at it on a case-by-case basis.
The hardest script to get in the UK is honestly benzos. It is crazy hard to get benzos here. I managed to get some out of sheer luck and jumping through many hoops and it took years. Benzos are more demonised than opiates in our medical system. The reason is because of a class action lawsuit in the 90's. Doctors got sued for overprescribing Valium and lost, since then most docs are too scared to script them purely for liability reasons.
You talk about "tests", is it common for doctors to drug test people over there? I've been scripted all manner of nice things and never once been drug tested. I do have annual blood tests to check kidney function and other such things, but this is something they're now doing for anyone on any psych meds. I know for sure they don't test for drugs because the tests they do are listed on the slip I have to bring to the hospital to get it done, and also because last time they tested me I had non-prescribed drugs (at least cannabis for sure) in my system and nothing was mentioned when they just gave me my next script as usual.
