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Re: Reward Deficit Syndrome.

Posted by Elizabeth on May 16, 2001, at 19:04:00

In reply to Reward Deficit Syndrome. » Elizabeth, posted by JahL on May 15, 2001, at 17:27:26

> I'm not looking to take sides here but I've been a long-time observer of yr posts (since back in '99) and I've never seen anything wrong in yr opioid use, given the context in which you place it.

Thank you. It's nice to know that somebody out there thinks it's okay for me to take the drugs that my doctor prescribed! < g > I think context is important, too.

> What's caught my attn is this 'reward deficit syndrome'.

I wish I could remember where I first heard that expression. Looking into it, it appears the term is "reward deficiency syndrome." Here're a couple links (I'm sure a good search would turn up more):

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11105655&dopt=Abstract

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11280926&dopt=Abstract

There's another temperamental trait, "sensation seeking" (or "thrill seeking"), that also puts people at risk for substance abuse. Supposedly this is what separates the "tweakers" (people who prefer stimulants like cocaine and methamphetamine) from the addicts who specifically prefer opioids -- sensation seekers prefer the thrill and excitement of stimulants.

I think that sensation-seeking and RDS might be related but are not identical.

> Anhedonia & cognitive dysfunction characterise my 'depression'. I can honestly say (with the exception of brief SSRI-induced euthymia) I have never, ever, experienced pleasure. As young as 6 or 7 I wld openly express suicidal urges. Despite being suicidal I'm not so much depressed as emotionally desolate; I have this overwhelming 'craving' feeling, like something's missing.

That's what a lot of addicts say -- that they feel an emptiness or a void that can only be filled by heroin. This leads to self-medicating, which IMO is extremely dangerous.

> I guess my question to you is, does this ring any bells? Do the eternal anhedonia (like my mum, *zero* mood reactivity) & 'craving' sensation possibly signify anything to you?

Yeah, it sounds like the way heroin addicts describe the pain that they felt before they discovered dope. I sort of feel bad telling you that because if I were in your position, I'd be scared sh*tless. But it's the truth: your words are hauntingly familiar. Please take this warning seriously.

If you're in a country where outpatient buprenorphine maintenance is legal, I'd suggest trying to get that. It's pretty much impossible to get high on it so you're not at any risk there (you also can't kill yourself by ODing on it). Addicts don't particularly like buprenorphine, although it does show up on the black market sometimes because of its capacity for blocking withdrawal symptoms.

> *To anyone out there; I'm not looking for Elizabeth's tacit approval to take opioids.

My approval isn't worth much, seeing as I don't have a DEA license. < g >

> Just after her (what I consider to be) informed opinion on what I consider to be a viable treatment option for a *small subgroup* of depressives.

Yes, that's how I feel. I don't think that most people with depression (especially mild-moderate depression) need or should use opioids. (Aside from addiction issues, the side effects suck! Buprenorphine is supposed to have milder ones than heroin and other full agonists, too...I can't imagine anybody taking this stuff as some kind of joy ride.)

> & guess what? I've tried more meds than her (if that's possible).

Maybe we can compare lists sometime. < g >

> I'm not looking to get high. Been there, done that. Compared to shooting myself (the last option), *trialing* (*possibly*) opioids is a walk in the park.

There's no "good" way to kill yourself, but leaving a bloody mess for your loved ones (or even complete strangers) to discover seems like one of the worse ways.

Best wishes and hopes.

-elizabeth


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poster:Elizabeth thread:17065
URL: http://www.dr-bob.org/babble/20010515/msgs/63276.html