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Pain Management in Australia

^out if ten, when it's been a really severe flare up,- maybe at best would come down to six or seven if lucky. So no huuuuge improvement which is why I'm currently set on coping better with the pain psychologically.

So subs huh? Were u on opiates the whole six yrs? I have a viscous cycle regarding my oxy use... I'm on a pretty big dose & not getting the desired effects anymore, so trying to find the inner strength to start lowering my dose.

Rtp

I was on and off (mostly on) painkillers for six years. With a lot of getting on the nod. The sub is working great, apart from when I get stressed out and just wanna get smashed...Ive only used extra opiates once in four months which I fink is perdy good.
 
^That's pretty amazing, well done!! Was it your choice to come off opiates, well, to switch to Subs? Are you on a highish dose? You've done a really great job to have only slipped up once. I hear you loud & clear re: stress & the urge to obliterate everything from my mind!

Does it give you any type of buzz, or pain relief? (Not that it sounds like you need it now, cmiiw). Years ago, my PM doc suggested it as a third line opiate, but discovered there wasn't an equianalgesic (sp)dose to what I was currently taking.

He then tried to convince me of the painkilling properties of methadone.... I've posted a LOT regarding my experience with encounters of judgement from supposed health professionals & was not prepared to throw them another bone. In the sense that it's only now becoming current knowledge that methadone Is an option for the treatment of CP. And still not in the wider community. Geez, I forget,- is it eight hours or six of training that our up & cmng GPs are receiving at medical school?!? I shouldn't be surprised at such ignorance. Rant over ;)

Also, the dangers of accumulation in your liver, toxicity & OD as well as the extremely slow titration process to reach adequate pain relief were a scary reality I didn't want to face, as I have difficulty taking meds as prescribed. The statistics on methadone ODs in Australia is sobering.( lol, not quite literally ;) ), though there is not enough data to show if the deaths were from tablets for pain or from mmt. I digress..

SKR,- it's hump day!! Two days until you're on leave right? How'd your lengthy chat with your GP go ystrdy?

Chat soon,

Rtp
 
^usually with Lyrica, but if I was working I wouldn't be able to get away with bumping into shit & mumbling/slurring my words.

Geez, that's actually not as messy as it sounds, but if I'm gonna be cushioning wds with lyrica I plan ahead so if don't have to drive or do anything much outta the house. Or cook, I've burnt myself, even splashed hot oil into one eye & ended up at ED!!

At home I can just zone out & watch a movie or put on some music & chill. It seriously works well, I save up most of my script either for potentiating opiates or withdrawl days. Loperamide too, as no grown up ever wants to not make it to the toilet on time :/

Other times I just have to agree to be sick for a few days. I pull myself together as best possible, & say hey, I'm in my thirties, I've been sick many times before, & this is just for a few days, & suck it up as best I can.

I realised a few yrs back that if I'm gonna require & abuse opiates to the extent that I do, then not every day is gonna be peachy. Obviously I wish this wasn't the case though.

Reading BL helps too, for support or just to know others are struggling as well.

I'll be starting working with a psychologist again soon, & it'd be helpful if I could be 100% honest.

We'll see..

Rtp

Well RTP you make withdrawal sound not nearly as bad as I imagine - Have I built it up in my mind too much? Probably. I've been on oxy non-stop for the last 12months and I'm dreading withdrawal. I've never been through it so I wouldn't have a clue. Yeah I shot smack a few times back in the day but I never caught the habit. I preferred running around smashed rather than laying around smashed in those days. Oh well gotta go through it at some stage, but I would rather taper down to nothing but damn it's hard when the pain is relentless - what a bitch. I'd love to eat a quarter gram right now but every time I increase my dose from the day before I beat myself up mercilessly the following day cos I know I'm digging a deeper hole for myself and my tolerance just rose another notch.

Yeah Brighton once in a few months is great! Well done

SKR,- it's hump day!! Two days until you're on leave right? How'd your lengthy chat with your GP go ystrdy?

