- shame on an IGA
- Apr 8, 2005
-
|
Like seriously, I'm 30 and it's amazing how many people I went to HS with have grandchildren.
|
#
¿
Apr 20, 2017 21:58
|
|
- Adbot
-
ADBOT LOVES YOU
|
|
|
#
¿
May 12, 2024 19:16
|
|
- shame on an IGA
- Apr 8, 2005
-
|
Carfent isn't a drug problem, it's a chemical weapons problem.
|
|
#
¿
May 25, 2017 23:45
|
|
- shame on an IGA
- Apr 8, 2005
-
|
I have a small ray of hope only because ultra-right-wing then-SC-congressman now OMB-director Mick Mulvaney (and also slightly moderate SC congressman-R Mark Sanford) actually signed the letter asking DEA to back off of kratom
E: holy poo poo Steve King R-IA as well
shame on an IGA fucked around with this message at 06:15 on Jun 8, 2017
|
|
#
¿
Jun 8, 2017 05:48
|
|
- shame on an IGA
- Apr 8, 2005
-
|
If they'd just let every doctor cut bupe scripts it wouldn't matter but no we are a nation of retards
|
|
#
¿
Feb 9, 2018 01:18
|
|
- shame on an IGA
- Apr 8, 2005
-
|
I mean just go look at the TCC thread. I haven’t looked at it in years but it turned into junkies waiting for their UPS packages pretty quickly
The Pavlovian Cult of FedEx was about some insane extract that was almost certainly stuffed with as yet unknown RCs or if you trust the two people who've say they've analyzed samples, it was o-DSMT
E: the reason I mention buprenorphine specifically is all of these roadblocks to getting the appropriate waiver as a doctor and then the low cap on how many patients they can have once the hoops have been jumped: https://www.ncbi.nlm.nih.gov/books/NBK64234/
shame on an IGA fucked around with this message at 05:38 on Feb 9, 2018
|
|
#
¿
Feb 9, 2018 05:31
|
|
- shame on an IGA
- Apr 8, 2005
-
|
Interesting, then-congressman now-OMB-director Mick Mulvaney signed on to a letter asking DEA to back off when they tried to schedule kratom last year
https://www.usnews.com/news/articles/2016-09-23/45-congressmen-ask-dea-not-to-ban-kratom-next-week
|
|
#
¿
Feb 9, 2018 06:01
|
|
- shame on an IGA
- Apr 8, 2005
-
|
people online sell plain kratom leaf around $70/kg and seem to do okay so I'm sure all these retailers charging people who don't know better literally ten times that much have awesome balance sheets.
|
|
#
¿
Feb 9, 2018 22:56
|
|
- shame on an IGA
- Apr 8, 2005
-
|
If they have access to a pill press, why not just cut the pills with neutral agents like chalk (doubling or tripling profit)? If you weren't super greedy, you could even cut the pills to ~75% of their original strength and your customers wouldn't even notice.
It's this except nobody doing it accounts for the fact that mixing powders consistently and homogenously is loving HARD.
|
|
#
¿
Feb 21, 2018 15:26
|
|
- shame on an IGA
- Apr 8, 2005
-
|
Also yeah that article is an embarrassment and it's basically worthless self-promotion on the backs of actually suffering people which is super gross - even grosser than Zizek normally os
Whoa whoa let's not say things we can't take back about how gross Zizek normally isn't just because this article didn't include a video
|
|
#
¿
Mar 29, 2018 03:00
|
|
- shame on an IGA
- Apr 8, 2005
-
|
FFS just let everybody prescribe bupes and remove the patient caps that'll go a loooong way toward fixing this poo poo
|
|
#
¿
Nov 29, 2018 22:09
|
|
- shame on an IGA
- Apr 8, 2005
-
|
Does anyone here have any experience (provider, patient, or other) with Sublocade, the injectable buprenorphine? Apparently it's coming down the pipeline in Canada and I know nothing about it.
At least in the states, it's a shameless cash grab being marketed heavily to judges and prisons because patients can't just take generic subs instead of the $1500 shot if it's specified by name on a court order.
|
|
#
¿
Jan 19, 2019 03:33
|
|
- shame on an IGA
- Apr 8, 2005
-
|
In the US at least the first steps would be to make bupe a hell of a lot easier to prescribe and to genocide all the boomers.
|
|
#
¿
Apr 6, 2019 02:37
|
|
- shame on an IGA
- Apr 8, 2005
-
|
I wrote something - specific to Alberta, where I live and work, but probably not all that different wherever you are. I mostly needed to get my thoughts in order, and writing helps. Maybe posting it will, too, IDK.
I lost another patient to overdose recently. I suppose that’s not that surprising – about once a week I have a patient die from an opioid OD, these days – but this one hits harder than most. He was a young guy, and like me he enjoyed playing video games. We’d had discussions about which DLC for Witcher 3 was better (he said Blood and Wine, I liked Hearts of Stone) in between discussing how best to treat the giant monkey on his back. However, recently we’d lost touch – he’d stopped going in for his methadone, and sometimes that just means that someone’s had a relapse, but sometimes it means that they’ve overdosed and I’ll find out later. Usually I get a call from the medical examiner or, in this case, when his partner told us a couple of months later that’d he’d died in his dad’s basement.
