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I HAD to abuse my medicine, WTF do I do now!!!

bennyZA

bennyZA

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So I touched on this in the Pain Management Megathread, but I'd like to post it here so I can hear from the TDS peeps.

Many have already heard my story, but I'll just put it out there anyways. I broke both shoulders and my knee a few years back, was given intense amount of painkillers, got addicted, od'd, was taken off. Started dislocating my shoulder, a lot. Was in super serious need of pk's so my doctor gave me fentanyl patches because I needed something, and he felt these were the hardest to abuse. He was right, and they've been great, but he refuses, absolutely refuses, to give me breakthrough meds. Which he does for good reason, and I can't blame him.

Today I dislocated my shoulder really bad, worse than normal, and it hurts sooooo much.

I put on a new patch, 50 mcg/hr (which is usually good enough for everyday pain), and then I put probably 25mcg/hr worth of patch on my gums. I feel a lot better, but I just used an entire patch and 1/2 before I needed to.

BUT MENTALLY, I FEEL TERRIBLE... I did some junkie shit by putting it on my gums. Something I told myself I would never do. I didn't just do it once either. I put 1 piece on my gums, felt okay, put on another. One piece came off, and even though the pain was sorta bearable at this point I put another half a patch on my skin AND gummed some more. I am officially high, recreationally high. I want to put on more and I want to get higher. I'm also really worried that now that I started I'm going to go down the path of abuse that I wont be able to stop. I violated the newfound trust my doctor put into me after about a year without any issues. I've talked to him not long ago and he said flat out that although he trusts me enough for the fent, he will probably never trust me with IR meds. I've proven to myself that no matter what, I'm still a junkie at heart. I feel like all the hard work I've done around me is falling apart.

But I'm in soooooo much pain. It still hurts, but not that bad. I just know that if I wasn't high like this, I would be in excruciating pain, like before. On top of it all, it's freezing outside and my knee hurts real bad too. How the fuck does someone like me, who is in so much pain, live. What the fuck.

This is why a lot of the time I consider committing suicide. Even though I'm not really that depressed, I just want the pain to go away forever. I've died once and I've had hella seizures, so I know what it's like for everything to just end. You know what... it's kinda nice. Things are just over. No more worrying about being a junkie, no more pain.

How to I right this sinking ship?
 
Hey whats with all the junkie bashing benny? something tells me your gonna end up there if you keep it up with the self administration of the full opiat antagonist... and any self respecting junkie just took offense to you gumming a little patch and putting that in our domaine.. please that doesn't even earn you a seat watching our club from across the street. I just playing around sir;)

So what have you done in any attempts to strengthen the shoulder from dislocating so often.. have you rehabbed it properly.. and yes I have had a dislocated shoulder and yeah I actually passed out when it popped back in on its own.. it went from numb to damn that might just well have been the sharpest pain I have had ever. But i religiously did all those small weight exercises for three years and now I have no worries of it coming out.. even kayaking. Another thing what technique do you use to replace the shoulder and what type of dislocation is it anterior? cause there is a really cool technique i can give you that is amazingly comfortable.. do you still have use of your hands when dislocated?

I know that a regiment of non steriodal anti inflamitories have thier own nightmares that acompany them but if you are not already suplimanting with these i think you will actually get better pain reliefe for your injuries from these than you are currently getting from the opiates.. long term opiat therapy with a reduction or long term stabilization of dose has been shown to signifiaclty increase a patients pain response..

If you are reaching a point of inability to control the opait ingestion but are still in need of the effects you will have to devise a system that will provide you the medication you need but has taken the responsibility of correct dosage out of you addict hands..

I hope you are able to come up with a solution to this dilemma<3
 
Hello Benny, I hope my post can give you some insight or help. I havent read your prior post but I will try to get to it because I don't know every detail.

A common thing in addiction, or engaging in such behaviors where we know what we're doing may not fully benefit, we may give our selves "limits" or things we swear we never will do. For you, you said you would not abuse your patch, but then you broke that solid promise, making you feel like you've hit a new low, causing shame, and low self esteem, and hopelessness as evidenced by you saying youre falling apart. This is common, and can create many set backs in peoples way of thinking, or the way they view themselves and their current situation. I can empathize with the feeling of hopelessness and helplessness, and the disgusting self blame that builds up when you feel like there is no positive way out of the situation youre in, or the feeling that you will just keep failing, over and over again, and all because you're trying to manage severe pain. And with the stigma of being an addict, it is even more difficult to overcome these extreme issues in your life.

