![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 33. Go back in thread:
Posted by MB on July 18, 2001, at 11:38:23
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 18, 2001, at 8:44:28
> > My drugs were codeine and morphine derivatives (drugs with slightly different, yet similar, mechanisms of action).
>
> Ultram is an opioid agonist, too -- just a very weak one.
>
> > If you take the methadone route, I would advise you to not choose the *maintenence* program (where they keep you on it for a long time).
>
> That might actually be the best thing (especially if Bijou isn't in the US, although I think that Ultram is strictly a US brand name). I'm not sure if they would admit someone to a MMT program who's dependent on Ultram, though, when there are so many people who need the service because of heroin addiction who aren't getting it.
>
> > It may sound rosey
>
> It's not, as you say. But most people I've met who are on MMT are happy with it, even in the US where it's very restrictive (as you also say).I sure wasn't happy with it, but then my situation was weird. They started me on 20mg every day...after the third day it was supposed to keep me "well" until the next dose (I don't know why it was supposed to take three days, the nurse said something about "building up in the body," but I never completely understood). Anyway, I'd get deathly sick (withdrawal) every night, and each day until my next dose. They kept increasing the dose, saying that larger doses would take longer to clear, which makes sense, I guess. They eventually got me up to 210 mg/day, but I was still getting sick at night. The larger doses didn't keep me "well" for longer periods, they just boosted my dependence so when I *did* get sick that night (and all next day until my next dose) the sickness got progressively worse. By the time I was at 210mg/day, I needed someone to help me walk into the clinic. I don't know why I was metabolizing it so fast, but they said it happens with some people. I tried everything. I even started eating a box of OTC Tagamet before each dose because it was supposed to inhibit the enzyme that metabolized methadone. It was a nightmare. My pdoc thought that if I could get dosed twice a day, it would keep my blood levels high enough to block withdrawal, but they were only open a few hours a day, and they wouldn't let me take the other half of my dose home because they thought i'd sell it!!! I mean, I was dying every night from withdrawals, why would I f***ing sell my dose??? I finally had to be hospitalized where it was legal for my pdoc to prescribe methadone, then he prescribed a "split dose" and I was off of it and back on heroin in a couple weeks. What a relief!!! And I must say that nobody in the clinic was glad to be chained to that clinic that treated people like animals. Maybe other clinics are different, but my whole experience to this day makes me enraged. So, sorry for the rant. Peace :-)
> > Choose the detox program (a program where they taper you down relatively comfortably over a two week period).
>
> I'm not even sure that they would be willing to admit an Ultram-dependent person to a methadone detox program; they might just try to force "drug free" detox (which can be ugly, although I think with Ultram it wouldn't be so bad -- I still want to know how much Bijou has been taking).
>
> Also, "detoxing" wouldn't solve the problem that Bijou has getting by without Ultram.
>
> > There's also a blood pressure medicine called Clonadine that helps alleviate withdrawal symptoms, and it is not addictive (as far as I know).
>
> It's also not very effective, unfortunately.
>
> -elizabeth
Posted by Elizabeth on July 18, 2001, at 20:58:06
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 18, 2001, at 11:38:23
> > It's not, as you say. But most people I've met who are on MMT are happy with it, even in the US where it's very restrictive (as you also say).
>
> I sure wasn't happy with it, but then my situation was weird. They started me on 20mg every day...after the third day it was supposed to keep me "well" until the next dose (I don't know why it was supposed to take three days, the nurse said something about "building up in the body," but I never completely understood).Steady-state serum levels, that's all. Methadone is very long-acting, so it doesn't take long to reach steady state (same with Prozac, for example).
> Anyway, I'd get deathly sick (withdrawal) every night, and each day until my next dose.
Methadone is *supposed* to last a day or more, but for some people it doesn't. (The recommended dosing schedule for pain is every 4-6 hours. I never understood why it would be different.)
> They kept increasing the dose, saying that larger doses would take longer to clear, which makes sense, I guess. They eventually got me up to 210 mg/day, but I was still getting sick at night.
You needed to take it in divided doses, twice a day perhaps. Getting you up to an unbelievably high dose was effective at enslaving you, though, wasn't it? (That was the original idea behind MMT.)
> By the time I was at 210mg/day, I needed someone to help me walk into the clinic.
I couldn't imagine being able to get myself to a clinic in the morning if I were dependent on methadone to remain undepressed and it didn't last as long as it's "supposed" to.
> I don't know why I was metabolizing it so fast, but they said it happens with some people.
Yet for some reason, they won't adapt the system to deal with it.
> I tried everything. I even started eating a box of OTC Tagamet before each dose because it was supposed to inhibit the enzyme that metabolized methadone.
That's an old trick! I guess it didn't work, though. I'm not sure how much cimetidine you'd have to take.
> I finally had to be hospitalized where it was legal for my pdoc to prescribe methadone, then he prescribed a "split dose" and I was off of it and back on heroin in a couple weeks. What a relief!!!
I guess you couldn't continue on MMT and use heroin as your nightly dose (because they test your urine for 6-monoacetylmorphine, presumably)? No way to win.
> And I must say that nobody in the clinic was glad to be chained to that clinic that treated people like animals.
They're not people, they're drug addicts (that's the idea, anyway).
> Maybe other clinics are different, but my whole experience to this day makes me enraged.
Maybe; or maybe other people are just so fed up with life on dope that they're willing to put up with all the cr*p.
> So, sorry for the rant. Peace :-)
Always peace. It's just a rant, after all. < g >
-elizabeth
Posted by MB on July 19, 2001, at 20:13:58
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 18, 2001, at 20:58:06
> > > It's not, as you say. But most people I've met who are on MMT are happy with it, even in the US where it's very restrictive (as you also say).
> >
> > I sure wasn't happy with it, but then my situation was weird. They started me on 20mg every day...after the third day it was supposed to keep me "well" until the next dose (I don't know why it was supposed to take three days, the nurse said something about "building up in the body," but I never completely understood).
>
> Steady-state serum levels, that's all. Methadone is very long-acting, so it doesn't take long to reach steady state (same with Prozac, for example).
