![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 81 to 105 of 170. Go back in thread:
Posted by Elizabeth on May 15, 2001, at 9:39:31
In reply to Re: Methadone » Elizabeth, posted by NikkiT2 on May 15, 2001, at 9:13:19
> I can assure you Cocaine withdrawal is *nothing* like withdrawal from effexor!!!
>
> You seemt ot hink Methadone and Effexor should be treated equally, thats what I find so hard.I don't think that at all, and I trust you about cocaine withdrawal. I was simply pointing out the absurdity of your proposed definition.
> Brain not working right today, so will leave the rest for alter!! :o)
Alter? Oh my, are we dealing with one of those multiple personality thingies here? :-)
peace,
-elizabeth
Posted by Elizabeth on May 15, 2001, at 10:13:43
In reply to Re: Methadone - ps » Elizabeth, posted by NikkiT2 on May 15, 2001, at 9:14:56
> Oh, and so if Effexor is as bad as Metadone, why is Methadone sold on the "black amrket", yet effexor isn't??
Actually I compared Effexor to cocaine, not methadone. (Personally, I never experienced Effexor w/d symptoms. But I did have the delightful experience of Nardil withdrawal. It's rather like simultaneously withdrawing from Xanax and amphetamine.)
Anyway, as I said above, I was pointing out an absurdity, not making a serious claim. I agree with you that Effexor doesn't make you high (except perhaps if you switch to hypomania on it < g >) and that methadone can. But I don't agree that the law should be used to make medical judgments. Ideally the law regarding the practise of medicine should be minimal (politicians, few of whom have any medical knowledge to speak of, should stay out of the doctor's office) and should be based on scientific and medical facts. But all too often, it's not.
> Cos Effexor doesn't give you a high... You say Methdone doesn't, but it does, else you wouldn't feel better for it.
Once again, *I never said methadone can't cause a high*. Perhaps you are confusing me with someone else. There was someone who posted that, and I actually *corrected* that person's misperception. People can get high on methadone, although people on MMT are taking exactly the right dose to match their tolerance, so they don't get high on what they're taking. Whole different kettle of fish, and the source of the myth that methadone doesn't produce a high.
> I just believe, that by taking a drug like methadone, Vicodin etc, you are simply "Putting" off the pain..
Okay, finally we're getting to your beliefs. That's a good start.
So, can you explain what you mean by that -- how is that different from "putting off the pain" by taking Prozac or Effexor or Nardil or imipramine?
I do think that buprenorphine should be tried before you reach for the heavier stuff (full agonists). *If* buprenorphine doesn't work, the next thing I would probably try would be Ultram (unless I was taking monoaminergic ADs with it), then either methadone, MS Contin, OxyContin (slow-release oxycodone), or Duragesic (the fentanyl patch -- this is the longest-lasting and has the most favourable side effect profile of these four). Long-lasting drugs or slow-release preparations are preferable because they don't cause the ups and downs throughout the day that you get from short-acting drugs.
I also really wish that buprenorphine was available in a metred-dose inhaler (a la Stadol NS), because it is absorbed through that route (although you have to lie down with your head tilted back for several minutes in order to get it to absorb!).
The fact is, I'm functioning better on buprenorphine than I have on *any* of the dozens of monoaminergic ADs and other types of drugs that focus on monoamines (stimulants, neuroleptics, etc.), as well as various mood stabilisers and so forth (I gave the complete list somewhere in response to SalArmy4me's claim that people who are trying opioids really haven't tried all the reasonable options).
I can't think of any reason to suppose that monoaminergic systems are the only ones that can break down. People who don't respond to monoaminergic ADs (including amphetamine, etc.) should have the opportunity to take something that actually works. To deny us that is nothing short of immoral. (My mother -- a professional bioethicist, as well as someone who has seen the positive effects that buprenorphine has had on me -- agrees. FWIW.)
-elizabeth
Posted by Dr. Bob on May 15, 2001, at 13:09:22
In reply to Re: Methadone » NikkiT2, posted by Elizabeth on May 15, 2001, at 9:39:31
> I was simply pointing out the absurdity of your proposed definition.
Thanks for keeping your cool during all this, but please be careful with words like "absurdity" that could be taken pejoratively...
Bob
PS: Follow-ups regarding civility should continue to be redirected to Psycho-Babble Administration.
Posted by dougb on May 15, 2001, at 16:52:21
In reply to Re: Methadone, Propoxyphene and APAP » dougb, posted by Elizabeth on May 15, 2001, at 7:24:16
Thanks Elizabeth,
you learn something evry day...> But it has ibuprofen added; excessive amounts can cause GI bleeding. Very serious.
Once you take away the apap or ibuprofen, the drug is reclassified as a Schedule II narcotic, go figure; they take away toxicity and re-categorize it as more dangerous.
I have this (perhaps?) slightly paranoid theory that "they" are really concerned about certain drugs because of the potential effect on citizens wholehearted participation as good drones and consumers....
During the 60's-70's with all of it's preoccupation with pot, etc. The predominant mind-set amoung that group was questioning of authority and questioning of the desirabilty of one's participation in the 'american dream' etc etc.
