Pain Managment & Dealing with Addiction - strategies or advice between treatment

[Jabberwocky]

hey guys (if you cant bother to read it all, theres a tl;dr section it would help to read it all though)

i've been receiving opiate treatment for coming on 6 years now, im only 24. i've spondylolisis (L4, L5 and S1) as well as sclerosis of the facet joint and have curvature in the lower back. sciatica seems to be another problem, as well as one leg being longer in length than the other - otherwise i'm a pretty healthy human being for the most part

i've been abusing opiates on and off for the most of these 6 years. it's only probably within the last 12 months where it's gotten to be a serious problem and i've become more aware of it, i'm not in denial about it anymore and am actively trying to seek help. ultimately i want to end up on the subutex program. i''ve been visiting my local ATODS for most of this year in hope of a spot opening up on the sub program; i refuse to go the methadone route for my own personal reasons.

over the last 4 months or so i've been seeing a therapist who specialises in addictions and she has been a huge amount of support and has been helping me turn the page and get on with my life away from drug abuse. this was up until a few days ago when i contacted the brisbane hospital i was supposedly on a waiting list for to attend a supervised detox and enter a physical/mental rehabilitation facility and start seeing a PM doctor. i'm not on the list apparently. she had been taking me for a ride as i understand it, supposedly liasing with doctors she's worked with before, having me update all my mri's and x-rays and a new consultation with an Orthapedic surgeon. having all this done was supposed to speed up my process and perhaps bump me above other patients given my circumstances. needless to say im fucking furious that i have been lied to and am not on any waiting list at all. i've got to start the whole process again by an assessment at the ATODS centre here in town. i am also having thoughts of not seeing her anymore - i feel the trust between us has been broken and is irreversible right now. and they say never trust a junkie

i feel as if im going round in circles again and it has been damaging my improvements. my motivation is dying and i'm at the point where it's all too easy to say "fuck it" and continue on with my bad habits. this i don't want, i've come so far and i'm not willing to give up without further fighting. i've been abusing my scripts again, mainly the IV route since i remembered my old way of prepping these nasty things that can gel up. i don't need any condescending remarks of that - i know the damage i'm doing and i use micron filters. i take all the necessary steps and precautions to eliminate as much harm as im doing. i've even changed from 27g to 31g since i've been injecting the morphine a lot of my cravings to continuously use and stay high have dissipated. it's what works for me, so try not to pass judgement. i tend not to use anymore than i'm prescribed too often either. my pain is also managed so it's not as if i'm sacrificing peace and comfort all for a rush and a couple hours of being high. i'm also not trying to justify my abuse.

my doctor is fully aware of me wanting to go through detox and is supporting me the whole way. what he is not aware of is that i'm injecting - a huge concern he had with initially prescribing this amongst me selling it etc. if he were able to, i would get subutex off him, but he doesn't have the appropriate license and the doctor in his surgery who does has filled his quota; i'm on his waiting list though. so basically it has come down to me and him working out a plan between us to keep me in as check as much as possible and away from abusing my meds and other meds i can get my hands on until i go to treatment. marijuana is no issue to him. he laughed when i asked him if it were going to be a problem "everyone is smoking these days, i'd rather you smoking ocassionally then being addicted to valium again" were his words.

one implementation is me having to drop him piss tests every month or two, randomly. i dont know the dates, but i know that every month or two im going to have to drop for him. for the most part this will keep me from scoring other drugs like i usually do - especially benzo's and other pain killers. pharmaceuticals are my poison of choice, i barely touch meth or any street drugs besides weed anymore.

i'm also going to be called in for random pill counts. this is another deterrant for me wanting to be greedy and overindulge. i currently don't have anything for breakthrough pain but have been given permission to use an extra 1/4 of a pill at a time when needed. sure i could just keep upping my dose every other week but that will raise red flags in no time. the dr has reservations of supplying me with an IR morphine formula as he said we will discuss options over the coming weeks once i am settled on the SR morphine.

