5 ms·

I really wish I could just (safely) order whatever medications, tests, and treatments I want online. Let me consult a doctor if I need one, but also: don't gat

I really wish I could just (safely) order whatever medications, tests, and treatments I want online. Let me consult a doctor if I need one, but also: don't gatekeep treatment from me because the doctor is having a bad day, doesn't like me, etc. I have a severe, debilitating anxiety disorder. It's extremely frustrating, and sometimes I will have to leave classes I'm teaching, social functions, etc. for no apparent reason because my body starts an anxiety attack. This flares up once every 3-5 years and has for most of my life. The solution to this, which has worked for most of my life, is: xanax. Take a small amount of xanax before an anxiety trigger, do the trigger, and break the trigger->anxiety association/cycle. It takes like 3 doses total, and the rest of the pills go in the trash (or in the medicine cabinet, and then eventually the trash). Almost every time I have to go through some weird and insulting dance with a doctor essentially pleading with them for this medication, I get told I'm a drug addict, and finally after explaining that no actually I'm a 40 year old semi retired founder/software developer, not a homeless unemployed addict, which is what your leading questions about what I do for a living led you to think, I might get a prescription for the drug that I have been taking rarely, but to great effect, for 30 years. I *HATE* the medical system. I hate it. People talk about how the rich get access to some other medical system that gives them what they want with concierge doctors or whatever. Well I'm rich and I don't get that. I'd pay almost anything to just get a license that says "this guy is responsible, successful, and a massive contributor to society. Let him do whatever the fuck he wants and order whatever the fuck medications he needs."

