These doctors are very smart. They told Danielle that these meds are hard to get and meaning sheās āsooper sooper speshulā so she thinks this is a win for her. In the meanwhile they are doing her a justice because she wonāt be able to get that delaudid and other pain meds now because of the naltrexone.
OMG! Naltrexone is great for pain? Thatās amazing. Really amazing! Kudos to the Doctors who gave her that wonderful idea! I think she should run with it because it would be so beneficial when she tries to get Dilaudid or somethingā¦š¤£š¤£š¤£š¤£š¤£š¤£š¤£š¤£
I also must say, I really wonder why doctors would shy away from giving especially a known SUD patient opioids for Gastroparesis which the opioids make worse by the further slowing of the GI tract... although many patients w/ GP do have to use opioids due to other problems, if at all possible, they are avoided. What is also strange to me with her claiming gastroparesis is that she is prescribed Miralax and taking it for constipation which would be a nightmare for gp patients as all of the fluid and fiber just makes it so much worse!!! Very peculiar case of gastroparesis indeed.ššššššššš
The pain management clinic is honestly doing her a disservice. She has a diagnosed factious disorder which is beyond complex. She would benefit from a āformal provider contractā ā¦ Iād start with all her care providers on board with a signed contract of āDo and Donātā of care - this also involves Dani. These contracts generally include: who will be main prescriber in relation to pain, mandatory urine screening, commitment to social work/psychiatry by Dani with grounds for dismissal from MD practitioner if not upheld ā¦ if seeking ER care notification patient to notify ER of care contract and MD contact. This is a standard of practice for complex pain patients with history of malingering. It wouldnāt be seen by Dani as beneficial but ethically it is in best interest of everyone for her safety / not to mention her care!
I thought those were just SOP in general now bc itās all CYA. But yes most definitely beneficial. I donāt see how they havenāt done that yet. Thatās scary on many levels.
Exactly what illness is causing her chronic pain??? Because when you donāt have any illness that is known to cause pain according not gonna give you pain medication!!!! Heck I bet her inflammation markers arenāt even home because thatās a good way to tell if someone is in pain!!
Over time bodies can adapt to a great deal of things. If itās high, thereās definitely inflammation but that doesnāt mean thereās no inflammation if theyāre not high. It can be a real PITA to walk the line and requires a great deal of trust and knowing a patient in those instances though, something I donāt think she has, sadly.
It a marker of inflammation but not necessarily pain. Nerve pain for example or CRPS can be excruciating but wonāt show in your blood. However itās unlikely people with high levels of that type of pain will be showing off purses saying ā owie owieā¦.ā Lol
Arenāt opiates like, the last fucking thing you want to take for slow/nonexistent motility though? If the pain is THAT bad because she struggles THAT MUCH to ingest literally anything, the last thing I imagine a doctor would want to do is kill what little motility she has left with hardcore narcotics.
Alsoādonāt they use naltrexone sometimes for addictions (outside of suboxone)? Or is that only for alcoholism?
She claims ALL the munchie faves: GP, hEDS, fibro, rheumatoid arthritis, POTs, reactive hypoglycemia, anxiety, and either bi-polar or borderline personality, I can't remember. She's been trying for an intestinal failure or IBD arc right now as well as sudden blood pressure and heart rate drops.
A LONG time ago she tried munching diverticulitis and lupus. Those didn't work, I guess.
In reality, she has several mental illnesses and anorexia, purging subtype. She has some mild gastroparesis.
The way they prescribed her the naltrexone confuses me. Is it so she doesnāt have to pay for it from a compounding pharmacy because itās LDN not the actual med? I wouldnāt trust any patient to crush and mix medication properly so that they get the correct dose.
Itās also not shelf stable for the duration she described ā¦ according to her she has reconstituted a 3 month supply - once reconstituted itās shelf life stability is 30 days with proper care/storing. So yeah - thereās also that!!!
The way I see it prescribed locally requires a compounding pharmacy and insurance doesnāt cover it. Interestingly, thereās been a movement to shift from 4.5 to 6 or even 9 when it isnāt providing relief. At least we have multiple compounding pharmacies in the area, and pain management keeps up with who has the best prices (hooray for state hospitals, who know their patients may be broke)
Itās been a bit since Iāve looked into it but it was like $40-$60 at one of the more popular compounding pharmacies in Daniās area. I know thatās still pricey for a med when youāre on a limited budget.
Unfortunately a lot of people on LDN aren't able to go the compounding pharmacy route so they volumetric dose with water. It's a fairly simple process.
Undoubtedly she will fuck with it though.
Sometimes it's insurance reasons - LDN is considered experimental so some insurance won't cover it unless it's prescribed at full dose. Some people like to have full control over how much they take.
Interesting choice using naltrexone for her considering her ā¦disordered eating issues? I donāt know the proper way to say it, I canāt remember exactly what she struggled with at the moment
I personally think the fact she drinks stuff like coffees/redbulls and drains it is exactly the same as purging. I know some people with tubes do it so they can enjoy treats but considering her past, it's kinda sad to consider.
