Posted by bsj on December 7, 2003, at 2:33:12
In reply to Re: Opioids for depression, posted by Viridis on December 7, 2003, at 1:32:52
"I'm thinking about how to broach this with my pdoc -- he's a very open-minded person and I expect will agree with my conclusions, yet he's also quite frank about what meds he can and cannot prescribe safely (from a legal perspective)."
It'll likely be a waste of your time. Even if a psychiatrist was willing to give you hydro for mood-improvement (and they all seem to be against this), if he did, the DEA would be down on him in no time. Opiates are not approved for psychiatric use. The DEA makes the medical decisions in this country, because doctors and the AMA lack testicles.
"The frustrating thing is that opioids are very safe when taken properly, and even if one does become dependent the health risks appear to be low."
Taken in reasonable doses, opiates are some of the safest drugs in the world. They've been with us for 200+ years, and we know all their longterm health effects; which are negligible (e.g., William Burroughs came off a lifetime of shooting street heroin with only a slightly weakened liver--and that could have been caused by his frequent drinking or adulterants in the heroin). The stigma against opiates is political, and can be traced back to the late 19th and early 20th centuries, when they were profoundly overused. Modern opiophobia is a knee-jerk reaction to this in the medical community; doctors have fallen pray to the fear just like ordinary people.
"...plus there's little money to be made"
Bingo. A monthly supply of hydro goes for about $25; a monthly supply of Wellbutrin or some other patent medicine for hundreds of dollars per month. Drug companies relentlessly peddle their cheap, third-grade psychotropics to the medical community. But many of these drugs later turn out to be unsafe or have unforeseen side-effects.
"I'm all for new developments in psychiatric drugs, but wish that there were some incentive for doctors and pharmaceutical companies to re-explore some of these older meds as well. It seems that once a new class of drugs gains patent status, the older, now-generic ones become taboo whether they're really inferior or not."
It's all about the Benjamins, and we suffer for it. I'd actually like to see a state-run medical industry in the U.S.; it works great in Europe and Canada. That would cut the profit motive.
poster:bsj
thread:952
URL: http://www.dr-bob.org/babble/20031202/msgs/287336.html