Substances my patients have tried and 3 simple rules that should be followed

[seeker78]

I'd like to share some of my patients experiences with mind altering substances. The list is long, so have patience. All of the substances were used orally unless specified otherwise.
A. BENZOS: Diazepam, midazolam, oxazepam, alprazolam, bromazepam, lorazepam, flurazepam, nitrazepam, triazolam, cinolazepam, brotizolam, lormetazepam, flunitrazepam, clonazepam;
B. OTHER SEDATIVES AND HYPNOTICS: zolpidem, zopiclone, clomethiazol
C. NEUROLEPTIC DRUGS: promazine, levomepromazine, quetiapine, olanzapine, sulpiride
D. ANTIDEPRESSANTS: amitriptyline, escalitopram, paroxetine, duloxetine, mianserin, mirtazapine, reboxetine, tianeptinum, trazodon, milnacipran, bupropion
E. OPIOIDS: DHC, codeine, hydromorphone, morphine, oxycodone (oral + snorted), tramadol, nicomorphine (rectal)
F. STIMULANTS: methylphenidate (oral + snorted), ephedrine, modafinil
G. DISSOCIATIVE SUBSTANCES: ketamine-S (i.m.), DXM
H. OTHER: gabapentin, pregabalin, ropinirole, cannabis (oral prepared in milk, smoked), melatonin, dimenhydrinate

List of favourites until now (1 is the best):

10. methylphenidate (snorted)
9. flunitrazepam
8. triazolam
7. DHC
6. cannabis (in milk)
5. hydromorphone
4. tramadol
3. midazolam
2. ketamine
1. oxycodone (snorted)

I'm a physician, not trying to be a smartass, but I think it's wise to follow some rules when dealing with drugs. 3 simple ones should be followed - learned from patient mistakes:
1. Always familiarize yourself with the substance you plan to try, be sure what and how much you have. (This can be acomplished by reading a lot about the stuff planning to take and to use only certified pharmaceutical products)
2. Don't use the i.v. route, especially if the substance is NOT designed for this (I've seen many times what can happen in this case even with drugs which are to be used in this way. In some cases even if they happened in hospital the patient couldn't be saved.) And the most important:
3. DO NOT exaggerate!!! (What I mean is this: don't allow that tolerance becomes an issue. If you get high every two weaks and you always need the same amount to achieve the desired effect then for me there's no problem. My patients make that mistake often. First example: it was with the benzos. He used them regularly for 2 years not worrying about the dosage and he suddenly found out that 10x or 20x of therapeutic dose isn't working anymore. He developed depression and was left with chronic insomnia. The second example: it was the tramadol. A wonderful drug, but he didn't have any control over his consumption. Once he ingested a four digit number in mg (less wasn't working anymore) and the result: a seizure, useless drug and some tolerance to other opioids.
That's it for the first time. If you have any questions (dosages I used, useful combinations, ...) feel free to ask.

Reputation Comments on this post:

i'm sure your getting loads of grief for not using swim., good post apart from that so I'll rescue you with some good re...

[Shiacmkmleer]

Welcome to Drug forums! Great first post! I couldn't agree more with 1 but 2 and 3 i disagree with

What wrong with I.V. ing certin things... like for instance herion?

As for three What wrong with wanting to get a little higher once in a while?

[keats]

Well SWIM thinks seeker is emphasizing not to IV shit that isn't designed for IVing, like pills. It's good advice, mainlining pills or the like is extremely dangerous and an all around bad idea. Heroin is designed to be IVed that's different, though making a rule of not shooting anything is never a bad plan. I mean really, do you need an explanation of what's "wrong" with shooting heroin?

[JDreaming]

Hey good to see you Seeker, looking forward to your posts because you seem to be a knowledgable person on drugs in general and pharmaceuticals in particular.

I think most people have their own personal 3 or 4 safety rules to try to keep their usage disciplined, and yours aren't bad. I personally am turned off by both the injection and insufflation routes of administration in general, and never use them out of concern for my veins and nasal passages. I'm not positive that I'm following your third item about "not exaggerating" but I think you're trying to say a person should monitor their usage and try not to let themselves get addicted... Personally I think drug experimentation is one thing, and drug addiction is another. One of my rules would be simply that if an experimenter should start to feel that they're even just beginning to get addicted to something, they should cease their useage until the dependency fades. Thanks for sharing your thoughts on how to try and keep one's habits under control.

[El Calico Loco]

Originally Posted by keats

Heroin is designed to be IVed that's different, though making a rule of not shooting anything is never a bad plan. I mean really, do you need an explanation of what's "wrong" with shooting heroin?

Heh...Swim's momma is a lifelong drug addict. The only drug advice she ever gave him: "Stay away from the spike."


ECL

[Drakzon]

Swim has just one rule he follows no illegal drugs, after he lost enough money and had enough problems he dumped his dealer and has stuck with prescriptions every since. He also only see's two doctors a GP for the fun stuff and a psych for hte necesary stuff. That means no doctor shopping so unless you can get one doctor to beleive you lost your prescription your looking at 30 pills a month limit. Swim recently did convicne his dr his prescription was lost so it does happen, but rules are good when swim has pills and the euphoria starts to wear of and it's time to redose he always takes a higher dose than he did before and keeps increasing until the bottle is gone usually in one long session. If it weren't for the few rules swim has he would be in very bad shape indeed

[English_T]

If IVing it is an excellent idea to use something which I wasn't aware of until very recently, an IV membrane filter. These filters remove all nasties that may contaminate ones ....product.
This link shows what I think are the correct ones (they look exactly the same)

[seeker78]

Sorry to wait a little longer for my answer. Had an exam, didn't do it, was totally down last week. Many things worth mentioning here also happened. (look in the other forums).

First the awser to Shiacmkmleer:
1. Look at my rule no 1. (and don't say you always kwon what you get...)
2. If we forget No. 1 and look at rule 3, there are still a few points to consider. Example: In hospital a fatient of mine was administred normal saline. After about 100 ml were in, she expereiced pulmonary oedema - her heart was failing and lungs were filling with water. i'm not sure WFH. Only becouse of a little saline???!!!!! That's not the only story I've experienced, but its the one always in my head. Not to write too much: You NEWER know what can happen if you do stuff i.v.

And JDreaming:
A patient of mine and a good friend was always appreciated (by all of us we knew him) as a strong character with limits set (for drugs also). One could say your quote: "
Personally I think drug experimentation is one thing, and drug addiction is another. One of my rules would be simply that if an experimenter should start to feel that they're even just beginning to get addicted to something, they should cease their useage until the dependency fades." ,applied for him 100%. But then a crisis followed, losses came he could'd manage in a short matter of time and the limit started to fade. Not he was in control anymore, the drug was. Sure he saw this, but it was to late and damage was done. What I'm trying to say is: Things aren't so easy as they might seem. What to do? Everyone has to find his own answer.

[snapper]

SWIM disagrees with the pulmonary edema example SWISeeker78 mentioned. Pulmonary edema in someone with CHF can be triggered by even a small fluid bolus delivered too quickly.It is fairer to say that Iv kicks in instantly and will cause more acute negative effects than other routes, along with more cause for complications. IV, however, is not much worse than other parenteral routes of administration.
SWIM does agree that everyone must find a happy medium. SWIM likes to get a habit going with some things, but SWIM also has the ability to stop that habit, having beat the worst out there (almost all of them) already. Willpower and a balanced life help a great deal for SWIM, though others would have self-destructed many times already doing this. Everyone has their limits and need to consider what them with every new dose.