![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 92 to 116 of 170. Go back in thread:
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
Posted by JahL on May 19, 2001, at 15:52:05
In reply to Re: fellow foxhole veterans » JahL, posted by Elizabeth on May 19, 2001, at 13:44:33
> > J the ex-Junkie ;-)
>
> I'm glad that it's "ex-." Heroin got to be fairly popular when I was in collegeNo, no, no, everything else BUT heroin (& crack only once) Transatlantic language confusion. I think 'junkie' in the US refers to users of 'junk', ie heroin (I learnt that from a W. Burroughs book). In the UK 'junkie' is often used as a generic term for street-drug users. Here heroin-users are more likely to be called 'smack-heads', or more kindly, 'sleepy-heads'.
J
Posted by JahL on May 20, 2001, at 11:23:47
In reply to Re: fellow foxhole veterans » JahL, posted by Elizabeth on May 19, 2001, at 13:44:33
> > 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.Elizabeth, the following story unfortunately illustrates your point only too well:
" May 15 - The NHS has come under renewed fire from mental health
advocacy groups after a West Sussex man admitted in court Monday that he helped his
manic-depressive daughter commit suicide when she begged him to help end her suffering.J L, a builder, watched his 22-year-old daughter Sarah take an overdose of pills, and then,
after she had become sleepy, helped her put her head in a plastic bag and smothered her with a pillow.
He called police immediately afterward and said what he had done.Sarah had suffered from depression and drinking problems for years and had attempted suicide many
times — three times in the week she died. She had recently been ejected from psychiatric care for
smoking cannabis."It's the last sentence that really gets me. Apparently committing the heinous crime of smoking a joint precludes you from life-or-death psychiatric treatment.
Given substance-abuse can be a symptom of mental illness I wonder if patients are 'ejected' for exhibiting other symptoms. Being 'too depressed' maybe...?
J
Posted by dougb on May 20, 2001, at 13:34:22
In reply to Re: fellow foxhole veterans » dougb, posted by JahL on May 18, 2001, at 10:33:20
> > > 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 :-)
--- LOL> 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.
---Several possibilities:
- They are just visiting the zoo, in which case they are not really welcome.
- The more likely scenario: They have not embraced their fears and dealt with them.There is such a stigma about mental illness, (which most of the time (if not all?) is really a physicalmetabolical/ imbalance that manifests itself as what outwardly may seem to be irrational behavior).
Most of us have a hard time saying, yes I AM one of those people who have ugh! a 'Mental Illness'. The phrase Mental Illness, should be removed from the dictionary, imho.
Until one has emraced that reality ( : yes, Virginia, i too suffer from quote-unquote mental illness), and hopefully realized that what we are dealing with is really a cleverly disguised cronic physical complaint, that one can let go of her fear.
Fear of the illness, the myriad treatments and fear of his fellow motley crew.
Those that feel spunky enough to do so, may actually serve fellow afflicionados (i just made that word up ;0)), by loudly, clearly and without timidity telling others exactly what we are going through, what it is called and re-educate those whose ignorance and/or fear is exposed thereby.
For me, at least, one of the most difficult parts of this illness has been dealing with people who simpply don't hear the words "I suffer from Major Depression", and not ask themselves, how that might be affecting this person.
Meeting a stranger in a wheelchair, one makes no negative judgement when that person does not get up and dance around the room. As most people are ignorant about what a Depressive may be going through, they can seem pretty callous.
Doug
Posted by dougb on May 20, 2001, at 13:48:04
In reply to Re: fellow foxhole veterans » JahL, posted by Elizabeth on May 19, 2001, at 13:44:33
> Nobody who knew these could help but feel compassion (in contrast to the intense hatred that most Americans seem to harbor for addicts).
We are taught the concept of 'Zero-Tolerance', quite useful for controlling casual experimentation, but now way to deal with those who are metabolically compelled to search for a remedy to an illness that the med profession has not identified nor treated adequately in that individual.
