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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by zoolin on October 24, 2005, at 4:24:20
I have a problem with my ritalin. I have a bad back and have an internal "morphine pump"..well..It is filled with dilaudid instead of morphine. I take oral methadone. I am so sleepy all the time (24/7) that when I take the ritalin it feels so good to feel..awake I have found myself to be ..:( abusing it. I take way more than my prescribed daily dose and that causes me to run out early. How can I get a handle on this problem? I know it is a disaster in the making. I try to take it as prescribed but once I start I cant stop...anyone have any advice for me? I need your help. Thanks, lin
Posted by med_empowered on October 24, 2005, at 9:46:15
In reply to ritalin .., posted by zoolin on October 24, 2005, at 4:24:20
First off, try not to beat yourself up or anything...it sounds like you're just abusing it because you enjoy being awake and fully functional. Who doesn't? So..the goal shouldn't just be to reduce your Ritalin use, bringing it down in line with your prescribed dosage (although that is **VERY** important); the goal should also be to find a way to keep you awake and alert without having to over-use your ritalin. So...here's what I'd do: talk to your doc, and explain that yes, the Rialin is helping but..you're not 100%. Not even close. The Ritalin has helped you realize that your other medications have been (and are) impairing your functionality and QUALITY OF LIFE..push her/him to do something--up the ritalin, add provigil, whatever- to help you lead a better life. I personally wouldn't disclose that you've been over-using the Ritalin..although that may feel like the right thing to do, in practice you'll be denied ritalin and most other stimulants, so your overall quality of life could suffer. Just try to get your doc to fix your meds so you're where you want to be w/o having to run out of medications early. Good luck!
Posted by Bill LL on October 24, 2005, at 11:27:28
In reply to ritalin .., posted by zoolin on October 24, 2005, at 4:24:20
Zoolin- Although I'm not an expert on Ritalin, I'm not sure that it is a disaster in the making. I have never heard of any dangers involved with taking a high dose of Ritalin, even if the high dose is taken every day.
Ritalin is supposed to be one of the best studied and safest of all prescription drugs. A high dose might make it more difficult to fall asleep, but other than that I don't think that it would hurt you. You should probably also monitor your blood pressure.
So I guess what I'm trying to say is that why not ask your doctor to increase your dose to the amount that makes you feel good every day?
> I have a problem with my ritalin. I have a bad back and have an internal "morphine pump"..well..It is filled with dilaudid instead of morphine. I take oral methadone. I am so sleepy all the time (24/7) that when I take the ritalin it feels so good to feel..awake I have found myself to be ..:( abusing it. I take way more than my prescribed daily dose and that causes me to run out early. How can I get a handle on this problem? I know it is a disaster in the making. I try to take it as prescribed but once I start I cant stop...anyone have any advice for me? I need your help. Thanks, lin
Posted by ed_uk on October 24, 2005, at 14:18:24
In reply to ritalin .., posted by zoolin on October 24, 2005, at 4:24:20
Hi Zoo,
My advice would be to stop the Ritalin and get a prescription for something else instead. Provigil might be the best option.
~ed
Posted by greenhornet on October 26, 2005, at 10:45:39
In reply to Re: ritalin .. » zoolin, posted by ed_uk on October 24, 2005, at 14:18:24
As one who was at one time in a somewhat similar , situation, and believe me, you have my prayers. There was a wonderful article in AARP magazine about people who must live in chronic pain mainly due to physicians who are afraid to prescribe opiates in the proper doses or fail to prescribe them AT ALL because they feel the DEA is breathing down their necks and/or they are afraid of the patient becoming "addicted".
From this article:
"in reality, for those using opioids as prescribed, the likelihood of addiction is extremely low, according to research. "It's really an unwarranted fear," says Christine Miaskowski, former president of the American Pain Society. Many patients do become physiologically dependent—meaning they'd go through withdrawal syndrome if they quit cold turkey—but this is a normal condition that can be managed by tapering down the dosage. It's not the same as addiction, which requires psychological dependence. Experts say patients with a history of drug abuse can safely use opioids too, as long as they are carefully monitored by their physicians to avoid a recurrence of their abusive behaviors."You can read the article in its entirety at"
http://www.aarpmagazine.org/health/prisoners_pain.htmlWhile I was on Ritalin (prescribed by my psychiatrist) I developed sever and debilitating pain from an old injury. I was given Fentnyl by an orthopedist. I took both medications AS PRESCRIBED. When my then-family-doc found out about both meds, he flipped out. Worse yet when I came in to see another physician in the same practice, I overheard my former MD telling the second guy I was seeing (For what turned out to be a broken foot) that I was a "med seeking addict who is already on all kinds of crap" -- Needless to say, I do not see those docs any longer. I sued for slander - it was settled out of court and the first doc had to pay!
So -- is it ADDICTION? is it ABUSE? or is it relief, that brings with it the ability to function as close to normal as possible?? Can you tell me??!