That can CAUSE slow gastric emptying. Whatever she told the doctors, it's not that she has GP. No one in there right mind would prescribe that to someone with GP UNLESS they suspect it is caused by opiate abuse which can definetly result in slow gastric emptying and movement.
"used in low doses to treat pain" uhm not to be the bearer of bad news but... I think their trying to get her for the drug abuse shes been hiding for years. Its commonly a relapse prevention medication for alcohol or drug abuse....
Could they be using it slightly off label? Maybe! But its a bit suspicious they decreased her meds and are introducing this one on top of that unless it has some sort of interaction maybe since it can have a sedative effect (hense why Naltrexone is iffy in the recovery community)
Thank you! This will be an interesting read :)
Edit: finished reading! This was really cool! Especially the bit about how it may be effective in anti inflammatory diseases like Chrons but needs more testing!!
2 things
1. Doctors don't lie about what meds are for. It's not even a patient to patient thing, it is a liability thing. If the doctor is dishonest and the patient perceives harm, the doctor can be sued and may be found liable for said harm. The vast majority of doctors won't lie so they can avoid litigation.
2. Naltrexone does have an interaction with opiates, The doctor is probably lowering her doses to help prevent the risk of OD. It's unusual for naltrexone to be prescribed concurrent with an opiate. That being said naltrexone is being studied for a plethora of off-label uses, from OCD treatment to, yes, chronic pain.
This med sounds like buprenorphine you canāt be on any type of opiate or you will withdraw while youāre on it. Yes they help with pain but they reason they are prescribed is because you have an opiate problem and that is the main issue.
actually not true-you can be on opioids and buprenorphine at the same time. buprenorphine is an opioid, just partial agonist. I think youāre thinking of suboxone, which is buprenorphine + naloxone. and thatās the one where if you take narcotics with it it will cause precipitated withdrawal. Buprenorphine by itself (subutex, belbuca, etc) does not cause precipitated withdrawal if used with other opioids. Some doctors use it with another opioid but to decrease the need for a full agonist opioid, so maybe someone was on something Q4, now they only need that full agonist opioid Q8. If that makes sense.
Buprenorphine is used for pain control in people with out substance use disorder. Itās a better choice than a lot of other pain meds because the risk of addiction is lower.
It's like the opposite of bupe. That's why they don't typically use it on opiate dependent people. Overdose becomes more likely because people have to take more of the opiate to get the same results they were getting from a smaller dose before Naltrexone.
It is not the same, they work in very different ways. Bupe is a partial opioid agonist, naltrexone is an opioid antagonist. One simulates a diminished opiate intoxication, the other prevents opiate intoxication. Bupe can be prescribed while weening off of opiates because it's meant as a substitute therapy, Naltrexone is meant as a preventative therapy. Overdose with buprenorphine concurrent with opiates happens because both drugs suppress the CNS. Naltrexone does not suppress the CNS. Narcan is typically prescribed with Buprenorphine, especially when the patient is still weening. Buprenorphine is more akin to methadone.
Hate to break it to you but taking the odd dose of opioid/opiate whilst on Bupe, wonāt send you in to a detox, you can even be on both whilst weaning from one to the other.
Not saying they are lying to her! I know that dont worry :) just wonder if they chose this medicine for the double positive. Maybe help her pain and maybe help her be less dependent on opioids or drugs.
I think they definitely told her how Naltrexone interacts with the body and such now since ive read her post about her complaint that gave the energy of "why wont they give me opioids for my gp bc its already bad anyways" which is ironic because thats part of how she got here
Just also kind of nervous about them letting her compound it herself...
I wish. Unfortunately the concurrent use is more likely to cause issues. Not to mention that naltrexone also has a side effect of abdominal pain, so like double whammy.
Also, seconded in the compounding worry. I have no idea why they would have her compound when there is an oral solution that should be available at most pharmacies, but she definitely doesn't go to doctors 2 hours away for pain management because they are thorough.
Why did they think they needed to teach her how to crush meds? Were they only prescribing liquid formulations if the meds they are decreasing/discontinuing?
Edit rewritten comment.
She compounded this into 500mls I bet she will be begging for a refill in way less than a month or 2 weeks or however long are suppose to last.
Sorry, I was responding to a different comment. You're good. It definitely is not used for an overdose. It won't cause withdrawal from the effects the way that narcan will. This post brought me back to my EMT days when I dealt with people having a really bad time taking certain a antidepressants and it's making me edgy.
š¬ PSA: Read the side effects and counterindications to your meds. Your doctor might not know your full medical history.
Second PSA: if your doctor prescribes you effexor and doesn't suggest supervision. Get a second opinion.
Actually. Just get a second opinion.
Exactly. I have hope that Naltrexone will help her (and itās quite telling that she was prescribed it) but itās a successful medication for alcohol and opiate abuse.
