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

[Psynaught]

I did not read the last 10 posts, just the one where you started arguing with your doc.

Don't do that because it will motivate him to cover his selfish ass. Do what I did and file a complaint with the board. I had a total s-hit bag like yours and she was heavily sanctioned. I was not taking pain meds I was on psych meds and she just abruptly cut me off.

Scumbag then had to go explain herself to the board to keep her license. I don't like doing stuff like this but there comes a point where you have to stand up to these arrogant A holes. Also, it is not always docs fault, our system is massively screwed up.

I have learned to get by by just taking Kratom (4.5 grams a day) but am worried about the day when I might need something stronger. That is also why I snag stuff from the black market when the opportunity pops up.

 

[4DQSAR]

Patients need to be the 'canary in the coal mine'.

I had one (very) bad experience with a particular surgery and when I moved, they asked me why. When I mentioned my previous surgery, they just said 'that's all we need to know'.

Turns out the surgery was subject to 'special measures' but of course, they do everything they can to avoid their remaining patients knowin of this.

Does the US have something similar in which a failing surgery becomes subject to a LOT more oversight?

 

[rentedbythehour]

I think I need to take the last pill the morning of because they're going to see it's not in my system if I don't

You should take it the night before. It doesn't always show up if you take it the day of
My guess is the first test you took was to measure the level of the drug. The second test will be to see if it's gone down, up, or not there at all.

 

[516CAZ]

You should take it the night before. It doesn't always show up if you take it the day of
My guess is the first test you took was to measure the level of the drug. The second test will be to see if it's gone down, up, or not there at all.

He refused to do the 2nd test. I posted a few updates w/in the thread since then if you're interested & bored! Lol

 

[516CAZ]

I have mentioned this before, but in the UK you are legally allowed to bring someone with you.

A carer is an obvious choice because they witness a person coping or more often failing to cope and since they are not the one's getting any prescription, their testimony can be of immense benefit to ALL parties involved.

Beyond that, obviously a family member.

After all, I ASSUME anyone needing such strong analgesia just to control the pain will have to have at lest some helip in getting to the appointment.

You can bring anyone, even a friend and at least here, a doctor would have to have a good reason for stopping said friend from sitting in. When someone has a physical or mental illness, it may be friends who are acting as carers. The only difference is that while a doctor can choose to listen to a friend, it is the patient who must ask the questions. But nowhere does it say a friend can't ask the patient to ask a question.

I know. It's odd. But no way in the witner months that I could possibly get to my surgery and as it's mostly my carer, she sits in. But I never asled fpo any specific medicine. It was the carer who pointed out to the doctor thaat I had not lefy my home for the previous year so obviously something had to be done.

If you suffer severe chronic pain, one's relationship to any medicaion is different. I'm not even curious to try abusing them. All I want is the ability to have a handful of hours where I can walk (slowly) and not need constant care. Is that an unreasonable thing to hope for?

I've taken my boyfriend a couple times, but I don't always have someone available to go w/ me.

 

[516CAZ]

I did not read the last 10 posts, just the one where you started arguing with your doc.

Don't do that because it will motivate him to cover his selfish ass. Do what I did and file a complaint with the board. I had a total s-hit bag like yours and she was heavily sanctioned. I was not taking pain meds I was on psych meds and she just abruptly cut me off.

Scumbag then had to go explain herself to the board to keep her license. I don't like doing stuff like this but there comes a point where you have to stand up to these arrogant A holes. Also, it is not always docs fault, our system is massively screwed up.

I have learned to get by by just taking Kratom (4.5 grams a day) but am worried about the day when I might need something stronger. That is also why I snag stuff from the black market when the opportunity pops up.

I don't think I just started arguing with my doc. I was standing up for myself. I'm definitely going to report him to the Board, I just don't want to do it until I officially am not relying on him for my medications. Ugh I'm jealous... I wish I knew how to buy anything on the black market...

 

[516CAZ]

Patients need to be the 'canary in the coal mine'.

I had one (very) bad experience with a particular surgery and when I moved, they asked me why. When I mentioned my previous surgery, they just said 'that's all we need to know'.

Turns out the surgery was subject to 'special measures' but of course, they do everything they can to avoid their remaining patients knowin of this.

Does the US have something similar in which a failing surgery becomes subject to a LOT more oversight?

I'm not sure what you mean by a failing surgery?

 

[KurtAurelius]

Can’t wait for the possibility of being in total agony and begging for relief to be given something like a 8mg co-codomal lol

We tend to be a little better here (UK) but I’ve know a friend who had a ovarian cyst burst and to have to cry her eyes out and beg to be given a proper dose of relief instead of just paracetamol and she attributed it to speaking to a younger nurse rather than the first doctor she saw.