Posted by JahL on May 15, 2001, at 17:27:26
In reply to of course it's real » Nichole, posted by Elizabeth on May 15, 2001, at 8:47:05
> > There's a definite risk of that in people who have "reward deficit syndrome." This is a form of depression with significant anhedonia which is hypothesised to result from a dysfunction in the opioidergic system (since opioids are effective, it's unlikely to be due to the same morphological changes -- decreases in receptor-effector coupling -- that occur in opioid addicts). This is, IMHO, all the more reason to provide these people with appropriate medical treatment. The effects of addiction can be devastating -- particularly in countries like the US that have draconian anti-drug laws and cultural attitudes, and that choose to spend their money on law enforcement rather than on harm reduction and medical treatment.Hi Elizabeth.
I'm not looking to take sides here but I've been a long-time observer of yr posts (since back in '99) and I've never seen anything wrong in yr opioid use, given the context in which you place it.
What's caught my attn is this 'reward deficit syndrome'. Anhedonia & cognitive dysfunction characterise my 'depression'. I can honestly say (with the exception of brief SSRI-induced euthymia) I have never, ever, experienced pleasure. As young as 6 or 7 I wld openly express suicidal urges. Despite being suicidal I'm not so much depressed as emotionally desolate; I have this overwhelming 'craving' feeling, like something's missing.
I have been a heavy 'substance-(ab)user' (self-medicator) in the past but *never* had *any* addiction probs. Gave up a 30 unit a day binge-drinking habit overnight. Piece of p*ss. The only drugs I've never tried are the opiates-always felt I'd like them too much.
I guess my question to you is, does this ring any bells? Do the eternal anhedonia (like my mum, *zero* mood reactivity) & 'craving' sensation possibly signify anything to you?
*To anyone out there; I'm not looking for Elizabeth's tacit approval to take opioids. Just after her (what I consider to be) informed opinion on what I consider to be a viable treatment option for a *small subgroup* of depressives. & guess what? I've tried more meds than her (if that's possible). I'm not looking to get high. Been there, done that. Compared to shooting myself (the last option), *trialing* (*possibly*) opioids is a walk in the park.
Thanx for any help E,
J.
(DISCLAIMER: opioids can be habit forming & addictive etc etc)
Posted by JahL on May 15, 2001, at 17:42:54
In reply to Re: Methadone, Propoxyphene and APAP » Elizabeth, posted by dougb on May 15, 2001, at 16:52:21
> > I have this (perhaps?) slightly paranoid theory that "they" are really concerned about certain drugs because of the potential effect on citizens wholehearted participation as good drones and consumers....Hi Doug.
Paranoid? Have you ever heard any Bill Hicks stuff? Please tell me you have.
> > During the 60's-70's with all of it's preoccupation with pot, etc. The predominant mind-set amoung that group was questioning of authority and questioning of the desirabilty of one's participation in the 'american dream' etc etc.Exactly. What do you think, say Bilderberg think of 'mind-broadening' drugs.
Cocaine is not a particularly pleasant drug (going by what I've seen) but it *should not* be class A in the UK (class A comprises 'hard drugs' ie everything bar pot & speed (which I consider to be far more damaging to the user than Cocaine, but I guess it makes people *more productive* ;-) ), when speed is not.
Paranoid? :-)
J.
Posted by Ann NY on May 15, 2001, at 18:34:30
In reply to Reward Deficit Syndrome. » Elizabeth, posted by JahL on May 15, 2001, at 17:27:26
J.
Your situation sounds so sad, I'm sorry you feel so empty (?). You've never been happy? How old are you? I hope you fall head-over-heels in love soon. That's always a good six week high. Do you trust people? (pls. ignore all if too invasive)
In addition to brain chemistry, it sounds like your psyche is crying out for help. If your Mom has similar problems, maybe she wasn't capable of giving you - a child - the essentials, love, intimacy, affection and all reliably so. Did your family know you were suicidal at 6 years old?
You may want to read some books by John Bradshaw. He has some interesting views and he's an easy read. I don't agree with everything, but he has helped both me and my sister understand ourselves much better which is a good spring board to recovery and happiness.
I too never took hard drugs because I was afraid I'd like them too much. Try to stick with your good instincts for awhile longer. Yes, opiates and cocaine were anti-depressants in pre-1900's Europe and China, but lots of Chinese women would commit suicide by overdosing on opium. I know you're desperate but it may not be the best alternative for you while you're feeling suicidal.
Please don't despair. If you shoot yourself acute procrastinators like myself won't be able to read your posts (instead of writing a term paper). I've had those thoughts too but the future does bring hope.
Hope you'll be feeling better! Hang in there – and keep us posted!
Ann> Hi Elizabeth.
>
> I'm not looking to take sides here but I've been a long-time observer of yr posts (since back in '99) and I've never seen anything wrong in yr opioid use, given the context in which you place it.
