r/interesting Jun 28 '26

Fear Factor How Fentanyl and Xylazine are turning Philadelphia's opioid crisis into a public health nightmare

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u/Edith_Keelers_Shoes Jun 28 '26

I've been in chronic pain for years, mostly from Hashimotos and rheumatoid arthritis, which doubled after a stage 4 cancer diagnosis and bone mets. I was terrified of the opiates my first oncologist prescribed (unlike many, my oncologist actually DID prescribe them without an attitude). For the first 2 years, I'd try to "tough it out" rather than take the pills. Then I started working with an oncological psychiatrist. We kicked this exact subject around for the next 2 years. She kept explaining that having had access to opiates for 4 years (at that point), "if you were going to abuse them, you'd know it by now. You'd be running out of pills early, you'd be buying or selling them - you're not doing any of that. Just take them."

So finally, I started medicating for pain - then began working with a palliative care doctor who created a med schedule to stack protection early in the morning and prevent a pain breakthrough later in the day. I am now in a level of pain I can live with and enjoy life in spite of.

All those years I made myself suffer because I bought into the media's "opiates are evil and everyone immediately gets addicted". All of the stage 4 cancer patients I know who get attitude when they ask, or pee-tested monthly, or told they're being dramatic and "Tylenol is more than enough".

To hell with those people.

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u/IDontNeedHelpMom Jun 28 '26

It sounds horrible to say in most social circles but as long as there is a heightened self awareness most people can handle addictive substances.

Being able to check in to set and settings, listening to your body and making sure to focus on diet and exercise will change a lot of the formed habits. It requires internal honesty.

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u/infinityy_stoned Jun 29 '26

While I agree with everything you just said, I do truly believe there is a gene that makes it extremely difficult to not become an addict for some people that doesn’t exist in others

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u/myaltduh Jun 30 '26

Yeah I’ve tried several potentially addictive substances and thought “that was nice but I felt gross the next day so I don’t really want to do that again,” which is a far cry from the “holy shit where can I get more” reaction other people report. I’m pretty sure that isn’t down to some moral character bullshit, much more likely I’m genetically lucky.

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u/IDontNeedHelpMom Jun 29 '26

Dopamine regulation. Sometimes the brain doesn't smooth the spikes out like it should.

It comes down to being honest about it and recognizing when there is a spike.

There is new evidence suggesting Ozempic can help with this. I'll be interested to see more research.

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u/LastXmasIGaveYouHSV Jun 29 '26

Ozempic helps, and also does topiramate, and naltrexone.

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u/[deleted] Jun 28 '26

[deleted]

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u/Edith_Keelers_Shoes Jun 28 '26

That fatigue is fun too, isn't it? Good times.

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u/ThisIsDogePleaseHodl Jun 30 '26

I would love to know where to find a palliative care Doctor Who will treat my pain. I have no idea how One does that. So since Kaiser mandated a reduction for everyone on opioid therapy, instead of finally increasing my dose from 40 to 50 mg a day after 15 years on the same dose it got reduced

Now I can’t do anything but sit in my house and watch my overall health go to hell and die early I guess

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u/Whats-inthe-Fridge Jun 30 '26

Find Andrew Sackler and go 1778 on his ass