 

[4DQSAR]

I'm not sure what you mean by a failing surgery?

I believe a whole set of metrics are applied but patient reporting is a key element. Things like 'forgetting' to write prescriptions and other constructive ways of getting patients who actually are ill off their books. In the UK a surgery gets something like £150/annum per patient on their books which is a terrible idea as it just means some surgeries don't WANT to spend money on helping the sick. It's all to make money.

I mean, the cost of medicines doesn't come out of that figure as most people still pay £9.90 per item (whatever the actual cost of the medicine) i.e. pharmcies are seperate legal enteties with seperate funding.

But given that a consultaion is 7.5 minutes... I highly doubt even sick patients are going to result in financial loss... just less profit.

 

[KurtAurelius]

I believe a whole set of metrics are applied but patient reporting is a key element. Things like 'forgetting' to write prescriptions and other constructive ways of getting patients who actually are ill off their books. In the UK a surgery gets something like £150/annum per patient on their books which is a terrible idea as it just means some surgeries don't WANT to spend money on helping the sick. It's all to make money.

I mean, the cost of medicines doesn't come out of that figure as most people still pay £9.90 per item (whatever the actual cost of the medicine) i.e. pharmcies are seperate legal enteties with seperate funding.

But given that a consultaion is 7.5 minutes... I highly doubt even sick patients are going to result in financial loss... just less profit.

Yeah I pay 9.90 an item, apparently you can pay a flat rate monthly fee, as I’m getting charged for 3 items now. (54mg Concerta, 18mg Concerta and 5mg Tranquilyn hilarious brand name) but I haven’t got round to doing it.

I joked the money may do some good but it’s never in a million years going to the right place..

Thanks for these insights, I’ve always seen evidence regarding the horror of monetised care (as someone who works in the industry) but I had never know about the annum sum on surgery members.. lmao

 

[4DQSAR]

Yeah I pay 9.90 an item, apparently you can pay a flat rate monthly fee, as I’m getting charged for 3 items now. (54mg Concerta, 18mg Concerta and 5mg Tranquilyn hilarious brand name) but I haven’t got round to doing it.

I joked the money may do some good but it’s never in a million years going to the right place..

Thanks for these insights, I’ve always seen evidence regarding the horror of monetised care (as someone who works in the industry) but I had never know about the annum sum on surgery members.. lmao

Well, to be fair the most recent firuge was £134/annum for 2022-2023 but I believe it has been increased slightly. So it could be a few quid either way, but many details are hard to acquire in real-time.

That your doctor has settled on three forms of the same medication seems a little odd. All I can tell you is that it's now a VERY cheap. I mean $600/Kg cheap...

 

[KurtAurelius]

That your doctor has settled on three forms of the same medication seems a little odd. All I can tell you is that it's now a VERY cheap. I mean $600/Kg cheap

It is annoying to be sure, they don’t make a 72mg Concerta even though it’s the first guideline “max” but not max dosage (weird differences in both practices here and other countries I’ve seen online as it was hard to find the max dose compared to Evanse but still it’s up to clinician by looks of it, for both drugs including IR boosters)

I’ve adjusted and found something that’s working consistently albeit with what can be said to be faff for some with 3 pills but I’ve always been used to taking them, both for fun and swallowing vitamins for yonks now.

I felt like I was lobotomising myself at first and I may still be, but so far I prefer life like this.

I was titrated from 18-36-54 (me asking to try the 72mg and finding it very stable) and then they added a 5mg “top up” and I must admit at first I wanted it just for purely experimental purposes to see the differences between slow and instant release Methylphendiate, but it does give me a nice little boost. I take it at 17:30 and although 72mg Concerta is still working for me, it just helps to be more present cooking dinner (else I will cut vegetables like shit! ) and for evening relaxation compared to unmedicated or just 72mg that’s dipping..

Putting it like that makes me laugh to see the disparity in cost, I’m happy for the prescription charge in ideals if they were fulfilled for the good of the community (likely not!) but yeah, quite the turnaround ain’t it.. deary me, but not quite ready to Walter White my own meds…

 

[4DQSAR]

(else I will cut vegetables like shit! )

Are we talking losing fingers here or simply somwhat uneven slices?

Because for £6 Ikea sells a vegetable slicer (Mandoline) that I assume provides that sub-millimeter accuracy some people appear to feel reflects on their cooking skills.

I've long been concerned that the UK initially ignored many of the very real mental health issues that methylphenidate is intended to treat and then has somewhat over-corrected - that low price a likely reason.