So that's all it is? Just takes time to reach steady state? The way the nurse described it, I thought she was talking about "stacking" (is that the right term?)...you know, when it stores up (I don't know where) and is realeased slowly? Doesn't Xanax do that? Hell, I don't know really what I'm talking about, but that's what the nurse made it sound like.> > Anyway, I'd get deathly sick (withdrawal) every night, and each day until my next dose.
>
> Methadone is *supposed* to last a day or more, but for some people it doesn't. (The recommended dosing schedule for pain is every 4-6 hours. I never understood why it would be different.)
Right, supposedly a patient on MMT could miss a day and still come back "well" 48 hrs after their last dose. I see that far fetched.
> > They kept increasing the dose, saying that larger doses would take longer to clear, which makes sense, I guess. They eventually got me up to 210 mg/day, but I was still getting sick at night.
>
> You needed to take it in divided doses, twice a day perhaps. Getting you up to an unbelievably high dose was effective at enslaving you, though, wasn't it? (That was the original idea behind MMT.)
I tried so hard to get them to give me a divided dose, but they were fixed on the idea that I was a charlatan and that I wanted to sell my second dose once I got out of the clinic with it. I somewhat understand that they might be wary after working with junkies for years (who often *are* charlatans after having to survive on the streets).
> > By the time I was at 210mg/day, I needed someone to help me walk into the clinic.
>
> I couldn't imagine being able to get myself to a clinic in the morning if I were dependent on methadone to remain undepressed and it didn't last as long as it's "supposed" to.
It really was a nightmare. And as sick as I was getting staying on the *same* dose daily, there was no way I could handle one of their tapering schemes. It was the most trapped I've felt.
> > I don't know why I was metabolizing it so fast, but they said it happens with some people.
>
> Yet for some reason, they won't adapt the system to deal with it.
Nope.
> > I tried everything. I even started eating a box of OTC Tagamet before each dose because it was supposed to inhibit the enzyme that metabolized methadone.
>
> That's an old trick! I guess it didn't work, though. I'm not sure how much cimetidine you'd have to take.
It actually did help a little. It kept me well through the afternoon, at least. Night time and the next morning were still bad, though.
> > I finally had to be hospitalized where it was legal for my pdoc to prescribe methadone, then he prescribed a "split dose" and I was off of it and back on heroin in a couple weeks. What a relief!!!
>
> I guess you couldn't continue on MMT and use heroin as your nightly dose (because they test your urine for 6-monoacetylmorphine, presumably)? No way to win.
No, it would have taken a *lot* of heroin, at that point, to do anything. My opoid tolorance was so high. I remember eating a handful of seven Lorcet (10mg hydrocodone each) one night when I was hurting, and it didn't even take the edge off. I couldn't even tell that I had taken them. Now *that* was scary. Truthfully, I didn't want to do street drugs. I wanted to be legit. Actually, I lasted a month off of the methadone before turning back to illegal stuff. I *did* try...
> > And I must say that nobody in the clinic was glad to be chained to that clinic that treated people like animals.
>
> They're not people, they're drug addicts (that's the idea, anyway).
> > Maybe other clinics are different, but my whole experience to this day makes me enraged.
>
> Maybe; or maybe other people are just so fed up with life on dope that they're willing to put up with all the cr*p.
Yeah, a methadone clinic beats life on the streets hustling for a fix. I was never there, though. I was a nice upper middle class addict. Their cr*p wasn't worth it to me.
> > So, sorry for the rant. Peace :-)
>
> Always peace. It's just a rant, after all. < g >
>
> -elizabethHeh...cool.
Posted by Elizabeth on July 19, 2001, at 23:31:31
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 19, 2001, at 20:13:58
> So that's all it is? Just takes time to reach steady state?
Yes, I think that's all.
> The way the nurse described it, I thought she was talking about "stacking" (is that the right term?)...you know, when it stores up (I don't know where) and is realeased slowly?
Methadone is long-acting; it's metabolised and eliminated very slowly. When you take your second dose, some of the first dose is still in your body, and so forth. After a little while the level is roughly constant (although it always will have some peaks and troughs).
> Right, supposedly a patient on MMT could miss a day and still come back "well" 48 hrs after their last dose. I see that far fetched.
I don't know; I've never taken methadone. I think it would be nice to have a pill that I could take once a day, though (forget about skipping days).
> I tried so hard to get them to give me a divided dose, but they were fixed on the idea that I was a charlatan and that I wanted to sell my second dose once I got out of the clinic with it.
I think that might be a rule that all methadone clinics have to follow, but I'm not sure. They do treat you like a second-class human being, don't they? :-( (I think that's how drug addicts are looked at in general.)
> I somewhat understand that they might be wary after working with junkies for years (who often *are* charlatans after having to survive on the streets).
You can sympathise with that, though, right? I don't think the people who run the clinics ever think about what it's like to be on the other side, they just feel superior.
> It really was a nightmare. And as sick as I was getting staying on the *same* dose daily, there was no way I could handle one of their tapering schemes. It was the most trapped I've felt.
So you did the only thing you could: you left the program. Jeez. That should *never* have to happen -- a person who's on MMT and genuinely wants to be shouldn't be forced out.
> > That's an old trick! I guess it didn't work, though. I'm not sure how much cimetidine you'd have to take.
>
> It actually did help a little. It kept me well through the afternoon, at least. Night time and the next morning were still bad, though.How much were you taking?
> > I guess you couldn't continue on MMT and use heroin as your nightly dose (because they test your urine for 6-monoacetylmorphine, presumably)? No way to win.
>
> No, it would have taken a *lot* of heroin, at that point, to do anything.It's true; methadone effectively prevents heroin from working at reasonable doses because methadone's affinity for the receptors is so high.
> I remember eating a handful of seven Lorcet (10mg hydrocodone each) one night when I was hurting, and it didn't even take the edge off.
70 mg? God. You could cause liver damage from taking all that Tylenol that they put in the pills with it.
> Actually, I lasted a month off of the methadone before turning back to illegal stuff. I *did* try...
Of course you did. Nobody *wants* to be a drug addict.
> > Maybe; or maybe other people are just so fed up with life on dope that they're willing to put up with all the cr*p.
>
> Yeah, a methadone clinic beats life on the streets hustling for a fix. I was never there, though. I was a nice upper middle class addict. Their cr*p wasn't worth it to me.I suspect there are a lot of people out there like you who have money so that they can buy dope and not have to steal, etc. (I knew some of them in college, come to think of it).
