[ANON POST] Narcotics Prescription for Ex-Drug Addict

[orange_fell]

OK, I Googled "Is it safe to take narcotics after using cocaine?" and didn't get anything useful. (And now I'm probably being investigated by the FBI . . .) I know from previous searches that cocaine itself remains in your system for one to three days, but the chemicals your body makes in response to the cocaine remains in your blood for much

Comments

[anonymous]

Even a known addict will be given morphine for severe pain such as serious burns, unless they have specified otherwise in a legally binding medical directive. The doctors will be giving her morphine long before any blood tests come back. If they know or learn about her history with morphine she will be monitored more carefully - she will be given strict doses with no opportunity to give herself extra, people are likely to be skeptical about her pain levels once she's conscious.

The information about cocaine will just mean that they will observe her more carefully for issues like vasodilation, kidney function and nausea. Cocaine is short-lived (15-30 minutes) so unless she's been on a mighty binge, it will be making its way out of her system even as she's getting treatment.

[anonymous]

Well, that answer's more informed and thorough than mine. I was just gonna say that users often take uppers and downers together, like cocaine and heroin (v. similar to morphine) respectively, so I wouldn't imagine she'll have a problem. And I might expect her to have been around people combining them if she's been around people using.

[corvideye]

But that doesn't mean that taking both is in any way a good idea, and I think the question was whether the dr. would give it, not whether she would take it.

[box_of_rocks]

If someone is severely burned, they'll get heavy painkillers immediately. Even if a person is addicted that doesn't mean they don't deserve pain meds in severe situations like that.

[error_page]

This very much depends on the doctor, and the patient, and their relationship - I'm an addict, and I have a condition which causes chronic pain. My GP (who's known me for years) is willing to prescribe opiate/opioid painkillers, as long as I'm okay with that, and as long as everyone is comfortable with how I'm using them. 'Upgrading' painkillers can be an issue, as can opiate tolerance, but someone who's in serious pain gets painkillers*, especiallly burn patients, as far as I'm aware

[evilstorm]

Kind of a complicated question. I'm guessing your character's in hospital, between the smoke inhalation, burn management and pain issues. To answer your question directly, you can use opioids (oxycontin, morphine, fentanyl etc) straightaway, the doctors would just be careful as fuck. In hospital they'd be able to monitor more closely for adverse effects and (presumably) be able to haul her to ICU if necessary, so they'd be less stingy with the painkillers. They'd also try to use other painkillers like paracetamol, voltaren/brufen/other NSAIDs, ketamine, maybe tramadol, basically trying to use as little opioid as possible. In her the problem isn't just the recent cocaine use, but also the previous morphine use, because that fucks with your dosing and sometimes causes weird shit like increasing sensitivity to pain in general. Honestly, if her pain is that bad she's going to get specialist anaesthetics care.

By the by, what was the reason the doctor tested her for cocaine? Because they knew the previous history? It's not SOP, is all.

[evilstorm]

OP here.

The doctor knew the patient had a history of drug use/abuse and wanted to see if she'd taken anything recently, in case it mixed badly with the drugs she needed to be given to deal with her injuries.

(The setting is slightly sci-fi, so some of the drugs and other treatments are different.)

[corvideye]

She might be given methadone? It is often used for people coming off of illegal drugs or morphine (it can help with the withdrawal but is usually less likely to become addictive than morphine), and is also used as a strong long-acting pain medication, esp. for people who can't take morphine for some reason (addiction history, allergy, etc.). (I am not a dr. and have no idea if it would be appropriate for her type of injury, since it can also cause respiratory depression, but it's something else you could research.)

[elialshadowpine]

This was kinda my thought, too, but I don't know about use of methadone for burns; OP, since the setting is 50 yrs from now and SF-y, why not make up a drug that is a painkiller with very low chance of addiction?

[mereprototype]

Sometimes, even if a patient's an addict, there are no other options aside from using the same medication and keeping a very close eye on the patient's dose and usage. I am an addict and my drug was Ambien. Given my continuing trouble sleeping, right now I am hoping that my insurance covers Rozerem because if it doesn't I will have to be put on Lunesta, which has similar risks of misuse as Ambien does. My psychiatrist is aware of this and the benefit of restful sleep to keep some psych symptoms as minor as possible means the risks are acceptable if the preferred med isn't available.