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At a meeting where Electronic Medical Records was on the agenda, I happened to have been sitting next to a manager involved with that and joked about that you can't take ICD-10-CM Diagnosis Code T43.616A ( Underdosing of caffeine, initial encounter https://www.icd10data.com/ICD10CM/Codes/S00-T88/T36-T50/T43/... ) to Starbucks with a prescription.

He chuckled a bit and told a tale of when he actually had that show up on his hospital visit once.

He was in the hospital for some reason. That next morning he was rather grumpy and after snapping at the doctor apologized and noted that it was 2 hours after he normally had his morning coffee... which he couldn't have. The doctor asked if he'd be better if he had some caffeine and the manager said "probably."

So T43.616A showed up on his chart and shortly after that a nurse came by and added one cup of coffee caffeine equivalent to his IV. Apparently it degrumped the manager sufficiently shortly afterwards.

The IV was much more than the cup of coffee from Starbucks and there was some dickering with insurance about if that was a necessary or elective treatment.

He concluded with that he wouldn't recommend it again.

> added one cup of coffee caffeine equivalent to his IV.

> The IV was much more than the cup of coffee

To be clear you mean about same concentration i.e 100mg but higher absorption?

Starbucks is like $5 per 100-200mg. IV caffeine is like $500 per 100-200mg.

And pills are like $0 per 100-200mg, so we know why the hospital didn't just use those.

If he's being administered IV caffeine instead of given a cup it's possible that he couldn't take pills either.

> [cup of coffee] which he couldn't have

Probably 'nil by mouth' (pre-op or something) not just no fluids/coffee.

> To be clear you mean about same concentration i.e 100mg but higher absorption?

I think he means that the IV caffeine cost much more than a cup of Starbucks would have.

The price that the hospital billed was much more than the cup of coffee.

If that was US what did it cost? Possibly the most expensive coffee of his life!

Now that’s some relevant info!

> Most people consume ecstasy by mouth, but I’ve heard from many that anal ecstasy is a more satisfying experience.

I don't know why now and why this, but this has convinced me that I really need to cut down on what I read online. 99% of it does not go towards my life objectives and 100% of it is probably taking up space in my brain. To be clear, I would have laughed at that fact and moved on before. It just hit me differently today; I could be thinking about my family, work, friends, whatever, but now I know some irrelevant fact about ingesting drugs via the butt.

It hit you different because you're subconsciously interested in putting drugs in your butt, and you took the time to comment because you wanted to learn more. Maybe.

I guess I don't understand why people are shocked to learn that recreational drugs can be ingested rectally, but don't bat an eye about the existence of medicinal suppositories. (Or maybe people are shocked to find out about suppositories?)

You've missed the point. The GP is saying that consuming data at random does not contribute towards the things they personally prioritize in life.

Understandable given the url and post title. Person is thinking, man what would matter in life right now is intravenous caffeine, let’s see what “sexdrugssuicide.com” can help me with. And shockingly, it didn’t really change their life after all. I hate that.

And yet they still took the time to write out a comment explaining their conclusion. Maybe they are not quite there yet on their priorities!

I fail to see the hypocrisy in the above comment, but maybe you can clarify your reasoning.

I probably missed their point because I reject their point entirely. Whimsy and curiosity for it's own sake are absolutely vital for your well being. That is the essence of being well cultured.

Putting recreational drugs in your butt is surely the pinnacle of culture.

Well, I mean, I don’t love thinking about suppositories tbh

Fun fact: people have died from buttchugging (alcoholics will pour beer into their butts to get drunk quicker)

It's significantly more dangerous than drinking to excess since it sidesteps vomiting.

I thought the danger was from the fact that it doesn't get processed by the intestine so you cop the full force of the ABV.

It is very hard for me to imagine anything more satisfying than taking MDMA. I do not need to experiment with other orifices, orally works just fine.

I had heard that there's a community of people who insufflate caffeine on Reddit, but this one is news to me.

Seems a little funny to go through all the trouble and extreme stigma of injecting yourself with an IV drug, only to pick ground up coffee beans as your poison of choice (!)

The study is interesting mostly for the fact that someone tried it, but ultimately the results don't show a very strong effect. I wouldn't put too much confidence in how well it would replicate either, these kind of studies can have a lot of variation.

>Every drug seems to have a “right” way to take it. You [...] booty bump ecstasy

That is not really typical. People normally eat it as ecstasy pills, or as MDMA powder.

