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big cock Salaryman posted:could this be referring to more of a kappa-opioid antagonism ala samidorphan/bupe combo instead of mu? i mean if they wanna investigate mu-opioid agonists as antidepressants just let ppl have some quality-controlled freaking heroin/whatever pleasurable thing lasts longer I'm not informed enough to have an answer...maybe my clinic doctor is more familiar...I'll ask. KingEup posted:They're investigating GHB as an antidepressant too. It almost seems like everything is an antidepressant! 
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Feb 27, 2017 21:57
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big cock Salaryman posted:perhaps the answer was.... in the middle... all along  (USER WAS PUT ON PROBATION FOR THIS POST)
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Mar 1, 2017 05:20
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pangstrom posted:I don't really know the street scene but seems like you would at least sell them as speedballs. Sometimes dealers don't really know what they have and fentanyl is cheap as heck to make though so that's probably part of why it's showing up in everything. As someone who has speedballed and/or done back to back shots of coke and heroin on hundreds of occasions, I can never once recall any of my dealers pre-mixing uppers and downers, packing that mixture for resale. I've always received separate bags for my separate drugs. Garbage-can mystery pills sold as (ecstasy) have always been a thing, but the IV user tends to buy their choices of dope as advertised, if perhaps sometimes weaker than expected. The market seems to recognize that people prefer to believe that they have a decent idea of what's in their needles. Apart from being good business, this tends to keep cops away and the addicts alive, high, and coming back. I tend to agree with the sloppy chemist hypothesis moreso than the willfully dangerous addict-killer narrative. As a sidenote, I'm drug tested twice a month through my methadone clinic. While I've failed for heroin more than I'd care to admit, they've never detected metabolites of fentanyl. Same story with everyone else I know who can't always stick to sobriety. While people are certainly dying from fentanyl-boosted dope here in ATL, I apparently don't see any of it.
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May 25, 2017 23:51
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Albino Squirrel posted:And if all the mice need higher opioid doses, then we should probably start using opioid-naive mice in studies lol. HelloSailorSign posted:I haven't thought about mouse or rat opioid usage for years (school, really), but I know that buprenorphine in mice is dosed about 0.03 mg/kg to 0.05 mg/kg (for HCl) or 0.6 mg/kg for the SR. How do you dose people with buprenorphine? I think mice need higher opioid doses for effect. Dosing for 180lb generally healthy males, except for that IV heroin issue: My personal prescription was 3.5 of the 8mg tablets qd (opioid replacement therapy) 16 mg qd is a comfortable dose; you won't have to worry about getting sick. You don't have to worry if you forget to dose for half a day or more. 8mg will usually bring a mild to moderate addict out of early withdrawal. 4mg will sometimes be enough With respect to 'ceiling effect,' I feel the same at 8mg as I do at 28mg. It's not "high" it's just "not sick." My personal maximum one-time dose was maybe 48mg. I noticed no additional benefit. _____ I tentatively plan to return to a bupe regimen at some point. For now, the counseling, accountability and social support I receive through my (rare and exceptional) methadone clinic is the perfect fit.
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May 28, 2017 08:06
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NATIONAL DRUG CONTROL STRATEGY Data Supplement 2015 (189 pages) Exhaustive 152 page pdf containing the Institute for Defense Analysis Report on the Price and Purity of Illegal Drugs 1981-2007 This is amazing research into the US drug markets over the last three and a half decades, answering all sorts of questions we never thought to ask. I spent about half of last Thursday studying these data and I still had to skim a ton of it.
