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Re: buprenorphine, legal issues » MB

Posted by Elizabeth on August 10, 2001, at 16:43:21

In reply to Re: buprenorphine, legal issues » Elizabeth, posted by MB on August 10, 2001, at 11:00:43

> This is totally true...getting on a maintenence program with anything other than methadone or one of it's longer acting derivatives is nearly impossable.

I think that's pretty bizarre. I mean, the clinics mainly use methadone and maybe LAAM, but is there some reason why they couldn't use something else?

> I knew a shrink that lost his job as the head of a methadone clinic becasue he was giving some of the patients codiene (it worked better for them than the methadone). Codeine is even scheduled lower than methadone.

Actually, pure codeine (with no Tylenol or aspirin or anything added) is Schedule II, the same as methadone. Of course, plain codeine is rarely used for anything.

> On the flip side, try to get a doctor to prescribe methadone for pain. Some of the more progressive docs might be willing to do it, but most will look at you like you're crazy.

That's true. Methadone is probably the single most carefully-watched controlled substance in the US.

> The pharmacy is likely to freak out on you too. It's as if they've divided opiates into two categories: those for addicts and those for pain.

As though the molecules could tell the difference!

> It amazes me that a doc could prescribe buprenorphine to a patient for depression but if the same doc prescribes it to an addict for maintenence, that doc could get slapped by the DEA.

I can sort of understand the twisted, sick reasoning here: addicts are deemed to be likely to abuse any drug that is prescribed to them, whereas a nonaddict who is depressed or has chronic pain can potentially be "trusted" with these drugs.

What I think is screwy is that psychiatrists claim to embrace the disease model of addiction, but they still treat addicts as though that "disease" is a moral failing.

> This country is so weird.

"Weird" isn't quite the word I'd choose, but yes.

-elizabeth


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