Eat clen, tren hard and accept no subs

I haven’t updated my blog in a long time and I want to start off the cycle by writing about something I’ve always felt the need to hide. I’m not even sure why besides a vague sense of it being right, and I’ll explain that the best I can now. I have had problems with substance abuse in the past and I’ve let my misadventures with methamphetamine, heroin and other fun and interesting chemicals define me. I’m the guy who was all for “better living through chemistry” and I wasn’t afraid to say it out loud to everyone who wanted to hear (and the ones who didn’t as well).

However, as I have grown older, I found myself looking askance at people like that. Admittedly there aren’t many people like me, and even less who has built up such an impressive chemical resume as I have. But the ones who have told me straight out that they’re users, I find that I tend to judge them a little. Even though I used to in the past? Especially coz I used to. I knew what kind of deviant I was and I’ll have no part of that. Now that I’ve quit for so many years, I find myself wanting to dissociate myself with other drug users.

My point is, most people have something against substance users, no matter if it’s recreational or a dependency. It speaks volumes about your character that you’re not willing to make your personal life private and maybe that’s why I stopped divulging so much. It doesn’t matter if you pop MDMA once a year or you’re shooting up smack every morning and lunch in the toilet. People don’t need to know.

There is an odd comfort in being truthful though, as long as you’re not shoving your personal politics down people’s throats. I’ve stopped using all illegal drugs for many years. However, a lot of my legacy is still there. I’m still on buprenorphine (Suboxone) and benzodiazepines.

Suboxone

I’ll talk about Suboxone first. It’s a very, very expensive and legal opiate substitute that the government has been pushing for several years. Government? So it’s free then, you say? No, it’s not. It costs RM 40 per 8 mg tablet and I take 2 per day. I used to run up RM 80 daily, RM 2,480 per month, RM 29,200 annually. RM 30,000! 30 fucking k per year! It was ludicrous.

I got on Suboxone as a legal way to get off OxyContin in 2012. I had a HUGE oxycodone problem. I was a monster. I would take 280 mg per day. That’s 14 tablets (one blister pack) of 20 mg OxyContin. It was, strangely enough, about the same price as Suboxone and offers a much superior high. However, it wasn’t legal, since I obtained them via doctor shopping, and that’s why I ultimately chose to switch over to the government Suboxone program. It was expensive but it was legal and I could travel all over the world with my prescription (except Singapore, who considers buprenorphine a Class A drug).

I was happily on Suboxone for several years before I realized I was hooked on it. Yes, that’s how buprenorphine works, it has a STRONGER binding affinity to your opiate receptors, that’s why you don’t crave other opiates like oxycodone. It’s not very pleasurable, but it’s good enough to prevent you from seeking other MORE pleasurable opiates like heroin. The buzz is acceptable, and it staves off withdrawals. Many Suboxone users already know this but I bet the general public doesn’t. Suboxone works by making you dependent on it. That’s why you don’t get withdrawals, it’s coz you’re still on opiates. In other words, you become addicted to Suboxone.

Quitting was hard. It was harder than OxyContin due to the longer half life of Suboxone. I tried once with the help of my better half and I’m not ashamed to say that I tapped out after 4 or 5 days, just when the withdrawals hit me really hard. I’m not embarrassed coz with my life experience now, I know that you’ll know when the time is right to quit. It’s when you want to, above all else, without any other reason, no pressure, no one to nag you, no guilt. You quit coz you want to be rid of it. That’s when you succeed.

I tried cutting down and I got down to 1 x 8 mg Suboxone tablet per day. After a few weeks, I cut it down to 1/2 then 1/4. It’s hard to get rid of that final bit, the “boost” you need each morning and which comforts you, but when you cut it out of your life, it’s a lot better. I wonder why I didn’t do it sooner but I know the answer to that. It was coz I wasn’t ready to.

The same thing with benzodiazepines. This is the most insidious drug I’ve ever taken. Not worse than meth, methamphetamine is the worst thing I’ve ever taken, all in all. But I personally think benzodiazepines are more insidious than opiates. You know why? There is no honest “value proposal”. I took benzos for fun at first, then to help with the come downs from meth, then I obviously got addicted to them. The one time I tried to quit was cold turkey, in drug rehab, coz the sick sons of bitches at the center didn’t know anything about benzodiazepines or how dangerous it is to quit cold turkey.

I seized in the jail cell while my ankles were shackled and my hands were handcuffed. I cried, I had multiple seizures, I thought I was going to die, and I wept again. It was a fucking nightmare, going from 10 mg clonazepam (Rivotril), 2 mg alprazolam (Xanax) and 20 mg diazepam (Valium) in a day to complete zero, cold turkey, back in 2007. I’m not sure if I can do it a second time. That’s what I thought for the next few years anyway, since I started taking them again after rehab.

However, and I’m really not sure what the catalyst is, I somehow decided to take less and less starting from last year. I was on 2 mg clonazepam (Rivotril) daily for many years and then I decided to start taking 1/2 of the tablet. Thus, I was on 1 mg. It felt better, and my head was clearer and I was feeling a lot more emotions and I thought that was good. It was. I cut again to 0.5 mg of clonazepam (which is 1/4 of the tablet).