obviously i'm also under careful watch regarding doctor shopping being on the medications prescribed; i don't need the hassle of fucking up treatment so dr shopping doesn't even enter the equation.

basically it has come down to me wanting to be on the subutex program but because of certain circumstances im unable to at the moment. so for the time being i'm managing my pain with full agonists and muscle relaxants. it's not your normal situation. i prefer bupe over any other opiates i've used for pain. it kills all my cravings and has been an aid in depression as well as anxiety issues. bupe has come to have a reputation as a shitty pain killer, but it's not the case for me.

so my question to all the other pain managment patients - or anyone else - in here is have you ever been under similar circumstances where you're aware of your addiction and are seeking help but unable to get that treatment as quickly as you'd like so you've had to implement other strategies into your treatment to keep you on the straight and narrow as much as possible? what have you done? did it work?

any other advice or input would be greatly accepted

i'll be updating this through my process.

hoptis, lil, madmick and doc - i was going to cross post this over in OD as well for a wider reception but will hold off for a while and get you guys to perhaps move it over there after a while of being in here. i mainly want views from australians but am unaware of how many PM patients circulate through here

tl;dr - im an addict on PM who is waiting to receive Bupe treatment. until then im wanting to hear of what strategies i could use with my doctor to help keep me off scoring other opiates/benzos etc, besides the morphine and baclofen i receive from my doc. i'm already dropping random piss tests as well as pill counts.

i'd appreciate if you read the whole thing but i know what the general consensus of long posts on the internet is lazy sods:D

 

[MazDan]

she had been taking me for a ride as i understand it, supposedly liasing with doctors she's worked with before, having me update all my mri's and x-rays and a new consultation with an Orthapedic surgeon. having all this done was supposed to speed up my process and perhaps bump me above other patients given my circumstances. needless to say im fucking furious that i have been lied to and am not on any waiting list at all. i've got to start the whole process again by an assessment at the ATODS centre here in town. i am also having thoughts of not seeing her anymore - i feel the trust between us has been broken and is irreversible right now. and they say never trust a junkie

Two things i think you should consider.

1. Talk to her and have it confirmed she has been spinning shit............maybe its a misunderstanding and she has been doing it all correctly.


2. If its confirmed she is spinning shit then you must report it so it doesnt happen to anyone else.

I have a feeling its probably a misunderstanding as I have always found medicine in Aus to be superb.

Best of luck champ and i will be following this with interest.

 

[Jabberwocky]

Two things i think you should consider.

1. Talk to her and have it confirmed she has been spinning shit............maybe its a misunderstanding and she has been doing it all correctly.

ive had a friend in the last hour tell me the exact thing. my only reservations on that is the anxiety i suffer from confronting such situations - something im going to have to grin and bear basically, for the better good. its what i need to do whether i want to or not. i will be seeing her sometime this week to eliminate any confusion there may be.

2. If its confirmed she is spinning shit then you must report it so it doesnt happen to anyone else.

I have a feeling its probably a misunderstanding as I have always found medicine in Aus to be superb.

Best of luck champ and i will be following this with interest.

yeah, thats what my friend also told me. if she has been undermining my (probably not the best wording) progress then that is exactly the action i will be taking. i hope for the sake of our relationship she hasn't dragged me along for the ride. she works for ADFQ - google it.

getting this treatment is extremely vital for me at the moment. with this obstacle of having to go through it all over again after exhausting all possible avenues i have been aware off i am extremely low in confidence and motivation. its too easy for me to give up, have my morphine slowly upped and continue down the same path.

wanting treatment but not being able to receive it leaves a lot for the mind to decipher

 

[MazDan]

Hang in there mate.

Dont give up on yourself now.

I would be prepared to wager a good deal that this is all above board and just a misunderstanding.

I understand your anxiosness so why not approach it when talking to her as if those you saw at the Brisbane hospital have confused you because they said this that and the other.

Then see what she has to say.........sort of act a bit dumb and at her mercy and a bit vulnerable and that way without her knowing, you are in a position of power.

