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No Butt Stuff posted:Yes, my doctors told me this, which I found to be patently false as well. FYI, this is not just a belief taught to doctors by drug reps but it part of the design of the drug (its a sort of targeted opioid that was supposed to have all of the benefits and fewer of the opioid side effects). Moreover, in a lot of countries this also means that the drug is less well regulated as it is not a controlled substance like morphine. This in turn means it is easier to get through doctor shopping etc. Without looking at any real papers i feel this explains at least partially the high rate of tramadol addicts.Tramadol it's quite good as a painkiller and is certainly les addictive than morfine /fentanyl. quote:Information from 2 tramadol safety databases allowed calculation of the incidence of abuse or dependency as 0.21 and 0.12 cases per million defined daily dosages (DDDs), with lower incidences in recent years. That doesn't mean its impossible to get addicted, just that it is a lot harder to form an addiction. I recently saw a patient using 2500mg of tramadol a day that she got through a reputable internet pharmacy. For her the route to non-adiction is starting with high dose fentanyl patches and slowly working back from there in a month long process. In general, short tem use of well monitored opioids is not addictive. If your doc wants you to take them for a short while for pain dont feel pressured to do so but also do not think that he's just a shill for big pharma trying to get you addicted. edit: as an aside, the fear of opioids instilled in some parts of the population is so great that terminal oncologic patients painfully awaiting death still routinely refuse opioid drugs because they dont want to end their life as an addict. IAMNOTADOCTOR fucked around with this message at 22:20 on Jan 26, 2016 |
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Jan 26, 2016 22:14
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Hardawn posted:I've been on suboxone/zubsolv for almost three years and I loving hate it. Your not tapering the dosage anymore? Not to be a dick, but the general experience with cold turkey heroin is that the relapse rate is quite high even if the first month goes well. Re: the person suggesting heroin as a maintenance drug. Heroin is a short working opioid whereas methadone is long working. Its difficult to dose heroin in such a way that you suppress the detox symptoms without inducing a heroin high. I've always felt slightly iffy about long term free heroin and methadone administration. It's undoubtedly better for society but it looks a lot like palliative sedation of the patients. In a sense you are slightly giving up.
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Feb 1, 2016 10:55
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Zarin posted:Granted, I didn't watch the Frontline episode, but re-reading Cudgel's post, I keep reading it two ways: Here's my experience from socialist European country: Almost all major cities (e.g. 200.000+ pop) have a treatment center in the city. Often these consist of several locations with different functions. In my current 150.000 population city there's a large location where alcohol and drug addicts can visit an addiction medicine doc. This is usually a GP with additional training. On this location there are user areas (separate for alcohol and drugs) where addicts are allowed to bring in their own supply of whatever floats their boat and use them indoors. There's a nurse supervising and making sure there are no products being sold. Crack pipes and lighters are available for 1 euro and the rest of the drug paraphernalia is free (e.g. mesh filters, straws and aluminium foil for crack, post it notes, needles etc.). Everyone is allowed to stay for 30 minutes. They can do this as often as they want. The main purpose of this room is to reduce the burden of drug and alcohol addicts on the rest of the city. For all the people using heroine there is an option to get free scheduled methadone. There's also a separate group of addicts that keep using heroin next to the methadone that instead get free heroin, they get to use this 1-3 times a day under supervision. Basically these patients have given up on becoming drug free. To me this looked a lot like palliative sedation. The same location also has facilities like a free barber, laundromat and optional programs to get these long-term addicts to do stuff like cleaning up in the streets or chopping wood to be sold. A separate location is used for short-term detox of all addicts that want to be treated in an in-patient setting. If the short-term detox is successful they get the option to move for 1-2 months to a long term treatment facility. At every step of the way there is free mental and physical health-care. At any current time 80% of these treatment facilities are occupied by frequent flyer addicts that are re-admitted once a every couple of years. For a lot of these patients there is a strong underlying mental health aspect: I recently saw a patient who was sold to gypsies (her words not mine) by her father when she was 6 and was sold into prostitution at age 16. Got married, stayed clean for 10 years, husband died and she couldn't cope so she relapsed and neglected her children so they were taken away by CPS. The obvious problem is that the societal costs are still huge (about 40.000 euro per person per year), you cant park your bike anywhere near any of the treatment centers because it will be stolen within in the day (they sell it for 10 euros, which is about what a gram of cocaine costs here) but burglary or robberies are rare. It's not perfect but I thinks its the best system I've heard of so far, and beats just making it legal and freely available.
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Mar 6, 2016 21:35
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