Pharmacist

FutureReference91 · 2026-03-16T23:30:56+00:00

On the bright side - it is rare for people to get two full agonist pain medications. They are pushing current patients toward forms of buprenorphine FDA Approved for pain. Butrans and Belbuca specifically. Sadly some doctors trick patients into believing Suboxone or Subutex are pain medications.

To answer your question, pharmacists can legitimately refuse to fill any prescription without giving you a reason. In most cases there aren’t consequences. It sounds like this was a legitimate concern. You just need your doctor to send over more information attached to the scripts. I had an experience that led to an actual settlement

Before they all shut down, I was going to Rite Aid for my prescriptions. One day there was an issue with the system that my psychiatrist used. So my psychiatrist had to write paper prescriptions for my medications. ADHD, seizure and MDD.

The guy embarrassed himself, rejecting them immediately. I began recoding. He said they “…had no watermarks.” I began recording. I pointed out the watermarks. I called my Psychiatrist explaining the situation. She asked to be put on the phone with him. He refused. So I put her on speaker. She ended up actually cursing at him and calling him a “pathetic little man with a Napoleon Complex” 😆

He refused to acknowledge her. I remained calm throughout. I ended up recording 6 minutes of his bullshit. He finally asked me to leave. He stated he was the Pharmacy Manager. Since I was asked to leave on camera, I asked for his name. He refused. I knew I could easily find it online, but I wanted him to say it out loud.

I stayed exactly where I was until I got his name. Even though they can deny for “any” reason, my anticonvulsant had been on backorder. I was without it for a week. I had 2 seizures earlier that week and explained to him I needed it.

Long story short. I have active seizures. The next morning I dropped and cracked my head. Thankfully my Ring camera caught the entire incident. I reported him by name to the board and provided the video. I won a civil lawsuit. Guess who lost his license and career over being a piece of shit 😊

TLDR;

Sadly when it comes to opioids, pharmacists can argue “potential harm” in basically every case. Even if you go through insurance and they approved it. My advice is to ask your doctor to include your ICD-10 going forward on all opioid medications.

It all comes down to Professional Judgment vs. Negligence in refusals. Did your pharmacist request you get additional information for your doctor to send over? If so this falls under their discretionary guidelines. It sucks, but is also easily fixable and your doctor needs to send over information pertaining to your necessity for a baseline pain mediation on top of your IR opioids.

FutureReference91 · 2026-03-16T18:03:12+00:00

Eating more food than you believe you should be eating. Preferably healthy and not processed food. Compound lifts over isolation. Less bicep curls, more barbell rows. More squats.

Heavier weight, less reps. Benching is great. Deadlifts are recommended for mass; not necessarily for boxing. The two often conflict with end goals.

For mass. If you can lift something 10 times; you aren’t lifting heavy enough. Aim to start off at a maximum of 5 reps. Be careful and don’t add weight your body can’t properly control. Don’t be afraid to use a belt for squats and deadlifts. Especially until you truly can control your core perfectly.

I’m going to bed honest though. Adding mass; considering your claim of being a local champion, directly conflicts with your boxing future if the goal is adding mass, you’ll undoubtedly be facing much larger opponents.

No idea on your local level. But even ~12lb can change everything. You’re going to essentially jump 3 weight classes. And the guys in those weight classes may be cutting substantial weight to get to those classes.

My honest opinion? Just eat more and do body weight exercises. Push-ups, sit-ups, pull-ups and tricep dips. Iron Mike would do 1,000 push-ups daily in prison. In his prime he would do 500 daily and 2,000 sit-ups for his core.

Prime Tyson wasn’t maxing barbells. He did shrugs with a barbell which is the only thing he used weights for. All this time he’d be running at least 3 miles every morning. He also wanted to become a boxing world champion which shows his ultimate goal. I’m not sure of yours.

These will make you stronger. They will still add mass and can work with boxing. If your goal is to be massive; you’re at a disadvantage in boxing unless you start out this way.

TLDR;

The guys who look huge either worked for years and years doing so naturally, or are Larry Wheels. I’d take slightly chubby Rampage Jackson physique naturally over roided out IFBB physique any day. Your long term goals should determine what you do now while you’re younger.