If she has a completely plausible explanation then you havent accused her of anything and your relationship continues.

If she cant explain it then maybe push a bit harder. Play it by ear and your comfort level.

trust your instincts........they will know if she is spinning shit or not.

 

[the_ketaman]

I know you said you dont want to be on methadone and I originally said the same thing, the thought of methadone scares the crap out of me but a while ago day I went in to try and get on bupe and ended up on methadone the very day I went in to the doc, they will taper me down until im at a stage where im suitable to be using bupe. May I suggest you go on methadone until there is a spot with your chosen doctor to get on sub?

Any way its good to hear your using micron filters, theres a surprisingly large amount of IV pill users in Australia who dont use them and most of them dont even know what the consequences are.

Is the reason you dont want to use methadone because it seems to be a worse monkey than the pills themselves? Thats what I originally thought and still do to an extent but I think we both agree its much better than shooting pills?

Ill be following this thread, the subject of methadone and bupe has become something of great interest to me in the last few weeks. Good luck mate. One more thing is it just morphine your using or oxy etc and what doses are you using?

 

[Jabberwocky]

Hang in there mate.

Dont give up on yourself now.

I would be prepared to wager a good deal that this is all above board and just a misunderstanding.

I understand your anxiosness so why not approach it when talking to her as if those you saw at the Brisbane hospital have confused you because they said this that and the other.

Then see what she has to say.........sort of act a bit dumb and at her mercy and a bit vulnerable and that way without her knowing, you are in a position of power.

If she has a completely plausible explanation then you havent accused her of anything and your relationship continues.

If she cant explain it then maybe push a bit harder. Play it by ear and your comfort level.

trust your instincts........they will know if she is spinning shit or not.

i trust my insticts for the most of it and through this whole "process" ive been left out to dry. sure they show concern with consulantcies (sp, i know its wrong byut my spell check isnt working) but the with personal side of things i feel as im being treated as any other hopeless addict in my area which is extremely unfair - we're all grouped together no matter what our circumstances, any other person in my position, im sure, would be able to express the same feelings.

ive been expressing this concern of being an addict for nearly 3 years now and ive been expecting more concern to my treatment - its all been the same response "youre not a red flag, youre not abusing your script like an addict would". i know im not, im buying off the street or i have acquired what ive need illegally or ive sweet talked my dr, but theyve not shown any concern especially with the rapport i have with my doc - im apparently one of his best PM patients. i dont want to be another statistic of our bluelight brethren, im fully dedicated to get the treatment that is supposedly available. id have easily overdosed by now if i werent as dedicated as i am, its crossed my mind all too often. to put it in perspective as of this tuesday i will be getting 60 x 60mg tabs of MsContin, along with baclofen and a temazepam/valium script as needed on my doctors discrepency. i wont divulge anymore because i feel as though id only be seeking attention i dont want.

I know you said you dont want to be on methadone and I originally said the same thing, the thought of methadone scares the crap out of me but a while ago day I went in to try and get on bupe and ended up on methadone the very day I went in to the doc, they will taper me down until im at a stage where im suitable to be using bupe. May I suggest you go on methadone until there is a spot with your chosen doctor to get on sub?

i probably would if i could but theres a better chance me getting on bupe. ive nearly overdosed on 'done alone in the past. my dad has had similar struggles in his past and knowing my history im likely to follow his past. ive got a lot to offer in my lifetime besides being a recovered drug addict, i have plans i wish to follow through with

Any way its good to hear your using micron filters, theres a surprisingly large amount of IV pill users in Australia who dont use them and most of them dont even know what the consequences are.

Is the reason you dont want to use methadone because it seems to be a worse monkey than the pills themselves? Thats what I originally thought and still do to an extent but I think we both agree its much better than shooting pills?

