Yeah, they pretty much crush it and snort it. Shilala hit the nail on the head for the most part. Although a lot don't get into it for the pain, but more for the rush and it's usually available; they'll make up a pain story to get the meds. Here in the southern counties of WV, Lortab is the pain med of choice. Lortab 10mg goes for about $10-20 a pill, or more here. Hell, you can walk behind some houses and readily get it if you got the cash, and that's why pill counts don't work, where the doc has you bring in your pill bottles and make sure you're taking the right amount. Also, since we're not to far from the Kentucky border, they go to docs or pharmacies across the border, so the State Pharm board review will not work either, although it does pick out quite a few--a doc can go onto a website and see who got what and where and from which doctor, so that way they can see if they're seeing multiple doctors for the meds, in which case the initial doc will often fire the patient. One problem, although I consider it minor, is that doctors readily prescribe it--it's easy money and income; but there are some that refuse to give any pain medications, and those that actually need it (if they're a patient of the stubborn doc) are often in unnecessary pain that the drug is actually intended to treat! Methadone is a good drug, and it's got a long long half-life and duration of action, so that's why it's used for rehab, it allows you to taper down the dose without sending the patient into seizures from withdraw. Something else to treat, Vivitrol is a naltraxone shot, once monthly. It's currently indicated only for alcohol although it is an opioid antagonist, but they're trying to get the FDA to give the OK for opioids--it works great, because no matter how much you take, you won't feel the effects of it (although I'm not sure about the metabolic effects, if it can still harm you if you take too much, which I'm pretty sure it may--especially if you're doing lortab, vicodin, percocet, lorcet, or any of them with acetamenophen in them--too much of that (ie tylenol) and you lose your liver and life).
Here's another interesting fact, opioids and benzodiazepens often go hand in hand, but more commonly it's with xanax, valium, klonopin, and ativan. Klonopin has mood stabilization effects, so it's good for bipolars with anxiety; valium has muscle relaxation properties, so great for muscle spasms with your pain; xanax, however, is the only one that also hits the side of the receptor that alcohol interacts with (alcohol, benzo's, phenytoin/dilantin, and a couple other drugs all hit the same receptor, just different parts of hit; so xanax hit's both it's side and the alcohol's side), thus you get more request for xanax. And it's addictive because of the short half-life/duration (4 hrs) compared to ativan/klonopin/valium (12-24+ hrs), so you have to keep taking it to get the effects to continue. That's when the tolerance comes in because you have to keep taking it more often.
Lets see now, any thing else want to know?
Quote:
Originally Posted by shilala
Christian, Oxycontin is the pharmaceutical equivalent of heroin. That's why it's sought after. Like TRicker said, junkers snort it, but it delivers a better buzz when they boot it (inject it).
The scenario where problems occur runs something like this...
Drug seeker finds doctor.
Said drug seeker is taken into a "pain management contract" where he/she promises to only get pain meds from that doctor and will only get them at a specific pharmacy and agrees to be subject to random drug screens.
What generally happens is that the patient becomes emotionally and physically dependant on the drugs and manages to screw up their pain management contract in one way or another. They usually find another doctor so they can get more drugs because the dose that the doctor supplies is no longer adequate for their "needs" or they piss hot for some other drug and are thrown off the program.
Once they can no longer score the drugs, they hit the open market for heroin or oxy.
You know how you mentioned they really don't have much effect for you?
It's because opioids work not only on pain centers, they shut off the pain in the brain. A person with excruciating mental anquish will get a huge relief from opioids.
If you don't have a lot of problems and a troubled mind, they just make you sleepy and sick.
The fact that they ease a troubled mind is why they are so addictive and why people find they "need" more and more. As they get used to their initial dose, it becomes less and less effective for their emotional problems and they start "seeking", which means they're gathering more drugs to get the job done.
That's when they find themselves in a tough place because docs are very reluctant to increase dosages. It's easier for them to find another doc a couple towns over and get double the meds, or find a half dozen doctors who will fill their needs.
There's no real "network" in place for doctors or pharmacies to catch folks who are heavily addicted and get them help.
Even if they can, "help" seldom works for addicts.
It's a real tough racket.
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