Yep only two more days till leave RTP. So I went to see my doc and she put me up to 15mgs morning and night with some Endone for breakthrough. I wish that's what I was taking. 55mgs this morning and 80mgs for lunch got me through the day. Playing with my boy when I got home has me wishing I was taking the 80mg now - my back is killing me! But what else is new - I bore myself with the whinging, I try to spare my poor wife with my complaints.

So how was your day? Oh yeah and I just took 160mgs - you somehow enabled me lol. cml.
 
Oh yeah I forgot - I'm booked for a consultation with QLD pain clinic at the start of June. Must be quite a few folks with pain cos that is the earliest booking I could get. My GP will be pleased that someone else is going to take responsibility for prescribing my drugs too so everyone is winning! Looking forward to the slight relief I'm about to experience. Damn I wish I was new to oxy - 20mgs would hit the spot. Just say NO to tolerance.
 
^^See, I've often wondered if for some metabolic/physiological reason I escape wds relatively easily. Or if it's the fact that when I run out, I run out & only my mindset will get me through.

Make no mistake it's definitely akin to hvng flu & gastro simultaneously, & I may have been lax in forgetting to mention Absolutely Everything is a huge task unto itself!! Lethargy & depression/anxiety are huge factors too.

Many wd stories are of BLs unable to sleep, but also unable to leave their bed. Chills/sweats, rls, running eyes & nose, vomiting, diarrhea. I get all of these. One chick writes of hvng to carry a vomit bag even just around the house she gets so violently ill. Most regular users would not be capable of going to work in wd.

In the UK there is such a term as a "drug holiday", that even drs go along with. Where a regular break from opiates is scheduled for tolerance reasons.

Whether I don't get tremendously sick because my body is accustomed to short breaks, from one to three times a month, ranging in length from two days up to seven (uuurgh). Or if I just cope with being sick & Woman up..

I often take doses of oxy ranging between 200-500 daily, then go CT. It's well documented that Pregabalin, & benzos help a great deal. Do you have any Lyrica left over from your taper? Even better, repeat scripts to stockpile? Can't recall you mentioning any benzos,- but it may be time to equip yourself with an arsenal for "just in case". Equally, have you checked out the "potentiation" thread?

Seriously the lethargy is the worst for me. As in, answering the phone is too difficult, as is opening mail or hvng visitors... Thank goodness sweet child of mine is school age & I put maximum effort into before school & after as I can possibly muster up.

I completely get that playing with your son you feel the need for more pain relief!! That is a sickening emotion when you're unable,( for whatever reason), to participate fully in life with your child. A principle I've fundamentally advocated for through this whole chronic pain bullshit!!

Most ppl get incredibly sick when their DOC isn't available, & I don't want to give the impression that it's ever easy. It's definitely do able, but I recommend stocking up on helpful ingredients before an unforeseen event unfolds.

I mentioned in an earlier post that I.m back on an antidepressant. Rather than taking around six wks to work, I feel it's already taking effect. I, well, so far, aren't being woken by my alarm with a feeling of dread in my gut. In regard to your amytriptyline use,-,I've noted most antidepressants have warnings in the provided literature that such meds may induce feelings of psychosis, suicidal tendencies & worsening of depression/anxiety. Which is paradoxical by any means.

So, these next two mths..are you planning on continuing the taper? June isn't that far off,- hopeful PM comes up with some new answers? Uh again duh, we all want answers or explanations or solutions.

I may enable your drug taking ;) but pls don't let my negativity affect you when it comes to PM.

We fight to hold on & we fight to let go,-change is never easy.

Now, make some positive affirmations & stimulate that tenth cranial nerve. Stat!!

Rtp
 
^That's pretty amazing, well done!! Was it your choice to come off opiates, well, to switch to Subs? Are you on a highish dose? You've done a really great job to have only slipped up once. I hear you loud & clear re: stress & the urge to obliterate everything from my mind!

