Posted by Chairman_MAO on May 7, 2005, at 12:42:04
In reply to Re: Best Opioids for social fear? - Experiences, posted by Declan on May 7, 2005, at 1:55:54
Methadone is a full mu (and I believe delta and kappa, too) agonist. Buprenorphine is a partial mu agonist and a kappa antagonist. Kappa stimulation can cause dysphoria other undesirable effects.
Honestly, at 1.25mg methadone, you really should just bite the bullet and try to switch to buprenorphine. 16-24mg/day of buprenorphine, IIRC, has been shown to be just as effective (not necessarily equipotent, but because of bupe's action and consequent longer-term effect on the receptors, I'm not sure you can make such an absolute potency comparison casually) as 90mg of methadone as keeping addicts in treatment ...
The main difference is methadone "feels" like an opioid--you get that "warmth", etc. Buprenorphine, after a while, feels like I'm taking nothing, except for the profound relief from dysthymia I Experience, heh.
Notwithdstanding the fact that such "treatment" is really just a government-sanctioned recapitulation of the drug dealer on the corner schema ...OK, I'll try to get off the soapbox before I start, but the fact that it is easier to cop heroin than get buprenorphine gets me really irate. I was initially refused a Suboxone prescription because I didn't test positive for opioids. It was only after I gave the doctor my signed treatment history and an affadavit from my girlfriend stating I have had addiction problems and psychiatric problems that the doc I get my bupe from was willing to prescribe. My shrink's supervisor at the clinic I go to actually is licensed to Rx bupe, but he had reached the government's arbitrary 30 patient prescribing limit, so I had to go to a methadone clinic to get it! I have to play it off like the reason I want to stay on "maintenance" is due to cravings/not wanting to "use", but honestly the main reason is that it treats my dysthymia and thus I don't have cravings or want to hurt myself!
It's like they truly want to keep the people that need opioids as miserable as possible. I am done complaining about the clinic, though, because spiritually I am so grateful to have this medication I don't care what I have to do to get it. At least I have it.
poster:Chairman_MAO
thread:491659
URL: http://www.dr-bob.org/babble/20050504/msgs/494867.html