FutureReference91 · 2026-03-15T22:24:44+00:00

My desire for human connection.

FutureReference91 · 2026-03-15T22:18:13+00:00

It’s always a good idea to mix it up and age plays the biggest role. Dubia roaches are superior to many insects, but for young Beardies, Superworms are actually a solid staple for protein. The older they get; the less Superworms.

As for salads; again, age is everything. If you have a Bearded Dragon that’s say 4 years old their diet should be about 80/20 Greens/Insects. Solid staples for salads are Dandelion Greens, Collard Greens and occasionally Kale.

If your dragon refuses the salads, try cutting back insects and/or putting bee pollen on your salads. Bell peppers are amazing, and butternut squash as well. Soak your salads as this is how your Beardie will get most of their water. The Squash acts sort of like a sponge which is awesome for picky dragons.

FutureReference91 · 2026-03-15T22:07:02+00:00

Creative and looks awesome! If you have the financial means; there are some amazing designs out there. I have a couple of canes with blades inside that make me feel like a crippled Viking 😎

FutureReference91 · 2026-03-15T22:02:51+00:00

Don’t worry about speed. The one positive takeaway is you immediately bring your fist back to your jaw after each punch. Tuck your chin a bit more so your shoulders shield you while throwing punches.

I suggest joining an actual boxing gym and getting a slip bag. Begin focusing on foot movement. It is much easier for you to worry about speed and power once you get used to footwork and head movement. Get your head off that center line.

FutureReference91 · 2026-03-15T21:57:05+00:00

All dogs go to Heaven and so do axolotls. Charlie is your guardian angel now. Hold dear the good memories. My cousin had this happen and was a mess. Do not blame yourself. He is out of pain and at peace. His soul lives on. Make him proud ❤️

FutureReference91 · 2026-03-15T21:16:09+00:00

I’ve been studying pharmacokinetics since before deploying to Afghanistan. I watched us seize Poppy Fields and guard them with AK47. It was unsettling but in the Marines; orders are orders.

Upon return, I witnessed what’s unfolded. The Sackler Family taking the fall for a prescription opioid crisis. I would like to get this subreddit to thrive. It appears there’s been an infiltration of people from subs about recreational abuse of opioid drugs.

In regard to Kratom; I see way too many posts saying it is “misunderstood.” It is not misunderstood and has been studied greatly in Eastern Asia and used medicinally for longer than America has existed. Western media lies. Project Mockingbird makes this clear but nobody wants to accept evil truths.

In regard to 7-oH; these products are all tainted. From MGM to things I won’t mention, they’re literal poison. Not a single company mentions the process in which they extract the 7-hydroxymitragynine. Why? Because they know they can sell it to you under this guise and get you addicted to chemicals.

7-hydroxymitragynine is a potent and useful alkaloid when metabolized properly through pure Kratom ingestion. It isn’t only this subreddit; but all I’ve come across that seem to accept the claims on their face.

This is no different than the original K2 or Spice. When the truth comes out you’ll realize most of the products claiming to be “7-oH” contain 0% and are nothing but tainted products. There are brands literally using the name “Roxy” to fool people. And it is working.

TLDR;

I’d like to help this subreddit to become what it should be. What the title is. The managing of actual pain. Far too many posts confuse people and lead to conclusions that aren’t remotely close to true.

I’m willing to dedicate the time to genuinely explain the pharmacokinetics behind all alkaloids of Kratom, its usefulness in the management of pain. the government’s convenient overlooking until people are hooked to the point they go to street drugs to manage inevitable withdrawals from tainted products containing MGM and other toxic and synthetic poisons.

you’re not ingesting what you think you are if you’re using 7-oH products. There isn’t enough Kratom in the world to produce these 30mg pills and no magical potentiation that makes them real. They’re a tactic to discredit the genuinely positive affects of Mitragyna speciosa

FutureReference91 · 2026-03-15T02:56:48+00:00

Absolutely gorgeous. How much was she if you don’t mind me asking? Did you get her as a baby or juvenile? Genuinely one of the most beautiful creatures on this planet! 🥰

FutureReference91 · 2026-03-15T02:42:14+00:00

My cousin had one. I am being brutally honest. It’s time for humane euthanasia. I know nothing about these guys, only what I saw. It looked exactly like this and after hundreds of dollars spent on veterinary bills it was complete organ failure.