One day, my doctor said he ran out of clonazepam and it’ll take 2 weeks to get the new stock so he gave me diazepam (Valium) instead. It was a 10 mg pill which is about equivalent to 0.5 mg of clonazepam (don’t look at the mg, trust me when I say these two doses are “similar” – think of clonazepam as being 20 times stronger than diazepam) but it wasn’t. I felt significant amount of anxiety and had mild panic attacks but I liked the clarity. Clonazepam has stronger anti-anxiety effects but it’s not as hypnotic as diazepam. I felt sleepier and I hated it coz it felt like I was “going back” on my progress.

I didn’t want to let myself acclimatize so I cut it again by 1/2 to 5 mg. I cut it again the week after to 1/4 of that and within a week I titrated the dose to 1/8, 1/10 and 1/12. Then I switched to 5 mg Valium (diazepam) – it’s half the amount of my previous 10 mg tablet so it’s easier to split for a smaller dose. The doctor didn’t have 2 mg ones. I then started splitting the 5 mg pill to 1/20 until I had to pinch just a bit. It was effectively nothing coz it was about 1/30 of a 5 mg pill – or 0.16 mg daily. Most people take 5-10 mg and I managed to cut it down to zero with my own super fast taper plan. I was essentially clean. The last bit to get rid off was more psychological than anything.

It wasn’t pretty but it wasn’t as bad as when I kicked it cold turkey in rehab. I kinda like the new clarity. It gives me purpose. It also made me feel bad about the time I’ve spent “under the influence” (kinda). Now, this is not medical advice, everyone is different and you should never cold turkey quit benzodiazepines coz you might die of a seizure.

However, I have grown to belief that it’s more like US FDA precaution. I’ve done plenty of things which should have killed me. I’ve taken things which I KNOW as a fact that’s over the LD50 (lethal for 50% of the population – everyone is different) many, many, God so many times and I’m still alive. There’s nothing wrong with being on benzos, some people need it for anxiety.

I just didn’t want it anymore. It was a personal decision.

This is probably the last thing I’m going to write about drugs. I’ve said I was off all illegal drugs. Well, now I’m off it all – legal and prescription included. I don’t want it to define me anymore. I just want to write an appendix for the blog. This is it.

Reductil (sibutramine) revisited

reductil box

I managed to get sibutramine (Reductil) which goes for RM 196 for a box of 10 mg sibutramine hydrochloride monohydrate. One box is a month’s supply of sibutramine and contains 28 capsules of sibutramine 10 mg equivalent to 8.37 mg sibutramine.

sibutramine 837

Reductil [sixthseal.com] is not new to me, but I decided to give it a second review with alternative methods of administration. It has come to my attention that sibutramine is a freebase and that means it can be smoked. I was planning to insufflate the sibutramine too (and at the risk of spoilers it was extremely good).

sibutramine contents

Sibutramine comes in capsules of blue and yellow and each blister pack contains 14 tablets for two weeks. Sibutramine is an appetite suppressant and it gives the feeling of satiety to the user. It feels like an amphetamine like most other diet pills and ADHD medication.

reductil 10

Sibutramine has two active metabolites and has a half life of 1 hour for the parent compound. It seems perfect for smoking and insufflating. It also has an extensive first pass liver effect so smoking and insufflating sibutramine would be interesting since it bypasses that route.

sibutramine capsules

I opened up a capsule of 10 mg sibutramine to find fine white crystalline powder. The capsules are easy to open with just a pull on the blue part of the capsule. The yield of each capsule is about 4 lines of cocaine (this is a very arbitrary comparison since everyone cuts different sized lines).

sibutramine snort

I am pleased to report that insufflating sibutramine makes the compound come on much faster than the oral route and there’s also a rush involved in it. I can’t comment on smoking since there’s so much filler I choked and coughed my lungs out.

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Lormetazepam (Loramet) benzodiazepine review

loramet

Loramet is a benzodiazepine that contains lormetazepam (also marketed as Noctamid) made by Wyeth. It is a rather rare benzodiazepine and should not be confused with lorazepam or loprazolam which are different benzodiazepines. Loramet contains 1 mg of lormetazepam and I took 35 tablets (35 mg) this morning.

lormetazepam

The pills are oval and scored, with the Wyeth imprint on one side. It is a nice benzodiazepine, it chills me out really quickly and it seems to have active metabolites coz I’m still feeling very relaxed. Lormetazepam is marketed as hypnotic but I’m not feeling sleepy (high benzodiazepine tolerance) at all. It is nice and sedating though…

I’m putting this in the same class as medazepam; it’s as nice as medazepam on high doses. I would guesstimate that 1 mg of lormetazepam (Loramet) is equivalent to 2 mg of lorazepam (Ativan) but it should be noted that the two benzos feel completely different. There is a mild euphoria on Loramet.

