Posted by 4WD on January 31, 2009, at 2:04:40
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » 4WD, posted by SLS on January 29, 2009, at 7:08:03
Thanks for the info Scott. I am hoping they will put me on Subutex. I told them at my evaluation that I had been on Naltrexone before and it made me nauseated so maybe they will take that into consideration. I will know for sure Monday since that is when I will receive my script for the meds.
My pdoc is not the one who is prescribing the buprenorphine for me. What happened is a miracle from God. The family doctor who has been maintaining me on Percocet insisted I call my pdoc and tell him it was an emergency. I called him (and this just happened to be on a Thursday, the one day I can reach him for sure. He called me back right away (another miracle). I told him what was going on: that I was addicted to the pain meds and wanted desperately to get off them but couldn't because every time I tried to quit, the withdrawal caused suicidal depression. So he said he had someone in mind for me to see; the clinic where I see him is not licensed to prescribe buprenorphine. He called an addictionologist, Dr. Rick Beach. who he said was the best in the field and talked to him about me. My pdoc told Dr. Beach that I was highly motivated and a good candidate for treatment. Then my pdoc called me back and gave me his phone number and told me they were waiting for my call. I called and took the first available appt. which was only about 10 days away (I had been afraid I'd have to wait a month to get in). Then I attended a seminar about a week later and got some good information, although he talked a lot about chronic pain. (Most of the people he treats have become addicted to narcotics due to chronic pain. I have had chronic pain since I broke my back last summer but my pain is not that bad - addiction is my primary problem).
Well, I went for my appt. and was accepted as a candidate for treatment. It involves a lot more than just going once a month for the script for the meds. I have to drive an hour and 15 minutes each way on Mondays, Wednesdays and Fridays for a three hour group therapy session and I have to be there by 9. Which is difficult because I can't go to sleep before about 2 because of the narcotics I am taking. But I already see that the group therapy is benefiting me so I'm glad they are making me do it.
I will turn the script in to the pharmacy on Monday afternoon and they will order it that day. It should be there by Tuesday late or Wednesday. So I went back to my family doctor and he gave me a new set of scripts through Wednesday to maintain me until I can be sure I have the Subutex in my hand. I won't be able to start it until the day after I get it because I wake up in withdrawal every morning and can't wait without taking something for long enough for that day's pharmacy order to arrive.
So everything is all set. I get the script on Monday for sure and start taking the med on Thursday. It's possible I will have the med on Tuesday and could start Wednesday but like the typical addict, I don't think I will have the strength to not get that last prescription filled. I prayed tonight that God would give me the courage to cancel that last script if I had the Subutex earlier than Wednesday - I won't be able to do it myself.
I will keep you all posted on how the therapy goes. I was told they had to coordinate my current psychiatric meds with my pdoc and that's why I'm not getting the script til Monday. It scares me a little bit - what if they want to take me off something that I know I need to keep taking? Like Geodon or Xanax. Well, I will worry about that when and if it happens. As I said, I will keep y'all posted on how the treatment goes.
In the back of my mind, I am hoping it will feel just like Percocet but I think I am placing too high expectations on the bupe. I should be grateful if it does nothing more than get me clean without having to go through the despair of withdrawal. But supposedly it "tricks" the brain into producing more endorphins so I am hoping that it will relieve my depression and give me energy and motivation - exactly what the Percocet does for me.
Marsha
> After doing a wee bit of reading, I see that Subutex might be better-suited for your condition than Suboxone. Naloxone is added to the buprenorphine in Suboxone ONLY to prevent I.V. abuse. If administered I.V., the naloxone induces a withdrawal episode rather than a euphoriant effect.
>
> Buprenorphine is a partial agonist at mu and kappa opioid receptors and a full antagonist at delta receptors. I believe that it is the partial agonism at the mu receptor that places a ceiling on the perception of euphoria, unlike complete agonists like heroin. It doesn't appear that naloxone is necessary in non-I.V. opioid users.
>
> Although I'm feeling pretty good and probably won't need opioids for my treatment, I wish my doctor had been receptive to the idea of using buprenorphine when I presented it to him. You are very fortunate.
>
> I look forward to seeing how you respond to buprenorphine.
>
> Take care.
>
>
> - Scott
>
poster:4WD
thread:875814
URL: http://www.dr-bob.org/babble/20090104/msgs/877304.html