This has happened so much in the past two years, frequently with patients I’ve known for over a decade. When I get a chance to sit with this, when my pandemic hours revert back to ‘normal’, I’m sure I’m going to have to deal with all this death and grief. But for now I’m just left with a profound sense of hopelessness. Unlike with a lot of additions, I essentially had a magic bullet in my toolkit when it comes to opioids in the form of buprenorphine; magic stuff, it treats opioid cravings as well as preventing overdose from most other opioids. But the problem is that the fentanyl and, latterly, carfentanil coming in during the pandemic is so powerful that bupe isn’t strong enough to treat everyone.
And this makes sense, in a way. Like most mental illnesses, most people don’t seek treatment for their issues for addictions – part of that is stigma, part of that is lack of availability, and part of it is simply denial that it constitutes a problem. Moreover, in my experience most addiction is deeply rooted in trauma, and serves as a coping mechanism to deal with the consequences of cruelty I can’t even comprehend. When you stop using, you have to deal with all of that horror flooding up. My drugs can help, but they can’t do this alone.
So what can we do to stem this tide, this epidemic that’s killing as many Albertans as COVID? Access to buprenorphine would help – not every physician offers it as part of their practice, even though it doesn’t require a triplicate. Teaching it well in med school and residence would be a start. Encouraging and incentivizing providers to do it as part of their practice – especially in the corrections system – would help as well.
For patients who fail the traditional therapies of suboxone and methadone, and there are many reasons why that may be, injectable opioid agonist therapy is an option that’s well supported by evidence – that’s where physicians and nurse practitioners prescribe an opioid that’s much safer to inject than anything found on the street, and the outcomes I’ve seen from that are much better than patients continuing to inject street drugs. Unfortunately, our present government in Alberta is opposed to this on principle, and has tried to close our iOAT programs. After winning a court battle, iOAT is allowed to continue to treat its present clients, but they can’t take on any new patients.
If patients can’t get into iOAT or can’t manage the scheduling required for that, what else can they do to keep themselves safe? Well, they can use in a safer consumption site (SCS)… or at least, they could, if this government wasn’t also trying to close all of those. The availability of this has dropped substantially, and now there’s essentially none in any smaller centres. It also doesn’t solve the issue that the substances they are injecting are so powerful that there’s still a high risk of overdose, although in SCS at least there’s a very good chance the overdose can be reversed.
There’s been some talk and movement towards the concept of ‘safe supply’, wherein the patient gets pharmaceutical grade opioids with the intent that they will be injecting them; it’s substantially safer than injecting whatever the hell is in the fentanyl that’s out there. I don’t know how I feel about this, fully, as a provider – it’s certainly not the safest option, compared to the previously listed treatments, and the amount of opioid you’d have to prescribe to compensate for the weapons-grade street stuff they’ve been taking is… substantial. But the point of harm reduction is meeting patients where they are to try to a) keep them alive, and b) move them towards safer options. Anyhow, it’s a moot point, because our enlighted government is presently hosting yet another sham committee that’s preordained to tell us how bad safe supply is and how we can never use it.
What IS the Alberta government trying to do? Well, they’ve been focussed on providing ‘treatment’ beds for patients. For some people, having a bed in a residential treatment facility can help give them time away from their addictions and give them some coping skills. However, in my experience it doesn’t do enough to treat the underlying causes of continued use i.e. untreated trauma and dire housing situations. Also, getting completely off of opioids is hard; “detox” and residential treatment, if not combined with opioid agonist therapy, is no better than no treatment at all. Finally, I have not seen a substantial increase in the availability of treatment beds for my patients – maybe if they had enough money to go to private facilities (coincidentally run by donors and friends of the present government) they’d have access, but alas, I have chosen to work in an inner-city environment.
It certainly doesn’t help that housing is more of a crisis than it’s ever been. Rent is going up, but funds for people who can’t work aren’t. I used to be able to get ‘housing allowances’ from Alberta Works for my patients, but those are nearly impossible to get now. People on ‘medical welfare’ get $330 in rental funds per month. This will not get you a place literally anywhere in Alberta. Also, if you’re homeless you don’t get even that because your housing needs are being met by homeless shelters! Nothing wrong with that whatsoever! I have never seen anyone who’s not housed get their addictions under control. I can’t argue with that; if I were on the street, or jammed cheek by jowl into the shelters here, I’d want to be as messed up as possible.
There are solutions for the drug poisoning epidemic, but they require foresight and investment, neither of which are in copious supply in Alberta in 2022. Until that situation improves, I’m going to continue seeing my patients die, one by one. And I’m going to get around to writing the medical examiner for information on the deaths of dozens of people I’ve known for years.
When it doesn’t hurt quite so much.
This is an incredibly powerful post and I hope you will consider sharing far and wide outside of these dead forums. Send this to your newspapers and elected officials.
|
|
#
¿
Feb 23, 2022 22:22
|
|
- Adbot
-
ADBOT LOVES YOU
|
|
|
#
¿
May 12, 2024 19:16
|
|
- shame on an IGA
- Apr 8, 2005
-
|
hell send it to my newspapers and elected representatives
|
|
#
¿
Feb 23, 2022 22:25
|
|
#
¿
Apr 20, 2017 21:58
