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Need Help Pain, opioids, and moral dilemma

dalpat077

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Joined
Oct 14, 2019
Messages
1,656
For the sake of my own interest:

This side she take pills daily (5mg or 10mg I think per day and that for about a week or two and then stops but the pain returns almost immediately. Rinse and repeat after about three days of being off of them.

How do the pills taken daily compare to an injection every three months? Of Prednisone I mean. Is the once every three month injection like a bomb of the stuff and that takes three months to sort of wear off or what?

Guess what I’m asking is if taking pills daily, as opposed to a bomb of an injection every three months, would still be an issue (unless I’m wrong about the action of the injection and it being a bomb of the stuff in one go)?
 

Sunyecho

Moderator: EADD
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Trying to find my self but unable so far.
Disclaimer: I don't know the medical history on your side of the story nor am I a doctor.

But pill form is for more systemic disorders/diseases and so that delivery system is spread out throughout the body. Injection is more specific area based. Plus of an oral intake is that multiple areas of the body (well, all actually) are treated. But it comes with the highest cost of the side effects. Cause of that doses must be fine tuned.

Injection is like a depo, and is targeting specific area. Pluses are that spillover in the system is not very high and with that systemic side effects are less pronounced. Obvious minus is that it is located to a specific area.

Like a difference between general anesthesia and lidocaine shot (just much more longer acting than lidocaine).

I hope that I am making sense and am actually not spreading false information. Please someone correct me for wrong information I gave here. This is not a topic that should've be taken lightly. And I am certainly not an expert on the topic.
 

dalpat077

Bluelighter
Joined
Oct 14, 2019
Messages
1,656
Good morning.

You are quite right. And it was a dumb question. Apologies i.e. it was late (for me anyway) last night, was already in bed, and was my last post and thought before going to the land of dreams! :sleep:

@MsDiz told me last year already to look up the "depot effect" (she's gong to send me a bill one of these days for professional or consulting fees! 🤣 ). I forgot about that. Sorry.

Something else that I learned from Ms. PhD: hard hitting and heavy (my words) opioids CAN permanently reduce pain levels even after cessation of use. I had a thread about this somewhere here but I cannot find it this morning. I just assumed, before I knew any better, that once on opioids and if used for pain that the patient would just continue to have their dosage increased over time, as tolerance built, until they popped! 🤣 Not so apparently. But that's another story for another day and I've probably derailed your thread more than necessary already.
 

Prettyboy12

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Joined
Nov 9, 2020
Messages
124
Location
Texas
First a disclaimer: Everything that you write is your opinion and will be treated as such. I am not looking for medical advice and none of your answers will be read/treated as such. I have a dilemma for which I am responsible and your input will be greatly appreciated. Don't hesitate to speak your mind as that is just what I am after for here.

I will give a little background while trying not to make it too long. I used all kinds of drugs except opioids from age 15. I was addicted to stimulants from age 15-20, and that ended up with amphetamine-induced psychosis. I was wrongly diagnosed with schizophrenia, locked up for waaay too long, beaten by security staff in a mental institution for "the crime of untying myself" and forcefully drugged. I never responded with any sort of violence as my psychosis was sort of happy spiritual mania, but that didn't deter the staff from tying me repeatedly, injecting me with all kinds of psychotropic medications (and I mean all kind), and physically assaulting me because I passively refused to cooperate in restraining. Spent 3 months locked up in a mental institution and 5 years on heavy-duty neuroleptics (mostly olanzapine, fluphenazine, tegretol, diazepam and midazolam). When I came to my senses (after 2 months in a mental institution...probably would comply sooner if they weren't so abusive, as I don't comply with bullies so that made it worse for me) I realized I have to play their game. So I "agreed that I have schizophrenia" and that I will take medications. There was no other way as my family was all in on this and I was threatened with hospitalization if I refused any order. After 5 years I was taken off all medications except diazepam. I am dependent on diazepam to this day, 20 years after hospitalization.

I got employed while still on olanzapine and everything became much better after I stopped taking it. I started to get promotions, have more energy, met my wife, married, got a kid...everything was going great. Even diagnosis of schizophrenia was overruled as my psychological testing revealed that I don't have a propensity towards psychosis. If I am off stimulants. That was confirmed by several psychiatrists and even the one who diagnosed me said his diagnosis was wrong. He didn't say he was sorry but that is an altogether different story. I was going to gym, played sports regularly and was overall very active, productive, and happy. But then the pain started. For a couple of years I dealt with it by popping NSAIDs and paracetamol. Didn't go to the doctor because of the past "lousy" experience, to say the least. But in my early 30s, I couldn't handle it anymore so I went to the doctor. First I was shrugged off. All I got was "it is all ok, I will prescribe ibuprofen 800mg twice a day". But the pain was getting worse so I insisted to have x-ray of the area that was causing the pain. When I finally got it done it was revealed that I have "spina bifida occulta + demineralization of bones + hipo-lordosis". I was sent to a physiatrist and further testing and got prescribed tramadol 150mg daily. After I got MRI it was further revealed that I have narrowing of a spinal canal and that disc L5-S1 bulged so the nerve was being pressed. That explained all symptoms. The physiatrist told me that there is not much I can do. There were 2 options - surgery later in life or taking stronger painkillers.