wholinator2 4y ago
You can just keep the pills. If you're really that strong about avoiding addiction why do you feel the need to throw them away?
- Broken_Hippo 4y ago
  I'm not sure where they said they got rid of them to avoid addiction: It is more that they have to convince medical staff that they aren't simply looking to get high but want health instead. But outside of that, getting rid of unused pills is good practice. These pills are going to expire. Once they do, you can no longer rely on them doing what you expect. Plus, a lot of folks don't like to keep stuff they aren't using around the house - it is always a bit of upkeep or storage. And that doesn't even get into it being safer around children. It is easier to prevent children from getting into such things if they aren't in the house. FYI: Check with your pharmacy about bringing unused medicine to them to dispose of properly instead of putting it in the trash.
  - berberous 4y ago
    I am not a doctor or chemist so I do not want to speak definitively, but I highly doubt most common drugs (Xanax, Advil, etc) really lose much efficacy past their expiration date (at least within some reasonable time, like 10-15 years). Happy to be shown evidence otherwise. I wouldn’t rely on this for say, antibiotics to treat an infection, but I wouldn’t hesitate to take a 5 year old Xanax.
  - csdvrx 4y ago
    > But outside of that, getting rid of unused pills is good practice. These pills are going to expire. Once they do, you can no longer rely on them doing what you expect. Evidence required. Expiration dates are put on many things as a CYA, but I don't expect dry chemicals destined for human (or animal!) use kept in an airtight container protected from the sunlight to degrade within 10 years. Should they degrade, the question is into what, and how much: 5% degradation into what the human body breaks the chemical into should have no consequence. > FYI: Check with your pharmacy about bringing unused medicine to them to dispose of properly instead of putting it in the trash. Or just keep it and use it as needed, solving both of your problems at once!
  - bookofjoe 4y ago
    >But outside of that, getting rid of unused pills is good practice. These pills are going to expire. Once they do, you can no longer rely on them doing what you expect. Disagree completely. Source: retired neurosurgical anesthesiologist (38 years practice) Reasons: 1) When you need those pills you won't have them 2) Properly stored pills (dark shelf/cabinet) lose potency/efficacy VERY slowly: perhaps 10%/year. So 5-year-old pills will still work fine. Take one, see if does what it did originally; if not, take another. 3) If you're traveling and need that medication, good luck. You'll wish you'd saved them.
- orbital223 4y ago
  Most medicine has expiration dates. If he needs it only every 3-5 years, it's unlikely the pills will still be usable.
  - csdvrx 4y ago
    > it's unlikely the pills will still be usable Pills (and chemicals) are not SSL certificates: they don't cease to work at the expiration date + 1 second.
    - bombcar 4y ago
      The US government tested a bunch of old World War II medication they found laying around, and it had something outrageous like 98% efficacy or whatever. Maybe a liquid medicine would go bad but I suspect pills are forever.
    - TylerE 4y ago
      And in the US at least, FDA requires a max expiration date or one year, despite many being shelf stable for probably decades. I know I read somewhere about morphine pills from WW2 medkits being found to still be useful 60+ years later - like say 30-50% of stated dose.
  - ars 4y ago
    > it's unlikely the pills will still be usable. Yes it will. The pills don't actually expire. They will work unchanged for decades. See: https://www.health.harvard.edu/staying-healthy/drug-expiration-dates-do-they-mean-anything https://www.health.harvard.edu/staying-healthy/drug-expirati...
- amalcon 4y ago
  For medication like this, the doctor will usually prescribe a specific number of pills at a specific dosage. The number will rarely exceed what you ask for, and asking for large numbers of pills is treated (not unreasonably) as a sign of drug seeking.
  - Calavar 4y ago
    This is true in general, but as a doctor, I've never written a prescription for only 3 Xanax pills. Usually more like 10 to 30 depending on the situation. The only time I write for a single digit number of pills is for antibiotics, where I know ahead of time exactly how many pills they will need.
    - somehnguy 4y ago
      Anecdotally I’ve received a script for exactly 3 Xanax pills. The eye surgeon prescribed them for my LASIK surgery.
      - throwing_away 4y ago
        This is also common for dentists and other outpatient procedures.
  - tux3 4y ago
    >and asking for large numbers of pills is treated (not unreasonably) as a sign of drug seeking. Something that keeps tripping me up with the label of drug seeking, is that in this situation the person is correctly drug seeking in a situation they've previously had a specific problem diagnosed and have had positive experiences with a therapeutic. They simply need to subject themselves to the ritual, follow doctor's orders, and not look like they are drug-seeking to successfully drug-seek the therapeutic. What bother me is the implicit confusion between seeking drugs to treat a specific problem, versus not. Confusion creates damage both ways, with an insufficiently individualized approach people subject to drug addictions may not be sufficiently protected (many are still successful finding someone who will fuel their addiction), while people not subject to drug addiction receive substandard care.
knaekhoved 4y ago
You can order xanax on the darkweb, FYI. I mostly agree with you - the problem is that doctors are trained to deal with the lowest common denominator of patient: an addictive idiot who would kill themselves with benzos or opiates, given the chance. 90% of doctors are absolutely not equipped to deal with high-agency, high-intelligence patients. I've had a few doctors that were smart enough to work with me on experimentation or nonstandard treatment, but they are few and far between.
- zen_1 4y ago
  You can also order fentanyl labeled as xanax on the darkweb...
  - deleted 4y ago
    [deleted]
  - knaekhoved 4y ago
    DNMs have minimal issues with adulterated drugs, especially compared to street drugs. They typically have extensive third-party testing.
hotpotamus 4y ago
You can order unscheduled drugs from pharmacies in India like alldaychemist.com. That means no benzodiazepines, but there are drugs with off-label anxiolytic indications like hydroxyzine, propranolol, or clonidine to name a few. I don't disagree with you regarding our medical system.
marcinzm 4y ago
Do you go to a different doctor every time, and is it a general doctor or a psychiatrist?
chiefgeek 4y ago
Sorry to hear about the suffering you endure with your condition. Have you investigated any somatic work? How about psychedelics? Over the past 10+ years, I've gotten myself off a 200mg dose of Zoloft, along with Wellbutrin and Adderall through a combination of the above. I've seen others heal similarly.
dennis_jeeves1 4y ago
>I HATE the medical system. A teeny nitpick, it's never the system, its always collectively the people, and common people at that. I have toyed with the idea of getting a medical degree but it's a lot of time, effort and money, to get over the issues you correctly pointed out, but it appears that searching and finding a doc that is disgruntled with the 'system' and who might be co-operative with things that I need is higher.
pkaye 4y ago
The tests can be ordered though a few online services. You pick the lab test, a doctor rubberstamps it and then go to Quest or LabCorp to get the blood draw. A few days later they send you the results. I don't think you can bill the insurer but the costs are not always that expensive for some of the common tests.
gizmo686 4y ago
Do you have a regular doctor? I'm in a simmilar situation and need a dose of Lorazepam about once or twice a year. However, I've never had the problem you describe. The first time I spoke to my primary care physician about this, we had a discussion about my options and I left the consultation with a prescription for a rather large dose of Lorazepam [0]. Since then, I've just called her office whenever I needed another dose, and told the receptionist that I was previously prescribed Lorazepam for X, and I need another dose because I will be doing X again. A couple of times, I also asked the receptionist to ask the doctor to lower the dose. I've never had any problem with this. I don't think my doctor has even asked to talk to me at all before putting in the prescription. (Although we have spoken about unrelated medical issues). I assume that she just looked at my file; confirmed that she previously prescribed it and that I wasn't asking for it too frequently, then rubber stamped a new prescription. On one occasion, I was speaking to a specialist (again, for an unrelated medical concern), and asked her for a prescription, because I happened to know I would be needing one soon. She glanced through my file and wrote the prescription without complaint. I don't know what is going on behind the scenes, but I think what is happening is that I have a regular doctors office through which I coordinate all of my care. This means that whenever I speak with a doctor, they have a file on me that says "patient prescribed Lorazepam for X", so doctors seem willing to repeated what they have documentation about having worked before. [0] Enough that she suggested I use a wheel-chair after taking it.

