Heroin "It's so good you only have to take it once"

[Babygirl25]

We were taught a very simple rule which is 'there is no such thing as a non-addictive CNS depressant'.

Some may not produce physical dependence, although Iwould still take the box outside and read the small print even on stuff like clonidine) but the body will always attempt to maintain homeostasis and since being wide awake was and to an extent still is an evolutionary advantage, the body will tend to respond if you try to dampen that down.

So after much tooing and froing with my consultant, I'm prescribed the myoclonus medication with the least CNS depressant side-effects and an analgesic that positively wakes me up (but not in a good way).

Never forget what a given medication is supposed to do. If you are simply after what any doctor would consider a side-effect, you are likely to be taking quite a lot.

Doctors struggle with the interaction of just two medications so as you are prescribed more than two, it's only their experience that guides them as to the likely outcomes.

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I give you the example of Keith Moon. Took literally tens of thousands of pills in his lifetime, was hospitalized twice - once because he was spiked, the other just because he was too messed up to play. But he survived it all.

Then he had a few lines of coke, two glasses of wine and his prescribed clomethiazole (Heminevrin). Now he did take a lot of them but who is to say that being such a potent CNS depressant, he forgot he had taken them and took more. This was quite common. Jimi Hendrix did the same with alcohol and an unfamiliar German-brand of barbiturate which was FOUR times more potent than the ones he was used to. It happens. But surviorship bias means BLers cannot tell us when it's all gone horribly wrong.

Wow, now I remember taking these back in the day. They were one of my favourite drugs. The nose burn feeling went off after about 2 doses in. But as you've pointed out Hemenevrin, affects our memory in as much as you forget when you last fosed. Then you redose again. The other thing about this drug is that if you stopped using them, abruptly, after a weeks use you'd have a complete psychotic episode needing hospitalisation. But the high was definitely worth the agony if this occurred. This really took me back. Little grey/very light purplish rubber feeling capsules. Like temazepam when it first came out, Heminevrin capsules seemed to be a gel filled, you could squeeze them, and they'd go back to their original shape. Keith Moon was lucky to have got to the age he did without anything bad happening to him. Still he was so badly missed. Rock on Keith.

Babygirl. X

 

[BuprenorphineBrian]

To be clear I was not calling opioid naive. thank you for showing me your experience. I would never type like that again on your comments leaning 1% towards I may know more than you or anyone again. I feel bad making feel the need to clarify you history. Justified.

I haven't had a break since the age 7, for more than 10 months in a row. I was dependent to morphine suppositories and hydrocodone by age 10 and no kid should grow up that way. It was demorol and morphine at 15 to 20. Before it was IV heroin. Then methadone 180mg and Clonidine for 6 years., Ten months clean time straight until IV heroin #4 75% for 3 years. then degenerative bone disease, 6 ankles fusions, a knee replacement, and achilles tendons decline past 60%. prognosis poor and three heart disorders. the past 15 years without missing a day it has been Roxi 30mg 6-10 per day, methadone 10mg 4-8 per day, with Clonidine 0.4-1.2mg 25 years, Ativan or Xanan for the 12 years, Lunesta 3mg or Haldol 20mg w/ Ambien 10mg 20 years. Visteril PAM 100-200mg. and 3 other blood pressure pulse meds enough doses to treat 4 adults.

Brother I am trying to measure pain with you or tolerance. I could learn something from you and you from me. We should not waste the medical information and give it to the people that will need it. You now know in your heart if I get cancer like this it will be so hard to manage pain at the beginning let alone hospice with out being in induced coma. My pockets do not run that deep to support that much custom narcotic demand and I do not want to burden my family's money in this current world. I have now have SVT, bradycardia, AFIB, hypertension II, and a pulse rate that send most people to ER every other day freaking. So I guess my intentions earlier with you was to be helpful with medical data vomit and help some people out.