Posted by dougb on May 20, 2001, at 13:53:21
In reply to Re: messed up stds. » Elizabeth, posted by JahL on May 20, 2001, at 11:23:47
> Given substance-abuse can be a symptom of mental illness I wonder if patients are 'ejected' for exhibiting other symptoms. Being 'too depressed' maybe...?
If this had occurred over here, it is certain that he would be put on trial for murder, but were not the so-called medical professionals who ousted this unfortunate individual from their 'care' not the ones who should really be put on trial?
db
Posted by dougb on May 20, 2001, at 14:01:07
In reply to Re: Methadone, Propoxyphene and APAP --- oh my!, posted by Elizabeth on May 18, 2001, at 19:41:56
> I don't like to discuss personal stuff on public forums
Noted>
_Listening to Prozac_.
Me too>
Now I'm studying this and related material in school.
--The reason i asked is that, reading your posts has often made me think that either you would make a very good/understanding/open-minded therapist, or that you already were one. (lucky guess, but hold the applause please)> > > > So I hear. Did you see the movie _Pleasantville_? ...
> >
> > ---The ads made it look fun, but never got around to watching it
>
> I recommend it.
>
--- Will watch it if i get the chance, thanksdb
Posted by JahL on May 21, 2001, at 12:23:18
In reply to Re: fellow foxhole veterans, and 'the enemy' » JahL, posted by dougb on May 20, 2001, at 13:34:22
> > What I don't get is why people who have no apparent interest in medication post on this board.
> ---Several possibilities:
> - They are just visiting the zoo, in which case they are not really welcome.I like that description.
> - The more likely scenario: They have not embraced their fears and dealt with them.
Fears that they are more than just 'sad', and may in fact be suffering from a biological *illness*, you mean? Makes sense.
I have no problem admitting I have mental illness to anyone. However I find that I get less raised eyebrows if I omit the word depression ( "what, you mean you sit around crying all day?") & talk about 'mood swings' & mental imbalance. In other words, give the impression I'm some sort of nutter (which some of those who know me might agree with:-) )
[ at this point some of the psychologists out there are probably thinking "Hmmm. This boy needs counselling; obvious defence-mechanism at work."(based on the premise that hostility is the child of insecurity).
To which I'd say "if you're physically & mentally below-par (due to biological illness) then you're *bound* to feel vunerable (& in fact *ARE*), in which case it probably isn't such a bad idea to signal you're not someone to be messed with (& I'm not)." Besides which, I'm not insecure. ]
I guess this (ie the question of causality) is one of my main concerns with psychotherapy. I take it you're not a great fan either?> As most people are ignorant about what a Depressive may be going through, they can seem pretty callous.
I think it's hard for people to empathise with psychic pain. Shouldn't stop them trying tho'.
You may have the soapbox back now....;-)
J.
Posted by dougb on May 22, 2001, at 13:00:03
In reply to Re: fellow foxhole veterans, and 'the enemy' » dougb, posted by JahL on May 21, 2001, at 12:23:18
>
> > - The more likely scenario: They have not embraced their fears and dealt with them.
>
> Fears that they are more than just 'sad', and may in fact be suffering from a biological *illness*, you mean? Makes sense.
>
Well not exactly, fears that they have some of that big bad 'mental illness' stuff, and all the misunderstanding that goes along with that term> I have no problem admitting I have mental illness to anyone. However I find that I get less raised eyebrows if I omit the word depression ( "what, you mean you sit around crying all day?") & talk about 'mood swings' & mental imbalance. In other words, give the impression I'm some sort of nutter (which some of those who know me might agree with:-) )
>
If you were fishing for a re-assuring second opionion, i'm afraid i'd have to throw in with those that know you better (;)))-sorry, you walked right into that one> I guess this (ie the question of causality) is one of my main concerns with psychotherapy. I take it you're not a great fan either?