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Lamictal (Lamotrigine) 50 mg

lamictal

Lamictal is the brand name of lamotrigine manufactured by GSK. It costs RM 50 per blister pack and one dose (tablet) of Lamictal is RM 5.

lamotrigine

This is the other medication I’m on now – it’s a mood stabilizer for bipolar people and it not just treats the manic phases but the depressive episodes.

lamictal gsk

I’m only taking 50 mg at 6 am and another 50 mg of lamotrigine at 6 pm (twice a day) so I’m not using it to control my mania (which I like) but my depressive episodes.

lamictal 50

I’m adding this to my existing prescriptions [sixthseal.com] with the following changes:
Remeron 60 mg at night to sleep
Risperdal divided into two doses of 2 mg each at 6 am and 6 pm for better concentrations
Rivotril 6 mg for maintenance

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Project MISER DAY 1: Panafen Plus Lunch

cf perth

I just got a care package from a friend in Perth, Australia who sent it via an intermediately due to her distance. It’s Panafen Plus, a preparation of 200 mg ibuprofen and 12.8 mg codeine in a 48 caplet box.

cf panafen plus

I took all of the 48 caplets for a heroic 614.4 mgs of codeine, just nice to put me into a good mood. Actually, I’m lying, I miscalculated and went OMFG after I used Calculator and found out that it was 600+ mgs of codeine instead of the 300+ mgs I calculated in my head. I’m still going to sit it out anyway. :p

cf note

The Panafen Plus came with a note from my friend in Perth who wrote it in her handwriting. I haven’t received handwritten notes in a long time.

cf panafen plus 48

This is what the Panafen Plus by GSK blister pack looks like. Inside are small easy-to-swallow caplets.

cf panafen plus eat

Down the hatch! That’s my codeine lunch.

Mmm…I can feel the warmth now…and I’m kinda nodding off. Opiate naive again….no tolerance.

Remainder: RM 250

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What are you on?

medication hb

I’m currently on:

Prozac (fluoxetine) 20 mg

medication prozac

This is Thailand Prozac coz I ran out of Prozac while in Bangkok and had to get my gf to go to a drugstore (chemist/pharmacy) to get it for me at Siam Square. It cost 1100 baht (about RM 110) for a single blister pack of 20 mg Prozac so its more expensive than Malaysia.

medication prozac thai

I take from 2 to 7 capsules every morning (about 40 mg to 120 mg) with an average of 5 capsules (100 mg) for my depression. I know, it’s bad to self-medicate but I’ve been on it for months now and it’s doing me good.

Remeron SolTab (mirtazepine) 15 mg

medication remeron

Remeron SolTab is the new orodispersible (meaning it dissolves in your mouth) version of mirtazepine, another antidepressant which I take at night.

medication remeron soltab

Remeron helps me sleep as well, so I can lower down my nightly dose of benzodiazepines for my insomnia/anxiety.

medication remeron tab

I take one tablet at night with my antipsychotic medication (Risperdal) before I go to sleep. It’s supposed to help with my depression too.

Rivotril (clonazepam) 2 mg

medication rivotril

Rivotril is the only benzodiazepine that I’m taking now – I’m on a taper plan for this too. I take 2 x 2 mg (4 mg of clonazepam) at night for my benzo dependency and I’m trying to get it down to 2 mg within three months.

Risperdal (risperidone) 2 mg

medication risperdal

Risperdal is an antipsychotic used to treat schizophrenia. My psychiatrist says that I have unusual thoughts and my gf reckons that it’s used to treat my manic phases.

medication risperdal tab

I take one and half tablets every night with my Remeron for 3 mg of Risperdal daily. Risperdal has a nasty side effect that I noticed – it is very difficult to orgasm when steady state plasma concentrations have been reached.

What medication(s) are you on?

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"Sum of Parts" Combination: Baclofen + zopidem + tramadol

sum of parts baclofen front

Well, any self-respecting professional drug user (?) is bound to have times when stocks of the Good Stuff (TM) runs low, and those times usually coincides with the experimentation of combinations of inferior (but available) pharmaceuticals with potential in the hopes of catching a high that exceeds the sum of its parts. I like to call this doing the “Sum of Parts” combo a.k.a. riding the potentiating effects of pharmaceutical stacking.

This is one of the right combinations.

sum of parts baclofen back

Baclofen is marketed as Lioresal and is prescribed as a muscle relaxant. However, the drug use community has found out that baclofen [sixthseal.com] could be a possible Gamma hydroxybutyrate (GHB) analog in higher-than-prescribed doses which I have documented in the link above due to the GABA (B) agonist properties.

sum of parts lioresal

I finally tracked down the elusive blister packs of Lioresal and used to have a whole stash of them before the police raided my place and carted away anything that resembles pills or capsules but I managed to find one last blister pack deep down in my stash box – it was caught between the cardboard and thus was missed by the raiding party. I know – it’s sad.

sum of parts baclofen pills

The baclofen is similar to the tablets that I have sourced before except this comes in the proper blister packaging. There is the familiar CG/K|J imprint on the pills and the brand name is Liorésal 10 mg. I had a full blister pack of this which makes it 100 mg.

