Do all your doctors always know all drugs you've been prescribed?

[Mycophile]

So, I'm not sure if this is the best sub-forum for this, so if a mod feels it should be moved to a different one then feel free.

This is going to be kind of a long, convoluted post, so be warned, you'll need to read a lot to understand it LOL...

I don't really use all that many substances these days, but I like to be able to on occasion.

I have anxiety and depression, so I'm prescribed Prozac and Klonopin which I take daily, and I'm also prescribed Naltrexone at 50mg which I take most days so that I can control my own ability to drink or take Kratom. The thing is, I love alcohol and Kratom, but like most, I don't have perfect self-control with how often I use them, and I prefer to be sober most of the time, so a couple years ago I got a prescription for Naltrexone, but I will NEVER let ANY doctor know that I have EVER used Kratom, for very obvious reasons...

Now if I don't want to be able to take Kratom or drink, all I need to do is take Naltrexone and I can't enjoy either, but if I want to drink or take Kratom, all I need to do is stop taking my Naltrexone for 3 days and it's out of my system and I can enjoy myself, so I do this sometimes. The only thing I have to be sure of is that I have no kratom left in my system before I go back to taking my Naltrexone or it could cause precipitated withdrawal.

However, a while back I became very interested in Ultra Low Dose Naltrexone which is entirely different from full dose naltrexone because if used properly it COMPLETELY eliminates most opioid withdrawal, including kratom, and is also good for pain and anxiety and depression.

I found a facebook group that helps people find doctors for ULDN/LDN, and I'd like to get some, because whenever I do decide to use Kratom for more than a few days I will get really annoying WD for about 3 days where I'm just EXHAUSTED and can't stop sleeping, so I can't get any work done or do anything for those 3 days.

But the thing is, I'm already a bit worried that if I was ever injured again (and I've had multiple injuries from martial arts so it could happen again) that I might need opioids again and be denied them by a doctor if they incorrectly thought I was on the Naltrexone for opioid addiction rather than alcohol. I can only hope that if that ever happens I can tell my psychiatrist and he'll be willing to vouch that even though I take Naltrexone for alcohol that I have no opioid problem and still be able to get those for an injury, and I also take Klonopin which is a scheduled substance, so I must be careful what I tell doctors.

So all of this makes me even more reluctant to seek out Ultra Low Dose Naltrexone which I'd really like to have on hand.

This facebook site hooks you up with doctors you can talk to who will prescribe ULDN and pharmacies that will fill it, and I'd like to do that, but I'm worried about either my psychiatrist or primary physician finding out that I got this prescribed for me.

I think one or both might be quite confused as to why I'd have prescriptions for BOTH full dose AND Ultra Low Dose Naltrexone, and I worry about hypothetical situations where I could get cut off from my Klonopin and/or full dose naltrexone, or denied a pain medication if ever injured, if my doctors thought I was some kind of serious opioid addict.



I'm sorry, I know this is a lot to follow, but if anyone understand what I've described so far, here's my question:

If I were to call one of these doctors and have an online visit with him/her, and have one of these pharmacies fill a prescription for ULDN, does that automatically mean that this info would be in a computer database that my primary doctor and/or psychiatrist and/or regular pharmacy would be able to access, so as to know about it even despite my not getting it from them??

I'm hoping not, but I'm not naive, and I can only assume that once a prescription goes into any database, regardless of prescriber or pharmacy, that the info is out there and can easily be accessed by all my doctors, and I'm not comfortable with that, and so I haven't made the call to get ULDN.

Am I wrong?

Is there any possible way that by using a different doctor and different pharmacy that my regular doctors and pharmacy might NOT know that I was also prescribed ULDN??


Again, sorry this is so long, but I'm paranoid about what doctors know, and I'm not taking this risk if it could somehow backfire down the road.

Thanks

 

[negrogesic]

The answer to your question is that in most cases, doctors cannot see the whole picture in terms of what is being prescribed as a whole. But this can vary by area. Your insurance company certainly can however.

But the real answer is just to reformulate it yourself and save yourself the time.

I'm experimenting with this myself. I dissolved a 50mg naltrexone tablet in 5000ml of water, thus producing a solution of 10ug/ml. As far as if its working, not sure. So far I feel like it definitely causes a bit of insomnia

 

[Jerry Atrick]

@Mycophile Negrogesic answered your question that while doctors may or may not be able to know what you are doing, your insurance company does.

Please see if you can alter the doses you are already prescribed, which would mean there is no reason to be dishonest with any doctors.

If anyone has advice on how to alter doses of this medication, they can reply here. However, we will be keeping a close eye on this thread because we cannot condone circumventing the medical system in Mental Health forum. If that topic arises, the thread will be locked.