One way I can suggest, by nudging some positive feeling into your life, or at least trying to offset these setbacks, is to remember, just because you feel as if you messed up, doesn't mean you can't go back from it. You can fix this. It's not a dead end road. The first thing you can do is go against your gut instinct, and do not take more than the dosage youre supposed to, even if you really, really want to. This requires the utmost self restraint and control. The thing with vices and chemically addicting substances, is that people know the consequences, they know what could result from continuing to abuse it, but people ignore that, and they continue, because yes, people do want to experience the high, the relief, etc. Try to ask yourself, why you feel the need to keep getting high. It is probably the combination of extreme physical pain and the psychological and physical need to increase the dose, which you probably know.

Be honest with your doctor. This will be scary. You need to be upfront about the fact that youre in way too much pain that you took more because you wanted relief. Describe the physical and mental aliments youre suffering, your doctor should be able to find a good balance to help with the pain while decreasing the potential for abuse. Your doctor should also help you in physical rehabilitation for your broken bones. They must be rehabbed, somehow, and you can't do it without the help of a professional do to the risk of further injuring it. Also, if you have anyone you can confide in, please do, don't be afraid to express the mental anguish youre in. Hopelessness and getting to the point where death seems like a plausible option is not a good feeling at all. This will just continue to fuel your need to over use your medication.

Also, do you think a massage could help? Try to distract yourself as much as you can for now. Put on a good or funny show. These seem asinine, but just a way to get your mind off the pain will probably do some sort of justice. It will be hard to overcome it completely, but remember to take baby steps, and have patience. Give yourself a break at times, and don't be hard on yourself, your body is doing enough of that for you. I hope these tips can provide some insight, I am not extremely confident they could help you, but who knows <3
 
/\ hmmmm, I totally disagree. Don't get me wrong, I think you should generally be honest with your doc and I certainly do not endorse lying to him in order to get meds but I fell absolutely certain (as a pain patient for many years and as a nurse for 20 years) that if you tell him about his incident then you will be shit out of luck as far as receiving any more pain meds goes.

That being said, what you are on and what you are doing now is obviously not working for you. You and I know that once you have done this once (with or without a history of narcotic abuse) it is a slippery slope from here on. Either you should talk to the doc some more about having him up your dose a little because it is sometimes not sufficient or you need to make a decision to completely come off narcotics. It is very tempting to self medicate when you are having uncontrolled pain and we (as abusers) generally cannot control our use no matter h ow much we tell ourselves we will.

So either you need to see about havingg him help you get it under a little better control and see how things go and if you are going to be able to control your use. Or you need to take a hard honest look and decide if you should come off them completely. I know what my answer would be (though I have come off before and decided for myself I cannot live a life of pain regardless of some of the consequences). Only you can decide what is ultimately best for you.

Also as said before, I would for sure see about some more strenghtening PT and definitely do not limit yourself to just use of narcotic medications. Try to supplement it with others if your health condition allows for it.
 
Neversickanymore:
I was talking about junkie shit because I do know what's up, I'm really sad to say. I've been there... Heroin addiction, oxy addiction, coke addiction, homeless, arrested, beaten up, robbed... I've been there. I have to say though, that when I say junkie behavior, I simply mean that I'm doing absurd things (like put a "little patch" on my gums) just to get pain relief. I really think you shouldn't trivialize fentnayl though. I really would not like people to get a bad impression, fentanyl is a fucking dangerous drug. It is super easy to OD. I think 25mcg/hr on your gums would probably kill an opiate naive person. I'm also wearing about 125mcg/hr worth of patches on my skin... which I'm sure you know is a fuck-ton.

When I say dislocation. I need to clarify. I dislocate each shoulder probably 2-3 times a week. I have a hole in my right shoulder about the size of a quarter, my labrum is torn, etc. Next month I will be getting it filled in with cadaver bone, getting a few screws, the works. When it comes to dislocation, unfortunately, I'm an expert. :( (A couple days ago, I dislocated my shoulder getting out of bed, just turning over on my side and it popped out) This time though it was real bad. When my shoulder came out it engaged, mean the glenoid bone got stuck inside the hole (a boney bankart lesion) there is another piece of bone hanging off the humeral head that prevented the glenoid from coming out. Imagine in the middle of a busy street in a downtown of a major city in the US and there's this dude, standing on the street corner, screaming in pain. I've become an expert at putting the shoulder back in and it usually only takes a few second. This time it was so fucking hard, I was SCREAMING in pain. A couple things popped, and a couple things tore. I had to push and pull, and literally jam my shoulder into a tree trunk just to get it to dislocate normally, then I had to put it back in. The pain is so fucking bad. I wish it was only a simple dislocation. That I can handle.