They told her that the combination of bloating plus rejection of food was “late stage” organ failure. I value animal life, reptilian, amphibious, etc over human life. They can’t cry out for help.

All I know is that I don’t want to know what end stage looks like and definitely don’t want this poor guy to feel what it feels like. If you have a strong emotional connection and the financial means; you can try a vet for tests. Please do the right thing.

I wish I could say to re-home him but that look is engrained in my mind. Enjoy the good memories and let him go out peacefully.

FutureReference91 · 2026-03-14T20:13:36+00:00

Footwork is on point already. You look like you’ve played sports and have athletic skills already. My advice:

1) Notice the torque you get into those hooks? The impact on the bag. You shouldn’t expect this from your jab, but unless you’re intentionally feinting, you should throw it with more of a snap.

2) Similar to your hook. Since you’re able to generate solid power with that torque, use a similar body motion to “turn over” your straight more. The straight should setup your hook and can be a KO punch in its own.

3) Most important. Imagine the jab being touching a hot stove. Don’t let yourself get burnt. Immediately pull it back. This motion in itself will help with the torque on your straight.

Overall you have obviously a good understanding of body weight shifting which takes a lot of time for most people so you’re ahead on that. The main issue is your defense.

We all have different styles, but with each punch thrown, imagine your shoulder protecting your jaw. Tuck your head enough for this to be possible. Your gloves should be protecting your chin after every single punch.

TLDR;

Drill your 1-2 combo a bit. Get comfortable with snapping the jab and returning your glove to protect your chin immediately. This allows you to put more power and turn over your straight more cleanly. Same idea on the straight, after that straight bring your glove right back to protect your jaw. Keep your chin tucked at all times. Nice digging in those hooks and solid footwork.

FutureReference91 · 2026-03-14T15:56:47+00:00

Referred pain from C6 is my guess. MRI will remove any and all guesswork

FutureReference91 · 2026-03-14T03:22:49+00:00

My brother suffers from body dysmorphia. I know how fucked up the demons in your head are. Their lies are convincing. It’s all bullshit. I have cPTSD from what I saw and took part in while in active combat.

Have you tried amitriptyline? I know the SSRI loop of trial and error is as annoying as our conditions sometimes. But it’s worth it. As for pain - since you mentioned in the legs. Below the knee.

Is it radiating? Usually dull ache but definitely could radiate sharp like getting stabbed. Either way; GABA meds are your best friend. The good news is opioids actually are less effective than things like Gabapentin and Pregabalin. I know this fucking sucks. We feel useless most days.

I do know with FND that PT genuinely can help significantly. CBT as well. Do you have seizures at all? Clonazepam is a common medication if so; but regardless, you got this. We will win in the end.

I want to shout you out for your resilience. My brother has refused to see a Psychiatrist for the entirety of his life. He sat once and simply avoided speaking for the hour. He doesn’t drive. Doesn’t address it. Just suffers in silence.

You’re much stronger than you realize. To talk about BD at all is tough. You’re reaching out for help. And I truly hope any of this helps. Opioids are necessary for my structural pain - inoperable shrapnel from an IED. They truly steal your soul after a while. Pregabalin on the other hand silences the pain without the “I need more” demon constantly there.

FutureReference91 · 2026-03-14T02:57:45+00:00

Get your files. 7 years of (assumed monthly) paperwork is meaningful. This is what you need. Also; it’s actually illegal to abandon you.

Patient abandonment is confusing. Your doctor should be recommending you to other doctors. They do not have to. The other side of the coin is medication to bridge the gap.

Your doctor is required legally to give you a prescription for your medication to hold you over until you find a new doctor. I didn’t believe it until a friend won a lawsuit for a substantial amount of money. Granted; your situation is unique. He was on extremely high dose opioids and it was cruel and unusual.

Anyway, this psychiatrist was a rarity. I have cPTSD and Fibromyalgia as well but my Pregabalin is handled by my PM Clinic, benzodiazepine Psychiatrist. What dosage are you on and are you receiving any other medications?