Dunno, never really ahd any, nor felt need to, i am a little nuts, just like everyone else i meet, but have always felt my problems were purely biological or, just a normal human reaction to the incredible stress that can accompany any disabling illness
Posted by JahL on May 22, 2001, at 20:42:58
In reply to Re: fellow foxhole veterans, and 'the enemy' » JahL, posted by dougb on May 22, 2001, at 13:00:03
> > Fears that they are more than just 'sad', and may in fact be suffering from a biological *illness*, you mean? Makes sense.
> Well not exactly, fears that they have some of that big bad 'mental illness' stuff.That's actually what I meant. Like you I tend to see depressive illness as primarily biological in its origin.
> >. In other words, give the impression I'm some sort of nutter (which some of those who know me might agree with:-) )> If you were fishing for a re-assuring second opionion, i'm afraid i'd have to throw in with those that know you better (;)))-sorry, you walked right into that one
> I am a little nuts,Ah I see. Takes one to know one, eh? ;-)
> just like everyone else i meet
I think those who are 'on the edge' (I speak for myself), so to speak, tend to gravitate towards one another. I find it a little difficult to relate to 'civvies'. I know more than my fair share of headcases. Guys who've spent yrs holed up in squalid Spanish nicks. You know, nice types. ;-) Also friends that have gone on to develop schizophrenia, or year-long psychoses.
>but have always felt my problems were purely biological.
Moi aussi.
J.
Posted by dougb on May 23, 2001, at 11:24:17
In reply to Re: Nutcase fellowship » dougb, posted by JahL on May 22, 2001, at 20:42:58
> I know more than my fair share of headcases. Guys who've spent yrs holed up in squalid Spanish nicks.
---Spanish nicks - please translate> As far as 'civvies' go, this is how i see many:
Slave away to compete for material prosperity; forget to smell the flowers, play with the kids, love the wife, step on any who get in the way, forgetting that what we reap is what we sow. Die prematurely due to stress of above lifestyle, go out the way you came in, with nothing....
db
Posted by DianeD on May 24, 2001, at 13:24:17
In reply to Re: Methadone - AndrewB and all interested, posted by H. Vincent MacGruder on May 7, 2001, at 9:32:55
Replies and additions
> >Elizabeth > We're talking about using it as an AD -- not for pain or opioid dependence.
> > Elizabeth > You can't assume that the principles that apply to MMT will also be true of the use of methadone (or other opioid agonists) for depression.I don't see why not. After so many days/weeks my system is clean of heroin so I don't see where I would then differ from a straight AD patient or anyone else.
If you are talking about starting dosage than yes maybe/probably so. But like I said before, clinics start you out on 40mg whether you are a light weight or heavy weight user.
I've gone in as both. The former (light weight) is when Methadone worked it's miracle on me.I don't know of any studies, clinical trial, with Methadone in regards to depression, except for the ones sighted below and the one I found by Goldstein, J.A. "Methadone for depression."
Biol. Psychiatry 19(8): 1272-73, 1984. , which is all of three tiny paragraphs. I'll add it to the end of this post*All I know is my own personal experience with it . I've said it before and I'll say it again, I had no expectation from Methadone except to keep me from getting sick. The
AD effect was a total surprise. And it was 100%. 180 degree turn 'round, complete remission, whatever you want to call it. That was with 40mg. The only reason I
eventually went up to 80mg was because I was scared to death the AD effect would disappear if I didn't (the old tolerance mentality). I mean this was the first time in my
life I'd ever felt/been NORMAL. First time ever!, my first taste, and I was scared to death of loosing it. I was Euthymic.> >Elizabeth >That depends on your reaction to it (highly individualized). Some people feel "foggy" on it.
I am not suggesting by any stretch that Methadone is right for everyone or that it will have the same effect. But I figure if it worked miracles for me that it just might work for others.