sum of parts zopiclone

I also managed to obtain 30 tablets of zopiclone (Imovane) in the form of 7.5 mg generic tablets from the pharmaceutical giant APO. I have also written about zopiclone [sixthseal.com] back in 2003 when I didn’t have an opiate habit (had a methamphetamine habit instead) and my benzodiazepine tolerance/dependence wasn’t quite as large as it is right now (it just keeps getting higher).

sum of parts zopiclone pills

Zopiclone isn’t hard to obtain coz my doctor already prescribes me a generous maintenance benzodiazepine course – 3 x 2 mg Rivotril (clonazepam), 4 x 15 mg Dormicum (midazolam) and 10 x 0.5 mg Xanax (alprazolam) daily so I just casually mentioned zopiclone and he just gave it to me, albeit with a rather strange spoken postscript – “Don’t inject it, ah”.

I think he knew I was desperate that night to get off and since I couldn’t score opiates off him, he probably figured I was going to get fucked up anyway, one way or the other.

(For the record, he was cleaned out – three 500 tablet DF-118 bottles was polished off by three patients in two months – and as luck would have it, the patients were named me, myself, and I, so you can imagine the implications behind that if anyone found out. To order more is to court disaster and risk questions about prescribing policies and would necessitate the second “disappearance” of my medical record should it be known that a single patient consumed that amount of DF-118 dihydrocodeine 30 mg with the willing participation of the said doctor. It would be useless to tell “them” that he justified his actions as a healthcare provider genuinely interested in my well being by getting me off street drugs and giving me a local harm reduction option in lieu of methadone replacement therapy in KL. The same thing happened about a year back and my medical record went “missing” to start me on a clean slate and to protect him from justifying prescriptions of certain controlled pharmaceuticals which some third-party observers might find excessive, but was actually necessary for your safety since I was using methamphetamine abusively then and was prone to aggression during meth induced psychosis and needed to be heavily sedated with large amount of benzodiazepines for public interest. I think one nurse was fired over that for “sloppy record keeping” and I still miss her to this day. I’m sorry you had to take the fall for us. Take care and Godspeed, wherever you are.) Combination dosage:
(Caution: This is not a dosage guide!)

Prior consumed pharmaceuticals:Prozac (fluoxetine) :40 mg (morning)
Benzodiazepines: Various (clonazepam 6 mg, alprazolam 4 mg and lorazepam 2 mg) throughout the day

“Sum of Parts” Dose:
Baclofen: 100 mg
Zopiclone: 225 mg
Tramadol: 400 mg
(and)
Dormicum (midazolam): 150 mg

I took 100 mg of baclofen and washed it down with 20 tablets of 7.5 mg zopiclone (don’t try this at home) and it felt good – it was better than the sum of its parts. I was full of serotonin for some reason, really happy, laughing, slurring my words and disinhibited. It was really good for 2 hours before a noticeable plateau so I took tramadol to boost it up again and it was great. It’s a really chatty disinhibited happy feeling, with a lot of slurring and anterograde amnesia (which is really quite fun while out, I would be talking and my friends couldn’t make sense of me with the slurring, and I would forget things in the middle of sentences which is quite amusing really).

There is an unusual amount of drug-seeking behavior (well, more than usual anyway :p) while on this combination – I kept on seeking more things to get me up, and I took the rest of the zopiclone (225 mg in all – the entire 30 tablets) and several benzodiazepines that I was carrying around with me (clonazepam and alprazolam – unknown amount). I can’t remember exactly what I took, but a friend had to stop me from popping pills and apparently I kept insisting that I was alright, but she got concerned anyway.

It was a blur for the next three hours (five hours from starting dose) before I got home and went straight to my prescription meds and gobbled down a full blister pack of Dormicum (midazolam) 15 mg. 10 tablets of Dormicum at once. I don’t remember much after that but apparently I decided to sleep at some point (that I remember) and left everything running and woke up to glaring lights and music at about 11 pm – a seven hour sleep.

I didn’t feel bad the next day, unlike the massive headache and excessive sleeping I encountered the first time I took baclofen (have taken more recreationally since then) but in hindsight, I took a lot of benzodiazepines and other hypnotics that night and while I was still aware of what I was doing, I could have overdosed if I hadn’t taken the strip of Dormicum 15 mgs which knocked me out.

I would probably still be fiending and trying to get more out of the “Sum of Parts” and take more benzos or mistake the Panadeine (500 mg paracetamol/APAP with 8 mg codeine) for Paralgin Forte (300 mg paracetamol/APAP with 30 mg codeine) or worse, didn’t give a flying fuck either way and grabbed fistfuls and swallowed it anyway (Panadeine is the devil coz paracetamol/APAP is Satan).
(Paralgin Forte is alright though if you can’t get any opiate only preparations)

It should be noted that 150 mg of Dormicum (midazolam) with the other benzodiazepines would be considered excessive to a benzodiazepine naïve person and could lead to an overdose in non-benzodiazepine tolerant people. I have taken larger amounts of Dormicum before since (therefore? – Cause and Causation) I’m desensitized to it, so I have to repeat – this is not a dosage guide.

