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  #1  
Old 05-23-2009, 06:56 AM
RickJay RickJay is online now
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How do junkies get all this OxyContin?

A recent article about the dreadful murder of little Tori Stafford details the widespread OxyContin, aka "Hillbilly heroin," addiction problem in her hometown of Woodstock, ON.

I don't understand how all these people are getting enough OxyContin to maintain their addictions. You can't make it yourself. I'm not hearing about any big pharmacy heists. I know for a fact that if any of it goes missing in the supply chain, like from a warehouse, it's a huge goddamn legal storm - it would quite literally be easier to rob a bank. And I had enough trouble getting my dentist to give me frigging Tylenol 3 when she screwed up my tooth. Pharmacies track this stuff, too.

Who's getting the OxyContin? It seems to me it should be easier to get actual heroin.
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  #2  
Old 05-23-2009, 07:18 AM
BigT BigT is online now
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IIRC, most prescription drug abuse is supplied by either (a)getting a prescription when you really don't need it, (b) obtaining the drugs from other people who don't use all of it, or (c) purchasing it from unregulated, disreputable sources (usually out-of-country).
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Old 05-23-2009, 08:08 AM
FoieGrasIsEvil FoieGrasIsEvil is offline
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Isn't Oxycontin super expensive, too?
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Old 05-23-2009, 09:37 AM
Hirka T'Bawa Hirka T'Bawa is offline
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There are a couple ways to get it, the most common way is to go to a doctor who will write you the script for $$$. There are plenty of doctors out there that will pretty much write anything for the money. The other way is through theft. There have been a bunch of break-ins in pharmacies down here in Georgia lately, the crooks break in through the roof, and steal all the good medications. I know of at least 5 pharmacies that have been broken into just in the Savannah area.

For the record, the oxycodone capital of the U.S. is in Broward county, Fl.
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Old 05-23-2009, 09:49 AM
Qadgop the Mercotan Qadgop the Mercotan is offline
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There are also 'patients' who can tell a very good story and put on quite a convincing show for certain pain syndromes. They often go to dozens of physicians across a region, present themselves, and end up with a prescription for the damned stuff from each prescriber. End result: Dozens of month-long supplies of the drug to sell and trade.

It's easier to trip these folks up than it used to be, due to cross-checking by pharmacies to see prescription histories. But it still can be done.

I rarely prescribe oxycontin. While effective, it's far too abusable, and there are usually equally effective narcotics which are a little bit harder to abuse. Methadone for one, but even long-acting morphine sees less abuse than oxycontin, due to the extremely rapid onset of action you can get with the latter, when it's misused.

It frustrates me to see just how gullible a lot of my colleagues are out there. I get literally hundreds of patients who managed to convince their physician that they truly needed 160 mg of oxycontin 3 times a day for their musculo-skeletal back pain. I find nothing on their physical exam that confirms such a dire problem, and I see from their pre-sentence investigation that they've been convicted of knocking over pharmacies and selling drugs since they were teenagers.

Last edited by Qadgop the Mercotan; 05-23-2009 at 09:52 AM..
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Old 05-23-2009, 09:59 AM
Harriet the Spry Harriet the Spry is offline
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This raises an interesting question. To what extent can doctors run a criminal background check on patients? Obviously, you're in something of a unique position in knowing your patients' criminal histories. I can't see it becoming standard, but is that something a doctor specializing in pain management could do? Or be required to do by the state?
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Old 05-23-2009, 10:23 AM
flodnak flodnak is offline
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My husband's aunt is a small animal vet (now mostly retired). She's had several break-ins in her office over the years, and each time the thieves have stolen what she assumes they believed was Oxycontin.

Unfortunately for them, it was canine oxytocin. Which won't get them high, but it just might induce lactation....
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Old 05-23-2009, 11:09 AM
Manda JO Manda JO is online now
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I find the whole system unbelievably frustrating and illogical: when my husband had 12 teeth pulled in one day, the dentist, who has known him for 2-3 years, still won't prescribe more than 15 vicodin. But when my husband has, on a couple occasions, gone to urgent care when an abcess has suddenly flared up in a tooth (he has hereditary rickets, and his teeth are a ruin), the doctors there, who don't know him from Adam, inevitably prescribe 30 vicodin without even being asked. I went into an urgent care one time with pus and blood running out of my infected ear in frankly disturbing quantities and was told to "look for drops at the pharmacy", but I have friends who seem to have infinite prescriptions of every pain-killer and tranquillizer out there. I truly do not understand the system.
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Old 05-23-2009, 01:50 PM
aruvqan aruvqan is offline
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Originally Posted by Manda JO View Post
I find the whole system unbelievably frustrating and illogical: when my husband had 12 teeth pulled in one day, the dentist, who has known him for 2-3 years, still won't prescribe more than 15 vicodin. But when my husband has, on a couple occasions, gone to urgent care when an abcess has suddenly flared up in a tooth (he has hereditary rickets, and his teeth are a ruin), the doctors there, who don't know him from Adam, inevitably prescribe 30 vicodin without even being asked. I went into an urgent care one time with pus and blood running out of my infected ear in frankly disturbing quantities and was told to "look for drops at the pharmacy", but I have friends who seem to have infinite prescriptions of every pain-killer and tranquillizer out there. I truly do not understand the system.
I'm able to get pretty much anything I ask my doctor for, but he also knows that I take exactly what I need when I need it, and it doesnt leave my possession. I hate pills, but recognize that pain control is a good thing ... so I will take them when I absolutely need them.
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Old 05-23-2009, 02:00 PM
KlondikeGeoff KlondikeGeoff is offline
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Funny (I guess) story. I was on Vicodin for more than a month for severe back pain. It did not help enough, so doc put me on morphine. I had just filled a Vicodin scrip for 90 days, so all those pills were left over. I was wondering if I should go downtown and try to sell them