Water is probably the only thing one could safely say is right for everyone.> > DianeD > methadone does not get you high
I knew I should of clarified that. Here goes. When people think of Methadone they immediately think that because it's used as a heroin "substitute", that it must behave the same as they
envision heroin. And most peoples knowledge of heroin comes from Hollywood. Which means, they see a gutter junkie stumbling around unable to keep his eyes open and speaking in a
slurry mess. What you are seeing is either a person who is in the middle of a heroin rush, which last maybe an hour or so depending of course on numerous factors. or one who has just
consumed way too much. Anyway, I don't want to think about that crap cuz I think it's gross too. Well Methadone doesn't work like that. GRANTED if you took some god awful
amount or were injecting it I'm sure it would. But we are not talking extremes here.....or at least I'm not. I'm talking responsible individualized dosing here."A single dose administered to stabilize an individual lasts between 24 - 36 hours without causing euphoria sedation or analgesia. This enables the individual to function normally and to
perform mental and physical tasks without impairment. "" In proper doses, methadone does not create euphoria, sedation or analgesia. It does not harm motor skills, mental capability or employability."
For me, 20 mins. after dosing I might feel it coming on for all of one minute, BUT, that is IF and only if, I happen to be sitting waiting at a stop light. Otherwise I didn't. Like I keep saying
it isn't that type of drug. The delivery is long and slooooow. Unlike other opiates which can slap you upside the head.> >NikkiT2 > Oh, and so if Effexor is as bad as Metadone, why is Methadone sold on the "black amrket", yet effexor isn't??
Because Effexor is readily available/obtainable to one and all. Methadone is not. Every time you "outlaw" something a black market develops. That's why the "War on
Drugs" is a failure. Prohibition was a failure.Re: Fears of methadone diversion (your black market). Yes, there are people who sell their doses of methadone but they are very very VERY few.
And there are even fewer buyers cuz it's sold at such ridiculously high prices. A dollar a milligram in 1992 (who knows what it is today) The normal/average dose of methadone
is 80 mg a day. Do the numbers. It'd cost you $560.00 per _week!"While methadone has some potential for abuse when diverted from normal channels, the extent of the abuse associated with diverted methadone is small relative to heroin and cocaine,"
reports a 1995 Institute of Medicine report on methadone. Dr. Lewis Judd, psychiatric department chair at the University of California at San Diego and chair of a National Institutes of
Health panel that examined methadone's utility, describes the black market for methadone as a "negligible" problem. Most of those who take diverted methadone are seeking to stabilize
themselves before entering treatment, or want to quit but aren't yet ready to seek help, he says. Most experts agree that methadone rarely is a preferred drug for illicit drug users because
its action is too slow and the level of euphoria it provides is too mild."Alcohol is toxic/addictive, has high abuse potential yet is legal. Cigarettes are toxic/addictive, have high abuse potential yet are legal. Methadone is non-toxic/ is addictive and has low
abuse potential but it is outlawed to the point were doctors fear prescribing it. It is villainized."Methadone has no active metabolites. Much of the toxicity associated with other opioids (e.g., morphine, hydromorphone, meperidine, and fentanyl) is the result of metabolite
accumulation.""Concerns about methadone's effects on the immune system and on the kidneys, liver and heart have been laid to rest. Methadone's most common side effects - constipation and sweating
- usually fade with time, and are not serious health hazards.""Methadone is well tolerated long term with no appreciable side effects other than physical dependence." J.A Goldstein.
Methadone has been around for what, 50+ years? Death and/or illness from Methadone is rare.
> >NikkiT2 > Cos Effexor doesn't give you a high...
Depends on what you consider a high. If it relieves you of your depression you might very well feel high......good. You definitely ain't feeling LOW. For me feeling normal for
once was the best high I'd ever had.Like I said before methadone is like a runners high. I can't compare it with other opiates cuz I never cared for other opiates. Heroin is garbage compared to Methadone. Heroin
is just a pacifier. Methadone gave me energy, stability, strength. Rid me of my anxiety therefore I could listen and learn and remember under stress. It put me on an equal
footing with everyone else. Gave me a positive, I-can-do-to-it, force. And on and on......Somebody here said something about a friend of theirs having to go into the clinic everyday.