Bro honestly, I am doing a great job faking how I really feel daily with my loved ones and I cannot ever put this sake of weight from health issues down. I wish I could stand listen to anyone, " God has a plan don't worry." So I hope your health issues to turn into diagnosis poor like me with me dependence tolerance and lowkey the biggest addict out many people here. Not a day that goes by I do not dream about living in India working on a poppy field. Trying to manage chronic pain syndrome without taking anymore meds is a battle and a respected effort by all that know. You know there will never be enough at this point just enough to keep the dependence in check, some pain relief, and having the DEA breathing down my provider's neck every other month. Like my brain would know regrow mu, delta, kappa, gaba, alpha2 receptors at this point and PAWS would never stop. too late for me to get. I didn't stand at chance at age 15 of that. I am compulsively thinking about not getting cancer because I know already too many that have had it and what they needed to have a quality of life as pain relief and the mental base to take that on. If they are not trying sedate a elephant status for me I see my pulse being so low they are scared while my brain is yelling yes louder than my heart is saying no . my good friend made it 8 years with pancreatitis cancer and I saw what he required. I am 30% tops from his end result and I had 20 years of Rx before him. my doctor bless his heart keeps me calm as can legally afford to. so that makes me lucky and blessed. have an awesome day and if you read all of this thank you, your a real one in my book. catch on the next thread

was raising 3 stepsons, my daughter and a wife like this doing X-ray welding and pipefitting for NASA and almost every government base on the east from NC to NYC and Long Island. Not caring one shit about myself or my future. 4 doctors convienced my stopped working and I got SSI disability on the first try with 5 complicated disorders conflicting with each other. Got Medicare A,B, and Wellness Rx Plan coverage at 43, not 65. Didn't even apply for it.

No need to apologize I was just sharing my story. I wasn’t offended. This isn’t a pissing contest lol. I agree. We all should learn from one another.

 

[SotPoker1012]

A lot of heroin addicts, like Jerry Garcia started off using psychedelics but eventually moved onto heroin because it's a much better suited for long term use. Psychedelics are only suitable for occasional use and over use can quickly lead to effects far worse than heroin has, such as life ceasing to make sense and the inability to relate to people who aren't heavy psychedelic drug users (which happens to be most people) so opioids are actually much safer for long term use provided one is in a situation where they can avoid overdose such as having access to pharmaceutical quality and not what is available on the street right now.

But yeah I would argue the appeal of heroin is it's suitability for long term use and pain relieving effect. If someone who had never done drugs before was looking to experience a great high and they had to pick between cocaine, heroin, psilocybin mushrooms, LSD, MDMA, methamphetamine and and marijuana heroin would imo would be the least likely to deliver, save for that small % of the population that just immediately loves opioids. All those other drugs provide more interesting and euphoric highs to the novice user. Think of your first time getting really stoned off weed. Wasn't it more euphoric, mind blowing and interesting than your first time on opioids? I think a lot of people would say yes.

However, for someone who for example is dealing with chronic back pain and trying to work 40 hours a week heroin is much more appealing. A drug like LSD isn't of much use to him, all it's going to do is make him trip out, lose sleep, feel exhausted and then face that depressing feeling of going back to work Monday morning with his boss barking orders at him like nothing happened after this big psychedelic experience that no one else cares about.

I can definitely see the path from psychedelics to heroin if you're chasing euphoria. I'm not surprised that it starts that way for a lot of people.

I've never met anyone who was legitimately "perma-fried" that didn't already have serious underlying issues, but then again I've never met anyone that does psychedelics daily. I use them almost every weekend and while I'm pretty schizo to begin with, I don't think I've experienced any kind of mental decline. As I said later in my post, psychedelics absolutely do have a far greater potential to trigger psychological issues than opioids though. Considering how fast psychedelics build tolerance, I'm not sure how it would even be possible to use them much more often than that. Not saying it doesn't happen but seems like they'd just stop working after a few days of use.

I suppose I am in that percentage that immediately fell in love with opioids. I remember my first time like it was yesterday, and it was up there with the best trip I ever had in terms of "feeling good". My first time smoking weed was actually quite unpleasant as it brought out underlying anxiety issues. I didn't have a panic attack or anything, but I did feel terrible because I couldn't get my mind out of every upsetting memory I had. That is likely not the typical experience and I did grow to love weed, but it was something that took a while to get comfortable with back then. I don't want to romanticize opioids, but to me, it was like the universe giving me a tight hug that first time. I'm probably in the minority. Most people I know thought they were boring the first time they tried them. On a similar note, I get no recreational effect from benzos - just sedation and anxiety relief. Some people claim they are strongly euphoric. Everybody responds differently to these drugs.

I was exclusively talking in terms of recreational use. Of course opioids are way better suited for pain management than any psychedelic. Psychedelics have potential for mental and spiritual benefits, while also just being a good time if you respond to them well, but nobody thinks they're a solution for pain relief.