> > Always peace. It's just a rant, after all. < g >
>
> Heh...cool.I just don't consider ranting to be a form of violence. :-)
-elizabeth
Posted by MB on July 20, 2001, at 2:06:33
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 19, 2001, at 23:31:31
> > So that's all it is? Just takes time to reach steady state?
>
> Yes, I think that's all.
>
> > The way the nurse described it, I thought she was talking about "stacking" (is that the right term?)...you know, when it stores up (I don't know where) and is realeased slowly?
>
> Methadone is long-acting; it's metabolised and eliminated very slowly. When you take your second dose, some of the first dose is still in your body, and so forth. After a little while the level is roughly constant (although it always will have some peaks and troughs).
>
> > Right, supposedly a patient on MMT could miss a day and still come back "well" 48 hrs after their last dose. I see that far fetched.
>
> I don't know; I've never taken methadone. I think it would be nice to have a pill that I could take once a day, though (forget about skipping days).
>
> > I tried so hard to get them to give me a divided dose, but they were fixed on the idea that I was a charlatan and that I wanted to sell my second dose once I got out of the clinic with it.
>
> I think that might be a rule that all methadone clinics have to follow, but I'm not sure. They do treat you like a second-class human being, don't they? :-( (I think that's how drug addicts are looked at in general.)
>
> > I somewhat understand that they might be wary after working with junkies for years (who often *are* charlatans after having to survive on the streets).
>
> You can sympathise with that, though, right? I don't think the people who run the clinics ever think about what it's like to be on the other side, they just feel superior.
>
> > It really was a nightmare. And as sick as I was getting staying on the *same* dose daily, there was no way I could handle one of their tapering schemes. It was the most trapped I've felt.
>
> So you did the only thing you could: you left the program. Jeez. That should *never* have to happen -- a person who's on MMT and genuinely wants to be shouldn't be forced out.
>
> > > That's an old trick! I guess it didn't work, though. I'm not sure how much cimetidine you'd have to take.
> >
> > It actually did help a little. It kept me well through the afternoon, at least. Night time and the next morning were still bad, though.
>
> How much were you taking?
Oh gosh, I don't know. The boxes came in different sizes. I'd buy the box with the single blister-pack of pills (I think the smallest box)...maybe twelve. Does that sound right? I don't remember how many milligrams of Tagamet were in the over-the-counter preperations.
> > > I guess you couldn't continue on MMT and use heroin as your nightly dose (because they test your urine for 6-monoacetylmorphine, presumably)? No way to win.
> >
> > No, it would have taken a *lot* of heroin, at that point, to do anything.
>
> It's true; methadone effectively prevents heroin from working at reasonable doses because methadone's affinity for the receptors is so high.
>
> > I remember eating a handful of seven Lorcet (10mg hydrocodone each) one night when I was hurting, and it didn't even take the edge off.
>
> 70 mg? God. You could cause liver damage from taking all that Tylenol that they put in the pills with it.
Yeah, I think each tab had 650...maybe 675 mg of acetaminophen in it. I think I *am* pretty lucky regarding the amount of tylenol I used to consume. I used to take a lot of N-acetylcysteine with the Lorcet. I went through a bottle of 30 vicodin in a 24 hour period once...without the N-acetylcysteine. I was pretty worried, but I think spreading it out over the 24 hours kept me from getting hepatatoxic.
> > Actually, I lasted a month off of the methadone before turning back to illegal stuff. I *did* try...
>
> Of course you did. Nobody *wants* to be a drug addict.
Well, I didn't mind being dependent...as long as I had a steady enough supply to keep me doing well. I didn't want to be a criminal, though, which was what I became using the heroin. No telling what that cr*p (tar) was cut with. Pretty dirty stuff. Glad to be off all that stuff, now.
> > > Maybe; or maybe other people are just so fed up with life on dope that they're willing to put up with all the cr*p.
> >
> > Yeah, a methadone clinic beats life on the streets hustling for a fix. I was never there, though. I was a nice upper middle class addict. Their cr*p wasn't worth it to me.
>
> I suspect there are a lot of people out there like you who have money so that they can buy dope and not have to steal, etc. (I knew some of them in college, come to think of it).
Yeah, I didn't have to steal, but the people I came in contact with were pretty scary. It's not like the pot scene...we're not talking about a few dead-heads with dreads. I had to interact with some pretty iffy characters. The scene was, well, lame.
> > > Always peace. It's just a rant, after all. < g >
> >
> > Heh...cool.
>
> I just don't consider ranting to be a form of violence. :-)
>
> -elizabeth
Posted by Elizabeth on July 20, 2001, at 17:08:07
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 20, 2001, at 2:06:33
> > How much were you taking?
>
> Oh gosh, I don't know.I'm not sure how many there are in the various size boxes and how much there is in each pill. If I remember, maybe next time I'm at a drug store I'll check.
> > 70 mg? God. You could cause liver damage from taking all that Tylenol that they put in the pills with it.
>
> Yeah, I think each tab had 650...maybe 675 mg of acetaminophen in it.There're actually hydrocodone-APAP preparations that have 10 mg of hydrocodone and only like 325 of APAP.
> I think I *am* pretty lucky regarding the amount of tylenol I used to consume. I used to take a lot of N-acetylcysteine with the Lorcet.
Another strategy I've heard of. It always surprises me when it turns out that one of those "food supplements" actually does something useful.
> I went through a bottle of 30 vicodin in a 24 hour period once...without the N-acetylcysteine.
300 mg? I guess if you're taking 70 at a time, that's not so far-fetched. I don't even want to think about how much APAP there was in that, though. I'm glad you're okay.
> Well, I didn't mind being dependent...as long as I had a steady enough supply to keep me doing well. I didn't want to be a criminal, though, which was what I became using the heroin. No telling what that cr*p (tar) was cut with.
Are you on the west coast, by any chance?
> Yeah, I didn't have to steal, but the people I came in contact with were pretty scary.
That's one of the many reasons why I say that nobody wants to be an addict. Even if you're well-off enough that you can afford whatever you need, you still have to make regular trips to "the bad part of town" (unless you have a friend who's willing to do that part).
> It's not like the pot scene...we're not talking about a few dead-heads with dreads.