Fortunately, our town has a drug recycling program, so I could safely dispose of them.
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Old 05-23-2009, 02:14 PM
Jettboy Jettboy is offline
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Just go anywhere in South Florida and look for a 'pain management clinic'; it shouldn't be too hard, you can't swing a dead cat without hitting one. Complain about anything from an excruciating back injury to a hangnail and they'll set you right up.
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Old 05-23-2009, 02:15 PM
Spectre of Pithecanthropus Spectre of Pithecanthropus is offline
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Originally Posted by KlondikeGeoff View Post
Funny (I guess) story. I was on Vicodin for more than a month for severe back pain. It did not help enough, so doc put me on morphine. I had just filled a Vicodin scrip for 90 days, so all those pills were left over. I was wondering if I should go downtown and try to sell them

Fortunately, our town has a drug recycling program, so I could safely dispose of them.
How does drug recycling work? I thought that, once dispensed, drugs could not be returned. The patient has to either use them, save them, or dispose of them.
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Old 05-23-2009, 02:17 PM
yabob yabob is offline
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Hmmm. I haven't gotten prescriptions to an opiate pain med, a least in years and years, but let's keep the option open. I don't generally take non-narcotic OTC pain meds, not because I'm apprehensive of any dangers, but because, as far as I can tell, they do squat. I can't recall that I've ever taken any "pain reliever" or prescription non-narcotic pain med, and experienced any pain relief. I recently had a flare up of lower back pain, and took it do a sports doc, preparatory to a round of PT. I had to leave town for a while, and the back pain resolved so I passed on the round of PT, but he gave me a scrip for an NSAID, Meloxicam. Yep, I took 'em, and yep, it did zippo, as far as I could tell. One of these days a condition of that sort is going to have me talking a doctor into some vicodin or something like that to see if THAT works.
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Old 05-23-2009, 02:45 PM
KlondikeGeoff KlondikeGeoff is offline
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Originally Posted by Spectre of Pithecanthropus View Post
How does drug recycling work? I thought that, once dispensed, drugs could not be returned. The patient has to either use them, save them, or dispose of them.
Yeah, i disposed of them to the drug recyclubg place.

I never thought to ask how they get rid of them (they insist that only the pills or capsules be put in a baggie, without the pill container). I know you should not flush them, so perhaps they burn them? I'll ask next time they have the monthly collection.
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Old 05-23-2009, 03:11 PM
drachillix drachillix is offline
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There were also more than a few stories a few years back of Pharmacueticals distributors turning out to be little mini offices with minimal signage. Apparently it was much easier to become a pharmaceuticals distributor for a while than many believed.
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Old 05-23-2009, 03:15 PM
paperbackwriter paperbackwriter is offline
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Originally Posted by Manda JO View Post
I truly do not understand the system.
Probably because you're confusing individual prescriber decisions for a system. There is no system as you're thinking of it. Prescribers have many, many resources that recommend for X condition there are Y drug treatment options, but there's nothing that says to always prescribe vicoprofen for every broken rib (for example).

There are too many factors to ever create such a system: What's the patient's abuse history? What's their liver and kidney function? What other medications do they take? What other conditions do they have? What's their weight? Are they male or female? What level of success has the prescriber seen when prescribing this drug for that condition? What are the local pain management protocols? Has the DEA ever visited or investigated this prescriber? What did the prescriber learn from his or her teachers about this condition?

All these questions, and more, go into every decision about prescribing drugs, narcotics especially. As a patient, you don't see any of this process, just the end result.
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Old 05-23-2009, 03:21 PM
LSLGuy LSLGuy is offline
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Originally Posted by Spectre of Pithecanthropus View Post
How does drug recycling work? I thought that, once dispensed, drugs could not be returned. The patient has to either use them, save them, or dispose of them.
"recycling" in this case doesn't mean "give out to somebody else to take as 2nd hand medicine", but rather "destroy & dispose of the residue in an environmentally safe manner".