 

[Mycophile]

The answer to your question is that in most cases, doctors cannot see the whole picture in terms of what is being prescribed as a whole. But this can vary by area. Your insurance company certainly can however.

But the real answer is just to reformulate it yourself and save yourself the time.

I'm experimenting with this myself. I dissolved a 50mg naltrexone tablet in 5000ml of water, thus producing a solution of 10ug/ml. As far as if its working, not sure. So far I feel like it definitely causes a bit of insomnia

I would like to try to make Ultra Low Dose Naltrexone from regular dose naltrexone, but i once spoke to a pharmacist at a compounding pharmacy about it and he told me he didn't think I'd be able to accurately do it myself. He said that even at the compounding pharmacy it's difficult for them to get the dosing right. So when he said that, that made me feel there was no way I could do it because I know jack shit about chemistry.

Not to mention that even on the facebook sites they say that usually the best you can get prescribed is LOW dose as opposed to ULTRA low and that they then need to give you advice on how to further dilute it down to Ultra low, so going from regular 50mg to ULTRA low seems like it could be very hard. I'd probably have to get it to low, then from their Ultra Low, and you have to get it JUST EXACTLY RIGHT because if the dose is even SLIGHTLY too high it will block the kratom, or worse yet, if you are in any kind of kratom withdrawal and you take it to try to eliminate that (which would be how I'd use it in that case) it could put you into precipitated withdrawal.

It's odd cause i use regular Naltrexone to block both Kratom and Alcohol so as to force temporary abstinence on myself so I won't go overboard, and it works well to keep a much cleaner more sober lifestyle, but then when I want to have fun I go off it, and i have to be careful with going back on to it again after using kratom so as not to get precipitated withdrawal.

Now I'd THINK that a few too many days of kratom with you only take LOW dose naltrexone a bit too soon if you messed up MIGHT not put you in such a bad spot with the precipitated withdrawals, but I really don't know.

@negrogesic Do you know what the proper doses for ULTRA low naltrexone are?

I have them written down somewhere, but they tend to vary.

Do you know anyone who's gotten this right so far, making Ultra low from regular, and successfully put it to the test to eliminate any kind of opioid withdrawals and potentiate opioids?

Because after what that pharmacist says, I'm not AT ALL confident I could get it right. I think it would be a complete crap shoot and I'd get the dosing wrong probably.

 

[paranoid android]

Here in Canada they can look up any drug youve been scripted.

 

[negrogesic]

I would like to try to make Ultra Low Dose Naltrexone from regular dose naltrexone, but i once spoke to a pharmacist at a compounding pharmacy about it and he told me he didn't think I'd be able to accurately do it myself. He said that even at the compounding pharmacy it's difficult for them to get the dosing right. So when he said that, that made me feel there was no way I could do it because I know jack shit about chemistry.

Not to mention that even on the facebook sites they say that usually the best you can get prescribed is LOW dose as opposed to ULTRA low and that they then need to give you advice on how to further dilute it down to Ultra low, so going from regular 50mg to ULTRA low seems like it could be very hard. I'd probably have to get it to low, then from their Ultra Low, and you have to get it JUST EXACTLY RIGHT because if the dose is even SLIGHTLY too high it will block the kratom, or worse yet, if you are in any kind of kratom withdrawal and you take it to try to eliminate that (which would be how I'd use it in that case) it could put you into precipitated withdrawal.

It's odd cause i use regular Naltrexone to block both Kratom and Alcohol so as to force temporary abstinence on myself so I won't go overboard, and it works well to keep a much cleaner more sober lifestyle, but then when I want to have fun I go off it, and i have to be careful with going back on to it again after using kratom so as not to get precipitated withdrawal.

Now I'd THINK that a few too many days of kratom with you only take LOW dose naltrexone a bit too soon if you messed up MIGHT not put you in such a bad spot with the precipitated withdrawals, but I really don't know.

@negrogesic Do you know what the proper doses for ULTRA low naltrexone are?

I have them written down somewhere, but they tend to vary.

Do you know anyone who's gotten this right so far, making Ultra low from regular, and successfully put it to the test to eliminate any kind of opioid withdrawals and potentiate opioids?

Because after what that pharmacist says, I'm not AT ALL confident I could get it right. I think it would be a complete crap shoot and I'd get the dosing wrong probably.

The pharmacist is right in the sense that it is fairly difficult to make a solution at home with the same precision of a pharmacy compounded solution, but it is quite easy to make one that is +/- 5%.

At these tiny doses even if you completely do the math wrong, are somehow off by a factor of 300% and take 15ug twice a day instead of 5ug twice a day, there is no risk for precipitated withdrawal. These tiny doses barely tickle the opioid receptors.

