![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 123 to 147 of 170. Go back in thread:
Posted by NikkiT2 on May 29, 2001, at 15:26:12
In reply to can't we all be friends? » NikkiT2, posted by Elizabeth on May 29, 2001, at 12:23:32
It was in no way an attack on people who claim benefit, but the way she used her words made it osund like I had the option to fly off on holiday when ever I feel like it, which is very very untrue... I actually travel less than any of my friends on benefits... I am only *just* managing to hold my job down right now, and to be critisized for my one break, my one thing that has been keeping me alive recently felt very very unfair.
I am, as a rule, happy to be friends with anyone, but I also refuse to be treated as I did, just for mentioning I was having a holiday.. I meant it in a way that when you know something helps, yet it is not a good thing, I still try to stay away from it.. it was a comment that I know I can get something that can help me, but I know it will not be good for me long term.
She could ahve commented on my commentsd, but no, she chose to attack ME, and I refuse to sit back any longer and allow people to do that.
nikki
> > You know nothing about my circumstances or how damned hard I have worked just for 2 weeks in Thailand seeing a very very close friend.
>
> Nikki --
>
> I know this is a heated subject, and Diane was way out of line (and was blocked for it, as you probably noticed). I really don't think she really believes that you *shouldn't* get to go to Thailand. I think she felt angry and defensive; anger often makes people say things that they don't really mean.
>
> > I work hard to earn money, and have never asked the state (I'm in the UK) for anything. Why should I not have 2 darned weeks with a friend to try and help me. I doubt it will help me a huge amount, but it may give me two weeks of feeling lsightly better out of 10 years.
>
> I'm sincerely happy for you that you'll be able to go on what sounds like it will be a fun and relaxing vacation. My suggestion is that you not worry about whether this vacation will be "therapeutic," but just try to enjoy yourself to the extent that you are able.
>
> But I hope that you didn't mean this as a general put down directed at people who get assistance from the government. Mental illness has different effects on different people, depending on the severity and time course of the illness, whether and how thoroughly the illness is treated, the specific type of impairment that the person suffers as a result of the illness, whether the person has good social supports, etc. Some people don't have family to help them when they need a break and are too disabled to work; some have young children they need to provide for, and can't take the time off to go on a vacation even if they are able to work. I believe you when you say that you worked hard to be able to take this vacation. I just hope that you don't look down on people who aren't able to work to save up enough money to do special things like that.
>
> I sincerely mean everything I've said here -- please don't take any of it as sarcasm. I wish you a pleasant vacation and hope that you return feeling a little bit better than you have been.
>
> peace,
> -elizabeth
Posted by NikkiT2 on May 29, 2001, at 15:30:26
In reply to Sometimes it just feels good ..., posted by Willow on May 29, 2001, at 14:44:02
Thanks fro understanding!! :o)
Its bascially a very cheap back packing holiday... we've paid off the flights and the outlay after that will be minimal... but will be total escape!!! We're going with some friends which will be good, as they can lkeep my husband occupied if I just wanna veg and get some UV into my system on the beach!! (No hotel or pool, just a wooden bungalow on a beach... think "The Beach"!!)
I would be more than happy to send you a postcard of the best tree I can find!!! I gues most will be Palm trees or what ever, but I bet I find my favourite one to sit under each day! Trees are indeed wonderful things... Oh to this time in 3 weeks!!! ;)
Nikki x
ps - I've left my email addy if you want to mail me your address for a postcard!
> to vent, let off steam, etc.
>
> I haven't followed the thread, but would be concerned if a med that gave me relief had addictive qualities. I'm planning on discussing codeine with my doctor since it allows me to get a refreshing sleep and as a result a normal day.
>
> Go ahead enjoy your vacation. I think we need to take them more often. They don't need to be to a exotic location, perhaps just another city or camping by the lakeside for a couple of nights. It helps to unwind and gives us something to look forward to. No matter what the financial cost, as long as it doesn't affect our ability to eat and keep a roof over our heads, I think they are well worth their weight in gold. Especially the warm memories that'll help tide us over the hard times.
>
> Bon voyage!
> Willow
>
> ps I wish you could send me a postcard of their closest tree that resembles a willow or elm or oak, etc. There's nothing like having a good steady tree for company, especially when people get too emotional! : )
Posted by Dr. Bob on May 29, 2001, at 21:22:45
In reply to Re: blocked from posting - DianeD, posted by NikkiT2 on May 29, 2001, at 11:32:16
> OK, I'm gonna get blocked - but you pathetic, spiteful cow. You know nothing about my circumstances or how damned hard I have worked just for 2 weeks in Thailand seeing a very very close friend.
I can't blame you for being outraged, but two wrongs don't make a right. Yes, I'm gonna have to block you.
Bob
PS: Follow-ups, if any, regarding civility or being blocked, if not redirected to Psycho-Babble Administration, may be deleted.
Posted by Elizabeth on May 29, 2001, at 22:10:49
In reply to Re: can't we all be friends? » Elizabeth, posted by NikkiT2 on May 29, 2001, at 15:26:12
> It was in no way an attack on people who claim benefit, but the way she used her words made it osund like I had the option to fly off on holiday when ever I feel like it, which is very very untrue...
OK. Just checking. :) My impression was that you and Diane were discussing a very charged issue, and things got out of hand, leading to an exchange of harsh words. That's understandable -- it happens to everybody on occasion.
Have a good trip!
-elizabeth
Posted by John Smith on June 15, 2001, at 1:21:48
In reply to Re: Methadone - SalArmy4me - Mexico? » DianeD, posted by SalArmy4me on May 1, 2001, at 14:07:54
Hi,
I visited Tijuana to purchase Methadone. US guidelines say I can purchase 50 doses of a medication if it is for personal use, in the original container, and declared at US Border on return. A Mexican script may be necessary in Mexico.