Posted by Paulbwell on October 28, 2005, at 21:43:17
In reply to ritalin .., posted by zoolin on October 24, 2005, at 4:24:20
> I have a problem with my ritalin. I have a bad back and have an internal "morphine pump"..well..It is filled with dilaudid instead of morphine. I take oral methadone. I am so sleepy all the time (24/7) that when I take the ritalin it feels so good to feel..awake I have found myself to be ..:( abusing it. I take way more than my prescribed daily dose and that causes me to run out early. How can I get a handle on this problem? I know it is a disaster in the making. I try to take it as prescribed but once I start I cant stop...anyone have any advice for me? I need your help. Thanks, lin
Hi there!
I don't know what dose of Morph you are on or whether it and other Opi's control your pain, or indeed your dose of Ritalin.
I have some experience of Morphine, and ALOT of experience with Ritalin (generic) being scripted it for nearing 2 years. I'm scripted 20mgs 4x daily=80mgs, while some days i take 20mgs, others 120mgs, it depends I'm guessing you are on about 10mgs 2-3x daily?
The Ritalin may be making you more functional (good) or may be enhancing the Opiates you are taking-a known effect, either way, tell your Doc of your situation and need for functionality, DO NOT MENTION THAT YOU HAVE BEEN ABUSING THE RITALIN-they will either change the meds or increase them, for your needs.
Tell the Docs your situation!
Good luck
Posted by University on October 30, 2005, at 20:32:51
In reply to Re: ritalin .., posted by med_empowered on October 24, 2005, at 9:46:15
How much Ritalin are you taking?
You might not be "abusing" it, per se; perhaps you're just determining the right dose for you.
I believe that, generally, the maximum daily dose of methylphenidate in humans can be expressed as 2mg methylphenidate per 1kg body weight--but let me check this
Posted by zoolin on November 22, 2005, at 3:30:47
In reply to Re: ritalin .., posted by University on October 30, 2005, at 20:32:51
HI all..you guys are all so great. I cannot express how nice it was to see people cared. I have been feeling like a piece of crap since I got on this cycle with the meds. Anyway..what I take ..oral meds..methadone 10 mg tabs..presc at 1 tab per 3 hrs. I take perhaps 2 tabs per day usually but there have been a couple of horrible times I took the dose prescribed. That is a RARE hing. I hardly even fil my methadone presc in fact. I fill about 4..maybe 5 of the 12 mo presc I am handed. The ritalin. I am prescribed 20 mg 3X a day. ..well...I have told you guys..I find myself (NO MATTER WHAT I TRY...(:..I take them before the time) I am out in about half as long as I should be. I tried taking my bottle as soon as I filled the script and dividing it between 4 envelopes and sealing them..wellll....I tore right into the envelopes before time. ( I hate myself..I am normally not a person who cant tell myself no) Ok..thats all the oral meds. The Dr did mention provigil and even gave me some samples ( I didnt notice anything though..I still ate up the ritatin) However the provigil is 244.00 for a mo supply so it is not within my financial capabilities so I have not requested a hard copy for a script. Ok..then I have a internal "morphine" pump. Actually it is a innerthecal pump. Morphine causes me to swell though and I cannot take it when delivered like that (I say that because the Dr gave me a 14 day sample of a time release capsule of morphine and it did not bother me however THAT med is 199.00 a mo comparted to about 40.00 a mo for the darn methadone so my budget forces me to remain on the methadone) My pump has a mixture of clonadine, baclophen and dilaudid in it. I am unsure of the exact ratio of the drugs but I think it is at about 6 mgs fow. I go for a pump adjustment tomorrow and I will ask the ratio. I also guess Ill see if I can get my scripts refilled and HOPE he doesnt ask why the script my Dr wrote on the 11th is ..gone. I figure it is gonna be soon they will notice that I am asking..early. Most of the time I just have to go without for about a week or a week and a half till its time to fill them but a couple of ties I "got away" with getting it early and went to a different pharmacy to fill it because I knew they would tell me it was to soon. I have suggested I be given more ritalin but my Dr has told me several times that 60 mg is a "high" dose. I weigh about 135 now I guess. I am loosing lots of weight the past several mo.....no appetite and ..well just weak all the time. I sure Thank you all for your thouhts and mostly for your compassion. My boyfriend..roommate..whatever one calls him is not very understanding. He just considers me a drug addict . He doesnt BEGIN to see that I just savor being able to have ANY energy and when I feel the ability to get out of bed and GO SOMEWHERE..anywhere..I dont want to stop. He says that is what all drug addicts do..make an excuse to feed their addiction. (sigh) maybe he is right..I dont know. I feel ashamed of myself for not taking the med as prescribed. Plus, when I get started on it I do KNOW that being awake for 2 or 3 days is NOT healthy. I just dont think I have got the exact dose down for how much it would take me to be awake all day but still be able to sleep that night.I get all happy about doing ..whatever it is I am doing and take more and more and more. Lord....I sound like a maniac! Well..its nice to be honest with you guys. I figure you will either understand otr not..either way..you have all been so very kind for expressing your thoughts and I appreciate that so very much. Hope I answered most of everyones questions..have I ?? Ill post tomorrow evening and give the ratio of meds in my pump plus tell you about a new med I tried (unsuccessfully) that was made after they studie cone snails abilitry to render their prey immobile! The stuff seems to have given lots of people a bunch of pain relief. It left me ..I felt paralized! EVEN after taking my entire supply of ritalin I just sat/laid and stared..unable to move. I guess thats what the fish do while the snails eat them! It was awful and I still had severe pain. I just was frozen..unable to do anything. Making a phone call was a BIG dal. I couldnt do anything. Well..thanks everyone. Linda
