Should I Go to a Pain Clinic?

[thetalkingasshole (OP)]

So like the heading to this subforum says
this is partially about enjoying myself in the best of health
but also keeping myself in the best of health
more so mentally than physically, as i take opiates for psychological reasons, not physical

but unfortunately societal stigma is still too much for ethics
and so i cannot be prescribed the only medication ive found effective


I want to know your opinions on if I should go to the pain doctor or not
Because of where I live, and my very nice dealer, I can get into see someone
few questions asked, lies accepted as truth, and I am on my way to the pharmacy

something tells me CVS or Walmart, or any pharmacy, charges $25/pill for MS Contin

I'm currently spending a little under half my paychecks to stay well
thats on a good week
weeks i only get 2-3 days, i am in big trouble


this is by no means a good situation
i see this ending with me getting arrested for buying drugs
(which means I can kiss my political career goodbye!)
probation, and the never-ending bullshit of having a record
(jobs, even housing, becoming VERY scarce)
and never moving out of my god damn parents house


the sane, harm-reducing, CORRECT answer is
stop doing dope, deal with withdrawal, get a life
but i live in reality so I'm hoping for some more useful answers

doing this would take me down from spending around 800/month
and breaking the law every few days,
and constantly worrying about if my guy is even alive (frequently in the hospital)
and bring me to spending 300/month, legally, at the pharmacy

so yeah, it seems to make sense
if i plan to stay on for even another month
but it seems to me like this means accepting this as part of me
an important part, that i need as part of me
and that is very hard to accept
especially since i have been getting shit on a lot lately for using

and for the record, i do plan to keep using for the foreseeable future

[Sand and Water]

So like the heading to this subforum says
this is partially about enjoying myself in the best of health
but also keeping myself in the best of health
more so mentally than physically, as i take opiates for psychological reasons, not physical

but unfortunately societal stigma is still too much for ethics
and so i cannot be prescribed the only medication ive found effective


I want to know your opinions on if I should go to the pain doctor or not
Because of where I live, and my very nice dealer, I can get into see someone
few questions asked, lies accepted as truth, and I am on my way to the pharmacy

something tells me CVS or Walmart, or any pharmacy, charges $25/pill for MS Contin

I'm currently spending a little under half my paychecks to stay well
thats on a good week
weeks i only get 2-3 days, i am in big trouble


this is by no means a good situation
i see this ending with me getting arrested for buying drugs
(which means I can kiss my political career goodbye!)
probation, and the never-ending bullshit of having a record
(jobs, even housing, becoming VERY scarce)
and never moving out of my god damn parents house


the sane, harm-reducing, CORRECT answer is
stop doing dope, deal with withdrawal, get a life
but i live in reality so I'm hoping for some more useful answers

doing this would take me down from spending around 800/month
and breaking the law every few days,
and constantly worrying about if my guy is even alive (frequently in the hospital)
and bring me to spending 300/month, legally, at the pharmacy

so yeah, it seems to make sense
if i plan to stay on for even another month
but it seems to me like this means accepting this as part of me
an important part, that i need as part of me
and that is very hard to accept
especially since i have been getting shit on a lot lately for using

and for the record, i do plan to keep using for the foreseeable future

The only downside I see since you're saying you really do need PM, is if the Dr gets caught up in an audit/sting and you/you're insurance is flagged. Otherwise, I say save yourself the $$, stress and risk and get that appointment ASAP. Good luck man!

[10kites]

I think that you should go for it. Harm reduction at it's best, not having to take the risks of scoring on the street. My Dr's been writing for me for 12yrs and my life is much better because of it. For 25yrs before that I was hitting the streets and was constently getting locked up, beat up, ripped off or some other such shit. I'd hate to have to return to that. Good luck with it.

Why the hell would you have to pay $25 per pill at a pharmacy for MS Contin? Seems like they would be much cheaper than that.

Actually, the correct, sane, and harm reducing answer is NOT quitting, dealing with withdrawal, living in reality, etc.

The correct, sane, and harm reducing answer is for you to safely do whatever is right for you, whatever allows you to live your life in the best possible way.

[thetalkingasshole (OP)]

I think that you should go for it. Harm reduction at it's best, not having to take the risks of scoring on the street. My Dr's been writing for me for 12yrs and my life is much better because of it. For 25yrs before that I was hitting the streets and was constently getting locked up, beat up, ripped off or some other such shit. I'd hate to have to return to that. Good luck with it.

Why the hell would you have to pay $25 per pill at a pharmacy for MS Contin? Seems like they would be much cheaper than that.

