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

[Psynaught]

Yeah.

OMGgggggh I've also had cytoscopy & I'm a woman. It was fucking awful.

..

 

[4DQSAR]

I think people should never lose site of the fact that there are non-opioid analgesics that a quite potent.

Sci-Hub | | 10.1093/bja/aew391

In the UK at least we use parentheral paracetamol solution and I was surprised by how effective it was. Nefopam worked but it has stimulant properties so I had to stop using it because I stopped sleeping. While long-term use of COX-2 inhibitors has there own dangers, again, I was surprised by how effective it was. I forget which one it was but in my defence, it was 25+ years ago.

Some clinicians are limited in what they are able to prescribe but if you are in pain and ask for a non-opioid, you might get an odd look but they seem to dispense it.

I suspect that asking for an opioid will be treated as 'drug-seeking behavior' which I appreciate is a tautolgy, but 'drug-seeking behavior' implies intent to abuse. So I have to say it's surprising that they didn't even offer a compound analgesic or (shudder) tramdol. When I broke my wrist I didn't ask for any analgesics but the doctor handed me maybe 20 or 24 30mg codeine phosphate tablets. Again, 25+ years ago.

I've spent so long in hospital and for so many reasons that I'm uncertain if I underwent cytoscopy but it was certainly something similar and yeah, it hurt a LOT but the pain was brief. Generally clinicians don't offter analgesia on the basis that 'lie still, it will be over in a few minutes;.

 

[emkee_reinvented]

@4DQSAR and @Them Witches , solid advice.
In NL you allowed to bring someone.
Specified when its a family member, unspecified when it s a family friend !
Which could be a befriended medical professional.
You do have to give notice, but they prefer it when you bring someone.

Next time a thing as this comes up, i am asking if i may tape it.
On the voice recorder of my phone. For this you need approval.
Wonder if its allowed official, if i guess the dr,. could refuse.

So secret recording will be the 2-nd option, i got two phones.
And a mini recording device. If it needs to be hidden.
Out sight, and record the Kakalawakan dr s and experts say to you.

Things that are wrong, assumption s, lack or behind on current knowledge.
And the fact that when you leave your breefing contains elements,
that are unknown to the team when you call em, and not in your file.

 

[emkee_reinvented]

I think people should never lose site of the fact that there are non-opioid analgesics that a quite potent.

While in NL they prescribe in-effecient Anti-Epileptic s.
So on Levetiracetam, the most shitty med i met.
I had 3 more Seizure s, totalling 5. I asked is their a reason you give me this ?
Instead of the first line treatment, Valproic Acid, silence.

Remember that the only drug i had that did work preventive, Clobazam.
Had shortages, so overall got little if, but the Addiction expert assumed,
i was addicted to em ? After switch to Valproic Acid,

and without the side effect s of Levetiractam, suicidal tendencies, insomnia,
nightmares and daytime agitation. I landed finally 2 years later.
The seizures stopped, i tapered the VPA DIY, and feel damaged but way better.

 

[4DQSAR]

Yeah - I was prescibed levetiracetam and it was fairly useless i.e. kept on suffering myoclonis. It's not even appropriate for myoclonus but there you go, that's what I got prescribed in The Netherlands.

Valporate produced some problematic side-effects (being wobbly on crutches is a bad thing).

So I did get clobazam (after discovering that clonazepam also made me wobbly). I don't FEEL clobazam, I just don't twich randomly. Sometimes myoclonus is embarassing but sometimes it's downright nasty. My wife still laughs about the night I managed to throw myself out of bed and onto the floor. I was fine, luckly, but clearly it was a problem that needed addressing.

 

[lost weekend]

Man, that stuff only made it worse in my case, Terrible griping pain in the gut.

I know loperamide used to be sold in quite large quantities in the US and deperate opioid-dependent individuals were necking down lirerally hundreds of capsules at a time.

Loperamide has this really dangerous two-phase dose-response curve. It can freely pass through the BBB but the ABC transport pumps it back out again. Until you overwhelm that transport and it then becomes centally active. I've read a few tales of people who consumed 200mg and we fine (well, at least not sick) only to become extremely ill when they increased the dose by only a small amount.

