Recruiting [Worldwide] Share Your Story: Research on Living with SSRI Antidepressants

[Dr. John Thackery]

I think there over prescribed is there real evidence of them helping with anxiety and depression,

now that opioids are de facto banned for chronic pain in the US, SSRIs are thrown are the problem more and more. they do absolutely nothing for chronic pain imo. you can find papers saying they do and papers saying they don’t or course.

pretty pathetic that they even prescribe them for chronic pain i think it’s more just to do something rather than tell the patient we can’t do anything

 

[notsmokeymcpot42088]

You gunna be in pain at least you could care in general less?

"Can't?" I dont wanna speak out of turn but it seems like "Won't" is usually more accurate?

What are the opioid script limits --- is it like a quota you can't go over ? Amount per patient in pain? % of pain patients given opis? Complete subjectivity by the alphabet ppl? I never get that one

 

[Dr. John Thackery]

You gunna be in pain at least you could care in general less?

"Can't?" I dont wanna speak out of turn but it seems like "Won't" is usually more accurate?

What are the opioid script limits --- is it like a quota you can't go over ? Amount per patient in pain? % of pain patients given opis? Complete subjectivity by the alphabet ppl? I never get that one

on paper, it shouldn’t be any issue if you’re under 90 mg MME (morphine milligram equivalent)….but the DEA prosecuting and sentencing doctors to decades in prison, stripping CII licenses , for prescribing well under 90 MME has scared them away from prescribing anything whatsoever.


as far as “not caring” of you’re in pain because you’re on SSRIs (i think that’s what you were implying) ….i don’t think that works. personally it doesn’t and anybody i’ve spoken to online doesn’t get any benefit from it.

if anything weed does a better job at this “not caring” about pain than ssris do. but weed increases the level of pain experienced for many patients (myself included)….so it makes you care less and may bring some distraction but does objectively raise the pain score, so you have to decide if you’re ok with that trade off.

 

[notsmokeymcpot42088]

so 90 mg morphine equivalent. THANK YOU I swear I been shaking doctors down tryin to get a hard # for months and couldnt -- I APPRECIATE YOU

(Yes you got my implication correct -- "not care" / "doesn't complain" -- I do not have a very positive view of the medical system though)

I know I have a terminal aunt whose morphine got cut wayy the hell down from like 300 mg to idk I think 60.

She is not a good patient though -- she was onced convinced by her roomate / brother in law (Who steals her morphine to the point of addiction) that she should tell her doctor she wants off.....So they gave her methadone; which she STRAIGHT REFUSED TO TAKE calling it "Liquid heroin" --- FUCK GIVE IT TO ME; ILL GO GET YOU NORCOS. (She likes the tylenol bombs best for w/e reason)

Hmm weed works for almost everyone in pain that I know -- "Objectively" implies data and sources -- may I see them if they exist? (It isn't unfathomable weed smokers are more inclined to hyperbole?)

Mostly THANK YOU for the 90 MME standard. Had a couple doctors chased out of town but they were way down the rabbit hole (Exchanging oxy for sexual favors)

 

[Dr. John Thackery]

so 90 mg morphine equivalent. THANK YOU I swear I been shaking doctors down tryin to get a hard # for months and couldnt -- I APPRECIATE YOU

(Yes you got my implication correct -- "not care" / "doesn't complain" -- I do not have a very positive view of the medical system though)

I know I have a terminal aunt whose morphine got cut wayy the hell down from like 300 mg to idk I think 60.

She is not a good patient though -- she was onced convinced by her roomate / brother in law (Who steals her morphine to the point of addiction) that she should tell her doctor she wants off.....So they gave her methadone; which she STRAIGHT REFUSED TO TAKE calling it "Liquid heroin" --- FUCK GIVE IT TO ME; ILL GO GET YOU NORCOS. (She likes the tylenol bombs best for w/e reason)

Hmm weed works for almost everyone in pain that I know -- "Objectively" implies data and sources -- may I see them if they exist? (It isn't unfathomable weed smokers are more inclined to hyperbole?)