Does it give you any type of buzz, or pain relief? (Not that it sounds like you need it now, cmiiw). Years ago, my PM doc suggested it as a third line opiate, but discovered there wasn't an equianalgesic (sp)dose to what I was currently taking.

He then tried to convince me of the painkilling properties of methadone.... I've posted a LOT regarding my experience with encounters of judgement from supposed health professionals & was not prepared to throw them another bone. In the sense that it's only now becoming current knowledge that methadone Is an option for the treatment of CP. And still not in the wider community. Geez, I forget,- is it eight hours or six of training that our up & cmng GPs are receiving at medical school?!? I shouldn't be surprised at such ignorance. Rant over ;)

Also, the dangers of accumulation in your liver, toxicity & OD as well as the extremely slow titration process to reach adequate pain relief were a scary reality I didn't want to face, as I have difficulty taking meds as prescribed. The statistics on methadone ODs in Australia is sobering.( lol, not quite literally ;) ), though there is not enough data to show if the deaths were from tablets for pain or from mmt. I digress..

SKR,- it's hump day!! Two days until you're on leave right? How'd your lengthy chat with your GP go ystrdy?

Chat soon,

Rtp

Aw shucks. Thanks. Yeah it was my choice to switch - I couldn't even get high anymore - 200mg of oxy wouldn't even touch the sides. Or kilos and kilos of seeds. I was maintaining on poppy tea for a while. I wish there was a tolerance antidote, because I was in the shit last year after surgery, I tried to explain my tolerance (Id had enough scripts in the past to justify it) but I it took days to get my dose raised - and this is in hospital ! I managed to get 400mg of tramadol and 100mg of morphine a day and it was just enough.

Im on 8mg of suboxone, in the low range I guess. They were wanted to increase my dose to 32mg but I thought that was overkill. I dont think I get any pain relief at all. I had quite a nice buzz for the first month (January) which is quite common. It just keeps me well and my receptors happy.

Yeah doctors have this hugely inflated opinion of methadone, as if it has the properties of all the painkillers in the world combined, times ten. My old GP tried to coerce me onto the program a few years ago when I was detoxing, as if it was some sort of cure-all.

Hump day!? Sign me up, I haven't had a hump in ages.
 
.

Hump day!? Sign me up, I haven't had a hump in ages.

lmao - classic!

All good RTP you've explained your withdrawals well enough to inform me that it's no cake walk. And yes I've got a plethora of drugs including Lyrica in case I decide to withdraw. I am going to continue the taper I started or more like re-start the taper and get used to using less consistently with the odd higher dose when I just can't hack the pain. Having this habit and using much higher doses than I'm prescribed are two main things that drive my anxiety and depression. While I like to get the extra pain relief by way of taking a bigger dose I beat myself up over it the next day so it's best if I get the doses down for a while. Easier said than done for sure, I'm not trying to kid myself I am after all a drug addict.

It's great to hear that the anti-depressant is having a positive effect, do you mind sharing which drug it is? For me whether it's the Endep or not I seem to be feeling and thinking a lot more positively, I am being less critical of myself these past couple of days even though I increased my opiate use again. I think Endep did knock me around a little bit - increased anxiety and depression which as you say is a fairly common trait with these kinds of drugs.
 
^signed up, take a number pls!!

Ahh, poppy seed tea.. I've tried in vain to feel anything, -anything from the seeds. after reading every post on BL & OD forums yrs ago, I had high hopes, but it seems my tolerance was higher ;)

Like you @Brighton, I can't get high off 200mg oxy, doesn't stop me trying though. Shit it'd be perfect if I could as then I'd never run out of meds! There seems to be other factors that come into play...that I can't pinpoint. At times I can catch a buzz from 250, other times zip, zero, zilch, nada from 4-500mg.

Pain plays an important role. I think, for me anyway, I've gotta be in a pretty great mood & hardly any pain to get any sort of high.