Last edited by LSLGuy; 05-23-2009 at 03:21 PM..
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Old 05-23-2009, 04:00 PM
Manda JO Manda JO is online now
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Originally Posted by paperbackwriter View Post
Probably because you're confusing individual prescriber decisions for a system. There is no system as you're thinking of it. Prescribers have many, many resources that recommend for X condition there are Y drug treatment options, but there's nothing that says to always prescribe vicoprofen for every broken rib (for example).

There are too many factors to ever create such a system: What's the patient's abuse history? What's their liver and kidney function? What other medications do they take? What other conditions do they have? What's their weight? Are they male or female? What level of success has the prescriber seen when prescribing this drug for that condition? What are the local pain management protocols? Has the DEA ever visited or investigated this prescriber? What did the prescriber learn from his or her teachers about this condition?

All these questions, and more, go into every decision about prescribing drugs, narcotics especially. As a patient, you don't see any of this process, just the end result.
I really don't think it's always that rational--again, urgent care docs load my husband down with stuff for his teeth, but our dentist would look at the exact same condition and suggest ibufrophin.
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Old 05-23-2009, 04:03 PM
Q.E.D. Q.E.D. is offline
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Originally Posted by LSLGuy View Post
"recycling" in this case doesn't mean "give out to somebody else to take as 2nd hand medicine", but rather "destroy & dispose of the residue in an environmentally safe manner".
No, it does not mean that.
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Old 05-23-2009, 04:47 PM
hotflungwok hotflungwok is online now
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Ugh, I've always wondered the same thing. I have severe nerve damage in my right foot after it was surgically immobilized, anything that puts pressure on my foot causes pain. Yes, socks hurt. I couldn't get my doctor to give me anything for pain. He 'didn't want to treat this with drugs'. Apparently, what he wanted to treat it with was some 'don't need to see you anymore, you're better now, get out'.
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Old 05-23-2009, 08:17 PM
Winsling Winsling is offline
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Originally Posted by Q.E.D. View Post
From your cite:
While details of the laws vary, most allow the return of prescription drugs in single use or sealed packaging from state programs, nursing homes and other medical facilities.

# all donated drugs must not be expired and must have a verified future expiration date.
# controlled substances, defined by the federal Drug Enforcement Administration (DEA) usually be excluded and prohibited.

Vicodin in a baggie isn't suitable on multiple counts.
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Old 05-23-2009, 08:24 PM
Q.E.D. Q.E.D. is offline
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Who said anything about a baggie full of them?
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Old 05-23-2009, 08:29 PM
Winsling Winsling is offline
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Originally Posted by Q.E.D. View Post
Who said anything about a baggie full of them?
The person who took them to the recycling place:
Quote:
Originally Posted by Klondike Geoff
I never thought to ask how they get rid of them (they insist that only the pills or capsules be put in a baggie, without the pill container).
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Old 05-23-2009, 08:35 PM
Q.E.D. Q.E.D. is offline
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Ah, well, I did miss that post.

FWIW, many programs will accept unexpired prescription medications in the original, labeled bottles. But, I don't know of any which will take unlabeled pills in a baggie for actual recycling as above. In that case, presumably they are destroyed, as noted.
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Old 05-23-2009, 10:40 PM
RickJay RickJay is online now
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Originally Posted by yabob View Post
Hmmm. I haven't gotten prescriptions to an opiate pain med, a least in years and years, but let's keep the option open. I don't generally take non-narcotic OTC pain meds, not because I'm apprehensive of any dangers, but because, as far as I can tell, they do squat.
I'm the same way, which is one of the reasons I find this issue interesting. I don't take painkillers regularly or anything, so I can't have built up a resistance, but they just have no effect on me at all. Well, ibuprofen has helped a little with tooth pain and muscle pain, but just a little. Aspirin, no effect. Tylenol, nothing. Presciption opiates? May as well be M&Ms. I've been prescived Demerol once, Vicodin once, and Oxycodone a few times, over the course of 20 years, and every time I may as well have been prescibed a double cheeseburger. I even started a thread on it. I was terribly disappointed with oxycodone. It had no more analgesic effect on me than, say, a peice of toast.

I'll be damned if I know why. I don't abuse painkillers. I don't take any drugs. I don't smoke. My drinking habits amount to about a beer a month, maybe.

