#meaning the drug is less effective

[mstopportunity]

I get where you're coming from (although I need you to know that both chemical and habitual addictions literally *are* diseases of the brain, same way that depression and PTSD are). My issue is that the theories described are not talking about the onset of addiction so much as they are the state of the addict. And while there may not really be much of a difference for the right-wing theory, the left wing theory doesn't posit that addiction pops up out of nowhere. Which is what this article seems to imply.

I guess that's my issue. The article says it debunks the left-wing model for addiction, because of their research into the onset of addiction. While the model they describe isn't concerned with the onset of addiction at all, but rather the state of the addict and what kind of support they need. It's both-sides'ing a model that is objectively wrong and a model that is mostly correct but not what they were looking at.

And I can go into more detail about how addiction really is a brain disease if you like.

“Get a rat and put it in a cage and give it two water bottles. One is just water, and one is water laced with either heroin or cocaine. If you do that, the rat will almost always prefer the drugged water and almost always kill itself very quickly, right, within a couple of weeks. So there you go. It’s our theory of addiction. Bruce comes along in the ’70s and said, “Well, hang on a minute. We’re putting the rat in an empty cage. It’s got nothing to do. Let’s try this a little bit differently.” So Bruce built Rat Park, and Rat Park is like heaven for rats. Everything your rat about town could want, it’s got in Rat Park. It’s got lovely food. It’s got sex. It’s got loads of other rats to be friends with. It’s got loads of colored balls. Everything your rat could want. And they’ve got both the water bottles. They’ve got the drugged water and the normal water. But here’s the fascinating thing. In Rat Park, they don’t like the drugged water. They hardly use any of it. None of them ever overdose. None of them ever use in a way that looks like compulsion or addiction. There’s a really interesting human example I’ll tell you about in a minute, but what Bruce says is that shows that both the right-wing and left-wing theories of addiction are wrong. So the right-wing theory is it’s a moral failing, you’re a hedonist, you party too hard. The left-wing theory is it takes you over, your brain is hijacked. Bruce says it’s not your morality, it’s not your brain; it’s your cage. Addiction is largely an adaptation to your environment. […] We’ve created a society where significant numbers of our fellow citizens cannot bear to be present in their lives without being drugged, right? We’ve created a hyperconsumerist, hyperindividualist, isolated world that is, for a lot of people, much more like that first cage than it is like the bonded, connected cages that we need. The opposite of addiction is not sobriety. The opposite of addiction is connection. And our whole society, the engine of our society, is geared towards making us connect with things. If you are not a good consumer capitalist citizen, if you’re spending your time bonding with the people around you and not buying stuff—in fact, we are trained from a very young age to focus our hopes and our dreams and our ambitions on things we can buy and consume. And drug addiction is really a subset of that.”

—

Johann Hari,

Does Capitalism Drive Drug Addiction?

(via bigfatsun)

[floral-hex]

I’m about a week and a half into starting Remeron and my main side effect so far is I’m just so dang sleepy all of the time.

[betty-burnout]

ozempic and other glp-1s really feel like medically sanctioned anorexia

[thoughtportal]

Opinion Here’s how to get free Paxlovid as many times as you need it

When the public health emergency around covid-19 ended, vaccines and treatments became commercial products, meaning companies could charge for them as they do other pharmaceuticals. Paxlovid, the highly effective antiviral pill that can prevent covid from becoming severe, now has a list price of nearly $1,400 for a five-day treatment course.

Thanks to an innovative agreement between the Biden administration and the drug’s manufacturer, Pfizer, Americans can still access the medication free or at very low cost through a program called Paxcess. The problem is that too few people — including pharmacists — are aware of it.

I learned of Paxcess only after readers wrote that pharmacies were charging them hundreds of dollars — or even the full list price — to fill their Paxlovid prescription. This shouldn’t be happening. A representative from Pfizer, which runs the program, explained to me that patients on Medicare and Medicaid or who are uninsured should get free Paxlovid. They need to sign up by going to paxlovid.iassist.com or by calling 877-219-7225. “We wanted to make enrollment as easy and as quick as possible,” the representative said.

Indeed, the process is straightforward. I clicked through the web form myself, and there are only three sets of information required. Patients first enter their name, date of birth and address. They then input their prescriber’s name and address and select their insurance type.

All this should take less than five minutes and can be done at home or at the pharmacy. A physician or pharmacist can fill it out on behalf of the patient, too. Importantly, this form does not ask for medical history, proof of a positive coronavirus test, income verification, citizenship status or other potentially sensitive and time-consuming information.

But there is one key requirement people need to be aware of: Patients must have a prescription for Paxlovid to start the enrollment process. It is not possible to pre-enroll. (Though, in a sense, people on Medicare or Medicaid are already pre-enrolled.)

Once the questionnaire is complete, the website generates a voucher within seconds. People can print it or email it themselves, and then they can exchange it for a free course of Paxlovid at most pharmacies.

Pfizer’s representative tells me that more than 57,000 pharmacies are contracted to participate in this program, including major chain drugstores such as CVS and Walgreens and large retail chains such as Walmart, Kroger and Costco. For those unable to go in person, a mail-order option is available, too.

The program works a little differently for patients with commercial insurance. Some insurance plans already cover Paxlovid without a co-pay. Anyone who is told there will be a charge should sign up for Paxcess, which would further bring down their co-pay and might even cover the entire cost.

Several readers have attested that Paxcess’s process was fast and seamless. I was also glad to learn that there is basically no limit to the number of times someone could use it. A person who contracts the coronavirus three times in a year could access Paxlovid free or at low cost each time.