Today my pain, lumbar spine but especially the sensation of my leg bones being drilled into, was pretty severe. Over the course of the day I took a sheet of oxy 30's. Starting with half the sheet then redosing.

It's as though I miss the buzz & move straight onto the nod, or opiate induced fatigue. I've been told many times now by the experts that if opiates were effective for my type of pain I'd respond to 60-70mgs per day.

If I didn't have such fucking awful tortuous pain then without a doubt I'd go the subs or mmt. It's so sporadic that I've thought deep & hard.

Once again, ideally, I'd taper, then be able to lower my tolerance substantially so that when I experience severe pain I'd have the knowledge & the means to treat my pain accordingly.

The two drawbacks that come to mind are; Accidental OD, & that never again in this lifetime am I gonna be lucky enough to be scripted the amount of opiates I currently am. Especially after reading this thread and the acute & chronic pain megathread. Many Cpp's are so poorly under-treated.

Speaking of surgery, I'm hvng my
wisdom teeth out next Thursday. I had my pre-surgery appt with the anaesthetist today, & though its normally a day stay procedure he requested that I commit to at least spending the first night as an inpatient.

For once in my life there was an established understanding that my body,(brain, technically), does not act in a predictable manner when it comes down to pain. As my PM dr says, "your brains not wired properly" lol. As no one around here has a crystal ball, it does seem a better idea to stay overnight for nursing care/pain relief.

Wish you both a pain free & peaceful evening ❤️

Rtp
 
Skip the high and straight to nod? Yep i know that story. The personality of oxy changes over time i've found. At first i found it stimulating, then the stimulation goes and you skip straight to nod as you say and now i get neither unless i take 200+ which sometimes gives me a little buzz but only if i've waited longer than say 14hrs since last dose and that previous dose is less than 100mgs. Of course its my body that has changed not the drug.
 
Respond to 60-70mgs per day? Well if you had no tolerance im sure you would feel pretty good 2-3 times per day. For me oxy really just allows me to not be so engulfed by my pain for that 30mins-1hr after taking it - assuming i took a big enough dose for a buzz or that i waited 12+ hrs since my last dose or preferably both. Its not like the drug targets my pain and works that way. Is it supposed to? I dont think thats how the drug works. A big shot of pure amphetamine would take my mind off the pain also but the come downs would be too heavy given my state of mind these days.
 
So once again thrown in from the deep end into acute wd. Softening the blow with Lyrica.

Ive just returned from my PM dr, he had a cancellation this morning, so I jumped at the chance. Bless you sweet Pregabalin! 600mg hides pretty much any wd symptoms.

I was hoping to see him prior to having my oral surgery, with the idea of transferring me to the private hospital he consults with for a ketamine infusion.

He agrees I'll likely require hospital care for more than one night, & even though I feel these infusions aren't that helpful for my regular acute flare ups, the ketamine may provide pain relief as well as assist my current level of prescription meds to work better.

He's sctually heading to France for a conference, so I have to wait & see if one of his colleagues is willing to oversee the infusion. Should be ok.


I'm really glad I've gone back to my original PM dr,(I was referred on for a second opinion), he shows a certain confidence & authority & is extremely knowledgable.

So, three days of wd seems like a Drop in the ocean really..

@SKR what's going on? How's the taper going, & the time off?

Rtp
 
600mgs of Lyrica would have me wobbling all over the place RTP! I took 300mgs last night and boy did it help me sleep - in bed for 9hrs, 3hrs more than my average. I was a wobbly mess this morning though. Regarding oxy - I waited 20hrs before my first dose (40mgs) which I took at midday. I must say though, I think I was witness to Lyrica hiding WD symptoms in myself today. Usually at the 16 - 19hr mark without oxy my nose is starting to run and my hands get restless, I didn't have the runny nose when I took the 40mgs of oxy today after waiting 20hrs which I could only put down to lyrica.