For ULDN I would recommend starting at a mere 1ug twice a day and work up from there.

 

[Mycophile]

The pharmacist is right in the sense that it is fairly difficult to make a solution at home with the same precision of a pharmacy compounded solution, but it is quite easy to make one that is +/- 5%.

At these tiny doses even if you completely do the math wrong, are somehow off by a factor of 300% and take 15ug twice a day instead of 5ug twice a day, there is no risk for precipitated withdrawal. These tiny doses barely tickle the opioid receptors.

For ULDN I would recommend starting at a mere 1ug twice a day and work up from there.

I don't know what those numbers mean to be honest, but I'd have to learn.

What kind of numbers are you looking for for ULDN?

I mean, whether or not it's the precision they have, it just needs to be precise enough to have the intended effects, and from what I've heard even then some experimentation is necessary, but I'm fine with experimenting if it's not dangerous, which it doesn't seem to be. Not to mention that LDN and ULDN also have other benefits as you have mentioned, both for pain and anxiety and depression, and I like the idea of using either one for depression and anxiety.

Do you know anyone who's successfully pulled this off to the extent that then they were able to use the solution to prevent WD symptoms from any opioid and possibly potentiate it?

 

[Nurse Ratched]

As far as i know all States in the US have adopted the database.

Dr.s go in there all the time and cross check people's scripts.

If your Dr. (mycophile's ) goes in the data base and checks your name he can see all prescriptions that have been given you by ANY Dr. or ER or urgent care or even out of state. There's no way to get scripts anymore without being caught. That's how people get cut off from pain management.

Example: Someone is on pain mgmt for back or neck issues. They break their leg and go to the ER. ER prescribes opioids and you FILL IT. Next time you see your Dr. he asks you why you didn't contact him to " approve " the script. Contracts specifically state that we are NOT allowed to fill any scripts NOT written by them or " approved beforehand " by them. Chances are you are now let go from his care .

It's just not worth trying to undermine the system anymore. We take what we can legally get or go to the streets. Or the darknet.

 

[Mycophile]

As far as i know all States in the US have adopted the database.

Dr.s go in there all the time and cross check people's scripts.

If your Dr. (mycophile's ) goes in the data base and checks your name he can see all prescriptions that have been given you by ANY Dr. or ER or urgent care or even out of state. There's no way to get scripts anymore without being caught. That's how people get cut off from pain management.

Example: Someone is on pain mgmt for back or neck issues. They break their leg and go to the ER. ER prescribes opioids and you FILL IT. Next time you see your Dr. he asks you why you didn't contact him to " approve " the script. Contracts specifically state that we are NOT allowed to fill any scripts NOT written by them or " approved beforehand " by them. Chances are you are now let go from his care .

It's just not worth trying to undermine the system anymore. We take what we can legally get or go to the streets. Or the darknet.

Thanks. Yeah, I'm not even risking it.

This is what I thought. I mean everything is in a computer somewhere so I don't see how anyone can try to say that it's not. There's always a strong possibility of something being seen by a doctor.

Not that having Ultra Low Dose Naltrexone is necessarily an issue, but it MIGHT be, and so is the fact that I already take Naltexone, so I will have to hope that if I ever get injured again that my psychiatrist will vouch for me having used that for alcohol and NOT opioids so that they'd prescribe what I need. It's all hypothetical, and I think (and hope) he would if it ever came down to it. He's nice so I could probably get him to agree, but I just don't want anyone ever denying me a pain med if i happen to get injured.

 

[Mycophile]

I would still like someone to explain to me how I would know if I had properly created ULDN from full dose naltrexone rather than LDN.

There are facebook groups explaining how to do it, but how really would I know whether the solution I had was low dose or ULTRA low dose?

All I can think is that low dose blocks opioids like kratom and Ultra Low potentiates them, so if I wanted to be sure I'd have to drink my solution, then take a dose of kratom and see if it blocks it or not.

Anyone know how else to know?

 

[Robi]

my doctor didnt, he is toooooooooo busy but asked me on a facetime call , when i asked for pregabalin, i told him what the psych he hooked me up with when he asked, prescribed me, but i know for a fact he looked me up because he did it while i was sitting there the first time i saw him in his office, when he left, i looked at his laptop, another psych before this one , told me what the GP gave me(miratzapine?) i had no history of any opiates prescriptions , seems that is their major concern, ive never asked for opiates, never will, thats a no no here, even with debilitating pain

 

[Mycophile]

As far as i know all States in the US have adopted the database.

Dr.s go in there all the time and cross check people's scripts.

If your Dr. (mycophile's ) goes in the data base and checks your name he can see all prescriptions that have been given you by ANY Dr. or ER or urgent care or even out of state. There's no way to get scripts anymore without being caught. That's how people get cut off from pain management.

