Yeah hubs is right about these things about 90% of the time (me not being on those parts of the internet often) but nobody bats 100%

I’m aware. I’m telling you someone told me in other parts of the world the solution is letting wild animals eat them.

The wildest part to me was the international / immigrant nurse who was shocked that in the US we care enough about the mentally ill to bother putting them in prison. She was like “back home if they don’t have family that’s willing to take care of them we just physically throw and/or kick them out of the city and let them wander off and die.”

I mentioned it and hubs immediately went on an unhinged rant about something called rationalism, “a snowcrash style ocean flotilla cult,” and his trust fund friend who hates homeless people (in his defense he did get stabbed but I can also hear him in my head saying the kind of dumbass thing that would get him stabbed). I’m still lost so I’m just going to keep trying to finish Interesting Times by Terry Prachett which I got for $1 as a paperback at my library’s used book sale last fall.

Depends on how relaxed I am, similar to a deep tissue massage. Hubs has a Goldilocks dick it’s juuust big enough to stretch me out if I’m craving it, otherwise like you said I just position myself to not let him that deep. Incidentally, he’s the same way.

Link

They do seem to multiply rapidly.

definition of gatekeeping and immeasurably destructive to any community, real or online

so I looked into this because your comment sparked some curiosity and from what I can tell it’s less about the chemical itself and more about how your brain regulates and uses it. There’s also limited evidence as to whether GABA as a dietary supplement is even crossing the blood-brain barrier (where it would cause these effects). The other thing you need to keep in mind with most “natural” supplements is that the FDA regulates them under the F, not the D! Things like melatonin (which I even take personally) are regulated as FOOD, not DRUGS. Drugs have to

• be exactly the chemical they say they are
• in exactly the amounts they say they are per. pill.
• and as over the counter medications have to have approved safe dosages and frequencies on the packaging
• and all pills prescription or not have to have a unique alphanumeric imprint on each pill that can be used to identify it if it is separated from its packaging. Even different doses need unique imprints.

Food needs to:

• mostly probably be the thing it says it is. If it’s a plant it might be a different strain between different manufacturers.
• that plant also might have a variety of other chemical structures in it that aren’t advertised on the bottle.
• say almost whatever the manufacturer slaps on it in terms of dosage or frequency.
• have no imprint whatsoever to identify it if it’s not in the original packaging.

Like I said I use several supplements myself that even have good evidence behind them in terms of safety and efficacy. But you need to be aware of the ways in which they’re regulated differently than drugs and know that you’re gonna have to do a little more research for yourself to really find what’s going to be safe and effective for you. Finding a physician who’s educated in holistic and integrative therapies can be super helpful for something like this.

no good answer due to normal variations in physiology and variations in the specific person’s quality and severity of addiction but in terms of timescale I would say a day-ish? Would be better to ask an ICU RN or MD. At my level and specialty of care (acute psychiatry) and assuming the pt has been screened appropriately by the ED to not already be in high acuity withdrawal (needs medical or ICU) we’re generally not talking minutes to a couple hours but we’re also not talking a week. The scale we use to measure is called the Clinical Institute Withdrawal Assessment. Depending on the half-life of the medication used for the taper I’m reassessing that score either every 4 hours (ativan) or every 8 (phenobarb). My unit usually does phenobarb because it requires less frequent and precise assessment due to the elongated half-life. And I can always reassess ahead of schedule and give 1 extra dose as a standing PRN order without even needing to call the on-call MD if they’re having breakthrough symptoms.

Also keep in mind that it’s not just mortality we’re worried about. I can’t make withdrawal fun but I definitely don’t want it to suck any more than it has to. There’s also a lot of permanent but nonfatal damage that can happen in the meantime. And it’s actually also an issue of my safety and that of my coworkers. My subspecialty is actually specifically the management of violence and drug withdrawal is an item on MOST violence risk assessment scales. Actually the only one I don’t see it on irrc is the BROSET and that’s just because it’s a rapid 6-12h tool and the CIWA is already addressing that under the agitation and paranoia items at that time interval. The paranoid delusions and audiovisual AND tactile hallucinations are no joke. One of the COMMON reasons I get called to medical units for backup is CIWA patients because we can’t take them until they’re on the tail end of a high dose taper but the medicine nurses aren’t always equipped to address the psychiatric symptoms and there’s more equipment available to throw / swing at them.

tbh I’m not on the research end I’m on the butt end with the people experiencing it directly (which is where I wanna be the most I wanna do is maybe teach someday) so I have empirical backup but most of my knowledge is experiential.

fun fact; drugs that act on your GABA nervous system (benzodiazepines such as xanax, also barbiturates and alcohol) are the only drugs that will kill you outright on withdrawal.