>
> What's caught my attn is this 'reward deficit syndrome'. Anhedonia & cognitive dysfunction characterise my 'depression'. I can honestly say (with the exception of brief SSRI-induced euthymia) I have never, ever, experienced pleasure. As young as 6 or 7 I wld openly express suicidal urges. Despite being suicidal I'm not so much depressed as emotionally desolate; I have this overwhelming 'craving' feeling, like something's missing.
>
> I have been a heavy 'substance-(ab)user' (self-medicator) in the past but *never* had *any* addiction probs. Gave up a 30 unit a day binge-drinking habit overnight. Piece of p*ss. The only drugs I've never tried are the opiates-always felt I'd like them too much.
>
> I guess my question to you is, does this ring any bells? Do the eternal anhedonia (like my mum, *zero* mood reactivity) & 'craving' sensation possibly signify anything to you?
>
> *To anyone out there; I'm not looking for Elizabeth's tacit approval to take opioids. Just after her (what I consider to be) informed opinion on what I consider to be a viable treatment option for a *small subgroup* of depressives. & guess what? I've tried more meds than her (if that's possible). I'm not looking to get high. Been there, done that. Compared to shooting myself (the last option), *trialing* (*possibly*) opioids is a walk in the park.
>
> Thanx for any help E,
> J.
> (DISCLAIMER: opioids can be habit forming & addictive etc etc)
Posted by JahL on May 15, 2001, at 19:47:48
In reply to Re: Reward Deficit Syndrome. » JahL, posted by Ann NY on May 15, 2001, at 18:34:30
> > J.
> > Your situation sounds so sad, I'm sorry you feel so empty (?). You've never been happy? How old are you?
Mid-twenties.
> >I hope you fall head-over-heels in love soon. That's always a good six week high. Do you trust people? (pls. ignore all if too invasive)
Nothing to hide.
I trust those who earn my trust but yeah, I give most people the benefit of the doubt
I LOVE women, but w/o emotions (a biological symptom not unlike the affective flattening seen in schizophrenia) it is physically impossible to fall in love (lust is slightly different tho' ;-) . However that's not so much an emotional reaction as animal instinct).> > In addition to brain chemistry, it sounds like your psyche is crying out for help.
I can see how you'd think this but I only gave these rather personal details in order to contextualise, or frame, my (controversial) question.
You would not believe how intact my psyche is! I've handled some pretty heavy sh*t with honours:-) .*Nothing* fazes me.> > If your Mom has similar problems, maybe she wasn't capable of giving you - a child - the essentials, love, intimacy, affection and all reliably so.
I didn't know she suffered from depression until I was 18. She hid it. I couldn't put it into words how great a mother she is.
> > Did your family know you were suicidal at 6 years old?
Perhaps an idea but I wasn't deeply depressed @ the time & seemed a contented kid.
> > You may want to read some books by John Bradshaw. He has some interesting views and he's an easy read. I don't agree with everything, but he has helped both me and my sister understand ourselves much better which is a good spring board to recovery and happiness.
Good. Therapy & self-help books aren't my bag however. Been there, done that :-). My illness is highly biologically-orientated (no self-esteem probs etc). I am a fully paid-up member of the 'Med-heads' society! Mood stabilizers are currently damping down the suicidal thang. It's only my opinion but I believe psychotherapy & the like *rarely* 'cure' depressive illness.
I'm not being facetious when I say the average psychotherapist would learn much more from a session with me than I wld with them. I stump them, but can dismantle *their* personalities with ease. In the end it became a kinda sport.
> > I too never took hard drugs because I was afraid I'd like them too much.
I can honestly say that I would not be half the person I am were it not for my hard-core drug experiences. I met some good people thru them. Not recommened for everyone of course.
> > Try to stick with your good instincts for awhile longer.
We'll see :-)
> >Yes, opiates and cocaine were anti-depressants in pre-1900's Europe and China, but lots of Chinese women would commit suicide by overdosing on opium. I know you're desperate but it may not be the best alternative for you while you're feeling suicidal.
I've tried opium. Slept thru it, but v. nice %-)
> > Please don't despair. If you shoot yourself acute procrastinators like myself [[ me too ]] won't be able to read your posts (instead of writing a term paper). I've had those thoughts too but the future does bring hope.I'm not about to shoot myself. Too much self-control for that. Just a (n irrevocable) decision made 2 yrs ago that should *all* treatments fail, I'm outta here. If I'm at a party & I'm not enjoying myself, I leave. No biggie.
> > Hope you'll be feeling better! Hang in there – and keep us posted!Thank you for yr kind words; I'm hanging with a firm grip!
J.
Posted by Ann NY on May 15, 2001, at 22:37:48
In reply to Re: Reward Deficit Syndrome.long » Ann NY, posted by JahL on May 15, 2001, at 19:47:48
Wow, I guess I completely miss read your original post. You said you were suicidal and I believed you. Now I know.
> I LOVE women, but w/o emotions (a biological
Sorry to hear this is a problem. I hope it isn't permanent. Love isn't meds but it is very profound and healing when it's real.> >I'm not so much depressed as emotionally desolate
The overall gist I was trying to make was simply: Maybe you would benefit by trying to connect a little more with the whole you: heart soul mind etc. But I that didn't work for you. Sorry I miss read.