Tried to sleep just now but couldn't - I've taken 150mgs of Lyrica right now in the hope that I can get some sleep before my lil boy wakes up from his nap. But Lyrica takes at least an hour before I feel any effects that would encourage sleep. One way I discovered, not surprisingly, to balance out the wobbliness of Lyrica is to take a bunch of oxy lol - but I really gotta lay off the opiates and get this tolerance down. I could take 100mgs for my next dose and I would still be lower (140mgs total) than my last few days daily doses which were somewhere between 160 - 320mgs. I wanted real pain relief but the addict inside me wanted to die. I hate being addicted to oxy I am a reluctant addict now instead of the addict that enjoyed getting high on stimulants all those years ago.

Anyway - sorry to hear you're in withdrawal RTP - I'm encouraged that 600mgs of Lyrica has hidden the symptoms, do you think you would be able to sleep in this state?
When will you take another dose of oxy? Do you have a minimum oxy dose that would just be enough to take you out of withdrawal?
 
^Unfortunately the addict in myself is far too likely to binge & wd, binge & wd. I don't have the sense & sensibilities to save some. If I have it I'm having it.

See, now this cycle used to be manageable, as I needed to see my dr for scripts three out of four weeks. My scripts never lined up, I am taking two strengths of oxy, 40mg & 30x2mg, & then the third week I'd get prescribed my authority for endone, 240.

As I've written about previously, I've had trouble getting scripts when my GPs on regular holidays & very part time hrs. So this last time she gave me partial scripts to match up at the same time of the month.

So when I next see her, I'll be coming home with a shitlload & won't have the strength to abstain.

Maybe I will, I dunno anymore, it's like a rat on a wheel. My life seems to revolve around dr visits, then whoops there's another month gone by, again & again. Before I know it another year passes me by.

I only ever see the cold hard reality when I'm wding. As I've always said, it's very different from the outside looking in then it is from the inside looking out.

I sound sad. I'm not, just cold hard reality kicking in. I'll have some more lyrica once ive picked my daughter up from school, & a few drinks tonight. My sleep doesn't suffer, & I've read some horrible wd stories & I just don't get that sick.

SKR, well done on waiting 20hrs!! I'm glad that you don't seem in the grip of addiction anymore. It's a hard, hard battle to resist oxy you're doing very well man!!

Rtp
 
You don't sound sad you sound like it is being addicted to pain relief and drugs - you're not deluded either. It sucks that to get pain relief you have to take drugs that are addictive. I don't drink anymore due to my pancreatic issues which tie in with anything hard on the liver and kidneys but I bet it would help WD's to some degree though. I'll always be an addict though, I think I'm worse for making sure I have enough oxy by supplementing my prescription with oxy I buy illegally. I'm not entirely certain that if I only had my prescription that I would mis-use it by taking more and running out like you do RTP. Having been clean for almost 10 years from hard drugs I was proud cos I really was a fiend and cleaned myself up - now being addicted to oxy because I just couldn't hack the pain anymore and what has happened to my life over the past year with regards to health and finances (had almost $60,000 stolen from me by an ex-business partner)......I have to clean my act up and my addiction to oxy needs curtailing - the backwards step in my life pains me so.

You do well to walk around with 600mgs of Lyrica bouncing inside of you lol, the 150mgs I took earlier has me wobbly enough. You certainly do get used to it though the more you take it - much like anything else I suppose.

Do you mind sharing what amount you are prescribed for daily use? Are you saying you are supposed to take 100mgs daily (40mg + 2 x 30mgs) and you get a script each week and on the third week you get a total of 240mgs Endone for the week? I don't think I've understood you properly with regards to your scripts.
 
And in regards to your statement about being a rat on a wheel - whenever an addict is taking their drugs their lives always revolve around that drug. I have been living pill to pill this last year. I don't shoot them up or plug them because it seems that oral BA is excellent. I used to shoot everything up but those days are past.
 
^yeah, ima bit scatty, thanks Lyrica;)

I'm prescribed 30 x 2 am & pm, 60mg. 40mg arvo & 20 mg endone mid morn & late arvo. 200mg total per day.

