Not as much as I ought to be.
In particular, there is one specific medication, that after YEARS, literally, years, of trying, including putting together culled research article fulltexts, and collating them, highlighting the most useful information, and talking my GP, the senior GP who runs the clinic I go to for my medical needs, he eventually agreed to support my being on it.
It's called memantine. An NMDA antagonist, (this mode of action is shared by PCP, ketamine, and other dissociative anaesthetics, such as the noble gas xenon, nitrous oxide, and others, although memantine is very, very different from these, in that it's a low-trapping, relatively low affinity antagonist with rapid dissociation kinetics, and a very long duration of action, and is also partially voltage-gated in it's binding kinetics, meaning unlike the dissociative drugs, memantine selectively binds to only NMDA receptors in the depolarized state, after the channel opens, thereby inhibiting only excessive NMDA receptor activity without compromizing normal function. It CAN be dissociative, but only in very large doses, massive compared to typical doses.)
Originally developed for alzheimer's disease treatment, it has quite a few other very laudable traits, although these are woefully littleknown and underexploited.
For example in patients with chronic pain who need to take powerful, and addictive painkillers of the opiate type, memantine does the following:
It more or less abates psychological compulsive need tendencies, or even caring about them, to the point where I had to literally remember to go and take them, felt no desire caused by the pain meds to use them at all.
It STAMPS on tolerance acquisition, slowing it drastictally.
It also greatly diminishes any tolerance one already may have.
It works wonders on physical withdrawals, vastly minimizing their impact and unpleasantness, the awful overloading, akathisia and other nasty symptoms of physical withdrawal if one does drop their dose, miss a dose or decide to go cold turkey and fuck them off even, or is prevented from taking their dose (saved me once, after being held a day, overnight and into the next day after being wrongfully arrested by the filth. Due to it's loooooong action, I didn't withdraw at all, despite being denied my pain meds, as the day before I'd taken a large dose of memantine, a couple of hundred mg orally, although from personal experience, such dose ranges are what I've found through trial and error, well, just trial really, to suit me best. Kept the dogs at bay 100%, without it, I'd have been in a living hell on earth after that long off the doses of pain meds I am on.
Also, it can help boost memory and cognitive performance, diminish excitotoxicity, and promote neuronal survival through several mechanisms.
And in me, personally, the memory problems, cognitive 'brain fog' I struggle with so often, and sometimes debilitatingly, the executive dysfunction, all the psychological-neurological problems of that kind just fucking evaporate into the aether as if they never were. As a bonus, I overload less by far, fear responses are dampened, but not to a level where acute danger signals would be overridden, it helps with physical pain, and unlike opioids, it helps a lot of people with pain of a neuropathic sort which just doesn't respond much if at all, for some, to opiates until the sufferer of nerve injuries is given a dose of opiate sufficient to render them unconscious completely. Brings my motivation up. I'm not someone I'd say is depressed, but there's a powerful antidepressive quality to it, and mood-elevating effects without being akin to something like speed. A gentle uplifting stimulation with no peripheral cardiovascular adrenergic type effects, no jitteriness, it's literally a lifesaver, wonder-drug with a million and one benefits when I can get hold of any.
It's the difference between life and death, day and night, white and black, pleasure and pain, it is THAT much of a boon to me. So many things it helps with, with a lot of side effects, and each and every single one of those side effects a GOOD one. Or a fucking brilliant one.
It can even be used to potentiate opioids, both allowing a lesser dosage of opioid to be used, and if mixed in as a dual-component solution into an injectable opioid, the rush is made phenomenally long-lasting and enough to knock a horse over.
I've had a dose of a couple of hundred milligrams of memantine for example, turn a 300mg intravenous dose of 6-monoacetoxydihydromorphine, a potent opioid that can be prepared by a simultaneous demethylation-esterification induced by heating dihydrocodeine freebase, with 2ml of a 33% solution of anhydrous hydrogen bromide as a solution in glacial acetic acid per gram of DHC base, in 2ml of regular GAA as solvent to 90-100 'C for two hours, then workup by simply adding methanol, and rotavapping off the methyl ester of the acetic acid/traces of gaseous (and highly toxic, carcinogenic) methyl bromide formed, adding a little more methanol at a time until it tests no longer acidic to wide-range PH indicator paper, and stripping off that last little bit of methanol.