> You would not believe how intact my psyche is! I've handled some pretty heavy sh*t with honours:-) .*Nothing* fazes me.
I'm glad you're so confident and healthy, but isn't that part of the problem, nothing fazes you??> >I couldn't put it into words how great a mother she is.
I'm sure she was a very loving mother, I never meant to suggest anything less. However, personally, I couldn't image the demands of raising a family while depressed! I can barely take care of myself. In my experience, my parents were also very depressed while I was growing up. It was a very loving family but personally, I can't say that my parents' depression didn't effect me.
Luckily, you are one who wasn't seriously effected by a parent's chronic illness. Having a great mother is a wonderful gift that some go without.> >Good. Therapy & self-help books aren't my bag however. Been there, done that :-). My illness is highly biologically-orientated (no self-esteem probs etc). I am a fully paid-up member of the 'Med-heads' society!
> >It's only my opinion but I believe psychotherapy & the like *rarely* 'cure' depressive illness.
> >I'm not so much depressed as emotionally desolateWhen I referred to your psyche needing help I was speaking on more of a metaphysical level. I was thinking along the lines of trying to integrate you're intellect with your emotions and/or subconscious? Personally, I believe for me to be truly healthy, I need to have a strong relationship with my mind, heart and soul. Yes meds are great and necessary but they can't solve everything. Since you said meds aren't making you happy and you've never once been truly happy I was pointing out a different issue to investigate that might help. Now I know this didn't work for you. I'm sure a new drug will come into the market soon. My Dr. said there is a new med coming into the US market this summer. It has had great success in Europe and I was going to go on it if Effexor didn't help me.
> >I stump them, but can dismantle *their* personalities with ease. In the end it became a kinda sport.
I never suggested you augment your ego needs by proving to a psychiatrist that you were smarter than him/her. I never suggested seeing a psychiatrist. But have you ever trusted a therapist? A therapist doesn't have to have a superior IQ in order to build a trusting relationship. One where a patient can let go of defenses and put the intellect aside so that issues regarding real human relationships can be discussed with sincerity. But yes I do know how it feels sitting in a session feeling like you are wasting your time b/c dr. doesn't get it.> >The only drugs I've never tried are the opiates-always felt I'd like them too much.
> > I can honestly say that I would not be half the person I am were it not for my hard-core drug experiences. I met some good people thru them. Not recommened for everyone of course.
> >I've tried opium. Slept thru it, but v. nice %-)
??? I was relating to your original reasoning for not taking opiates "always felt I'd like them too much"
> >. Despite being suicidal I'm not so much depressed as emotionally desolate.> >Compared to shooting myself (the last option), *trialing* (*possibly*) opioids is a walk in the park.
> I'm not about to shoot myself. Too much self-control for that. Just a (n irrevocable) decision made 2 yrs ago that should *all* treatments fail, I'm outta here. If I'm at a party & I'm not enjoying myself, I leave. No biggie.
If you're not considering suicide please don't make references in your post that you are. It is a very serious issue, I simply thought you were serious.
> Thank you for yr kind words; I'm hanging with a firm grip!
>
Well I hope so, telling everyone here that you are suicidal doesn't sound like you have a firm grip. But now, if you say you're suicidal again I won't believe you. I'm still new to the board and I don’t know people's personalities yet.I hope things get better for you. :)
Posted by Marie1 on May 16, 2001, at 7:47:09
In reply to of course it's real » Nichole, posted by Elizabeth on May 15, 2001, at 8:47:05
What do you mean by "reward deficit syndrome"? I mean, what characterizes it?
I've been following this thread and feel real sympathy for people who don't get relief from their depression from the usual AD's, but have no doubt that can be the case. I guess I'm just lucky Prozac works well for me.
Posted by dougb on May 16, 2001, at 10:55:52
In reply to Re: paranoia » dougb, posted by JahL on May 15, 2001, at 17:42:54
> Hi Doug.
>
> Paranoid? Have you ever heard any Bill Hicks stuff? Please tell me you have.
---No but a quick web search turned up some samples of his comic performances on mp3, will try to check it out, one labeled "War on Drugs" I and II looks appropriate
> Cocaine is not a particularly pleasant drug (going by what I've seen) but it *should not* be class A in the UK (class A comprises 'hard drugs' ie everything bar pot & speed (which I consider to be far more damaging to the user than Cocaine,--Dunno about that, tried crack once and by the end of the evening i spent 30 minutes crawling around on the floor looking for a lost rock the size of 1 cooked pinto bean. I _never_ want to go back there again.
Posted by JahL on May 16, 2001, at 12:08:54
In reply to Re: paranoia » JahL, posted by dougb on May 16, 2001, at 10:55:52
> > Cocaine is not a particularly pleasant drug (going by what I've seen) but it *should not* be class A in the UK (class A comprises 'hard drugs' ie everything bar pot & speed (which I consider to be far more damaging to the user than Cocaine,
> --Dunno about that, tried crack once and by the end of the evening i spent 30 minutes crawling around on the floor looking for a lost rock the size of 1 cooked pinto bean. I _never_ want to go back there again.Crack's a different story altogether.
