I took a risk by being honest w/ my pain doc...

[DeathIndustrial88]

Thank you for your insight, DeathIndustrial88!

Absolutely! My pleasure! Anything I can do to help!

Oxycodone is metabolized by the CYP3A4 pathway, so you could try drinking grapefruit juice with your oxy to extend the duration of analgesia. But it's also possible some of the other meds you're on could be metabolized by this pathway (I'm not sure). So doing this could potentiate more than just your oxycodone.

Oral antifungal meds are also CYP3A4 inhibitors, like itraconazole. I actually took itraconazole recently a few months back & felt like it potentiated my buprenorphine but only slightly.

If you look up "CYP3A4" inhibitors, it should show you what drugs & foods will inhibit this enzyme, which will slow down your metabolism of oxycodone.

The gabapentin will work wonders for opioid withdrawal. I take about 900-1,200mg of gabapentin myself every day. It should absolutely help in the right doses.

Dextromethorphan is another thing that can help tremendously. It's the main ingredient in Robitussin & OTC cough meds. Make sure to only use products that contain DXM and nothing else. Taking 30-90mg of DXM can help potentiate an opioid. Taking higher doses can actually help with withdrawal big time but the higher dose causes a dissociative trip & I don't think you're trying to go for that. lol

I use to take small doses of DXM, loperamide & tonic water when I had withdrawals. Some times it helped, some times it didn't do much.

Tizanidine can potentiate opioids. My sister gave me some of those a few years back & I snorted some of them (because I'm an addict & like to snort things lol) and it knocked me on my ass. I believe it's related to clonidine but is more of a muscle relaxant.

The vyvanse should also help. I'm surprised you're able to get all of these meds honestly! lol The gaba, vyvanse & tizanidine should be doing at least a little to help keep withdrawal at bay.

And yes, you may need a little bit higher doses of loperamide than that. Supposedly no more than 8mg a day of loperamide is safe. Some sites say no more than 16mg a day... So I would hover around that area & see if it helps any better.

 

[516CAZ]

UPDATE: I just got an appointment reminder for the pain doc that says my appointment is on THURSDAY, the 15th, which is the day I'm actually due to run out. Sooooooooo, I would have an empty bottle no matter what. I'm confused... Was this a mistake by the scheduler? Should I call them and point it out or keep quiet and show up on THURSDAY instead of TUESDAY??

 

[DeathIndustrial88]

UPDATE: I just got an appointment reminder for the pain doc that says my appointment is on THURSDAY, the 15th, which is the day I'm actually due to run out. Sooooooooo, I would have an empty bottle no matter what. I'm confused... Was this a mistake by the scheduler? Should I call them and point it out or keep quiet and show up on THURSDAY instead of TUESDAY??

I would just point it out when you get there. That way you can show them their mistake to their face. And then ask them why they wanted you to bring an empty pill bottle if they knew that's when they'd be out.


I'm hoping for the best for you & maybe your doc wants you to come in & dish out some anti-junkie rheotoric & then give you something else or extra. He just wants to see you in person. At least this is the scenario I'm hoping for you. My mom use to have to refill her tramadol for me every month for 11 years & she (we) dealt with a ton of bullshit from doctors & pharmacies once tramadol became a controlled substance. Always making her come in for refills & unnecessary appts. I feel pretty bad that my mom had to do all that bullshit for me for so long.

But if he's an ass or isn't helpful, definitely time to consider looking around for a new one. But it sounds like you're on a lot of meds & it might not be easy for find a new doc willing to prescribe all those same meds either, so that does make this a nerve racking situation. I'm really sorry to hear.

Good luck!

 

[SuperPsych]

I pulled up my last drug screen record. It does not list kratom as a tested drug. I've had kratom before, but can't remember where I got them? Was it a smoke shop? I guess I need to make a decision quickly as I just took my second to last oxycodone...

I will definitely be looking for a different provider! Like you said, I'll only keep going to this doc until I find another. The majority of reviews for pain places around me (Phoenix, Arizona) are not good.