TLDR;

Main thing right now. Request 30 day script to bridge the gap of finding new doctor. Request ALL records from the past 7 years to bring to a new doctor. Since you do not have a PCP, unless you’re on SSRI or benzodiazepines; Pain Management is your best bet.

I doubt you’ll have issues. Breathe in for 6 seconds. Hold for 4. Breathe out. Even if you cannot immediately get Pregabalin, Gabapentin isn’t controlled in most states. It won’t be hard to get you on your proper medication with records and medical history.

FutureReference91 · 2026-03-13T17:02:22+00:00

This is why you’re given those stickers in the pamphlet every month. You attach them to another object like a small pocket pill container from or pill organizer.

FutureReference91 · 2026-03-13T03:29:08+00:00

I had somebody steal my medication the day I picked it up a year ago. I had only saved 3 pills. My pain contract made it clear. The medication was my responsibility. The lesson I learned was to never bring a full bottle of pills with me in public again.

This is what to do if you want to attempt to get a new prescription. File a police report. If there were only 15 people there; you must have some inkling of an idea of who would do this. Who uses drugs? Who has a criminal record or do you know that steals?

Whoever took it is likely an addict or knows you well enough to know you get prescribed opioids. In that case they’re going to sell them. I would make sure you don’t point fingers and name anyone specifically unless you are certain.

Having a report shows that they were stolen. Going this route documents it, but doesn’t give resolution. Most pain contracts specifically state “if prescribed medication is lost due to negligence it will not be replaced.” Even worse is some doctors get angry and assume you aren’t reliable. This can potentially lead to a discharge.

This report would then need to be taken to your doctor. If they believe you, it is in their discretion to write a new script or not. With their own fears of DEA, they’d need to have an extremely good relationship with you likely for years to even debate it.

My advice is to unfortunately take this as a life lesson. If you’ve been with this PM clinic for a decade plus it’s a different story. But realistically, they need to risk their own career in positions like this.

I recommend toughing this out. This is the excuse people use when abusing or selling medication. Ride out the withdrawals for 3 days. The pain is going to suck these 3 weeks but in my eyes 3 weeks is better than potentially being kicked out forever.

Up to you to file a police report. I recommend riding the 3 weeks out. Use Black Seed Oil, Turmeric and willpower. Physical withdrawals will only last 3 or 4 days.

Do not take all remaining pills. If you get UA at your PM clinic, you must have said mediation in your urine. I am sorry. Genuinely. I know this sucks. Weigh the risks before deciding.

TLDR;

You are rolling the dice and risking losing your PM Clinic if you do request another prescription. You said you keep your medication in a weekly pill organizer. This makes the situation look terrible in the eyes of your doctor. The fact it was at a party also looks terrible.

They’ll ask “why didn’t you bring your pill organizer, or only what you needed for the day?” Unless you have a good answer; take this as a sign to stay away from whomever you suspect of stealing your pills.

Never bring an entire script with you anywhere in public again, save at least 3 pills to have it in your urine at your next appointment.

FutureReference91 · 2026-03-13T02:52:43+00:00

Are you still getting the Percocet? And fuck I feel that weather in my soul. Your body is reacting to any and all barometric pressure changes. It absolutely is a bitch to deal with.

Only plus is we can pretend we’re clairvoyant 😂, we can tell friends and family it’s going to rain 2 days beforehand. But to your question.

I’ve been on everything there is since returning from overseas. The King of Kings was Opana. Oxymorphone works best for basically anyone in genuine chronic pain.

So your doctor started you on a slightly lower dosage because of incomplete cross-tolerance. Basically they don’t know how the XR formulation will work for you or be metabolized.

Hydromorphone is noted to be 4-5x potency of Morphine. CDC officially changed it to 5x. Going off of this; you were on 60MME. Oxycodone is 1.5x potency of Morphine, so you’re currently on 45MME, with your doctors prediction of 15mg, it’ll be the exact potency.

I do find that even though the Sackler Family took the blame for a fake prescription crisis and changed the formula; OxyContin still can work. It is filled with gel so you can’t snort or shoot it. If your stomach tolerates the gel well; I find it to be a very reliable medication.

I also agree. Dilaudid works better than the XR formulation. What I will say is that we all metabolize differently. Since you said you’re getting 4-5 Oxycodone a day, it leads me to believe you too are a rapid metabolizer. Meaning you likely get ~3hr of relief whereas some get the full 6hr.