I wasn't actually suggesting Cocaine shouldn't be Class A, just that it's classification makes no sense in terms of speed's Class B status.J.
Posted by JahL on May 16, 2001, at 13:36:46
In reply to Re: Reward Deficit Syndrome.long » JahL, posted by Ann NY on May 15, 2001, at 22:37:48
> > Wow, I guess I completely miss read your original post. You said you were suicidal and I believed you. Now I know.
Sarcasm has no place on this board.
I *am* suicidal. Just because I am not sitting here slitting my wrists, *doesn't* me I don't harbour intense suicidal feelings.> >Love isn't meds
Didn't say it was.
> >isn't that part of the problem, nothing fazes you??
No, it means that I can reason or rationalise most things, so they do not become an 'issue' with me. If I said 'everything fazes me', you'd probably be telling me *that's* my problem. Which is it?
> > I'm sure she was a very loving mother, I never meant to suggest anything less. However, personally, I couldn't image the demands of raising a family while depressed!
That's yr experience. Let's leave her out of this. I understand yr point but trust me, her problems did not contribute to my own. Besides I didn't say she was depressed per se, just that she is mood-unreactive.
> > You said meds aren't making you happy and you've never once been truly happy.
No, I said I've only ever been happy *on* meds (however briefly). Where does this leave yr argument?
I've been misdiagnosed in the past & was prescribed drugs contraindicated for my condition. Now I'm (just recently) on mood-stabilizers, my condition seems to be improving a little by the day, & we haven't finished adding meds yet.
> > > >I stump them, but can dismantle *their* personalities with ease. In the end it became a kinda sport.
> > I never suggested you augment your ego needs by proving to a psychiatrist that you were smarter than him/her.They shouldn't attempt to bedazzle me with their so-called intelligence in the first place. I treat others as they treat me (& live my life by the virtuous 'Do unto others..' motto). This is why it became sport. After their conventional 'theories' had been proved to have no foundation in fact or rationale, inevitably they would try & engage me in a battle of the IQs. Inevitably I won. My ego is very well adjusted thank-you-very-much. It needs no augmenting.
> > But have you ever trusted a therapist?
Implicitly. I would not have borrowed $10000 to pay for therapy if I did not have at least some faith in it. I wld bet I have seen more therapists than you.
> >defenses
What defenses? I've had this brought up so many times. Sometimes anger is just that, anger. A symptom rather than a cause or exacerbating factor.
> > If you're not considering suicide please don't make references in your post that you are. It is a very serious issue, I simply thought you were serious.You say you're new here. Please don't try to tell me what I can or cannot post here. I am not responsible for how you react to a post. I *am* suicidal. I *consider* it every minute of every day. I *am* serious. Suicidality involves obsessive suicidal thoughts & a desire to act upon these. I have both. What part of this don't you understand? If you take the time to read a few more posts you will see a no. of regulars (quite rightly) describe their depression as suicidal. They are still posting. Does this mean they're not suicidal? Think about it.
> > Well I hope so, telling everyone here that you are suicidal doesn't sound like you have a firm grip.
I object to that statement. Please go back & read my posts properly. It's not me advising people to 'integrate yr intellect with yr emotions'. Whatever that means. You cannot 'integrate' one entity with itself (ie *no* emotions!).
> > But now, if you say you're suicidal again I won't believe you.
More fool you. I suggest you aquaint yourself with just what it means to be suicidal.
Ann, I think the problem here is that we come from 2 different planets (this is not an insult). I don't place much store in all that 'learn to love yourself' ,& 'get to know yr inner child' stuff. I'm not saying that it's necessarily bad advice; I think it's OK advice for everyone, but doesn't have any particular relevance to the treatment of serious depressive illnesses (besides, I've done plenty of 'work' on myself). Just my opinion. I also think you confuse me with my condition. We're rapidly becoming one, but there's still a clear line of separation.
Anyway I've gone into the therapy thing a no. of times on these boards recently & don't have the time or inclination to do so again.
How about we agree to differ & leave it at this? There's far too much tension on this board as it is. You can carry on mistrusting me ("I won't believe you"). I have some real difficulties with yr take on my condition & wld rather you made no further comment upon it. Not all depression is the same. Remember that.
Back to the opioids discussion...
Sincerely,
J.
Posted by Elizabeth on May 16, 2001, at 18:39:42
In reply to Re: Methadone, Propoxyphene and APAP » Elizabeth, posted by dougb on May 15, 2001, at 16:52:21
> Once you take away the apap or ibuprofen, the drug is reclassified as a Schedule II narcotic, go figure; they take away toxicity and re-categorize it as more dangerous.
Exactly! (As a lawyer friend put it when I explained the drug laws to him: "you mean they add poison to it to make it safer???")
OTOH, Percocet (oxycodone + APAP) is C-II (I assume that Percodan (oxycodone + aspirin) is too, but you never hear about that one anymore).