Most recreational drugs can be taken rectally, that usually makes for a higher bio-availability and a faster peak plasma concentration. Some people do that a lot, with everything. It is not specific to ecstasy, that I know of.

Nearly any drug (modulo those that have very specific contraindications for it, like codeine) that can be taken rectally can be IVed too. Back when I was still an active heroin addict, I would IV MDMA if I was going out for the night. It’s incredibly intense, more intense than most other drugs when administered that way. bk-MDMA was superior to even MDMA itself when IVed, as well.

Just chiming in to say: Holy shit and you've done well to still be alive. You've seen some shit.

A paramedic friend advised that if you ever end up in the hospital in a lot of pain, always opt for the suppository.

Reoccurring kidney stone sufferer here!

Belladonna and Opium (B&O) suppositories are one of the best things that I've discovered. They were very reluctant to write me a prescription for them but they were life changing last time I had to pass a stone. Dunno what would happen if I asked for one outright... when I tell them dilaudid doesn't do much for me I get treated very skeptically.

https://clinicaltrials.gov/ct2/show/NCT03332056

> Dunno what would happen if I asked for one outright...

Nowadays unless you're over 65 you'd be labelled with "drug seeking behavior" (in your records) and sent home with nothing and a "come to the hospital when you pass your stone." Forget the fact that the difference between drug-seeking behavior and legitimately needing something stronger is indistinguishable, and forget the fact that it will cost thousands upon thousands of dollars for you to do it in hospital. Thank God they're keeping you safe from the evil Sacklers

I had a staph infection on my balls when I was recovering from cancer. My normal doctor was busy so I went to urgent care, with blood dripping down my leg. It was the first time I ever asked for pain killers. I was prescribed acetaminophen.

I understand that addiction is a big problem, but this was a male doctor looking at a whole in my testicles, and telling me he can't give me painkillers

I think that it universal of urgent care. If you need pain meds it has to be the ER or your PCP/GP in my experience.

Do you have long hair or any other signs?

I barely had any hair I was just a few months off chemo.

Absolutely.

My wife had some core muscles in her back collapse. Think unable to walk and could only crawl with me holding her hips up. When she went to the primary doc, he thought it was drug seeking behavior. When she went to the ER they luckily decided that she was serious and gave her the most powerful muscle relaxant available - Valium. She had no idea, but it it saved her life.

I see several issues here, but I think it is extremely important that no one leaves thinking Valium is the most powerful muscle relaxant available. Valium is a centrally acting muscle relaxant, among others. It is very difficult to kill someone with an overdose, mostly interactions with other drugs.

The best muscle relaxant / antispasmodic depends on the patient and the situation. Valium is a safe indication from someone not dealing with those medications, as a temporary measure.

All benzodiazepines (including valium - diazepam) create dependence.

All I know is that that is what the ER doc told me, and it worked wonders.

It's possible the ER doc meant most powerful that he could legally prescribe given the clinical presentation; or perhaps he was just saying that because you don't give someone medication and say "well, you just got a basic painkiller, it's near the end of the its use-by, maybe it'll work", you say "We're giving you the best". It's the placebo effect, albeit with a medication that should work regardless.

What does it mean for a muscle to collapse?

What I meant is that she had a serious muscle spasm which caused any attempt to use the muscle to leave her in agony. Since the muscle in question was in the lower back and is used for everything to do with balance, this left her bedridden.

It was extremely scary to go through.

American healthcare is a mess because of religious shit like this.

Its interesting because its a very specific, recent, and almost uniquely American religious concept, that's written into virtually every aspect of our culture.

That is, it seems like nowhere else has the idea of purification through suffering really taken hold at such a widespread level for so long. I'd argue its because its just the flipside of the Prosperity Gospel. If you assume that one's physical conditions are a reflection of one's spiritual choices, then your first move when someone says "I'm in pain, please help me with my pain" is to ask "What have you done to deserve this pain? I won't remove God-given pain; if you deserve it, it would be a sin to do so", instead of "Here's something to make the pain manageable while we figure out how to remove the source of the pain".

> I'd argue its because its just the flipside of the Prosperity Gospel.

I loathe the prosperity gospel too, and never miss a chance to blame its preachers where I can. But in this case I think glorification of suffering can’t be blamed on them because suffering was also fetishized by mother Teresa.

It does seem to be a uniquely American problem though.

I don't disagree that others outside of the US have taken up the cause of the holiness of suffering. I'm arguing that only the US has taken it and injected it into every aspect of our culture, because we have taken the Prosperity Gospel and injected it into every aspect of our culture.