The sum of the pharmaceutical combination is greater than the parts though, for what it’s worth. 😉

…but it’s also a dirty, desperate attempt to get off and for that price (the price of the pharmaceuticals) you can catch a better high though non-pharmaceutical substances. Only for the desperate (in my defense, I was doing it to stave off opiate withdrawals :p) with no other better substances or those who has miscellaneous pharmaceuticals with potential lying around at home.

For what it’s worth, it feels like low dose MDMA, and I could have gotten Ecstasy tablets instead…except I don’t do e anymore, unless it’s for a worthy cause (or with the right people) coz the day after serotonin depletion effect exacerbates my depression.

Speaking of opiates, it seems that the Malaysian government has decided to take DF-118 and other opiate containing preparations off the market slowly and leaving only morphine and fentanyl for palliative care patients so stock up while you can. It seems to be true, from the trends in the industry and more importantly, coz a beautiful angel told me so (she’s right, trust me, coz she’s a divine being and thus cannot be wrong, or it would violate the fundamental omniscience basis of most religions).

I’m sending out a team of my protégés (two male and one female) to obtain as much opiate preparations as they can coz I am unable to get prescriptions filled anymore due to pushing my luck once too many at the various medical establishments over here (and also due to general no-go red flags on my good name and the medical records it is associated with due to rampant documentation of my activities on this blog and the inevitable word of mouth mechanism creating sixthseal.com awareness amongst the medical fraternity and my reputable name along with it).

I am now limiting my doctor shopping activities to a couple of select doctors who are blissfully unaware of the existence of this blog or its connection to me (Why do you think I never put up another huge picture in the About Me page? That’s what the Narcotics police printed out in full color glossy A4 sized glory along with the more incriminating parts of my blog when they arrested me at my office so I’m not going to repeat that mistake. You have to search for photos now.) and I have a couple of solid links with dihydrocodeine 30 mg (just got 84 tablets off one doctor for a “slipped disc”).

My protégés are going to do most of my opiate doctor shopping for me now, since they’re “clean” (no prior records) and they’re actually getting quite good (one guy and one girl have successfully obtained DF-118, Paralgin Forte and DF-118, generic dihydrocodeine 30 mg, and morphine respectively) with a bit of my guidance, and they’re all presenting different ailments and are unaware of each other and don’t take opiates themselves which is a Good Thing (TM) coz you never ask an opiate user to score for you. It’ll just end up consumed. 😉

I’m offering them different terms too – one is new, one is swapping the opiates he gets for my benzodiazepines as a favor, and one is just doing it coz she can (and coz I reimburse the price of the consultation + medication for both hits and misses) but I do get a little concerned about the methods employed by the last one – the morphine was boosted in a CCTV covered area – but I must admit, she’s good at it, probably coz you’re so klepto. :p Oh, which reminds me, she’s doing it coz she owes me anyway, I saved her ass when she boosted some articles from MNG and she had to call me and I had to pay her way out so they don’t call the cops. I love you all anyway. =D

Go forth, and make fishers of men!

(or something)

Hmm…I seem to have greatly deviated from the post subject. My apologies.

You know I’m spun when I write voluminous posts with lengthy asides and constant meanderings like this one. 😉

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Pethidine (meperidine) IM injection experience report

pethidine ampoule

Pethidine is also known as meperidine a.k.a Demerol, an opiate agonist used for moderate to severe pain, with an equivalency of 7.5 mg of pethidine to 1 mg of morphine in parenteral administration. Pethidine/meperidine has a duration of 2 hours so it’s a pretty short acting opioid. I was out doctor shopping the whole of last night and didn’t get a hit out of the five medical establishments I went to. I guess six is my lucky number coz I managed to get a pethidine IM injection from it. =D

pethidine flash

This is Injection Pethidine Hydrochloride 50 mg/ml made by DuoPharma (Malaysia). I have never tried pethidine IM injection so imagine my glee as I made this happen. 😉