So to me this oxycontin phenomenon is fascinating for many reasons. For one I didn't understand where it was all coming from, though this thread is helping. For another, the money involved is staggering; some articles say prices in parts of Ontario go as high as FORTY BUCKS A PILL, holy shit! (In Woodstock, one article cited residents saying the prices really plummented when they opened the methadone clinic.) And finally, to me it's like people are becoming addicted to, say, vitamins or Pez. It's alien to me how anyone could be addicted to something that, to me, doesn't make you feel different.

I've never tried any really high grade dangerous stuff like heroin or cocaine, and don't plan to, so I guess I may never find out.
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Old 05-24-2009, 12:27 AM
berff berff is offline
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Originally Posted by hotflungwok View Post
Ugh, I've always wondered the same thing. I have severe nerve damage in my right foot after it was surgically immobilized, anything that puts pressure on my foot causes pain. Yes, socks hurt. I couldn't get my doctor to give me anything for pain. He 'didn't want to treat this with drugs'. Apparently, what he wanted to treat it with was some 'don't need to see you anymore, you're better now, get out'.
I tore the cartilage in my chest twice in the past two years which caused significant pain whenever I twisted my body even slightly. Another time last spring, I injured my back and could hardly even get out of bed for a period of almost two weeks. And most recently, I pulled a groin muscle or something from lifting weights.

And every single time, the doctor would tell me to just take tylenol or advil (12 advil pills in a 24 hour period). I couldn't even get any codeine.
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Old 05-24-2009, 03:53 AM
Hirka T'Bawa Hirka T'Bawa is offline
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Originally Posted by Winsling View Post
From your cite:
While details of the laws vary, most allow the return of prescription drugs in single use or sealed packaging from state programs, nursing homes and other medical facilities.
Acording to the federal FD&C act, once we dispense medication it can not be returned, the one exception is above, single use packaging that is unopened or altered. There is even some restriction on that.

Quote:
Originally Posted by RickJay View Post
I'm the same way, which is one of the reasons I find this issue interesting. I don't take painkillers regularly or anything, so I can't have built up a resistance, but they just have no effect on me at all. Well, ibuprofen has helped a little with tooth pain and muscle pain, but just a little. Aspirin, no effect. Tylenol, nothing. Presciption opiates? May as well be M&Ms. I've been prescived Demerol once, Vicodin once, and Oxycodone a few times, over the course of 20 years, and every time I may as well have been prescibed a double cheeseburger. I even started a thread on it. I was terribly disappointed with oxycodone. It had no more analgesic effect on me than, say, a peice of toast.
For some people opiates really won't do anything. All opiates do the same exact thing in the body, and most opiates are converted to the same thing. If you don't have the enzyme, or enough of it, that converts something like Codeine to Morphine, it won't do a damn thing for you. I don't remember exactly how much of the population doesn't have the enzyme, but it is somewhere around 5%. So there are plenty of people such drugs as Codeine, Hydrocodeine, or Oxycodiene won't do a damn thing... There are also people who have altered opiate binding sites in their CNS so no opiate will do a thing to them, even Morphine won't work.

Now, this shouldn't effect drugs with a different mechanism of action like NSAIDs, so if you are someone who can't take NSAIDs and Opiates, that just means you lost the medicinal pain reliever lottery.
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Old 05-24-2009, 04:14 AM
Waenara Waenara is offline
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Originally Posted by Qadgop the Mercotan View Post
There are also 'patients' who can tell a very good story and put on quite a convincing show for certain pain syndromes. They often go to dozens of physicians across a region, present themselves, and end up with a prescription for the damned stuff from each prescriber. End result: Dozens of month-long supplies of the drug to sell and trade.

It's easier to trip these folks up than it used to be, due to cross-checking by pharmacies to see prescription histories. But it still can be done.
I know there are some jurisdictions (states in the US, and provinces in Canada) that have triplicate prescription programs to track prescriptions for some classes of drugs that are at higher risk for abuse. They keep track of all the prescriptions each patient gets, and they can also how much (and how often) each physician prescribes those drugs. This makes it easier to keep tabs on patients who double-doctor, and on physicians with bad prescribing practices.

However, not all jurisdictions use these programs, so it would be difficult for a doctor there to easily find out all the prescriptions a patient has been given from different doctors.

Regarding the OP and the incident in Ontario, AFAIK Ontario does not have any kind of provincial prescription tracking program.
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Old 05-24-2009, 04:18 AM
MadPansy64 MadPansy64 is offline
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There are licensed physicians out there who write the prescription for their long-term "upper-class" patients without really thinking about it.

Mom doesn't sell them, but she could -- if she'd take one every 6 or 8 or 12 hours, instead of every four.

It seems to me that pain management is difficult. Some docs over prescribe, and some undertreat, and in the meantime, we have cancer patients in agony while junkies rob pharmacies and the FDA jerks an occasional license.

