I am 54yrs old, as of this January, and for the last 5yrs or so I have been suffering from sufficiently bad osteo-arthritis in my knees that it has driven me back to heroin addiction, which I had not touched for over 9yrs previously (@the time I began using it again). I was prescribed a mixture of Pregabalin and various opiates & opioids for severe Peripheral Neuropathy, from which I have been suffering, at the time of writing, for approx. 12yrs and thus no doubt contributed to the fact that I didn’t notice a build up with the arthritis: 1 day I was what passed at the time for alright, the next I had a bad pain in my left knee and maybe a month later, after hobbling about with a stick, my right knee began to bother me as well.
I was recently evicted from my previous accommodation (a flat that was the whole 2nd, top, floor of a converted house, which had sloping ceilings and a fire place, plus a cast iron bath, even if the bathroom sink was actually in the bedroom, on the other side of the wall from the adjoining bathroom, which was literally too small to fit the sink in, and the kitchen was way too small: nevermind a cat, it was too small within which to swing a mouse!!!) because my Landlords wanted to replace the roof and extensively remodel my flat, which would then become outside my price bracket, so there was no point in them putting me up in alternate accommodation while the work was done, as I could not afford to return anyway, which inevitably resulted in a change of General Practicioner, GP, or Doctor, during the startup interview for whom I let slip that I had been using heroin to top up the pain relief afforded by the Morphine (Zomorph timed release capsules) and Pregabalin which I was prescribed. What I did not tell her was that I had become addicted to heroin again.
This snippet of info I reserved for the clinic my new GP referred me to, as she was no longer willing to prescribe me 28days supply of Morphine at once unless I cut my heroin use right down and/or ceased… little did she know, lol! Of course unless she was willing to actually cease prescribing me Morphine altogether, which she assured me she was not, this was not actually much of a threat to my status quo, although it could have become a pain in the arse if she had gone down to 1 week’s supply at a time instead of the 2 weeks she settled on, due to the fact that my fiancé lives in Sheffield, an hour away by car, and I was in the habit of going to stay with her for extended periods, although this had been reduced a lot since I’d moved into my new place (which is a flat in a dedicated block for older/old people who require support to remain independently living, rather than go into residential care. It has a lift up to the 1st Floor where my new place is, so it’s a massive improvement on the several flights of stairs I had to negotiate on the way in/out of my old place which significantly contributed towards me becoming a hermit! So I am now officially a Fogie, as well as a hermit, ffs!
How did the situation get to this however? You’d have been forgiven for thinking that, if the hospital Pain Team who were supervising my original GP’s prescriptions of pain meds for me and they had settled on 60mg of Zomorph Twice Daily that they clearly understood that there is no cure for Peripheral Neuropathy and that, although medication may slow its progression, the long term prognosis is bleak, thus it matters far less about me being addicted to my prescribed Morphine than the pain I would be in without it, right? And, of course, with all pain meds they are “titrated” which means started at a low dose and steadily increased until the desired effect is reached. Well, no, not at all!!!!!
The Pain Team were practicing what is known in the profession as “Defensive Medicine” and rather than take my word for it, see what The British Medical Journal have to say: https://www.bmj.com/content/350/bmj.h87.full … They were far more concerned about what would happen to them if anything went wrong with my life, and told me straight, “We do not want to prescribe you Morphine at all, because you are a recovering addict, but you have forced our hand. Understand that you will not get any more than this, there will be no increase, even if you tell us that it is no longer working as it once did. This is your lot!” even though I swore blind that I would not sue them no matter what happened and that I was prepared to write a letter to that effect, binding on my heirs and successors also (FFS!).
And the reason they capped the Morphine where they did? Not because that is anywhere near as much Morphine as a body can handle before the brain’s receptors are full: that happens at 80mg or so (more for me since I’ve been using opiates off and on since I was 13) but that is 80mg at once, not released over 12-15hrs, although my metabolism is so quick that I would begin feeling withdrawal symptoms every day after approx 8hrs on days when I could not afford heroin. At no point during a day just taking Zomorph would the bio-availability of consumed Morphine be more than 30mg and that was the peak of each pair of 30mg capsules. No they capped it where they did because that was the minimum they could prescribe and have me not kill myself in response to the pain.
It was supposed to allow me to continue my favourite sport, Airsoft which is somewhat like Paintball but far more tactical, since the range of the projectiles is 20-30m further and thus camouflage also actually works at 70-80m, but it never really did help me. When I managed to cajole* a further 150mls of 10mg in 5ml Oramorph per 28 days (which is a liquid syrupy solution of Morphine Sulphate and flavourings that make it un-injectable) I did get a couple of months of Airsoft (every weekend either Saturday or Sunday) but I’d be laid up in bed for 3 days afterwards with my feet hurting so much that I could barely make it to the toilet, so it was just unsustainable… *And that took a full on presentation to my GP by my social worker and my partner as well as myself, for the love of all that’s wholly fucked up!
The thing is, it was their very parsimonious attitude that directly led to me using street drugs again: if they’d given me a decent amount of Zomorph, so that I wasn’t withdrawing twice/day, every fucking day, I’d have been sorted, not able to Airsoft maybe, but nevertheless not putting my life at risk continuously and damaging my veins while I’m at it!!! 60mg 3 Times daily would have done it, 90mg Twice + 60mg Once Per Day would have allowed me to continue being active and I wouldn’t now be looking at a massive uphill struggle to regain fitness, assuming that I survive both operations, because I am overweight and in very poor cardio-vascular shape: my Q-T Interval is lengthened, which is a problem often caused by opiates, but it is also exacerbated by lack of fitness, so there is a very real possibility that I will die on the table, or that I have a very poor outcome due to being unable to exercise sufficiently thereafter…
Anyway, I’m on Methadone now, 110mg/day, which is not as much as it sounds like, for anyone familiar with opiates/oids, because for me the pain relieving function of Methadone wears off after about 14hrs and the withrawal prevention function starts to wear off after about 16hrs, unlike the advertised lasting time of 24hrs, so actually it's more like I'm taking 65mg/day when compared with someone for whom it does last the advertised 24hrs: I take 65mg @08:00 and 45mg @22:00 and it keeps me pain free so long as I don't move about and I no longer have withdrawal symptoms every day, woo-the-fuck-hoo!!! So I'm trying to look on the bright side and ignore the problems, because there’s very little to nowt I can actually do about them now anyway, so I’m really looking forward to having mechanical knees and getting back to Airsofting, but realistically it could be as long as 3 years before I have both knees done and then there’s the uphill struggle of trying to regain my cardio-vascular fitness so that I can actually take part, as it often involves running while carrying 20-30lbs of gun and gear and quite apart from pain in my knees and feet, if I tried that right now I’d puke up!!!
As an alternative to watching TV and surfing the net, I’ve become a dedicated dabbler in Xbox gaming. I say “dabbler” because the only game I play with any frequency is Witcher 3: The Wild Hunt, which is just so immersive that, even though I’ve had it since it came out (I bought it bundled with my Xbox One: what a piece of luck, since I knew nothing about gaming or what I would like, etc., but I randomly selected the best game of the decade!!!) I still play it regularly and it helps me to ignore the pain, even though manipulating the controller actually causes additional pain in my hands…
TL;DR I am ill; just given up heroin again, which I was using because I am ill and was badly treated by hospital doctors practicing "Defensive Medicine"; just recently moved into supported housing; looking forward to having knees replaced with mechanical joints; into gaming a bit on Xbox + TV, Netflix, surfing the net...