Example: Someone is on pain mgmt for back or neck issues. They break their leg and go to the ER. ER prescribes opioids and you FILL IT. Next time you see your Dr. he asks you why you didn't contact him to " approve " the script. Contracts specifically state that we are NOT allowed to fill any scripts NOT written by them or " approved beforehand " by them. Chances are you are now let go from his care .

It's just not worth trying to undermine the system anymore. We take what we can legally get or go to the streets. Or the darknet.

I'm a little confused here though.

You're saying if an emergency room were to prescribe me an opioid for some injury that if I didn't call my primary physician and have him "approve it" that I could get cut off from being his doctor or even considered to be a medication abuser even though I was legitimately given it by a doctor?!?!

That's really fucked up if that's the case.

I've never been in that situation, but I have been prescribed pain meds by different doctors who were not my primary physician but part of the same medical group, because they were the specialists I was going to see based on those specific injuries (3 times my knees and once my wrist).

I never got those meds "approved" by my primary physician and I didn't get in trouble for it.

Are you saying I just got lucky?

Cause if so, that doesn't make sense to me. A doctor is a doctor right? Why would I need another doctor's approval?

I was never told anything like that the times I was injured.

 

[Nurse Ratched]

I'm a little confused here though.

You're saying if an emergency room were to prescribe me an opioid for some injury that if I didn't call my primary physician and have him "approve it" that I could get cut off from being his doctor or even considered to be a medication abuser even though I was legitimately given it by a doctor?!?!

That's really fucked up if that's the case.

I've never been in that situation, but I have been prescribed pain meds by different doctors who were not my primary physician but part of the same medical group, because they were the specialists I was going to see based on those specific injuries (3 times my knees and once my wrist).

I never got those meds "approved" by my primary physician and I didn't get in trouble for it.

Are you saying I just got lucky?

Cause if so, that doesn't make sense to me. A doctor is a doctor right? Why would I need another doctor's approval?

I was never told anything like that the times I was injured.

These rules only apply to pain mgmt. They all make you sign a contract specifically stating many rules that we have to follow. Because of the opioids they are prescribing.

If we just have a primary/psych/reg. Dr..............these rules do not apply. They may, or may not, care if you receive other scripts. Whether or not they care is up to them but they still access our records from time to time.

 

[Eligiu]

To answer your question simply, no. In general each of your doctor's will not and cannot know every drug you are prescribed unless you tell them.

My GP, for example, knows every medication I take and it's his responsibility to be aware of that and any possible interactions. GPs (General Physicians) are specialists, despite the fact they are often seen as the first port of call for medical issues. They need to have adequate knowledge of a vast range of conditions, ailments, medications and their interactions. My GP used to not be aware of what my psychiatrist was prescribing me but I had some issues come up with that where I ran out of medication and he wasn't allowed to prescribe me what the psychiatrist had unless he had it recorded on file that she had already treated me with that medication.

Some pharmacies use live script monitoring systems like we do in Australia for controlled substances, things like benzodiazepines, prescription stimulants, and prescription opiates. If you were to get a dual scriptb of this type filled then your prescriber would be made aware of that fact. I think this is also the case for any 'authority' medication, which naltrexone is (at least in Australia).

I'm still somewhat confused as to why you'd need both however. From research that I've done, ULDN seems to be fairly effective at treating moderate to severe pain, so I'm not sure why you would get cut off from your other medications (or why getting cut off from the normal dose of naltrexone would matter in this case). I would recommend just using the ULDN as prescribed and not bothering with the normal dose in order to get the full benefit from the lower dose.

@Mycophile if you lived in Australia you would be considered lucky because of that series of events. That would almost certainly be considered doctor shopping her because if you have anyone taking care of your pain using controlled opiates, they need an authority from the Drug of Dependence Unit in order to do so, that authority is supposed to be limited to one doctor. For example last time I was on suboxone strips before I tapered off and relapsed, my GP initiated the treatment. Then when I was tapering off I had to switch to subutex pills to taper by smaller amounts and he isn't allowed to prescribe that, so I had to go to the drug and alcohol state services to see an addiction medicine doctor and have him prescribe it and have the authority transferred over to him. Same with my dexamphetamine prescription - my GP initiated treatment and he retains the authority to prescribe it. If I were to go to my psychiatrist and ask her to prescribe me Vyvanse or Ritalin due to my ADHD diagnosis, my GP would have to relinquish the authority for the dexamphetamine or I would be picked up as doctor shopping by the DDU for trying to access controlled stimulants from several sources at one time. If, however, my psychiatrist decided that it was necessary to add in Vyvanse or Ritalin to my medication regime then she could write to my GP and take over the authority or have him update it to reflect that medical order and that would be fine for the DDU. Does that make sense? So in a way, I can't tell if you were lucky because I don't know where you live but I know if you were in Australia you can certainly count yourself very fortunate that you haven't got a strike against your name, although they don't tend to actually tell people when they do that, they usually just stick them on management plans like I am with my dexamphetamine.

