5 ms·

Yep, absolutely. My doctor of 10+ years recently retired, leaving me in search of a new doc. I've been managing my pain for 15+ years just fine with 10mg Hydr

Yep, absolutely. My doctor of 10+ years recently retired, leaving me in search of a new doc. I've been managing my pain for 15+ years just fine with 10mg Hydrocodone. In 15 years I only once asked to increase the dose, and it was only from two pills per day to three to help me get through the afternoon/evening better. A minuscule dose. After doing "new patient" appointments (which by the way were like $200 to $300 each) and not having a doc willing to take me on as a patient unless I dropped the opioids, and making several calls (who refused to tell me over the phone whether the doctor was even open to controlled substances without that $300 "new patient" appointment) I gave up. Since coming off the opioids my quality of life has plunged. I struggle with depression and thoughts of suicide now, especially when I'm unable to leave the house or my bed. I went from stable and productive and what doctors used to say is the model patient, to being miserable. Every doc has offered to give me additional antidepressants or crank up the doses of those, but none are willing to treat the pain that is exacerbating it. I absolutely believe that what the medical establishment is doing to people like us (withholding treatment that we know works) is cruel and borders on torture. It is the epitome of taking macro-level stats and explanations and applying them broadly on the micro-level, regardless of the harm caused. I believe Hippocrates would be rolling over in his grave to hear that these people took an oath to "do no harm." For the record. I mostly don't blame the doctors. They are protecting their medical licenses, which the DEA and FDA have proven they are willing to revoke over the slightest anomaly. When the feds started throwing pain specialists in federal prison because some tiny percent of their patients were abusers, it really drove home that individual doctors are not allowed to think anymore. You implement government policy, or you risk financial ruin and even jail time. I don't blame them for being cowards. I probably wouldn't risk imprisonment on a stranger either.