> During the 60's-70's with all of it's preoccupation with pot, etc. The predominant mind-set amoung that group was questioning of authority and questioning of the desirabilty of one's participation in the 'american dream' etc etc.
So I hear. Did you see the movie _Pleasantville_? It was billed as this lighthearted little comedy, but really it's quite subversive. (This becomes a little bit painfully obvious later on in the film.) I assume it's a metaphor for the transformation of the '50s into the '60s.
-elizabeth
Posted by Elizabeth on May 16, 2001, at 19:04:00
In reply to Reward Deficit Syndrome. » Elizabeth, posted by JahL on May 15, 2001, at 17:27:26
> I'm not looking to take sides here but I've been a long-time observer of yr posts (since back in '99) and I've never seen anything wrong in yr opioid use, given the context in which you place it.
Thank you. It's nice to know that somebody out there thinks it's okay for me to take the drugs that my doctor prescribed! < g > I think context is important, too.
> What's caught my attn is this 'reward deficit syndrome'.I wish I could remember where I first heard that expression. Looking into it, it appears the term is "reward deficiency syndrome." Here're a couple links (I'm sure a good search would turn up more):
There's another temperamental trait, "sensation seeking" (or "thrill seeking"), that also puts people at risk for substance abuse. Supposedly this is what separates the "tweakers" (people who prefer stimulants like cocaine and methamphetamine) from the addicts who specifically prefer opioids -- sensation seekers prefer the thrill and excitement of stimulants.
I think that sensation-seeking and RDS might be related but are not identical.
> Anhedonia & cognitive dysfunction characterise my 'depression'. I can honestly say (with the exception of brief SSRI-induced euthymia) I have never, ever, experienced pleasure. As young as 6 or 7 I wld openly express suicidal urges. Despite being suicidal I'm not so much depressed as emotionally desolate; I have this overwhelming 'craving' feeling, like something's missing.
That's what a lot of addicts say -- that they feel an emptiness or a void that can only be filled by heroin. This leads to self-medicating, which IMO is extremely dangerous.
> I guess my question to you is, does this ring any bells? Do the eternal anhedonia (like my mum, *zero* mood reactivity) & 'craving' sensation possibly signify anything to you?
Yeah, it sounds like the way heroin addicts describe the pain that they felt before they discovered dope. I sort of feel bad telling you that because if I were in your position, I'd be scared sh*tless. But it's the truth: your words are hauntingly familiar. Please take this warning seriously.
If you're in a country where outpatient buprenorphine maintenance is legal, I'd suggest trying to get that. It's pretty much impossible to get high on it so you're not at any risk there (you also can't kill yourself by ODing on it). Addicts don't particularly like buprenorphine, although it does show up on the black market sometimes because of its capacity for blocking withdrawal symptoms.
> *To anyone out there; I'm not looking for Elizabeth's tacit approval to take opioids.
My approval isn't worth much, seeing as I don't have a DEA license. < g >
> Just after her (what I consider to be) informed opinion on what I consider to be a viable treatment option for a *small subgroup* of depressives.
Yes, that's how I feel. I don't think that most people with depression (especially mild-moderate depression) need or should use opioids. (Aside from addiction issues, the side effects suck! Buprenorphine is supposed to have milder ones than heroin and other full agonists, too...I can't imagine anybody taking this stuff as some kind of joy ride.)
> & guess what? I've tried more meds than her (if that's possible).
Maybe we can compare lists sometime. < g >
> I'm not looking to get high. Been there, done that. Compared to shooting myself (the last option), *trialing* (*possibly*) opioids is a walk in the park.
There's no "good" way to kill yourself, but leaving a bloody mess for your loved ones (or even complete strangers) to discover seems like one of the worse ways.
Best wishes and hopes.
-elizabeth
Posted by JahL on May 16, 2001, at 20:06:03
In reply to Re: Reward Deficit Syndrome., posted by Elizabeth on May 16, 2001, at 19:04:00
Thanks for responding.
> > There's another temperamental trait, "sensation seeking" (or "thrill seeking"), that also puts people at risk for substance abuse. Supposedly this is what separates the "tweakers" (people who prefer stimulants like cocaine and methamphetamine) from the addicts who specifically prefer opioids -- sensation seekers prefer the thrill and excitement of stimulants.
That's interesting. I used to be a big-time thrill-seeker (how pre-disposed to substance-abuse can you get??!!), car-surfing (Teen-Wolf stylee!) & the like. If I wasn't so depressed I'd be jumping out of planes, base-jumping etc.
Strangely enough I'm not too big on stims. Coke used to get me high briefly but would soon turn me mean & moody. Speed (+E) was good for clubbing but generally makes me climb the walls. Didn't particularly care for ADD stims.
The only drugs I got a real kick out of were ALCOHOL (I wonder how many of those that attacked you regularly imbibe this state-endorsed DRUG, which in any one yr is directly responsible for as many deaths as opiates have been in the last century), E & the psychedelics (which cld be considered 'mental thrill-seeking' in high enough doses).