Ill be following this thread, the subject of methadone and bupe has become something of great interest to me in the last few weeks. Good luck mate. One more thing is it just morphine your using or oxy etc and what doses are you using?

partly, yes, it will become an even bigger monkey. ive had enough troubles over over the last 2 years not upping my dosages to satisfy my personal gains.

im currently on 2 x 60mg SR MsContins. nothing huge, but enough to keep an active habit. ive got many different unclaimed scripts i havent processed.

forgive me if im coming off as a whiney cunt right now but i've nearly gone through a bottle of vodka and am only trying to express my feelings. thanks maz and ketaman

 

[MazDan]

Not whiney at all mate.

I think it seems like your head is in the right place........keep working at it mate.

Considering all this started due to back problems, im guessing they wont have just magically disapeared so will you be able to come up with alternatives for that?

 

[Jabberwocky]

gah, someone cry me a river haha. i'm glad i didnt go off on too bad of a tangent - i'm never drinking again. i know theres got to to be others out there in my situation?

 

[Jabberwocky]

Considering all this started due to back problems, im guessing they wont have just magically disapeared so will you be able to come up with alternatives for that?

as in alternative treatments? i see a physiotherapist every couple of months and have been getting back into light exercising lately - walking, light weights, that kind of thing. accupuncture is something id like to try out, ive heard a lot of good reports from that. simple stretching exercises work great.

i can get my spine fused together but at my age i am refusing to do that, doctors have even been against it. sure there are some successful spinal fusions done, but from what ive seen and heard a good amount of them dont turn out good which then leaves the patient in a wheelchair for the rest of their life and in even more agonising pain

 

[MazDan]

I guess what Im getting at is that its all very well to get clean..........but it was your back that started all this and as such that probably requires a different solution in order to not start the downhill ball rolling again if that makes sense.

 

[person]

I know you said you dont want to be on methadone and I originally said the same thing, the thought of methadone scares the crap out of me but a while ago day I went in to try and get on bupe and ended up on methadone the very day I went in to the doc, they will taper me down until im at a stage where im suitable to be using bupe. May I suggest you go on methadone until there is a spot with your chosen doctor to get on sub?

Any way its good to hear your using micron filters, theres a surprisingly large amount of IV pill users in Australia who dont use them and most of them dont even know what the consequences are.

Is the reason you dont want to use methadone because it seems to be a worse monkey than the pills themselves? Thats what I originally thought and still do to an extent but I think we both agree its much better than shooting pills?

Ill be following this thread, the subject of methadone and bupe has become something of great interest to me in the last few weeks. Good luck mate. One more thing is it just morphine your using or oxy etc and what doses are you using?

Hey some good advice mate! ive been on the methadone program for 12months now, on 85mgs everyday! before MMT id be on 200mg (or less) of morphine everyday (on top of my other addictions) or 100mgs morphine turned with AA, and the odd oxy40s, 80s when its available. Methadone is definitely controversial worldwide!! I know that sadly im addicted to methadone and it is hell just having one day off/missing a dose, I go into extreme hot cold sweats similar to a BZP high lul.
I sweat like hell when im at work which is annoying as im working with circuitry etc, but have been requested recently by my doctor that I be put on 6 - 8mg of suboxone (both are govt subsidized in n.z. and free dispensing, weekend takeaways after 3 months) id be keen to hear from other people who have switched from methadone to suboxone/PM. Here they use suboxone to taper off methadone!?
Have had a problem when I went home for 2 weeks and the local melbourne clinic wouldn't dispense 100mgs to me (started at 30mg, 45, 55, 65, 75, 85, 100mg and now back steady on 85mgs), spent 3 hours for confirmed faxes.. Anyway methadone has actually stopped me from injecting altogether!? or even craving for a fat hit of opiate goodness (worser when back in Melbourne, but glad now since heroin is kinda low last time I was home, it was all meth unfortunately the places I went to lul).
I used to inject a lot of Ritalin and even though that isn't an opiate, methadone helped me stop that addiction as well?? ! maybe I have a needle envy addiction - lol.
All the best for everyone's recovery!!..

p.s. I did whack some morphine under the influence of methadone (not long after being on the program) to be sadly disappointed by no rush, and just a 5 second huh? stopped me from wanting morphine again and aided towards my recovery of opiates for now...

