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  • AADD Moderators: swilow | Vagabond696

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

lil angel15 said:
How's everything coming along with this lefty - Has there been any progress on getting onto the bupe program?
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no, not yet lil. ive sort of gone through a slump just recently to be honest, i pocketed a few"spares" of morphine from substituting for a few days which led to a bender that was meant to stop friday but continued through until just then:|

ive started going through a little post-depression and been a bit bummed today mostly - only reinstating the point i need to cut it as of my last fix i just had. ive also got a few IRL matters to deal with over the next few weeks as well where i cant afford to be doped up or battling wd's trying to stabilise myself.

ive still been checking out alternative treatment centres that mainly deal with the withdrawal process then build on your social skills through camps. a lot of them are religiously based or dont even involve any type of medical treatment for pain patients which sort of still has me steering clear that way, though my mind may change. some of the costs are also enough to put me off.

i havent updated this because ive had nothing positive to add, ive been going backwards. i have been speaking with counsellors online from time to time - www.counsellingonline.com.au - through the website MrIbis recommended in his thread. theyve been comforting through harder times and id suggest to anyone that they should visit the site whenver they feel they need to talk to anyone - its all anonymous as well:)

i still havent caught up with my therapist - thats how backwards my priorities have been.

MrIbis said:
oxy actually seems to be more of a Kappa agonist from some reading i did recently.
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as opposed to a mu agonist?
 
Keep with it Lefty. <3

It wont be an easy battle but when you come out the other side it will all be worthwhile. :)
 
wiki said:
Mechanism of action

A group of Australian researchers has proposed (based on a 1997 study in rats) that oxycodone, unlike morphine (the effect of which is mediated by μ-opioid receptors), acts on κ-opioid receptors.[53] Further research by this group indicates the drug appears to be a κ2b-opioid agonist.[54] However, this has been disputed, primarily on the basis that oxycodone produces effects typical of μ-opioid agonists.[55]
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hmmm...

lefty, i'll pm you with my msn details, i think we could make pretty good mates - i'm willing to help support you bud - perhaps you might do well to move interstate for a few months dude?

Melbourne its piss easy to get on a bupe program. I got on bupe within 3 days.

My thread is also a sticky now - and if you can forward me the stuff from rolls old thread, i'd be appreciative.
 
lil angel15 said:
Keep with it Lefty. <3

It wont be an easy battle but when you come out the other side it will all be worthwhile. :)
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thanks lil:)

MrIbis said:
hmmm...

lefty, i'll pm you with my msn details, i think we could make pretty good mates - i'm willing to help support you bud - perhaps you might do well to move interstate for a few months dude?

Melbourne its piss easy to get on a bupe program. I got on bupe within 3 days.

My thread is also a sticky now - and if you can forward me the stuff from rolls old thread, i'd be appreciative.
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got it, thanks:)

and yes, if i were in brisbane it would basically be a matter of me walking into a clinic or finding the right doctor and id be on the program within a week, tops. thats what is so frustrating about my situation. i know the resources are there but theyre not available to me where i am at the moment and moving isnt really in the scope of things at the moment. set me up a ticket interstate into a halfway house or something and im sure we could work something out haha;)

sorry i havent managed to forward those links yet, ive been lazy, i admit that. ill start getting around to it now since im not really doing anything and then format it up in a pm to you.
 
I'm a similar situation with chronic pain and a fucked up spine. I'm really sorry for what u have to go through since I've been there. But once all the hassles is done and u got on the bupe program it will only get better from there. It's just a waiting game for u now. U need to just make sure that u r doing everything possible to get on a bupe program.

I agree with MazDan saying that it's probably a misunderstanding with the doctor about the waiting list. It might not be her fault at all, there are so many varaiables in the situation that blaming the doc right away might not be fair.

I take bupe for my pain. A small amount is enough to keep the worst pain away. It's a great medication since u get as much as u need and there really is not desire to abuse it. With other opiates I never got as much as I needed and I always took more than needed to get high but for some reason bupe is different and the high is a leave it or take it kind of a thing. Plus unlike morphine it has a very long half life so sometimes I don't take it for days and its still working. If I can handles the pain I don't take it and if it gets really bad I take it.

I'm not familiar with Aussie healthcare. Here in the States u can go to any doctor that has a license to prescribe bupe and at any given moment there is a doctor in ur area that can take u, so u can get on a program w/i days.

Is it the same as here that u get a monthly script? If that's the case then even a few hours drive once a month might be worth it to get the subs. I guess I don;t really know how the sub program works where u r at so I can't really offer more advice.

Are u even a few hours away from a bigger town. The drive every month to get the script might be the best thing to do.
 