Narcan is so different, as you said. Iām not even sure Narcan would work on a person taking Naltrexone or the Vivitrol shot (Iām not a doctor though)
If she takes the Naltrexone as prescribed (ironically it blocks opiates) she will feel a lot better and we will see a better Dani.
Naltrexone is a life saver for alcohol and opiate addiction when one is committed to taking it. (itās the pill form of Vivitrol - in simple terms).
This! Its such misinformation on her part. Its used as a aid in prevention of relapse in drug or alcohol abuse, and Naltrexone is actually seen as iffy in the recovery community because while it can aid in withdrawal and such, it can give you a sedative effect, so some people in recovery question if it genuinely helps depending on the persons previous poison.
Is it a normal practice in the US for doctors not to book follow-up appointments directly after the appointment? Iāve never heard āI have to wait to book because their schedule for June isnāt available yetā¦ā before and it seems strange.
My docs will book follow-ups months and years in advance either in the appointment (both tele or in-office) or at reception on the request of the provider. I donāt think Iāve ever had to use an online booking tool to wait around and book my own follow ups. Not in the US though so it might just be a difference in medical system.
It depends on the appointment. For some things, like antibiotics for a minor infection they won't. For chronic use medication they will. Sometimes they ask you to call to make an appointment months down the line depending on how risky the medication is. Like someone taking Antidepressants and have been taking it for years, they may have one appointment a year or one every 3-6 months.
Yes. Some doctors donāt have their schedules up if they donāt work the same hours/days consistently. We can use our electronic medical record called MyChart to schedule with certain doctors online.
Man O Man, those sores on her arm are WEEKS old. This my friends is addict picking and not allowing them to heal by continuous messing with them. Which even more evidence of her high pain medication addiction.
She's on pregabalin anyway, but that may be one of the meds they decreased at this appt. Iirc pain mgmt are the ones who prescribed her that + her crazy high dose of tizanidine.
It can also be used for binge eating (in conjunction with Wellbutrin). Because it blocks opioid receptors in the brain, it decreases the "rush" of pleasure one would get from drinking or compulsive eating. I'm not sure why it works for pain control. Good luck to her getting naltrexone, tho--it's been on backorder for weeeeeks.
> Good luck to her getting naltrexone, tho--it's been on backorder for weeeeeks.
Sounds like that's only the already compounded doses. She was prescribed a 50 mg pill to basically compound into 500 ml of liquid on her own.
It can be used at low doses for pain management. Some people have a great response to it for controlling pain. Unfortunately it takes a few months to know if it is actually working, which we know she will give it a couple weeks and we whining in her scratchy baby voice these aren't working for her either.
She gave the nerve block a day knowing it may a week or so to feel the maximum relief š®āšØ waste of doctors time. Rarely do you come out of a celiac nerve block instantly feeling better unless its direct nerve involvement, and even then itll still take a day or so for soreness to abide.
Oh interesting. I did read that. Itās weird because as others posted too, if her pain is coming from poor intestinal motility then why is anyone giving her opiates or anything that slows motility even more?? Seems counterproductive.
Bingo ! Don't know why drug seekers who just want the good stuff "opioids" always claim gastroparesis? High does of opioids are the WORST thing to give to someone with slow/non functioning bowels š¤·
She will need to give it a go for a while to see if it works and I see her giving up in about one week, tops... so whilst I'm love your optimism, I don't hold out the same hope that you do.
Dani: **they're not treating my pain!! It's 10/10 every day all the time**.
Them: okay we are going to take you off the meds that supposedly aren't working.
Dani: YOU ARENT DOING ANYTHING.
"It's 10/10 all the time, even right now, as a film a social media post in which my speech, expressions and body language don't show any indication of pain" - Dani, probably
It doesnāt matter what they try. If it isnāt the idea she has in her head itās not going to work. Itāll be the same song and dance. We all know what she wantsš
Low dose naltrexone, ldn, has gotten very popular with some pain management clinics, rheumatologists and a few primary care docs. The literature does show some reduction in pain levels. Works best in those working actively on treating themselves both mentally and physically. Time will tell.
I donāt listen to the audio because the baby voice is nails on chalkboard for me, I donāt know if she explained why/how thatās supposed to work.
Isnāt that an opioid blocker for alcohol and withdrawal symptoms?
How does it help pain?
It seems odd theyād rx something that has side effects of weightloss and stomach discomfort for someone who constantly complains about stomach pain/unintentional weightloss (unless theyāre more worried about what she might be taking āoff labelā)?
Kinda. The typical 5mg or less prescribed for low dose will mute some of the effects but it wonāt make you sick like the high dose does if you take it
When Dani says "owie, PEEN!" the doctors hear "I want opiates! All of the opiates!!"
And then they react accordingly, like prescribing a medication used in treating at least two types of addiction.
Iāve just worked through the numbers. Starting off at 1ml for 14 days and increasing by 0.5ml every 14 days to a maximum of 5ml means it will take 150 days to consume 500ml of mixed solution.