Scratchy robes for monks in certain orders has long been a thing all over the world. But successfully banning comfortable clothing for all, regardless of religiosity, is really more of an American thing.

I agree it's terrible and very American, but I don't think it's recent. There's a good bit in this Backstory podcast where they talk about how part of the shift to sleeping straight through the night (as opposed to the previous behavior of first and second sleep) was partly driven by puritan busybodies (from the temperance movement, I think?) who thought that it was virtuous to sleep a bare minimum or less: https://backstoryradio.org/shows/on-the-clock-4/

And that of course goes back to the Puritans around at America's founding, who were deeply opposed to anybody having fun or enjoying themselves: https://en.wikipedia.org/wiki/Puritans#Behavioral_regulation...

I also recall reading of Calvinists who came to American in the mid-1800s to be free of such things as vaccines and insurance, because they thought those things interfered with God's plan. A plan, apparently, wherein a lot of people suffered while others stood around and quietly gloated that they were god's favorites.

It's not religious - it's an overcorrection based on rampant over prescription of pain killers for years.

Yeah. This overcorrection happened in my country too. We saw what happened in the US and the result was doctors became more afraid of prescribing opioids even when in cases of acute pain where it's warranted. Fear of causing harm to patients due to risk of drug dependence.

And yet benzodiazepines are taken by vast amounts of people as if it was water.

It might be both. An over-correction made more likely in part due to religious beliefs.

Go to Europe and you don’t get pain medication unless you’re in the hospital.

Is that due to religiousness too?

> Go to Europe and you don’t get pain medication unless you’re in the hospital.

Where on Earth did you get this idea?

Go look at opioid prescriptions by country. Europe is way lower than the US. Plenty of anecdotes about how hard it is to get opioid prescriptions in Europe.

I'm not saying it's wrong, I'm just it's lower than the US, yet less religious, which pretty much blows up OP's thesis.

But you said "pain medication", many forms of which are sold OTC in Europe just like basically everywhere else. Now that you've narrowed it to "opioids", sure...

Opioids are only really safe to use in a hospital, by and large.

The exception seems to be fentanyl, which gets handed out to old ladies with dodgy hips who chug it like milk.

Huh? The country where you got Oxycotin for a headache only a decade ago doesn’t prescribe pain relief because of religion?

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Your friend isn't wrong. It's pretty much a direct blood vessel highway to the brain.

Hows that more direct than an injection?

Probably the ease and reliability of application.

Not everyone is easy to start an IV on, especially if it's hard for them to hold still (like if they're in so much pain that they're considering between IV drugs or a suppository).

Venous drain doesn't go to the liver, first. Absorption is very regular. Works on unconscious patients.

Better that pills in every way, except convenience.

Injection is still better.

It isn’t - but if you’re a tough stick, it’s preferable to getting a central line or an IO shot.

What's the reasoning? Instead of an IV? If I was in extreme pain, I would by default opt for an IV, which would be the fastest way to relieve it.

I guess I misspoke a bit in the original comment. Yea - in the hospital, they’ll just inject if possible; however, if a doctor is writing a prescription and you’re offered pills vs a suppository, take the suppository.

Was the footnote there when you wrote this comment?

>Most people consume ecstasy by mouth, but I’ve heard from many that anal ecstasy is a more satisfying experience.

I think the author was being a little facetious.

More like... fecetious

You know what the root word of facetious is?

It's not, but it should be.

> I had heard that there's a community of people who insufflate caffeine on Reddit

I'm curious if it even absorbs well via the sinuses. From experience with powdered caffeine (mixing with shampoo as a folk treatment for hair loss), it doesn't readily dissolve at room temperature water, though of course it dissolves just fine in hot water, which is why the standard quick extraction from coffee beans involves hot water (cold brew by contrast, involves long periods of steeping for a result that still has less caffeine)

Caffeine is only "sparingly" soluble in water (as opposed to "freely" soluble in boiling water).

Chemists have wonderful words to quantify the exact degree of solubility under various conditions: "sparingly soluble" means it generally takes 30-100ml of solvent to dissolve 1g of the material in question.

So, if you're hip to the quantity of caffeine in your beans (by, perhaps, grinding and boiling 100g and then analytically extracting the mass of relatively pure caffeine with something like DCM, followed by recrystallization in water maybe), you can figure out how much caffeine will be present in your cold brew based on the quantity of solvent.