Guess how I dislocated the shoulder? I waved at someone when my arm was a little too far back... yea... that's how fucked up my shoulder is. So I can't even remotely do physical therapy. Also, the way shit is fucked up, if I use ice or take NSAIDS, it actually makes things worse. A lot worse. So yea, I'm fucking fucked. Even a massage has popped my shoulder out in the past. Oh, and when I talk about shoulder I mean both shoulders, although the right is worse than the left.

I'm having a huge, huge surgery next month. As I said. The shoulder doc even told me that she's never seen a shoulder as fucked up as mine. She even presented my case at a confrence for shoulder docs in front of 600 docs. So I did get 600 second opinions though.

What I'm about to say is super fucked up. After my surgery I'm going to be in-patient for up to a week because of the pain. Doc says this will be unbelievably painful, worse than all the crazy pain I'm in. Thing is, I'm actually looking forward to the surgery and hospital stay. I can't wait to be in the hospital fucked up out of my mind on painkillers for a week. I can't believe that. Not because of the recreational aspect - though I'm looking forward to that too - but the pain control aspect. I'm looking forward to being fully pain free, even if only for a little bit. My pain is so pathetically uncontrolled. I can't live like this... I hope I put more perspective on this. Cause I do still need more advice. Now I look back on my post and I realize I should have clarified more. I too would have mentioned NSAIDS and PT, but yea, that shit's not gonna work :\

Oh, did I mentioned that I shattered my knee too? I can barely walk on top of all this. My knee is really, really fucked up too.

Neversickanymore: you said I need to devise a system to take it out of my addict hands. You have any system you wish to share?

Oh, did I mention I have a neurological disorder that causes me to have uncontrolled seizures, and that I did most of this damage slowly over time from seizure after seizure. That most likely non of this will ever heal. :(

I think maybe, just maybe, you guys might now understand why I want to die. I can't live like this. I can't live in this pain. This is too much. This is way, way too fucking much. I have the body of an 80yo man, and I'm 26. I want to die, it would be so much better than this. I know what it's like too. I know what it's like to die. I've died for 2 minutes before. It was so nice. :\
 
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No free access to your patches. Hand them to someone you can really trust and tell them no matter what not to give you one til time for the dose (new patch to be applied). Its the only way.
 
That's not junkie shit that is i am fed up with the fucking pain and i want to feel good for once shit. But for fuck sakes don't go putting a fent patch in your mouth again as it is very very easy to OD like that. I have done it to with the old gel ones and i smoked the shit but i found fent to be practically devoid of euphoria so i only abused them a few times. I would tell your doctor that the amount of pain meds your on is just not cutting it if that is indeed the case. The shitty thing about fent is that tolerance can build quickly to it. With any opiate tolerance builds overtime and you will need higher doses of your medication to stay reasonably pain free.

I know what it's like to be in blinding pain as i have trigeminal neuralgia and severe stomach issues that cause me a fuck load of pain as well. Right now i am on morphine SR with MS IR's for breakthrough as that is the only long acting opiate my insurance covers but i have been on fentanyl patches in the past when i could afford them. I switched to the 50ug patches from the 120mg's of morphine SR i was taking and i was never so pain free before or since. It was also the only opioid i didn't abuse as i got no euphoria to speak of from it. Too bad i can't afford the stupid outrageous pharmacy price for them :p

Breakthrough meds are pretty much a must for chronic pain patients. Perhaps your doctor would be willing to give you a much less abusable IR opiate such as codeine? Yeah i know codeine ain't fuck all compared to fent but codeine on top of the fent patch might help you and would be worth a shot imo. You can't take it anyway other then orally and it's shitty side effects in high doses will deter you from taking too much. Also taking a anti-inflammatory such as ibuprofen will probably help your shoulder pain as well. My shoulder is fucked to from a old injury and ibuprofen does help alot more then just taking morphine alone.
 