The fact that there are forensic reports on cases of fatal loperamide toxicity should hint at the risks.

Someone I knew gave us all the full rundown of how they had been taking 100 capsules and were OK but decided 'as a treat' to just top that up to 240mg. They ended up in hospital with compartment syndrome and other really serious issues. They only survived because a friend turned up, heard the TV but couldn't get anyone to answer the door. Police of whoever had to kick down the front door to get them into the ambulance and on to the ICU.

Yeh I try and stay away from lopermide ,it's better to let a bug take its course unless it lasts to long .I would never even think of trying to abuse it ,there's plenty other otc options for pain ,I guess I was very lucky to be prescribed codeine .I used to love dhc because it gave me energy but codeine now beats it hands down .I just don't understand why cwe dosnt work for me ,in fact I hate it but the same dose of pure codeine feels brilliant .

 

[4DQSAR]

Yeh I try and stay away from lopermide ,it's better to let a bug take its course unless it lasts to long .I would never even think of trying to abuse it ,there's plenty other otc options for pain ,I guess I was very lucky to be prescribed codeine .I used to love dhc because it gave me energy but codeine now beats it hands down .I just don't understand why cwe dosnt work for me ,in fact I hate it but the same dose of pure codeine feels brilliant .

Well - be aware that the dependence liability of codeine is out of all proportion to it's analgesic activity. DHC less so, but DHC tartrate isn't anywhere nearly as water soluble as codeine phosphate which is why you cannot use the CWE to extract it.

Even DHC really should be treated with respect. It's longer duration and the fact it doesn't have a ceiling dose can work for you or equally against you.

Opioids can make a useful servant, but it makes a terrible master.

 

[lost weekend]

Well - be aware that the dependence liability of codeine is out of all proportion to it's analgesic activity. DHC less so, but DHC tartrate isn't anywhere nearly as water soluble as codeine phosphate which is why you cannot use the CWE to extract it.

Even DHC really should be treated with respect. It's longer duration and the fact it doesn't have a ceiling dose can work for you or equally against you.

Opioids can make a useful servant, but it makes a terrible

 

[emkee_reinvented]

Yeah - I was prescibed levetiracetam and it was fairly useless i

It was far from useless ! Death in a pill, dangerous.

Along the missing info a Neurologist know s,
and should tell their patient and especially them accompanying them.
[they know your memory is shot after seizing 2 hours]

For me it was the path to suicide they paved, the pill given right after,
my 2-nd short seizure.
Got Opioid s, Benzo s and Booze, and the will to end it all.

Its that call to my Mom stopped it all, or this would be past sentence.

Dr didn t mention suicidal tendency s are normal after Seizure s,
prescribed a med that worsened my complaint s as side effect.
And gives suicidal tendency s. 1+1=3
A specialist Neurologist for Seizure s.
While maintaining insomnia, and worsening it.
Not prevent seizure s ! So got 3 more. What a gift.

And she didn t know the term Ictal-Psychosis,
so was def not updated recent decades.
One word Pharma whore. Fore sure

 

[lost weekend]

That's good advice but I sometimes wish I could feel the ultimate rush ,not from any stimulants but from strong opiates ,I

Well - be aware that the dependence liability of codeine is out of all proportion to it's analgesic activity. DHC less so, but DHC tartrate isn't anywhere nearly as water soluble as codeine phosphate which is why you cannot use the CWE to extract it.

Even DHC really should be treated with respect. It's longer duration and the fact it doesn't have a ceiling dose can work for you or equally against you.

Opioids can make a useful servant, but it makes a terrible master.

I see alot of the chemists are stocking the ones you put in water and it fizzes like aspron although they do still have the tablets .maybe there catching on ,you just wonder how many of the staff know it can be extracted ,but it's not for me ,maybe there's caffeine or something in it because it's just not enjoyable. On the rare occasion I have had dhc I use the other route of administration if you know what I mean.if I new how to score which I don't I'd surely be in the gutter .

