LIST OF MEDS RECOMMENDED AND OK TO ***FLUSH***

Source is FDA.GOV so this is the official word on this subject! 
As you will see, narcotics of all kinds are on this list along with one benodiazepine:
DIAZEPAM OR VALIUM

WHY FLUSH?
In past the concern was all about the water. Now, with the opioid crisis, it was determined that it doesn't affect the water supply enough to make a difference compared to the lives SAVED by flushing all pain medications. You see, once you cross over from tolerance to dependence to addiction, you are willing to do anything to get your next fix. This includes dumpster diving and trash hunting. Nurses used to crush it and mix with kitty litter and detergent. But even this measure is not good enough. The addiction is stronger than any offense from detergent or garbage! To do this properly it is recommended to crush the tablets then flush them twice. Whether they are capsules or tablets, put them in a bag, put your boots on, and STOMP them to powder then flush them twice. If it is just a couple and you have a pill crusher or hammer then you can use that. **If it is a fentenyl patch then *PUT GLOVES ON*, TAKE THE PATCH APART AND CUT IN TINY PIECES THEN FLUSH MULTIPLE TIMES. A fentenyl patch is made to be absorbed through the skin over a period of time such as 24 hrs or more. If a child, pet or maybe even an adult were to ingest part of this patch by mouth then it would definitely be deadly! Here is the official list from fda.gov., A-Z

"Medicines Recommended for Disposal by Flushing Listed by Medicine and Active Ingredient  There is a small number of medicines that may be especially harmful and, in some cases, fatal with just one dose if they are used by someone other than the person for whom the medicine was prescribed. This list from FDA tells you what expired, unwanted, or unused medicines you should flush down the sink or toilet to help prevent danger to people and pets in the home. 
 [the one with]* These medicines have generic versions available or are only available in generic formulations.
FDA continually evaluates medicines for safety risks and will update the list as needed. Please visit the Disposal of Unused Medicines: What You Should Know page at www.fda.gov for more information.
Medicine Active Ingredient
Abstral (PDF - 1M), tablets (sublingual) Fentanyl
Actiq (PDF - 251KB), oral transmucosal lozenge * Fentanyl Citrate
Avinza (PDF - 51KB), capsules (extended release) Morphine Sulfate
Belbuca (PDF – 44KB), soluble film (buccal) Buprenorphine Hydrochloride
Buprenorphine Hydrochloride, tablets (sublingual) * Buprenorphine Hydrochloride
Buprenorphine Hydrochloride; Naloxone Hydrochloride, tablets (sublingual) *
Buprenorphine Hydrochloride; Naloxone Hydrochloride
Butrans (PDF - 388KB), transdermal patch system Buprenorphine
Daytrana (PDF - 281KB), transdermal patch system Methylphenidate
Demerol, tablets * Meperidine Hydrochloride
Demerol, oral solution * Meperidine Hydrochloride
Diastat/Diastat AcuDial, rectal gel [for disposal instructions: click on link, then go to "Label information" and view current label]
Diazepam
Dilaudid, tablets * Hydromorphone Hydrochloride
Dilaudid, oral liquid * Hydromorphone Hydrochloride
Dolophine Hydrochloride (PDF - 48KB), tablets * Methadone Hydrochloride
Duragesic (PDF - 179KB), patch (extended release) * Fentanyl
Embeda (PDF - 39KB), capsules (extended release) Morphine Sulfate; Naltrexone Hydrochloride
Exalgo (PDF - 83KB), tablets (extended release) Hydromorphone Hydrochloride
Fentora (PDF - 338KB), tablets (buccal) Fentanyl Citrate
Hysingla ER (PDF - 78KB), tablets (extended release) Hydrocodone Bitartrate
Kadian (PDF - 135KB), capsules (extended release) Morphine Sulfate
Methadone Hydrochloride, oral solution * Methadone Hydrochloride
Methadose, tablets * Methadone Hydrochloride
Morphabond (PDF – 162 KB), tablets (extended release) Morphine Sulfate
Morphine Sulfate, tablets (immediate release) * Morphine Sulfate
Morphine Sulfate (PDF - 282KB), oral solution * Morphine Sulfate
MS Contin (PDF - 433KB), tablets (extended release) * Morphine Sulfate
Nucynta ER (PDF - 38KB), tablets (extended release) Tapentadol
Onsolis (PDF - 297KB), soluble film (buccal) Fentanyl Citrate
Opana, tablets (immediate release) Oxymorphone Hydrochloride
Opana ER (PDF - 56KB), tablets (extended release) Oxymorphone Hydrochloride
Oxecta, tablets (immediate release) Oxycodone Hydrochloride
Oxycodone Hydrochloride, capsules Oxycodone Hydrochloride
Oxycodone Hydrochloride (PDF - 100KB), oral solution Oxycodone Hydrochloride
Oxycontin (PDF - 417KB), tablets (extended release) Oxycodone Hydrochloride
Percocet, tablets * Acetaminophen; Oxycodone Hydrochloride
Percodan, tablets * Aspirin; Oxycodone Hydrochloride
Suboxone (PDF - 83KB), film (sublingual) Buprenorphine Hydrochloride; Naloxone Hydrochloride
Targiniq ER (PDF - 48KB), tablets (extended release) Oxycodone Hydrochloride; Naloxone Hydrochloride
Xartemis XR (PDF - 113KB), tablets Oxycodone Hydrochloride; Acetaminophen
Xtampza ER (PDF – 67.6KB), capsules (extended release) Oxyccodone
Xyrem (PDF - 185KB), oral solution Sodium Oxybate
Zohydro ER (PDF - 90KB) capsules (extended release) Hydrocodone Bitartrate
Zubsolv (PDF - 354KB), tablets (sublingual) Buprenorphine Hydrochloride; Naloxone Hydrochloride"