Don't get me wrong, I think it a far better option that amphetamine (of any type) but we are now rather ending up back in The Valley of the Dolls (if you know the work). In fact possibly the best option of all is phenmetrazine - but that stuff ended up being so widely abused that it's use ended in the 70s. Even researchers cannot trial it just to see if it IS better (<plot spoiler> it IS).

 

[KurtAurelius]

Are we talking losing fingers here or simply somwhat uneven slices?

Because for £6 Ikea sells a vegetable slicer (Mandoline) that I assume provides that sub-millimeter accuracy some people appear to feel reflects on their cooking skills.

I've long been concerned that the UK initially ignored many of the very real mental health issues that methylphenidate is intended to treat and then has somewhat over-corrected - that low price a likely reason.

Don't get me wrong, I think it a far better option that amphetamine (of any type) but we are now rather ending up back in The Valley of the Dolls (if you know the work). In fact possibly the best option of all is phenmetrazine - but that stuff ended up being so widely abused that it's use ended in the 70s. Even researchers cannot trial it just to see if it IS better (<plot spoiler> it IS).

Just uneven slices, lake of patience, and concentration at my homeostasis, always done anything in a rush while thinking about so much else LOL.

My partner has used similar devices on occasion but my stubborn pride reaches for the knife to do it propaaaa.. but we have observed improvements once titrated..

I’ve yet to be able to say with confidence regarding my opinions on Methylphenidate, as someone who has used SSRIs and Mirtazapine (both not appropriate at all for someone later found to have ADHD, Autism and EUPD) and plenty of self medication, and then spiritual and self improvement, to find that Methylphenidate has been the most efficacious.

Not to discredit improving self care, but I would have never felt the clarity and viewpoint I now do, and it’s been over a month on the same dose with no loss of efficacy. Even at my best in my discipline and living so well, working so hard, I never ever felt peace and fought kicking and screaming Everday to ignore the plethora of shite swirling upstairs.

But it has quite literally bridged the gap that seemed to be the deficit in my brain.

Hard to articulate without rambling anymore but to no longer question the entire world and to have my life be enough, and to be at peace instead of thrashing violently in agony is worth it.

But the opinion Ive not yet said was that I’m not sure if it’s just because I have adhd, that it has this special effect that people argue day and night about stimulants (and supposed opposites from neurotypical to divergent), lasting seemingly long so far, without dip, and the studies on brain region adaption to stimulants (positive change) or that indeed would this drug be more effective for depression than SSRIs let’s say? I really used to believe that meds are a Bandaid and only except the Poor souls I work with that have severe schizophrenia have no choice most of the time to take horrible drugs to get some quality of life.

This instead seems different as my quality of life exists when it never did, and would this have more efficacy? Or as it stands does it only remain for those with ADHD?
That voice is so quiet now, the one that would perceive that of course elevating dopamine so high would trick you into a false peace that’s not real, but at this point I couldn’t care less. What luck I live in a time where I got such a effective treatment boosted by the hard work I did for myself.

I do second your stance compare to amphetamines, but my comes from my childish knowledge of pharmacology (amphetamines release so therefore BAD, Methylphendate ok cos only reuptake even though that’s so unnuanced due to the supposed inverse agonism I’ve read before) and personal bias, both my experience and that super guy on here who should be sponsored by The Company who make Ritalin (Dextro.45)

valley of the dolls I’ve heard, as in the sense of I know it’s likely good but not delved in, I will take a peek thanks…

I know I’ve rambled, but I’m curious to ask you regarding the Phenmetrazine just as you can hold your self very well in pharmacology talk, I’m just confused as to why it’s so much diffrent ? And abusable..

From my vague memory and the quick cheat I just looked up, it’s binding etc ain’t anything better or even less so on paper compared to say Dexamp? Is it because there was shit tons of injectable ampules, being pharma pure flooding the street and it became sort of just epidemic like? Love to hear your thoughts..

 

[4DQSAR]

I believe that atomoxatine is also prescribable for similar conditions but even in bulk, it costs twice as much. I note people are posting that the prices in nations where prescription costs are seeing the retail formats of the drug increasing steeply.

I think what concerns me is that homeostasis will alter body chemisty so users of stimulants need to keep on increasing the dose. While the arguments go on as to them producing physical depencence, without a doubt they have the capacity to produce psychological addiction. I mention this as in the past BLers have mentioned that methylphenidate based medications are often being traded as the person it was originally prescribed to treat simply becomes tolerent so they were even giving them away!

So, just a couple of things to consider.

I'm also not unaware of the fact that shortages DO occur in the UK and so I recommend at least holding a few back.

I always mention to people that they should first take a their own mental 'temperature' and decide if they need to take a dose. You would be amazed at just how many people develop OCD because their brains tell them it's 'pill o'clock' and they really suffer if they do not take the medication.

