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They’re not completely useless, but I agree that we overprescribe them.

I had a kidney stone with complications that required three procedures to take care of. The only thing that would touch that pain was opioids.

It was a miserable experience and, thanks to the opioids, I essentially have a four-month hole in my memory. They made me nauseous, dizzy and cognitively useless. I had to titrate off of them because I had developed some degree of dependence.

Still, in that situation I would take them again, the pain was unreal.



>The only thing that would touch that pain was opioids.

I had a similar experience, albeit (and thankfully so) much more short term. I had spine surgery (lumbar laminotomy[0]) to address spinal stenosis[1] that significantly weakened my right leg and was prescribed oxycodone after the surgery.

I had prepared for this by acquiring significant amounts of cannabis (concentrate, butter and flower) to address the pain, but for four or five days, cannabis was insufficient to address the pain.

After the first two days I reduced the dosage and frequency of taking the oxycodone as I was concerned about dependency.

I will say that the first two days (full doses at four hour intervals) made me understand why some folks end up dependent on opioids.

My takeaway was that short-term use for acute (vs. chronic) pain, opioids are very effective.

For lesser pain levels, cannabis is also useful, with the caveat that cannabis doesn't actually get rid of the pain, you just don't care.

Your experience (and mine as well as that of many others) make it quite clear that (at least in the US -- elsewhere too, but legal regimes are different elsewhere and I'm not necessarily familiar with those) cannabis should be removed from schedule I (and potentially moved to schedule IV or removed completely) of the Controlled Substances Act[2], which would allow more widespread research into pain management and other medical uses.

I hope you don't find yourself in that situation again.

[0] https://adrspine.com/treatments/lumbar-laminotomy

[1] https://en.wikipedia.org/wiki/Spinal_stenosis

[2] https://en.wikipedia.org/wiki/Controlled_Substances_Act


I find kratom superior to cannabis in this regard. Of course kratom is not without concerns, but in the scheme of things they're just unpleasant rather than deadly.


>I find kratom superior to cannabis in this regard. Of course kratom is not without concerns, but in the scheme of things they're just unpleasant rather than deadly.

Is your implication here that cannabis is deadly, or am I misunderstanding your point?


Kratom has abuse potential and requires mindful tapering to get off if used on a daily basis. Nothing fatal but I'm trying to acknowledge that it is not without some concern.

I have chronic pain and some headspace stuff that it really helps with but at this point my relationship with it could be construed as, um, er, addicted -- but same thing with coffee.

Cannabis can be psychologically addicting (a close friend is a chronic cannabis user who wheezes like a 2 pack a day cigarette smoker). It is not for everyone but should absolutely be legal everywhere.


Maybe not, I read that as compared to opioids, both Cannabis and Kratom being safer, with this person saying Kratom is more useful than Cannabis for this. Hopefully I read that right!


You did indeed. Thanks!


And I misunderstood. My apologies.


No problem at all! You were quite respectful in your questioning ;-)


> cannabis was insufficient to address the pain.

Not only cannabis isn't a good painkiller, but it comes with very strong side-effects: it makes you totally unable to do any activity. This is fine for a recreational usage, but for a therapeutic usage, it's a serious problem. Especially when alternatives exist.


>Not only cannabis isn't a good painkiller, but it comes with very strong side-effects: it makes you totally unable to do any activity.

Well that is just completely, wildly untrue, and laughably so. C'mon now.


>Not only cannabis isn't a good painkiller, but it comes with very strong side-effects: it makes you totally unable to do any activity. This is fine for a recreational usage, but for a therapeutic usage, it's a serious problem. Especially when alternatives exist.

I disagree. There are varying levels of pain. The pain from being cut open and (metaphorically speaking) my spine scraped out with gardening tools, then being stitched up again is much more significant than pain from muscle aches, mild nerve pain and many other sources.

Cannabis was insufficient (for me) immediately (and for a couple days) after surgery. However, it was absolutely sufficient after three or four days.

Yes, the psychotropic effects can be debilitating, but that's not true for everyone.

N.B.: The observations below are anecdata, so obviously YMMV.

I find (as an InfoSec/Infrastructure guy) that I can't give the level of focus required to do my job effectively if I use cannabis regularly.

However, I know several lawyers and other folks with mentally rigorous professions that use cannabis multiple times daily and are able to function reasonably well. Note (as I mention above) that I am not one of those people.

The impact of cannabis on an individual is subjective and nuanced, so I don't accept your assertion that "[cannabis] makes you totally unable to do any activity."