 

[4DQSAR]

That's good advice but I sometimes wish I could feel the ultimate rush ,not from any stimulants but from strong opiates ,I

I see alot of the chemists are stocking the ones you put in water and it fizzes like aspron although they do still have the tablets .maybe there catching on ,you just wonder how many of the staff know it can be extracted ,but it's not for me ,maybe there's caffeine or something in it because it's just not enjoyable. On the rare occasion I have had dhc I use the other route of administration if you know what I mean.if I new how to score which I don't I'd surely be in the gutter .

I think soluble paracetamol takes advantage of the fact that solubility is pH dependent.

Now I've never tried this, but often phenolic compounds can be crashed out of solution by adding calcium hydroxide (lime) or even calcium oxide (quicklime). It would be messy and likely only of use at scale, but I've watched how Russians 'cook' krokodil. They crush up the tablets, add them to a minimal amount of water, add caustic soda (drain cleaner) and extract the freebase codeine into... petrol.

I actualy ended corespondance to a group who were partly in Spain, partly in Brazil who were researching krokodil. I'm quietly proud that I was able to point out that red phosphorous forms phosphine (itself very toxic) but which reacts with the basic nitrogen of norcodeine/normorphine/nordesomorphine to form phosphoramides and it's the phosphoramides that cause the dreadful tissue damage.

I also saw footage of one girl who was an 'expert cook' and who carefully produced the hydroiodic acid seperately on a sand bath. But she put the sand bath on her bedside table so while she didn't end up with the typical gory images of people missing limbs or visibly rotting. But for a year she was breathing in phosphine... which melted her bones. Her back broke in two places.

Just one more reason why I stick to my prescribed medications and consume them only as prescribed. These days, you really don't know what you are getting.

 

[Shady's Fox]

I can say something, most pains are diseases at their origin and they last for life or they don't but becomes something else, maybe an early cardiac arrest and people sayin "Hey, remember X, yeah.. bla bla all his life and now she/he had to.."

I have someone in my family that needs a denture I mean both arches. Is a she, because she had took drugs and shit despite teeth brushing however she did it then, maybe she used hard vs soft brush or did it too fast, at end of day she would brush eventually and come back do drugs and live on. Plus a eventual mid way self aware canceled dental treatment.

She takes all nsaids possible and even methadone and for fuck all. On her end, is where dental infections transforms into neuralgia which means that her mouth is dead basically.

Yes dental infections sometimes let you live but take control of your perception.

Same for cancer pain or chronic skeletonal, eye pain and so on.

 

[Thejackal5654]

It's so fucking tiresome, save yourself the trouble and just fake a heroin addiction and get all the methadone you want to take home with you. addicts are given all the opioids they want and then some with no issues unlike pain patients.

I had to comment even though this is pretty old, but yea. I agree, and I've seriously thought about telling a few people this, and in all honesty, they'd definitely feel better on long lasting junk anyways. Taking oxy all day every day is a miserable thing. I mean, it all sucks, but with bupe/methadone at least you're not on a *constant* roller coaster and can just take a dose and go on with life.

 

[516CAZ]

I had to comment even though this is pretty old, but yea. I agree, and I've seriously thought about telling a few people this, and in all honesty, they'd definitely feel better on long lasting junk anyways. Taking oxy all day every day is a miserable thing. I mean, it all sucks, but with bupe/methadone at least you're not on a *constant* roller coaster and can just take a dose and go on with life.

But how's the pain control with those?

 

[Thejackal5654]

But how's the pain control with those?

Well, honestly, from my experiences Oxy makes pain worse. It's such an *insanely* short lasting drug. It's actually how it became famous you know. It was first called Eukodol and rapidly gained fame for its insanely potent *short lasting* euphoria and it's no odd coincidence it's the drug they started pushing so very hard and the one responsible for the epidemic we're still seeing the effects of. Methadone and Bupe are both very proven pain medications, and IMO far, far better for living a life of any type. It's been a very long time but as I remember taking oxy constantly was the most miserable roller coaster of constant feigning and rapidly diminishing returns (and this was during my robust early 20s). I'd get a 30 minute great high in the morning and then by the end of the night I'd be taking as much as I could for a 4 minute high and anything outside that slight rush just left me feeling like shit. The 2 drugs I mentioned aren't like that. Look up opioid induced hyper algesia. It's VERY real and I believe more prone to people taking short acting drugs. Obligatory I'm not a doctor, and all this is just my opinion. I got air cared and spent months in a HALO as a younger person so I have some experience, but not as much as yourself. Real pain is a nightmare, but I think some people would be better off on longer acting drugs. Just my opinion. I'm sure there are threads on here you can find or people that can give you more info. Some Dr's do prescribe methadone, but I'm unsure of how many or how common. It's also WAY WAY WAYYYYYYYYYYY easier to taper on methadone/bupe.