Then all thats needed are solvent washes, of the formed dihydromorphine-6-acetate, yield nearly quantitative, although a small proportion of the 3,6-diester, dihydroheroin is formed. Although it isn't at all an undesirable or unwelcome byproduct considering one is intending to synthesize an extremely similar, potent opioid to begin with. But more or less selective for 6-O-demethylation. The traces of HBr present after, catalyzing a subsequent fischer esterification, to form the ester from the glacial acetic acid solvent, giving the acetate and some HBr salt of the opioid as the result.
Quick, easy and a very pleasant, potent product from crappy dihydrocodeine.
Mixed 300mg of that, without removal of dihydroheroin, in whatever proportion it was formed, 200mg memantine or so, into the same syringe, and shot as one would, IV, and fuck ME..the IV rush that accompanies IV of many potent opiates, it wasn't just amplified to a huge degree, it was prolonged massively. Not the usual minutes, but over 3/4 of an HOUR!, and so damn hard, was I rushing, before the main effects even began, that I could barely even stand up, but was lurching from support to support, stair rails, tables, sofas, just to keep from my knees buckling from the intensity of the sheer chest-pounding euphoria.
And to put the dose into perspective, tolerance-wise, at the time, I could easily withstand and enjoy a 1.5g dose of intravenous morphine, or even an entire gram of dipropionylmorphine (the dipropionate ester, the propionyl analog of heroin, it lasts longer, up to 15 or even 17 hours, compared to 6 hours for morphine sulfate or heroin, it hits harder, more euphoric, better rush, more potent than H by weight, at least as potent again to H as H is to morphine [H is about 2.5-3x the potency of morphine, when both are given IV], its just all round a superior compound compared to diamorphine. And I've had both of them uncut, prepared from pharmaceutical grade morphine, DEFINITELY uncut, not dealer-schpiel to sell product, but verified by attending upon the process personally from beginning to end. From extraction of pure, pharm grade morphine from morphine XR capsules, purification, esterification, purification again and workup. So I can safely say I KNOW there was no cut, in what I am making the comparisons based against), at the time, I could IV a fucking GRAM dose of dipropionylmorphine and just smile, light a cigar and lay back with a beer, without fear of overdose, or even nausea.
Even taking the greater potency of dihydromorphine compared to morphine, and the esters likewise, into account, there's no way 300mg of 6-monoacetoxydihydromorphine could have done THAT to me, then, without the memantine,
But despite all these multitude of boons granted me by memantine, my GP supporting it, apparently he has to get specialist approval from a specialist of some kind, before I actually see it on my prescription. I've been waiting over a year AFTER he said 'yes'. And it's pissing me off big time. Always promises of jam tomorrow. Well tomorrow never comes. The only memantine I get, I have to buy myself, or else I had a gift of a couple of grams of pure memantine powder (doses start from 5-10mg in alzheimers patients although for my uses I find 100-200mg ideal per dose, either once or twice daily)
Medical system, even with our NHS could be a LOT better. It isn't super-expensive, it's just an off-label use. Because it's only approved for moderately severe alzheimers disease. Which of course I do not have.
But shit, it's not a drug of abuse, and I was able to be put on chlormethiazole for my seizures at just my request, on the grounds of it's being the GABAa agonist type anticonvulsant drug which I prefer above all others, same goes for sedative-hypnotics, I just personally like it better than any other. And it works for me, works fast and works well, and I HAVEN'T, astonishingly, developed a physical dependency to it; it just seems to work well with the way I'm personally wired up.
And chlormethiazole can certainly be abused or used recreationally, it's a downer of the old-fashioned nigh extinct these days wallbanger style. Dangerous or deadly in overdose, but most effective and with a kick no benzo will ever be able to aspire to. If all that it took to get me on that, despite it's not being licensed here for anticonvulsant usage, only for temporary severe anxiety or short term insomnia treatment, as well as in in-patient alcohol detox; is personal preference, then surely my GP can make the decision on his own back, and his clinical choice is his to make?