God you'd think anyone would be happy with that amount right?

In a month, wk one, I get 112 30mg oxy, two wks later 28x 40mg, wk later 240 endone. The whole charade of taking as prescribed. Yeah right ;)


But, I changed GPs two & a half years ago. Prior to that I was on two 100mcg fent patches + oxy +endone.

Tolerance is a bitch. Pain more so!! My current GP & PM worked with me getting me into hydro, physio, injections, nerve blocks, plenty of ketamine.. So I could be on a maintainable doseage.

My metabolism is another issue, I was in wds having 80mg oxy twice a day. Even with the endone. Hence the 40mg afternoon dose.

So, I've pretty much been abusing since the GP switch,(she is a Great Doctor), but coming off the fent was extremely difficult as anyone who's been though it can attest.

I pretty much came up with my own dosing schedule which then got out of hand.

I often have weak moments where I think I should come clean to my drs, but I know they'll take me off the oxy & I can't afford for that to happen!! So I never will.

Even new patients get put on Targin (sp)? The newer supposedly less abusable slternative.

Wow, that would suck being clean for so long & then developing pain & needing an addictive substance. Doubly so that your partner scammed you!! Lotta arseholes in the world.

I've tried Jurnista,( ER hydromorphone), several times and never even lasted a week on it. MS Contin & IR hydromorph combined with a lower oxy dose, never even felt any pain relief.

When I saw my PM dr today, I asked him if we're still at loggerheads over Increasing my dose. Yes, esp with new research being done, as apparently I'm five times more likely than anyone else my age to die from any reason (not just drug related).

This is not new news, he's been telling me so for yrs.

Anyway, Iooking fwd to being knocked out thurs & getting pain meds in hosp.

Rtp
 
Bloody hell RTP - you've been through the wringer and more by the sound of it. Being knocked out in hospital is great. I loved it cause it's a time without pain just like a good sleep with no interruptions. I need the Michael Jackson treatment before bed each night, that would work for me.
 
Far out! Withdrawals when taking 80mgs twice a day.....thats shitty for sure. I could handle taking 200mgs per day for about 2 - 3 weeks with my current tolerance then I would need to increase the amount for the same relief. I think it's about accepting a certain level of pain if you want to make the prescription last by having oxy on the daily without running out. I can see why you take more by my own experience - you want pain relief, or the high which basically makes you not care about pain for a little while. It sucks because the tolerance your body has makes staying on a certain amount impossible if you want the same relief you are used to. Terrible cycle.

It took my GP 6months to increase my daily dose by 10-15mgs. It will be interesting to see what the PM clinic tries with regards to drugs. It's one of the main reasons I need to get this tolerance and doses down because I have no idea what's coming with regards to treatment.

Do you get tested for illicit drugs such as cannabis at all RTP? Do you have such conditions put on you?
 
No restrictions at all, never had to take in pill boxes, have meds counted, pee, (cept at hospital receiving ketamine, making sure it's going into me not a jug on the side. And that's not each time).

My gp is in charge of writing my scripts, though PM has made changes ultimately I'm in charge as what meds I can live with being on and what ones give me intolerable side effects.

GPs are more confident in prescribing opiates generally once you're involved with a PM dr. So, hopefully you'll be raised from the pittance you're currently prescribed.

I am regarded as taking 350mgs morphine daily. The oxy 200mg equivalent. This presents problems when presenting to the ED with kidney stones etc. I carry drs letter with my scripts printed on it now.

Also why I had to have an appt with the anaesthetist last wk, to make sure the anaesthetics strong enough to knock me out.

A side note, I've also been accepted into the public pain clinic, took a few mths, but my gp wrote urgent on my referral. Apparently the wait is usually two yrs. my first appt isn't til the first of June, for four hours!! Drs, physio, psych etc talking. Really just doing this to go through the motions & be on the system at the public hospital (where the ED is).

How long do you have to wait? Do you have a date yet?

Rtp
 
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