Doctor: You were here for DF-118 last time right? The medical record says you have a bad back.
Me: I actually had a slipped disc (actually, I don’t ;)) and it slipped again for the second time.
(makes “ouch face”, grimaces and made as if my spinal cord was killing me)
Doctor: Do we have DF-118 here? (talking to nurse)
Nurse: (after rummaging through the restricted access medication cabinet, they don’t have it, I know that coz I’ve been here before) No we don’t, but we have Voltaren.
Doctor: Do you want something else? I can give you another pain-killer.
Me: (Hell no! It’s opiates or nothing) Doctor, I hope you can help coz I’m in a lot of pain right now. Can you write a script or something?
Doctor: Okay, do you have a medical history of your slipped disc?
Me: Yeah, I had an MRI and X-Ray done in KL, where it happened (which didn’t happen, of course ;)) and the prognosis was a slipped disc, which I slipped again just now (*grimace of pain*)
Doctor: Do you have it with you?
Me: No, I’m sorry doctor, I left the medical documents in KL…
Doctor: Okay, well since you have a prior here, I’ll script you. Is there anything else?
Me: (pushing my luck, deciding to go for gold) Hey, I know this is a strange question, but I’m in a lot of pain right now, do you have anything to help me get through tonight? Can you give me a morphine shot? (Prays to God he doesn’t go amok)
Doctor: Morphine…hmm…well, we do have morphine but we don’t give it to outpatients. I think we have pethidine though, do you want that?
Me: Is pethidine an opiate? (Knowing full well it is, but no harm in playing the dumb patient)
Doctor: Yes it is.
(Writes Pethidine 50 mg IM stat on my medical record)
Me: (looks) (tries not to grin) (tries not to grin again, perhaps somewhat unsuccessfully) Thank you very much doctor.
Doctor: Alright, just lie there and I’ll prep the shot.
Me: (puts on a show of painful lying down and bolts straight up, apparently with a good back again) Hey, I’m sorry doctor, another unusual request, can I take a photo of the pethidine vial?
Doctor: Why?
Me: It’s just an interest of mine. (starts photoshoot of the IM pethidine 50 mg snap off ampoule) Thanks doctor.
Doctor: Okay, I’m going to inject you now. Turn over.
Me: Er…can I take the IM injection in my arm? (I don’t want the doctor to see my thigh, which is the best place to bang shit if you’re holding down a professional job – full of scar marks and bruises from injections – he would have known for sure I’m an IDU – Injecting Drug User).
Doctor: (Grips my arm) Seems to be okay here.
Me: (starts filming the procedure)

pethidine shot

Script from pethidine injection video:
Me: Is it in? Pethidine 50 mg?
Doctor: Mmm…
Me: Okay, IM, sixthseal.com (Jesus Christ, I should not have said that in the video but it just slipped out).
(sounds of pethidine injection process)
Me: Yeah, that’s the place.
Doctor: Hmm…why do you have some bruises here?
(OMG those are my IM injection spots when I was injecting ketamine)
Me: Er…uh…they’re some just bruises, ya know. I probably hit something.
(Quickly changes subject)
Me: So, is that pethidine 50 mg?
Doctor: Yeah.
Me: Thanks.

pethidine video

Download: Pethidine IM injection video [sixthseal.com]
(24 MB .MOV file zipped. Requires QuickTime)

Doctor: Are you driving?
Me: Er…no. (actually I am)
Doctor: This will cause the usual opiate side effects, drowsiness etc. so be careful.
Me: I will, my friend is just outside (actually no one is outside, I don’t take friends on doctor shopping expedition after a disastrous incident where I lost a good doctor coz me and my friend was stoned and high on meth and she had a laughing fit).
Doctor: Okay, here is your script. You’re not a drug addict are you?
Me: (*coughs and nearly chokes*) Of course I’m not. I hate drugs. 😉 (I didn’t wink, I’m just winking on the blog)
Doctor: Good.

pethidine bill

Price of 50 mg pethidine vial: RM 10
Price of surgical consumable items (that means the syringe and swabs): RM 0.40
Price of boosting a pethidine shot: PRICELESS! =D

pethidine charges

Pethidine Experience Report:
(10 minutes after the shot)
Me: I’m not feeling it yet, doctor? How long does it take to kick in?
Doctor: It’s not going to be so fast.
Me: So we can’t IV pethidine huh?
Doctor: (gives me a strange look) No, it’s for IM.
Me: Okay, thank you very, very much doctor.
(Shakes doctor’s hand very vigorously, perhaps too enthusiastic to be unsuspicious)

pethidine shot after

T+ 0:30: A general feeling of elation and well being. Don’t know if it’s the pethidine or the euphoria of getting away with a shot of pethidine just like that.
T+ 0:45: Cigarettes smokes well, like on opiates but it’s nowhere near as strong as dihydrocodeine. It does give a rather pleasant high though – kinda chill, but still motivated, I’m typing this as we speak, which I usually don’t.
T+ 1:00: I think this is the peak – it’s nothing special – I could compare it to a cross between tramadol and codeine if that makes sense. It feels like tramadol + codeine…and er, it seems a wee bit hallucinatory, I don’t know how to explain it, it’s like the feeling when you get a hit of LSD and is about to come up and trip, but it never happens. I just mentioned it coz I saw the cigarette smoke drifting off. Perhaps a more apt description would be a very mild case of Ambien induced hallucinations.
T+ 1:30: Hey, I’m feeling a little of that opiate warmth now. It’s nice but too mild for my tolerance.