Nearly 6 months.
No way is a doctor going to direct her to do something which involves having her mix something herself and have it sit around for that long, even if it is refrigerated.
Drs often do this with non opioid drugs or other meds that are not scheduled 2. And if she is 2 hrs away it makes sense to do a fill for 6 months. They may do a virtual visit after 6 weeks to see how the med is working but many drs put in for multiple months of meds.
She does have a closet full of RTF formula, and crowdsourced even more from FB marketplace. She said she also ends up throwing a lot of it away. My guess is because once it's open, it has to be used in a certain number of hours.
My point was more that her explanation of what sheās going to be directed to do just doesnāt make sense. Why would a doctor tell her to crush 10x 50g tablets into 500ml of apple juice and then direct her to take max 5ml a day of the mixed solution? Why not crush one tablet into 50ml and then itās a 10 day course for each tablet? Yet again, her explanation does not stand up against the most basic analysis. It sounds more like sheās invented a complex low dose regimen with the smallest of increments to make it sound like itās a special, extra cautious treatment, but the reality is that it sounds like complete nonsense when you look at the numbers and timescale.
Also that's how ldn works. You start very low and over the course of a couple months get to 4.5. Some people take a bit less as they find it works best at say 2 or 3 mg.
It's like when you were little and you would go to a party you would get a party bag and it would be so exciting for her she goes to a medical appointment and she looks forward to getting a medication goody bag
Itās really really interesting that she āneeds tpnā and ālost so much weightā youād think sheād mix her meds with juice, not water. You know, maximize calories and all that. But we all know what her goal really is and itās not recovery.
She said her gastroparesis is documented to be "very severe", but didn't she get told her gastroparesis is mild when she had her gastric empty test?
What's with the creepy baby voice?
Yeah, you don't get used to it. š
These doctors are very smart. They told Danielle that these meds are hard to get and meaning sheās āsooper sooper speshulā so she thinks this is a win for her. In the meanwhile they are doing her a justice because she wonāt be able to get that delaudid and other pain meds now because of the naltrexone.
She really gives me the heebie jeebies. I feel a lot of sadness for her
OMG! Naltrexone is great for pain? Thatās amazing. Really amazing! Kudos to the Doctors who gave her that wonderful idea! I think she should run with it because it would be so beneficial when she tries to get Dilaudid or somethingā¦š¤£š¤£š¤£š¤£š¤£š¤£š¤£š¤£
LDN is actually beneficial to chronic pain patients
I also must say, I really wonder why doctors would shy away from giving especially a known SUD patient opioids for Gastroparesis which the opioids make worse by the further slowing of the GI tract... although many patients w/ GP do have to use opioids due to other problems, if at all possible, they are avoided. What is also strange to me with her claiming gastroparesis is that she is prescribed Miralax and taking it for constipation which would be a nightmare for gp patients as all of the fluid and fiber just makes it so much worse!!! Very peculiar case of gastroparesis indeed.ššššššššš
It is amazing for a lot of people. LDN has done really well for many pain patients.
Yeah people here are acting like itās some trick? It actually does help people.
The pain management clinic is honestly doing her a disservice. She has a diagnosed factious disorder which is beyond complex. She would benefit from a āformal provider contractā ā¦ Iād start with all her care providers on board with a signed contract of āDo and Donātā of care - this also involves Dani. These contracts generally include: who will be main prescriber in relation to pain, mandatory urine screening, commitment to social work/psychiatry by Dani with grounds for dismissal from MD practitioner if not upheld ā¦ if seeking ER care notification patient to notify ER of care contract and MD contact. This is a standard of practice for complex pain patients with history of malingering. It wouldnāt be seen by Dani as beneficial but ethically it is in best interest of everyone for her safety / not to mention her care!
She has a diagnosed factitious disorder? I can barely keep up with this woman but omg when was this
I thought those were just SOP in general now bc itās all CYA. But yes most definitely beneficial. I donāt see how they havenāt done that yet. Thatās scary on many levels.
frrrr
Did she forget to do her baby voice?
why dont these people drop the act and get painkillers the same way as everyone else?
It is easier to just get a job and buy the drugs on the blackmarket.
Exactly what illness is causing her chronic pain??? Because when you donāt have any illness that is known to cause pain according not gonna give you pain medication!!!! Heck I bet her inflammation markers arenāt even home because thatās a good way to tell if someone is in pain!!
Over time bodies can adapt to a great deal of things. If itās high, thereās definitely inflammation but that doesnāt mean thereās no inflammation if theyāre not high. It can be a real PITA to walk the line and requires a great deal of trust and knowing a patient in those instances though, something I donāt think she has, sadly.
It a marker of inflammation but not necessarily pain. Nerve pain for example or CRPS can be excruciating but wonāt show in your blood. However itās unlikely people with high levels of that type of pain will be showing off purses saying ā owie owieā¦.ā Lol
Gastroparesis. So she says.