atdrummond 5y ago
I don't blame the doctors either. My pain doctor was a rural boy from my hometown who made good, graduated from Berkeley and finished medical school and finished desirable postdocs at Harvard. He simply straight up quit pain management as a specialty rather than be forced to provide his patients with what he considered subpar care. The loss of doctors like him hurts particularly badly, as it leaves us with pain specialists who either knowingly ignore the decades of successfully treated patients who used opioids or the remaining (and they do still exist) pill mill operations, who have simply gotten more sophisticated in their execution. Regardless of which doctor archetype chronic pain patients end up with, they're going to suffer.
google234123 5y ago
We also now know that those treatments kill people and users gain dependence and tolerance to opioids. It’s more than just protecting their medical license.
- atdrummond 5y ago
  The proportion of patients who become addicted from properly prescribed opioids is extremely small. The majority of addicts created were provided with opioids that were not appropriate for their particular medical situation, in doses that were too high, and on a regimen that exceeded in length what was supported by the medical evidence. The proportion of new cancer patients who go on to receive palliative care that includes opioids who end up becoming addicted has always been, and remains, in the low single digits. For patients with a genuine need and who are properly inducted and maintained on them, opioids are a powerful and useful medical tool. Further, the bulk of use in illegal opioids stateside, such as fentanyl and its analogues, is not (at least today) driven by the conversion of the legal opioid user to an illegal drug user. Fentanyl is now commonly found in drugs that never previously would have contained an opioid, such as counterfeit benzos and MDMA. Further, the majority of fentanyl users on the street arrive at its use after consuming other illegal/street drugs. For those who started on other opioids, their first opioid will tend to be the illegally diverted pills or liquid cough treatments containing codeine/hydrocodone called "lean". Very few new users of fentanyl and fentanyl analogues come from legal opioid users, mainly because very few new users are now inducted on reckless prescriptions such as an immediate script for 180 Oxycontin and 240 benzodiazepene pills a month. Your narrative is about a decade out of date at this point. Thomas Kline is a superb resource if you want to take a deeper dive into the actual statistics and how the narrative of a crisis was used to systematically deny law abiding patients the pain treatment they should receive. https://twitter.com/thomasklinemd https://twitter.com/thomasklinemd
  - google234123 5y ago
    A meta study of 38 studies from 7 years ago on patients using opioids for chronic pain found that 21-29% of the patients misuse the drugs and 8-12% of the patients are addicted to them. That doesn't seem "extremely small" like you said, though maybe it's better now. I think there are reasons why opioids are no longer recommended for the treatment of most patients with chronic pain that you aren't fairly acknowledging. https://journals.lww.com/pain/Abstract/2015/04000/Rates_of_opioid_misuse,_abuse,_and_addiction_in.3.aspx https://journals.lww.com/pain/Abstract/2015/04000/Rates_of_o...
fvv 5y ago
Sorry if i sound blatantly stupid with my question, maybe In your case this could not be a sufficient solution for pain but did you ever tried with something like Marijuana and if it's illegal in you state considered migrating where it's legal? Or even considered to relocate to somewhere where you can get access to proper medication ?
- seattle_spring 5y ago
  Weed is a joke medication for many (most, I'd argue) types of pain. And yes it is condescending to suggest it to a longtime sufferer of chronic pain. It's akin to asking a suicidal person if they've tried exercising.
- zdragnar 5y ago
  Anecdotally, with N being roughly 5 people, THC/CBD do nothing for several types of chronic pain, short of getting high enough that you stop caring about the fact that you are in pain. Worth a shot, but I wouldn't recommend anyone getting their hopes up trying it. Tiger balm, on the other hand, is nothing short of magic.
dijonman2 5y ago
You can buy oxy on the street. Super expensive. $1/mg.
- buildsjets 5y ago
  And 50/50 odds it's actually an unknown dosage of fentanyl.
  - Jerrrry 5y ago
    If it is a 30mg pill, it is likely a synthetic analog. the actual probability depends on your location, but in general: the kids are FUCKED
    - deleted 5y ago
      [deleted]
  - dijonman2 5y ago
    Not true! They’re real pills sold by people who have an rx in my case. Be smart and learn how to identify fakes. I can spot fake m30s by texture.
throwaway42124 5y ago
- Jerrrry 5y ago
  You can not buy legitimate painkillers more powerful than Tramadol on the darknet. all legitimate pills have been bought, sold, and removed from the open market, monthes in advanced, years ago.. the safest thing you can buy to treat pain on the internet is tramadol, or, believe it or not, is... black tar heroin. everything else is Fent.
  - The_rationalist 5y ago
    According to wikipedia the reason tramadol has a ceiling point is because it depends on the number of CYP2D6 enzymes. This can theoretically easily be bypassed by co-administrating a CYP2D6 inhibitor however doing so require research and care about dose since a CYP inhibitor can in some contexts upregulate a drug dose potency by 1000X
    - Jerrrry 5y ago
      I meant, you cannot safely, as everything else, due to market forces, has fent in it. The only products on the market that have a near 0 chance of being fent are Tramadol and BTH.
  - atdrummond 5y ago
    I would not encourage anyone to acquire any opioid medication not prescribed, for a number of reasons. That said, Tapentadol - a cousin of tramadol but much stronger - can be easily bought from Indian and other Asian pharmacies on the clearnet and at affordable prices. One might have a package here and there get seized but all that results in is a snide letter from customs.
    - Jerrrry 5y ago
      So that is what they are putting in the percs now... thank you, genuinely, it will be looked into.
The_rationalist 5y ago
you can get research chemical opiod derivatives legally OTC such as ODSMT or Kratom however I would be extremely careful regarding addicition potential, not all opiods are created equal, e.g. tianeptine sulfate should never be attempted
throwawayboise 5y ago
Thank you for another reason when people ask why I don't go to doctors.

atdrummond 5y ago

I don't blame the doctors either. My pain doctor was a rural boy from my hometown who made good, graduated from Berkeley and finished medical school and finished desirable postdocs at Harvard. He simply straight up quit pain management as a specialty rather than be forced to provide his patients with what he considered subpar care. The loss of doctors like him hurts particularly badly, as it leaves us with pain specialists who either knowingly ignore the decades of successfully treated patients who used opioids or the remaining (and they do still exist) pill mill operations, who have simply gotten more sophisticated in their execution. Regardless of which doctor archetype chronic pain patients end up with, they're going to suffer.

google234123 5y ago

We also now know that those treatments kill people and users gain dependence and tolerance to opioids. It’s more than just protecting their medical license.