I talked to my pain doc today, told him everything. He told me there is nothing he can do. That's it. He's this Russian hard ass that's never said a kind word in his life. He just looks at you and prescribes meds he thinks are good, then moves on. It's ridiculous. Fucked up part is that I can't get a new doctor... I just want to be pain free. Please god, let me be pain free.

I'm really, really, really worried I'm going to do something stupid.
 
missmeyet? said:
/\ hmmmm, I totally disagree. Don't get me wrong, I think you should generally be honest with your doc and I certainly do not endorse lying to him in order to get meds but I fell absolutely certain (as a pain patient for many years and as a nurse for 20 years) that if you tell him about his incident then you will be shit out of luck as far as receiving any more pain meds goes.

That being said, what you are on and what you are doing now is obviously not working for you. You and I know that once you have done this once (with or without a history of narcotic abuse) it is a slippery slope from here on. Either you should talk to the doc some more about having him up your dose a little because it is sometimes not sufficient or you need to make a decision to completely come off narcotics. It is very tempting to self medicate when you are having uncontrolled pain and we (as abusers) generally cannot control our use no matter h ow much we tell ourselves we will.

So either you need to see about havingg him help you get it under a little better control and see how things go and if you are going to be able to control your use. Or you need to take a hard honest look and decide if you should come off them completely. I know what my answer would be (though I have come off before and decided for myself I cannot live a life of pain regardless of some of the consequences). Only you can decide what is ultimately best for you.

Also as said before, I would for sure see about some more strenghtening PT and definitely do not limit yourself to just use of narcotic medications. Try to supplement it with others if your health condition allows for it.
Click to expand...

Thats what i feared to be honest. Most doctors dont understand this issue very well and get scared more for liability reasons and refuse to hand out pain meds to abusers, even if they truly need it. So yes, I do agree with you.
 
Yes...doing what seems to be the right thing doesn't always pay. It sucks that things are this way now but its true.

OP...I hate it that he won't do anything else for you. I have been where you are and I know that when you have uncontrolled pain you are so much more likely to misuse the meds. The term "psuedo addiction" applies to people who have uncontrolled pain. Because they are hurting so bad a lot of the things they do appear to be like that of an abuser; med seeker, taking more than they are supposed to, being solely focused on their meds, running out early, preoccupied with running out early, etc. It is a genuine condition but because most docs aren't educated about it they frequently just tag these patients as abusing their drugs.

I wish I could tell you other options but if you are unable to find a new doc then I'm not sure there is an easy answer. The one thing that I have found that I have had to do on occasion when my regular meds aren't cutting it is the following... I have went to the ER. Now you know most of the time the ER won't do shit for you if you are a chronic pain patient. But I have went in and said hey, I have plenty of pain meds at home so I'm not here looking to get a script but I am in so much pain and my meds aren't touching it. Can you please look at (your injury) and give me something to help at least get it under control. As long as they don't think I am trying to get a script they have been helpful. The problem is if your pain is constant of course this won't help. But sometimes when things are really bad this has helped get it under control and then my meds were actually a little more effective. Probably won't help in your case but its good when your pain is that bad that a different doc is taking a new look at things.

"Pseudoaddiction” is a concept developed by pain specialists in the 1990s to describe desperate drug-seeking, produced not by true drug paddiction, but by the under-treatment of pain. The behaviour of patients exhibiting pseudoaddiction mimics the out of control conduct of the addicted: they may increase their dose without approval, complain aggressively, or lie to get more drugs and turn to street drugs or doctor shopping to increase their supply. Pseudoaddiction looks like addiction but it is not addiction. In cases of pseudoaddiction, the drug-seeking behaviours cease once the pain is properly controlled, thereby confirming the absence of true addiction."
 
The idea that you ruined your entire sobriety period by this one (or even 2 or 3) act of abuse is ridiculous. Believing so can itself act as justification to begin using again. It's not 'all or nothing'—You aren't starting from day 1 of kicking a habit. Enjoy the high and ride it out, take it as a positive reminder of times long gone, and then sleep and wake up at baseline, and go about your day. But the real issue here is pain management and I'm sorry but I have no experience with this so I can only recommend going to a specialized pain management clinic or seeing a specialist if your doctor isn't one. Take it easy on yourself!
 
Not that you should replace one drug with another when it comes to addiction, but have you tried MXE for the pain?

