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? ;))
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).
(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)
Anyway, I’m going on-site for work now. Will reply all the comment later.]]>