Talk LOUD; Don't Die

                                      Takoda the Rescue Dog Says:  Talk LOUD; Don't Die

Let's talk about
Opiate
Use and
Drug abuse

Takoda the Rescue Dog got a second chance at LIFE......YOU Might NOT......Your KIDS MIGHT NOT.......talk LOUD !!!
     with your kids, your parents and your friends!

Recovery: The Intake Appointment Part 2

So you already gave you address, phone numbers, emergency contact, paid your fees and have been told countless of instructions and rules. Don't worry about remembering all that. You can always ask and most likely you will be reminded by both staff and other patients. The mindset of patients in recovery seems to vary according to what state or part of the USA you live. I have been told countless of times by "visiting" patients from other states how this is true. So this is straight from the patients themselves. (By the way, in NH, we are very friendly and helpful to all.)
So the Addiction Counselor is the next professional you will see after the business part. This is a long detailed meeting but it is very important! Please do NOT use right before this Intake appointment and do NOT use in the bathroom in between seeing professionals! You nod off, and you have to reschedule! You are cranked up and can't sit still, you have to reschedule! and that postpones your first medication appointment with the doctor so it is pointless. Now, we don't want you vomiting either so plan accordingly....you know what I mean. The appointment is at least 2 maybe 2 1/2 hours. When you see the Addiction Counselor you will be asked everything from the first day you ever used in your life until present day. Questions about every drug you tested including cigarettes and alcohol. Please be honest but don't embellish. No one will be impressed. They will ask about your childhood, your family, employment, legal stuff etc...all this plays a significant role in your recovery. If Uncle Brian beat you every Christmas morning, we aren't going to ask you how your Christmas was. If your friend overdosed in March, we will be on the alert for depressive behavior and possible alcohol/drug use near springtime. All the questions are for a reason. We don't like paperwork that much. A big thank you for being patient with all the questions! The last professional you will see is the nurse in The Intake appointment part 3.
.

Recovery Program: The "Intake" Appointment part 1

You made the phone call and have your first appointment. It is commonly called the "Intake" appointment. This appointment is the most important! From my experiences, this appointment is where all info on you is gathered by MULTIPLE healthcare/addiction professionals. These professionals have heard every story so don't leave out any details and please BE HONEST & precise. After all, this is YOUR life! First piece of business is getting your address and a reachable phone number such as your cell number. If you give a second phone number, please specify if it is OK to leave a message. Don't worry, no one will call you mindlessly or call to check on you. It is needed in case your counselor has the flu and has to cancel counseling, in case of fire and the place of business is in a temporary location etc....in other words, for something very important. You will also be asked for at least one emergency contact name and phone number. This is in case you have a medical emergency or injury, so someone close to you can be told. Otherwise, an emergency contact is NEVER called. Confidentiality is taken seriously. The other piece of business is the payment. Programs can't run on love and good intentions. There should be an "intake" fee or it could be called an administrative fee for the admission process. You will also be asked for the first week's payment up front. Yes, that is a big blow to someone who spends all their money, and other people's money on drugs. But it is necessary for two reasons: 1) It is common for addicts to act on impulse by being admitted to a program then not showing up or paying. It is a lot of work to admit someone into a program. It is considered a waste of time and money when this happens. Someone else who is ready for recovery could have come to that appointment. and 2) If you pay a week in advance with your money or borrowed money, you will be sure to show up that first week to get your money's worth, right? Commitment it what it is. That commitment of one week in treatment opens the door to maybe another week, maybe even another month and bingo! You are on your way to a BETTER life and loving it!