 

[4DQSAR]

Well, honestly, from my experiences Oxy makes pain worse.

I've been on a sustained release formulation for years. Now OFFICIALLY its supposed to work for twelve hours - but it does not and never did. I'm VERY lucky to have a clinician who knows this and swapped me from [BID] to [TID] which touch wood <taps forehead> has worked for many, many years. In fact, might be a decade now.

I'm old enough and damaged enough for a clinician to think 'well, this patient is likely to die due to comorbidities long before we run out of theraputic window for the oxycodone'.

BTW oxycodone is MORE active orally than by any parentheral route. Because first-pass metabolism converts around 10% of a dose to the much more active metabolite - oxymorphone which may actually be responsible for the majority of analgesic activity. Wikipedia doesn't note this but look how old the references it relies on are. Someone chose to post a link to Wiki as some manner of 'check mate' when proving themselves right... so I just posted the new research. But that is science. It's often replaced by better science.

I'm happy to find and repost those links - I do my homework on these things.

But injected oxycodone - terrible idea. All the 'side effects' (like euphoria) without any of the benefits (analgesia).

 

[Survival0200]

BTW oxycodone is MORE active orally than by any parentheral route. Because firsr-pass metabolism converts around 10% of a dose to the much more active metabolite - oxymorphone which may actually be responsible for the majority of analgesic activity. Wikipedia doesn't note this but look how old the references it relies on are.

I've heard some claims saying that the metabolites aren't clinically significant.

Maybe there's some new research that says otherwise?

 

[4DQSAR]

I've heard some claims saying that the metabolites aren't clinically significant.

Maybe there's some new research that says otherwise?

I went through this wish someone a few months ago in this thread. All the refs are there.

 

[Thejackal5654]

I've been on a sustained release formulation for years. Now OFFICIALLY its supposed to work for twelve hours - but it does not and never did. I'm VERY lucky to have a clinician who knows this and swapped me from [BID] to [TID] which touch wood <taps forehead> has worked for many, many years. In fact, might be a decade now.

I'm old enough and damaged enough for a clinician to think 'well, this patient is likely to die due to comorbidities long before we run out of theraputic window for the oxycodone'.

BTW oxycodone is MORE active orally than by any parentheral route. Because firsr-pass metabolism converts around 10% of a dose to the much more active metabolite - oxymorphone which may actually be responsible for the majority of analgesic activity. Wikipedia doesn't note this but look how old the references it relies on are. Someone chose to post a link to Wiki as some manner of 'check mate' when proving themselves right... so I just posted the new research. But that is science. It's often replaced by better science.

I'm happy to find and repost those links - I do my homework on these things.

But injected oxycodone - terrible idea. All the 'side effects' (like euphoria) without any of the benefits (analgesia).

Good to hear your Doc is a man who relies on perception and patient feedback instead of being just another mindless robot and guideline Nazi. The latter is what brought this whole mess down on so many people when the status quo was 'throw pills at everyone.' I wholly agree that oral is the most beneficial route. It's funny because I was laughed at quite a bit and got some really weird looks way back in the day when I did this stuff because (most of the time) I went with oral administration. It lasts longer, works better, and as you mentioned, doesn't give the monster rush everyone's looking for, but yet can never find after the first month. I still remember the hilarious faces and the incredulous "YoUrrEE eAtTinggG IttT?!?!?!" line I heard from time to time. Like, hell yeah man, it lasts longer and is more relaxing that way. Then again, I guess I'm one of those weirdos that honestly doesn't like a rush. IMO it's 5 minutes of fun that ruins the rest of your night.

 

[notsmokeymcpot42088]

I wish you would have asked if you should have done that! I read the title and literally "Nooo!" popped right out of my mouth - I got some strange looks lol