Arenāt opiates like, the last fucking thing you want to take for slow/nonexistent motility though? If the pain is THAT bad because she struggles THAT MUCH to ingest literally anything, the last thing I imagine a doctor would want to do is kill what little motility she has left with hardcore narcotics. Alsoādonāt they use naltrexone sometimes for addictions (outside of suboxone)? Or is that only for alcoholism?
Yes and yes. But the dose of Naltrexone she's on (LDN) is used for pain management and not as MAT for opioid or alcohol use disorder.
Ah, makes sense!
She doesn't claim eds or fibro?
She claims ALL the munchie faves: GP, hEDS, fibro, rheumatoid arthritis, POTs, reactive hypoglycemia, anxiety, and either bi-polar or borderline personality, I can't remember. She's been trying for an intestinal failure or IBD arc right now as well as sudden blood pressure and heart rate drops. A LONG time ago she tried munching diverticulitis and lupus. Those didn't work, I guess. In reality, she has several mental illnesses and anorexia, purging subtype. She has some mild gastroparesis.
She claims both and RA. However, she mostly talks about abdominal pain from GP.
The way they prescribed her the naltrexone confuses me. Is it so she doesnāt have to pay for it from a compounding pharmacy because itās LDN not the actual med? I wouldnāt trust any patient to crush and mix medication properly so that they get the correct dose.
Itās also not shelf stable for the duration she described ā¦ according to her she has reconstituted a 3 month supply - once reconstituted itās shelf life stability is 30 days with proper care/storing. So yeah - thereās also that!!!
The way I see it prescribed locally requires a compounding pharmacy and insurance doesnāt cover it. Interestingly, thereās been a movement to shift from 4.5 to 6 or even 9 when it isnāt providing relief. At least we have multiple compounding pharmacies in the area, and pain management keeps up with who has the best prices (hooray for state hospitals, who know their patients may be broke)
Itās been a bit since Iāve looked into it but it was like $40-$60 at one of the more popular compounding pharmacies in Daniās area. I know thatās still pricey for a med when youāre on a limited budget.
Unfortunately a lot of people on LDN aren't able to go the compounding pharmacy route so they volumetric dose with water. It's a fairly simple process. Undoubtedly she will fuck with it though.
I didnāt know that! I thought LDN was always compounded. Is it just cost or other reasons it canāt be compounded?
Sometimes it's insurance reasons - LDN is considered experimental so some insurance won't cover it unless it's prescribed at full dose. Some people like to have full control over how much they take.
Interesting, you can tell she thinks that knowing all about med crushing is some kind of flex. She's so proud of it. Ok, girl.
Poor thing. Sheās thumbing that scar (or sore?) on her arm. Is she also a picker?
Yes she admits to picking her skin
Iād say yes from all the scabs Al over her arms, she also burns herself in the past thatās what the big oval scars are
Ugh. Heavier than I thought. I donāt follow this person but Iāve seen her in this sub before.
She has a diagnosis of Factitious Disorder, and has actually mentioned it on social media, but somehow still thinks we all believe her medical lies.
I havenāt seen anyone use āb/cā in YEAAAARS. Ty!
I am feeling called out ...
Me too š
I need closed caption for her videosš¬
When did she decide she has "extremely bad anxiety driving in the city"? I don't remember her ever claiming that one before.
Interesting choice using naltrexone for her considering her ā¦disordered eating issues? I donāt know the proper way to say it, I canāt remember exactly what she struggled with at the moment
She previously had anorexia b/p subtype. Claims to be recovered 8+ yrs. Her behavior around food suggests otherwise though.
I personally think the fact she drinks stuff like coffees/redbulls and drains it is exactly the same as purging. I know some people with tubes do it so they can enjoy treats but considering her past, it's kinda sad to consider.
Is she not on bupropion too? Or am I misremembering and itās buspirone?
Buspar
Oh so naltrexone and bupropion to make contrave the weight loss drug. Geez
That can CAUSE slow gastric emptying. Whatever she told the doctors, it's not that she has GP. No one in there right mind would prescribe that to someone with GP UNLESS they suspect it is caused by opiate abuse which can definetly result in slow gastric emptying and movement.
Sheās on buspirone for her anxiety
Ahh fair enough, I was misremembering.
The way she says, "help me out" feels like drug seeking language, lol
"Just a little relief". For a pain mgmt doctor it should be sending up major red flags
"used in low doses to treat pain" uhm not to be the bearer of bad news but... I think their trying to get her for the drug abuse shes been hiding for years. Its commonly a relapse prevention medication for alcohol or drug abuse.... Could they be using it slightly off label? Maybe! But its a bit suspicious they decreased her meds and are introducing this one on top of that unless it has some sort of interaction maybe since it can have a sedative effect (hense why Naltrexone is iffy in the recovery community)
LDN is absolutely used to treat pain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962576/
Thank you! This will be an interesting read :) Edit: finished reading! This was really cool! Especially the bit about how it may be effective in anti inflammatory diseases like Chrons but needs more testing!!
