I know your pain all too well my friend. Ive been in the same position many times, and the last year or so it has been more of an issue than ever before. Likely due to the obviously stronger substances (certainly not the type of stronger I would like.... I dont even get a nod anymore)
A little background.....About 6 months ago, i dropped a daily habit of 5-10 blues. All snorted. And decided to make the jump to B.T.H. in an effort to essentially stay alive.... because those damn fake 'pills' were killing me. (as im sure the H is doing, albeit slower it feels like, while being less expensive, and hopefully I stopped in time to save the tissue inside my nose from completely rotting away.... although I am still worried about it)
So I have the same issue every so often when it gets that bad. Where Ive come so very close to going to the ER.... but obviously noone in their right mind wants to go to the ER.... and especially for this particular issue!
I have tried many different things. Stool softeners (which I still take from time to time when I feel I may be getting a bit more stopped up than usual. Ive tried laxatives, which have worked in the past, but also have not worked a time or two.... which was very unsettling and uncomfortable.
I have used the fleet enemas before, and those generally will do the trick. But the last time I tried one of those, I instantly got an EXTREMELY weird/ uncomfortable/ kind of frightening sensation and reaction that has me no longer interested in using those. (thats the most I will say here.... but am open to discussing in a private message)
For a while, I was using daily Metamucil.... If you or anyone reading this are fans of Howard Stern, youll know that he talks up Metamucil all the time, and how his duddies are 'amazing' lol
Another thing Howard Stern talks about all the time.... is his Toto Toilet.... or his bidet toilet.
I have since gotten one of the bidet attachments for my sh*tter.... and man does it help.
Not only does it help save on TP and make you much cleaner down there.... But It can help in this situation as well.
Basically, you want to be in sh*tting position.... and let the bidet shoot water up your a$$hole....
If your 'close' to some coming out, its possible to let the water not only lubricate, but to literally help break some off, and alot of the times the remainder will follow.
I have also found that a warm shower will help. As well as physical movement. And last but not least.... massaging your lower belly right below your waist line pretty firmly with 3 or 4 fingers grouped together, kind of in a circular motion.... but really however you feel comfortable.
Another thing that seems to help me. Is Ibuprofen. Since Ibuprofen helps with swelling, usually when i need to go really badly but cant, I will take a single liquid gel.... sometimes 2. And by the end of the night I end up feeling much lighter, and more comfortable.
I will note something with the Ibuprofen....
Even though i have not been to a DR or even had one that I would say is 'my dr'..... I am fairly sure i have an enlarged prostate. at the minimum.
Ive had 'symptoms' or things that have presented themselves.... that make me feel "enlarged" may be the least of my worries..... But alas, I am a coward. and will do all I can to simply try and ignore it.... and hide behind more drugs until I stop thinking about it.. Obviously a very dumb choice. But I am working up the courage to go get checked out.
My point in telling you this, is the ibuprofen could possibly be aiding the swelling from my prostate.... therfore making it easier to sh*t.....
Again, speculation on my part.
I hope any of my ramblings, and likely 'too much info', is helpful in some way.
Good luck my friend. Hope you get to feeling better ASAP.
I know how EXTREMELY uncomfortable it can be.