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Jun 7, 2017 04:33
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Remember how this all came about? NPR has a story about how the 2012 reformulation of opana ER led to a coating that made snorting difficult. This actually was followed by a decrease in snorting and an increase in IV usage. But was that the cause of the 'spike' in IV usage? My experience in Nashville TN seemed to indicate different factors at play. For the last 5-8 years, available quantities of oxymorphone on the market have been marked by periodic, major disruptions in supply. Causes include formulation changes, increased scutiny of doctors who prescribe medication, better awareness of addiction and frequent widespread pharmacy shortages of oxymorphone. Partly explained by supply, the prices for opana have steadily increased. In the late aughts, when opana was first gaining a toehold in the marketplace, nobody had any clue where to set the price. It was common to swap oxymorphone and oxycodone milligram for milligram, and 30mg was around $20. When I quit shooting pills in 2014, 30mg of opana was at $120 while oxycodone 30s were 'only' up to $30. Supposedly the oxymorphone prices keep going up; 30mg is reported to be closer to $200. What do addicts do when their supply is short, the prices are extreme, and they still have a prescription? some augment their prescription with heroin or street pills. Many others overcome their needle aversion with a quickness. Did I mention that the oral bioavailabilty of oxymorphone is only 10%? Cutting one's per milligram cost by 90% has an allure. Suddenly, IV makes a ton of sense for the opioid-dependent individual with access to oxymorphone through their insurance and the inability/unwillingness to procure heroin. In conclusion, the prevalence of IV opioid usage should likely continue to increase. The dent in supply caused by the new opana ER ban will probably cause some oxymorphone users to switch to the needle. Oxymorphone users have already demonstrated a marked increase in IV usage when snorting became impossible. That said, numbers of IV opioid users have already been steadily increasing, and this ban is just a tiny chapter in the story of the contemporary epidemic.
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Jun 10, 2017 23:44
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Does anyone in the thread have a recommendation for something I could read to better understand cross-addiction (where addicts often give up one class of intoxicants, only to abuse another). The addiction/recovery thread isn't exactly the most academic of places, and my methadone doctor's answer seemed really basic, but he's a busy dude. I have a long history with everything, and this last time quitting alcohol (4 months ago?) has seen me get back into cocaine in a disgusting way. I've seen plenty of articles on PubMed that link higher methadone dosages to decreased cocaine use, but I also see articles that indicate a persistent problem with people successfully treating the heroin addiction but unable to kick the crack. I can imagine social pressures may play a role, but I've switched states/cities/scenes enough time to know I can be an addict anywhere.
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Jun 23, 2017 09:27
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tetrapyloctomy posted:We've already seen carfentanil in local drugs, and not just the heroin (probably just cross-contamination -- "Warning, this crystal meth was produced in a facility that also contains carfentanil, and both peanut and milk products"). Per the best studies we have (which are not good) the ED50 (mean effective dose) is much, much lower than fentanyl, but the LD50 (mean lethal dose) is not. If you believe that you can generalize from studies where narcotics are injected into rat tails, anyway. It would appear that all of this "All you do is touch it and you'll overdose!" talk is nonsense as well. Fentanyl in media devised precisely for transdermal absorption does not just knock someone the gently caress out and put them into respiratory failure without warning; other stronger opiates in powder form are not going to achieve symptomatic blood levels transdermally with nearly the same efficacy. I'm willing to bet that the first responders who end up ODing accidentally inhaled the agent (or rubbed it on their gums and don't want to admit it later). This is the correct answer to that scare-tactic article. ----- Grey Death! Lol
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Jul 23, 2017 22:42
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I've spent the last few weeks working in Nashville, and (due to differences in regulations between the states) I chose to transfer to the (only) methadone clinic here in town. Since BHG holds a monopoly, they can hire truly incompetent staff who provide the barest minimum of service, while adopting attitudes of contempt toward the patients. At least the heroin dealers pretend to be friendly, gently caress. Anyhow, I was assigned a counselor who functions as little more than a paperwork filler. On our first encounter, she addressed the fact that I've failed drug tests for cocaine. "Can you actually still get high on cocaine while taking methadone?" she incredulously inquired. I told her that concurrent cocaine and methadone usage is quite common, and one can find online dozens of studies addressing their usage. Higher doses of methadone sometimes seem to reduce (but not eliminate) cocaine usage among many patients. The counselor looked at me like a deer in the headlights, replying "um, I don't have that [sic] study in front of me." I was pretty disenchanted by that interaction, but we stayed cordial enough through the rest of the paperwork she had to complete. Yesterday, I again saw her. "Did you see that Trump declared a state of emergency about opioids!? The previous guy wouldn't even talk about it, but Trump just said 'give me the facts' and did something about it." loving unreal. It's her job to know SOMETHING about the topic, isn't it? I'm blessed to be a patient at my Atlanta clinic, with educated and compassionate staff. Small wonder almost nobody ever gets sober when organizations like BHG (with something like 80 clinics nationwide) operate as they do. Side note: Bain Capital was an early investor.