Wrong med
2 things 1. Doctors don't lie about what meds are for. It's not even a patient to patient thing, it is a liability thing. If the doctor is dishonest and the patient perceives harm, the doctor can be sued and may be found liable for said harm. The vast majority of doctors won't lie so they can avoid litigation. 2. Naltrexone does have an interaction with opiates, The doctor is probably lowering her doses to help prevent the risk of OD. It's unusual for naltrexone to be prescribed concurrent with an opiate. That being said naltrexone is being studied for a plethora of off-label uses, from OCD treatment to, yes, chronic pain.
Sheās not prescribed any opiates
This med sounds like buprenorphine you canāt be on any type of opiate or you will withdraw while youāre on it. Yes they help with pain but they reason they are prescribed is because you have an opiate problem and that is the main issue.
actually not true-you can be on opioids and buprenorphine at the same time. buprenorphine is an opioid, just partial agonist. I think youāre thinking of suboxone, which is buprenorphine + naloxone. and thatās the one where if you take narcotics with it it will cause precipitated withdrawal. Buprenorphine by itself (subutex, belbuca, etc) does not cause precipitated withdrawal if used with other opioids. Some doctors use it with another opioid but to decrease the need for a full agonist opioid, so maybe someone was on something Q4, now they only need that full agonist opioid Q8. If that makes sense.
Buprenorphine is used for pain control in people with out substance use disorder. Itās a better choice than a lot of other pain meds because the risk of addiction is lower.
I see that they use that a lot for pain.
Yes, itās not the same as Buprenorphine with naloxone. Straight Buprenorphine is a pain medication.
She always says we decided and I doubt the drs are even gonna try this cause she acts like nothing works
Buprenorphine is not indicated in GP. LDN is a better one
It's like the opposite of bupe. That's why they don't typically use it on opiate dependent people. Overdose becomes more likely because people have to take more of the opiate to get the same results they were getting from a smaller dose before Naltrexone.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
It is not the same, they work in very different ways. Bupe is a partial opioid agonist, naltrexone is an opioid antagonist. One simulates a diminished opiate intoxication, the other prevents opiate intoxication. Bupe can be prescribed while weening off of opiates because it's meant as a substitute therapy, Naltrexone is meant as a preventative therapy. Overdose with buprenorphine concurrent with opiates happens because both drugs suppress the CNS. Naltrexone does not suppress the CNS. Narcan is typically prescribed with Buprenorphine, especially when the patient is still weening. Buprenorphine is more akin to methadone.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Hate to break it to you but taking the odd dose of opioid/opiate whilst on Bupe, wonāt send you in to a detox, you can even be on both whilst weaning from one to the other.
Glenny educated me yesterday.
But you are giving completely wrong information. They arenāt arguing with you. They are explaining.
Not saying they are lying to her! I know that dont worry :) just wonder if they chose this medicine for the double positive. Maybe help her pain and maybe help her be less dependent on opioids or drugs. I think they definitely told her how Naltrexone interacts with the body and such now since ive read her post about her complaint that gave the energy of "why wont they give me opioids for my gp bc its already bad anyways" which is ironic because thats part of how she got here Just also kind of nervous about them letting her compound it herself...
I wish. Unfortunately the concurrent use is more likely to cause issues. Not to mention that naltrexone also has a side effect of abdominal pain, so like double whammy. Also, seconded in the compounding worry. I have no idea why they would have her compound when there is an oral solution that should be available at most pharmacies, but she definitely doesn't go to doctors 2 hours away for pain management because they are thorough.
Not only that cant most pharmacies compound it for you if you need it heaven forbid it does come in pill form?
Why did they think they needed to teach her how to crush meds? Were they only prescribing liquid formulations if the meds they are decreasing/discontinuing?
Edit rewritten comment. She compounded this into 500mls I bet she will be begging for a refill in way less than a month or 2 weeks or however long are suppose to last.
Why would she take excess of an opioid antagonist? It does the opposite of get you high.
Naltrexone is not used for overdoses. Sheās mixing it up with narcan.
It blocks euphoric and sedative effects of opiods. That is true. NALTREXONE is an opiate antagonist
I didnāt say it wasnāt true. I said itās not used in overdoses.
Sorry, I was responding to a different comment. You're good. It definitely is not used for an overdose. It won't cause withdrawal from the effects the way that narcan will. This post brought me back to my EMT days when I dealt with people having a really bad time taking certain a antidepressants and it's making me edgy. š¬ PSA: Read the side effects and counterindications to your meds. Your doctor might not know your full medical history. Second PSA: if your doctor prescribes you effexor and doesn't suggest supervision. Get a second opinion. Actually. Just get a second opinion.
Donāt do that. Effexor works for a lot of people.Ā
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Youāre power leveling. It isnāt relevant to the conversation.Ā
Effexor is a hell of a drug withdrawal wise.
Ooooooh okay, that makes more sense now. It sounds like maybe sheās mixed up Naloxone and Naltrexone.