Unfortunately, readers informed me of one major glitch: Though the Paxcess voucher is honored when presented, some pharmacies are not offering the program proactively. As a result, many patients are still being charged high co-pays even if they could have gotten the medication at no cost.

This is incredibly frustrating. However, after interviewing multiple people involved in the process, including representatives of major pharmacy chains and Biden administration officials, I believe everyone is sincere in trying to make things right. As we saw in the early days of the coronavirus vaccine rollout, it’s hard to get a new program off the ground. Policies that look good on paper run into multiple barriers during implementation.

Those involved are actively identifying and addressing these problems. For instance, a Walgreens representative explained to me that in addition to educating pharmacists and pharmacy techs about the program, the company learned it also had to make system changes to account for a different workflow. Normally, when pharmacists process a prescription, they inform patients of the co-pay and dispense the medication. But with Paxlovid, the system needs to stop them if there is a co-pay, so they can prompt patients to sign up for Paxcess.

Here is where patients and consumers must take a proactive role. That might not feel fair; after all, if someone is ill, people expect that the system will work to help them. But that’s not our reality. While pharmacies work to fix their system glitches, patients need to be their own best advocates. That means signing up for Paxcess as soon as they receive a Paxlovid prescription and helping spread the word so that others can get the antiviral at little or no cost, too.

{source}

[kanvasal]

this would do absolutely nothing to discourage me from taking fentanyl (there are various other reasons why I will never)

The real solution are ads like those incredibly dark and disturbing anti-smoking ads. I don't think that I actually saw that many, but god damn do they stick

[ahopefulbromantic]

Hello Mouthwashing enjoyers, a doctor here

So i finally played the game yesterday and noticed a detail that isn't talked about enough:

10 mg oxycodone for someone in Curly's condition wouldn't do jack as a painkiller. From what i understood, he also takes it only once a day orally. When he's easily at the very top of the analgesic ladder (meaning due to his state he would need the strongest narcotics in the highest doses, preferably intravenously). Especially that 1) idk about the state of his digestive tract but i can venture to say the absorption would be very poor (meaning a big portion of the drug would just pass through his guts without actually going into the body), and 2) he's been taking it for months and oxycodone as an opioid builds tolerance (meaning his organism "gets used to" the drug and gradually needs more for the same effect). He probably feels that himself, that's why he's reluctant to take it throughout the game.

But don't worry, it gets worse!

Because later on, when we find out we're out of meds and find a hidden stash, it turns out to be...

500 mg paracetamol. As in, half a dose you yourself would take for a headache on a good day. It's placebo at best. What's even the point.

So yeah, if any of you playing thought something along the lines of "it's horrible i hate it i hate giving meds to Curly but at least the painkillers make him feel better" No. They don't. They never did. He may moan less but he's not in any less pain. I'm sorry.

[reasonsforhope]

"The Biden administration on Thursday [August 15, 2024] released prices for the first 10 prescription drugs that were subject to landmark negotiations between drugmakers and Medicare, a milestone in a controversial process that aims to make costly medications more affordable for older Americans. 

The government estimates that the new negotiated prices for the medications will lead to around $6 billion in net savings for the Medicare program in 2026 alone when they officially go into effect, or 22% net savings overall. That is based on the estimated savings the prices would have produced if they were in effect in 2023, senior administration officials told reporters Wednesday.

The Biden administration also expects the new prices to save Medicare enrollees $1.5 billion in out-of-pocket costs in 2026 alone.

“For so many people, being able to afford these drugs will mean the difference between debilitating illness and living full lives,” Chiquita Brooks-LaSure, administrator for the Centers for Medicare & Medicaid Services, told reporters. “These negotiated prices. They’re not just about costs. They are about helping to make sure that your father, your grandfather or you can live longer, healthier.”

It comes one day before the second anniversary of President Joe Biden’s signature Inflation Reduction Act, which gave Medicare the power to directly hash out drug prices with manufacturers for the first time in the federal program’s nearly 60-year history.

Here are the negotiated prices for a 30-day supply of the 10 drugs, along with their list prices based on 2023 prescription fills, according to a Biden administration fact sheet Thursday.

What Medicare and beneficiaries pay for a drug is often much less than the list price, which is what a wholesaler, distributor or other direct purchaser paid a manufacturer for a medication before any discounts...

The administration unveiled the first set of medications selected for the price talks in August 2023, kicking off a nearly yearlong negotiation period that ended at the beginning of the month.

The final prices give drugmakers, which fiercely oppose the policy, a glimpse of how much revenue they could expect to lose over the next few years. It also sets a precedent for the additional rounds of Medicare drug price negotiations, which will kick off in 2025 and beyond. 

First 10 drugs subject to Medicare price negotiations

Eliquis, made by Bristol Myers Squibb, is used to prevent blood clotting to reduce the risk of stroke. 

Jardiance, made by Boehringer Ingelheim and Eli Lilly, is used to lower blood sugar for people with Type 2 diabetes. 

Xarelto, made by Johnson & Johnson, is used to prevent blood clotting, to reduce the risk of stroke.

Januvia, made by Merck, is used to lower blood sugar for people with Type 2 diabetes.

Farxiga, made by AstraZeneca, is used to treat Type 2 diabetes, heart failure and chronic kidney disease. 

Entresto, made by Novartis, is used to treat certain types of heart failure.

Enbrel, made by Amgen, is used to treat autoimmune diseases such as rheumatoid arthritis. 

Imbruvica, made by AbbVie and J&J, is used to treat different types of blood cancers. 

Stelara, made by Janssen, is used to treat autoimmune diseases such as Crohn’s disease.

Fiasp and NovoLog, insulins made by Novo Nordisk.