That is incorrect or rather that is not the norm.
After 2 or 3 months, if you are clean/drug free, you get your first take-home. Usually within 6 to 8 months of your admittance you have five take-homes. So you only come
into the clinic twice a week. If you are dirty tho, you're not given take-homes or your take-homes are taken away from you as punishment. Take-homes are "earned"> >Elizabeth >. I don't believe there are "good drugs" and "bad drugs" (except for a few
things which are simply toxins). I believe there are helpful uses and unhelpful or harmful
uses of almost all drugs.I agree 100%. Elizabeth is able to put this subject in better perspective. It's too much of an emotional issue for me. It angers me that I can't get the one thing that works for me.
And that makes me feel more helpless than I already am. Suicidal. I've tried asking my doctor to help me. No go. I have asked at various boards. Got one guy who gets it indirectly for
depression. He has become a serious methadone advocate as a result of his experience. And is in fact co-director of ARM Home Page - Advocates for Recovery through Medicine
(http://www.arm-advocates.org/). He was never a heroin/opiate user. Here is some of what he wrote to me. "Fortunately for me Diane, America is a Capitalistic society. In other words, if
you got money you can get what you want---away with murder even, I'm afraid (he's referring to O.J, that's how long ago this was) I had "friends" and a valid reason to get dolophine,
even though my doctor knew it was for depression. He and I were the ones that went and found that research you read on Rose Whithers website-and he prescribed me dolophine
(methadone) for depression."Here's Rose Whithers website and the index page of "Medical Articles about opioids and their use as a treatment of Depression, Bipolar Disorder and other psychiatric
conditions" http://www.addict.f2s.com/medarticlemenu.html
> >Cecilia > I`m quite certain my HMO would never approve of opiates for depression-there`s no way I would even ask.
I'm quite sure they wouldn't either and I find that a real shame. Even mentioning it would probably send up warning flags and brand you as a possible drug seeker. The doc might even put
a six-sided star * in your file.Yep. I was totally up front and honest with my doctor (something I will never do again) but it's obvious now that he didn't believed me. I even told him I had hepatitis three times and was
interested in getting vaccinated against Hep. B. But it wasn't until five years later and for reasons unknown, he decided to run a liver function test. The results of which he never bothered
to inform me until I just happened to make an appointment to ask for a Wellbutrin scrip. ONE YEAR and 27 days later. Turns out I had had Hep B. and currently had/have
Hep. C. Could I sue for malpractice over that? It's all in my file. I handed him a printout of my history the very first day I went to him in '95, and have handed him a printout of
symptoms, question etc. every time I've seen him.
Anyway, after that, I think he finally believed me about heroin/methadone, cuz he now treats me like I'm the scum of the earth. I kid you not. It's like night and day. It's amazing the
prejudice and out and out hate surrounding heroin/Methadone. Even tho I've been clean of heroin for 17 yrs, and methadone 9 yrs. Elizabeth's "negative knee-jerk
reaction" says it all. People's minds just clamp shut.I read somewhere on a website dedicated to statistics, that 80% of the people who abuse/use heroin were from the middle and upper socio-economic class brackets. That
only 20% came from the lower to poverty levels. And I can believe it. My husband and I were middle class and most the heroin users we knew were also.> > Elizabeth > Methadone is a controlled substance because it is considered (rightly) to have *abuse potential* -- *not* because it is considered "addictive."
In my mind, everything has abuse potential and can be addictive. Methadone has the least abuse potential of all the pain killers. See above.