Mostly THANK YOU for the 90 MME standard. Had a couple doctors chased out of town but they were way down the rabbit hole (Exchanging oxy for sexual favors)

it’s all on the CDC guidelines

i believe they’ve since removed the 90 MME or at least made a clarification that it is not meant to be used to enforce laws or constitute malpractice because the initial implementation of this rule led to thousands of suicides and is the thing that definitively caused the fentanyl crises

you can see at FIG4 of the CDCs own data that massive vertical spike in fentanyl death right after the 2016 guidlines came out and the doctors instantly cut everyone off

Products - Data Briefs - Number 522 - December 2024

Published: 12/19/2024

www.cdc.gov

so after realizing they were responsible for all this death they tried to back track and soften the guidlines and say that ppl can be prescribed above 90 MME if that’s what’s appropriate etc….but it didn’t matter; the DEA was already on a tear and the public was hungry for someone to pay for all their young 20 year old kids dying from fentanyl so they took it all out on doctors since the cartel is untouchable

@4DQSAR has some further interesting info abiut about a clamp down on everything except methadone and bupe.

i had never heard of this until recently and id be curious to hear more about if from him or find sources of info because i was suddenly switched to methadone with zero warning out of nowhere around 2019 or something. and the doctor will give me 90 MME methadone but won’t go past 15 MME hydrocodone which is kind of strange

 

[notsmokeymcpot42088]

it’s all on the CDC guidelines

I somehow missed or am not privy to the CDC guidelines -- I have been asking doctors who have been evasive at best until you answered.

i believe they’ve since removed the 90 MME or at least made a clarification that it is not meant to be used to enforce laws or constitute malpractice because the initial implementation of this rule led to thousands of suicides

I can certainly see that you tell ppl there is a ceiling limit to prescribing and they gunna listen cuz who wants to lose there M.D for perceived over prescribing.

and is the thing that definitively caused the fentanyl crises

This I aividly disagree with and suspect I will to the bitter end. It was the cartel contaminating the heroin that led to the fentanyl crisis .....

Being open minded I would like to hear your theory on how that 90 mme led to the fentanyl crisis though. (Truth is I believe it to be a 'perfect storm' type situation with many variables; all interesting to me!)

I have heard ppl blame obama for the fent crisis based on some prescribing guidelines (you got any insight into that please do let me know; I had to write it off as partisan BS as no evidence was supplied)

you can see at FIG4 of the CDCs own data that massive vertical spike in fentanyl death right after the 2016 guidlines came out and the doctors instantly cut everyone off

Products - Data Briefs - Number 522 - December 2024

Published: 12/19/2024

www.cdc.gov

This time period also coincides directly with fent being thrown into the heroin on an increasing level -- to the point there was no option for most street users.

Correlation and causation are different? (again I am interested to hear your thoughts on it though!)

so after realizing they were responsible for all this death they tried to back track and soften the guidlines and say that ppl can be prescribed above 90 MME if that’s what’s appropriate etc….but it didn’t matter; the DEA was already on a tear and the public was hungry for someone to pay for all their young 20 year old kids dying from fentanyl so they took it all out on doctors since the cartel is untouchable

Tell El Chapo the cartel is untouchable --- they do life in a cell; you guys lose your license. That said doctors are not criminals and once a 'rule' is layed down I can certainly see them being inclined to follow it and not go "Ope that got lifted - more pills for everyone!" after the change....

Could you cite a doctor that got prosecuted/lost they license for prescribing more than 90 MME? (In a way that wasn't already inherently corrupt)

@4DQSAR has some further interesting info abiut about a clamp down on everything except methadone and bupe.

i had never heard of this until recently and id be curious to hear more about if from him or find sources of info because i was suddenly switched to methadone with zero warning out of nowhere around 2019 or something. and the doctor will give me 90 MME methadone but won’t go past 15 MME hydrocodone which is kind of strange

Maybe this had something to do with the methadone switch but this was like 2013 - 14 ish --- she told the doctor she didnt wanna be on morphine so they provided her an alternative; which she turned her nose up at even more. (pain in my ass)

She did the same thing with oxy even though it worked great. "Thats hillbilly heroin I can't be on that" --- Fuck you dumb, god bless your heart lol

 

[Dr. John Thackery]

I

This time period also coincides directly with fent being thrown into the heroin on an increasing level --

that’s because overnight there were 20 million opioid users that got thrown off their meds and heroin was not produced in high enough amounts to make up for it. heroin is also more expensive and many of these ppl didn’t have the money for it

 

[notsmokeymcpot42088]

Overnight there were 20 million opioid users thrown off there meds? This sounds like something that would be noteworthy -- what night did this happen and any sources to back 20 mil cut off overnight? (Even if it were hyperbole)

At the time -- and I will admit this is just personal experience -- but one echoe'd throughout the US. In the 00's even early 2010's you could get heroin that was like 80% pure straight off the corner.

a "Dime bag" = 200 mg of morphine...... Whereas a "Dimebag" worth of money in the blackmarket pharma world got you one maybe two perc 10's ---- 200 mg of morphine would be about 10x that dimebag of heroin....