atdrummond 5y ago
The proportion of patients who become addicted from properly prescribed opioids is extremely small. The majority of addicts created were provided with opioids that were not appropriate for their particular medical situation, in doses that were too high, and on a regimen that exceeded in length what was supported by the medical evidence. The proportion of new cancer patients who go on to receive palliative care that includes opioids who end up becoming addicted has always been, and remains, in the low single digits. For patients with a genuine need and who are properly inducted and maintained on them, opioids are a powerful and useful medical tool. Further, the bulk of use in illegal opioids stateside, such as fentanyl and its analogues, is not (at least today) driven by the conversion of the legal opioid user to an illegal drug user. Fentanyl is now commonly found in drugs that never previously would have contained an opioid, such as counterfeit benzos and MDMA. Further, the majority of fentanyl users on the street arrive at its use after consuming other illegal/street drugs. For those who started on other opioids, their first opioid will tend to be the illegally diverted pills or liquid cough treatments containing codeine/hydrocodone called "lean". Very few new users of fentanyl and fentanyl analogues come from legal opioid users, mainly because very few new users are now inducted on reckless prescriptions such as an immediate script for 180 Oxycontin and 240 benzodiazepene pills a month. Your narrative is about a decade out of date at this point. Thomas Kline is a superb resource if you want to take a deeper dive into the actual statistics and how the narrative of a crisis was used to systematically deny law abiding patients the pain treatment they should receive. https://twitter.com/thomasklinemd https://twitter.com/thomasklinemd
- google234123 5y ago
  A meta study of 38 studies from 7 years ago on patients using opioids for chronic pain found that 21-29% of the patients misuse the drugs and 8-12% of the patients are addicted to them. That doesn't seem "extremely small" like you said, though maybe it's better now. I think there are reasons why opioids are no longer recommended for the treatment of most patients with chronic pain that you aren't fairly acknowledging. https://journals.lww.com/pain/Abstract/2015/04000/Rates_of_opioid_misuse,_abuse,_and_addiction_in.3.aspx https://journals.lww.com/pain/Abstract/2015/04000/Rates_of_o...

fvv 5y ago

Sorry if i sound blatantly stupid with my question, maybe In your case this could not be a sufficient solution for pain but did you ever tried with something like Marijuana and if it's illegal in you state considered migrating where it's legal? Or even considered to relocate to somewhere where you can get access to proper medication ?

seattle_spring 5y ago
Weed is a joke medication for many (most, I'd argue) types of pain. And yes it is condescending to suggest it to a longtime sufferer of chronic pain. It's akin to asking a suicidal person if they've tried exercising.
zdragnar 5y ago
Anecdotally, with N being roughly 5 people, THC/CBD do nothing for several types of chronic pain, short of getting high enough that you stop caring about the fact that you are in pain. Worth a shot, but I wouldn't recommend anyone getting their hopes up trying it. Tiger balm, on the other hand, is nothing short of magic.

dijonman2 5y ago

You can buy oxy on the street. Super expensive. $1/mg.

buildsjets 5y ago
And 50/50 odds it's actually an unknown dosage of fentanyl.
- Jerrrry 5y ago
  If it is a 30mg pill, it is likely a synthetic analog. the actual probability depends on your location, but in general: the kids are FUCKED
  - deleted 5y ago
    [deleted]
- dijonman2 5y ago
  Not true! They’re real pills sold by people who have an rx in my case. Be smart and learn how to identify fakes. I can spot fake m30s by texture.

throwaway42124 5y ago

Jerrrry 5y ago
You can not buy legitimate painkillers more powerful than Tramadol on the darknet. all legitimate pills have been bought, sold, and removed from the open market, monthes in advanced, years ago.. the safest thing you can buy to treat pain on the internet is tramadol, or, believe it or not, is... black tar heroin. everything else is Fent.
- The_rationalist 5y ago
  According to wikipedia the reason tramadol has a ceiling point is because it depends on the number of CYP2D6 enzymes. This can theoretically easily be bypassed by co-administrating a CYP2D6 inhibitor however doing so require research and care about dose since a CYP inhibitor can in some contexts upregulate a drug dose potency by 1000X
  - Jerrrry 5y ago
    I meant, you cannot safely, as everything else, due to market forces, has fent in it. The only products on the market that have a near 0 chance of being fent are Tramadol and BTH.
- atdrummond 5y ago
  I would not encourage anyone to acquire any opioid medication not prescribed, for a number of reasons. That said, Tapentadol - a cousin of tramadol but much stronger - can be easily bought from Indian and other Asian pharmacies on the clearnet and at affordable prices. One might have a package here and there get seized but all that results in is a snide letter from customs.
  - Jerrrry 5y ago
    So that is what they are putting in the percs now... thank you, genuinely, it will be looked into.

The_rationalist 5y ago

you can get research chemical opiod derivatives legally OTC such as ODSMT or Kratom however I would be extremely careful regarding addicition potential, not all opiods are created equal, e.g. tianeptine sulfate should never be attempted

throwawayboise 5y ago

Thank you for another reason when people ask why I don't go to doctors.