(Full disclosure -- I turn her timer off, tell her she has already taken her pills, and throw out the "extras" with the kittylitter. I'm a sneaky liar, so sue me. I'm not messing with her Morphine patch, or her Vicodin, or her Ambian or her Xanax)
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Old 05-24-2009, 04:24 AM
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The bathroom medicine cabinets of friends or the parent of friends are also a great resource for junkies. Many junkies will make excuses to use the bathroom and swipe as many drugs as they can.
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Old 05-24-2009, 06:47 AM
Little Nemo Little Nemo is offline
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It frustrates me to see just how gullible a lot of my colleagues are out there.
The stories I could tell. One of our doctors can't seem to grasp the importance of looking his office door when he leaves. Even after somebody went into his office and stole his prescription pad and stamp - which he forgot to report was missing for twenty four hours. We've had to assign a guard to watch the doctor's office and lock the door behind him.
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Old 05-24-2009, 12:14 PM
Crafter_Man Crafter_Man is online now
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The bathroom medicine cabinets of friends or the parent of friends are also a great resource for junkies. Many junkies will make excuses to use the bathroom and swipe as many drugs as they can.
My cousin did this about 10 years ago.

I went to the doctor for something (forgot what it was now), and he prescribed me some pain medication. I don't even recall what kind of medication it was. I didn't take it... I have never taken pain meds, so I just threw it in the medicine cabinet. A few month later my cousin paid a visit. After she left I noticed the medication was missing.

As long as I've known her, she has complained about vaguely described "head pains," and routinely visits doctors for treatment. I'm guessing she got hooked on pain meds.
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Old 05-24-2009, 03:05 PM
Qadgop the Mercotan Qadgop the Mercotan is offline
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It's alien to me how anyone could be addicted to something that, to me, doesn't make you feel different.
Your experience is not universal.

For me, my first experience with opiates was like a great big hug from God. All anxiety, fear, doubt, restlessness, and anything else that had ever been bad in my life was swept away, replaced by a sense that I was okay and everything was not going to be just all right, but wonderful. My first thought was "so this is what has been missing from my life!"

And that was from a teaspoon of codeine cough syrup I had been given for a bad cough.

Taking a drug which makes one feel wonderful, even when they have essentially nothing to feel wonderful about, eventually becomes problematic.

Last edited by Qadgop the Mercotan; 05-24-2009 at 03:06 PM..
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Old 05-24-2009, 03:25 PM
Tamerlane Tamerlane is offline
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Originally Posted by Qadgop the Mercotan View Post

And that was from a teaspoon of codeine cough syrup I had been given for a bad cough.


That's astounding. Would you call that an uncommon hypersensitivity ( it certainly seems like it from where I'm sitting )? And given your history what would you do today for serious pain relief, assuming a major injury or chronic condition? Would non-opiate pain relievers do the job for you, without triggering that kind of extreme euphoria?
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Old 05-24-2009, 04:05 PM
RickJay RickJay is online now
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Your experience is not universal.
Well, I assumed that. It's part of what makes it fascinating.
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Old 05-25-2009, 09:43 AM
Qadgop the Mercotan Qadgop the Mercotan is offline
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That's astounding. Would you call that an uncommon hypersensitivity ( it certainly seems like it from where I'm sitting )? And given your history what would you do today for serious pain relief, assuming a major injury or chronic condition? Would non-opiate pain relievers do the job for you, without triggering that kind of extreme euphoria?
That response is pretty typical for people who have an opiate addiction.

The euphoria does tend to diminish over time, until large doses of opiates are needed just to feel somewhat normal.

And for serious acute pain, there is no substitute for opiate pain relievers; when given in such situations, the euphoria tends to be subordinate to the pain relief. So say I and other folks I know who have needed to take opiates for brief periods, for significant acute pain.

For headaches, back spasms, and mild to moderate strains and sprains I rely on ibuprofen and tylenol, though.

For chronic non-malignant pain, opiates aren't all that great of a choice for many folks, anyway. Since most chronic pain is due at least in part to nerve remodelling, opiates will generally be needed in higher and higher doses over time to treat such conditions. Side-effects of the opiates (like severe constipation and sedation) tend to outweigh pain-relieving effects in the long run.

For those situations, meds which re-program how nerves transmit pain signals may show more beneficial results. Gabapentin, pregabalin, amitriptylene, carbamazepine and others can be used for that.
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Old 05-25-2009, 10:05 AM
PoorYorick PoorYorick is offline
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Originally Posted by Qadgop the Mercotan View Post
And for serious acute pain, there is no substitute for opiate pain relievers; when given in such situations, the euphoria tends to be subordinate to the pain relief. So say I and other folks I know who have needed to take opiates for brief periods, for significant acute pain.
Yeah, I was kind of pissed off when I was prescribed Vicodin and Lyrica for my facial nerve pain, and it didn't even get me high. You'd think there'd be an upside to the whole Bell's Palsy thing. Took the edge off the pain, though.
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Old 05-25-2009, 11:07 AM
DJBFivE DJBFivE is offline
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There was an article here in the paper(I'm in FL) that said 60% of the nation's oxycodone scripts written last year were written in Broward county (Ft. Lauderdale). People carpool down from Tenn, WV, KY, and pretty much every other state and hit the pain clinics down here. Between Fort Lauderdale and West Palm Bch, there are probably a couple hundred pain clinics. People drive down here because 1)no doctor in their home state will write the scripts, and 2)it's ridiculously cheap.