 

[Mycophile]

To answer your question simply, no. In general each of your doctor's will not and cannot know every drug you are prescribed unless you tell them.

My GP, for example, knows every medication I take and it's his responsibility to be aware of that and any possible interactions. GPs (General Physicians) are specialists, despite the fact they are often seen as the first port of call for medical issues. They need to have adequate knowledge of a vast range of conditions, ailments, medications and their interactions. My GP used to not be aware of what my psychiatrist was prescribing me but I had some issues come up with that where I ran out of medication and he wasn't allowed to prescribe me what the psychiatrist had unless he had it recorded on file that she had already treated me with that medication.

Some pharmacies use live script monitoring systems like we do in Australia for controlled substances, things like benzodiazepines, prescription stimulants, and prescription opiates. If you were to get a dual scriptb of this type filled then your prescriber would be made aware of that fact. I think this is also the case for any 'authority' medication, which naltrexone is (at least in Australia).

I'm still somewhat confused as to why you'd need both however. From research that I've done, ULDN seems to be fairly effective at treating moderate to severe pain, so I'm not sure why you would get cut off from your other medications (or why getting cut off from the normal dose of naltrexone would matter in this case). I would recommend just using the ULDN as prescribed and not bothering with the normal dose in order to get the full benefit from the lower dose.

@Mycophile if you lived in Australia you would be considered lucky because of that series of events. That would almost certainly be considered doctor shopping her because if you have anyone taking care of your pain using controlled opiates, they need an authority from the Drug of Dependence Unit in order to do so, that authority is supposed to be limited to one doctor. For example last time I was on suboxone strips before I tapered off and relapsed, my GP initiated the treatment. Then when I was tapering off I had to switch to subutex pills to taper by smaller amounts and he isn't allowed to prescribe that, so I had to go to the drug and alcohol state services to see an addiction medicine doctor and have him prescribe it and have the authority transferred over to him. Same with my dexamphetamine prescription - my GP initiated treatment and he retains the authority to prescribe it. If I were to go to my psychiatrist and ask her to prescribe me Vyvanse or Ritalin due to my ADHD diagnosis, my GP would have to relinquish the authority for the dexamphetamine or I would be picked up as doctor shopping by the DDU for trying to access controlled stimulants from several sources at one time. If, however, my psychiatrist decided that it was necessary to add in Vyvanse or Ritalin to my medication regime then she could write to my GP and take over the authority or have him update it to reflect that medical order and that would be fine for the DDU. Does that make sense? So in a way, I can't tell if you were lucky because I don't know where you live but I know if you were in Australia you can certainly count yourself very fortunate that you haven't got a strike against your name, although they don't tend to actually tell people when they do that, they usually just stick them on management plans like I am with my dexamphetamine.

I'm honestly super confused by your post. I guess part is because i have a headache due to doing work online all day.

I don't think I'm lucky, I think I just have a psychiatrist who prescribes me certain meds and my primary knows what he prescribes me and is ok with it, and in the past when I got injured I got prescribed opiates for short periods of time from different doctors who are all part of the same medical group and who interact with eachother.

I also don't think I believe you that other doctors wouldn't know what I'm prescribed after talking to Nurse Ratched. She seems to live in the U.S. like I do so she knows how things work.

I don't think you understand why I like to use regular dose Naltrexone, and why I'd also want UDLN.

I use regular dose naltrexone to keep myself from drinking most of the time (and kratom, but I don't let my doctors know that) and I like it because I can just take it and not be able to drink for as long as its in my system, but if I want to drink I can stop for 3 days and drink (or use kratom), then hop back on the naltrexone.

The reason I also want ULDN is because it is good for opioid WD, and whenever i do decide to stop taking my regular dose Naltrexone and start taking kratom for fun, if I do it too many days in a row I get WD. So I figured if I had ULDN I could then use that with my kratom after getting off the full dose Naltrexone and not get WD. Then I'd make sure the kratom was out of my system and go back on full dose naltrexone.

I know this may sound weird, but this is how I use regular dose naltrexone: to keep myself sober most of the time, except for when I feel like drinking or taking kratom, which is when I stop taking it. So far, doing this has resulted in me being able to usually be sober, but still have fun when I want, which works really well as it takes will power out of the equation, and that's why I would not stop taking full dose naltrexone, as it helps me maintain that lifestyle of mostly being sober. But ULDN is entirely different, and does something completely opposite, not blocking opioids but potentiating them and eliminating WD, so I have reason to want both.