I said to him, "I definitely regret being honest with you." I'm usually a very strong advocate for myself, but I think I was just shocked at his reaction. As a woman, I know I have to advocate harder. It just caught me off guard, I guess... WHAT A DICK.

Unfortunately there is a thing with some male doctors where they don't take their female patients seriously, especially when it comes to pain for some reason. I was just talking to my sister about this and she was sharing some bad experiences that she's had. Medicine is no place for misogyny (not that there IS a place for it), and unfortunately it seems more common than one would expect. Keep on trying to find a new doctor though! Kratom is very commonly found in Smoke Shops and Mini Marts. You wont be likely to find any at chain mini marts but mom and pop corner stores often have it, at least in my area. It's also available online but it'd take a few days to receive it

 

[SuperPsych]

I would just point it out when you get there. That way you n show them their mistake to their face. And then ask them why they wanted you to bring an empty pill bottle if they knew that's when they'd be out.

This is what I would do. You could even play it off as you were mistaken. Like that you thought you had taken extra but evidently did not. Or that yes, sometimes you'd take a dose a little bit early but that you did stick to the 3x a day (or whatever your prescribed schedule is). This honestly might play in your favor, although I wouldn't get your hopes up. I still think that Kratom is a decent choice to get you through to your appointment

 

[JackARoe]

UPDATE: I just got an appointment reminder for the pain doc that says my appointment is on THURSDAY, the 15th, which is the day I'm actually due to run out. Sooooooooo, I would have an empty bottle no matter what. I'm confused... Was this a mistake by the scheduler? Should I call them and point it out or keep quiet and show up on THURSDAY instead of TUESDAY??

No more fear. I would show up annoyed talking loud at times how this miscount of pills is irritating and this is becoming a pharmaceutical nightmare (as they ask you to lower your voice). But no one should ever be talked to like that. I could never be a pain patient. I would have told him to lower his voice as he talks to me and looked at him strongly. Take back control. Big frigging deal a few extra pills. Sorry to get your undies in a bundle doc. What is the malpractice? We say you had to go to the black market because he do wouldn't use his abilities as a doctor to help.

Once one of us wins a lottery we get together and take a slew of doctors to court for malpractice. You can do anything with money. We include a few benzo doctors that are telling their patients to just go CT. Malpractice. May not win in court but dragging their asses in there is an inconvenience. And we get to preach.

Last bit of advice. Learn to do a little poppy gardening. You don't get much but enough for a few serious times. Nature does not yell at you for this like the stink ass doctor that has a complex does.

 

[Curt Mandible]

Nature doesn’t yell at you… but your neighbor might when they see your “mystery garden”

 

[LucidSDreamr]

I've had 6 different pain doctors and they've all been awful.

I've noticed that all pain management clinics are awful post 2016 CDC guidelines/DEA crackdown. I live in a major urban center with a population of 7.5 million and was told by a sympathetic pain specialist that were are only 5 pain specialists left in the area that still prescribed schedule 2 drugs. So if you do the math that's 5 clinics to serve 1.5 million people (20 percent of Americans have chronic pain) - this doctor gave me me their names but of course they are all full. All the pain specialists have switched to schedule 3 bupe and this is where they all want to take their practice as it is not scrutinized by the DEA as much due to higher schedule - but they can't switch YOU to buprenorphine because you are already on a full agonist opioid and the risk of making the switch/precipitated withdrawal is something they don't want to assume. they also know your pain won't be managed after switching from a full agonist to dupe so you wouldn't be a good outcome for them. They just want to replace their schedule 2 patients with new opioid naive patients they hook on buprenorphine. That's the goal, that's the DEA-stress free dream for these pain doctors.