There are MRI places all over FTL and WPB that do MRIs for $200-250. Then you just take your MRI to a pain clinic and get the typical setup: 180x Oxycodone 30mg and 60x oxycodone 15mg. Some places also disburse Xanax with those 2 scripts...I've heard of people getting 240 and up to 300 30mg pills monthly. The doctor visit is $200 or so. Street value in TN,KY, etc on what you are getting when you 180/60/60 (30s, 15s, and Xanax bars) is around $7000-$7500. (Here in FL, street value is about 1/2 that)...so a group of 4 people carpooling to FL can drive down, spend under $1000 for the doctor visits and $1500 or so to fill the scripts, and ride back with $30,000 worth of pills in the car.

I go to one of these clinics to treat chronic pain, so I know pretty much how the whole deal works. Most of the MRI places are crooked, if you pay their fee, they will find something wrong with you, whether it's true or not. Also, FL has no statewide tracking system for patient info, although it was just passed as emergency legislation to start one. The governor is due to sign it soon. It will allow your medical data to be assigned to your DL, so any cop that pulls you over can also see your medical history. I have a problem with that...I can admit there is a painkiller problem in FL, and the DEA is really cracking down on pharmacies and doctors, and the state to enact a tracking system, but it shouldn't be accessible by DL info. I would rather see one that doctors can get into, and then see if you have been given anything recently.

I have a friend who owns an independent pharmacy here in Jacksonville, they were given a directive by the DEA not to fill any scripts for narcotics for out of town people. I also know of a couple of pain clinics in particular that are being heavily watched by the DEA and state police (they will follow people who leave to pharmacies and pull them over). One clinic I know of in particular has to be seen to be believed. I've been told by several people it's owned by a biker gang. EVERY employee is a male, mostly with long hair and tons of tattoos (except for the DR). There are bouncers who patrol the front door and parking lot. They see over 300 patients a day, most from out of state. If there is a long line and you are a walk in customer, you can tip the male receptionist $20 and he will move you up the list. If you are going to fail your drug screen, you can tip the guy $20 when you hand it to him and he will pass you. I've got an acquaintance who goes to this one, and he has seen people tipping the bouncers(not sure what that gets you). He legitimately has 2 herniated discs and 1 other bulging disc in his neck/back, and on his initial visit, he was given 180x30mg, 60x15mg, 60x xanax 2mg, and 60x Soma 350mg.

Other states complained to the DEA so much (one sherriff said every time he busts someone selling OC, the script is from FL) that the DEA is pushing the state to clean up it's act. People are driving down cars full from other states, staying for 2-3 days, and seeing a different doctor each day. They then ride back with $75K to $100K worth of pills, which hits the streets in their respective home towns.

Last edited by DJBFivE; 05-25-2009 at 11:10 AM..
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Old 05-25-2009, 11:35 AM
Diogenes the Cynic Diogenes the Cynic is offline
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Wouldn't it be easier just to de-schedule the stuff and let the junkies knock themselves out? It would at least eliminate the street value, as well as the charades being enacted in crooked pain clinics, not to mention the theft from pharmacies. I don't see what good is accomplished by trying to schedule it and control it. It just seems like it just creates problems, it doesn't prevent them.

I'm also guessing a lot of GP's would appreciate not having to deal with a parade of drug seekers every day.
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Old 05-25-2009, 11:49 AM
DJBFivE DJBFivE is offline
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To clarify my situation: I have chronic knee, back, and shoulder pain, all from 3 different incidents. The knee needs to be replaced, but I've been told that I'm too young(35). The shoulder is much better now that I've taken a break from lifting weights (I have a couple of small tears from lifting). I've been told that as long as I don't try to get back to the size I was (working out with 300+lb bench, 140lb tricep ext, etc) it should be manageable without surgery. In fact, my doctor's exact words were"you can quit lifting as much and realize you aren't 25 any more, or we can do surgery at some point), and I have 2 bulging discs that aren't quite full herniations from being rearended by a 16 year old girl driving 40mph. On bad days, the back pain is so bad that it shoots down my leg with each step and I have difficulty standing up straight. On bad days, my shoulder hurts so bad I can't dress myself. Both of those are mostly intermittent pain, but the knee is a different story. I tore the ACL, MCL, both meniscus, and strained pretty much everything else in it (basketball injury). I have had 2 surgeries already, and have been told that it just needs to be replaced, there isn't a single component of my right knee that isn't damaged (except my new ACL), but that no orthopede will do one on someone under 50 years of age, since they need to be redone after 20-25 years. I was told to look into pain management to allow me to have a functional life until the time arises that I can have the replacement.