Pot? I associate that more with, you know, high school kids. (and springtime, for some reason)
-elizabeth
Posted by MB on July 20, 2001, at 18:31:31
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 20, 2001, at 17:08:07
> > > How much were you taking?
> >
> > Oh gosh, I don't know.
>
> I'm not sure how many there are in the various size boxes and how much there is in each pill. If I remember, maybe next time I'm at a drug store I'll check.
You know what's really funny? I had a dream last night about this whole converastion...in the dream I was counting the tablets in the blister pack, and the blister pack kept getting bigger and bigger...I finally counted like 40 tabs and was thinking, "holy sh*t, I can't believe I took that many!"
> > > 70 mg? God. You could cause liver damage from taking all that Tylenol that they put in the pills with it.
> >
> > Yeah, I think each tab had 650...maybe 675 mg of acetaminophen in it.
>
> There're actually hydrocodone-APAP preparations that have 10 mg of hydrocodone and only like 325 of APAP.
Wow, I should have gotton those. I wish they just made hydrocodone without the acetaminophen...I guess they put the acetaminophen in there just to poison people: "We'd rather people die of LIVER FAILURE than get high!!! Let's denature the ethanol while we're at it; getting high is THE DEVIL (unless it's taxed, of course)."
> > I think I *am* pretty lucky regarding the amount of tylenol I used to consume. I used to take a lot of N-acetylcysteine with the Lorcet.
>
> Another strategy I've heard of. It always surprises me when it turns out that one of those "food supplements" actually does something useful.
I know. I read about acetaminophen overdoses being treated by IV N-acetylcysteine, and I was like, "huh, I think I have some of that stuff in the cupboard!" (using the word "like" in conversation, by the way, is one sure way to demonstrate one's erudition).
> > I went through a bottle of 30 vicodin in a 24 hour period once...without the N-acetylcysteine.
>
> 300 mg? I guess if you're taking 70 at a time, that's not so far-fetched. I don't even want to think about how much APAP there was in that, though. I'm glad you're okay.
Me too. I was pretty nauseated the next day. I was really going for broke, I don't know why. Opiates cure my depression, but sadly, I *am* compulsive when I use them. I wonder if I would be with buprenorphine. Probably.
> > Well, I didn't mind being dependent...as long as I had a steady enough supply to keep me doing well. I didn't want to be a criminal, though, which was what I became using the heroin. No telling what that cr*p (tar) was cut with.
>
> Are you on the west coast, by any chance?
Yeah. I lived on the West Coast at the time. Any of the major cities along that coast (San Diego, L.A., San Francisco, Eugene, Portland, Seattle...) are innundated with the stuff (tar).
> > Yeah, I didn't have to steal, but the people I came in contact with were pretty scary.
>
> That's one of the many reasons why I say that nobody wants to be an addict. Even if you're well-off enough that you can afford whatever you need, you still have to make regular trips to "the bad part of town" (unless you have a friend who's willing to do that part).
Right. And those people can see the well-off addict a mile away...and they're dying to rip you off...
> > It's not like the pot scene...we're not talking about a few dead-heads with dreads.
>
> Pot? I associate that more with, you know, high school kids. (and springtime, for some reason)
Oh yeah, well, when you're a deadhead, it's always springtime, dear < g >.
Posted by Elizabeth on July 21, 2001, at 22:22:06
In reply to Re: Ultram withdrawal!, posted by MB on July 20, 2001, at 18:31:31
> You know what's really funny? I had a dream last night about this whole converastion...in the dream I was counting the tablets in the blister pack, and the blister pack kept getting bigger and bigger...I finally counted like 40 tabs and was thinking, "holy sh*t, I can't believe I took that many!"
That's pretty funny, yup!
> (using the word "like" in conversation, by the way, is one sure way to demonstrate one's erudition).
You mean as in "to be like" = "to say?"
> Opiates cure my depression, but sadly, I *am* compulsive when I use them. I wonder if I would be with buprenorphine. Probably.
As far as I know, buprenorphine doesn't get you high. FWIW.
> > Are you on the west coast, by any chance?
>
> Yeah. I lived on the West Coast at the time. Any of the major cities along that coast (San Diego, L.A., San Francisco, Eugene, Portland, Seattle...) are innundated with the stuff (tar).Yeah, that's what I was thinking: tar seems to be a west-coast-specific thing. I don't think one sees it in New York or Baltimore or Boston, for example.
> > Pot? I associate that more with, you know, high school kids. (and springtime, for some reason)
>
> Oh yeah, well, when you're a deadhead, it's always springtime, dear < g >.< sniff > Ahh, spring is in the air!
-elizabeth
Posted by MB on July 22, 2001, at 1:31:46
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 21, 2001, at 22:22:06
> > You know what's really funny? I had a dream last night about this whole converastion...in the dream I was counting the tablets in the blister pack, and the blister pack kept getting bigger and bigger...I finally counted like 40 tabs and was thinking, "holy sh*t, I can't believe I took that many!"
>
> That's pretty funny, yup!
>
> > (using the word "like" in conversation, by the way, is one sure way to demonstrate one's erudition).
>
> You mean as in "to be like" = "to say?"
It's like all funny to say "like."
> > Opiates cure my depression, but sadly, I *am* compulsive when I use them. I wonder if I would be with buprenorphine. Probably.
>
> As far as I know, buprenorphine doesn't get you high. FWIW.
That detox place (not the methadone clinic, this was after that) in California, that stole my Xanax and put me on Tegretol, gave me buprenorphine for H withdrawal. They were too cheap to have a nurse practitioner or MD on site, so we couldn't get injections. The gave it to us sublingually. It didn't work, I thought it was bull****. Then one day they took me to the doctor for a checkup (this was inpatient treatment) and he gave me an intramuscular buprenorphine shot and I felt much better...cleared the chills and runny nose right up. I have no idea what it would have been like to take if I *hadn't* been withdrawing. But I can tell you (as you've said before) that sublingual buprenorphine is for the birds.> > > Are you on the west coast, by any chance?
> >
> > Yeah. I lived on the West Coast at the time. Any of the major cities along that coast (San Diego, L.A., San Francisco, Eugene, Portland, Seattle...) are innundated with the stuff (tar).
>
> Yeah, that's what I was thinking: tar seems to be a west-coast-specific thing. I don't think one sees it in New York or Baltimore or Boston, for example.