And no, I don't necessarily think I'd get cut off from my regular dose naltrexone or klonopin if somehow my doctors found out I'd gotten a prescription for ULDN, but it's possible, as I think they'd be confused and wonder why I wanted both, as I am not in pain management of any kind, so they might ask why i wanted it, and I'd have no good reason, and I'd NEVER be stupid enough to mention my kratom use to ANY doctor, especially seeing as I get prescribed naltrexone for drinking and klonopin for anxiety, they could easily consider me a drug addict, which I'm not. But i hope that if I ever need prescription pain killers again that they'll be ok with prescribing them even despite my being on naltrexone (I'd obviously have to stop taking it then, and i wasnt yet prescribed it in the past when prescribed pain meds.) That's something I'll only know the answer to if I'm ever injured again, so I have to hope my psychiatrist would vouch for the naltrexone only being for drinking and that its' safe for me to go off it to use a pain med if necessary. I wouldn't want to use kratom for pain if i got injured as I can't sleep on kratom, and in the past it was making it through the night with knee pain that was the hardest, so for that i need regular opioids like oxycodone or hydrodoone.

You seem to think I'm a pain management patient, which I'm not.

Does this make sense now?

And do you really think "I'm lucky because of that series of events" as you put it?

Because honestly, I don't believe I'm lucky at all. Here in the U.S., i think things are different. I'm not a pain management patient, and those injuries i'd had in the past were treated by the surgeons who operated on me and who are associated as part of the same medical group as my primary care physician. It wouldn't have been seen as "doctor shopping", if my primary care doctor asked, it would have been considered "well yeah, obviously it was the surgeon and specialist that operated on your knees that gave you those pain meds, as you were in his care, and I as your primary physician, do not operate on knees, LOL."

I think you are kind of confused as to my situation and questions, to be honest.

 

[Eligiu]

I'm honestly super confused by your post. I guess part is because i have a headache due to doing work online all day.

I don't think I'm lucky, I think I just have a psychiatrist who prescribes me certain meds and my primary knows what he prescribes me and is ok with it, and in the past when I got injured I got prescribed opiates for short periods of time from different doctors who are all part of the same medical group and who interact with eachother.

I also don't think I believe you that other doctors wouldn't know what I'm prescribed after talking to Nurse Ratched. She seems to live in the U.S. like I do so she knows how things work.

I don't think you understand why I like to use regular dose Naltrexone, and why I'd also want UDLN.

I use regular dose naltrexone to keep myself from drinking most of the time (and kratom, but I don't let my doctors know that) and I like it because I can just take it and not be able to drink for as long as its in my system, but if I want to drink I can stop for 3 days and drink (or use kratom), then hop back on the naltrexone.

The reason I also want ULDN is because it is good for opioid WD, and whenever i do decide to stop taking my regular dose Naltrexone and start taking kratom for fun, if I do it too many days in a row I get WD. So I figured if I had ULDN I could then use that with my kratom after getting off the full dose Naltrexone and not get WD. Then I'd make sure the kratom was out of my system and go back on full dose naltrexone.

I know this may sound weird, but this is how I use regular dose naltrexone: to keep myself sober most of the time, except for when I feel like drinking or taking kratom, which is when I stop taking it. So far, doing this has resulted in me being able to usually be sober, but still have fun when I want, which works really well as it takes will power out of the equation, and that's why I would not stop taking full dose naltrexone, as it helps me maintain that lifestyle of mostly being sober. But ULDN is entirely different, and does something completely opposite, not blocking opioids but potentiating them and eliminating WD, so I have reason to want both.

And no, I don't necessarily think I'd get cut off from my regular dose naltrexone or klonopin if somehow my doctors found out I'd gotten a prescription for ULDN, but it's possible, as I think they'd be confused and wonder why I wanted both, as I am not in pain management of any kind, so they might ask why i wanted it, and I'd have no good reason, and I'd NEVER be stupid enough to mention my kratom use to ANY doctor, especially seeing as I get prescribed naltrexone for drinking and klonopin for anxiety, they could easily consider me a drug addict, which I'm not. But i hope that if I ever need prescription pain killers again that they'll be ok with prescribing them even despite my being on naltrexone (I'd obviously have to stop taking it then, and i wasnt yet prescribed it in the past when prescribed pain meds.) That's something I'll only know the answer to if I'm ever injured again, so I have to hope my psychiatrist would vouch for the naltrexone only being for drinking and that its' safe for me to go off it to use a pain med if necessary. I wouldn't want to use kratom for pain if i got injured as I can't sleep on kratom, and in the past it was making it through the night with knee pain that was the hardest, so for that i need regular opioids like oxycodone or hydrodoone.