> > >Do the eternal anhedonia (like my mum, *zero* mood reactivity) & 'craving' sensation possibly signify anything to you?
> > Yeah, it sounds like the way heroin addicts describe the pain that they felt before they discovered dope. I sort of feel bad telling you that because if I were in your position, I'd be scared sh*tless. But it's the truth: your words are hauntingly familiar. Please take this warning seriously.I do. My (not inconsiderable) intuition tells me you're probably right (& you're *certainly* not 'pushing' [as if] in this instance ;-) ! )
> > If you're in a country where outpatient buprenorphine maintenance is legal, I'd suggest trying to get that.That's what I hoped to try first. Unfortunately I'm UK (psychiatry is stuck in the dark ages). However I've just e-mailed 3 specialist psychopharmacologists advising them not to respond unless they are prepared to look @ truly novel treatments. 2 have responded so far!
> > There's no "good" way to kill yourself, but leaving a bloody mess for your loved ones (or even complete strangers) to discover seems like one of the worse ways.
I agree, but it's so *final*, which is why it appeals. I wouldn't want anyone to think it was an accident or a cry for help (it wldn't be). But lets not dwell on that; I have plenty more chemicals to poison myself with first :-) !
I have been contemplating chasing the dragon for some time (v easy for me to obtain heroin) but given yr info I'll abstain. Thanks for framing my symptoms in a context that makes sense for once. I'll keep perservering with the AEDs also.
J.
Posted by dougb on May 17, 2001, at 17:13:17
In reply to Re: paranoia » dougb, posted by JahL on May 16, 2001, at 12:08:54
> Crack's a different story altogether.
> I wasn't actually suggesting Cocaine shouldn't be Class A, just that it's classification makes no sense in terms of speed's Class B status.
---I agree with that, i know a guy in Colombia who snorted cocaine for years and outside of a messed up nose, (perforated septum)he was otherwise socially functional. (no recommendation intended)But speed does people in quickly and makes them ugly, internally and externally.
Doug
Posted by dougb on May 17, 2001, at 17:23:27
In reply to Re: Methadone, Propoxyphene and APAP --- oh my! » dougb, posted by Elizabeth on May 16, 2001, at 18:39:42
> Exactly! (As a lawyer friend put it when I explained the drug laws to him: "you mean they add poison to it to make it safer???")
>
> OTOH, Percocet (oxycodone + APAP) is C-II (I assume that Percodan (oxycodone + aspirin) is too, but you never hear about that one anymore).
---Why is that? and am curious Elizabeth, how do you know so much about the pysco-farmacopia? are you dr/therapist/?
>
> So I hear. Did you see the movie _Pleasantville_? It was billed as this lighthearted little comedy, but really it's quite subversive. (This becomes a little bit painfully obvious later on in the film.) I assume it's a metaphor for the transformation of the '50s into the '60s.
---The ads made it look fun, but never got around to watching itDoug
Posted by JahL on May 17, 2001, at 23:20:04
In reply to Re: paranoia, posted by dougb on May 17, 2001, at 17:13:17
> ---I agree with that, i know a guy in Colombia who snorted cocaine for years and outside of a messed up nose, (perforated septum)he was otherwise socially functional. (no recommendation intended)I know dozens of people who take it on a regular basis & function perfectly normally. According to the Drug-Workers Bible it is common for users not to have to increase their dose. I think the problems start with individuals who find it habit-forming. I know a few of them as well. A lot of them exhibit mild paranoia & given the cost, are drawn into crime.
> But speed does people in quickly and makes them ugly, internally and externally.
Exactly. Try taking (base) speed daily. I did (a few years back). When you look in the mirror & see yr hair crawling with 1000's of insects, & the voices float in & out of hearing range, you know it's time to pack it in %-). Nasty drug. Quick burn-out. No redeeming qualities (tho' paradoxically, Desoxyn can be of benefit to some ADD people). No good for sleep, appetite, libido, skin, gums etc etc.
J.
(D/C: I do not endorse use of street drugs & haven't touched anything for 2 yrs. OK?)
Posted by dougb on May 18, 2001, at 10:05:35
In reply to Re: paranoia » dougb, posted by JahL on May 17, 2001, at 23:20:04
> J.
> (D/C: I do not endorse use of street drugs & haven't touched anything for 2 yrs. OK?)
--- J., no negative bias here, i like you and your posts - honest, informative and no bs (high signal to noise ratio :0)Doug
Posted by JahL on May 18, 2001, at 10:33:20
In reply to Re: paranoia - fellow foxhole veterans » JahL, posted by dougb on May 18, 2001, at 10:05:35
> > J.
> > (D/C: I do not endorse use of street drugs & haven't touched anything for 2 yrs. OK?)> --- J., no negative bias here, i like you and your posts - honest, informative and no bs (high signal to noise ratio :0)
Hi Doug. Thankya! This Disclaimer was most definitely NOT directed at you. I read all yr posts & am considering setting up a Doug-Jah (name order still to be confirmed) Mutual Appreciation Society :-)
It was actually there to pre-empt any silly claims that I' m some sort of drug-peddling, subversive 'junkie' ('their' word, not mine). If it shuts 'them' up I'll include a disclaimer in every post! What I don't get is why people who have no apparent interest in medication post on this board. I mean, I don't post on stamp-collecting boards (tho' I'm sure it's a fine hobby).
