thanks for the response man.
Shit liquid and unable to go seems a bit contradictory though?
palexia definitely does have a constipation affect, at least ime
Bit amazed your family member was prescribed all that, or is some self medicating?
10mg of oxy sr and 4 200mg palexias taken twice 2x daily with 4x quick release 50mg palexias and 2 x 5mg valium?
you're saying they took 4x200mg twice daiily? so 800mg SR twice a day plus 4x50mg?
1800mg plus the oxy is a lot
i thought 700mg on day 1, then 600mg after that was the daily limit of palexia, at least in terms of prescription?
1800mg is over double that alone, plus the oxy is full on
2x200mg sr and 4x50mg ir is where my doc maxed out and the pain specialist has recently referred me to another pain specialist who is also a psychiatrist after he misunderstood me asking about rotating meds to prevent tolerance building. I think he interpreted that as me saying im already opiod dependent because he started talking about bupe.
The pain specialist/psychiatrist says on his website he doesnt use opiod therapy and also lists all the mental health issues he wont treat, which makes no sense to me in terms of him being a psychiatrist.
sipping with sprite did add a nice touch as the palexia can get jittery and the morning after feels like pretty bad withdrawls sometimes, like someone else mentioned, waking up cold or shivering
the sorbitul did have a bit of an effect, mostly gas.
Also had some gold cross pharmacy codeine syup which was ok, nice not to have the side effects of sorbitul but noticably weaker than the dhc
No problem brother sorry if I wasn't completely clear I was a little buzzed my self at the time of writing
To clarify the dosage he was on 200mg SR pills and he was taking 2 at once twice a day, however that is 1800mg if you check the TGA free of information page its a pdf I could find it for you, the Palexia SR pills 100mg contain 200mg total the 50s 100 and the 200s 400, 150s and and so fourth fall into the same thing. As for tarjin oxy 10mg are more like 9.8 or 9.9mg of oxy equiv.
So he was on 1800mg a day without the quick release which I have no checked if they are the dosage as said but i assume they would be I believe tapentadol is slow release based on its actual formulation hence breaking a pill like a sr oxy wont have the same affect or shouldn't now I'm not 100% sure of this its just my theory on it.
Not to go into to much detail but my family member was given this all medically as with the valium as well, however the oxy was only administered on top of it all when in hospital and if ever rarely at home it would of been self medication at that point. My self and my immediate family don't seem to have much issue with addiction thankfully but the patient needing this dosage was in a very particular situation. Many past operations, advanced age, medical complications and far more had lead to that being the case. After 2 and a bit years this was slowly reduced and while issues are still around that dose is no longer given.
As for the constipation and diaretic part. This works because sorbitol is a sugar-alcohol, laxative. Unlike some laxatives it works by pulling water, and is only really broken down by the bacteria in the colon, this means you can still have the opioid induced constipation as the receptors are still being affected, and the feeling of constipation and still needing to go can be quite uncomfortable and since it pulls so much water in depending on your diet and your own digestion this can make you just pass essentially water in your stool and no so much solid mater.
As for your issue with your pain specialist and psych, you can get some abbrasive people in that line of work and sadly a lot of well intentioned and good workers are played and used by every last kind of person from every walk of life and become hardened against those people or bias and start seeing them where sometimes they are not, even if you are a person who may use the medication on an occasion for other affect. As for non opioid treatment that is incredibly common in Australia even in GP offices to say they don't hold or wont prescribe S8 or S4 medication first time or sometimes ever. This is usually to deter patients looking for drugs off the bat. However there are doctors out there unable to prescribe above codeine and tramadol due to either request to the TGA for removal of their ability to without authority for patients needing certain medication for life out of hospital in acute or long term cases, and finally they can get in trouble for over prescribing and have issues prescribing s8 medications and so fourth.
Lastly as a little note may I ask why you are seeing a psych for pain, unless its neuropathic or they believe it to be possibly stemming from a psychiatric area, this can be treated with Lyrica (Pregabalin) or something like gabapentin and certain issues so fourth, but it also comes down to your reaction on these drugs how you talk to the physician and believe it or not, not can just some of those you think can't really tell if your lying to them or not, they can also and a good gp, specialist and so fourth will no matter your qualification, levels of trust and actual evidence for pain will check to make sure your not fooling your self or anyone else and getting addicted and so fourth.
Luckily my doctor for my chronic pain *non cannabis doc* is one of these doctors and despite my own background in medical studies in multiple areas and caring most my life for very medically complicated family members and all other factors so fourth they are still ever vigilant towards my pain relief, reduction of opioid tolerance and so on, however should I ever exceed a daily dose or need to give some to a family member and go without on top the tolerance break is immaculate when you start to medicate again. Although it should be noted I personally have a very very light comedown compared to most, for example id need to be on over 50mg of oxy daily before my come downs exceed just some bad sweats and an occasional sleepless night if I stop cold turkey). My worse comedown to date from an opioid was codeine phosphate, around ~510mg as a late teen, haven't had a comedown id rather have avoided over the experience preceding since.
As a Chronic pain patient I known its like putting salt in the wound to say take a break from the pain medication, but if you can cut it completely for even a week or two without going through too much distress to be worth it of course (to your mind and body, if the pains to extreme the negatives to at some point out weight the positives of a tolerance break, blood pressure and many other factors as I'm sure you know).
