[Pseudoscience-is-malarkey (OP)]

I'm in an embarrassing, confusing and somewhat scary situation. I have a history of substance abuse- opiate based drugs are my favorite (I love the feeling they give me). But to "keep myself honest" I take naltrexone (not to be confused with naloxone, a drug used in reversing an opiate overdose), which blocks the effects of opiates and alcohol and works perfectly as long as the person takes their recommended dosage every day. So, knowing I will not receive the euphoric effects of opiate based drugs or alcohol, I obviously will not attempt to use them. I would have to wait two or three days for the drug to completely leave my system if I desired to get high or drunk.

The problem is that opiates are great at stopping pain and the protocol in hospitals and ambulances is to administer it when someone is in obvious pain. But what if the pain victim is unable to communicate, and the analgesics are not doing their job because the naltrexone in their system is blocking their effects?

[exothermic]

what if the pain victim is unable to communicate, and the analgesics are not doing their job because the naltrexone in their system is blocking their effects?

Naltrexone id card:

[RD]

... But what if the pain victim is unable to communicate ...

Bracelets / pendants / wallet-cards are available to quickly communicate medical information to doctors if the person is unconscious , e.g MedicAlert  , (other brands are available).

Q. Should I fear opiate blockers?

You should be concerned about opiate "abuse",  as it can be fatal.
People develop tolerance, increasing the dose to get the same effect , eventually leading to fatal doses : they stop breathing ... https://en.wikipedia.org/wiki/%CE%9C-opioid_receptor#Tolerance_and_overdoses

... opiate based drugs or alcohol...

There is synergistic effect if alcohol & opiates are combined ... http://www.ncbi.nlm.nih.gov/pubmed/2821747

[chiralSPO]

Firstly, kudos to "keeping yourself honest!" I know that rising above substance abuse is very difficult, even with help--keep it up! :-)

If you are really worried about being incapacitated and unable to communicate when in pain, you might want to get a "medical alert" bracelet or necklace (https://en.wikipedia.org/wiki/Medical_identification_tag). First responders and hospital staff are trained to look for these when treating unconscious or incapacitated patients. You wear it with the medical information "in" or covered, for your privacy, but if somebody needs to know they can easily check. Presumably you can find one or have one made that addresses your particular situation, and they can choose analgesics that are not blocked by naltrexone. If you go this route, you may as well add vital information such as blood type and any severe allergies etc.

Good luck, and stay strong!

EDIT: I see my answer collided with two others...

[chris]

I take naltrexone (not to be confused with naloxone, a drug, when used intravenously is the fastest way to strip opiates from the system, reversing an overdose)

Just to be clear, both of these agents (naloxone and naltrexone) are opiate antagonists and both will block the same receptors to prevent opioid effects, including reversing overdoses. The difference between them is in the duration of effect. Naloxone is shorter acting and useful for acute overdose in emergency settings. Owing to its longer half life, naltrexone is helpful for long-term prevention of opioid use such as in depot preparations.

[Pseudoscience-is-malarkey (OP)]

There is synergistic effect if alcohol & opiates are combined ... http://www.ncbi.nlm.nih.gov/pubmed/2821747
[/quote]

There is also a death effect if alcohol and opiates are combined.

[PmbPhy]

First, I don't understand why your position is embarrassing. If its because you were addicted to opiates then consider that being addicted is like having a disease. It's not as if you have full control of your actions, regardless of what others might suggest to you about "will power." I myself take opiates for chronic pain. Without them I'd be in intolerable pain. The pain would be so great that I wouldn't want to live. There's something that has happened to me that may happen to everyone. Right now I take 40 mg of oxycontin twice a day. This pain killer doesn't give me any sense of euphoria whatsoever. And I also have 30 mg tablets of oxycodone which I'm allowed to take three at a time, twice a day. And that's 90 mg of oxycodone in one shot! But I still don't get any euphoria. Therefore there's no reason for me to abuse them. I've been on these medications on and off for ten years now. You really need to find a compassionate and brave doctor to have your pain properly treated. I tried everything else and nothing worked. My previous doctors wouldn't prescribe narcotics so I lived a nightmare for close to ten years. But now I'm doing okay and living somewhat of a normal life thanks to narcotics! They really get a bad rap.

I myself keep a list of all the medications that I'm currently on in my wallet. I think that everyone should do that. Usually hospitals identify patients and I assume that if the patient is unconscious and doesn't have information on them about their meds then the hospital would then try to contact their doctor to find out. So it'd be a good idea to keep information about your doctor in your wallet too.

[Pseudoscience-is-malarkey (OP)]

First, I don't understand why your position is embarrassing. If its because you were addicted to opiates then consider that being addicted is like having a disease. It's not as if you have full control of your actions, regardless of what others might suggest to you about "will power."

I take full ownership of my "disease".  I am against it being classified as a disease because it suggests that I myself am a victim to it the same way someone with cancer or ALS  is a victim to their diseases. Addiction does not meet the internationally accepted definition of "disaese". Someone with cancer or ALS or hydrocephalus, cannot defeat their diseases with willpower. My drugs problems were really just me being too self indulgent, chasing good feelings no matter who gets hurt in the process.