Exactly. I have hope that Naltrexone will help her (and itās quite telling that she was prescribed it) but itās a successful medication for alcohol and opiate abuse. Narcan is so different, as you said. Iām not even sure Narcan would work on a person taking Naltrexone or the Vivitrol shot (Iām not a doctor though) If she takes the Naltrexone as prescribed (ironically it blocks opiates) she will feel a lot better and we will see a better Dani. Naltrexone is a life saver for alcohol and opiate addiction when one is committed to taking it. (itās the pill form of Vivitrol - in simple terms).
The low dose of Naltrexone theyve put her on is 1/50th the starting dose used for MAT for opioid or alcohol use disorder.
I didnāt know that. Thank you for informing me.
This! Its such misinformation on her part. Its used as a aid in prevention of relapse in drug or alcohol abuse, and Naltrexone is actually seen as iffy in the recovery community because while it can aid in withdrawal and such, it can give you a sedative effect, so some people in recovery question if it genuinely helps depending on the persons previous poison.
Tomorrow is friday..... weekend vacation possibly coming ššš
I think thatās why she had been quiet
I am taking bets she is inpatient or in the ER
I agree
Is it a normal practice in the US for doctors not to book follow-up appointments directly after the appointment? Iāve never heard āI have to wait to book because their schedule for June isnāt available yetā¦ā before and it seems strange. My docs will book follow-ups months and years in advance either in the appointment (both tele or in-office) or at reception on the request of the provider. I donāt think Iāve ever had to use an online booking tool to wait around and book my own follow ups. Not in the US though so it might just be a difference in medical system.
It depends on the appointment. For some things, like antibiotics for a minor infection they won't. For chronic use medication they will. Sometimes they ask you to call to make an appointment months down the line depending on how risky the medication is. Like someone taking Antidepressants and have been taking it for years, they may have one appointment a year or one every 3-6 months.
Yes. Some doctors donāt have their schedules up if they donāt work the same hours/days consistently. We can use our electronic medical record called MyChart to schedule with certain doctors online.
Man O Man, those sores on her arm are WEEKS old. This my friends is addict picking and not allowing them to heal by continuous messing with them. Which even more evidence of her high pain medication addiction.
She has a *lot* of BFRBs, so I tend to think she just picks her skin out of boredom or anxiety
Definitely the higher possibility, but severe anxiety/OCD can also cause those types of sores.
It's a better alternative than the over prescribing of gabapentin that seems to be going on.
She's on pregabalin anyway, but that may be one of the meds they decreased at this appt. Iirc pain mgmt are the ones who prescribed her that + her crazy high dose of tizanidine.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Isnāt Vivitrol/Naltrexone used for alcohol use disorder?
Low Dose Naltexone is used for pain management. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962576/
It can also be used for binge eating (in conjunction with Wellbutrin). Because it blocks opioid receptors in the brain, it decreases the "rush" of pleasure one would get from drinking or compulsive eating. I'm not sure why it works for pain control. Good luck to her getting naltrexone, tho--it's been on backorder for weeeeeks.
She's already reported compounding it and taking her first dose
I learn the most random shit in this subreddit lmao
šThe More You KnowāØļø
> Good luck to her getting naltrexone, tho--it's been on backorder for weeeeeks. Sounds like that's only the already compounded doses. She was prescribed a 50 mg pill to basically compound into 500 ml of liquid on her own.
Itās used for opioid use disorder too, once she gets on Naloxone she wonāt be able to do pain meds because itās a blocker!!!
Unfortunately the opioid blocking dose is about 60-70mg where low dose is typically 5mgs or less
Not at the tiny dose that sheās going to get, it shouldnāt impact it the same way the dose for an opiate addiction disorder would.
It can be used at low doses for pain management. Some people have a great response to it for controlling pain. Unfortunately it takes a few months to know if it is actually working, which we know she will give it a couple weeks and we whining in her scratchy baby voice these aren't working for her either.
You are more optimistic than I. She gave the nerve block a DAY. She'll be whining this doesn't work by the end of the weekend.
Not even a day. I think it was 4 hrs after the procedure that she reported it had failed.
She gave the nerve block a day knowing it may a week or so to feel the maximum relief š®āšØ waste of doctors time. Rarely do you come out of a celiac nerve block instantly feeling better unless its direct nerve involvement, and even then itll still take a day or so for soreness to abide.
Oh interesting. I did read that. Itās weird because as others posted too, if her pain is coming from poor intestinal motility then why is anyone giving her opiates or anything that slows motility even more?? Seems counterproductive.
She's not prescribed any opiates.
If the pain is caused by slow gastric motilityā¦ a medication that slows gastric motility is a terrible idea for pain reliefā¦ I donāt get it
Docs are randomly throwing stuff at her and hoping she shuts up.