>
> > > Pot? I associate that more with, you know, high school kids. (and springtime, for some reason)
> >
> > Oh yeah, well, when you're a deadhead, it's always springtime, dear < g >.
>
> < sniff > Ahh, spring is in the air!
I hear ya. Thank god for Flonase. I was a wreck until I got a script for that stuff (that *is* the "sniff" you're talking about, isn't it?).
Posted by MB on July 22, 2001, at 1:35:37
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 21, 2001, at 22:22:06
> As far as I know, buprenorphine doesn't get you high. FWIW.Hmmmm...this is very interesting, by the way. This just might be something that would help me. You've mentioned that it really helped you. I've always wished there was an antidepressant that helped me like opiates but that didn't get me high (I don't want to be "messed up," I just want to be un-depressed). Did you have a difficult time getting this sanctioned by a pdoc?
Posted by Elizabeth on July 22, 2001, at 13:21:30
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 22, 2001, at 1:35:37
> I've always wished there was an antidepressant that helped me like opiates but that didn't get me high (I don't want to be "messed up," I just want to be un-depressed).
Then I think buprenorphine could be very helpful to you. In a number of countries, it's used the way we use methadone here, as maintenance treatment for opioid dependence. Addicts say that it takes away their feelings of not-rightness without impairing them.
> Did you have a difficult time getting this sanctioned by a pdoc?
I was lucky: my pdoc referred me to a colleague who happened to have extensive experience using it in clinical and research settings. Since then I've moved, and yes, it has been challenging (but not impossible: eventually I was successful) to convince other doctors to prescribe it, even though I was already taking it.
-elizabeth
Posted by Elizabeth on July 22, 2001, at 13:30:16
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 22, 2001, at 1:31:46
> It's like all funny to say "like."
< valleygirl >You are, like, *so* right.< /valleygirl >
> That detox place (not the methadone clinic, this was after that) in California, that stole my Xanax and put me on Tegretol, gave me buprenorphine for H withdrawal. They were too cheap to have a nurse practitioner or MD on site, so we couldn't get injections. The gave it to us sublingually. It didn't work, I thought it was bull****.
That's right: the solution doesn't work reliably if you take it SL; you just end up swallowing most of it, and it's not orally active (at typical doses). There are tablets that you dissolve under your tongue, which might work better than trying to take the injectible solution sublingually, but they're not available in the USA. (They're marketed as Temgesic or Subutex in other countries, and are under investigation as a treatment for opioid dependence in the US.)
> Then one day they took me to the doctor for a checkup (this was inpatient treatment) and he gave me an intramuscular buprenorphine shot and I felt much better...cleared the chills and runny nose right up.
Out of curiosity, how fast did it work? It takes about an hour intranasally, and I've wondered if taking it IM would speed up the process (it definitely would be convenient).
> I have no idea what it would have been like to take if I *hadn't* been withdrawing.
I suspect there are commonalities to depression and dope withdrawal (never experienced the latter). (Of course, depression doesn't cause vomiting, diarrhea, chills, shakes, etc.)
> > < sniff > Ahh, spring is in the air!
>
> I hear ya. Thank god for Flonase. I was a wreck until I got a script for that stuff (that *is* the "sniff" you're talking about, isn't it?).Nope, I was referring to the lovely smell that used to waft through my dorm in college.
-elizabeth
Posted by MB on July 22, 2001, at 20:16:11
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 22, 2001, at 13:30:16
> > Then one day they took me to the doctor for a checkup (this was inpatient treatment) and he gave me an intramuscular buprenorphine shot and I felt much better...cleared the chills and runny nose right up.
>
> Out of curiosity, how fast did it work? It takes about an hour intranasally, and I've wondered if taking it IM would speed up the process (it definitely would be convenient).
When you say that it takes about an hour to work, may I assume you are not keeping a steady state serum level? Are you taking it PRN?I think that I felt better within a few minutes. Some of it could have been psychological (from the needle prick). I'm thinking that it kicked in after about ten minutes and that I felt better for about two and a half hours.
> > I have no idea what it would have been like to take if I *hadn't* been withdrawing.
>
> I suspect there are commonalities to depression and dope withdrawal (never experienced the latter). (Of course, depression doesn't cause vomiting, diarrhea, chills, shakes, etc.)
The depression from dope withdrawal feels different to me than the depression I feel every day. Comming off of opiates, I feel a really intense feeling of longing...not necessarily for the drug (although craving *is* present), I'm talking about an intense, free-floating, bittersweet nostalgia. Like the heartache of remembering good times, or a departed loved one, to the point of crying. Often, I will remember events that I had forgotten for years and years. Also, there's this feeling that an evil presence is imminent. The evil presence thing is a touchy deal with pdocs, and sharing it with them, I fear, is a good way to get slapped on a neuroleptic if I'm not careful. I took a psychological test once that asked if I had ever seen spirits. I answered "yes" because one time on LSD I thought there were spirits in the room. I didn't even get a chance to discuss why I answered "yes," the pdoc just assumed I was psychotic without even discussing the test. Wham, and I was on Zyprexa.> > > < sniff > Ahh, spring is in the air!
> >
> > I hear ya. Thank god for Flonase. I was a wreck until I got a script for that stuff (that *is* the "sniff" you're talking about, isn't it?).
>
> Nope, I was referring to the lovely smell that used to waft through my dorm in college.
Ah, yes...the days of the dorm.
Posted by Kristi on July 22, 2001, at 21:23:24
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 22, 2001, at 20:16:11
Hi,
Sorry for the question..... just started reading this thread..... are you all talking about Ultram? or has the topic digressed? Just curious what I'm reading about..... thanx
Kristi
>
> > > Then one day they took me to the doctor for a checkup (this was inpatient treatment) and he gave me an intramuscular buprenorphine shot and I felt much better...cleared the chills and runny nose right up.
> >
> > Out of curiosity, how fast did it work? It takes about an hour intranasally, and I've wondered if taking it IM would speed up the process (it definitely would be convenient).
>
>
> When you say that it takes about an hour to work, may I assume you are not keeping a steady state serum level? Are you taking it PRN?
>
> I think that I felt better within a few minutes. Some of it could have been psychological (from the needle prick). I'm thinking that it kicked in after about ten minutes and that I felt better for about two and a half hours.