J.
Posted by Elizabeth on May 18, 2001, at 19:41:56
In reply to Re: Methadone, Propoxyphene and APAP --- oh my!, posted by dougb on May 17, 2001, at 17:23:27
> > OTOH, Percocet (oxycodone + APAP) is C-II (I assume that Percodan (oxycodone + aspirin) is too, but you never hear about that one anymore).
>
> ---Why is that? and am curious Elizabeth, how do you know so much about the pysco-farmacopia? are you dr/therapist/?I don't know why Percocet is C-II (the same as plain oxycodone). The "oxy-" synthetic opioids are supposed to be very euphoric, though (oxymorphone more than oxycodone), so maybe that's it.
I don't like to discuss personal stuff on public forums, but pharmacology and psychiatric medicine are interests of mine. I first became interested when I read _Listening to Prozac_. (That was more than a decade ago, when it first came out -- I was only about 12 or 13 years old, I think. Now I'm studying this and related material in school.)
> > So I hear. Did you see the movie _Pleasantville_? ...
>
> ---The ads made it look fun, but never got around to watching itI recommend it.
-elizabeth
Posted by Elizabeth on May 18, 2001, at 19:45:49
In reply to Re: fellow foxhole veterans » dougb, posted by JahL on May 18, 2001, at 10:33:20
> It was actually there to pre-empt any silly claims that I' m some sort of drug-peddling, subversive 'junkie' ('their' word, not mine).
I'm sure you've noticed how loosely those words get tossed around by some people (fortunately very few). All I can suggest is that you not take these "accusations" seriously; *you* know you're not an addict, so these people's opinions don't matter.
(Pet peeve: when people use psych terms as insults. I don't think "psychotic" or "drug addict" should be used this way, because it stigmatises people who really do have these problems.)
-elizabeth
Posted by JahL on May 18, 2001, at 20:44:06
In reply to Re: fellow foxhole veterans, posted by Elizabeth on May 18, 2001, at 19:45:49
> > It was actually there to pre-empt any silly claims that I' m some sort of drug-peddling, subversive 'junkie' ('their' word, not mine).
> All I can suggest is that you not take these "accusations" seriously; *you* know you're not an addict.
Hi e.
Even if I was it wouldn't be anything to be ashamed of. As you point out, it's an illness. The US govt's failure to comprehend this explains why it has the world's largest prison popn.
I think that those who want the subject of drugs off this board fail to realise that censoring discussion only adds to the mystery & mystique of drugs. People need the facts in order to make informed decisions. I wish I was better informed when I was using. In the UK (unlike other European countries) there is no educational drug program & guess what? We have the highest Euro rate of adolescent drug-use. Co-incidence?
J the ex-Junkie ;-)
Posted by Elizabeth on May 19, 2001, at 13:44:33
In reply to Re: fellow foxhole veterans » Elizabeth, posted by JahL on May 18, 2001, at 20:44:06
> > All I can suggest is that you not take these "accusations" seriously; *you* know you're not an addict.
>
> Hi e.Hi j. :-)
> Even if I was it wouldn't be anything to be ashamed of. As you point out, it's an illness.
What confuses me is that the psychiatric profession has supposedly embraced the "disease model" of addiction, but people diagnosed as substance abusers are still stigmatised even in the realm of psychiatric treatment.
> The US govt's failure to comprehend this explains why it has the world's largest prison popn.
...And the US pressures other countries to adopt similarly draconian drug laws.
> I think that those who want the subject of drugs off this board fail to realise that censoring discussion only adds to the mystery & mystique of drugs.I find it hard to conceive of a psychopharmacology discussion board in which there was no discussion of drugs!
Seriously, I know you mean "drugs of abuse," but that isn't such a clear-cut category as people seem to think. The question is, what counts as "legitimate"/"appropriate"/"nonabusive" use? A lot of people have really strong, emotionally charged beliefs about this (as has been demonstrated here on this forum).
> People need the facts in order to make informed decisions. I wish I was better informed when I was using. In the UK (unlike other European countries) there is no educational drug program & guess what? We have the highest Euro rate of adolescent drug-use. Co-incidence?
Many (most?) public schools in the US have adopted a supposedly educational anti-drug program called "DARE." (I forget what that stands for.) It's not education at all, though; it's political indoctrination. (It's "taught" by police officers -- they don't have a doctor or scientist come in even once.)
> J the ex-Junkie ;-)
I'm glad that it's "ex-." Heroin got to be fairly popular when I was in college, and I watched a very close friend destroy himself and eventually die of an overdose. And then, two years later -- almsot to the day -- another friend, who I thought had stopped using, fatally ODed on a combination of heroin and N20. Nobody who knew these could help but feel compassion (in contrast to the intense hatred that most Americans seem to harbor for addicts).
-elizabeth
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