Actually, the correct, sane, and harm reducing answer is NOT quitting, dealing with withdrawal, living in reality, etc.

The correct, sane, and harm reducing answer is for you to safely do whatever is right for you, whatever allows you to live your life in the best possible way.

This is exactly the kind of response I needed to see

And for the record, im currently paying $25/100mg MSC
I have heard they are between free and less than $1/pill
So ive heard...

[thetalkingasshole (OP)]

I should also add I would obviously receieve more than a months supply
most likely of two, possibly three different meds

I was told to be prepared to switch to oxy ER and IR at first
then potentially something else after that
a benzo is almost obligatory, although I have no interest

This means a surplus, a good problem
or a whopping increase in tolerance, a total nightmare

[suboxstitute]

I wouldn't even hesitate for as long as it took me to write this response:  I'd make the appointment yesterday.    If you can get in to see someone at a pain clinic where "few questions are asked" and scripts are written that puts you across the fine line that is not-criminal vs. criminal I say GO FOR IT.    YESTERDAY!!!!!   

Yes, if the doctor is raided or flagged your name could be dragged through the mud along with him or her, but I'd take that chance.  I really would.    I don't feel that the (legal) consequences to individual patients are much of anything to worry about. 

I can relate so much to your comment that you use opiates for psychological pain vs. physical pain.   And psychcological pain is every bit as valid.     I think many of us opiate addicts found that taking our first opiate way back when made us feel so much better emotionally and psychically ; that was the hook that kept us coming back, not the "high".  At least not the high in the sense most people think of it.     

It's so frustrating that those dirty, awful opiates could actually provide help to so many people - I'll bet you're one of them - with a sense of well-being & the ability to be motivated, productive and happy that is equal to or better than what a person gets with the frequently prescibed and "oh-so- much-mor -socially-acceptable" anti-depressants (SNRIs like Cymbalta & Effexor and SSRIs like Lexapro & Prozac),  anxiety meds (benzos), and the list goes on. 

I even felt great (that sense of well-being, calm, productive, energetic, HAPPY!!!) from that otherwise pretty useless pill tramadol.  Sure enough, it's an opiate-type med and an SNRI at the same time (I don't understand the pharmacology but I know this to be true.....)    But even getting that?  No way, sorry, you might get addicted.

It was the same way with bupe when I was in recovery from opiate abuse (oh - and not tramadol here, I got addicted to REAL opiates thank you very much!)  Suboxone really helped my depression SO MUCH.    I actually wanted to stay on it indefinitely but that that wasn't the "protocol:, couldn't be done, blah blah blah. 

I could go on and on about my wish that someday we'll use opiates again to treat depression and other illnesses.  Of course, we've been going in the wrong direction for decades and took a SERIOUSLY  wrong turn when hydrocodone was transferred to schedule II.      So it will never happen.  So, given that it will never happen, if you can find a legit path to an opiate script I say take it and sleep well with a clean conscience.   


"It is no measure of health to be well adjusted to a profoundly sick society".   (The Indian philosopher Jiddu Krishnamurti)



tl;dr   You should get an appointment YESTERDAY and the medical establishment should use opiates  (even tramadol & bupe can work well!) to treat depression. 

[makita]

+1 to everything 10kites and suboxstitute said.  That IS harm reduction and this is how everyone deserves things to be, so if you have the opportunity take it.

For all we are told of these supposedly inspiring stories about hitting bottom, people almost never really quit and stay quit because they are forced into a corner by awful and desperate circumstances (your deal with withdrawal and get back real life plan).  They quit and stay quit when they have the resources, both external and internal.  Stability and absence from the everyday fear of copping and police, and absence of poverty (because you're paying $1 pill instead of $25), are the kinds of things that allow one to build resources.  So if that is a goal of yours in the long term, getting on PM could help with that. 

Tolerance can be lowered with time, tapers can be done.  And its also a lot easier to stockpile and not take every opiate you get when your source is stable and reliable and you know you're getting the same amount next month.  But police records are forever.

Just make sure you have a backup plan for if this dude gets busted, even if that backup plan is methadone.

After approaching 20 years on opiates I can tell you with certainty; there are worse things than tolerance/dependence/addiction.  Like wasting your life running from police and being depressed/anxious and unable to function.  After years of doing/selling heroin and more years on the klinik (which offers a great deal of stability in comparison, but you still get the stigma, even from them at a lot of places), getting on PM was one of the best things that ever happened to me.  Now I feel and am treated like a fucking human being by most people, even when they know.  I cant even explain what a difference all the little and big things about that that makes to my self esteem and ability to function in the world. 