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Aug 12, 2017 18:05
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Another complicating factor wrt withdrawal is the fact that most people simply can't put life (job, family, school, etc) on pause for the first phase of withdrawal. Especially if one has the sort of addiction that consumes virtually all of one's disposable income (and then chips-away at things most sober folks see as 'necessities').
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Feb 7, 2018 19:18
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Lote posted:Work requirements are going to kill people. Medicaid is how you pay for medications. From what I was told during one rehab stint, one has a higher likliehood of success using a comorbid psychiatric diagnosis. While I might benefit from filing for disability, it's much easier to exist in shame, blaming my addiction rather than admitting my brain is broken.
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Feb 7, 2018 21:36
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Eventually, everyone's a loser. Makes u think
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Feb 8, 2018 19:59
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fishmech posted:Why do you think a Pfizer or a Merck couldn't make kratom very profitable? Fishmeh is making sense; close the forum
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Feb 8, 2018 23:45
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Lol @ the drunk guy whining about people doing reasonable amounts of uncut dope (getting well instead of wrecked) because 'they might make poor decisions.' SPAY OR NEUTER THIS POSTER! E: in response to the idea that persons on opioid substitution drugs should get off them... In some cases, people may be able to succeed with said strategy. However, the relapse rate of people discontinuing maintenance drugs is incredibly high. In short, if what keeps people off street drugs is working, and they aren't interested in quitting, leave them alone. Personally, I was able to reach sobriety on methadone. And then I tapered-off, thinking I was ready. Within a month, I was a full-blown junky again. I went from 190lb to 155 in a couple months. My job disappeared, my vehicle was impounded, and I'm facing multiple felony charges. Since returning to medication-assisted treatment, I no longer look like a skeleton. I work. I haven't been arrested again. My personal relationships are flourishing. Please, please don't advocate that addicts discontinue the most effective treatment available. The_Book_Of_Harry fucked around with this message at 07:48 on Feb 11, 2018 |
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Feb 11, 2018 07:34
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case study of maintence in Russiahttps://www.theguardian.com/world/2015/jan/20/ukrainian-drug-addicts-dying-due-to-treatment-ban-says-un posted:Around 800 former heroin addicts there were cut off from replacement therapy, roughly 100 of whom have died, according to advocacy groups and the UN’s special envoy Michel Kazatchkine.
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Feb 11, 2018 08:09
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San Francisco takes steps toward opening the nation's first legal heroin injection sitequote:SAN FRANCISCO, Calif. – The San Francisco Department of Public Health has unanimously endorsed a task force’s recommendation to open what could become the nation’s first legal safe injection sites aimed at curbing the opioid epidemic.
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Feb 12, 2018 05:07
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I, for one, would have killed for cold turkey in jail. Seriously, though, top-teir analysis. E: i forgot about that one time I did ~35 days on a clerical error before being released. It was Thanksgiving. We got a thin slice of turkey with both a salt and pepper packet. I cried from joy. E2: I've never been accused of (or committed) a violent or property crime. The_Book_Of_Harry fucked around with this message at 22:18 on Feb 12, 2018 |
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Feb 12, 2018 22:13
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Lote posted:I was being mostly serious. If you cut your product, only people without tolerance are going to overdose. If the addicts are the ones dying, then you know it’s strong. For the last year or two, nothing I've ever gotten from my dude when tested has shown anything fent-related, and I've been very vocal about appreciating dude keeping it real. But over the last couple weeks, he wound-up with a blended batch. He let me know immediately, and I could definitely tell the difference. Fent hits pretty hard on the rush, but it doesn't have much in the way of legs (duration of intoxication). And that's not really what I want from my drugs. Unfortunately, my connect is getting pressured by consumers who represent much larger accounts than me to keep stocking the blended poo poo. So far, he's carrying both, but I have my doubts that unblended dope is gonna be around much longer. Ugh. gently caress it. I've cut way back on my dope intake, but this is extra incentive to just quit. My counselors, nirses and doctor at the methadone clinic would be happier, too.