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hey zyggy, i'll reply to your post in a minute, sorry for the delay as i haven't had anything positive to report until now:)

my doctor had the good luck of bumping me up in seeing an ortho specialist this coming wednesday in rockhampton:D i'm absolutely elated, considering it was going to be a couple month wait in the least!

the good news, being a pain management doctor i'm quite certain he has the required license to dispense buprenorphine (subutex and/or suboxone). if all goes well in my visit i'm hoping he'll dispense that to me rather than continuing me on morphine treatment, although my doctor said it may be likely he may try and push oxycontin.

because it's a saturday his office isn't open for me to ring and confirm some options with him.

i've been put back on valium, 1 b.d, with the option of taking an extra if needed. he's comfortable having me back on valium again because of my recent panic and anxiety attacks related to my high BP and heart palpitations. it's great having relief from therapeutic doses of benzos considering my previous tolerance before being tapered at the beginning of the year. the valium is actually causing me quite a bit of sedation while curing my anxiety but does interfere with my concentration with tasks at hand. i'm hoping to maybe trial and switch over to lorazepam (ativan) in hope of less sedation.

he's also given me a beta blocker which i can't yet start until i see the PM doc, which should help subside the palpitations. once i'm off the tramadol i also take i can start the 5htp supplements my naturopath has supplied me with. phenibut is another substance i'm wishing to use in aid of anxiety/depression and help with sleep.

wish me luck:)
 
Z Y G G Y said:
I take bupe for my pain. A small amount is enough to keep the worst pain away. It's a great medication since u get as much as u need and there really is not desire to abuse it. With other opiates I never got as much as I needed and I always took more than needed to get high but for some reason bupe is different and the high is a leave it or take it kind of a thing. Plus unlike morphine it has a very long half life so sometimes I don't take it for days and its still working. If I can handles the pain I don't take it and if it gets really bad I take it.
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to control the worst of my pain (around an 8, sometimes bordering on 9) a small dose of bupe, 2-3mg, is more than enough to tide me over for well over 24 hours. bupe seems to work extremely well for me and it's halflife is what is so appealing. if i miss a dose i'm not too concerned because in the past i've gone 48 hours without dosing and still have been pain free.

I'm not familiar with Aussie healthcare. Here in the States u can go to any doctor that has a license to prescribe bupe and at any given moment there is a doctor in ur area that can take u, so u can get on a program w/i days.
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that's how it is in some places, mainly metropolitan areas, but in a smaller town (50000) it's a bit different because there are only so many doctors with the required license. and all of them are full at the moment, same as methadone maintenance.

Is it the same as here that u get a monthly script? If that's the case then even a few hours drive once a month might be worth it to get the subs. I guess I don;t really know how the sub program works where u r at so I can't really offer more advice.

Are u even a few hours away from a bigger town. The drive every month to get the script might be the best thing to do.
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if you're seeing a PM doctor or maintenance dr, not a walk in clinic, then yes you can get a months script at a time. otherwise if they're walk-in clinics, as i understand it, you have to turn up for daily dosing with allowances for take homes on the weekends. since i'll be seeing a PM doc i will be getting month scripts, no matter what the opiate i'm on

the closest pain doc is an hour away and i'm seeing him this wednesday. it's definitely worth the hours drive there and back.
 
terrible, ill expand later when i've got more time. waste of 2 hours drive and a $240 consultation
 
heya leftwing,

theres a whole host of issues i can see in your first post that i may also be contributing to your experience of dealing with your pain/addiction issues. Firstly if your going to see a therapist you need to have trust in them and you also need to be aware that therapists are not their to be your friend either they theoretically should challenge and guide you while being understanding and providing information, advocating etc. If there is a breach in trust i would talk to them about the issues and get it into the open. If that does not suffice then lodge a complaint with their professional association or the state medical service or state health minister.

towards the end of your post you briefly mention depression/anxiety- how bigger role does this play in your life- in my experience both of these potentiate the other and can affect the way that we operate and view the world. (Anxiety-> threat-> mistrust-> Catastrophising-> Run away) Depression-> thinking about the past dwelling on it staying stuck doing less)

and if your stuck in a drugs/depression/anxiety loop than fuck it will always be available and easy to pull out as a response to dealing with uncomfortable feelings/experiences. on top of this if you are hiding your drug use due to shame then it is hard to get the appropraite help that you are after- being honest and truthful with your GP is the best bet i have found and if they are not helpful then talk to a addiction speacilist doctor.

now the pain management is also an interesting conumdrum that also is affected by addiction. Should you use more than the prescribed dose then you tolerance to opiate go's way up and your ability to get adequate pain relief for emergencies is greatly reduced at the same time.