In a statement Thursday, Biden called the new negotiated prices a “historic milestone” made possible because of the Inflation Reduction Act. He specifically touted Vice President Kamala Harris’ tiebreaking vote for the law in the Senate in 2022.

Harris, the Democratic presidential nominee, said in a statement that she was proud to cast that deciding vote, adding there is more work to be done to lower health-care costs for Americans.

“Today’s announcement will be lifechanging for so many of our loved ones across the nation, and we are not stopping here,” Harris said in a statement Thursday, noting that additional prescription drugs will be selected for future rounds of negotiations."

-via CNBC, August 15, 2024

[yzashaven]

2023 KINKTOBER︰10﹒01 / 10﹒02

꒰ —♡ B R E E D I N G ﹒ PART 2 ꒱

EVENT MASTERLIST !

FEATURING ! childe, tighnari, gorou, wriothesley x fem!reader

WARNINGS ! ofc breeding!!, "accidental" use of aphrodisiac, mating press, use of handcuffs, bottom-not-so-bottom gorou, ooc idk

NOTE ! yza posting late again... SORRY LOVE YOU GUYSSS i've been trying to balance my sleep sched with school so i've been doing and resting okay lately! ANDDD THIS IS NOT PROOFREAD...... also short.... anyway

event taglist— @yukiitaooo @scara6 @peakalatus @kanaedd @returningluv @im-the-ruler-here @scarafixation @kateybuggi @hanni7 @asimpforpeople @ju1yyyzzz @saturnsapothecary @alexiassleeping @cheeze-noo @supercoolusernameomg @shining_dhei @uchihaeirin @black-rxse @3herri-berri @anon-eu @gojoswife201 @abeitriz @chlebek1 @mechanical-lily @breadybuu @dawning-bliss @poisonedmoonl1ght @scaraismybbgreal @nothingfuninthislife @hellithides @eunchaeluvr @doumastip @pandash @cuntz0ne @zomzomb1e @bitchylillyrose @apocalypticchimera @wolfiafan10 @zxdksimpo @kikosaidbye

—CHILDE

oh, him? another family oriented man, of course daily breeding is a must!! he is straight up addicted to the feeling of your walls surrounding his cock, and when you're cumming? even better.

"just a little bit more, baby~" childe says for the umpteenth time; it seems like he's just making up excuses now to keep releasing ropes of his cum inside your cunt, making you whimper at how sore your body is from the overwhelming amount of pleasure being given to you by him. his body weight holding you down in a tight mating press on his luxurious bed, "feels good, yeah?" he continues his merciless and rough pace, snapping his hips against yours in the perfect rhythm. "you need more, don't you? tell me how bad you need me to fuck you senseless—to breed you full of my seed~"

—TIGHNARI

experiment purposes... and maybe also for pleasure. an experiment including breeding and pushing your limits with the addition of a few drug testing as well to see the possible side effects of a few herbs he's using to create a new medicine. don't mind if i include some overstimulation here too <3

"this is okay, yes?" tighnari's fingers thrust in and out of you at a slow pace, creating a wet sound with each movement due to his cum that was deep inside your pussy, mixing with your own, prior to the encounter from earlier. "still aroused, huh? that drug seems to be a rather strong aphrodisiac then, hehe~" you whine from all the built up pleasure as the sensitivity of your body increases with each passing contact you have with one another. he then abruptly pushes back deep inside you, letting the fluids overflow from the sides, coating his cock in the sticky, white liquid, "let me help you sooth yourself~"

—GOROU

hear me out when i say that he's already extremely sensitive after a few rounds, and by that i mean around 3 or 4 rounds, and it'll take less time to reach that point when you focus on his ears or tail throughout the session :3 btw you're on top for this one but not the one in charge

"d-don't... sensitive..." gorou whimpers softly as your fingers tangle themselves in his hair, ever so often making contact with his ears that twitched slightly upon feeling the warmth of your touch. his hands grab onto your hips and guide you up and down his length, "oh, already so full~" he comments upon seeing how your thighs had your mixed fluids of arousal dripping down them; he then flips you over, laying you down with your legs spread wide just for him as he began to thrust deep and relentlessly, "god—you feel amazing, and you look so damn pretty... all for me~"

—WRIOTHESLEY

handcuffs. yes. he is just so in love with the idea of having you completely at his mercy below him as he breeds you full of his seed, with no choice but to take all that he has to give you. slightly rough wrio !! <3

"fuck, fuck...!" wriothesley curses as he empties out yet another load inside your pussy, the 5th creampie and counting. you weakly moan under him as your body spasms a bit due to how used your body was after hours of continuous fucking. "gotta make sure i breed you right~" he says and slams back inside you, earning a loud whine to leave your lips as you tug on the thin metal that restrained your hands just above your head, "just a few more, alright? shit—your cunt just feels too addictive not to fill up~"

[kiragecko]

Story Idea

Telekinetic supervillain who REALLY loves historical architecture. Living in a superhero universe where heroes keep crashing through stained glass windows and leveling entire streets. As well as the normal corruption causing building to be demolished or “restored” in extremely destructive ways.

Kinda has Poison Ivy vibes, without any of the femme fatale trappings - her entire focus is preserving historical valuable buildings, and she doesn’t really care if humans that get in the way die. But she also isn’t going out of her way to kill people.

And the leader of the local superhero team can see where she’s coming from. And decides that just throwing her in jail every time she acts up is a sign they’re failing in their duty to protect the city. Instead, he starts trying to gain her trust. He doesn’t care that much about buildings, but he works on lessening his team’s collateral damage. He promises the supervillain that he’ll try to pressure the city government if she brings problems to him rather than taking them into her own hands. Eventually, he convinces her that she can protect the city’s infrastructure better by being on his team than she can on her own.