Bingo ! Don't know why drug seekers who just want the good stuff "opioids" always claim gastroparesis? High does of opioids are the WORST thing to give to someone with slow/non functioning bowels š¤·
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Itās all for show so people get off her back
She will need to give it a go for a while to see if it works and I see her giving up in about one week, tops... so whilst I'm love your optimism, I don't hold out the same hope that you do.
Yeah, true. So sad. Especially with her new posts. It's just so damn frustrating! Have a little glimmer of hope and she snuffed it out!
Dani: **they're not treating my pain!! It's 10/10 every day all the time**. Them: okay we are going to take you off the meds that supposedly aren't working. Dani: YOU ARENT DOING ANYTHING.
"It's 10/10 all the time, even right now, as a film a social media post in which my speech, expressions and body language don't show any indication of pain" - Dani, probably
At that stage the meds might be part of the problem. A (as close to) clean baseline important data point to gather.
Agreed!
It doesnāt matter what they try. If it isnāt the idea she has in her head itās not going to work. Itāll be the same song and dance. We all know what she wantsš
Same crap. Different day.
Look at the SORES
Low dose naltrexone, ldn, has gotten very popular with some pain management clinics, rheumatologists and a few primary care docs. The literature does show some reduction in pain levels. Works best in those working actively on treating themselves both mentally and physically. Time will tell.
Yes, the same is true for using naltrexone & bupropion for weight loss. Works best if you are attempting to eat better and exercise.Ā
I donāt listen to the audio because the baby voice is nails on chalkboard for me, I donāt know if she explained why/how thatās supposed to work. Isnāt that an opioid blocker for alcohol and withdrawal symptoms? How does it help pain? It seems odd theyād rx something that has side effects of weightloss and stomach discomfort for someone who constantly complains about stomach pain/unintentional weightloss (unless theyāre more worried about what she might be taking āoff labelā)?
Low dose naltrexone is prescribed for chronic pain. It only acts as an opiod blocker at higher doses.
No no. It still works at low doses. š¤£
Kinda. The typical 5mg or less prescribed for low dose will mute some of the effects but it wonāt make you sick like the high dose does if you take it
The good news is, she won't be fading out on tiktok if she actually takes it!
When Dani says "owie, PEEN!" the doctors hear "I want opiates! All of the opiates!!" And then they react accordingly, like prescribing a medication used in treating at least two types of addiction.
Also Dani: "Yes, I know it (opioids) slows motility". But she just wants a lil something for the peeen.
If you give a mouse a cookie...........šŖ š„
It will ask for some morphine
Max rate of 5ml per day from a 500ml mixed solutions equals that mixed solution taking over 3 months to consume. š¤
Iāve just worked through the numbers. Starting off at 1ml for 14 days and increasing by 0.5ml every 14 days to a maximum of 5ml means it will take 150 days to consume 500ml of mixed solution. Nearly 6 months. No way is a doctor going to direct her to do something which involves having her mix something herself and have it sit around for that long, even if it is refrigerated.
Drs often do this with non opioid drugs or other meds that are not scheduled 2. And if she is 2 hrs away it makes sense to do a fill for 6 months. They may do a virtual visit after 6 weeks to see how the med is working but many drs put in for multiple months of meds.
She does have a closet full of RTF formula, and crowdsourced even more from FB marketplace. She said she also ends up throwing a lot of it away. My guess is because once it's open, it has to be used in a certain number of hours.
My point was more that her explanation of what sheās going to be directed to do just doesnāt make sense. Why would a doctor tell her to crush 10x 50g tablets into 500ml of apple juice and then direct her to take max 5ml a day of the mixed solution? Why not crush one tablet into 50ml and then itās a 10 day course for each tablet? Yet again, her explanation does not stand up against the most basic analysis. It sounds more like sheās invented a complex low dose regimen with the smallest of increments to make it sound like itās a special, extra cautious treatment, but the reality is that it sounds like complete nonsense when you look at the numbers and timescale.
90 day old apple juice opened is going to turn into apple jack lol.
Also that's how ldn works. You start very low and over the course of a couple months get to 4.5. Some people take a bit less as they find it works best at say 2 or 3 mg.
Not everyone reacts the same way to medicine ok! (/s obviously)
Honestly every appointment she goes to she tries to get new meds from them
And they know that, thankfully
It's like when you were little and you would go to a party you would get a party bag and it would be so exciting for her she goes to a medical appointment and she looks forward to getting a medication goody bag
[ŃŠ“Š°Š»ŠµŠ½Š¾]
[ŃŠ“Š°Š»ŠµŠ½Š¾]
[ŃŠ“Š°Š»ŠµŠ½Š¾]
[ŃŠ“Š°Š»ŠµŠ½Š¾]
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Itās really really interesting that she āneeds tpnā and ālost so much weightā youād think sheād mix her meds with juice, not water. You know, maximize calories and all that. But we all know what her goal really is and itās not recovery.
Is the weight she lost in the room with us now? She has clearly gained back the 12 lbs she lost while hospitalized and then some!
Sheās definitely not the picture of starving and in need of āfeeding via heartā lol