What QtM said is absolutely true in my case. Originally, 5 years ago when I had the knee injury, and then the car accident (a few months later), I was put on hydrocodone (lortab/vicodin)10mg 4-6x daily. I would get pain relief, and a euphoric buzz. After retearing a meniscus in my knee 2 years ago, and injuring the shoulder, I started going to a pain clinic. I was initially put on oxycodone (percocet) 10mg 6x daily. At that time, I still would get a euphoric buzz. Now I am on oxycodone IR 30mg 6x daily. I no longer get a euphoric buzz. I wake up in pain every morning, so I make my way to the medicine cabinet, take my pill, and 20-30 minutes later my knee feels ok enough that I can start getting ready for my day.

I won't lie and say I've never taken more than I'm supposed to, in fact I often double up in the morning to help me get started, but the euphoric buzz is completely gone. I take them solely for the pain management they provide. I have a weird conundrum...if I would start working out and get back into shape and lose the 20 lbs I have put on since I quit due to my shoulder, I would carry less weight, and with stronger muscles I think my back and shoulder would bother me less often, but if I begin lifting weights, or doing any type of aerobic activity, I'm going to have more pain from the activity in my knee and shoulder.

At any rate, any questions anyone has about the pain clinic deal in FL just ask here, I pretty much know how the crooked ones work from talking to people who have been there, and how the legitimate ones work (like the one I go to)
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Old 05-27-2009, 11:12 PM
Bigtoe39 Bigtoe39 is offline
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In ga it would be crazy to walk in and ask a dr how much for a script ... So how to some people do it..... I hsve a friend who is legit and the ones who don't need it make the real ones hard to get what they need.., so there had to me help for the ones who really need it
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  #42  
Old 05-27-2009, 11:32 PM
Boyo Jim Boyo Jim is offline
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Never mind.

Last edited by Boyo Jim; 05-27-2009 at 11:32 PM..
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  #43  
Old 05-28-2009, 12:03 AM
Markxxx Markxxx is offline
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The thing people fail to understand is there is a market for pretty much any drugs. So the patient will doctor shop, if they don't get OxyContin, they can get something else and sell that. Then it's on to the next doctor to try again.

Also Mexico and the like is wide open. It's so easy to get it there and other countries. Look at meth, the simple act of limiting sales and requiring ID to buy the drugs to make meth, stopped around 90% of the meth production. The production in the USA fell apart. But the use didn't fall off one bit.

It's simply moved to Mexico where you can get the drugs.

I have worked with Mexicans who don't go to the doctor, they want penicillian they simply call their mom in Mexico and she gets it from her doctor and mails it up here.
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Old 05-28-2009, 08:11 AM
shiftless shiftless is offline
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Ah, the big secret of drug use in America. Most of the druggies are using "legal" stuff (I believe), developed, manufactured and distrusted right in the good ol' USA. All you need it a good excuse. If you use heroin, you are a low-life and we have the DEA to track you down and destroy the network that got the drugs to you. If you use Oxycotin you are an unfortunate and deserve our sympathy. I don't mean to sound unsympathetic but I suspect that a huge percentage of the opiates manufactured in the US are used recreationally and that is just fine with the drug companies and everybody else for that matter.

Personally, I don't even believe that opiates do anything. I've had a lot of codeine and morphine for knee pain over the years (and tried a little recreational opium) and as far as I can tell it only make me irritable. Is that common? Doctors don't believe me - "Here, let me increase your dosage" they say. Surely it isn't that hard to get if you really want it when they press it on me constantly. If you want some serious drugs and can't get them you're just going to the wrong doctor.
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Old 05-28-2009, 01:27 PM
jlynes jlynes is offline
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Oxycontin and Woodstock

My nephew, who grew up in Woodstock and also became a heavy drug user led me to become very interested in searching for information on Oxycontin. I didn't know that it is a drug used the same way as heroin and can be injected. He had long track marks on his arms when he was found shoeless wandering the streets this past winter. He had a psychotic breakdown and is now on antipsychotic medication.