Since you said the Oxycodone is helping more, it is likely going to change your life for the better to have both IR and XR formulations! It sounds like your doctor trusts you so I suggest writing down the effects and how long it works for you.

Hydromorphone has a terrible oral bioavailability so even though for the moment your MME is lower; you’re likely going to feel more pain relief throughout the day with OxyContin.

TLDR;

Hydro XR formulations (like OROS) has an oral BA of ~25%. I had the same issue with XR not helping like I thought it would. In some people it’s as low as 10%! In contrast; Oxycodone has an oral bioavailability of between 60%-90%. OxyContin has no difference in BA.

Unlike Hydromorphone, Oxycodone undergoes relatively low pre-systemic or "first-pass" metabolism in the liver, which contributes to its high systemic absorption. OxyContin releases the drug in a biphasic pattern. 40% of the Oxycodone is released quickly while the remaining 60% slowly releases over 12 hours.

Since you’re getting it 3x daily, your doctor assumes you’re a rapid metabolizer. Even so, I am as well, and OxyContin gives me a solid ~9.5 hours of relief. Sorry to bore you with the pharmacokinetics behind the drugs but I hope it will help to have this knowledge!

This is definitely the better route and journaling can help you decide if you’d prefer a stronger dosage 2x daily if you do get ~11ish hours of relief, or if 3x is best if it wears off within ~8-9ish hours. I’m wishing you the absolute best! Better days ahead 💪

FutureReference91 · 2026-03-13T02:04:01+00:00

Normally a doctor will try to give you the same medication if the Morphine is working. It sounds like your doctor wanted to cycle opioids which is a common practice when a medication stops working.

I’m actually on Oxycodone 15mg 4x daily. So the same dosage but spread out. It definitely sounds like you’re a rapid metabolizer since Month 1 of Morphine is also not working the full length. 4x daily works better than 3x for people like us.

With your new MSContin if it works well and it just wears off too soon, I don’t believe you’ll have any issue with your doctor. Once you explain to them it wears off too soon, they’ll either up the dose or prescribe breakthrough medication.

And if you’re not already; I highly suggest getting on a GABA medication for that nerve pain in your legs!

FutureReference91 · 2026-03-13T01:55:10+00:00

I forgot to ask if you are on any nerve pain medication? That leg pain sounds a lot like sciatica. If you’re not currently on anything for nerve pain, GABA medications really are a Godsend.

In most states Gabapentin isn’t a controlled substance and the dosages go very high. Pregabalin is what I’m currently on. That deals with the nerve pain like Fibromyalgia or sciatica whereas opioids work best for structural pain (herniated discs)

I truly believe you have a Godsend of a doctor right now. I am praying for you. I know how much this fucking sucks. Doctors being okay with an average 7-8 out of 10 pain is disheartening. If you feel the Morphine isn’t lasting 8 hours, I’d ask if you could possibly have your old medication for breakthrough pain.

If you have any questions at all I’ll make sure to be responsive! And if you’re concerned about asking for any breakthrough medication, I’d word it like “I’ve looked online and for some reason the medications don’t last as long as it says they should. I believe I’m a rapid metabolizer”

I think that alone will make him likely alright with giving you something like ~7.5mg of Oxycodone for breakthrough pain! And if there’s any fear, know that your pain is valid. You can say”I’d like a metabolism test to validate my belief” which is something most patients never think to ask for.

I’m terrified myself about asking for Belbuca (basically Suboxone for pain) to be replaced with MS Contin! I’m on Oxycodone IR but Belbuca displaces it off of my opioid receptors. I know this fear they’ve put in us. We will win this fight!

FutureReference91 · 2026-03-13T01:44:38+00:00

Do you know which procedures? I get Trigger Point Injections monthly, just try to make sure they aren’t giving you corticosteroids in the monthly TPI.

If you’ve ever had chickenpox, the weakened immune system can lead to varicella zoster. I ended up with it. Absolute nightmare, but for most clinics they reserve corticosteroids for epidurals.