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Feb 23, 2018 17:48
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In my experience, some opioid drugs blow right through bupe. We used to shoot opana with little to no diminished effect, while heroin was completely worthless while medicated. Maybe somebody more science-minded could explain the particulars, but both myself and others will attest to this.
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Feb 25, 2018 22:16
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Thanks again, NA Bulletin #29 wherein NA condemns medication-assisted therapy ps - another dead associate has been added to my circle
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Mar 6, 2018 20:38
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How many loving studies will it take??? Economic Evaluations of Opioid Use Disorder Interventions: A Systematic Review
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Mar 6, 2018 20:40
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Ytlaya posted:Ugh, I had this problem with trying to find meetings due to being on suboxone. I had to lie about it, which defeats the entire purpose of those meetings. It's really dumb, since people on replacement therapy have to deal with a lot of the same stuff as any other sober addicts (assuming they're using the medicine as prescribed anyways). I'm glad you were able to find a group of reasonable people. After 15 years of addiction and 3 of successful medication-assisted therapy (and multiple failed rehabs and outpatient programs concurrant with hundreds of *A meetings), I gave-into pressure to quit medication, leading soon into the mother of all relapses. I blame myself primarily, since I had done enough homework to know this was likely a stupid idea, but I have lingering resenment about the arguments I allowed to sway my decision process. I lost a girlfriend, a cushy living situation, a job and a sweet-rear end convertable...and very nearly my life. I'm also fighting several criminal/felony charges, which will likely lead to further incarceration. Getting back into the methadone program saved my life, as it did the first time. I know that withdrawal in jail (hopefully not prison) will be a particular sort of hell, but I'm choosing life...even when (as Irvine Welsh says) I could choose junk. The_Book_Of_Harry fucked around with this message at 21:55 on Mar 10, 2018 |
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Mar 10, 2018 21:48
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Sinners Sandwich posted:Did no one ever sit down and explain the opiod crisis? I think it's pretty basic stuff how people get hooked off prescription medication. Iatrogenic addiction is more rare than folks might think. Overprescription led to diversion, however, and this gave rise to a massive epidemic. metastudy
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Mar 16, 2018 01:39
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KingEup posted:FYI Slavoj Žižek has a take on the opioid crisis: https://health.spectator.co.uk/trump-wants-to-end-the-opioid-crisis-but-what-if-he-is-himself-its-prime-symptom/ What a bloviating nincompoop (non compos mentis) as the tedious jerk would likely supplant into his wordshitting. The American people wove the prerequisites for urgent disassociation into our lives' fabric decades (centuries?) ago. gently caress Trump, fine. But that piece hurts anyone serious about real change.
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Mar 29, 2018 00:41
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No seriously opioid dependent individual takes neurontin/gabapentin for fun. [redacted] had hundreds of the drat things that [redacted] couldn't even give away. They are commonly prescribed in conjunction with opioid medicines by many pain management doctors. That said, one may achieve limited relief from withdrawal symptoms by taking gabapentin during dopesickness. I've seen mixed results.
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Mar 29, 2018 04:36
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I guess one could strap-into a CPAP, but every time I have ODed, I've been found in the hallway outside whatever space I used to get off. Dunno if a mask would remain on my head in those instances.
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Nov 29, 2018 17:52
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.motherfuckers act like they forgot about Portugal
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Dec 12, 2018 04:28
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