Posted by Rudiger on November 9, 2001, at 2:40:58
In reply to Elizabeth - Need Buprenorpine Help, posted by JeffH on November 7, 2001, at 16:27:22
I truly sympathize with your situation, and not just because I find myself in the same one. Unfortunately, I'm quickly coming to the conclusion that virtually every pdoc would rather lose a limb (or two) before they would even consider prescribing what they ignorantly assume to be little more than a gateway drug to heroin. (These are supposed to be rational scientists?)
I'm discovering that most pdocs' practice of medicine is influenced much more by self-interest and paranoid fear (fear of litigation and the DEA) than it is by consideration of the well-being of their patients. The fear of litigation is why many, if not most, psychiatrists refuse to prescribe MAOI's, and some even do all they can to avoid prescribing tricyclics. If treatment-refractory patients don't respond to their limited arsenal of meds, well, that's unfortunate, but there's not much that can be done. "Maybe you should try ECT," is the standard refrain.
And if you don't bring up the option of buprenorphine yourself it's a pretty safe bet that your pdoc won't either. But if you do bring it up, you are usually rewarded with some suspicious looks and are almost immediately suspected of being a "drug-seeker." A rather lovely Catch-22.
It should be acknowledged that by not offering the full option of all reasonable and literature-based treatment options to their desperately-ill patients, physicians, in effect, are saying that suicide is preferable to trying these "evil" medications.
I am beginning to fear that Elizabeth is one of the very few that will ever get a chance see if buprenorphine can give them back their lives. Don't get me wrong, I'm very happy for Elizabeth, but the pain, misery and death of nameless thousands of others, whose only sin is that they had the temerity to fail to respond to what they should have, is a real tragedy.
> I talked to a few docs, including one that Dr. Bodkin recommended. However, all are either not taking any referrals or don't dab in opioids.
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> It's a bit frustrating. One might think that the only ones who believe that drugs such as buprenorphine are worthy are researchers who don't see patients. I also don't care to be lectured by doctors who are flat-out against opioids without being fully-educated about their uses with some hard-core depressives.
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> What about your doc? Would he/she be willing to do a consult with my doctor in New Mexico? (I really don't mind the travel.) If you want, could you let me know how my family doc or myself could try to set something up?
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> Thanks again, Jeff
poster:Rudiger
thread:83458
URL: http://www.dr-bob.org/babble/20011104/msgs/83635.html