She’s incredibly helpful! She will keep burning buildings from collapsing until everyone can get out and the fire is extinguished. She’ll hold skyscrapers up while supervillains reign destruction down around them. She’ll deconstruct traps and grumpily direct her teammates towards the hidden mastermind who set them up. And when the crisis is over, she’ll see what can be salvaged and rebuild it if possible.

But she’s a PR nightmare.

Former Supervillain refuses to help people. She DOES NOT care. Your kid is trapped in the burning building? That is not her problem. Go bother someone else. Dude is holding a bunch of people hostage? It’s fine, he’s not causing any damage to the building he’s in.

People DO NOT like this attitude. People do not accept that she’s part of a team, and other heroes are capable of filling the “empathy” and “human rescuing” gaps.

And she’s high maintenance! The team frequently end up in situations where protecting lives is in conflict with protecting property. They take missions that mean very little to them, because they’re important to her. And the leader is constantly having to talk her out of rampages, pressuring the government to drop lucrative and unethical contracts, and making sure she’s sticking to the plan in the field. And she isn’t interested in interpersonal relationships or social niceties, so none of them are even doing this out of friendship!

-

Sometimes, you help someone not because they’ll be grateful, but because it will make your community better. Sometimes, you help the local drug addict not because he’s likely to turn his life around, but because he smashes less windows when he has a warm, quiet space to stay. And sometimes, keeping that community benefit takes a long term commitment.

I want to see a superhero team turn a villain as harm prevention and then willingly bear the cost of keeping that villain from causing harm. Not because it’s rewarding (though there are rewards) but because it’s more effective than any other method. And I want the villain to go along with it because the heroes actually found a more efficient way for her to reach her goals.

And it being messy for everyone, but I want them to make it work. And it to be worth it, in the end.

[doberbutts]

Curious about something you mentioned in your post last week, you said that in your opinion all drugs should be legal and I’m curious about how that would be a positive at all? Like I get weed bc it’s pretty harmless but when I think of drugs I think of cocaine and heroin, which have destroyed so many lives. If it was widely available wouldn’t that end up hurting more people than helping? That’s just my opinion but I’m curious on the other side

I do think all drugs should be legal. This is said knowing that addiction runs in my family and that the only reason my older sister is my *sister* is due to drug use and addiction. Otherwise she'd be my cousin.

Making drugs illegal does not stop people from getting high. It does not stop drug related crime. And it certainly does not stop drugs from tearing families apart.

Addiction is a symptom of a larger problem. Solve the problem and the addict problem goes away. Solve the addict problem and drugs stop ruining lives and destroying families and creating massive amounts of drug related violence. Places that have roled out decriminalization strategies effectively have seen an overall reduction in crime rates across the board, a reduction in recreational drug use, and a reduction in bloodborne illness like HIV. Creating safe needle exchanges as well as safe places to get high with medical staff onhand has also created a locale where very few people die from overdose.

Most people hear "decriminalize all drugs" and think I mean a free-for-all. I don't. I think the drug market should be regulated. I don't think you should be able to get ketamine or heroin over the counter at a walmart like you can get asprin. But I think it's time to stop putting people in jail for getting high.

My aunt tore her life and her family and her health apart for years while she was addicted to heroin. My sister, her daughter, needed to be removed from her care due to the amazingly bad choices she made as a mother due to her addiction and her prioritizing drugs over the health and safety of her daughter. My aunt has had multiple heart attacks from the damage the constant drug use did to her body.

My aunt is more than a decade sober and do you know why? It's not because she got a wakeup call when her daughter was taken away, because at the time she willingly and freely signed her over to my parents because that got her "out of [her] hair". It's not because she had a heart attack, because she went right back to it the moment she was out of the hospital. It's not even because she spent time in rehab and prison, because the moment she was out she was using again.

No, my aunt got sober because her life changed. She was put on a better pain management plan. She got out of her shitty marriage to her shitty husband. She completed some education to make her more hireable so she didn't have to rely on less than safe means of paying her bills. She reconnected with my sister and reforged their relationship once she was 18. She bought her own house. She found love with someone who didn't give a shit about her past and brought out the best in her.

My aunt was a deeply unhappy person. Heroin made life more tolerable for her. Until she couldn't tolerate life without it. Until she'd do anything, anything, to get her next high.

A lot of addicts are addicts because they are self-medicating for something else and their drug of choice has chemical properties that makes their brains crave it more. If you fix the "deeply unhappy" part, you create a healthier environment for that addict to take control over their life again. Without it, they are far more likely to continue to relapse.

Knowing this, why would I then want to add the threat of prison and jailtime- life-ruining things themselves- to an addict's list of concerns?

Look up rat park sometime. In the rat paradise, drugged water was freely offered, and occasional a rat here or there would take a hit or two, but rarely enough to even get high and almost never habitually. Addiction literally didn't exist even though the rats were taking addictive substances. But the rats in cages, seperated from each other, with no enrichment, crammed into small spaces and stressed to hell? Those rats took hit after hit after hit until they overdosed and died. The addict rats were deeply unhappy. The drugs were their only escape. The paradise rats had to be lured in with sweetened drugs to even consider and even then they rejected them. The caged rats did not need sweetner, even though the drugs made the water bitter.

If we can see such a stark difference in rats having their needs met vs rats experiencing isolation and stress, what would happen if we showed human addicts the same consideration?

I think a lot better results than continuing to jail deeply unhappy and desperate people for doing the only thing they can think of to cope.

[veryrockyraccoon]

I see a lot of “Batfam can’t take care of themselves and are insanely self destructive” or “Batfam members (usually Tim) need to be drugged to sleep” and don’t get me wrong I read a lot of stuff like that and it’s really interesting and entertaining, however I would now like to present a Batfam that is not only hyper-competent about vigilante shit but civilian shit to.