50 mg of phethedine wasn’t enough to get me off, but I did feel good – which part of it is the phethedine and which part is the elation of pulling this shit off is subjective. I’m full of glee though. 🙂

pethidine vial

Pethidine IM feels a lot like a combination of tramadol and codeine at doses of 100 mg and 300 mg respectively. There is a general feeling of well being and slight stimulation but with some of the jitteriness of tramadol (very mild). It’s more like a cross between tramadol and codeine. The opiate warmth is present but mild. At my tolerance level, 50 mg of pethidine isn’t much, but at least I can feel it…and I’m STILL feeling st0ked about pulling this off! =D

Hail to the King, baby! =D

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My doctor reads my blog

df118 120 script

My doctor reads my blog and I screwed it up big time with the Duragesic post…I’m not getting any fentanyl patches coz “it would be gross negligence for me to prescribe it to you after all I know”. Which is fine, seriously. I’m cool with that. Everyone has an ass to cover and you’re doing just that. It’s cool with me.

df118 120 side

Thus, we entered discussions of what a secondary taper plan would be (dammit I should not have written about fentanyl that day :p) and we discussed morphine (MS-Contin 30 mg) which he nearly prescribed before thinking twice and just decided to fall back on Old Faithful (DF-118 not OxyContin, the latter causes a lot of phone calls for verification and takes about 1 hour to process).

df118 120 show

I told him I’m serious about quitting and told him my actual maintenance dose (which is at least 30 tablets of DF-118 (900 mg of dihydrocodeine) which is equianalgesic to 270 mg of MS-Contin (about 9 tablets of 30 mg morphine) which didn’t shock him much, being my old doctor and that (and partly why he dared to put me on Duragesic fentanyl patches in the first place, I would have OD if I didn’t have an opiate tolerance).

He gave me one last prescription for DF-118 (120 tablets) staggered by 10 days (basically a dated repeat Rx script) authorizing 60 tablets today and 60 tablets 10 days down the road. He basically put me on DF-118 30 mg x 2 (60 mg) three times a day (240 mg per day). That is not enough to even stave off my withdrawals so I had to renegade on my promise and despite this being the last prescription, I think I’m going to take it (in a non-recreational but non-withdrawal inducing manner ;))and then go on methadone.

You can tell I’m not serious about quitting. 😉 Like I said, I’ll quit when I’m good and ready, hey, I smoked and injected crystal methamphetamine for several years (abusively and compulsively) and quit just like that *snaps fingers*. I’ll do that same with opiates…when I’m good and ready. I’m thinking about Methadone Replacement Therapy (on the condition that only my opiate problem is being treated and not my benzodiazepine issue) when I run out of opiates from the Sibu Connection.

Me: Can I get both the prescription filled, so that I can have 120 tablets instead of just 60 tablets and come back again in 10 days just to refill the script coz this place is kinda far from where I stay?
(after calling my doctor to verify the script, oh boy, he must not be happy to hear I’m getting all 120 at once)
Pharmacist: Sure, I’ll make that arrangement for you.
Me: Thank you very much, I appreciate that.
Pharmacist: So you took time off work today?
Me: Nope, I had a client somewhere near here so I just happened to pass by.
Pharmacist: You must be pretty hardworking.
(wondering wtf that question meant)
Me: Well, I get the job done.
Pharmacist: Where do you stay?
Me: Tabuan Jaya.
(which is not really where I stay)
Pharmacist: Yeah, that’s a bit far.
Pharmacist: Anyway, the prescription is ready. 120 tablets of DF-118.
Me: Thank you very much, I always get a lot of problems with cashing in the script due to the nature of the medication.
Pharmacist: No problem. Glad to be of service.
Me: Thanks! You have a nice day, now.

(at the prescription counter)
Pharmacist #2: Mr. Poh?
Me: That’s me.
Pharmacist #2: 120 tablets of DF-118. Wow, do you mind me asking what ailment you’re suffering?
Me: I have a bad back and migraines. I’m opiate tolerant so the basic NSAIDs and triptans don’t really work on me.
Pharmacist #2: Really? What were you on?
Me: Well, I was put on Paralgin Forte (a 30 mg codeine preparation) at a very young age.
Pharmacist #2: *nods unconvincingly*
So who is you primary care doctor?
Me: (uh oh, I have scripts from literally dozens of doctors cashed in this fine medical facility) Well, it’s Doctor X (who died from cancer).
Pharmacist #2: Okay. We’re not supposed to give out so much DF-118 at once but we’ll make an exception this time ok?
Me: Thanks, I appreciate that…and do you know that you’re the only place to stock DF-118 in Kuching? (That’s me getting all chatty and shit) Timberland, they have morphine and fentanyl only. Kuching Specialist, they only carry morphine and Duragesic.
Pharmacist #2: Really? Why don’t you try those instead?
(wtf?!?)
Me: Er…I’m 25, who’s going to want to prescribe me morphine and fentanyl? *smiles*
Pharmacist #2: Oh, okay yeah I get what you mean. Thank you and have a nice day.
Me: You have a nice day too, and take care…and you know what, can you put down a note there that says I’m opiate tolerant, not opiate dependant, just in case, God forbid, I get run down by a car and checks into this fine medical facility, I just want to be on an equianalgesic dose, ya know.
(at this point most of the pharmacists look at me quizzically – some were smiling, some were not – but at least the girls were smiling)

Wise guy till the end. 😉 I’m not doing mosaic on the medical facility anymore – they’re the only ones carrying DF-118 anyway, and referring to the previous comment about whether it is from Normah, well if it looks like it’s from Normah, tastes like it’s from Normah and smells like it’s from Normah…then it probably came from Normah!