> all the trouble and extreme stigma of injecting yourself

IM and subQ is surprisingly not much trouble, as long as you have a relatively pure dissolvable compound and safe solvent (various oils or bacteriostatic water) it takes like 2 minutes and $1.50 in supplies (a $0.25 syringe, two $0.25 needles, and a $1 PVDF/PETF 0.22um syringe filter). Not much more hassle than at-home insulin or TRT injections.

But definitely a huge stigma, and often the pharmacokinetics of IM/subQ administration aren't desirable for many drugs.

Snorting caffeine is one of the most comparable ways to realize that it's just as "safe" as cocaine.

What? You must be confounding route of administration with safety. Sure, oral administration is technically the safest because of first pass metabolism, but the choice of drug is a MUCH bigger safety factor. Snorting caffeine is much safer than snorting cocaine by every metric.

Milligram for milligram the pharmaceutical difference is mainly limited to the local anaesthetic effect not present in the caffeine.

Administration is just how you can figure it out for yourself at similar doses.

Go ahead and consume a gram or two of caffeine by any means and compare the stress on the heart and other organs, as well as personality.

Just because it's cheap, legal, and easily available doesn't mean it's safer by comparison.

Also since cocaine users generally consume recreational overdoses doesn't make either one any safer at any dose.

Plus think how many more addicts there are even at much less harmful doses.

Why do you think some of these hard-core caffeine addicts are injecting it anyway, plus handling it as well as they do. Definitely not recommended for anyone who hasn't already built up the tolerance addicts are known for.

Clean living pays off.

To go even more extreme, imagine if there were a nuclear war because somebody who was a little overly nervous pushed "the button".

What drug do you think would be detected if put to the test?

There's a footnote below on ecstasy

double bum drop

Didn’t realise caffeine was used IV in anesthesia. Apparently it speeds up awakening (which makes sense to me as a non-medic). https://theanesthesiaconsultant.com/2019/06/18/intravenous-c...

But the story in OP is that the patient received caffeine IV at the beginning of the surgery (inducing severe anxiety).

Does anyone know why you would do this?

I know people use a similar strategy for napping. Some people (not me) can fall asleep very fast so they down a coffee and go sleep for a nap...and then wake up super fresh 30 mins later

Combined the effect is stronger than each on its own. Caffeine takes ~15 minutes to work. Sadly no source handy but i once read that naps are most effective below 15 minutes. Above it is possible to enter deeper sleep states and wake up worse than before.

So when people talk about napping like this, do they ever actually "fall asleep"? I cannot possibly imagine falling asleep in 15m in the middle of my work day or whatever.

I don't fall asleep. But just lying in bed, eyes closed, sleepmask on and low Binaural Beats on the ears helps me when i feel a slump. When i set a timer to 12 minutes i usually feel the urge to get up after roughly ten minutes.

I've done this sort of caffeinated nap when I chugged a cup of coffee and passed out. It feels as bad as it sounds but it was effective.

I had caffeine in an IV before. I was going under for surgery, and the doctor asked are you a coffee drinker? I told him oh yes, I'm a huge coffee drinker.

When I woke up from the surgery, it was pretty weird. I was wide awake and alert very quickly. Never got a caffeine withdraw headache. It was awesome.

Epinephrine increases the strength of painkillers. That's why there's caffeine in Excedrin.

I thought the caffeine was there to restrict/narrow blood vessels which usually helps with migraines. Multi-purpose maybe?

AFAIK, I think it depends on where in the body, vasoconstriction in the head vasodilation for the rest of the body.

What does epinephrine have to do with caffeine?

Caffeine directly kickstarts the adrenal glands

Maybe for vasoconstriction.

Maybe someone put the wrong IV in?

Not mentioned in the article, but IV caffeine citrate is routinely used as a drip to support hypoventilating pre-term neonates.

Yes, my daughter (born several months prematurely) was given caffeine for a while. The nurses described it to me as "reminding her heart to keep beating and her lungs to keep working", since she was so premature that it wasn't something they were supposed to have to do without the mother's help yet.

My wife, who had gone through significant discomfort in order to cut off caffeine while pregnant (she was told otherwise the baby could be born already addicted to caffeine), was a bit exasperated when told that almost the first thing they did was give her daughter a caffeine IV. It was probably still the right thing for her to have done (so the caffeine IV had full affect), but I could sympathize with her position.

I was curious about the booty bumping of ecstasy comment.

https://goaskalice.columbia.edu/answered-questions/plugging-...