Like sure they don’t sleep through the night but they consistently take naps throughout the day/night, and it works great for them, even before the whole vigilante thing most if not all of them had a preference for consistent naps over consecutive hours of sleep.

In regards to food, they burn thousands of calories, if they didn’t consistently eat they wouldn’t be able to go on, and not in a “I’m so hungry but I must carry on at the exact same level of capability as I did when I ate consistently but will pass out when convenient for the plot” type of can’t go on, I mean migraines, nausea, dizziness and passing out kinda can’t go on. I imagine having a good relationship with food is incredibly important to them (eating when hungry, eating how much you’re hungry for and eating what you’re hungry for). I think members who went through starvation periods probably put a lot of work into fixing their relationship with food.

When it comes to wounds or illness carrying on would not only be foolish and make them less effective while dealing with the injury/illness but could permanently affect how well they operate.

Maybe their various teams don’t think they take care of themselves and try to feed them or make them sleep or something, but at the end of the day they are keeping themselves in a condition where they can go toe to toe with aliens, metahumans and various other powerful individuals and not only hold their own, but win, that’s not something you do unless you take damn good care of yourself.

The bats and birds are self-sacrificial not self-destructive.

Anywho that’s just my thoughts, and like I said I’m not bashing anyone who writes or portrays them as self destructive, like I said I appreciate and read those takes on them.

[teine-mallaichte]

Let's talk hallucinations in whump/general fiction.

So first off full disclosure, I have schizoaffective disorder - think some bits of bipolar and some bits of schizophrenia kind of squished together, and as such hallucinations are a BIG part of my general existence.

Definition: A hallucination is a perception of a sensory experience—such as sight, sound, smell, taste, or touch—that appears real but is created by the mind and lacks an external stimulus.

Now, I see a fair few "hallucinations" type prompts in whump events, and just generally within the whump community, and I see a LOT of auditory hallucinations type prompt fills - mainly in the form of malevolent whispers - and ye that's a thing, but there are so many other hallucinations.

The thing is hallucinations can effect literally any sense, not just hearing - though I will add that auditory is usually regarded as the most common.

this is a long post so I am going to put a cut here... below the cut is exploration of the tyoes of hallucination, the causes and a bit about insight.

So, I thought it could be "fun" to explore a few in a post. Lets explore the 5 "main" senses first:

Auditory Hallucinations

Description: These are the most common type of hallucinations. They involve hearing sounds that are not present. The sounds are hear as if they are coming from somewhere external to the body. So in my case I have a few of these, but my main one is a voice who is with me even when I am in meds (another good point there for anyone who wants to use mental illness in their fics even in meds we can do have symptoms). This voice has a name and most of the time he just sorts off passes comments about things and people around me, like a sarcastic narrator and it sounds like he is standing just behind me.

Common Examples:

Malevolent Whispers: Insidious voices that might threaten, taunt, or belittle you.

Hearing Music: Melodies or songs playing that no one else can hear. For me this kind of sounds like someone is playing a radio in a different room.

Environmental Sounds: Hearing footsteps, doors creaking, or other sounds suggesting someone else is present.

Command Hallucinations: Voices that instruct or suggest (its not always ademand, sometimes more subtle and manipulative) you to do certain things, often with a compelling and distressing sense of urgency.

Less used examples:

Kind/supportive hallucinations: Voices that are encouraging, reassuring and supportive.

Distortion: Rather than sounds with no origin hallucinations that disort or warp actual sounds/voices changing the meaning, making it as if the TV or Radio is addressing you personally, making it sound as if a friend is threatening you.

Fun fact: it actually is possible to have a two way (sort of) conversation with a hallucination - I know I do it relatively often. It will be different for everyone, but fo me its a bit like having a conversation on a bad phoneline, yes the voice will respond but often its almost as if he hasn't fully heard what I said - or is ignoring key points. I can do this both outloud and "in my head".

Visual Hallucinations

Description: Visual hallucinations involve seeing things that are not present. These can range from simple shapes and flashes of light to detailed images or scenes. They often appear as if they are in the physical world and can be very convincing.

Common Examples:

Shadowy Figures: Seeing indistinct, shadowy forms that may move or appear to watch the character.

Distorted Faces: Perceiving familiar faces as grotesque or altered in frightening ways.

Apparitions: Full-bodied figures that may interact with the character or appear menacing.

Lights/sparkles: The whump community seems to very much enjoy lights and sparkles, especially in drugging.

Less Used Examples:

Intrusive Visuals: Images of disturbing or graphic nature that suddenly appear in your line of sight.

Perceptual Distortions: Objects appearing to warp, change shape, or color in unnatural ways.

Double Vision: Seeing multiples of objects or people, creating a confusing and disorienting experience.

Scenery Shifts: The entire environment changes, making you believe they are in a completely different place.

Fun fact: Sleep deprivation can cause some wild visual hallucinations, even relatively "mild" sleep deprivation can start to effect a persons perceptions.

Gustatory Hallucinations

Description: Gustatory hallucinations involve tasting things that are not actually present in the mouth. These can range from pleasant to extremely unpleasant tastes and can be triggered without any external food or drink.

Officially these are considered "rare", but personally (as someone who has done a lot of peer support work in the psychosis/voice hearing community I think they are simply under reported.)

Common Examples:

Bitter or Metallic Taste: A persistent bitter or metallic taste in the mouth, often leading to a sense of unease or concern about poisoning.

Sweet or Sour Taste: Tasting something sweet or sour unexpectedly, which can be confusing if it doesn’t match the current context.

Less Used Examples:

Spoiled Food: Tasting something rancid or spoiled, causing nausea and distress.