It's becoming SO frustrating, knowing that a fix for so many issues with a single medicine, that literally works miracles exists, is not expensive, is available in this country on the NHS, that the senior GP who owns the clinic agree'd with me that yes, I should be allowed to start on it, that it is there, but always jam tomorrow but none today.
That I've seriously considered synthesizing it, from the ground up, constructing the methylated adamantane core of it (it's a relative of amantadine, an antiviral drug actually), saving the money up for a R&D effort, and enough reagents once the synthesis is perfected, workup and cleaning perfected and optimized etc. that I could then knock out a kilo batch, maybe even 5kg and have it last me many many years.
So comfortable? could be worse, I could be stuck in a dark ages shithole for healthcare like the US (seeing as I'm not frothing with money coming out of my ass and ears and nose all at once), or could be in some arab-infested jihadi hellpit like syria. But the docs look down on chronic pain patients just because they need opiate painkillers to be able to physically remain able. Without them, I'd not even be able to lie down, I'd be in so much constant horrendous pain with my hips, walking would be a nightmare and I'd be pretty badly disabled, worse than I am as things are, in terms of mobility. Even WITH the painkillers I'm in I should be walking with a cane. I just haven't GOT a cane anymore, after I had to whack someone over the head with mine, and it broke the cane after I'd given the recipient a good noggin floggin'. So I need to get the time and remember to build myself a nice new one, out of the right wood, ebony, I think, is what I'd like, Perhaps with mahogany patterning, inlaid with silver inscriptions and decorative work that I'll have to craft myself using the technique of lost-wax casting for the lettering and scrollwork, take the time to cut precise depth and width incisions into the cane to set the silver lettering and decorative inlays, as well as cast the metal parts of the part wood, part metal handle. Along with a concealed locking mechanism that can be unlocked with something like pressure applied to a small hidden switch in something like a decorative head of a mythological beast of greek legend (I've always had a fondness for ancient greek legend and mythology), to allow a reinforced carbon fiber blade with a toughened glass or fused quartz blade edge, something that won't show up on X-rays in the handle, and to get myself (albeit not cheaply) a piece of iridium metal to machine (with difficulty I should imagine, too, given the extreme resilience and hardness of iridium) for an end-cap for the bottom that won't wear down. (Ir is both extremely heavy, if ever I need whack a pikey over the bonce with it, very dense, either just under, or just over the density of osmium, by a fraction of a percent, it's also both VERY chemical-resistant, attacked only by halogens at high temperatures, fluorine gas at least, not sure if the other halogens would attack it, as well as molten, fused caustic alkali metal hydroxides at several hundred degrees 'C, and molten sodium/potassium cyanide. But it's just as physically hard and tough as it is chemically resistant. Used in an alloy with osmium, another platinum-group metal for giving a thin surface plating to the nibs of high-end fountain pen nibs to prevent them suffering wear, due to the extreme hardness of the metal)
I've got just the design in mind, I just need to save for the materials, and then apply the time and effort to sufficiently fine craftmanship. I've already got a set of gem-setting pliers, for jewellery manufacture, as the animal head, a cobra with spread hood, or perhaps one of the large vipers, or the viper-like elapid snake of australia known as the death-adder, although a hooded cobra would look great, could inlay the oo lemiscate-shape on the back of the hood of a snake like a Rinkhals spitting cobra in niobium, anodize it to give it a lovely play of colours, whilst the rest of the head would be cast in silver, with just a trace of other alloying elements to harden it, would like to inset a pair of different coloured gemstones into the eyes too, say a sapphire in one eye, and an emerald for the other, or a ruby and an emerald pair.
Anyhow though, even as it is, just BEING on these meds, for pain, which comes from undeniable injuries sustained in childhood (hard to fake falling on a large spike of glass, and having to drag yourself home for several miles with it having penetrated through the patellar tendon into the joint, blood everywhere, in hospital) and getting my knee stamped on as I was recovering. Knee surgeries, lots of steroid shots into my knee joint, as well as into both hips. As well as knee surgery, nerve damage as a result....but just needing pain meds, even the docs who first prescribed them look at you as if you are a pariah.