Why wont you go on methadone- i think methadone has had a bad rap of the last few decade due to its stigma with heroin. My concerns from working in the relevant area would be that if you are given suboxone rather than subutex that would limit your ability for breakthrough pain relief when you need it the most. with methadone you just increase the dose whereas buphrenorphine has a limited capacity for pain relief.

if you are in NSW it is really hard to get into opiate maintenance therapies, you might be better off going to a pain management service then get transferred back to a clinic once you have started on a therapy. Another option would be to try interstate- i know canberra's waiting list is pretty short at the moment.

ive had numderous people in you position who have really had a bit of a run around due to the complex nature of their case. services have been bitten very hard by people trying to approriate drugs for other tan legitimate reasons.

there are a few things that i do with clients in these situations- most of them start by looking at the person holistically. some counselling and strategies around coping and resilience always work well. Reduction of anxiety and depression would lessen the psych based pain or even aversion to pain, mindfulness mediatation with pain is another good way of looking at pain managment.

planned activity during the day including things that you can get some satisfaction out of (sense of achievement) then maybe even some relapse prevention stuff such as SMART recovery groups or attending AA or NA.

i guesss at the end of the post there is what can i do to stop scoring opiates- well the best answer i have seen to this is either high dose methadoe till a maintained behaviour change takes hold or really serious motivation and commitment to not do it

one of the most important things to do is keep trying differnt thngs, just cause one thing did not work once does not mean it wont work another time.
 
so

after spending $240 and 10mins, getting a few reflex tests, flexibility tests, a prod here and there, the diagnoses is i still have spondylolisis:| he told me everything i've ever heard from any doctor i've seen, nothing new. i could have been the one behind his desk doing his job.

i was mis-informed by my GP thinking he was an ortho specialist and PM doc, just the specialist he is(who'd have though dr's work in cohorts?).

but he was all too willing, for a first consultation fee of $400, to refer me to the PM doc he works with. i said thanks, but no thanks, i'll continue seeing my GP who costs nothing, is a 10min drive from home where i get my scripts covered by the PBS. All instead of having to travel 100kms each way and spend hundreds of dollars each visit to be told the same thing over and over and still have my doctor hand me the scripts.

so i've accepted i'm continuing on morphine and will keep trying other avenues chasing the bupe program.

some positive that comes out of it is i can now start my 5htp and am again under piss tests and pills counts as my doctor is back in town.

maybe when it's cooler again i will switch back the durogesics; fentanyl patches.

or pitch up a tent and move to melbourne
 
That's a shame to hear lefty. :(

Keep your chin up and keep moving towards your goal.

<3
 
thanks heaps for that mick, greatly appreciated:) i'll take the time tomorrow, when i've had time to unwind from an extremely stressful day, and address your post.

thanks as well lil <3
 
guys i'm crying i'm so fucking happy!

i just got a call back from the Miami (Gold Coast, Queensland - not Florida;)) ATODS (alcohol, tobacco and other drugs services) and they've accepted me on their buprenorphine program.

they even contacted the gladstone hospital on behalf of me to try and squeeze me on but just told me they've lost their other bupe doctor now so they're in a bit of a predicament. rockhampton (an hour away) has no doctors either. nor are there any prescribing GP's with positions in my area.

it'll mean relocating down there short term in the least but i've got some family i could shack up with and i'm waiting to hear back from my friend as to whether it's possible i stay at the families friends' apartment he's living in at the moment. otherwise i'll be finding a halfway house or something like that or a live-in facility.

words can't describe how good i feel=D

guess it's time to start organising my shit together so i can get my ass down there as soon as possible!
 
hey congrats, im still a bit unsure of why you have to move the QLD script is statewide all you would have to find a doctor willing to put you on and a chemist needs to dispense. Plus chemists receive the methadone and buphrenorphine for free so it does not cost them anything to purchase
 
Yeah zyg, i understand that... I just hopped off hte bupe program, as that was my plan, to tie myself through until winter months and i could deal with the WDs, which havnt been so bad at this point, im still able to be reasonably active etc - just the leg pains, and broken sleep + dreams about heroin... those suck..

I mean literally last night, i had a dream where we were driving to my dealer, i was getting txt msgs and shit, then right before i get there, i woke up... its 5am and stuff sucks..

In other news, S3 of breaking bad just started.. so theres a + to my week
 
thanks mick, lil and crankinit.

mick, that's the thing that has had my head spinning and me frustrated this whole fucking time trying to get on the bupe. i'm fully aware that they can do such a thing - me finding a doc willing to prescribe and a chemist willing to dispense - but they've been giving me the run around saying that no, it's not possible. it's as if they've been deterring me from trying to get on the bupe.

asking whether my doctor has recommended me getting on the program (no, i want it myself), repeatedly telling me it's daily dosing and that i have to turn up to the chemist everyday to dose (i know, obvisouly), that there's UA's regularly initially (i know) and that there's mandatory therapy to attend (i know and want this). all little things as if they're going to be too much hassle for some junky to adhere too. it's been a struggle from day one. the state of the qld bupe programs and resources is laughable at best.
 
Glad to hear you'll finally be getting some reprieve!!!! :)

Can't believe there is so much red tap for equivalent treatment programs in QLD, as compared with VIC... we may have one of the most corrupt Police forces, but at least our addiction & chronic pain treatment programs are well-regarded...

well at least there's a positive case to hear of here!
 
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