Unfamiliar Tastes: Tasting something completely unfamiliar and hard to describe, adding to the character's sense of disorientation.

Mimicking Actual Foods: Tasting specific foods that trigger cravings or aversions, despite not eating anything.

Transforming food: Food tasting like other food - I know someone for whom everything tasted like strawberries for days.

Common Causes: Neurological conditions or can be a side effect of medications.

Olfactory Hallucinations

Description: Olfactory hallucinations involve smelling odors that are not actually present. These can be pleasant or unpleasant and occur without any corresponding external stimulus. They can be particularly disorienting because they may trigger memories or emotions associated with certain scents - extremely complex if the person also has PTSD.

Common Examples:

Burning Smell: Wood, rubber, or food, which can lead to panic and fear of a fire.

Rotting Flesh: An overpowering smell of decay or rotting flesh, causing distress and nausea.

Perfume or Flowers: Smelling strong scents like flowers or perfume - hallucinations don't have to be inherently unpleasant sensations.

Less Used Examples:

Chemical Smells: Smelling chemicals like bleach or petrol.

Unfamiliar Scents: Smelling odors that you cannot identify.

Food Smells: Smelling specific foods that trigger hunger or nausea, despite the absence of any actual food.

Tactile Hallucinations

Description: Tactile hallucinations involve feeling sensations on or under the skin that are not actually there. These can range from mild tingling to severe pain and can be extremely distressing.

Common Examples:

Crawling Sensation: Feeling as though insects or bugs are crawling on or under the skin - often leading to frantic scratching or picking.

Electric Shocks: Experiencing sudden, sharp, electric-like jolts.

Pressure: Feeling pressure or tightness around certain body parts, such as a hand gripping the arm or something heavy on the chest.

Less Used Examples:

Temperature Changes: Feeling extreme cold or heat on the skin without any external cause.

Wetness or Dripping: Feeling as though liquid is dripping or running down the skin, even when dry.

Phantom Touches: Sensations of being touched or grabbed, often when alone. Sometimes its an almost feather like touch, other times its more akin to a grab that if reak would leave a bruise.

Right now let's expand - because there are more than 5 senses.

Proprioceptive Hallucinations

Description: Proprioception is the sense of the relative positioning of one's body parts. Proprioceptive hallucinations involve distorted perceptions of where your body is in space or how it is moving.

Common Examples:

Floating Sensation: Feeling as if the body is levitating or moving without control.

Distorted Body Size: Perceiving limbs or the entire body as being unnaturally large or small.

Less Used Examples:

Misaligned Limbs: Feeling as though limbs are twisted or out of place.

Movement Hallucinations: Sensing movements that aren't occurring, like swaying or rotating.

Common causes: Neurological disorders or the effects of certain drugs, but can by caused by a huge array of things.

Vestibular Hallucinations

Description: Vestibular sensations involve balance and spatial orientation. Vestibular hallucinations affect your sense of balance, making you feel dizzy or as though you're moving when you're stationary.

Common Examples:

Vertigo: A spinning sensation, as if the environment or oneself is rotating.

Imbalance: Feeling as though you're about to fall over or can't maintain your balance.

Less Used Examples:

Motion Sensation: Sensing movement, like rocking or swaying, when you're still.

Gravity Distortions: Feeling as if gravity is stronger or weaker than it actually is.

Common caused: Inner ear issues, migraines, or anxiety.

Temporal Hallucinations

Description: Temporal hallucinations involve distorted perceptions of time. They can make time feel like it's speeding up, slowing down, or standing still.

Common Examples:

Time Dilation: Feeling as though time is passing much slower than it actually is.

Time Compression: Perceiving time as moving rapidly, making events feel like they're passing in a blur.

Less Used Examples:

Frozen Moments: Experiencing time as if it's stopped, with everything around you appearing frozen.

Temporal Displacement: Feeling as though you're living in a different time period.

Temporal Dissonance: Feeling as if time is moving differently for you in comparison to those around you.

Common caused: Extreme fatigue, high stress, or under the influence of certain drugs.

Interoceptive Hallucinations

Description: Interoception refers to the perception of sensations from within the body, such as hunger, thirst, or the feeling of a heartbeat. Hallucinations in this realm involve feeling internal sensations that aren't actually occurring.

Common Examples:

False Hunger: Feeling extremely hungry despite having eaten recently.

Nonexistent Thirst: An intense sense of thirst even when well-hydrated - I have had this one a few times and given myself electrolyte imbalances due tot he amount of water I ended up drinking (not fun).

Less Used Examples:

Phantom Heartbeats: Feeling the heart racing or skipping beats without any physical basis.

Digestive Sensations: Sensations of digestion, such as gurgling or bloating, without any real cause.

Common causes: Panic disorder or certain types of seizures.

Right, now lets quickly review the main "causes" of hallucinations

Mental Illness:

Schizophrenia: Can involve basically anything from this list, but anecdotally auditory and visual appear to be the most common.

Bipolar Disorder: Can include hallucinations, especially during manic or depressive episodes.

Schizoaffective Disorder: A combination of symptoms from both schizophrenia and mood disorders, often leading to a variety of hallucinations.

EUPD/BPD: Auditory hallucinations are relatively common.

In all of these the hallucinations will rarely (if ever) exist in isolation. If you do not have primary or secondary experience of mental illness then I would recommend doing a LOT of research - and talking to people who do (on this note my asks are open if anyone has any schizoaffective based questions).

Neurological Conditions:

Epilepsy: Particularly temporal lobe epilepsy, can cause a range of sensory hallucinations.

Parkinson's Disease: Can lead to visual and auditory hallucinations.