Stimulant withdrawal (amphetamines, cocaine, caffeine, nicotine) causes headache, confusion, fatigue, and occasionally suicidal ideation. Opiate withdrawal (oxycodone, heroin, fentanyl), causes flu-like symptoms that can be fatal if severe enough (dehydration, GI complications) but do not kill you outright. (THC / marijuana withdrawal is the chillest, usually only causing mild irritability and appetite loss, which the others do to a much greater extent).

Benzo (and other GABA active withdrawals) causes a rebound of your nervous system’s stress and fight or flight system that cascades from extreme anxiety, then into vivid hallucinations and paranoid delusions, and finally into back-to-back seizures that eventually result in nervous system failure, hypoxia, and death.

If you begin using them at an unsustainable dose (which can cause respiratory depression and weakness of gait / traumatic head injury) you will need to be withdrawn in a either a specialized rehab with medical capabilities or if the addiction is severe enough a hospital or even specifically an intensive care unit.

This has been a PSA.

One of my points of pride is actually using my teeth. A light scrape or nibble dramatically increases tactile sensitivity and emotional intensity. If you know how to simultaneously integrate the tongue and lips properly you can really leverage that “crazy girl sex” that drives dudes fucking nuts. I may have had years of therapy but there’s a few holdovers just because crazy girls do it better. The other big thing is gregariousness because once you learn to use it with real day-to-day support and respect for people it just magnifies it.

One of my coworkers said she loves working with me because she’s not scared of running into problems because I have the solution to 90% of what she runs into. I was like bitch. what. but then I remembered she doesn’t fight me on having to take charge nurse all the time and like. A few weeks ago she got in trouble for something one of the junior nurses didn’t handle quite right (tbh none of us would though that pt should not have been on our unit) and getting in trouble for shit other people do is exactly why I fight like hell not to be charge nurse ever so like. Just for you. None of you other people. If you’ve ever asked “well why can’t Apy be charge she has the most experience!??!???!” Exactly. Y’all stupid and idw be on the hook for your shit. I’d rather just solve the problem on the sidelines and you can take all the credit for whether it works or not (and like 90% of the time it will so 🫅)

Also if I have to deal with that demented old bint of a house supervisor imma throw hands (although months ago I said to myself that if she writes me up for a third bullshit that’s found completely unsubstantiated I’m filling a complaint of targeted harassment and I think someone actually alerted her to that subtext because I think she got in trouble for the two complaints she wrote about me. One because when they pulled the tapes for me being insubordinate she was standing over me in the nurses station shouting at me for questioning a safety issue and one for snooping in my patients charts trying to find dirt on me). And that second one she came to the unit to try to rub it in my face and I had that charge nurse I mentioned with me and just giggled in her face the whole time and she kept saying “I don’t know what your problem is with me” and I just really wish I could’ve been there when someone pointed out that girl you are the one picking these fights!

One of the interesting things I’ve found while reading through is that while there’s a lot of minor sins mentioned once each in the old testament (like mixed fiber clothing) the one commandment that is mentioned more than any other, like almost word for word with every repeat is keeping the Sabbath. And many of those repeat mentions also specify that it applies to your workers / servants as well. Even if they’re not also Jewish, it’s a sin for you as the Jewish person to not give them their rest day. Idk I just found that super interesting especially in this modern context of modern US Christianity flavored capitalism.

Yeah the industry has just kinda accepted that surgeons are just like that lol. A lot of hospitals are settling for just getting them to stop shanking the circulating nurses with spare scalpels. Honestly I used to work with criminally insane men so I could probably grapple a surgeon. My issue with OR was that it’s too cold and I couldn’t scratch my nose when it itches. Also ortho surgeries in particular are a sensory nightmare it was like a soundbyte of a dwarven mine from a fantasy movie on loop for eight hours just –ding ding ding CLANG ding ding ding CLANG ding ding– I could not.

have had IBS my whole life. hearing people say this is like hearing people say they only breathe at home. they just. hold their breath. until they get back.

From another comment of mine on a similar post:

ADHD protip: commit to only setting up the digital workspace as soon as you get the assignment. Set up a cloud storage folder with google drive or one drive or whatever you use with:

• a copy of the assignment outline
• an empty document in the paper format, complete with title and reference pages
• a folder for reference PDFs or diagrams or quotes or whatever

Not only have I written numerous fabulously scoring assignments on my phone while taking horrifying IBS shits but also–

–one time I set this up for a group project and sent the folder out to the members. A few days later I logged in and one of the other members who also had ADHD had basically completed the entire assignment. Cannot say whether she was shitting while writing it but it’s certainly not impossible. A day after that another group member edited it and it was ready for submission five days ahead of schedule.

The neurochemistry isn’t actually averse to work, you just gotta catch it at the right angle.

Hubs gets annoyed sometimes by my attention seeking hypersexuality. He’s fond of this bit:

I made it custom!