>
>
> > > I have no idea what it would have been like to take if I *hadn't* been withdrawing.
> >
> > I suspect there are commonalities to depression and dope withdrawal (never experienced the latter). (Of course, depression doesn't cause vomiting, diarrhea, chills, shakes, etc.)
>
>
> The depression from dope withdrawal feels different to me than the depression I feel every day. Comming off of opiates, I feel a really intense feeling of longing...not necessarily for the drug (although craving *is* present), I'm talking about an intense, free-floating, bittersweet nostalgia. Like the heartache of remembering good times, or a departed loved one, to the point of crying. Often, I will remember events that I had forgotten for years and years. Also, there's this feeling that an evil presence is imminent. The evil presence thing is a touchy deal with pdocs, and sharing it with them, I fear, is a good way to get slapped on a neuroleptic if I'm not careful. I took a psychological test once that asked if I had ever seen spirits. I answered "yes" because one time on LSD I thought there were spirits in the room. I didn't even get a chance to discuss why I answered "yes," the pdoc just assumed I was psychotic without even discussing the test. Wham, and I was on Zyprexa.
>
> > > > < sniff > Ahh, spring is in the air!
> > >
> > > I hear ya. Thank god for Flonase. I was a wreck until I got a script for that stuff (that *is* the "sniff" you're talking about, isn't it?).
> >
> > Nope, I was referring to the lovely smell that used to waft through my dorm in college.
>
>
> Ah, yes...the days of the dorm.
Posted by MB on July 22, 2001, at 23:08:12
In reply to Re: Ultram withdrawal!-silly question, posted by Kristi on July 22, 2001, at 21:23:24
We started talking about Bijou taking Ultram for depression and ways to cope when she ran out. I suggested methadone detox, but unleased a pejorative diatribe against methadone maintenance. Then we got way off topic and started discussing methadone in general, heroin, etc, etc. Wow, we really did get off topic. Sorry, Bijou!
Posted by Kristi on July 23, 2001, at 11:15:26
In reply to Re: Ultram withdrawal!-silly question » Kristi, posted by MB on July 22, 2001, at 23:08:12
Thank you!!!!! I take ultram myself... and kind of joined at the end, and started hearing things that kind of baffled me. Tx for taking the time to clear it up........kristi> We started talking about Bijou taking Ultram for depression and ways to cope when she ran out. I suggested methadone detox, but unleased a pejorative diatribe against methadone maintenance. Then we got way off topic and started discussing methadone in general, heroin, etc, etc. Wow, we really did get off topic. Sorry, Bijou!
Posted by Elizabeth on July 23, 2001, at 16:15:15
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 22, 2001, at 20:16:11
> When you say that it takes about an hour to work, may I assume you are not keeping a steady state serum level? Are you taking it PRN?
It's prescribed for 3 times a day. I do achieve a low steady-state level. I can't take it at bedtime, though (it would keep me awake), so by the morning, it's pretty much worn off.
> I think that I felt better within a few minutes. Some of it could have been psychological (from the needle prick). I'm thinking that it kicked in after about ten minutes and that I felt better for about two and a half hours.
If it worked fast, it would make sense that it wouldn't last long. But I'm surprised by the difference: for me it lasts 5 or 6 hours.
> The depression from dope withdrawal feels different to me than the depression I feel every day. Comming off of opiates, I feel a really intense feeling of longing...not necessarily for the drug (although craving *is* present), I'm talking about an intense, free-floating, bittersweet nostalgia.
I've heard this described as "emptiness" or as a "void" that needs to be filled.
> Also, there's this feeling that an evil presence is imminent.
I've experienced something similar to that in the context of panic attacks. I don't like going into details like that with doctors.
> I took a psychological test once that asked if I had ever seen spirits. I answered "yes" because one time on LSD I thought there were spirits in the room.
That's a nondelusional hallucination: you know that the "spirits" weren't really there. (IOW, the right answer was "no.")
I hate those silly multiple choice personality tests. Nobody should be diagnosed based solely (or primarily) on one of those.
-elizabeth
Posted by Elizabeth on July 23, 2001, at 16:16:31
In reply to Re: Ultram withdrawal!-silly question » MB, posted by Kristi on July 23, 2001, at 11:15:26
> Thank you!!!!! I take ultram myself... and kind of joined at the end, and started hearing things that kind of baffled me.
What's your experience with Ultram? You take it for pain, right?
-elizabeth
Posted by Mb on July 23, 2001, at 17:08:00
In reply to Re: Ultram withdrawal! » MB, posted by Elizabeth on July 23, 2001, at 16:15:15
> It's prescribed for 3 times a day. I do achieve a low steady-state level. I can't take it at bedtime, though (it would keep me awake), so by the morning, it's pretty much worn off.
Hmmmm...huh (that's me thinking, do you smell something burning? < g >) I think the whole deal with opiates and sleep is strange. I don't understand it. Sometimes they will allow me to fall into the most beautiful sleep state with these evanescent glimpses of soothing images...or else they give me insomnia to the high heavens. Usually, it's the pills cut with acetaminophen that do it. Do you think the tylenol could cause the paradoxical insomnia? I bring this up because you mentioned buprenorphine keeping you up. Why do you think the buprenorphine does?
> > I think that I felt better within a few minutes. Some of it could have been psychological (from the needle prick). I'm thinking that it kicked in after about ten minutes and that I felt better for about two and a half hours.
>
> If it worked fast, it would make sense that it wouldn't last long. But I'm surprised by the difference: for me it lasts 5 or 6 hours.
I would say that it blocked withdrawal for 2.5 hours, but it's possible that it continued to mitigate the symptoms even after that, but that I didn't notice...so it's not necessarily incongruent with your experience...all I know is when symptoms returned.
> > The depression from dope withdrawal feels different to me than the depression I feel every day. Comming off of opiates, I feel a really intense feeling of longing...not necessarily for the drug (although craving *is* present), I'm talking about an intense, free-floating, bittersweet nostalgia.
>
> I've heard this described as "emptiness" or as a "void" that needs to be filled.
Yeah, but it's weird...it's a bittersweet emptiness...like having an unrequited crush when you're thirteen years old. I don't know if that would be melancholia. What exactly *is* melencholia, anyway? I've never really fully understood that term in the clinical sense.> > Also, there's this feeling that an evil presence is imminent.