 

[Them Witches]

I suppose I am in that percentage that immediately fell in love with opioids.

I remember the first time I took them at age 7. The warmest feeling, body was light, pain went away, took a 2hr nap, and I loved the heavy feeling when I woke up and how long it lasted afterwards. Now 40 years later, I have only had two years off of opiates & opioids. Somebody has to do it and I accept it with loving arms.

 

[Them Witches]

My last surgery post-op it was difficult to treat acute pain for the first 48-72hrs. Even with Dilaudid IV & PO Gabapentin 1200mg on top of my normal PO's Roxicodone, Methadone, Clonidine, Ativan, Lunesta, and Vistaril PAM. I figured this would happen and because of my current 52bpm pulse, they were concerned I would have cardiac issues if given too much narcotic. I talked them into doubling the IV Dilaudid dosage at every 4hrs. I made a gentleman's agreement with them that if I tried it their way first & my pulse was not a concern, they had to increase it. For some reason today's doctors and nurses at the hospital, think a pain management patient will have profound pain relief by their daily scheduled pain medicine. Even if it is Roxicodone 210mg and Methadone 30-40mg, add post-op acute pain and the patient will not even notice those meds. They will only address the chronic pain or chronic pain syndrome the face every day. Yet somehow the medical staff is somehow mislead regarding this simple truth which is doesn't require any invested reasoning or education.

My upcoming surgery this year, I am requesting to be sedated for at least 48hrs on Inapsine (Droperidol), Haldol (Haloperidol), Phenergan (Promethazine), and Dilaudid (Hydromorphone). I love this combo because it detaches me from reality not caring if I am in severe pain. They can do this combo or give me Nembutal Sodium (Pentobarbital). It is too hard to treat acute pain if someone has a 400MME or higher going into the surgery. And if they do increase someone's MME drastically and they are there for 4-5 days in post-op, they go home with a dinky 2-7:day Rx. After 7-12 days of added narcotic, they will instantly drop their MME back to previous and their previous schedule will not work like it did. This is not always the case with everyone but long-term narcotic patients will have these issues returning to the previous MME. 18 months before said surgery, It took me a long time to get down to 400MME and accept it was going to be my cap dosage unless something drastic happens. Reducing my MME allowed my brain some room to learn how to fight against the pain without being completely numbed by narcotic. It can be called allowing room to experience semi-normal flux and allowing room for narcotics to medicate future procedures with certain success.

This is why I would rather be sedated for as long as possible and take less narcotic in the hospital. Last year, I was very sick with and infection that reached my bones and I was in extreme pain at the hospital and after I got home. My home nurse was awesome and I flirted with her non-stop. Due to the amount of pain I was in, she arranged for me to infuse Dilaudid, Roxicodone, Methadone, Ativan, and Clonidine via PICC line. The meds in that formulation were expensive and a nurse had to come twice a day to infuse them. The rest of the time during the day, I took the meds PO. I had a PICC line for 55 days and experienced the "end-boss" of intravenous protocol. For 7 days at home, I was prescribed to infuse those brand name clear formulations. I will never forget how good I felt and how good I slept for the condition I was in. When the nurse wan't there, SWIM was good and did not infuse the PO meds

Now I know why those with severe infected body sores on tranq-dope have a hard time getting their health back. They need infused antibiotics every 6hrs for a long period of time at an infusion rate only a PICC line can provide. The infectious disease doctor will not give them a PICC line because (the high chance) they will not maintain the weekly nurse appointments to keep things free from infection. The doctor also knows they will be shooting up the minute they leave the hospital because "not being able to miss" is too tempting. The PICC line is a threaded IV connection and uses a large dia syringe with a large dia catheter leading directly to the heart. The narcotic rush is greater because the medicine is shot to brain instantly and the syringe holds an insane amount of medicine that can be pushed abnormally hard & fast. This adds a different dynamic of rush & dosage strength compared to a typical small gauge IV or insulin needle. Also the large threaded PICC syringe can hold 10-20mL of medicine or flushing agent. The solution can never be too thick nor require considerations to prevent that. I hope a health program will be funded to cover the costs of admitting tranq-dope addicts and provide the life-saving treatment they desperately need. The same sentiments for any drug addict transitioning to get clean and rejoin society to the best of their ability.

Sorry this post ended up being so long. I struggle at trying to say something short and concise while trying to tell a story or make a detailed point.