Migraine: Migraine auras can include visual and auditory hallucinations.

Once again the hallucinations will not be in isolatation so same advice as with mental illness.

Substance Use and Withdrawal:

Psychedelics: Drugs like LSD, psilocybin, and mescaline are known for causing vivid visual and auditory hallucinations.

Stimulants: Methamphetamine and cocaine can cause tactile and visual hallucinations.

Alcohol Withdrawal: Can lead to visual, auditory, and tactile hallucinations.

You know what I am going to say that my "if you do not have experience of this then go talk to someone who does" advice may just stand for every potential cause.

Sleep Disorders:

Sleep Deprivation: Can cause a variety of hallucinations across different senses.

Narcolepsy: Often includes hypnagogic (while falling asleep) and hypnopompic (while waking up) hallucinations.

Medical Conditions:

Delirium: Acute confusion and hallucinations often seen in severe infections, fever, or after surgery.

Dementia: Especially Lewy body dementia and Alzheimer's disease, can cause hallucinations.

Medications:

Anticholinergics: Can cause hallucinations as a side effect.

Steroids: High doses can sometimes lead to hallucinations.

Certain Antidepressants and Antipsychotics: Occasionally, these medications can cause hallucinations.

Psychological Stress and Trauma:

PTSD: Flashbacks and hallucinations related to traumatic events.

Extreme Stress: Can sometimes trigger hallucinations.

Metabolic and Endocrine Disorders:

Thyroid Disorders: Hyperthyroidism or hypothyroidism can sometimes cause hallucinations.

Electrolyte Imbalances: Severe imbalances can lead to hallucinations.

Deprivation:

Sensory Deprivation: Go google the ganzfeld effect, it's facinating.

Isolation: Extended periods of isolation can lead to hallucinations, known as sensory deprivation hallucinations.

Autoimmune Disorders:

Lupus: Can cause neurological symptoms including hallucinations.

Tumors:

Brain Tumors: Depending on their location, they can cause hallucinations affecting different senses.

Ok, finally point for this post. Let's discuss insight, because it is not as black/white or binary as people seem to assume.

Definition: Insight, in this context, refers to the awareness and understanding that one's hallucinations are not real but are a product of their mind. Insight can be partial or complete, and it often fluctuates.

Complete Insight:

Description: The individual fully understands that their hallucinations are not real and are caused by an underlying condition.

Impact: This can help the person manage their symptoms more effectively and seek appropriate treatment. However, it doesn't necessarily lessen the distress caused by the hallucinations.

Partial Insight:

Description: The individual has some awareness that their hallucinations might not be real but can still struggle with differentiating them from reality.

Impact: This can lead to confusion and anxiety, as the person oscillates between believing and doubting their experiences.

Lack of Insight:

Description: The individual firmly believes that their hallucinations are real and external.

Impact: This can lead to significant distress and functional impairment, as the person might respond to these hallucinations as if they were real.

Now imagine these three points on a scale from 0 (complete insight) to 10 (lack of insight) a person can be anywhere on this scale, and can slide back and fourth along it.

Factors such as stress, fatigue, medication changes, or daily fluctuations in mental state can cause insight to vary. A person might have high insight at one moment and low insight the next.

Basically Insight Is Not Static.

Also sometimes insight is just FREAKING RANDOM fluctuation for no discernible reason - honestly at times there is zero logic.

so ye, halluncinations… the brain is freaking wild.

Disclaimer - this is by no means an exhaustive list and like with many things every individual will experience these things slightly differently.

A similar post about delirium A similar post about fever

[macgyvermedical]

Harm Reduction Ideas for Substance Use Disorder

Recently I have been listening to a podcast called The Curbsiders Addiction Medicine. If you are a clinician that works even sometimes with people who use substances (every clinician ever), it is a fantastic look at all the harm reduction practices you can use to make these individuals safer. Plus, you get free CME.

I’m hardly going to do the podcast itself justice with this post, but I wanted to share some things I learned from it:

If the dangers of using substances (social and legal consequences, time commitment, health problems, money problems, etc…) was a deterrent, people wouldn’t be doing it. But it’s not. Because uncontrolled substance use is a chronic disease that generally does not get better without treatment. When people are treated, not only do they generally use less, but they have a much lower chance of death and a much higher chance of a happy, productive life- whatever that means for the patient.

Previously (even a few years ago) we hung such treatment on the requirement that people be abstinent from substances in order to receive help. This works for some people, but far from everyone.

The evidence shows that best thing we can do for many individuals is to make their use safer and less of a burden on their life and health. This is called harm reduction, and it WORKS.

Here are some evidence-based ideas for how to help your patients:

Create a space where you are working together with your patient and following your patient’s lead. Do they want to become abstinent? Great! Do they want to use less or use in a more controlled way? Also great! Do they want to continue use in a safer way? You guessed it, also great! Support them in whatever their goal is

Provide or prescribe safe, clean tools of use. Things like clean needles, Pyrex pipes, and straws. This decreases rates of infection and abscesses

Prescribe medications that reduce cravings or reduce/eliminate withdrawal (methadone, buprenorphine, topiramate, bupropion, naltrexone) without requiring abstinence

Teach people safer use practices and safer routes, such as rectal (booty bumping) or oral (parachuting) instead of injection drug use

Prescribe PrEP if people are at risk of HIV without requiring abstinence

Test for and treat the consequences of substance use (such as HIV and Hep C) without requiring abstinence

Provide fentanyl and xylazine test strips so people know what is in the substances they are using and can adjust doses/use pattern accordingly

Recommend Never Use Alone hotlines to prevent overdose death or better yet, take turns using with a buddy

Prescribe naloxone to anyone who uses any substance- nearly all street drugs are contaminated with synthetic opioids and naloxone is an effective way to prevent deaths

People use substances for a reason, especially early in their journey- pain, coping with depression/other mental illness, ADHD, and social issues like being unhoused. Treat the problem if you can find it, and you can help people significantly decrease use or use in a more controlled way

Be aware that return to use (or return to uncontrolled use) is a thing you can plan for with the patient and manage before it even happens

It’s hard sometimes to change the idea of addiction/substance use disorder as something that can only be treated as a reward for staying sober. But thats why so few people seek treatment for it. The evidence does not equivocate. Harm reduction WORKS.