>
> I've experienced something similar to that in the context of panic attacks. I don't like going into details like that with doctors.
Yeah, I think "evil presence" is a red flag for pdocs. Anything that resembles a delusion with religious overtones gets them hot. hahaha...I mean that tongue-in-cheek to a certain degree, but there's also some truth to it.
Posted by Kristi on July 23, 2001, at 23:01:24
In reply to Re: Ultram » Kristi, posted by Elizabeth on July 23, 2001, at 16:16:31
Yes,
I take it for pain. Usually about 200mg a day(4 50mg tablets).... was kind of suprised about all these things I've been hearing about it. Anything you think I should know? (ex, be warned about?) Thanks, Kristi
> > Thank you!!!!! I take ultram myself... and kind of joined at the end, and started hearing things that kind of baffled me.
>
> What's your experience with Ultram? You take it for pain, right?
>
> -elizabeth
Posted by Elizabeth on July 26, 2001, at 23:32:51
In reply to Re: Ultram withdrawal! » Elizabeth, posted by Mb on July 23, 2001, at 17:08:00
> I don't understand it. Sometimes they will allow me to fall into the most beautiful sleep state with these evanescent glimpses of soothing images...
"nodding?"
> or else they give me insomnia to the high heavens. Usually, it's the pills cut with acetaminophen that do it. Do you think the tylenol could cause the paradoxical insomnia?
I doubt it. Remember the rule that reactions to psychotropic drugs can depend greatly on set and setting.
> I bring this up because you mentioned buprenorphine keeping you up. Why do you think the buprenorphine does?
All opioids do that to me. I have no idea why.
> I would say that it blocked withdrawal for 2.5 hours, but it's possible that it continued to mitigate the symptoms even after that, but that I didn't notice...so it's not necessarily incongruent with your experience...all I know is when symptoms returned.
People who take buprenorphine for opioid addiction often need to take it only once a day.
> Yeah, but it's weird...it's a bittersweet emptiness...like having an unrequited crush when you're thirteen years old. I don't know if that would be melancholia. What exactly *is* melencholia, anyway? I've never really fully understood that term in the clinical sense.
The main distinctive characteristic of "melancholic" depression is lack of mood reactivity and near-total anhedonia. The depression is unlike normal grief or feelings of loss. Some associated features are early-morning awakenings; worst mood in the morning; appetite loss (food doesn't taste good, the desire to eat is lost); marked psychomotor changes (slowing down or agitation); and intense feelings of guilt.
> Yeah, I think "evil presence" is a red flag for pdocs. Anything that resembles a delusion with religious overtones gets them hot. hahaha...I mean that tongue-in-cheek to a certain degree, but there's also some truth to it.
It's just one of those odd feelings that people can have. Even a generally skeptical atheist can have a "mystical experience" under the right conditions.
-elizabeth
Posted by Elizabeth on July 26, 2001, at 23:37:39
In reply to Re: Ultram-Elizabeth, posted by Kristi on July 23, 2001, at 23:01:24
> I take it for pain. Usually about 200mg a day(4 50mg tablets).... was kind of suprised about all these things I've been hearing about it. Anything you think I should know? (ex, be warned about?) Thanks, Kristi
It's an effective antidepressant and anxiolytic for some people. I found it too weak to help when I tried it. If you decide to stop taking it, you should decrease the dose gradually rather than stopping altogether. This is a good rule of thumb with any drug that you have been taking regularly for a long time.
-elizabeth
Posted by Gracie2 on July 27, 2001, at 2:25:09
In reply to Re: Ultram » Kristi, posted by Elizabeth on July 26, 2001, at 23:37:39
I haven't been here for awhile and was surprised by the length of this thread. For some reason, I thought that the abuse of Ultram, which is my drug of choice, must be unusual. I guess there really is nothing new under the sun.
Be careful with that Ultram. Although it is touted as a non-opiate and non-addictive, they say the same thing about chocolate. Anyone who has stood at the kitchen counter at midnight eating Oreo after Oreo while staring at the clock, they know it's not true.
Seriously - I've had terrible problems with Ultram, it is truely my drug of choice. For someone with an addictive personality, this is quite a statement. When I'm agitated, it relaxes me. When I have insomnia, it lets me sleep. Curiously, it wipes out all desire for alcohol-
something else I tend to abuse.
Unfortunately, over the last couple of years, I've developed a massive tolerance to it. I can take so much Ultram, it reminds me of the story about the king who was afraid of being of being poisoned, so he purposely developed a tolerance to it by gradually taking larger and larger doses of poison every day. Then one day the enemy overran his castle, and the king tried to kill himself with poison before they caught and tortured him, but by that point it would have taken so much poison to kill him that there just wasn't enough around. (Wonder what a psychiatrist would make of me relating to THAT story).
Anyway, obviously, over-rating your tolerance for a drug can be lethal. It did in Marilyn Monroe and Sid Vicious and it could have killed me.
At one point, things were so bad, I was taking a heavy dose of depakote, seroquel and paxil (prescribed) and 30 or more pills of Ultram every day (unprescribed). I ended up in the hospital after having a seizure. I was so depressed that I did not care about myself, but I scared the hell out of my family and, my God, what if I had been driving? I could have killed someone.
Anyway, so here I am, after several relapses, determined to stay off the Ultam. I can't relax, I can't sleep for more than a couple of hours at a time. And let me tell you - I truely love to sleep. I'm exhausted and miserable, but I've been clean for a couple of weeks now.
You have to have the right attitude, you have to decide that you're strong enough to take the pain.
I was in the Army for a long time, and they understand this mindset. They have a running song...your heart is pounding out of your chest, your lungs are on fire, and still you're shouting as loud as you can, "One mile - no sweat! Two miles - better yet!" That kind of crap. And it works, you keep on running - full backpack, leg cramps, hangover, whatever.
So, you know, we're in withdrawal. We can take it.
Bring it on.Airborne-
Gracie
Posted by MB on July 27, 2001, at 12:31:58
In reply to Re: Ultram withdrawal! » Mb, posted by Elizabeth on July 26, 2001, at 23:32:51
> > I don't understand it. Sometimes they will allow me to fall into the most beautiful sleep state with these evanescent glimpses of soothing images...