Supply was larger than ever after we went into afghanistan

I don't think that theory pans out; H was easily affordable compared to the script drugs they were use to purchasing...... (The ? are not rhetorical in this case)

 

[Dr. John Thackery]

Overnight there were 20 million opioid users thrown off there meds? This sounds like something that would be noteworthy -- what night did this happen and any sources to back 20 mil cut off overnight? (Even if it were hyperbole)

At the time -- and I will admit this is just personal experience -- but one echoe'd throughout the US. In the 00's even early 2010's you could get heroin that was like 80% pure straight off the corner.

a "Dime bag" = 200 mg of morphine...... Whereas a "Dimebag" worth of money in the blackmarket pharma world got you one maybe two perc 10's ---- 200 mg of morphine would be about 10x that dimebag of heroin....

Supply was larger than ever after we went into afghanistan

I don't think that theory pans out; H was easily affordable compared to the script drugs they were use to purchasing...... (The ? are not rhetorical in this case)

we can see the massive vertical death spike at 2016 right when everyone was cut off. that’s hard data.

we know for a fact that they were cut off. there is data to show that opioid scripts plummeted at this time…that’s not debatable

you’re saying it just happened to be a coincidence that the CDC cut everyone off legal opioids immediately before that but that has nothing to do with it and it was that fentanyl came on the scene and was a preferred choice to the oxy 30s and dilaided 8s ppl were getting completely legally and free under insurance.

so ppl chose to then break the law, get off of legal oxy 30s that were free and with to fent because fentanyl is better (it’s not it’s a shit drug for pain management and abuse compared to the oxy 30s and dilaided)

 

[notsmokeymcpot42088]

No I am asking to see the data that "everyone was cut off" you say there is data -- may I see it?

Again I am saying it was a perfect storm of sorts but I think the fentanyl in the heroin had more to do with it than the CDC. Perhaps the data will convince me otherwise - I am open minded.

No not at all, what I am saying is a large % of people were already using both they scripts and heroin --- than the heroin became fentanyl as did the oxy 30's; leading to said death spike.

Ppl getting pulled off they pills went to heroin as they had for decades -- just the heroin wasnt heroin anymore.

Not to mention at the time you could order fent analogs off the clearnet all day long -- u4477880 or w/e comes to mind but that was before we got to things like AF etc

LSD that you?

 

[Dr. John Thackery]

No I am asking to see the data that "everyone was cut off" you say there is data -- may I see it?

there were massive manufacturing quotas instituted limiting the amount of opioids available by 33% and then more

we have a C2 prescription data base and they know how many scripts are written and not written .



you seriously want me to search that for you?


this was the first google scholar hit and it proves what i said. do your own further research look it up yourself. this study shows a /12 decrease over the study period

and this was for initial prescriptions only too so doesn’t account for all of them.

Changes in Initial Opioid Prescribing Practices After the 2016 Release of the CDC Guideline for Prescribing Opioids for Chronic Pain​

Google Scholar

scholar.google.com

Results
The rate of high-dosage prescriptions (≥90 morphine equivalent milligrams per day) was 683 per 100 000 persons in January 2012 and declined by 3.56 (95% CI, −3.79 to −3.32) per month before March 2016 and by 8.00 (CI, −8.69 to −7.31) afterward. Likewise, the percentage of patients with overlapping opioid and benzodiazepine prescriptions was 21.04% in January 2012 and declined by 0.02% (CI, −0.04% to −0.01%) per month before the CDC guideline release and by 0.08% (CI, −0.08% to −0.07%) per month afterward. The overall opioid prescribing rate was 6577 per 100 000 persons in January 2012 and declined by 23.48 (CI, −26.18 to −20.78) each month before the guideline release and by 56.74 (CI, −65.96 to −47.53) per month afterward.

