Posted by v on September 18, 2001, at 17:11:02
In reply to Re: in case of an accident... LONG...LONG » v, posted by Elizabeth on September 17, 2001, at 9:22:57
> I don't know. Let me ask my in-house consultant < g > when he comes home. Opioids, of course, have effects on dopamine, thought to be linked to the observable behavioural reinforcement that makes them so hard to stay off for people (and other animals) who've been addicted. In animals, acute administration elevates extracellular dopamine levels in the nucleus accumbens (NA) (an effect also associated with stimulant administration). Increased firing rates of dopamine neurons in the NA and the ventral tegmental area (VTA) are associated with activation of opioid receptors in these areas.
>
> (Of note, pharmacologic or "physical" dependence is not necessary for behavioural reinforcement to occur.)please bear with me if i ask dumb questions as i am MUCH more ignorant than you about the scientific stuff but is it possible for the domanine levels to top out - i don't know if i'm explaining myself clearly as i am sooo out of my depth here, also i don't really know if it's the ritalin... it just felt like it might be related... it could also be the wellbutrin - doesn't that also affect dopamine? Probably it could be that since i feel some stimulation from the ritalin, i just don't feel the effects of the painkillers as much and that's what leads me to believe they are not working as well.
and as i found out yesterday from my doctor, i take hydrocodone... she just freaked out when i asked her for opiad painkillers, and when i mentioned having used lortab in the past, she asked me why i was asking for opiads when i was talking about hyrocodone which she doesn't mind prescribing. so am i talking about 2 totally different things here or are we talking different composites? - hydrocodone having other stuff in it and obviously being a weaker version
> > i really don't know much about this stuff... but i have a VERY low threshold for pain, probably due to the pain in my past, the traumas and the depression itself
> That's interesting. I'm very curious to learn what my pharmacologist friend will have to say about this.i'm really curious to hear what she/he will say about it...
> The key difference between the "physiological dependence" caused by these drugs and "substance dependence" as defined in DSM-IV is drug cravings. Do you have cravings for Effexor or Klonopin (similar to cravings for food when you're really hungry)?> > the dictionary definiton of addiction is: compulsive physiological need for a habit forming drug
> That's silly. Pharmacologic dependence isn't a result of psychopathology -- it's a normal, expected response to chronic drug administration. Most people who take opioids, stimulants, alcohol, etc. do not become addicated. Use of stimulants in the treatment of childhood ADHD is associated with a *decreased* risk of later substance abuse, in fact.
>
> > i'd say anything that causes withdrawal symptoms when removed fits the definition...
>
> That depends how broadly you define "withdrawal symptoms." Lots of drugs -- including plenty that aren't even psychoactive -- cause specific withdrawal symptoms (e.g., antihypertensive drugs often cause rebound hypertension if they're discontinued too fast). Only the "drugs of abuse," for want of a better term, cause "cravings" and drug-seeking behaviour, which are *not* specific effects associated with any particular mechanism of drug action (that is, they're caused by a wide variety of drugs with a variety of mechanims).
>
> > their "definition" or rather their distortion of the definition is self-serving and is the very reason it is so hard for people to often get the drugs they need... substance use and substance abuse are such different things.