So, getting the downsides of coffee without the upsides of drinking it?

Ah yes the venerable tooth decay upside.

Coffee doesn't cause tooth decay. Sugar causes tooth decay. You can drink Coffee without sugar.

Not a dentist, but I think it's the acid that causes tooth decay. Microbes create the acid from dissolved sugar in your mouth.

The question is whether coffee is acidic enough to do damage even without the sugar.

Hey look something I’m relevant too as a dentist.

Tooth decay requires several parameters 1- bacteria 2- bacteria food source 3- acidic environment 4- time

We all have the bacteria but the other ones are somewhat controllable. What many people don’t account for is the 4th parameter of contact time. It would be better (for your teeth, not overall health) to rapidly drink several sodas than periodically sip one for several hours.

Decay typically only occurs in a pH environment of 5.5 or lower, otherwise the enamel is resistant to the acid. So the longer the pH is lower the more likely you will develop a cavity.

So... how bad is a black coffee I sip on for 30 min? Google says the PH is about 5. No

Also: it has definitely stained my teeth. Is there a way to remove the stains that doesn't weaken the enamel?

Adding milk to coffee will raise the pH to above 6.

You can try drinking coffee through a straw.

So the trick is to have basic teeth.

This comment made me chuckle. Thanks!

I believe the common theory is not the coffee acidity on its own, but the habits around it.

People often drink coffee slowly and without a straw, this leads to staining but not tooth decay. However the slow part contributes to the teeth not getting a chance to neutralize acidity normally. This gets worse when people then brush their teeth after their morning coffee to prevent bad breath, which the abrasiveness combined with the acid environment does cause havok.

Both of them can be avoided in a variety of ways, to reduce both staining and decay.

You can have your espresso standing up at the café's bar like an authentic southern European and avoid the problem? Sounds great! :D

Interesting. For a few years I was extremely bad about brushing my teeth. I wonder if not doing that is why my consumption of coffee, carbonated drinks, and sugary snacks/desserts did nothing to the teeth themselves other than maybe a little extra staining. The first dentist visit I had after that stretch of 3 years required nothing but a cleaning! (Of course it's still bad to not brush consistently because the plaque turns to tartar along the gums which causes them to recede)

Similar situation, he was surprised by how white they were too. I drink almost everything that isn't water through a straw and never swish it around. He said that's probably why the only reason he had to do any work was due to the very back edge of my teeth where even when drinking through a straw the liquid touches.

Tooth decay is inevitable unless ur eating meat with water as your diet.

Can confirm, did carnivore for 2 years and had very good teeth. Sill brushed twice a day but didn’t feel like I needed it.

Despite brushing twice a day and now only eating foods with some sugar, dentist agreed had better teeth on the meat and water diet.

I eat a varied diet and don't have tooth decay. I'm guessing I'm not the only one.

I recently had a nuclear stress test where they injected me with a radioactive tracer through an IV. The nurse told me that sometimes it can give you a pretty wicked headache and to let them know if I started having any pain and they would give me caffeine through my IV. I had needed to abstain from any caffeine for 24-48 hours ahead of the test so this was surprising to me - but luckily I didn't need it through the IV. But I really wondered what it would feel like...

I experience a chalky scent from high dose caffeine pills. I don’t think the taste is unique to the intravenous caffeine.

I've been trying to figure out if other people get this too! Finally I'm able to corroborate this. Never thought of it as chalky, to me it's indescribable in a way that one might attempt to approximate with such a word.

Not related to caffeine pills though, I get it from caffeine itself.

Are they pure or adulturated with calcium? Most of the caffeine pills I've spotted are not just caffeine and I think this is the chalkiness you would be experiencing.

They’re pure as far as I know. Would calcium be listed as an ingredient?

Yes should be on the box somewhere, they usually claim to add it to reduce bone loss. Example label: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=0dbca...

It’s very unlikely they’re pure caffeine. If it’s a pressed pill (versus a capsule) they’re definitely not. It needs binders to hold it together.

Gotcha, I take capsules. They’ve got rice powder to add volume I assume, but other than that I think it’s pure caffeine.

I found coffee drinking + mask wearing pretty cumbersome during the situation, and I was surprised they still make No-Doz. Seemed like something that would have been regulated away by now. Don't notice any chalkiness though.

Same, and on occasion I have had coffee do the same.

That's if I'm reading this correctly and you're describing the smell in your blood?

I assume so, either that or its neurological. Its like the scent comes from inside my head.

