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Why doesn't buprenorphine not block tapentadol?

Smuck_Hey_Dee_Hewitt said:
Definitely (at least in most European countries ) ...:"Psychiatrists " for the scripts and "Psychologists " for verbal gymnastics and such. I thought it was like that everywhere.
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I'm in Europe (UK) but my general doctor prescribes my pain meds (though I'm waiting for an app. with the pain management clinic who can prescribe but I think your general doctor can veto them :/)

I don't understand why a psychiatric doctor could or would prescribe meds for PHYSICAL stuff, though?
 
Smuck_Hey_Dee_Hewitt said:
I know Burial´s "Antidawn " Ep distract me from crack cravings ...some should try it ...good med ...
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Skorpio said:
A man of taste I see. You may like Andy Stott and Actress. Both have similarities to Burial in that they do headphones oriented re-imaginations of UK club genres (kind of a post-punk tinged techno by Andy stott, and crystalline lo-fi house by Actress). Hope that can keep your mind occupied next time you need distraction.
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A thread devoted to Burial, if there isnt, do it. The music thread needs some balance. Gonna check those out righty now better then typing.
 
smokeymcpot42088 said:
^Yea chiatric = pez despenser cologist = belongs in a classroom. Yes Im a dick. (My father had a PhD in psychology i can make that joke. i.e I sware I have a black friend) Ooh dont get ancy.

16 seems like THE dose in US. That is what they sstarted me and everyone I know got started on. Including a kid that just did coke. Idk how sub is suppose to help him but hey hey heyy welcome to amerrika. That said id rather start at 16mg than idk 1mg; and realistically the latter is closer to what is necessary; but too much is better than not enough as long as you have control over your own input (if that made sense).
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I can confirm thats a highly usual number here in Aus while iv heard of people up at 32mg its always usually a taper down.

And nah you made enough sense hahah :) They do seem to, be it intention or not, like to give you a replaced addiction they can tax and win on the public view side as you seem to be helping, be it addicts or kids fucking around trying drugs, when really your just giving them a really jaggered system that skews the very potential it can provide for some, and applying it across the board.

Imo honestly, everyone is different, hell i once nodded off pure Slow Release Sublingual Buprenorphine, with a tolerance at the time, not dependency. I believe the potential is only going to be recognisable by and for those wishing to stop and not still chasing the high. But iv also heard this issue with methadone and clinics trying to put people on dosages so high they'll never come off when they enter with addictions that pale in comparison.
 
ChemicallyEnhanced said:
I'm in Europe (UK) but my general doctor prescribes my pain meds (though I'm waiting for an app. with the pain management clinic who can prescribe but I think your general doctor can veto them :/)

I don't understand why a psychiatric doctor could or would prescribe meds for PHYSICAL stuff, though?
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Everything that stems from the brain is physical... er I sound like a hippy better go to an example or metaphor or something.

Real life scenario -- Some people are prone to seizures and "physical" docs don't really like to touch anything they dont understand. (not that they dont constantly but hypocracy is everywhere)

In most cases this person is refered to a neurologist/psychiatrist. Almost everyone I know on seizure medication recieves it from a psych.

My real life example: Since was about 8 yrs old I would literally start to get chest pains and have to just sit wherever I was (im not callin time out lol) and if I was 'got' so be it; better than that pain. Now I get to be about 12 and im waiting for the state spelling bee to start. This same pain returns. (It had quite a bit). I had been communicating this with my parents since the first time it had happened.

Thankfully my dad was a dr. of psychology and nailed in three questions. Does this usually happen around large groups of people? "Yes, unless I am alone and questioning how I am to get home." Do you ever get these pains when you are just goofing around, playing nintendo etc. "No".
So it is only when you are taking something very seriously and feel some kind of obligation to; friends, family, teachers, parents etc. "Yes exactly!"

Boy you got panic attacks, Im gunna get you into a psychologist. Which became a psychiatrist as life became harder and more stressful. By 17 it was well diagnosed that I suffer from panic attacks. If I had a regular GP could I convince him to do that; depends completely on ALL of the variables. But IMO/E No
 
smokeymcpot42088 said:
Everything that stems from the brain is physical... er I sound like a hippy better go to an example or metaphor or something.

Real life scenario -- Some people are prone to seizures and "physical" docs don't really like to touch anything they dont understand. (not that they dont constantly but hypocracy is everywhere)

In most cases this person is refered to a neurologist/psychiatrist. Almost everyone I know on seizure medication recieves it from a psych.

My real life example: Since was about 8 yrs old I would literally start to get chest pains and have to just sit wherever I was (im not callin time out lol) and if I was 'got' so be it; better than that pain. Now I get to be about 12 and im waiting for the state spelling bee to start. This same pain returns. (It had quite a bit). I had been communicating this with my parents since the first time it had happened.