As to a solution to your doctor issues, I've alway found that primary care doctors are FAR more willing to prescribed opioids than pain specialists (post DEA crackdown). The caveat is that the doses will not be as high - but I've heard of some pain specialists giving fucking joke doses anyways so it could be better than what you get. You get 5 pills a day (of what I don't know). If it's 5 10 mg hydrocodone per day, that might be at the upper limit of what I've found primary care doctors willing to do, but its without all the hassles pain clinics put you through.

The demographics for doctors most likely to prescribe are as follows. Whenever I've had to get a new doctor I found one on literally the first attempt that would prescribe using this formula:

1. old as humanly possible. 75+ year old primary care doctor
2. male (may be different since you're female, but I don't know)
3. office in rich neighborhood
4. Not asian/indian

Of course the way you come off also plays a huge role. You have to be extremely knowledgeable about your disease, all of its known treatments both medicine and non-medicine treatments, and be able to basically know more about your disease and its treatments and speak above that doctors own level of understanding of that area of medicine....this isn't as hard as it sounds unless you're dealing with a doctor that is an expert in one specific disease, which a primary care doctor definitely won't be. I made another post in my history recently about leading a doctor to the narcotic script by way of process of elimination of all other shitty drugs and interventional treatments that don't work. Taking the doctor through the story of how you've tried all these things has the double effect of showing you are extremely knowledgable about the disease and have tried all kinds of things and its about just finding relief and not narcotics, but you've eliminated every other option at that point and all the doctor has left in his tool kit is narcotics. you always have to come off as seeking pain relief and functionality by any means available, as soon as the doctor see you're focused on narcotics specifically its over.

 

[daturetard]

Nature doesn’t yell at you… but your neighbor might when they see your “mystery garden”

As far as the majority of poppies that are grown on US soil, they're used as ornamentals as opposed to opium production.

 

[LucidSDreamr]

As far as the majority of poppies that are grown on US soil, they're used as ornamentals as opposed to opium production.

so its legal to grow them in he US? I am an avid artist using floral arrangements and just curious.

 

[LucidSDreamr]

No more fear. I would show up annoyed talking loud at times

I honestly wouldn't play it like that. evoke pity instead, cry if you can (being in withdrawal helps with this btw), mention about how your life is falling apart because of the pain. As soon as a doctor with this sort of dynamic gets it in their head that you aren't deferential and scared of them..it's over.

 

[daturetard]

so its legal to grow them in he US? I am an avid artist using floral arrangements and just curious.

They're in a legal limbo. They just grow like weeds, so you can't stop it from happening naturally, even if it's not naturalized here, we use the seeds for foods and birds eat bagles n shit the seeds out, so it's not illegal unless they can prove you were harvesting opium. Which is pretty hard to especially when the evidence is all in your bloodstream, and then you can just claim it was seeds making you pop

 

[LucidSDreamr]

They're in a legal limbo. They just grow like weeds, so you can't stop it from happening naturally, even if it's not naturalized here, we use the seeds for foods and birds eat bagles n shit the seeds out, so it's not illegal unless they can prove you were harvesting opium. Which is pretty hard to especially when the evidence is all in your bloodstream, and then you can just claim it was seeds making you pop

I know various types of poppies grow in the US but I wasn't aware that the somniferum (the "good" ones) grow in the US.

 

[daturetard]

I know various types of poppies grow in the US but I wasn't aware that the somniferum (the "good" ones) grow in the US.

They need to be introduced, but that's very easy to do and very hard to prove intent
Unless you're being a moron and really brazen with it (lancing the pods, selling it, making black and such)

 

[JackARoe]

I know various types of poppies grow in the US but I wasn't aware that the somniferum (the "good" ones) grow in the US.

The red poppies that grow all over, and the seeds of the red poppies that are sold in all the plant racks are Papaver Somniforum. I have seen them growing around schools and police stations in the spring. They really are all over the place at times. Most people don’t understand that the red or white poppy that grows is the opium poppy. So if you save your seed packs you got legal recourse. Also, no way in hell is anyone gonna look it up plant garden.

 

[516CAZ]

Absolutely! My pleasure! Anything I can do to help!