[Narkotikon]

I definitely agree with 10kites, Suboxstitute, and Makita.  They gave excellent advice and perspectives.  If I were in your situation, I'd go to that PM in a second. 

As others said, just make sure you have a backup plan if that doctor gets taken down.  IIRC, you're in FL, and pain clinics are scrutinized there now b/c of the heyday several years ago.  Stockpile and think about the clinic if that happens. 

I'm a big proponent of morphine maintenance.  Other types as well.  I think opium maintenance is an excellent option as well b/c of it's longer half-life, and the fact that it hits the receptors with all its different alkaloids. 

It's such a shame pods aren't as plentiful in the US now, and aren't as good from what I've heard.  Plus the price is outrageous.  I just can't see myself maintaining on pods anymore.  Even if I could ever afford them everyday, the quality wouldn't be there.  I miss the days of AZ Purples. 

I'm assuming the $25 per 100mg MS-Contin is a street price.  You can definitely get them much cheaper at the pharmacy.  They're generic, and morphine in general is cheaper than other opiates. 

If you have insurance, the cost may even be free.  I know if I ever got scripted MS-Contin, I'd get them for free.  Simply b/c I have no co-pay on generics.  And only $3 on brand. 

I've always said I'd love to be on morphine for maintenance.  I'd be quite happy, thrilled even, if I got 2-3 100mg MS-Contin per day.  Especially if it was legal. 

I've always wanted to live in late 19th century, for many reasons, one of which is it was the heyday of legal opiate consumption.  Laudanum maintenance would have been my choice back then.  Morphine maintenance a close second. 

Good luck, and do this.  I definitely think it will improve the quality of your life, which is what HR is all about.  You're right, opiates are a great antidepressant.  Most opiate addicts say opiates give them energy, reduction of depression and anxiety, and make them more functional, motivated, and overall happier.  I know that's how it was for me. 

...........................................................................

@ Suboxstitute.  What was their reason for not letting you stay on it indefinitely?  Have you ever thought of switching to a new doctor? 

You'll also be interested to know that Harvard University and some other places are studying bupe as an antidepressant.  Hopefully one day it will be approved for hard-to-treat depression, or depression in general.  Perhaps that would entice other doctors and researchers to consider studying full-agonist opiates for depression.  Or even maintenance. 

[suboxstitute]

@Narkotikon -  The reason for not letting me stay on bupe indefinitely was simply that it was not the clinic's philosophy/protocol.   Everyone was pushed to get off within a year. Never mind the evidence that being on bupe indefinitely can work very effectively for some people. 

The frustrating thing was that the main physician (a psychiatrist with a sub-speciality in addiction medicine) felt that bupe was really helpful in treating depression and that I would be a good candidate for scripting it off-label for that purpose.  Never happened for a variety of reasons. 

[Narkotikon]

@Narkotikon -  The reason for not letting me stay on bupe indefinitely was simply that it was not the clinic's philosophy/protocol.   Everyone was pushed to get off within a year. Never mind the evidence that being on bupe indefinitely can work very effectively for some people. 

The frustrating thing was that the main physician (a psychiatrist with a sub-speciality in addiction medicine) felt that bupe was really helpful in treating depression and that I would be a good candidate for scripting it off-label for that purpose.  Never happened for a variety of reasons. 

I really dislike that kind of "philosophy."  Even RB says Subs can be used for as long as necessary.  I hate when doctors make arbitrary time limits, and forcibly take people off it before they're ready.  IMO, 1 year isn't even enough time to work on most issues and make serious life changes.  The long you're on it, and stable, the more likely you're able to deal with the things that caused your addition in the first place. 

I've had a few doctors like that too.  I just switched to a new doctor.  I know the only think keeping me off opiates, and therefore stable, is the fact that I take Subs.  If I weren't, I know I'd be using.  I just know myself in that respect. 

Doctors in this country need to understand what maintenance really is.  Maintenance implies taking the replacement opiate for as long as necessary / wanted.  It shouldn't have time limits.  That's not maintenance IMO.  That's just a period of stabilization then forcible detox.  So not good. 

Sorry the psychiatrist wouldn't let you take it off-label for depression.  I really don't like doctors who tell you these amazing things, get your hopes up, then dash them in the end.  It's like taking hope away from a patient. 

[makita]

regarding your other thread about dating, people are MUCH more accepting of opiates for pain control when prescribed by a regular Dr then they are for maintenance/addiction reasons.  It's like night and day.  And much more likely to understand the need for continued pain control, the plight of pain patients with opiophobia, etc.  Those kinds of things can be a way in with average people who know nothing about this stuff to eventually develop a better understanding of these issues and not see opiate use as a nonstarter for relationships. 