Thankfully my dad was a dr. of psychology and nailed in three questions. Does this usually happen around large groups of people? "Yes, unless I am alone and questioning how I am to get home." Do you ever get these pains when you are just goofing around, playing nintendo etc. "No".
So it is only when you are taking something very seriously and feel some kind of obligation to; friends, family, teachers, parents etc. "Yes exactly!"

Boy you got panic attacks, Im gunna get you into a psychologist. Which became a psychiatrist as life became harder and more stressful. By 17 it was well diagnosed that I suffer from panic attacks. If I had a regular GP could I convince him to do that; depends completely on ALL of the variables. But IMO/E No
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Thanks for the help :)

And YES, I actually have seizures (I'm not Epileptic, but I have "Non-Epileptiform Seizure Disorder" and it has always been a Neurology specialist that has prescribed my meds, adjusted the dose, etc.
 
neurology specialist, that is the US hey? I guess ive never really had a good reason to brush shoulders with a neurologist but they seem strange non entities in the medical community almost. Im suprised once he figured your meds out he didnt offload you to a psychiatrist; I would infer it is too serious to leave to a 'pez dispenser'. (my respect for doctors seems to lessen daily)
 
ChemicallyEnhanced said:
Thanks for the help :)

And YES, I actually have seizures (I'm not Epileptic, but I have "Non-Epileptiform Seizure Disorder" and it has always been a Neurology specialist that has prescribed my meds, adjusted the dose, etc.
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Non epeleptic seizure's not connected to a disorder, can easily occur when under chronic stress and insomia. They go great together.

Got these, thanks to mis information it was labeled as a Alcohol WD symptom, which was not the case.
Neurolgists sadly around here lack any knowledge about there specialized medical role. Got prescribed Levetiracetam as 1 st choice med, one that causes not only psychiatric side effects. It also messes your sleep, gives lucid nightmares, de sensitizes your dick and causes a state called Kepprage (Keppra is the brand name). And a flat mood.

Good 1-st choice. They know less about neurologie and seizures then even me. And questions stayed unreplied, advises ignored. So i just made my own choice to just let go, let em boil in their own soup so to say. And doing much better now, btw. medication free, but back on ADD.
 
smokeymcpot42088 said:
Everything that stems from the brain is physical... er I sound like a hippy better go to an example or metaphor or something.
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Worse physical pain and psychological pain activate the same respons in the brain.

Only physical pain is treated as such. While even that has an equal psychological impact. Drs are a bit bended in their thinking processes.
 
smokeymcpot42088 said:
In most cases this person is refered to a neurologist/psychiatrist. Almost everyone I know on seizure medication recieves it from a psych.
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Here its the other way around, you go to the ER, then after they think they figured out what happenen send you home.
If it happens again, 2-nd seizure. Then they start up medication, Levetiracetam in my case, 1-st choice med according to neurologists. Later on there is a follow up appointment with an neuroligist. After you have taking there poison for a while without any dr explanation what to expect. That you have to do yourself, and forcing them to put you on something with less side effects and more efficiency. As it never stopped seizures for me.

Levetiracetam causes lots of side effects that are psychiatric, so a lot of patients on it end up with seizures and psychiatric problems from Levetiracetam. So the psychiater switches you to Valproic Acid (VPA), the real 1-st choice med. And the psychiatric association warns the neurolgic association. Years ago without succes as as of now they still prescribe Levetiracetam before VPA.
 
Oh man never start at the ER! They suspect everyone who walks in of seeking; instantly. Once they gave me a placebo shot at the ER and admitted it. Went a little something like this,

So that must be hurting alot do you need something for it? Yes, even if its novocaine! "Well were just gunna go straight to the good stuff than" "Sound like a plan" *nurse gives injection, waits about 45 seconds "you feeling better now?" me "Actually no I didn't feel a change, staring back agitated" .... "Ohh good you can never be too sure that one was just sugar water" (why not saline!?!? I didn't ask that) "So you just gave a placebo?"...."Give me your arm again this time its morphine" ... That answer will shut my mouth most of the time. Especially if im in desperate pain.
 
smokeymcpot42088 said:
Oh man never start at the ER! They suspect everyone who walks in of seeking; instantly. Once they gave me a placebo shot at the ER and admitted it. Went a little something like this,

So that must be hurting alot do you need something for it? Yes, even if its novocaine! "Well were just gunna go straight to the good stuff than" "Sound like a plan" *nurse gives injection, waits about 45 seconds "you feeling better now?" me "Actually no I didn't feel a change, staring back agitated" .... "Ohh good you can never be too sure that one was just sugar water" (why not saline!?!? I didn't ask that) "So you just gave a placebo?"...."Give me your arm again this time its morphine" ... That answer will shut my mouth most of the time. Especially if im in desperate pain.
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Starting there was not a choice. After the seizure I was taken to the Hospital during in a ambulance where I regained some conciousness.