 

[notsmokeymcpot42088]

I do not have a c2 prescription data base and am not one for taking peoples word -- but NO, I DO NOT want you to do anything that would pop any red flags or put your job at risk. Not worth it.

1/2 decrease valid ---and Believable. The whole "opioid epidemic" did a # on pain patients

20 million people dropped (Completely) over night is a very different claim however.....

a "Dime bag" of heroin = 200 mg of morphine (at 80% unless my math wrong)...... Whereas a "Dimebag" worth of money in the blackmarket pharma world got you one maybe two perc 10's? ---- 200 mg of morphine would be about 10x that dimebag of heroin....

Everyone I know was plenty happy with the cost of H -- until fent/death became the cost of H *who am I kidding most are still on board*

my premise remains that the fentanyl in the heroin had far more to do with the death spike than the CDC

at least you had an option that was better, more euphoric, cheaper, more effective, and honestly fairly safe as long as you were careful.....

 

[Dr. John Thackery]

I do not have a c2 prescription data base and am not one for taking peoples word -- but NO, I DO NOT want you to do anything that would pop any red flags or put your job at risk. Not worth it.

1/2 decrease valid ---and Believable. The whole "opioid epidemic" did a # on pain patients

20 million people dropped (Completely) over night is a very different claim however.....

a "Dime bag" of heroin = 200 mg of morphine (at 80% unless my math wrong)...... Whereas a "Dimebag" worth of money in the blackmarket pharma world got you one maybe two perc 10's? ---- 200 mg of morphine would be about 10x that dimebag of heroin....

Everyone I know was plenty happy with the cost of H -- until fent/death became the cost of H *who am I kidding most are still on board*

my premise remains that the fentanyl in the heroin had far more to do with the death spike than the CDC

at least you had an option that was better, more euphoric, cheaper, more effective, and honestly fairly safe as long as you were careful.....

so the fact that the CDC guidelines and the scripts being cut off cold turkey were released 6 months before the massive fentanyl death spike at FIG 4 is just a coincidence?


it was a total coincidence that fentanyl killed tons of ppl all of a sudden right after they lost their legit scripts due to the cdc.

even if the cdc would’ve left everyone on their oxy the spike in FIG4 would’ve still happened? ppl would’ve voluntarily stopped doing their legal and free oxy 30s and turned to fentanyl all at once ?

 

[notsmokeymcpot42088]

No, again I think it is a combination of the two - the fentanyl bears the majority of the weight though by far . For decades and decades when people got cut off their opiates or ended up with an unmanagable habit they would go to heroin.....and never started dropping dead in #'s anywhere near that.

No it was not a complete coincidence; but it was a coincidence of sorts so many ppl got dropped from scripts at roughly the same time the dope got spiked - people who get cut off they scripts typically go to the blackmarket - which did not kill them until the fentanyl cut. In this particular case when they went to the blackmarket they were sold a product they did not ask for and that was far more fatal --- hence the death spike.

Absolutely yes. If the CDC would have left everyone on their oxy we would have still seen a very large death spike - I will grant it may have been slightly smaller than FIG4 as there would be less ppl switching to "H" in the first place.

The amount of ppl already on H or supplementing they scripts with it would have still caused said death spike when the fent was introduced without the CDC changes --

they didnt help anything and I am not in favor of said guidelines certainly.

I think I am almost ready to rest my case here --- the logic feels pretty sound.

 

[anhedoniacel]

I have pretty much used all the most commonly used antidepressants among all classes in the past 3 years currently available. I'd love to chat.