Posted by zoolin on November 22, 2005, at 4:00:24
In reply to Re: ritalin .. » ed_uk, posted by greenhornet on October 26, 2005, at 10:45:39
Yea, you are right I believe. Each time I see my pain management DR I must fill out a pain questionare and one of the questions is "do you feel you are becomming psychologically dependant on your pain killers" ..not physicaly but psychologically. Those questionres are so odd anyway. "Rate your pain on a scale of 1 to ten and then you have to say HOW it feels.IE: burning, tingling, so on and so forth. Its bizarre to me because pain is many things over the course of a day. (at least for me it is) Usuay its al of the things but describing my pain is a hard thing for me. It is severe I know that ! OH!!...thank you for the link to that acticle. I feel sad about what happened to you. Something similar happened to me after a back surgery one year and I had a family Dr that had presc...gee I forget now but..OH!! Firinol or something ike that for migraines and I went to the dentist later on who gave me a script for a few ( you know how dentists give like..8 pills.. ) anyway....then after I had my first back surgery the Dr gave me a script for loratab5 and when I went to fill it the pharmacist decided to call the back surgeons office and tel them "several" other doctors had prescribed me pain meds. That caused the back surgeon to FREAK out and give me ONE script (I had to retrieve it in person) once per mo for 2 tabs per day. It was not enough for my back as the surgery was unsuccessful anyway. I was so stunned and felt like the people in that office saw me as a junkie in spite of the fact Id listed every med I was taking and why on the origional questionare at the back doctors office. I am sure Id listed the firenol as needed for migraines..I cant recall if the dentist was before or after the fact but I never had hid anything from any of my doctors. BUt I know how it feels to have something happen and all the sudden you are portrayed as a person after meds. I feel it is remarkable you sued! Right on! I wish I had energy to seek remedy for some of the wrongs Ive suffered ( ~a ongoing BAD situation with an orthodontist/dentist in fact..bad..BAD dental situation..:( ) ..but I simply dont have the energy to pursue it . I admire you for fighting for what is right though. Heck, I look back at all the unfilled scripts I have here for methadone 10 mg ..270 tabs and think...They thought I was going from Dr to Dr for pain meds..??? I dont even want to take any med that leaves me feeling all tired and sleepy. I wish I didnt have to take any med. I would love to me able to just eat right and exercise and try to be healthy. Well..anyway , I guess we all wish for stuff huh? :) thanks for your thoughts OK? Take care..Linda> As one who was at one time in a somewhat similar , situation, and believe me, you have my prayers. There was a wonderful article in AARP magazine about people who must live in chronic pain mainly due to physicians who are afraid to prescribe opiates in the proper doses or fail to prescribe them AT ALL because they feel the DEA is breathing down their necks and/or they are afraid of the patient becoming "addicted".
>
> From this article:
> "in reality, for those using opioids as prescribed, the likelihood of addiction is extremely low, according to research. "It's really an unwarranted fear," says Christine Miaskowski, former president of the American Pain Society. Many patients do become physiologically dependent—meaning they'd go through withdrawal syndrome if they quit cold turkey—but this is a normal condition that can be managed by tapering down the dosage. It's not the same as addiction, which requires psychological dependence. Experts say patients with a history of drug abuse can safely use opioids too, as long as they are carefully monitored by their physicians to avoid a recurrence of their abusive behaviors."
>
> You can read the article in its entirety at"
> http://www.aarpmagazine.org/health/prisoners_pain.html
>
> While I was on Ritalin (prescribed by my psychiatrist) I developed sever and debilitating pain from an old injury. I was given Fentnyl by an orthopedist. I took both medications AS PRESCRIBED. When my then-family-doc found out about both meds, he flipped out. Worse yet when I came in to see another physician in the same practice, I overheard my former MD telling the second guy I was seeing (For what turned out to be a broken foot) that I was a "med seeking addict who is already on all kinds of crap" -- Needless to say, I do not see those docs any longer. I sued for slander - it was settled out of court and the first doc had to pay!
> So -- is it ADDICTION? is it ABUSE? or is it relief, that brings with it the ability to function as close to normal as possible?? Can you tell me??!
This is the end of the thread.
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