In fact, different strains of cannabis (presumably based on THC/CBD/other cannabinoids levels) have different effects on different people.

I don't doubt your (and/or others you know) experience has been that cannabis is disabling. But that's not true for everyone in every circumstance.

Which is why I strongly believe (as I stated in the comment to which you replied) that cannabis and the chemicals it contains should be thoroughly researched to determine its impacts, both positive and negative.

tl;dr: I disagree with your statement because it was categorical, not that it was necessarily wrong in all cases.


I consume cannabis occasionally and recreationally. I tested it for different types of pain. Back pain, nerve pain... For me, the effect was mild to none. But if I want any effect at all, I need to consume so much that I'm not productive.

I also know people who smoke cannabis all the time and are able to work. But I suspect their tolerance is so high that it's also ineffective as a pain killer.

Of course, this is anecdata as well. I'm willing to concede that on some very specific cases, cannabis may work as a painkiller (right type of pain, right dosage and so on). But I'm convinced there are always better conventional choices. And same thing for anxiety, depression, sleeping issue, and most things people try to advocate cannabis for.

Cannabis should be legal for recreational use, and may have some niche therapeutical applications. But it's certainly not a miracle drug as some people try to picture it.


Totally unable to do any activity is not a side affect of cannabis. If that happens to you, you’ve taken too much.


If you take one puff, it's not going to work as a painkiller either...


Admittedly, some people don't react well to them.


Have a mix of nerve pain and a number of kidney stones.

A bad kidney stone will leave you suicidal after awhile. Tramadol was only thing that go me through those.

Nerve pain is harder as it’s long term. Never as bad as a kidney stone. But it is it something you can live with indefinitely. Tramadol works. But then you get long term addiction. I would stop for a month every few months just to detox some.

Eventually I discovered LDN. Which got pain under control. Plus side you can’t take opioids.

Was a nightmare finding a doctor that would prescribe it though.



I have some nerve pain. I tried LDN for maybe a month and it did nothing for me. What dosage are you and how long have you been taking it before seeing an improvement?


4.5 Started at 1.5. Fairly quick results. Only side effects being externally vivid dreams. After a week went to 3, week later to 4.5 I alternate between 3 and 4.5 mostly because dreams can be a bit much. But pain reduction is great.

I have Sjogrens autoimmune as underlying condition.

Other trick I found was I was taking a b complex. Removing the b-6 seemed to help.


Thanks!

Did your Sjogrens popup on autoimmune blood work?


I’m always curious about using ketamine for situations like this.

I’ve found that with medical marijuana you still feel the pain but you just don’t care because you’re stoned, granted I haven’t had pain such as yours.

With ketamine, at low doses you get a disassociated effect without much cognitive load but I haven’t taken it when I was in pain and unfortunately don’t have ready access to it anymore.

I’d taken Vicodin for 2 days after a surgery and quit it immediately because I couldn’t think clearly, nausea, etc and didn’t want anything to do with it.


I can answer this actually.

I bulged a disk in my back, new job, no health insurance. My boss was a friend and knew I was a weirdo. I would bike (!) to work, take a keytip of ketamine, program for about an hour, lay down, do a gravity inversion (had one shipped to the house we were using as an office), do another minimal key, I could get three, maybe four of those out of a day.

I hate the effect of opiates except for the part where they make physical pain go away, and even if I had a doctor at the time, to get a scrip, it was a non starter for getting work done.

Worked out ok, still use a standing desk, lift weights, my back has been at least nominal every since, no surgery. I don't recommend it, the bulging disk part, and I'm not here advocate for off-label use of controlled substances, ketamine is habit-forming and can be quite destructive. It was effective however.


That’s great to hear!

It does seem to be gaining in popularity for anxiety and depression.

I really can’t imagine it being as destructive as opiates having known plenty of people who have done both to the extent of having a habit with only opiates ruining people’s lives and killing some them. As far as I understand it ketamine is more of a psychological dependence than a physical one.

Time will tell I suppose.


I said "habit-forming" rather than "addictive" for a reason, yes. That habit can be quite physically destructive, you can find papers on the effects of a heavy habit out of China which are somewhat toe-curling. It's not capable of stopping breathing or causing cardiac arrest, dying of an overdose isn't practical.

However, ketamine can make the brain go... weird. Like cocaine and amphetamine, habitual/binge use gets psychotogenic, and while bizarre delusions won't usually kill you (or anyone else), they can absolutely fuck up relationships, or earn someone a brand-new one with the authorities. Opiates, for all their terrible flaws, don't do this.




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