 

[Jabberwocky]

I guess what Im getting at is that its all very well to get clean..........but it was your back that started all this and as such that probably requires a different solution in order to not start the downhill ball rolling again if that makes sense.

i dont think im understanding what youre trying to say, sorry. as i said in my OP i ultimately want to be put on subutex (buprenorphine). once youve been stabilised on the drug after a few weeks it saturates your receptors much like methadone and it has a much higher binding affinity than other opiates - nothing else can get in basically unless youre only using a small dose of 1mg or so. it has ceiling dose of 32mg though its most effective in the 2-6mg range; less = more with bupe, recreationally and therapeutically. it lacks a rush that most mu agonists give when injected - think of morphine, heroin and oxy - and isnt considered recreational by a lot of dope heads. it satisfies all my needs and kills my cravings - i dont feel the need to get high when im on around 4mg of IV bupe. im starting to repeat myself now so ill stop.

sure i could start the ball rolling again when i switch but its highly unlikely. i would much prefer to be shooting up a full mu agonist like morphine or heroin; i do enjoy the recreational side of bupe though

i would be getting piss tested every month and when you first start the program you have to pick your dose up daily, only receiving take homes for the weekend. they normally crush the pill up for you and watch you dose it and make you wait around so you dont go home to shoot it, sell, whatever. eventually it would be my doctor prescribing me the bupe.

once i make the switch to bupe it will be a matter of working on my needle fixation which has recently come out of retirement. sometimes its the needle i feel more attracted to rather than the drugs - its a powerful thing.

p.s. I did whack some morphine under the influence of methadone (not long after being on the program) to be sadly disappointed by no rush, and just a 5 second huh? stopped me from wanting morphine again and aided towards my recovery of opiates for now...

it would have been because of your methadone dose. generally when youve been stabilised on 40mg+ for a while the methadone saturates your opiate receptors. basically youll get the analgesic effects from other opiates but you wont get high unless you go busting out some bullshit amount of whatever youre wanting to use. i dont advise this at all because its likely youll overdose - so many people have become victims of trying to shoot through their methadone dose only to overdose and die. be careful with that.

as for switching over to bupe from methadone youll want to lower your dose to around the 40mg mark - this seems the be the standard when switching from 'done to bupe. check out the bupe and methadone mega threads in OD for some info.

 

[MazDan]

I was sort of thinking ahead mate................Lets assume you beat the addiction but dont change what your using to stop the pain in your back..............Im worried the cycle might start again some time in the future hence why Im suggesting it might be an idea to find a suitable alternative solution for your back problems.

 

[Jabberwocky]

yeah well i dont like to think that im going to relapse, im keeping my thoughts on the positive side of things if i could deal with the pain without having to reach for a pill everyday i would, but thats not the case in my situation. some people manage to cope with their pain on a day to day basis, i cant. it impedes my life too much and my quality of living goes to shit.

if you know of any alternative treatments id be more than happy to take them on board.

 

[MazDan]

No I dont really mate..........Im just a humble sparky who trys to help people.

But I do suspect that it will be important to find an alternative.

Might be a good idea to have a long heart to heart with your doctor.

 

[GvMe1More]

Kind of picking thru this whole thread............Alot of people say that you have to pick up your dose over time. I disagree. I researched a doctor, called and went in. I explained my usage and was put on the correct dose from the get go. It sounds like your scared of that the most. Have you researched personal doctors in your area that provide subs? Or is it the money? I am in the same situation(you can read my post, Opiate Addiction And A New Beginning). I did not go thru insurance and the first visit cost me $250.00 with follow-ups every month of $105.00. Meds cost me $380.00.
I was in pain management. I took my pharmacy print outs to prove the amount of shit I was on and then explained I was copping on the street.