In my experience, and from what I've read, that of many others, it's one of the best analgesics out there. I've worked out on it, and pushed myself harder than I ever could before without any soreness (not good), a friend even almost tore something doing it with me. In addition, I've used it for mild pain reduction before to great benefit, literally no pain left.

IME it isn't like opioids that kill some of the pain, but mostly just make you feel good and ok with it. It actually straight up kills the pain.
 
Okay this one is a toughy...I wouldn't let your guilt over ride you knowing how to stop and take the fent as prescribed. You messed up...Once in a year.......Don't feel so guilty that you tell your doc because I don't know what they will do.....I don't deal with physical pain but alot of mental anguish....and I have slipped up so many times that I just feel I'm lucky to have the doctor I have because he has been patient with me as I recover.....Guilt will eat you alive.....You have to forgive yourself....death is not the answer to anything.......There isn't anything that bad....But about the pain I will leave to others to discuss since I don't have alot of knowledge in that. But Please forgive youself and use that will power you have built. Don't feel like your defeated because your not.....You just made a choice that your conscience is conicting you for and you need to examine why it is and then let it go. Coming here is a very smart idea because that showes you are seeking guidence and help.....
 
for a CCP you can't use your opiates everyday and expect that to last you will build a tolerance and eventually it will reach a point that it would take a lethal dose to effectively treat your pain so if you want your meds to work right don't take them on your better days even if better days are shit at least they're not as shit
 
Thanks for all the replies. Unfortunately I'm starting to realize I'm just shit out of luck in this world... :\ My pain doc told me that if I dislocate my shoulder again to just wait it out... wtf!!! That's his answer, "wait it out." I want to break his arm into pieces and when he's crying in pain I'll tell him to "wait it out." To make matters worse, I just 'jumped' my tolerance ahead of schedule AND I'm going to run out ~week early. FML.

It really sucks, but frankly, you cannot be honest with most doctors when it comes to pain and pain control. I can't fault most of them, it must feel like shit for a new doctor to get 'played' the first time. After that, I'm sure he/she vows "Never again!" Too bad that means an overzealous distaste of people who take opiates on a regular basis (for whatever reason). I feel like if a doctor gets fucked over by a patient, he/she should use it as a learning experience in order to help the patient. Learn how addicts function and operate. Especially pain doctors. They must get fucked with the most - obviously - but they also should know addict behavior and spot signs of use. If you can't stand getting burned by an addict once in awhile, or dealing with addict behavior THEN DON'T BECOME A CHRONIC PAIN DOCTOR. It's such a hard thing for me to NEED something that I have to - essentially - ask permission for. If that fucker doesn't give me permission, wtf am I supposed to do? I can't do life right now... I really can't, and the only thing that stands in between my ability to function - to start participating in the game of life again - is some Russian douchebag who really doesn't give a fuck.

MissMeYet, I really identify with the whole "pseudo-addiction" thing. I had a lot of access to opiates when I was deep into my cocaine phase, but it never became my thing. It was only after I had my big accident that I started getting into the opiates, hard. I went from opiate naive to needing ~250mg of oxy - minimum - in about 6 weeks. Within 10 weeks I needed ~400mg. I've also done every trick in the book to get more pain meds. When they started weening me off I spent almost every dollar I have buying H and other opiates. I feel that if my pain were handled responsibly, and effectively, I wouldn't be in this mess...

Oh well... All my fault, right?
 
Jesus fucking christ this is the shit that pisses me off big time because i have gone through some of the exact same shit myself. I have had doctors brush off the fact that i have trigeminal neuralgia aka the suicide disease and basically just give me a script for gabapentin and just send me home to put up with the pain. I once had to nearly physically threaten a doctor so he would give me codeine pills to ease the agony ffs! I got told i was too young to be on painkillers so often it's not even funny. I told one doc that i wouldn't grow old enough to get on opiate painkillers if he didn't treat me. Thankfully i have a doctor now that actually gives a shit and is willing to work with me so i have morphine SR's and morphine IR's also to help the breakthrough pain. That is the typical protocol for chronic pain management is to have breakthrough painkillers as well as the long acting ones.

Is there anyway at all you can find another doctor? This guy sounds like he has his mind made up already.
 
it takes seeing a lot of different doctors and a lot of negotiating to get treated decently when it comes to addictive medications and as i said before taking your tolerance causing drugs everyday they will stop working well enough and if you find a doctor willing to increase your dose indefinitely to effectively treat your disorders your new therapeutic dose will likely be fatal
 
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