> Every drug seems to have a “right” way to take it. You drink alcohol, smoke tobacco, snort powdered cocaine, inject heroin, and booty bump ecstasy

Nicotine at least is probably more commonly consumed via alternative means now (in North America, in <40 demographics at the very least)

Vaping would likely be the most common, but there are also patches, gum, lozenges, dip, and snuff. I've never heard of anally consumed nicotine though

I've never heard of anally consumed nicotine thoug

Never heard of blowing smoke up someone's ass? It was literal in the 18th century.

Wow, I thought for sure that would turn out to be an urban legend, but it's real and was medical:

> ...it was a general mainstream medical procedure used to, among many other things, resuscitate people who were otherwise presumed dead. In fact, it was such a commonly used resuscitation method for drowning victims particularly... Smoke was blown up the rectum by inserting a tube. This tube was connected to a fumigator and a bellows which when compressed forced smoke into the rectum. Sometimes a more direct route to the lungs was taken by forcing the smoke into the nose and mouth, but most physicians felt the rectal method was more effective. The nicotine in the tobacco was thought to stimulate the heart to beat stronger and faster, thus encouraging respiration... Artificial respiration was used if the tobacco enema did not successfully revive them. [1]

So it's not like it was for fun. But I can see how for fast delivery of nicotine, it made perfect sense.

[1] https://gizmodo.com/blowing-smoke-up-your-ass-used-to-be-lit...

There’s also nasal spray and I think drinks in Japan. Snuff (nose) is big India I believe.

If you stretch out your hand and fingers and draw a line down from your index and thumb there’s the radial fossa aka “anatomical snuffbox.”

I’ve never done rectal or IV nicotine but I’ve done all the rest. For my money, the Swedes make the best smokeless tobacco. I’m guessing it’s big there?

IV drugs, not for the feint of heart. Even with a good technique you will eventually blow up your spot and need to go fishing, then it gets horrific.

I think this may be referring to this study: https://pubmed.ncbi.nlm.nih.gov/29206091/

"Effects of caffeine administration on sedation and respiratory parameters in patients recovering from anesthesia"

> Caffeine has been shown to enhance the speed of recovery from general anesthesia in murine models, though data in human patients is lacking. This is a retrospective review of intravenous caffeine administration (median dose 150 [125, 250] mg) to 151 heavily sedated patients in the post-anesthesia recovery area, to determine the association between caffeine administration and changes in sedation score, respiratory rate, and oxyhemoglobin saturation.

Migraine sufferer here. Been to the emergency room for bad headaches about 8 times. I get a cocktail of toroidal, benedryl, an caffeine by IV w a morphine chaser. Works.

A guy I know once suggested a wet suit and a caffeinated bath.

By the time you release you've had too much, you're not even halfway there.

As probably the only person on HN who has ever intentionally IV'd caffeine...I can confirm that it's not really that interesting. Just like regular caffeine, but slightly faster. Oral caffeine already absorbs pretty rapidly anyway.

Drugs work or not due to symbolic context; which is not obvious, but can be inferred, when they actually do stop working and there is no scientific explanation for that.

Sounds like one of these "cocktails": https://www.ivbars.com/cocktails

Coffee enemas are apparently an influencer thing right now.

Whenever I hear something like this my first thought is that it's some stupid TikTok "challenge" that's intended to get people to humiliate/injure themselves on camera for the lols.

Coffee enemas were a big thing in the 90s. The coffee is not hot (obviously). But you’d be correct to think there’s no benefit.

There was a show called “my weird addiction” or something similar. A young good looking couple would frequently take breaks to do coffee enemas. She likes “Java” or something, he preferred something else and more like espresso. I think they had a kid. Only episode I ever watched.

What a treat.

TLDR; participants with cocaine history were administered caffeine IV. At high doses (300mg) they reported some mild euphoria, and a strange taste and/or smell.

Ask HN: aside from caffeine, what is the drug of choice around here?

I’ve settled upon: Caffeine at work, alcohol not at work, molly to party with friends, weed to party on my own.

THC containing gummies, once a week, for music enhancement before bed.

Tangential details...

The 2018 hemp farm bill allows products to have up to 0.3% THC, but it took years for people to realize that gummies are hefty enough that 0.3% means a gummy can have 10-20mg of THC. So, at the ripe age of 57 I finally tried THC.