Just to be clear, I'm not a doctor and would not aspire to be one. My field is purely on small-molecule drug chemistry. Very niche, to the point where I know almost everything about almost nothing. But I talk to others and try to provide wherever information they seek.

 

[Psynaught]

I don't think I just started arguing with my doc. I was standing up for myself. I'm definitely going to report him to the Board, I just don't want to do it until I officially am not relying on him for my medications. Ugh I'm jealous... I wish I knew how to buy anything on the black market...

Be careful. I am lucky and have never had a problem with opioids. I have had a Tramadol stash for about 4 years, a big Fentanyl stash for a year and an Oxy stash for a year and a half. According to everyone on this forum I should be homeless/dead by now but am OK. I do take 4.5 grams of Kratom about 5 days a week but have been doing that for years with no problem.

 

[4DQSAR]

Be careful. I am lucky and have never had a problem with opioids. I have had a Tramadol stash for about 4 years, a big Fentanyl stash for a year and an Oxy stash for a year and a half. According to everyone on this forum I should be homeless/dead by now but am OK. I do take 4.5 grams of Kratom about 5 days a week but have been doing that for years with no problem.

We have essentially stopped prescribing tramadol in the UK. It's back to the classic 30/500 Co-codamol tablets.

I think a lot of users mistakenly think that a strip of ten tramadol capsules will be more or less the same as a strip of 30mg codeine tablets. They are not.

Since I heard about it I've kept asking why, given the ultra-low price, nobody is resolving the two enantiomers so that only the MOR ligand is used. Because that IS more or less the same as codeine (but cheaper) and without a doubt, much safer.

 

[Psynaught]

We have essentially stopped prescribing tramadol in the UK. It's back to the classic 30/500 Co-codamol tablets.

I think a lot of users mistakenly think that a strip of ten tramadol capsules will be more or less the same as a strip of 30mg codeine tablets. They are not.

Since I heard about it I've kept asking why, given the ultra-low price, nobody is resolving the two enantiomers so that only the MOR ligand is used. Because that IS more or less the same as codeine (but cheaper) and without a doubt, much safer.

I've had my 2 bottles of Tramadol for 2 years. I've probably take 25-30 during those 2 years. They are 100 gs, pretty strong. Bottles are still pretty full. Tramadol is a solid pain reliever and gives a mood boost. I am recovering from Covid. Got up today and felt better...but now I have this shooting pain running down from the right of my neck down my trap.

I thought about taking a Tramadol but instead just took 2 grams of Kratom and am having a cup of coffee. That seems to be doing the trick.

 

[4DQSAR]

I thought about taking a Tramadol but instead just took 2 grams of Kratom and am having a cup of coffee. That seems to be doing the trick.

Glad to hear it. I even found a human study in which O-DMT was compared to tramadol and it turned out that about 20mg of O-DMT (also referred to as the M1 metabolite) was as effective as 50mg of tramadol and produced far fewer side-effects. That sort of suggests that the mumbo-jumbo talked about how the mixture of enantiomers somehow produces synergy making the mixture of the trans isomers of tramadol more potent is a lie.

It wasn't a huge study but animal models suggest that the enantiomer responsible for monkeying around with monoamine levels added nothing to analgesia. it's sole purpose appears to be to make the compound dysphoric.

I was briefly prescribed tramadol but the side-effects (mediated by the inactive enantiomer) saw me end up in hospital not once but twice. But when you realize that it sells for $40-80Lg in bulk, even if you throw half of it away, it's still extremely cheap. I'm choosing to ignore the (+1) derivative which is about twenty times as potent because as impressive as the potency is, DAST is a disaster waiting to happen.

 

[Psynaught]

Glad to hear it. I even found a human study in which O-DMT was compared to tramadol and it turned out that about 20mg of O-DMT (also referred to as the M1 metabolite) was as effective as 50mg of tramadol and produced far fewer side-effects. That sort of suggests that the mumbo-jumbo talked about how the mixture of enantiomers somehow produces synergy making the mixture of the trans isomers of tramadol more potent is a lie.

It wasn't a huge study but animal models suggest that the enantiomer responsible for monkeying around with monoamine levels added nothing to analgesia. it's sole purpose appears to be to make the compound dysphoric.

I was briefly prescribed tramadol but the side-effects (mediated by the inactive enantiomer) saw me end up in hospital not once but twice. But when you realize that it sells for $40-80Lg in bulk, even if you throw half of it away, it's still extremely cheap. I'm choosing to ignore the (+1) derivative which is about twenty times as potent because as impressive as the potency is, DAST is a disaster waiting to happen.

How much Tramadol were you taking that put you in the hospital?