Posted by Elizabeth on February 15, 2002, at 21:40:59
In reply to Re: opioid stuff and dealing with doctors » Elizabeth, posted by shelliR on February 15, 2002, at 13:04:37
> Hi Elizabeth. Sorry to have been so hard on you; I'm just feeling very very depressed and very frustrated.
Of course -- I understand.
> The reason I would say that I was addicted to oxycontin was that I continued to have to raise my dose to get ANY anti-depressant effect.
I'm not a huge fan of the DSM, but I think that they did a fairly good job defining addiction. Tolerance is neither necessary nor sufficient. Here's a link to the diagnostic criteria (in DSM-IV, it's given the confusing name "substance dependence"): http://www.behavenet.com/capsules/disorders/subdep.htm
You've already said that your oxycodone use satisfied criteria 1 (tolerance) and 2 (withdrawal). What about the other criteria? (Note that it wouldn't be accurate to say that you had "oxycodone dependence" since you didn't take it for the required 12 months, or even close to it.)
> And I had gotten myself up to a $1000 a month habit.
OxyContin is *very* expensive. I've heard that the maker of NuMorphan (oxymorphone) is trying to get a sustained release formulation of oxymorphone approved. That might give OxyContin some real competition (MS Contin is made by the same company, and methadone, a naturally long-acting opioid, is not prescribed much for pain, probably because it's so closely scrutinized by the government, even compared to other "narcotics").
> There are several suits against the manufacturers of oxy for touting its appropriateness for arthritis, etc. and getting people addicted to it.
Those people (the ones claiming to be "addicted") don't know what addiction is. Anyway, I don't see grounds for a lawsuit. OxyContin is labelled for "moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time," and the monograph makes it clear that using it regularly will lead to tolerance and that it has high abuse potential (among other things). I think that the people who are trying to sue Purdue were well aware of these risks when they started taking OxyContin. I have a hard time imagining a scenario in which the drug company would be at fault if a patient had a hard time getting off the drug or misused it and became addicted. The fact that someone has sued a company doesn't tell us whether the company has done anything wrong.
> When I got taken off of it in the hospital, I think I would have robbed someone if I thought they had oxycontin, or any opiate. I went from oxy to methodone and they were supposed to detox me with bupe but it did nothing.
That's awful. They obviously weren't giving you a high enough dose. I think that buprenorphine has a lot of potential to be very useful for people who have trouble discontinuing full agonists, since it seldom causes nasty withdrawal symptoms.
> I was in horrible pain. A guy who is part of some methodone maintentance program told me that one should never ever use buprenorphine right after methodone--that it will make withdrawal worse.
That's a possible risk because of buprenorphine's mixed agonist/antagonist activity, but I've talked to a lot of people who've used buprenorphine to get off of full agonists and I've never encountered anyone who found that buprenorphine made the withdrawal symptoms worse. My impression is that buprenorphine only acts as an antagonist at very high concentrations.
I'm glad you got through the experience. That's terrible that the people in the hospital let you suffer like that -- IMHO, that should never happen. Yet hospitals regularly force people to detox too fast. The system is very broken. *sigh*
-elizabeth
poster:Elizabeth
thread:93100
URL: http://www.dr-bob.org/babble/20020215/msgs/94345.html