It was very frustrating because most of the good stuff I expected didn't happen: no euphoria, no munchies, no relaxation. I do get some of the negative things, like dry mouth. The one good thing I get is music enhancement, but only if I do it once a week or less (10-15mg). I've tried doing it more frequently and upping the dose to compensate, but nope: if I invoke the genie too frequently he refuses to come out of the bottle.

Is there anything other than THC in those gummies? Many of the effects might depend on non-THC cannabinoids. Also, for some reason, some effects happen upon smoking or vaping but not through edibles. There are various theories about why, but it's all very complicated.

Part of my experimentation was to try many different doses, just thc, thc + cbd in various ratios, ones claiming to have "live rosin" or whatnot.

I did finally try a real joint -- of course it hits much faster, but the lung irritation and health concerns weren't worth it.

I'm a bit jealous of people who have a great time. A guy in the band I'm in is 45 and has been a daily smoker for 30 years. He is highly functioning -- has a good job, has kids -- and can work while high. I guess he knows exactly his response and does enough to feel good but not enough to cause problems. He also has a really high tolerance.

Some people just don't have the brain chemistry for it, I suppose.

I'm kind of jealous of your friend. I've been a daily smoker before, and I'm usually able to like do simple tasks and such. But I just get too lazy and dysfunctional. And I feel dumber. Part of me is drawn to that because it's so much easier to be dumb. But I also depend on working memory to make a living and also for my favourite hobbies. Eventually I learned that the only thing that actually works is occasional use. I can't be completely abstinent because then I never actually learn moderation, and I just end up binging again. But if I know I can enjoy myself if I want to, I don't have to be constantly thinking "fuck I want some weed". And then when I do finally give in, there's this shame spiral about it that leads to binging. Whereas now I can just smoke if I feel like it, have a great night of sleep and go on with my life the next day.

Meh I think I’m done with THC. You’ll always find plenty of enthusiasm and love everywhere for it, but then I never really met or talked to a single person who didn’t eventually became conflicted about it and concluded the negatives far outweigh whatever you get out of it.

Thankfully it’s doesn’t cause any serious harm to you as far as drugs go.

I wonder though, about a 100 years ago, when weed was criminalised, it wasn’t just made illegal - people went out of their way to destroy and get rid of every single hemp plant they could find in nature. Across the whole globe no less. That’s quite a statement. Maybe that’s bound to happen again.

Nice to meet you. I've actually concluded(through experience) that heavy cannabis use has mainly downsides with no upsides, but that sporadic use only has upsides. I have several friends who feel the same way. They smoke even less than me, maybe a couple times a year. I've met some people who completely swore it off too.

Everything in moderation

Especially moderation :)

I’m surprised you do it before bed! I find that especially with edibles, using thc too close to bed makes me sleep deeply but wake up groggy. Typically I need an afternoon nap the next day. I believe thc fucks with REM.

Food is totally unchanged for you? Wild! What about movies/tv?

Yup, it isn't enhanced at all, and I don't get extra cravings.

Although I gone up to 25mg while I was experimenting to find a dose that works best for me, my target is 10mg. Maybe that isn't enough to trigger munchies.

Because the only thing I find it good for is music enhancement, I like to take a gummy around 9pm-10pm, then two hours later put on three albums with a particular kind of music, then hope that I get enhancement. If I'm feeling tired that day, though, I put it off because sucks to hit the sweet spot and then immediately fall asleep and not get to enjoy the music.

By enhancement, I mean I experience pronounced stereo separation and deeper notes seem to be very resonant. Sometimes I get little floaty and feel like I'm suspended in zero gravity while I drift to the music. Because I do it only once a week, I don't notice any disruption of my sleep.

EDIT: you asked about TV/movies. I don't watch them, so I don't know.

I get very little effect from weed unless I take a huge amount, in which case I also feel miserable with "too much" symptoms. It just doesn't seem to work for some people

Low dose dextro-amphetamine for ADHD in everyday life, weed for music and various other enjoyment, only occasionally. Alcohol and whatever nose-friendly stimulants are available for parties. Psychedelics at most annually(ideally 2C-B or (1p-)LSD, but I've tried a whole host of different ones) for deep contemplation and introspection.

Watching my brother destroy his life with Heroin has kept me away from opioids for the most part, but I don't like the way they make me feel anyway.

Opioids are no joke for sure. If you have good self discipline and can limit yourself to one every 2 to 3 days, it can be amazing and safe. But it makes you feel really good and many people don't have the self control required, so I recommend staying away. If you develop a physical dependence, it is not pleasant to say the least.