>
> And so are pharmacologic dependence and addiction. Don't conflate them.well, i think we'll have to agree to disagree here... as the definition existed way before the DSM-IV started using it to decribe abuse... i think we're up against the connotation of a term and the denotation of the term... personally i think there should be classifications of addiction, ranging from the dictionary's version (what you call pharmacologic dependence), then on to describe the many levels of abuse. i recently read an article that stated that there were alot of people (many of them elderly) who refused painkillers because they were afraid of becoming "addicted". i think we need to de-stigmatize the damn word & see it for what it is, as well as what it can become... many more people stand a chance of being helped by drugs that were initially made to serve a purpose - to help with pain. and it's just possible that by making the concept more understandable, people like us would have an easier time getting the help we're asking for
> > this is a bit of a problem for me particularly as my personality is so fragmented, he right is some ways but not in all... my add actually seems worse lately
>
> How do you mean that when you say your personality is fragmented?i have did - dissociative identity disorder - meaning that there are alot of me's in here...there being a huge continuum in the disorder - i'm not full blown multiple - my personality is broken into many subpersonalities - some have names, some remain hidden, many talk at once and i don't know if i actually have a core personality or if we're just run by a bunch of us... different ones at different times. it makes some things funny... i'll read a book and not remember anything about it... i've bought books i already have in my library. my partner has to constantly tell me "we've already seen it" when looking at movie videos - i've even accused him of just telling me that when he isn't interested in seeing something since i wouldn't know the difference, but he swears he doesn't... i often won't remember ever being somewhere before... i don't remember alot of things in the past, which drives some of my friends crazy.. but do remember alot too....although what i remember can change depending on who was present... i do have many, many memories, although very little re: my childhood. a new personality emerged when i recently changed all my meds - new to me, mind you... not new to life inside me, but it was weird for me and alittle scary. they hold the memories i couldn't at the time deal with... and i suppose the "splitting" is what kept me alive at one time. survival tactics take all forms... i'm back in therapy trying to get feel what i must, what they know... i dissociate very easily... sit perched in my mind. it's hard for me to really cry... i did, however, cry hysterically last tuesday due to human capacity for cruelty and evil. i find life here very difficult... with dailiness being the hardest... living does not come easily to me...obviously. and integration is of no interest to me... there are alot of things i enjoy about us... we sometimes have alot of fun together and i feel alot of love for some of the children i know. now if we can just learn to live! as well, as it is probably obvious, i also suffer from ptsd.
> No, Wellbutrin really decreases appetite. SSRIs don't necessarily, and I don't think they would be a great treatment for binge-eating. Wellbutrin (which is related to a marketed diet pill, Tenuate (diethylpropion), BTW) might even help long-term. It just occurred to me, though, that based on a single, possibly skewed study, there's a warning in the labelling and Wellbutrin isn't "supposed" to be used in treating *any* eating disorder. An alarmingly high percentage of bulimic patients (4/55, or about 7%) given WB in the study in question had seizures. Somehow, based solely on this single result, it was concluded that bulimics (and by extension all eating disorder patients!) are more susceptible to the seizure threshold-lowering effects than are non-eating-disordered people.
i wasn't suggesting that ssri's would help with weight loss, particularly as they so often cause weight gain.. what i did mean what that most compulsive overeaters need more than a diet pill to make themselves well... let's face it, if diet pills worked, americans wouldn't be continuing to become more and more obese. btw, i was on wellbutrin before - by itself - and it had absolutely no noticeable effect on my appetite... i do however remember tenuate; it was a mild diet pill and it did decrease my appetite
> > BTW, is there anything that can be done to help with the short term memory loss, word finding difficulty - even spelling! and general stupidity that seems to accompany these drugs? it frustrates the hell out me...
>
> Umm...Aricept? Amisulpride? I dunno, this is a common problem with antidepressants but there hasn't been much research into what causes it or how it can be alleviated.
that's something i'll look into...btw, i don't want you to feel you have to continue this exchange... i have, however, enjoyed conversing with you immensely, as i think of you as one of the most "knowledgable" people on this board. i recently listed the things that were sorely missing in my life and conversation was one of them... i live in an area where there isn't much to say to people who don't understand, nor want to... it's rather backwards here, to say the least, but it is beautiful. my conversations with you has been a blessing
so i have thoroughly enjoyed this exchange and would be interested in probably anything you had to say... and i've appreciated the time you've given me as well, so i thank you for that
i hope i get to know you better
blessings,
v
poster:v
thread:76946
URL: http://www.dr-bob.org/babble/20010917/msgs/79016.html