I still wont date someone who's like "sure you're cool cuz you're in pain, but fuck those selfish junkies" because I need them to accept all of me, even past/future iterations, and I think its valid to use drugs as a functional coping mechanism and I insist my partners think so too, even if Im not currently doing that myself--they cant disrespect a part of who I am (not to mention some of my friends), and if they're even marginally into social justice (also non negotiable for dating me) then they can  learn to open their eyes to how the drug war and society's attitude toward drug use is based on racist, oppressive ideas about life and human suffering and who deserves what.  And ever since I started approaching it as a political ideology, like something I am going to ASSUME you will understand in order to understand ME, much like how I would expect them to get things like cissexism or misogyny; I've never had to beg for someone's respect again. 

At this point my history as a junkie has majorly improved my character, given me huge empathy and non-judgement capacities that make me excel at my job (therapist) and as a partner and friend.  It made me a more interesting, more emotionally flexible, more authentic, better person, someone who is now uniquely positioned to do a lot of good in this world by helping other people in this life suffer less for it.  Anyone who can't see that can kiss my needle-scarred ass.

Before I approached it this way I did occasionally get people who rejected me even as a pain patient, not because of being currently on opiates but because I disclosed my past as a recreational heroin user and saw it as an important part of myself, not something to be regretted or avoided, and I refused to promise I would never use again (which as I understand it even reformed NA members cannot say: one day at a time and all that).  One bitch 15 years older than me had a friend whose son died of an OD and wouldnt go on a 2nd date with me because she was afraid she would fall in love with me and Id perhaps start using again (at some unknowable, potential date in the future, and after 6 years of abstinence from heroin) and that very rare possible future if it happened would be too hard for her.  I guess the fact that I didnt see heroin use as a catastrophe made her think I was more likely to make that future happen than someone who did (which is not borne out by evidence).  Her loss. 

(I should have told her, "dont worry you're neither interesting nor attractive enough for me to want to date you long enough for that future to occur.")

But Im saying, PM helps.  And being proud of who you are helps more.  It took the former for me to get to a place where the latter was possible.

[thetalkingasshole (OP)]

Youz guise are teh shit

I'm going to be looking into an appointment for some time this month

I STRONGLY believe in all that you have said, ESPECIALLY makita
For a long time I was proud of who I was
Proud that I could openly admit I needed something to help me get my life straight

People would, and still do, laugh in my face (at best) or ridicule me as a total fool
when I tried to tell them how much my life has improved while maintaining on morphine

It is a HUGE part of who I am
and has imparted upon me values I would have never dreamed of having
empathy, compassion, acceptance of others for exactly who they are NOW,
not for their potential, or what they COULD be

And most importantly it taught me to accept myself as I was (well, as I was + morphine)
To not compromise that for anyone
and to not let anyone convince me that it makes me an inherently bad person

I am a fairly socially conscious person, or at least I try to be
Unfortunately the rights of drug users is well below everything else
on the list of shit we are going to see as socially acceptable


I could rant on this all day, and I just might


How about a thread dedicated to combating negative perceptions and stereotypes of drug users?
We need to elevate the discussion beyond what we have here
It can have a huge impact, I know it can
We have some of the best and brightest minds "our kind" (self-segregation....) have to offer!

[thetalkingasshole (OP)]

So I am finally gling to get the info I need
at a price of course 

Half my first script of IR meds
most likely #30-45 4mg hydromorphone

But thats it!
He said all I have to say
is that I have been having to buy my meds on the street!

"Hey doc, I'm hurting real bad and cant afford to buy my shit from one of your patients"
"Thats ok, I will write you for whatever you need"

Does anyone else think that^^^^ is even possible?
Apparently so haha

[corlene]

Before Sept 2010 u could want into any pill mill, tell the doctor u don't have pain and walk put with no less than 240 30s 120 15s soma and xanax, all for 175 dollars a visit, and for u ease they would also fill those scripts I  house for a huge markup so u could avoid going to a legit pharmacy..

Most of the mom and pops would fill any script written charge twice the amount it normally would be and make bank, most of the clinics and mom and pop Pharms also had armed security guards inside and outside the establishments..

[Daughter of Dionysus]

TTA- I know someone who got written a pretty fat script for saying almost exactly that
"I don't want to keep buying them off the street"

I wonder what would happen
To a doc
If he decided to write
Opiates off label
For depression??

I say go for it too
You going to a pain clinic
Is more harm reduction
Then you continuing the way you are