At the ER (SEH called here), it was black out from the moment of entrance. So during some more seizure's, and a team that didn't have clue what to do. They didn't follow the protocol for seizure treatment. Total chaos, Moments of consiousness that occured was when alone or with one relaxing person.

Then went into a Ictal psychosis, unconcious. Which complicated their situation, they called in a outside psychiater, as they had none. So when the man arrived after at least an hour. He just sedated me and added some haldol , problem solved. Body and mind scrambled.

They administered a placebo, for what ... , and then admitted they gave a placebo and acknowledged your pain. Sounds like the typical hospital mash-ups. Shitty thing to do, considering there oad and protocols.
 
Of course, seizure ER not make an apointment at leisure. Sorry.

I was there for a wrist sprain, turned out to be fractured. Yea man. "What level is your pain" Me "Well im not being waterboarded or cut up slow so i guess not ten but it feels about as bad as I can stand"..... Them "Ok let us give you something for that before looking at it" getting shot together and giving it to me IV, standing back for about 45 seconds. "So is the pain a little better now?" Me "Suprisingly no I feel no difference" Them "Oh well that one was just sugarwater we are getting the morphine ready right now." Statement, no admission of placebo but I think she knew I got it by the change in the "public face" to "death daggrs" and the word morphine coming out in the next 2-5 seconds.

We are a peninsula and one hospital chain controls the entire peninsula; hence absolute power in their little area of the world. Which unfortunately ven diagrams with mine.
 
ChemicallyEnhanced said:
Sorry, I can't help, but I have a similar question.
In an episode of A&E's Intervention, in one episode this woman who is addicted to prescription meds (including some unusual ones that I would NOT call recreational, like Seroquel and Trazodone*), including taking both Suboxone and Opana (Oxymorphone) and she definitely got high.
So, are there certain opioids that are NOT blocked by it?


*I HATE the feeling of Trazodone, and it gives me horrible dreams
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Shit man, I remember watching that exact episode years ago and thinking wtf?? Wondering how she got high on subs AND opana at the same time. maybe everything in total she was taking just fucked her up too much to notice the weakening/inactivation or however you'd put it of oxymorphone from the subs.
 
krkkhed said:
Shit man, I remember watching that exact episode years ago and thinking wtf?? Wondering how she got high on subs AND opana at the same time. maybe everything in total she was taking just fucked her up too much to notice the weakening/inactivation or however you'd put it of oxymorphone from the subs.
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Yeah, it was weird and she was legit high as fuck, nodding off mind convo, talking in non-sequiturs etc.
But her pill choices were...odd. Like TRAZODONE? I'm rx'd that for sleep and almost never take it 'cause medium or high doses make me feel like shit and it gives me horrible dreams. Plus, she took 1200mg Seroquel/day that she had no actual need for. People in severe Schizophrenia take less than that.
Oh, and Alka-Seltzer Plus? Which I thought was just an NSAID?
 
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paranoid android said:
Isnt tapentadol a norepinephrine reuptake inhibitor as well as a opioid? That could explain it
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Yes Tapentadol is a Norepinephrine Reuptake inhibitor as Tramadol is however it does not share the Serotonin activity Tramadol does, Also while being a derivative of Tramadol, Tramadol is not a parent drug of Tapentadol they are to dissimilar for that classification IIRC.

Tapentadol was developed from Morphine, Tramadol and some of its metabolites. Something like this:
Opening the cyclohexane ring, changing from a prodrug to a direct acting drug, selecting one enantiomer, and replacing the tertiary hydroxyl group
 
ChemicallyEnhanced said:
Yeah, it was weird and she was legit high as fuck, nodding off mind convo, talking in non-sequiturs etc.
But her pill choices were...odd. Like TRAZODONE? I'm rx'd that for sleep and almost never take it 'cause medium or high doses make me feel like shit and it gives me horrible dreams. Plus, she took 1200mg Seroquel/day that she had no actual need for. People in severe Schizophrenia take less than that.
Oh, and Alka-Seltzer Plus? Which I thought was just an NSAID?
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yeah she was taking alka seltzer and stuff, I thought maybe would help to potentiate the Oxys in some way because I think those also do something with stomach pH? Might be wrong I always thought they did. But that episode was wild, probably one of the most interesting in terms of drug of choice and the combination of all the pharmaceuticals
 
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