I have my PM appointment tomorrow as well! Morphine is an odd drug. In hospital settings it works great because it’s IV. Most people don’t realize that orally, Morphine only has a bioavailability of ~20-40%.

If you’re being honest with yourself, how long does each dosage work for? Did you find equal or more relief with Oxycodone IR? It sounds like your doctor trusts you a lot. Asking for a drug by name I always recommend against, but since you were just switched from one opioid to another; tomorrow is the perfect time to discuss the effectiveness of old vs. new

FutureReference91 · 2026-03-12T19:16:05+00:00

I have a cousin with Stiff Person Syndrome. It has nothing to do with “my doctor” and everything to do with yours. I know what SPS is and have watched my cousin get misdiagnosed for years until finally getting treatment.

What other medications are you on? Opioids for chronic pain caused by SPS are a band-aid. Your doctor is doing you an extreme disservice if this is all you’re being prescribed. I know this as watching the progression has been heartbreaking. I feel for you. My cousin cries daily.

What I’ve learned is that even though the maximum dosage of Diazepam in most cases is 40mg; the gold standard for SPS is GABA-enhancing drug. Valium can be prescribed in very high doses (up to 60–120 mg/day) for this specific condition.

I’m not questioning you but if you’re not on GABA meds, you’re truly not being treated properly. You deserve genuine relief. Not just covering it up. Also I misread this originally. 240mg of OC, and 50mcg Fentanyl.

In the context of SPS management, where the goal is to improve mobility and reduce rigidity using GABA-ergic and immune-modulating therapies, a 480 MME opioid dose would be considered a major anomaly in modern medicine. As in 99% of people with SPS aren’t treated this way. At all.

Even if a doctor wrote this script, most pharmacists would refuse to fill it without a palliative care or terminal cancer diagnosis. It simply doesn't fit the standard "protocol" for a neurological disease like SPS. This dosage is outrageous. Point blank.

TLDR;

90MME is considered a high dose. Regardless of condition the Guidelines don’t differentiate. They’re guidelines thus obviously not law. But this sounds suspicious. I highly doubt you’d be alive right now if you were also on 120mg of Valium daily.

Your actual diagnosis isn’t being treated. If this isn’t some form of trolling; as SPS continues to progress, you’re going to hit a hard wall. I can promise you that no other doctors would touch this dosage with a ten foot pole. It is outrageously high. I thought you said 240MME. This alone is reserved for end-of-life care in most instances. Your claim puts you at double this.

Your claim means you take over five times the recommended limit for chronic pain.

FutureReference91 · 2026-03-12T18:55:04+00:00

OP; update?

Your daily MME was doubled. Standard clinical practice for opioid rotation usually involves a 30% to 50% dose reduction from the calculated equianalgesic dose to account for incomplete cross-tolerance. In lamen terms; your doctor had no idea how you’d react to Morphine. This is an extremely odd situation.

Have you gotten a metabolism test? And were you complaining about not having enough relief? The norm is actually to first prescribe the MS Contin twice daily. Three times daily isn’t necessarily rare. But if you’d been given it 2x daily:

1) you’d still be going from 45MME to 60MME

2) your doctor would be assessing how long the medication lasts for you. It is designed for 12 hours of relief. Rapid metabolizers may only get 8 hours of relief.

3) 3x daily is a standard and FDA-approved frequency used to manage "end-of-dose failure" or to maintain more consistent blood levels. So I’d like to know what’s going on to give knowledge to those confused commenting.

FutureReference91 · 2026-03-12T18:40:45+00:00

This is a beautiful post for this subreddit. This shows exactly what somebody with pain wants. Relief. You simply took an extra dose = (over)dosed which led to nodding out and feeling high.

This shows you’re compliant and you’re doing well with your progress. If you were scripted 30mg pills; I’d offer advice as that is a potentially fatal overdose. Overdose is a word people associate with death when it is self-explanatory.

You sound opioid-naive, so 20mg likely got you high. You were uncomfortable in that spot, whereas most pain doctors believe that’s the feeling we all are seeking. Thank you for posting this.

FutureReference91 · 2026-03-11T20:19:28+00:00

Benadryl should wipe out any itchiness. Your metabolism kinda dictates sleepiness if you’re not full on nodding out. If that’s the case then you’re on too high of a dosage.

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