wholinator2 4y ago

You can just keep the pills. If you're really that strong about avoiding addiction why do you feel the need to throw them away?

Broken_Hippo 4y ago
I'm not sure where they said they got rid of them to avoid addiction: It is more that they have to convince medical staff that they aren't simply looking to get high but want health instead. But outside of that, getting rid of unused pills is good practice. These pills are going to expire. Once they do, you can no longer rely on them doing what you expect. Plus, a lot of folks don't like to keep stuff they aren't using around the house - it is always a bit of upkeep or storage. And that doesn't even get into it being safer around children. It is easier to prevent children from getting into such things if they aren't in the house. FYI: Check with your pharmacy about bringing unused medicine to them to dispose of properly instead of putting it in the trash.
- berberous 4y ago
  I am not a doctor or chemist so I do not want to speak definitively, but I highly doubt most common drugs (Xanax, Advil, etc) really lose much efficacy past their expiration date (at least within some reasonable time, like 10-15 years). Happy to be shown evidence otherwise. I wouldn’t rely on this for say, antibiotics to treat an infection, but I wouldn’t hesitate to take a 5 year old Xanax.
- csdvrx 4y ago
  > But outside of that, getting rid of unused pills is good practice. These pills are going to expire. Once they do, you can no longer rely on them doing what you expect. Evidence required. Expiration dates are put on many things as a CYA, but I don't expect dry chemicals destined for human (or animal!) use kept in an airtight container protected from the sunlight to degrade within 10 years. Should they degrade, the question is into what, and how much: 5% degradation into what the human body breaks the chemical into should have no consequence. > FYI: Check with your pharmacy about bringing unused medicine to them to dispose of properly instead of putting it in the trash. Or just keep it and use it as needed, solving both of your problems at once!
- bookofjoe 4y ago
  >But outside of that, getting rid of unused pills is good practice. These pills are going to expire. Once they do, you can no longer rely on them doing what you expect. Disagree completely. Source: retired neurosurgical anesthesiologist (38 years practice) Reasons: 1) When you need those pills you won't have them 2) Properly stored pills (dark shelf/cabinet) lose potency/efficacy VERY slowly: perhaps 10%/year. So 5-year-old pills will still work fine. Take one, see if does what it did originally; if not, take another. 3) If you're traveling and need that medication, good luck. You'll wish you'd saved them.
orbital223 4y ago
Most medicine has expiration dates. If he needs it only every 3-5 years, it's unlikely the pills will still be usable.
- csdvrx 4y ago
  > it's unlikely the pills will still be usable Pills (and chemicals) are not SSL certificates: they don't cease to work at the expiration date + 1 second.
  - bombcar 4y ago
    The US government tested a bunch of old World War II medication they found laying around, and it had something outrageous like 98% efficacy or whatever. Maybe a liquid medicine would go bad but I suspect pills are forever.
  - TylerE 4y ago
    And in the US at least, FDA requires a max expiration date or one year, despite many being shelf stable for probably decades. I know I read somewhere about morphine pills from WW2 medkits being found to still be useful 60+ years later - like say 30-50% of stated dose.
- ars 4y ago
  > it's unlikely the pills will still be usable. Yes it will. The pills don't actually expire. They will work unchanged for decades. See: https://www.health.harvard.edu/staying-healthy/drug-expiration-dates-do-they-mean-anything https://www.health.harvard.edu/staying-healthy/drug-expirati...
amalcon 4y ago
For medication like this, the doctor will usually prescribe a specific number of pills at a specific dosage. The number will rarely exceed what you ask for, and asking for large numbers of pills is treated (not unreasonably) as a sign of drug seeking.
- Calavar 4y ago
  This is true in general, but as a doctor, I've never written a prescription for only 3 Xanax pills. Usually more like 10 to 30 depending on the situation. The only time I write for a single digit number of pills is for antibiotics, where I know ahead of time exactly how many pills they will need.
  - somehnguy 4y ago
    Anecdotally I’ve received a script for exactly 3 Xanax pills. The eye surgeon prescribed them for my LASIK surgery.
    - throwing_away 4y ago
      This is also common for dentists and other outpatient procedures.
- tux3 4y ago
  >and asking for large numbers of pills is treated (not unreasonably) as a sign of drug seeking. Something that keeps tripping me up with the label of drug seeking, is that in this situation the person is correctly drug seeking in a situation they've previously had a specific problem diagnosed and have had positive experiences with a therapeutic. They simply need to subject themselves to the ritual, follow doctor's orders, and not look like they are drug-seeking to successfully drug-seek the therapeutic. What bother me is the implicit confusion between seeking drugs to treat a specific problem, versus not. Confusion creates damage both ways, with an insufficiently individualized approach people subject to drug addictions may not be sufficiently protected (many are still successful finding someone who will fuel their addiction), while people not subject to drug addiction receive substandard care.