>
> "nodding?"Yeah, the images are the same, but the circumstances are a little bit different than what I would call "nodding" (and here I risk making a semantic digression). I always considered it nodding when I was in the middle of doing something and I'd wake up from some weird dream five minutes later with drool on my chin. At least what I described in the past post was marked by a *decision* to go to bed. Ok, Ok, I know I'm nitpicking...maybe we could call it a "purposeful" nod. I'm sure it's the same phenomenon at heart.
> > or else they give me insomnia to the high heavens. Usually, it's the pills cut with acetaminophen that do it. Do you think the tylenol could cause the paradoxical insomnia?
>
> I doubt it. Remember the rule that reactions to psychotropic drugs can depend greatly on set and setting.
Very true...but I've got a friend with fibromyalgia who takes opiates for her pain. She swears up and down that the pills "cut" with acetaminophen "wire" her...make her restless. with some nudging, she was able to get her doctor to prescribe something with hydrocodone and asprin. She likes it much better. Psychosomatic? Maybe. But then again, maybe not.
> > I bring this up because you mentioned buprenorphine keeping you up. Why do you think the buprenorphine does?
>
> All opioids do that to me. I have no idea why.
Well, is there a positive side to it...I mean, do they help give you energy during the day? That would be cool.
> > I would say that it blocked withdrawal for 2.5 hours, but it's possible that it continued to mitigate the symptoms even after that, but that I didn't notice...so it's not necessarily incongruent with your experience...all I know is when symptoms returned.
>
> People who take buprenorphine for opioid addiction often need to take it only once a day.
Wow! Now *that* totally (there's the valley talk again) surprises me. Let me rephrase that: Like, wow dude, that's like totally no way, man. How was that? ;-) Why do you think the dosing schedule for pain and/or depression is different than the dosing schedule for addiction? I guess different underlying disorders require individualized treatment. The pharmacology behind it piques my curiosity. It might give some insight into the disorders being treated...
I wonder if the same people endorsing a once-a-day dosing schedule for addicts on buprenorphine are the same ones who say you can go 48 hrs without a methadone dose and not get sick (sarcasm here not directed at you, by the way).
> > Yeah, but it's weird...it's a bittersweet emptiness...like having an unrequited crush when you're thirteen years old. I don't know if that would be melancholia. What exactly *is* melencholia, anyway? I've never really fully understood that term in the clinical sense.
>
> The main distinctive characteristic of "melancholic" depression is lack of mood reactivity and near-total anhedonia. The depression is unlike normal grief or feelings of loss. Some associated features are early-morning awakenings; worst mood in the morning; appetite loss (food doesn't taste good, the desire to eat is lost); marked psychomotor changes (slowing down or agitation); and intense feelings of guilt.
OK, so I think the term "melencholia" would be the opposite of what I feel withdrawing (if there are opposites to emotions < g >).
> > Yeah, I think "evil presence" is a red flag for pdocs. Anything that resembles a delusion with religious overtones gets them hot. hahaha...I mean that tongue-in-cheek to a certain degree, but there's also some truth to it.
>
> It's just one of those odd feelings that people can have. Even a generally skeptical atheist can have a "mystical experience" under the right conditions.
Yeah, I saw a show where I guy tried to explain near death experiences as physiological anomolies by reproducing something similar in a healthy mind by placing powerful magnets near certain parts of the brain. Now *that* was quite a run-on sentence. Anyway, the person felt a "presence" in the room...some felt there were supernatural overtones.
Posted by Elizabeth on July 27, 2001, at 20:13:28
In reply to Re: Ultram withdrawal- real message, posted by Gracie2 on July 27, 2001, at 2:25:09
> I haven't been here for awhile and was surprised by the length of this thread. For some reason, I thought that the abuse of Ultram, which is my drug of choice, must be unusual. I guess there really is nothing new under the sun.
The length of the thread doesn't mean anything.
> Be careful with that Ultram. Although it is touted as a non-opiate and non-addictive, they say the same thing about chocolate.
< g > Ultram is a mu opioid receptor agonist, and it's to be expected that some people will abuse it, although it's much *much* weaker than morphine, codeine, and even propoxyphene. Its reputation for being mild and relatively non-habit-forming (and its legal status as a non-controlled substance) means that doctors prescribe it much more freely than they prescribe the stronger opioids.
> Anyone who has stood at the kitchen counter at midnight eating Oreo after Oreo while staring at the clock, they know it's not true.
Uhh, I can't say I've had that experience. (When I was on Nardil, though, I did have a tendency to devour 1-lb bags of M&Ms at an alarming rate.)
> Seriously - I've had terrible problems with Ultram, it is truely my drug of choice. For someone with an addictive personality, this is quite a statement. When I'm agitated, it relaxes me. When I have insomnia, it lets me sleep.
I always think it's weird when people say stuff like this: I didn't find Ultram helpful at all.
> Curiously, it wipes out all desire for alcohol-
> something else I tend to abuse.Perhaps it fills whatever void leads you to abuse drugs?
> Unfortunately, over the last couple of years, I've developed a massive tolerance to it.
That's not especially surprising (although people using opioids as antidepressants or anxiolytics often do not need to increase the dose once they've been stabilised). Out of curiosity, what's the effective dose for you at this time?
> Anyway, obviously, over-rating your tolerance for a drug can be lethal. It did in Marilyn Monroe and Sid Vicious and it could have killed me.
Yes. Dangerous to play around with drugs without a doctor (or at least, some knowledge about their actions, interactions, how to use them safely, etc.).
> At one point, things were so bad, I was taking a heavy dose of depakote, seroquel and paxil (prescribed) and 30 or more pills of Ultram every day (unprescribed).
What strength are the tablets? 50 mg?
> I ended up in the hospital after having a seizure.
That's one of the risks of taking large amounts of Ultram (although I think some people probably can safely take doses somewhat higher than the recommended maximum of 400 mg/day).
> Anyway, so here I am, after several relapses, determined to stay off the Ultam. I can't relax, I can't sleep for more than a couple of hours at a time. And let me tell you - I truely love to sleep. I'm exhausted and miserable, but I've been clean for a couple of weeks now.
I'm glad to hear it. Best of luck to you in your efforts to stay off of Ultram.
-elizabeth
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