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Physician screwing over my handicapped friend.

Tolerance isn't really much of a problem with long-term opioid use. Of course it occurs but can generally easily be overcome by dose adjustment or opioid rotation. Tolerance to side effects (other than constipation) generally occurs before tolerance to the analgesic effects. And there is no ceiling effect for pure opioid agonists.

Also, physical dependence will be the norm, but not addiction. Addiction is going to be an issue more for folks with preexisting predilection for addictive/abuse behaviors.

Long term use of opioids is nonetheless not without concerns for problems and should not be pursued apart from an expert and interdisciplinary approach, IMO. See my earlier post.
 
I've always preferred the older supercharged cooper s's over the new turbocharged ones. I think that's mainly because of the subtle differences in the exterior styling not the engine itself. Good choice.
 
I was serious about the nerve cauterizing. During my herniated disk problems a nurse friend said that in extreme cases they can do I t and end the pain but of course you cannot walk ever again.
 
Shorty said:
Does you friend still drink? I mean, it's not covered by insurance but it usually works for me.
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he actually doesnt enjoy drinking anymore. he likes to manage his liquid intake and keep a regular cath schedule. also the alcohol mixed with his medications gives him sever heartburn, and nausea. he was always more of a ganja man anyways though.
 
Toogs said:
Ahh, the south. You can take the NCSU out of the boy by sending him to Wake, but you can't really take the NCSU out of the boy. Or something.
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Meh, just as many racist at MD
 
I took a pill from a stranger last night at a concert. She said it was ibuprofen and that I could trust her because "I'm a mom".
 
Skipped through most of the thread, and I am not sure how much use of his arms and stomach muscles he has since it was stated " from the stomach) down but there are Yoga series made for the handicap, and I know it helps with my back issues. Probably too simple of an answer, but one that is extremely healthy and I imagine your friend could do by himself.
 
ITK said:
I took a pill from a stranger last night at a concert. She said it was ibuprofen and that I could trust her because "I'm a mom".
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I think it's pretty cool there's wifi in the pit. Don't forget to put the lotion on your skin.
 
pourdeac said:
The major problem with opiates is tolerance to the drug which leads to higher and higher required doses. When that happens, the therapeutic window shrinks making the use of them riskier because the dose is closer to one shutting down respiration and OD. Controlled studies to date show they don't shorten lives when used properly. As we know, that often doesn't happen leading to risky drug taking. Opiates also reduce immune system function and can promote increased virulence of certain pathogenic microbes. The result of these effects is unknown and may not mean much because it's treatable in most cases, but the emergence of superbugs could significantly change those risks.

Do you seriously think heroin use doesn't lead to ODs? The reason the prescribed opiates have higher OD numbers is access more than anything. They're easy to get. The rising danger is people playing Breaking Bad and selling drugs like methylfentanyl which is 5000 times more potent than morphine. The profits look great, but users don't just do 5000th the dose and they end up ODing.
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exactly, they don't shorten lives as a result of the drug itself, but due to misuse. that's not a lot different than most other drugs.

i think you misread me, of course heroin use can lead to OD.
 
ConnorEl said:
Tolerance isn't really much of a problem with long-term opioid use. Of course it occurs but can generally easily be overcome by dose adjustment or opioid rotation. Tolerance to side effects (other than constipation) generally occurs before tolerance to the analgesic effects. And there is no ceiling effect for pure opioid agonists.

Also, physical dependence will be the norm, but not addiction. Addiction is going to be an issue more for folks with preexisting predilection for addictive/abuse behaviors.
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Like I said, tolerance is the primary problem you have to deal with, regardless of how you overcome it. Long-term in a very controlled environment and with proper compliance....the compounds can be used safely. But it's still risky because of people not being compliant or who chose to abuse it for the obvious reasons. That is a major problem.

Physical dependence is part of addiction and usually the process of seeking reinforcement, so I'm not really sure why you separate the two. The addiction field uses those terms very carefully because of the connections. Addiction can be defined in many ways and many people define it to include dependence of any kind. If you can't stop taking the drug because of withdrawal, it's still a abuse/addiction problem.
 
dmcheatw said:
exactly, they don't shorten lives as a result of the drug itself, but due to misuse. that's not a lot different than most other drugs.
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I disagree, these compounds are a lot different than most drugs. Abuse problems are far more likely with these compounds than most clinical drugs and that leads to shortened lives BECAUSE of the compounds/drugs. Are the drugs biologically toxic? No, if that's how you're defining "problems", but they are what we call behaviorally toxic. Those problems are not measured very well in controlled studies.

dmcheatw said:
and we as a society could fix the latter problem pretty easily w/heroin.
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How in the world does society fix the problem with heroin?
 
No, the importance (of distinguishing physical dependence and abuse/addiction) can be quite relevant and important. And is critical to understand for many folks who need or benefit from appropriately prescribed opioids.

Physical dependence (and associated withdrawal syndromes) can occur with lots of substances that are never abused. As it most certainly does for most people on long term opioids. Considerations of addiction certainly can include physical dependence but probably/properly is seen or described in psychological/behavioral terms.

And, again, tolerance occurs but is clinically not a major problem as it can usually be overcome easily.
 
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opiates are very safe drugs when used properly. they, in and of themselves, do not cause shorter lifespans, as you said yourself:

pourdeac said:
Controlled studies to date show they don't shorten lives when used properly.
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Those are your words, which I agree with. users of opiates do have shorter lifespans, true, but it's a correlation, not causation except for in the rare case of a fatal OD. that's why the bolded part of this first sentence quoted below is false:

pourdeac said:
Abuse problems are far more likely with these compounds than most clinical drugs and that leads to shortened lives BECAUSE of the compounds/drugs. Are the drugs biologically toxic? No...
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and is contradicted not only by the sentence immediately following it, but by your aformentioned quote regarding controlled studies as well.

Your concern seems to be that the abuse potential for the synthetics drugs makes their use potentially unsafe. That I agree with, but that is not the same as saying the substance itself is dangerous. That's saying it's misuse is dangerous. Those are two different things. This is as good as I can articulate it.

pourdeac said:
How in the world does society fix the problem with heroin?
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There are three main ways, in no particular order, to mitigate deaths/injuries associated with heroin abuse and the secondary crimes related to its procurement: education, decriminalization, and regulation. You could add a fourth about changing attitudes as a society (for example sherlock holmes and freud using cocaine was not a problem back then, but it is now....why? what changed?), which is really a pre-req to the other three things. Human civ is 10,000 years old, and we got along just fine smoking opium bascially the whole time. synthetics and needles have increased the danger for negative outcomes with opiate use, but the danger is not intrinsic to the drug, and it's really a minuscule problem when compared with the other problems we have the U.S., and the way you fight that is, primarily with education.

current policies are not just semi-effective, they actually exacerbate the problems, and that's why prohibition will continually fall out of favor. Most things, most of the time, cannot be successfully prohibited. History has really been clear on this, so to address this "problem" you need to be more creative.
 
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the drug in and of itself is not dangerous, but its misuse can be dangerous. that's the distinction, and that sentence can be applied to just about anything.
 
zqglass said:
wait, so what exactly is the procedure? any idea if they do it for people with spinal injuries?
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My friend was dying and no painkillers were working. His wife told me the Docs "cut" something in his spine to prevent pain from getting to his brain. I don't know anything more.
 
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