> >NikkT2 > *g* I personally luuuurve diazapam.. its one of the few meds that have ever helped me ... but I won't take them due to their addiction level,
Oh the sacrifices we make. Gee, isn't it nice that NikkT2 has the option/choice of getting Valium, which she dearly loves, but suffers to not partake. Her forbidden fruit.
And how nice to be able to fly off to Thailand for a little backpacking. Must do your depression/anxiety good. It's a totally different ball game when you have the power of
choice (and money don't hurt either).
I use to do allot a backpacking (CA,OR) till a black bear wrenched my brand new big Kelty from between two trees (30' up mind
you) and ripped it to shreds. Ate all the food, packaging and all! Don't you know, some people just have all the luck ;o) I apologize in advance Dr. Bob.
Can a psychiatrist prescribe methadone? Can a psychiatrist prescribe methadone for pain?LINKS OF POSSIBLE INTEREST (I should of search for more but I've got a raging headache now. I'm sorry, maybe next time 'round)
http://www.ampainsoc.org/pub/bulletin/sep00/upda1.htm
http://www.amazon.com/exec/obidos/ASIN/0767900316/drbobsvirte00-20 Excellent book on how it is and how the War on Drugs is failing. This
comes from the same guy who wrote "Homicide" (from whence the TV series came) another excellent non-fiction book.*___________
Methadone for Depression Jay A. Goldstein January 25, 1984
I read with interest the article in the September 1983 issue "Methadone, Monomine Oxidase, and depression: Opioid Distribution and Acute Effects on Enzymes
Activity", by Kaufmann er al.The authors were unable to account for the antidepressant effect of methadone by monoamine oxidase inhibition. A paper has been published showing that methadone displaces
3H-impramine from it's binding sites in rat brains and platelets with a IC50 at least 100 times less
than morphine or met-enkephalin (De Montis et al. 1982). The authors suggested that the antidepressant effect of methadone was probably independent of it's opioid activity for this
reason.I have prescribes methadone or suicidal patients with severe cardiopulmonary disease when their cardiologist were apprehensive about using traditional antidepressant agents (Goldstein,
1981). I have found that very low doses were effective in this elderly population, usually
about 5mg daily. One woman became hypomanic on this dose but did well on 5mg every other day. Tolerance did not develop, and one patient was maintained on methadone for 3 years,
since she became depressed again when it was stopped. No side effects were apparent.Several researchers have used methadone as an opioid agonist when assessing neuroendocrine relationships in various diagnostic groups. Since methadone appears to have intrinsic
antidepressant properties, results in studies such as these should be skeptically viewed if certain
skewing of results toward the affective disease category is demonstrated.
REFERENCESDe Montis, G. M., Devoto, P., and Tagliamonte, A. (1982). Possible antidepressant activity of methadone. Eur. J. of Pharmacol. 79: 145-146.
Goldstein, J. A. (1981, September 23). Therapeutic lessons from a family practitioner. Terapaeia, 24-23.
Kaufmann, C.A., Kreek, M., Raghunath, J., and Arns, P. (1983). Methadone Monoamine oxidase, and depression: Opioid distribution and acute effects on enzyme activity. Biol.
Psychiat. 18" 1007-10021.
___________I've written everybody from the President of the US on down the line thru the House, Senate, DEA, FDA, Boarderpatrol, local and non-local Newspapers editorials, you name it I've
written to em to share my experience and express thoughts on the issue of Methadone. I write my own congressmen regularly and send my own personal form letter quarterly to every
member of the Senate, House of Rep.I want my Methadone. I don't want to have to lie to a doctor to get it. The rules governing methadone prescribing are archaic. They are not based on currant knowledge but on old
unfounded fears. More damage has been done in this world because of fear than probably anything else. Fear and ignorance go hand and hand. They feed off each other.Which reminds me, I just finished reading Steven Kings latest offering "Dreamcatcher". It stinks. It is his worse yet. It is the worse book I've ever read in my whole life in fact. I don't
recommend it :o)
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