 

[Them Witches]

The story of how buprenorphine was testef IS objectively hilarious. But as early as 1973 the drug discovery team at Edinburgh University were suggesting that buprenorphine might be a useful tool in opioid detoxification.

I know the 'tea in the lab' story is funny, but it also shows that even in the hands of 'experts', highly potent opioids are dangerous. It MAY have been the tea incident that lead them to develop buprenorphine and diprenorphine.

I remember when it was first commercially released and the intended purpose used to sell the new drug.

It was commercially intended to assist Methadone clinic patients in completing a quick, safe, and predictable 30-day Methadone "transition detox/fast-taper" by substituting Methadone for Suboxone (buprenorphine). The predicted period of time the patient would take Suboxone (buprenorphine) was at most 30-days after the Methadone was stopped. An elaborate 30-day taper plan was proposed and 30-days was all the time it would require. This was around 2005-2006 at a South-Eastern Virginia Methadone clinic, we were proposed to try this if we wanted to get off Methadone safely without doing the "safe" long traditional taper protocol.

Apparently, this is not how things worked out for Suboxone (buprenorphine). Like Methadone, Suboxone (buprenorphine) became another first line choice for long-term opioid abuse treatment and was eventually adopted into pain management for many uses. This is a good thing another opioid abuse treatment drug was put to use. It also gives pain management patients a few additional options -- MME reduction, rotating medications, and a tool for projected "outing" as they end treatment it provides pain relief while safely slowly tapering. The last tool mentioned would be better for a opioid tolerant patient with the advantages the drug offers compared to traditional opiates/opioids with short half-lives.

 

[4DQSAR]

The McFarlen-Smith team at Edinburgh universitty explicitly stated that buprenorphine was unsuited to maintainance. It's utility lies in the fact that it provides a bridge allowing people to detox.

But of course, if you prescribe a medicine for 6-8 weeks tops, the income is limited. If you simply give people 16,24 or even 32mg of buprenorphine, you just swapped one dependence for another,

Even THEN they recognized that a big problem with buprenorphine was that naloxone sort of struggles to reverse an OD. It WILL do it, but it needs much higher doses - and that IS an issue. Also, it precludes the use of most full agonists to treat extreme acute pain.

Pro tip - sufentanil will EASILY overcome buprenorphine's blocading effect. But only an anethnetist can prescribe it. I've seen it done once only. Some poor lady with Stage IV cancer had been unwisely treated with buprenorphine. But fair play to the doctor. They realized that it was a problem outside their compitence and handed off to someone who essentially uses things like sufentanil multiple times a day. They just set up a syringe-driver and changed it ever 4 hours. She died, but was peaceful at the end.

BTW like the majority of the high-potency opioid analgsics, sufentanil is a MOP/NOP ligand - so produces less respiratory depression and doesn't produce euphoria.

 

[BuprenorphineBrian]

The McFarlen-Smith team at Edinburgh universitty explicitly stated that buprenorphine was unsuited to maintainance. It's utility lies in the fact that it provides a bridge allowing people to detox.

But of course, if you prescribe a medicine for 6-8 weeks tops, the income is limited. If you simply give people 16,24 or even 32mg of buprenorphine, you just swapped one dependence for another,

Even THEN they recognized that a big problem with buprenorphine was that naloxone sort of struggles to reverse an OD. It WILL do it, but it needs much higher doses - and that IS an issue. Also, it precludes the use of most full agonists to treat extreme acute pain.

Pro tip - sufentanil will EASILY overcome buprenorphine's blocading effect. But only an anethnetist can prescribe it. I've seen it done once only. Some poor lady with Stage IV cancer had been unwisely treated with buprenorphine. But fair play to the doctor. They realized that it was a problem outside their compitence and handed off to someone who essentially uses things like sufentanil multiple times a day. They just set up a syringe-driver and changed it ever 4 hours. She died, but was peaceful at the end.

BTW like the majority of the high-potency opioid analgsics, sufentanil is a MOP/NOP ligand - so produces less respiratory depression and doesn't produce euphoria.

When I had dental surgery I just took fentanyl buccal tablets. They come in 100ug, 200, 400 and 800 instant release. The day of the surgery no Buprenorphine was needed. Just a day or two of IR fentanyl. Then I just went back on. 2-3 days of a full agonist will not cause precipitated withdrawal