Now comes the problematic part. I live in a country where opioids are not prescribed except for surgery, severe acute pain and cancer-related pain. When I asked my primary doctor for something stronger than tramadol because my life was starting to go south because of pain - he refused to prescribe any. I was told that because of my medical history (addiction to stimulants and mental health problems that came out from that) I was not a candidate for opioid medications. To make matters even more complicated, anything stronger than tramadol can be prescribed only by an anesthesiologist in pain clinics that are part of hospitals. Have in mind that I live in a country that was behind an "iron curtain" and private health doesn't really exist. We have public health, which is called "free" but is paid from our taxes. Also, the whole system is very bad, to say the least. It is a very centralized and government-based country and so is the health department.

After not being able to take it anymore, as sitting and doing my job became torture I started "do it yourself" pain management. I contacted people I knew when I was doing drugs and started taking MS-Contin. I was going between morphine, oxycodone, methadone, and kratom for 2 years but it all became too expensive. Plus I was tired of all the hassle and illegality of it all. In the end, I felt forced to treat my pain by going on maintenance therapy. I reasoned that methadone would help me so I went to an addiction specialist. First I was prescribed buprenorphine but then I transferred to methadone. Unfortunately, methadone did deal with my pain but it changed my personality (cognition and emotions) for the worse. I was forced to go back on buprenorphine which didn't help with the pain.

Meanwhile, I tried everything else, including acupuncture, lidocaine shots, physical therapy, massages, the whole deal. But the pain was getting progressively worse over the years. By the end I also tried to cope with "taking breaks from my painful life" by taking amphetamine sulfate and cocaine. That made things eventually even worse so I stopped doing that. I went off buprenorphine a year and a half ago and I don't want to go back.

Now comes the dilemma:

Without opioids for pain I am not functional. I have a kid that started to go to school and started training sports. My kid needs me mobile and functional. I am currently unemployed but at the moment I still have savings. but I can not live off of my savings as it is not enough. Plus, this kind of life is taking a toll on my mental health. I have had many months of introspection and I can sincerely say that I don't have opioid use disorder - I have chronic pain disorder. My addiction to stimulants could reignite if I was to start using cocaine, I am aware of that. but I am actually prescribed methylphenidate as I was diagnosed with ADHD. I consider returning my script as I am on the highest dose that there is available in my country (36mg Concerta) and it is not doing enough for me. But that is not so much relevant to my dilemma. I am in pain that is making me non-functional and the medical community, even after all the wrongs that they did to me is once again leaving me dry.

CORE QUESTION:

Is it morally wrong for me to not take opioids just so I can say that I am sober if that is affecting my life negatively? Or am I obliged to do whatever I can to be the best father and husband I can be even if that means taking opioids that are not prescribed (like kratom) or opioids that are prescribed to treat addiction not the pain (buprenorphine or methadone)?


And I am not trying to fool myself. This is now almost a decade of pain getting worse and me trying to treat it. I am almost 40 and I don't know what to do. The situation, pain wise, will not get better. In fact, it is getting worse. I tried every medication/model of pain management that doesn't include opioids, but it all failed. SNRIs and gabapentin/pregabalin did not help me. In fact, I lost a year of my life trying to make duloxetine work. None of the SSRIs/SNRIs help with the pain, I just get bad side effects.

That is my predicament at the moment. I think that I could get away with kratom. At least that would give some actual pain relief and energy so I can start working again and be a functional father for my kid. I can get prescribed anything from a psychiatrist but nothing from a pain clinic. Except for gabapentin... For example, I was prescribed, in one visit: "4mg of Xanax (SR) + 150mg Lyrica + 36mg Concerta + 15mg Dormicum (midazolam)". So I am not after the high, I am after pain relief. Currently, I am prescribed 30mg diazepam + 36mg methylphenidate as I felt pregabalin and midazolam weren't contributing to my overall wellbeing.

So that is my predicament. I know that I will not take any action, except stopping methylphenidate, until September. But when the temperatures drop and the weather becomes more moist and sunny days are gone - I know that pain will get worse. At the same time, I have to get a job following fall because my finances are being screwed up. If it weren't for my beautiful wife my finances would be totally screwed up already. But neither she can't hold it all together on her shoulders and me not being able to contribute is taking a toll on her also.

Sorry for the long post. I would very much appreciate some insight. Thank you.
I found myself in a similar situation. I have suffered from debilitating chronic pain for 9yrs. I have been prescribed opioids for it the last 9yrs.
I weighted the pros and cons of being an opioid addict (heroin) vs being able to function because of my pain pills. As much as I want to be 100% clean I have to be able to function and be able to lower my pain because of this I will never be 100% clean and Ive made my peace with that.
Dont allow yourself to suffer man BC all itll do it have you seeking out to self medicate.
 

hylite

Bluelighter
Joined
Mar 23, 2021
Messages
1,106
Yes, I suffer from it. Pain. I still have pain with or without the opioids. And even before I even knew what opioids were I still was sick with allots of it. So yes, it's not the dependence that is causing the pain at all is the situ.
So the opioids just help make it all better. And allot. Ouch. ☹💛
 

hylite

Bluelighter
Joined
Mar 23, 2021
Messages
1,106
Opioids give me energy and strength. Wtf is that all about. Since I have neither. I almost died without it too. And nothing else will be able to help as well for pain. At all. ♡.

Maybe medical marijuana could work better but I need more research for that. For my kind of pain mm AND opioids just touch the pain level back to normal that's it . . . . . But helps greater than life itself. In other words it's the only medication that helps. Together it keeps the usage of them to a minimum. If that can even possibly be an acceptance or an understanding to greet anyone with.

I think I have read the thread ( scroll ) and stuff. But bottom line. Opioids fuckin help with pain. Damn.
 
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