 

[Jabberwocky]

im not scared about getting on any kind of dosage - i want to get on buprenorphine. i already know what dosage is suitable to me from using subutex in the past. nothing about bupe scares me, what is worrying me is my current addiction. as ive said ive been on one type of opiate or another for 6 years now and ive been abusing for most of that but over the last 2 years things have gotten a lot worse, upping doses, scoring off the street, scamming my doctor for extra pills, you get the idea.

ive called around and checked with all the doctors in town who have the license to prescribe bupe but none of them have a spot for me, so i am on ones waiting list. money isnt really an issue because i get my scripts covered by the PBS. my family would be able to help me out if i did have money problems anyway. the ATODS centre at our hospital has no openings either and ive
been regularly dropping in all year checking if something has opened up. they dont even have room for me on the methadone program, i probably would jump on that as a last resort if things were getting too out of hand for me.

ive managed to get control over my habit somewhat over the last month and am doing a lot better than i had been. i had a 3-400mg oral oxy tolerance alone from abusing my fentanyl script. shooting my oxycodone was equivalent to having a crack problem - i was continually chasing that high.

Might be a good idea to have a long heart to heart with your doctor.

i have, dont worry. hes fully aware of my situation and he liases with my therapist.

 

[person]

sometimes its the needle i feel more attracted to rather than the drugs - its a powerful thing.

I feel like that atm! you are so right! - also thanks much for your input, I forget that there are other forums on bluelight lul so will read some threads in OD on done+bupe, and yes the docs were wanting to taper me down to 60mg or less before switching to sub..

edit: forgot to mention leftwing: yep will definately not shoot morphine on top of my methadone dose anymore! so rest assured I am well aware of the overdose potential!! one would need at least a 100mg hit to feel a rush which of course is dangerous. And I must admit it is tempting to have the odd benzo now and then after taking the daily meds - but it can be strict with the odd urine test and blood sample.

 

[lil angel15]

How's everything coming along with this lefty - Has there been any progress on getting onto the bupe program?

 

[MrIbis]

i dont think im understanding what youre trying to say, sorry. as i said in my OP i ultimately want to be put on subutex (buprenorphine). once youve been stabilised on the drug after a few weeks it saturates your receptors much like methadone and it has a much higher binding affinity than other opiates - nothing else can get in basically unless youre only using a small dose of 1mg or so. it has ceiling dose of 32mg though its most effective in the 2-6mg range; less = more with bupe, recreationally and therapeutically. it lacks a rush that most mu agonists give when injected - think of morphine, heroin and oxy - and isnt considered recreational by a lot of dope heads. it satisfies all my needs and kills my cravings - i dont feel the need to get high when im on around 4mg of IV bupe. im starting to repeat myself now so ill stop.

sure i could start the ball rolling again when i switch but its highly unlikely. i would much prefer to be shooting up a full mu agonist like morphine or heroin; i do enjoy the recreational side of bupe though

i would be getting piss tested every month and when you first start the program you have to pick your dose up daily, only receiving take homes for the weekend. they normally crush the pill up for you and watch you dose it and make you wait around so you dont go home to shoot it, sell, whatever. eventually it would be my doctor prescribing me the bupe.

once i make the switch to bupe it will be a matter of working on my needle fixation which has recently come out of retirement. sometimes its the needle i feel more attracted to rather than the drugs - its a powerful thing.



it would have been because of your methadone dose. generally when youve been stabilised on 40mg+ for a while the methadone saturates your opiate receptors. basically youll get the analgesic effects from other opiates but you wont get high unless you go busting out some bullshit amount of whatever youre wanting to use. i dont advise this at all because its likely youll overdose - so many people have become victims of trying to shoot through their methadone dose only to overdose and die. be careful with that.

as for switching over to bupe from methadone youll want to lower your dose to around the 40mg mark - this seems the be the standard when switching from 'done to bupe. check out the bupe and methadone mega threads in OD for some info.

oxy actually seems to be more of a Kappa agonist from some reading i did recently.