[lanawinterscigarettes]

What if Wilson accidentally consumed an aphrodisiac, how do you think his partner would deal with him lol?

I see the Wilson lovers are starting off strong here with their requests lmao

James Wilson accidentally consuming an aphrodisiac

Warnings: nsfwish content given the obviously suggestive subject matter

Honestly given how often House drugs/has drugged Wilson canonically in the show I wouldn't put it past him to do something like slip a substance containing some type of aphrodisiac into his coffee when he's not looking just for the hell of it

Regardless of how or why it occurred, I imagine Wilson wouldn't notice anything was wrong until it just sort of hit him all at once

Incredibly flustered, he'd excuse himself from whatever sort of interaction he was having, whether that be with a patient or another doctor, and lock himself in his office with hope that the feeling would soon pass

Once it became clear that wasn't going to happen anytime soon, he was stuck with the alternative option: paging you in hopes you could provide him some much needed, ahem, relief

(How you got into his office is entirely up to you. It's most likely he opened the door for you himself but if you want to imagine hopping over the divider between his and House's balconies for a more comical effect go for it)

He's so pathetic when you finally get a good look at him. He has an obvious bulge in his pants and looks even more like a kicked puppy than usual

Typically he's not one to ask for sexual favors at work, but it's clear an exception needs to be made before he combusts from all the pent up sexual frustration

He's torn between politely declining any help and begging for assistance until he sees you sink to the floor in front of him

At that point all the blood that was being used to form any sort of thought went rushing somewhere else if you know what I mean

Knowing Wilson he probably needed to be gagged (most likely with his own tie, as you didn't have anything else immediately on hand) so no one would hear his desperate moans while you sucked him off/gave him a handjob

Depending on how strong the aphrodisiac was would determine just how long you spent with him in his office. If it was weaker, then thirty minutes to an hour would suffice. Anything stronger than that and the two of you wouldn't be seen for the rest of the day

If you were to ask him about it afterwards, he'd admit it was a lot more enjoyable than he thought it would be given the fact you were both at work during the day

Still, he'd prefer if the next time he took an aphrodisiac it was in a less public area with him having knowledge of it beforehand

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[webbluvrsugar]

okokok first up thinking about: ethan keeping you away from act 3 by less than morally sound means… drugging, kidnapping, convincing you to run away with him, (etc.) dealers choice!!!

*sorry if this is really broad, i wanted to leave room for creativity + i’m also on a bus home rn so i’m a little delirious lol but i’ll think of some more stuff to send your way when i’m home bc it’s time for ethan to come home for halloween the kids miss him😖*

a/n: faeeee you always be giving me the best requestsss, and also yes omggg Jack come home, there’s a kid waiting for you!!!

Ethan not-so-subtly “putting you to sleep” to protect you.

“I’ll take care of her, promise, just don’t touch her!” Was what he said to Quinn when they had a massive argument about you.

She called him soft, that he was falling for you.

Soft? Him? No, he was just fooling you, mocking you, you were the stupid one here, not him, you were the one who fell for him, he certainly doesn’t love you. He just… enjoys spending some time with you, enjoys kissing you maybe, sometimes he may even find pleasure in fucking you.

But he’s not growing soft and he is not falling in love… yet he finds it weird why he wants to protect you so much.

It’s getting even harder because you won’t fall for his bullshit excuses, you won’t fall for “Oh, they all cancelled, why don’t we stay in tonight?” or “I just wanna hang out with you instead.” so he has to get creative, lately he’s been putting sedatives in your drinks, that green smoothie of yours, — not morally correct, yeah, but so isn’t shoving a knife in your best friend’s guts, whoops, he’ll apologise later — the problem is that you’ve began to notice.

“Dunno, I just have been feeling a lot sleepier lately.” You mention, he sits beside you on the couch, watching you take clueless sips of your juice. “Do you think I’ve gotten the wrong powder? Maybe it has some random side-effects I don’t know about.”

His hand drives itself to your thigh, slightly flexes on top of your skin. “Have you read the full ingredients?”

“Top to bottom.” You huff, lean your shoulder into him.

“What about the side-effects? Does it mention anything about it?” He portrays himself as the perfect boyfriend, just trying to help you and your sudden tiredness, luckily, you fall for it.

“No, not really.” You sink even more into his shoulder, your vision already looking hazy.

“Huh… that’s weird…” he glances sideways at you, watching the way you make yourself comfortable, his arm leaves your thigh to wrap around you waist.

“Mhm..” you yawn, he bites down a smirk.

It’s like you don’t even notice, like you’re so clueless, but he likes you this way, maybe he’ll even succeed in his plan if he just keeps doing it.

He sees the how you allow your eyes to fall shut, how you trust him so much that you don’t mind getting this vulnerable next to him — it’s cute.

“Don’t worry, I’ll be here when you wake up.” He mutters, his hand slightly caressed your exposed skin.

He will in fact be here when you wake up.

But before that, he’ll make sure you’re comfortable in bed and go out to try and shoot Tara’s brains out.

[narendur]

Safe sustainable home for everyone

Explain your personal feelings about how urban environments should be designed in 5 words or less