knaekhoved 4y ago

You can order xanax on the darkweb, FYI. I mostly agree with you - the problem is that doctors are trained to deal with the lowest common denominator of patient: an addictive idiot who would kill themselves with benzos or opiates, given the chance. 90% of doctors are absolutely not equipped to deal with high-agency, high-intelligence patients. I've had a few doctors that were smart enough to work with me on experimentation or nonstandard treatment, but they are few and far between.

zen_1 4y ago
You can also order fentanyl labeled as xanax on the darkweb...
- deleted 4y ago
  [deleted]
- knaekhoved 4y ago
  DNMs have minimal issues with adulterated drugs, especially compared to street drugs. They typically have extensive third-party testing.

hotpotamus 4y ago

You can order unscheduled drugs from pharmacies in India like alldaychemist.com. That means no benzodiazepines, but there are drugs with off-label anxiolytic indications like hydroxyzine, propranolol, or clonidine to name a few. I don't disagree with you regarding our medical system.

marcinzm 4y ago

Do you go to a different doctor every time, and is it a general doctor or a psychiatrist?

chiefgeek 4y ago

Sorry to hear about the suffering you endure with your condition. Have you investigated any somatic work? How about psychedelics? Over the past 10+ years, I've gotten myself off a 200mg dose of Zoloft, along with Wellbutrin and Adderall through a combination of the above. I've seen others heal similarly.

dennis_jeeves1 4y ago

>I HATE the medical system. A teeny nitpick, it's never the system, its always collectively the people, and common people at that. I have toyed with the idea of getting a medical degree but it's a lot of time, effort and money, to get over the issues you correctly pointed out, but it appears that searching and finding a doc that is disgruntled with the 'system' and who might be co-operative with things that I need is higher.

pkaye 4y ago

The tests can be ordered though a few online services. You pick the lab test, a doctor rubberstamps it and then go to Quest or LabCorp to get the blood draw. A few days later they send you the results. I don't think you can bill the insurer but the costs are not always that expensive for some of the common tests.

gizmo686 4y ago

Do you have a regular doctor? I'm in a simmilar situation and need a dose of Lorazepam about once or twice a year. However, I've never had the problem you describe. The first time I spoke to my primary care physician about this, we had a discussion about my options and I left the consultation with a prescription for a rather large dose of Lorazepam [0]. Since then, I've just called her office whenever I needed another dose, and told the receptionist that I was previously prescribed Lorazepam for X, and I need another dose because I will be doing X again. A couple of times, I also asked the receptionist to ask the doctor to lower the dose. I've never had any problem with this. I don't think my doctor has even asked to talk to me at all before putting in the prescription. (Although we have spoken about unrelated medical issues). I assume that she just looked at my file; confirmed that she previously prescribed it and that I wasn't asking for it too frequently, then rubber stamped a new prescription. On one occasion, I was speaking to a specialist (again, for an unrelated medical concern), and asked her for a prescription, because I happened to know I would be needing one soon. She glanced through my file and wrote the prescription without complaint. I don't know what is going on behind the scenes, but I think what is happening is that I have a regular doctors office through which I coordinate all of my care. This means that whenever I speak with a doctor, they have a file on me that says "patient prescribed Lorazepam for X", so doctors seem willing to repeated what they have documentation about having worked before. [0] Enough that she suggested I use a wheel-chair after taking it.