You seem to think I'm a pain management patient, which I'm not.

Does this make sense now?

And do you really think "I'm lucky because of that series of events" as you put it?

Because honestly, I don't believe I'm lucky at all. Here in the U.S., i think things are different. I'm not a pain management patient, and those injuries i'd had in the past were treated by the surgeons who operated on me and who are associated as part of the same medical group as my primary care physician. It wouldn't have been seen as "doctor shopping", if my primary care doctor asked, it would have been considered "well yeah, obviously it was the surgeon and specialist that operated on your knees that gave you those pain meds, as you were in his care, and I as your primary physician, do not operate on knees, LOL."

I think you are kind of confused as to my situation and questions, to be honest.

You yourself asked if you were lucky in your previous comment before Nurse Rachet. I said you'd be lucky if you lived in Australia because the way our prescription system works is that only one doctor can issue an authority to any patient at any one time for opiate pain relief. You're basically under the care of the Drugs of Dependence Unit and they oversee any new authorities coming in. So if more authorities come in under your name, it flags in their system and is considered doctor shopping. Just like how I have a sleep specialist I can get Klonopin from, only he is allowed to prescribe it if my GP does not, I can't ask for a script for them both, nor my psychiatrist even if it's for a different problem. When I filled the prescriptions it would alert the system and the pharmacist would probably refuse to fill the script then the doctors would both get an alert, as would the DDU that I tried to fill drugs of dependence from multiple different specialists at the same time.

I understand how to use Naltrexone. I've been on it about a dozen times and I know I need to wait 5 days to get it fully out of my system as per a study I found online where they measured the blocking effect at 1,2,3,4 and 5 days post dose against fentanyl. I used to take it when I wanted to, then I'd randomly stop taking it on a whim and go use again. Unfortunately in Australia naltrexone is only allowed to be prescribed for a maximum of 3 months on the pharmaceutical benefits scheme so eventually I always ended up relapsing anyway.

The reason I thought you were a chronic pain patient is because that is the main medicinal use of ULDN. Many people with severe chronic pain who have exhausted opiate and other pain relief turn to it as an option. I'm a bit confused as to why you want the prescription for both when you don't have any need for its pain reliever properties. I've never heard of it potentiating opiates before and I'd be interested to see a source for that as to the best of my knowledge it's only used off label at lower doses as an analgesic.

Your doctor's would probably be confused as to why you'd want both but I don't think they'd cut you off either, it just sort of seems weird as there isn't really a valid medical reason to want the lower dose version. I get why you want it after you explained it in the above post, but I don't think they will.

If anything insurance might take issue with you being prescribed two versions of the same drug because I thought in the US you need to have reasons to be prescribed them, like in Australia for the pharmaceutical benefits scheme. You could pay privately but I imagine in the US that would cost you an arm and a leg. I just know from friends over there that doubling up on any kind of medical test/medication/procedure is generally seen as a bit of a no go zone for most insurance companies and the private cost of naltrexone in Australia off the PBS is $150 so I can only imagine it being much higher over where you don't have well subsidised healthcare.

 

[Mycophile]

You yourself asked if you were lucky in your previous comment before Nurse Rachet. I said you'd be lucky if you lived in Australia because the way our prescription system works is that only one doctor can issue an authority to any patient at any one time for opiate pain relief. You're basically under the care of the Drugs of Dependence Unit and they oversee any new authorities coming in. So if more authorities come in under your name, it flags in their system and is considered doctor shopping. Just like how I have a sleep specialist I can get Klonopin from, only he is allowed to prescribe it if my GP does not, I can't ask for a script for them both, nor my psychiatrist even if it's for a different problem. When I filled the prescriptions it would alert the system and the pharmacist would probably refuse to fill the script then the doctors would both get an alert, as would the DDU that I tried to fill drugs of dependence from multiple different specialists at the same time.

I understand how to use Naltrexone. I've been on it about a dozen times and I know I need to wait 5 days to get it fully out of my system as per a study I found online where they measured the blocking effect at 1,2,3,4 and 5 days post dose against fentanyl. I used to take it when I wanted to, then I'd randomly stop taking it on a whim and go use again. Unfortunately in Australia naltrexone is only allowed to be prescribed for a maximum of 3 months on the pharmaceutical benefits scheme so eventually I always ended up relapsing anyway.

The reason I thought you were a chronic pain patient is because that is the main medicinal use of ULDN. Many people with severe chronic pain who have exhausted opiate and other pain relief turn to it as an option. I'm a bit confused as to why you want the prescription for both when you don't have any need for its pain reliever properties. I've never heard of it potentiating opiates before and I'd be interested to see a source for that as to the best of my knowledge it's only used off label at lower doses as an analgesic.