I learned that pharmacists are making money on the side selling pills to drug dealers and that oxycontin can be purchased easily on the internet. One wonders why big pharmaceutical companies aren't behind bars.
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  #46  
Old 05-28-2009, 06:08 PM
Mama Zappa Mama Zappa is offline
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Originally Posted by Manda JO View Post
I find the whole system unbelievably frustrating and illogical: when my husband had 12 teeth pulled in one day, the dentist, who has known him for 2-3 years, still won't prescribe more than 15 vicodin. But when my husband has, on a couple occasions, gone to urgent care when an abcess has suddenly flared up in a tooth (he has hereditary rickets, and his teeth are a ruin), the doctors there, who don't know him from Adam, inevitably prescribe 30 vicodin without even being asked. I went into an urgent care one time with pus and blood running out of my infected ear in frankly disturbing quantities and was told to "look for drops at the pharmacy", but I have friends who seem to have infinite prescriptions of every pain-killer and tranquillizer out there. I truly do not understand the system.
Never been prescribed oxycontin, but I've been given Vicodin a couple of times. Once for a root canal (I think I took 2 of them). Once for a crown (ditto). And once, when I broke my elbow 2000 miles from home. On that occasion, I went to the ER quite late at night (after I decided the fall was more than a bruise). The ER folks X-rayed me. Announced my elbow was NOT broken (proven incorrect 2 weeks later back at home; it *was* broken).

And gave me a scrip for 14 Vicodin tablets.

I guess I don't fit the mental profile of an abuser, being a female in her late 40s, but here was an ER doc giving me - a total stranger - NARCOTICS. For an injury that wasn't honestly all that bad (they thought). I'd sure have been suspicious of this if I were a doc!

As the elbow pain was mostly tolerable with large doses of Advil, I thought about not even getting it filled. Typo Knig persuaded me I should, as my restless legs syndrome was kicking in (hah) from the stress, and narcotics are quite effective with that.

So next day, we visited a pharmacy. I asked for just 5 tablets of the 14-tab scrip. The PHARMACIST urged me to get all 14. Wouldn't really cost more than the 5, why not get 'em all? . I wound up getting the full scrip filled, used I think 4 of them (at bedtime over the next 4 days), and for all I know they're still in the closet somewhere.

Honestly, I wonder if it isn't just some random thing where a doc will give or withhold based on some arcane algorithm I'll never understand.
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Old 05-28-2009, 06:09 PM
snailboy snailboy is offline
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Originally Posted by Hirka T'Bawa View Post
For some people opiates really won't do anything. All opiates do the same exact thing in the body, and most opiates are converted to the same thing. If you don't have the enzyme, or enough of it, that converts something like Codeine to Morphine, it won't do a damn thing for you. I don't remember exactly how much of the population doesn't have the enzyme, but it is somewhere around 5%. So there are plenty of people such drugs as Codeine, Hydrocodeine, or Oxycodiene won't do a damn thing... There are also people who have altered opiate binding sites in their CNS so no opiate will do a thing to them, even Morphine won't work.
This isn't totally accurate. Opioids don't all do the same thing. There are different opioid receptors in the body such as mu-opioid receptors and kappa-opioid receptors. There's an opioid sold in some anti-diarrhea medicines (I think it's loperamide) that stops peristalsis but will not get you high. In fact, most of the natural opiates (the ones found in opium) such as papaverine won't get you high.

Also, you're right about some people not having the enzyme that converts codeine to morphine, CYP2D6. I don't remember the percentage myself, but it's more common among people of European descent. Some people have double that gene, which makes codeine work a lot better for them. (Perhaps Qadgop has it.) That's not true for hydrocodone and oxycodone though. They're not prodrugs like codeine. They work as they are. And they're not metabolized into the same thing. Neither of those two are metabolized into morphine like codeine and heroin. Also, there are two main enzymes that metabolize opioids and each one metabolizes it into something different. For instance, codeine (methylmorphine) and heroin (diacetylmorphine) are metabolized into morphine by different enzymes. The one that metabolizes codeine into morphine metabolizes heroin into 6-monoacetylmorphine.

I've read a ridiculous amount of information about opioids. Most of the above is going by memory, so there may be an inaccuracy or two.
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Old 05-28-2009, 10:24 PM
Hirka T'Bawa Hirka T'Bawa is offline
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Quote:
Originally Posted by snailboy View Post
This isn't totally accurate. Opioids don't all do the same thing. There are different opioid receptors in the body such as mu-opioid receptors and kappa-opioid receptors. There's an opioid sold in some anti-diarrhea medicines (I think it's loperamide) that stops peristalsis but will not get you high.
It is Loperamide, otherwise known as Imodium. But the real reason it won't get someone high is because it can not cross the Blood Brain Barrier in order to get into your CNS.

Thanks for also pointing out my errors, thats what I get for posting right after waking up, when I should have been studying. I knew Hydrocodone and Oxycodone are not prodrugs, but I didn't make that very clear in the post. I'll also admit I don't know too much about the actual Mechanism of Action for those two drugs, since I haven't had that class yet.
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