You don’t go eating something that looks like shit, tastes like shit, and smells like shit and go “Mmm…this here is some mighty fine chocolate pie” do you?

Jesus Christ…

Oh, and in other news, I lost RM 3,500 on football over the weekend…

…and that girl in the Miri fight video (the assailant with the blue scrunchie) is fucking hot! Can you call me at 013 811 2088 if you’re reading this? I’ll fly over to Miri for some S&M action if you’re up for it. 😉

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Dig your own hole

dig your own hole df118 rx

I’ve been really sick for the past few days due to The Bird Nesting By My Windows Part III (long time readers will know what I’m talking about) it’s been giving me sinus problems, diarrhea, pains and aches over by body, fever and insomnia (despite my healthy regiment of benzodiazepines). I wake up everyday feeling like shit and the thing is, I don’t know if it’s avian flu (very low probability) or I’m just dope sick (opiate withdrawal – symptoms sound familiar to you? ;))

dig your own hole df118 today

It’s a good thing that I managed to get 60 tablets of DF-118 (dihydrocodeine 30 mg tablets) scripted just now. I kinda messed up my story a little but this doctor knows everything about me, hell, so does the other, they’ve been seeing me for two years, it would take a fool to not see that I have a drug problem (the doctor was not fooled when I accidentally injected methamphetamine into an artery and told him I snagged my wrist on a rusty nail).

dig your own hole df118

(after scripting me the 60 x DF-118)
Doctor #1: *sigh* Huai Bin, you know you have a problem right?
Me: Yeah…I’m trying to sort things out but work is kinda hectic, you know…
Doctor #1: *sigh* Huai Bin, I really hope you can get off of these. It’s not helping you know.
Me: I know doc (actually I don’t ;)) but thanks for scripting me anyway, yeah? I appreciate it.

(after consuming all of his two new DF-118 500 tablet containers he ordered for me)
Doctor #2: Huai Bin, you come here several times a week and I’ve been through your medical records and I’m thinking that you’re not on maintenance anymore but you’re escalating your doses.
(This is the doctor who’s been treating me for years and has given me an infinite supply of maintenance benzodiazepines – Dormicum, Xanax, and Rivotril but is starting to get worried about my opiate use)
Me: You know doctor, work has been very stressful, and the opiates really help me get through the day.
(This doctor has scripted me Oxycontin before and also knows about my drug problems)
Me: I mean, the plan for this is for off-label harm reduction use right? I don’t want to go back to getting alternative non-pharmaceutical opiates (a euphemism for street heroin)
(We don’t actually talk about the fact that I use drugs intravenously – we walk around the issue – but he knows I’m safe about it – no sharing, one needle for each hit etc plus I have an excellent blood work record at his place, no transmissible diseases)
Doctor #2: You’re a really intelligent person, Huai Bin…I just don’t understand how someone like you would get yourself into this. I’ve seen kids coming in trying to get Nospan (Dextromethorphan – DXM a cheap high for the lower income folks) but you’re not like them.
Me: I’m just trying to get through the day, to smooth the edges a little…
Doctor #2: Don’t get me wrong, but I don’t think you have any intention of maintaining the dose – you’re increasing the dose. I know you’re on other opiates and I don’t want you to get involved in alternative non-pharmaceutical opiates in the interests of harm reduction. Don’t go down that road again, Huai Bin. I’ve run out of DF-118 and I cannot prescribe you any more opiates coz I don’t want you to dig a larger hole than you’re already in. I know you can get opiates elsewhere but I want you to think seriously about MRT.
(MRT = Methadone Replacement Therapy, recently initiated and only available in KL and I would have no problems getting into the program coz of my drug arrest and a letter of recommendation from my Case Officer in PDRM Narcotics Department, which I’m still close to)
Me: I can’t get away from work for long periods of time. How long will it take?
Doctor #2: I can write a letter of recommendation for 2 months. I think it would take that long for you to taper off…
Me: I definitely cannot go for rehab (MRT is a self-check in rehab with no restrictions e.g. you don’t have to stay in there for a fixed period but you can check yourself out anytime) for that long. Can you allow me to taper myself off? I’m interested in fentanyl patches (Duragesic patches) – the lowest dose is .25 ucg and you wear the patch for the whole day, much like a nicotine patch. Can you do that for me doctor?
Doctor #2: That is for cancer patients with terminal pain but I can accept a harm reduction taper program. Give me an honest answer…how long do you think you will need to be on it?
Me: Two weeks. It comes in a box of 5 patches so probably 3 boxes of Duragesic.
Doctor #2: Alright, I’ll make an Indent Order for that. But after this, there’s no more opiates alright? Just benzos, I can accept that due to your anxiety issues but no more opiates ok? This will be the last taper course.
Me: Okay doctor, I promise.
Doctor #2: Okay, I’ll get them in for you next week. Take care of yourself Huai Bin, I hope you can get off it by this.

Thus, I have some Duragesic patches coming in next week. Fentanyl, baby! =D

(The patches are injectable too if you get out the fentanyl)

w00t!

Anyway, I’m going on-site for work now. Will reply all the comment later.

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