Oxycodone is metabolized by the CYP3A4 pathway, so you could try drinking grapefruit juice with your oxy to extend the duration of analgesia. But it's also possible some of the other meds you're on could be metabolized by this pathway (I'm not sure). So doing this could potentiate more than just your oxycodone.

Oral antifungal meds are also CYP3A4 inhibitors, like itraconazole. I actually took itraconazole recently a few months back & felt like it potentiated my buprenorphine but only slightly.

If you look up "CYP3A4" inhibitors, it should show you what drugs & foods will inhibit this enzyme, which will slow down your metabolism of oxycodone.

The gabapentin will work wonders for opioid withdrawal. I take about 900-1,200mg of gabapentin myself every day. It should absolutely help in the right doses.

Dextromethorphan is another thing that can help tremendously. It's the main ingredient in Robitussin & OTC cough meds. Make sure to only use products that contain DXM and nothing else. Taking 30-90mg of DXM can help potentiate an opioid. Taking higher doses can actually help with withdrawal big time but the higher dose causes a dissociative trip & I don't think you're trying to go for that. lol

I use to take small doses of DXM, loperamide & tonic water when I had withdrawals. Some times it helped, some times it didn't do much.

Tizanidine can potentiate opioids. My sister gave me some of those a few years back & I snorted some of them (because I'm an addict & like to snort things lol) and it knocked me on my ass. I believe it's related to clonidine but is more of a muscle relaxant.

The vyvanse should also help. I'm surprised you're able to get all of these meds honestly! lol The gaba, vyvanse & tizanidine should be doing at l⁰east a little to help keep withdrawal at bay.

And yes, you may need a little bit higher doses of loperamide than that. Supposedly no more than 8mg a day of loperamide is safe. Some sites say no more than 16mg a day... So I would hover around that area & see if it helps any better.

The CYP3A4 inhibitor drugs are an interesting idea. I may try that for just my regular dosing.

I have been taking the dicyclomine, gabapentin, loperamide, tizanidine, and trazodone at increased dosages since last night to get through withdrawals, but I'm still feeling them. I've definitely had worse, but it still sucks lol!

I do have dextromethorphan, but from the drug screen panel I looked at earlier, they actually test for it! It has helped me in the past.

I would take more lisdexamfetamine, but I have 30 mg capsules, sooo I can't split them unless I want to go from 30 mg to 60 mg.

Honestly, I am also surprised that I can get all of these meds... I can be quite charming, and I always go in armed with research. You really need to become knowledgeable of multiple chronic diseases to get any real help.

 

[SuperPsych]

The CYP3A4 inhibitor drugs are an interesting idea. I may try that for just my regular dosing.

I have been taking the dicyclomine, gabapentin, loperamide, tizanidine, and trazodone at increased dosages since last night to get through withdrawals, but I'm still feeling them. I've definitely had worse, but it still sucks lol!

I do have dextromethorphan, but from the drug screen panel I looked at earlier, they actually test for it! It has helped me in the past.

I would take more lisdexamfetamine, but I have 30 mg capsules, sooo I can't split them unless I want to go from 30 mg to 60 mg.

Honestly, I am also surprised that I can get all of these meds... I can be quite charming, and I always go in armed with research. You really need to become knowledgeable of multiple chronic diseases to get any real help.

You can still most likely take DXM as long as it's mot recreational doses. They will see the amount in your system and will be able to determine if you were abusing it or not.

I once popped dirty at my outpatient treatment facility for opioids and I hadn't had any in years besides the buprenorphine that they were prescribing to me. The UA Lab tech was like "that's strange. There ARE a few things that could cause a false positive. Certain drugs can trigger a false positive, poppy seeds..)

I cut him off there as I had been eating poppy seed muffins almost every night. So they had me UA again and they sent it to a lab for analysis. The results showed that the level was low enough that it was indeed the muffins.

If your doctor tests for DXM then its almost certainly not just a UA with a test strip. They're likely sending it to a lab so they should see the level of the drug.