Spoodle - I'm so sorry to hear how tough things are at the moment
I can't pretend I know exactly how you feel, but I do know what it feels like when everything is getting too much and you are exhausted and feel like there is no hope. It sounds like you really have had enough at the moment. Thank you for posting your story up here, I know it isn't easy saying these things out loud (or typing them!) but I hope it has helped you a little bit.
I'll tackle the issue that leaps out at me first - your thoughts of amputating a toe. This is a very extreme thing to be considering! I can't see it helping your situation at all. You might get a small script of opioids, but certainly nothing long term - it would only ever be a temporary solution, but having no toe is something that would be permanent! Also, as you'd be taking the opioids to treat the pain resulting from your amputation, you may well find that you don't notice any of the other opioid effects with them.. From a purely practical perspective I don't think it would work at all, I think it would just make matters worse. Plus something like that would ring huge alarm bells for any doctor treating you, and you would certainly be referred for a psychiatric evaluation, if not admitted to a psychiatric ward..
From a psychological perspective - it isn't a healthy thought process to be having. I'm not saying you are "abnormal" at all (hate that word) - but clearly you are completely exhausted and are reaching the limits of what you can cope with, and are searching for desperate solutions. I really think you need to get some help with this. You have so much to cope with at the moment - some professional psychological support sounds like it is needed. I would strongly advise you to seek some professional help, but as well as that, do you have any sort of support structure you can call on to help you at the moment? Friends, family, anyone you trust? If you do, please reach out. If not, please keep talking to us.. (keep talking to us anyway!)
Why was it that Suboxone and methadone didn't work for you? I know a lot of heroin addicts would much prefer morphine, oxycodone or diamorphine maintenance, but unfortunately it isn't something that is available.. what was it that didn't work with the regular maintenance for you? It definitely sounds like you need to be on something, as you've clearly given NA and abstenance your best possible shot, and it hasn't worked - which is fine, it definitely doesn't suit everyone..
Are there any other factors in your life that are keeping you tied to heroin? Social situation, psychological issues etc.. is there anything that could be tackled from a different angle, to help address any underlying factors in your addiction and make your life a little easier?
Having chronic pain as well must make things a lot harder. Have you seen a pain specialist? Unfortunately, doctors often are wary of prescribing opioids to heroin addicts/ex-addicts.. however, methadone/buprenorphine also act as pain killers, so a maintenance programme might help your back pain too. There are a lot of non-opioid options out there as well - have you tried those? Things like NSAID painkillers, gabapentin/pregabalin (Neurontin/Lyrica), physiotherapy, muscle relaxants, TENS, acupuncture.. a pain specialist would know more about your options than your primary care physician I think. Tackling your pain might make it easier to tackle your addiction, as it is very hard trying to fight two things at once.. and your physical and mental state interact and have such a huge effect on each other. Insomnia certainly doesnt help either! It makes even small difficulties insurmountable.. again, have you tried everything you can for this? Including sleep hygiene, relaxation techniques etc, as well as conventional medicine..
Please, reconsider your decision. I can see how much you are hurting and how desperate you are for some respite, but this isn't the answer.. if you get an urge to harm yourself in any way, please ring someone (friend/family member/ambulance/suicide or self harm hotline)..
Things will improve. Nothing lasts forever, everything changes, and I truly believe that your situation is not as hopeless as it feels to you at the moment
