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.

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