I mean I've tried opioids, but they make me nauseous. And tired. And i specifically avoided trying really strong ones because yeah, I know I wouldn't be able to handle it. It took years of suffering even to be able to control my cannabis use...

Caffeine pretty much every day, I can only have it in the mornings though or it interferes with sleep. Alcohol a few times a week, usually just one or two drinks. Now that i'm mid thirties the booze hits me much harder than before and hangovers are easy to get. Pot gummies on the weekend when I want to relax. I know quite a few heavy users who will smoke a couple joints then go do yardwork - crazy. If I have any i'm eating a heavy meal and playing video games. I sleep great with it. I started smoking cigars over the pandemic, only a couple times a month, you certainly get a nicotine buzz that is kind of nice. It is smelly though so I don't do it often and it's more for the ritual and relaxation than the buzz. Amyl nitrates for other recreation.

Wow writing that all out makes me look like a degenerate :)

AI hype

I doubt you'll get too many serious replies, but as a Canadian my DoC is cannabis.

Arrogance

That's the good stuff!

Successful debugging session euphoria.

LSD is my happy place -- and Adderall, but I've a prescription for that one!

Microdosing?

Running, hiking, lifting

Serious? I pre & post all of those + bicycling. Whammy, huge difference, especially if you leverage e.g. the caffeine for mental work, or whatever else each chemical is good at.

Had some funny experiments in there but would never go back to nothing. It doesn't make sense, especially if you don't have an addictive personality & any chemical risk is more likely associated with quitting beneficial chemicals than staying on them too long.

Personally, prescription medications are great: legal, consistent, safe, and effective.

Wellbutrin (NDRI) every morning. Helps with attention and alertness. It isn't classified as a stimulant, so I don't need to deal with the regulations around regular ADHD meds. It also helps with sexual dysfunction caused by other meds.

Benzos for social events. Way better than alcohol. All of the chill and none of the impairment. :)

Music. String ensembles are the best, choir is a close second. Rapid response, mild euphoria, no unpleasant side effects. Repeated exposure can induce fatigue, making it an excellent sleep aid.

Mushrooms

Methylphenidate

Caffeine, nicotine, thc and alcohol.

meth and adderall

> high doses (300mg)

What's the equivalent of a 300mg IV dose in oral ingestion?

Per article it's 4-5 shots of espresso. Apparently caffeine is absorbed quickly by the gut, so if you shoot it all down at once, you'd get similar results.

chocolate

Zungenwurst, can't get enough of it

web3 projects not working out; schadenfreude in general; the smell of my own farts.

Prescription amphetamines.

Adrenochrome

kratom.

Books.

ketamine

crypto laced with AI

you want to try some snowcrash...?

That stuff will mess you up, man.

open source utopia

benzodiazepines.

leverage.

Anecdote: someone told me she knew some nurses and they knew a quick way to get over hangovers. Quite illegal, but it involves IV.

Don't come at me: I'm not recommending this, I've never done it, and your nurse friends probably won't do it for you.

Edit: TIL it's not illegal. However, in a hospital I'm pretty sure the nurses aren't supposed to do it for free.

There are IV bars in Colorado so not all that illegal (doing at home: yeah a little different). You can get just a reg. IV, or vitamins - that sort of thing.

Being at a high altitude, hangovers suck up here, so there may be a market. I don't drink anymore - and it wasn't a hard decision. I haven't been down to sea level in a very long time, but drinking is completely different up here than down there.

Illegal where? This is a "show up to your hotel room" service you can get in Las Vegas.

It’s legal - I’ve stayed at hotels even in London where you can get a nurse administered IV of some bullshit in your room. I passed on that, and went with the time honoured method of a greasy fry and a pint.

The illegal part is if the nurse is stealing the IV and “works” from their workplace (a hospital).

In case people are wondering, you the IV injects a few hundred ml of saline, which most medical professionals would have access to. There were clubs that specialized in selling this to hungover people [1]. I wouldn't lightly risk sending myself into septic or hypervolemic shock but I know former EMTs who swear by it.

[1]: https://www.elle.com/beauty/health-fitness/advice/a14177/iv-...

what's the way? just rehydration drip? that's widely known and there's nothing illegal about it if you have the equipment

It's not illegal here. They advertise it in bar restrooms as a "hangover and extreme sports recovery" treatment.

https://hangoveriv.com/

Caffine pills are cheap af...

Reserach for cheaper drugs?

The Bum's Rush.