Myth: Methadone rots your teeth

FALSE. Teeth do not rot within months of starting a methadone program. It takes time, lots of time to have more than one tooth rot enough to be pulled. It is the amount of time you spent using that is the culprit. Years of not eating properly (and not taking vitamins), years of not brushing, years of not seeing a dentist for preventative cleanings will lead to tooth decay. A poor diet for an extended period of time will leave your body deficient in nutrients. Then your body start taking nutrients where it can, at the least vital place...your teeth. Once you are in recovery, you start noticing what you couldn't see or feel while you were using all those years. Your gums are sore, they might bleed easy, you have uncontrolled bad breath. You start taking care of your health and think you escaped any health issues. Then one day you bite into something and start chewing and....snafoo! A broken tooth. It is easy to blame methadone and since there is some amount of sugar in the liquid form. It might sound like a very logical blame to you. But know it takes years to do that kind of damage. Nothing you can do about it now except take care of what is, and do what you can to prevent any further damage. At the first sign (or before) of trouble with teeth or gums, make an appointment with a dentist. Don't wait until you are in pain, have an infection or break a tooth since there will be a period of waiting until an appointment is available. Worst case scenario:  having a legitimate infection with pain and going to the Emergency Room as an addict asking for an antibiotic and pain med. If they don't want to give you pain med, you suffer. If they give you pain med, you should give the med to a family member who can dispense the correct amount of tablets to you during the prescribed time frame. Until you are further along in recovery it is way too tempting to abuse the prescription. You don't want to make your situation worse, make yourself feel worse or lose any ground you gained while in recovery. If you made progress in recovery, be proud and ask someone to help you with your prescribed med!

The First Step: The Phone Call

So you don't want to tell your family or friends you have a problem with misusing substances or medication...OK. It's your life, but if you want to take that next step towards a BETTER life, then you need to talk to professionals who can help you with tackling this disease and head towards recovery. So it is a matter of making that first phone call. NOT always a  simple task!  You might feel a rush of all kinds of feelings that are very uncomfortable. Feelings you have numbed and shoved back inside of you all this time. One way to help minimize this experience is to have someone with you when you make that first call. It can be someone from a recovery group or local community service. Heck it can be a firefighter or a social worker or nurse in the local Emergency Room. All public service professionals will be willing to sit with you for a few minutes as support while you make your first phone call for help with your disease. If you have someone in your personal life with you at the time of the phone call, make sure they are stable, sober, not impaired and have your best interest at heart. FYI:  The first phone call will 1) give you basic info on the service,  2) info on insurances accepted or cash payment and either 3). make your first appointment for an Intake or put your name on a wait list. ***This phone call, entire conversation and any info given is completely confidential.  NO ONE can call and see if you called, NO ONE can check to see if you have appt or are on the wait list. NO ONE, period. Not even your mom! This is the law! A violation of this law can get a person jail time. So congratulations if you made your first phone call :)  I will talk about the first Intake appointment in another section with the word Intake in the title.

Do I have to tell anyone?

Have you ever tried to explain the mechanics of what is wrong with a car and how to fix it to someone who doesn't have a clue?  That is what you will get trying to talk addiction to friends and family who are not educated on the subject. It is a foreign language and a foreign land. Not their fault and not their problem. It's your problem and your recovery. Some family are open to the subject and if they are ....well, you are very lucky!  Not everyone is open to the subject when it comes to family. Could be pride, or maybe they are addicts/alcoholics themselves! Who wants to look in the mirror? If you don't have the support of family and/or friends then there are plenty of support groups and others in recovery you can turn to. If it's one thing I know to be true:  addicts will always accept other addicts and be there for that 2 am phone call when you really want to use. You don't have to be BFF, but some type of support is needed in recovery. Someone who understands exactly what you are going through and can listen without judging. With the opioid crisis going on there are many new hotlines, support groups, treatment centers and professionals in this field. If one doesn't suit you, there are plenty more to try.

"I'm getting clean...now what....I still have problems!"

Problems, problems, problems! You had a problem and turned to drugs/alcohol to fix it, then got addicted. You had a problem and did drugs to distract you or numb you, then got addicted. You did drugs/alcohol, you got addicted, and it caused problems in your life. Addiction ruins every aspect of your life: personal, family, social, employment, legal. It is a vicious cycle: problem....drugs, drugs....problems...back to drugs etc...Your mind makes up excuses and reasons to continue using drugs. In the old day it was called, "Stinkin Thinkin". Your mind wants to win, and your mind is strong! That's where Addiction Counseling comes in with Addiction Focused Problem Solving to break the cycle. It is a specialized approach to .....everyday shit.  You need Addiction Counselor to show you how it works. With focus and 100% effort it can be done!

HOPE

Like the Phoenix, the addict can rise from the ashes of  the old self into the new self!

Recovery CAN be successful!

YES it can work!
But I have often heard these statements:
"i can't"
"I've been doing this for x years, I can't stop...recovery won't work for someone like me...it's my life".
Yes you can!
But don't expect it to happen in 1 day or 5 days. Patience is NOT a virtue of any type of addict!

**So you must PUT IT INTO PERSPECTIVE:
It took ____yrs to become addicted to opiates. It didn't happen overnight. So it will take a little time for recovery. Like something that has been out in the rain for years and has lots of rust....it takes more time to get all that rust off. But if you don't START cleaning it, it will never get clean! So, think about it, and decide what it is you want to do. Everything is a choice that YOU make. Start cleaning or let it rust some more