Your doctor's would probably be confused as to why you'd want both but I don't think they'd cut you off either, it just sort of seems weird as there isn't really a valid medical reason to want the lower dose version. I get why you want it after you explained it in the above post, but I don't think they will.

If anything insurance might take issue with you being prescribed two versions of the same drug because I thought in the US you need to have reasons to be prescribed them, like in Australia for the pharmaceutical benefits scheme. You could pay privately but I imagine in the US that would cost you an arm and a leg. I just know from friends over there that doubling up on any kind of medical test/medication/procedure is generally seen as a bit of a no go zone for most insurance companies and the private cost of naltrexone in Australia off the PBS is $150 so I can only imagine it being much higher over where you don't have well subsidised healthcare.

Yeah, sounds like the system is entirely different in Australia than in the U.S. Here, even though some doctors can be quite strict, you can get different medications from different doctors without it being the kind of issue you describe.

For me, I was told by my 1st doctor who prescribed the Naltrexone that 3 days out of the system is enough for an opioid to work, and I have found this to be the case with kratom in the past, though I have wondered if maybe it was weakened a bit, so I think next time to be smart and be sure the kratom has its full effect I'd stop for 5 days.

Yes, I know that ULDN works well for pain (and I might need for that someday) not to mention some say it can work great for anxiety and depression, both of which I have, but it most definitely potentiates opioids and allows pain patients to lower their doses and also helps greatly mitigate withdrawal for people getting off opioids.

Thats why I want it because even though I barely ever use kratom, I really love it, and for some reason (probably kindling from over-use in the past) if I take it for more than like 2-3 days in a row I'll get withdrawal that will last 3 days and make me really tired. Some people didn't even believe it could happen so fast for me, but it does.

So for me, ULDN and Naltrexone seem to be two ENTIRELY different medications with ENTIRELY different effects, and that's why I have use for both.

However, after what Nurse Ratched said I'm afraid to even try to get ULDN online, despite the fact that I might be able to.

You might be right that they wouldn't cut me off from either regular naltrexone or Klonopin, but my fear would be that someday I get injured again and they get confused as to why I had prescriptions for both types of Naltrexone and start questioning if I'm an opioid addict.

I mean, I'm already concerned that should the day come they might deny me pain meds simply because I take Naltrexone. I have only ever told my psychiatrist that I take it for alcohol, so I HOPE AND THINK in such a situation he'd PROBABLY vouch for me that it's safe for me to stop taking it temporarily to use whatever pain meds they'd give me, but I can't be sure, and the way the medical establishment is these days you have to be SUPER careful not to do or say ANYTHING to be labeled any kind of drug user or next thing you know you can't get pain meds or other kinds of meds, so I'm a bit too worried about even trying to get a script for ULDN now.

I'd like to make it myself from my regular Naltrexone, and there are people who teach you how (both on facebook and here), but then I get worried I'd get the dose wrong and somehow end up in precipitated WD if I still had kratom in my system.

That's a big concern for me every time i go back on Naltrexone after stopping kratom, but so far 3 or more days off kratom has been enough to get back on the Naltrexone without problems.

Another poster said not to worry, that even if I failed to make ULTRA low dose and ended up with Low Dose naltrexone instead that it wouldn't be enough to cause precipitated WD, but then I told that to a mod. on an facebook group who helps people with these things and he said that wasn't true and posted a story about a women who got HORRIFIC precipitated WD by accidentally taking Low dose vs Ultra Low Dose Naltrexone when the opioids she was taking hadn't completely cleared her system, so I'm concerned with trying it.

I don't know, I feel like such a druggie for wanting to use it in one way to stop myself from drinking or using and in another way to potentiate and eliminate WD, but hey, I guess I'm amongst like minded people HAHAHAH, and seriously, it's my freaking body to do with what want IMO.

I guess if I was better at tapering kratom or knew anything else that helped with the WD I'd be less concerned.

It's just that I always look forward to using kratom again, but I rarely do because the WD kicks in so quickly, and without wanting to be dependent, i don't like having 3 days where I'm practically sleeping non-stop and unable to get work done or do anything productive.

If you know any other way to help with kratom WD, feel free to let me know about it lol.

 

[lonelyDude]

having asked a few doc friends of mine in the past I found that in australia if you get 3 scripts from 3 different doctors in a set period of time then all doctors you see get informed.

there are two scripting systems here private and public.

if you get a private script from the doctor which is not covered by pbs then even after 3 different doctors it does not get reported.

I have a funny feeling though with some drugs private scripts are not possible.

 

[Mycophile]

Yeah, but I don't live in Australia.

 

[lonelyDude]

but there are others who do