 

[notsmokeymcpot42088]

whatup dog, you down with citalopram? What antidepressant you wanna talk about

Chat away --- I promise im usually nice

 

[Dr. John Thackery]

No it was not a complete coincidence; but it was a coincidence of sorts so many ppl got dropped from scripts at roughly the same time the dope got spiked -

the latter was in no way a coincidences “of sorts”

heroin could not supply the population that was dumped off scripts. it is limited in its production, harder to smuggle and more expensive.

the cartel saw a business opportunity when all these ppl got cut off and they were forced to fill the demand with something because they couldn’t produced enough heroin; so enter fentanyl. and finally ppl were desperate enough to even touch fentanyl which had been around in circles for decades prior but it was considered shit dope.

btw fentanyl had been around for decades upon decades before all of this, and it never exploded because there was little demand for it because 99% of dope users find oxy dilaided and heroin far mor euphoric and practical and safer if drugs to be on.

this was no coincidence that fentanyl entered at the time of an insane market demand was created by the cdc. it was a necciscisity to provide even a sub par opioid to these millions of stranded opioid users and an amazing business opportunity the cartel calculatedly capitalized on —- because NOW ppl were indeed desperate enough to use fentanyl since the way more euphoric and safer opioids were gone

 

[notsmokeymcpot42088]

I am aware that fentanyl has existed for many decades.

I absolutely disagree with the premise that heroin could not supply the population of people dumped off scripts. Heroin production, importation, and purity were at an all time high.

That is a claim that would require data which I do not believe to exist (Though I may see what I can find im bored; in 2014 they seized 5,000 ki's; good round # -- now to find a rough success to failure ratio lol)....
law enforcement often only seizes a small fraction of total illicit drug shipments, with some estimates suggesting around 10-15% (or one-seventh) of the total flow for certain drugs like heroin.

so 5k x 7 = 35,000 keys in 2014 ---- sigh now to do some population math --- (I should note there are too many variables to be that accurate but ill try)

2013, approximately 517,000 people were dependent on or abused heroin, which was about 0.2% of the population (2014 they only had 'used in the last month' which doesnt really fit) so 2013's # will have to do

The average dose of intravenous heroin was 466 mg/day;

91,250 g per day *I encourage anyone to check my math, foreal; btw I rounded u to 500mg a day lol* (Damn the demand is gunna be higher than the alledged supply and this was pre 2016)

3330625 g a year -- move the decimal for kilo --- 330 thousand kilo demand. (Now obviously everyone that uses isnt doing an HG a day, but some do more, idk anyone got a better formula run it)

OKAY BASED ON THAT THE SUPPLY NEVER MET THE DEMAND SO I QUESTION MY OWN MATH AND THE SOURCES PROVIDED QUITE A BIT HERE -- but IN FAIRNESS I CAN PRESUME IT WAS WORSE IN 2016 and continue on the possibility. Waste of time lol

so I think we are going to have to respectfully disagree.

Alternate theory - the RC market/chinese chemists hooked up with the cartels and simply found a higher profit option. In the 2010's RC's were big and any drug user worth their salt had to recognize these chinese chemists had value -- im sure the cartel saw that as well.....(MDPV and JWH-018 alone had to get they attention and we aren't even to opioids yet)

If I had to pitch a theory as to "Why now" it would have more to do with the chinese chemists than CDC guidelines

 

[Dr. John Thackery]

I am aware that fentanyl has existed for many decades.

I absolutely disagree with the premise that heroin could not supply the population of people dumped off scripts. Heroin production, importation, and purity were at an all time high.

are you going to address the issue of ppl (many poor) getting gigantic bottles of oxy 30s for free would sudden have to switch to an equivalent heroin habit of like 100 to 300$ per day?

while fentanyl is massively cheaper for the customer and producer?

if alls equals who in their right mind would pick fentanyl over heroin? why would ppl do that if there was so much abundant cheap heroin to supply every one that was cut off as you claim?

all i see in this forum is complaining about how shitty fentanyl is vs heroin, never heard the reverse. yet you’re arguing ppl willingly chose the reverse

 

[notsmokeymcpot42088]

no it would be your turn to supply the data that indicates there was a large enough amount of people cut off a large enough amount of opioids that the heroin market could not meet said demand.

Which math I am working on diligently -- until that data exists we are operating off of YOUR SPECULATION.

noone in they right mind would pick fent over H -- They were not offered a choice the fentanyl is a cut; this was not a supply issue -- an adapt to survive and make higher profit issue. To the cartel of course.

Like you said cheaper to produce, less bulky, idk about fentanyl dogs but I know it has less odor than H....

I am absolutely not arguing people chose the reverse - the end user doesnt choose. The cartels choose, bigpharma and doctors choose. ( I was really hoping for packs of benzo powder but I dont have much say )

To further prove my point there is an emerging market for H that tests clean and it is more expensive and more desired than the grey death found on the street.....