I went to about 30 farmacias but couldn't get any. I was told that it wasn't made in Mexico so not available. I probably should have visited a Doc to get a script first, then to a "specialized" farmacia.
Can anyone give me the name of a doc and/or farmacia they know will cooperate??
Thanks. John
Posted by Annie on June 15, 2001, at 17:11:51
In reply to Re: Methadone - SalArmy4me - Mexico?, posted by John Smith on June 15, 2001, at 1:21:48
I am also interested in getting methadone in Mexico....please help! Thanks.
Annie
> Hi,
>
> I visited Tijuana to purchase Methadone. US guidelines say I can purchase 50 doses of a medication if it is for personal use, in the original container, and declared at US Border on return. A Mexican script may be necessary in Mexico.
> I went to about 30 farmacias but couldn't get any. I was told that it wasn't made in Mexico so not available. I probably should have visited a Doc to get a script first, then to a "specialized" farmacia.
> Can anyone give me the name of a doc and/or farmacia they know will cooperate??
> Thanks. John
Posted by SalArmy4me on June 16, 2001, at 0:18:18
In reply to Re: Methadone - SalArmy4me - Mexico?, posted by Annie on June 15, 2001, at 17:11:51
I just realized methadone is a highly controlled substance. Sorry, I don't know how to get controlled substances in Mexico.
Posted by Cam W. on June 16, 2001, at 0:24:20
In reply to Re: Methadone - SalArmy4me - Mexico?, posted by John Smith on June 15, 2001, at 1:21:48
John - The way the federales act towards opiates, I think it would be easier to buy black tar heroin than get a prescription for methadone in Mexico. Getting a substance as controlled as methadone back into the States would be next to impossible, if one was honest. Why not enter a drug rehab program in the States and get methadone that way?
Posted by John Smith on June 16, 2001, at 12:28:03
In reply to Re: Methadone - Mexico? » John Smith, posted by Cam W. on June 16, 2001, at 0:24:20
Hi Cam,
First, I don't use any drugs. My friend does, and is addicted to heroin. Treatment programs cost approx $55/week, but difficulty of getting to clinic each day. Continuing to buy "black" is not the option - getting on the right track is.
US Border agents/DEA have a policy of allowing entrance of controlled substances under the following cicrumstances: for personal use, up to max of 50 doses, in original container, and declared for personal use. Look up www.house.gov/commerce_democrats/press/107ltr24.htm. I am assuming that a mexican script is necessary. So....still looking for legit methadone in TJ.....John
Posted by John Smith on June 16, 2001, at 23:17:59
In reply to Re: Methadone - SalArmy4me - Mexico?, posted by Annie on June 15, 2001, at 17:11:51
Hi,
Methadone is a controlled "B" drug in Mexico, equivalent to a class 2 drug in the US. Most of the drugs I see mentioned on posts here are also Class 2, class B drugs, most of which are available in farmacias in Tijuana, including such as hydrocodon, percodin, kolonopin,codeine, etc., etc.,and most other opiates, sometimes with a script and sometimes without a mexican docs script.
Methadone is not manufactured in Mexico, so one of the reasons why it is not readily available for purchase.As I mentioned else on posts, DEA rules allow the import of a medication up to 50 doses, if it is for personal use, unopened, and declared while entering back into the US. Elsewhere, I quoted the DEA guideline letter setting up such, and I listened most recently to Washington DC hearings by the Department of Commerce also reiterating such a policy.
Sorry...I thought you told someone you knew where to purchase such a medication???? There are over 1,000 farmacias in TJ, each vying for US tourist business. The tourists are there for medications they can't afford in the US. I assure you there are not overrunning TJ to buy cheap pottery, which is available just as cheaply in Los Angeles.
John
John
>
> Annie
>
>
>
> > Hi,
>
> >
> > I visited Tijuana to purchase Methadone. US guidelines say I can purchase 50 doses of a medication if it is for personal use, in the original container, and declared at US Border on return. A Mexican script may be necessary in Mexico.
> > I went to about 30 farmacias but couldn't get any. I was told that it wasn't made in Mexico so not available. I probably should have visited a Doc to get a script first, then to a "specialized" farmacia.
> > Can anyone give me the name of a doc and/or farmacia they know will cooperate??
> > Thanks. John
Posted by karen harris on June 19, 2001, at 21:35:54
In reply to Buprenorphine, My experience , posted by DianeD on April 22, 2001, at 15:12:49
Last week I ordered 20 tablets of buprenorphine from a pharmacy in tijuana. I was very disturbed when I called the US post office only to find out that my money order had been seized by the postmaster general, and the DEA. My friend had given me the address, which she got on the internet. The pharmacy no longer answers the phone. The comforting news is the postmaster informed me that of the $8250.00 they seized from 38 differrent people, that are refraing from charging any of us at this time. Is there any legal way to obtain it without going to Mexico? I was informed my money order is now the property of the US gov. SCARY!! I had 18 mo. of recovery off vicodin and unfortunately relapsed in early May. A wonderful addiction specialist detoxed me with liquid buprenex. Sadly the DEA threatened his license if he contines to use it to treat addiction. What is even more frustrating is the FDA will tell you nothing about when it will be approved in under the tongue tablet form. I again slipped 10 days ago and found buprenorphine useful. I would like to know when it will be available. I have heard horrific stories about methadone and would love to avoid it at all costs. I guess its just the typical bureacracy and red tape of the FDA. I know that of recent, there is clinic in Florida And Pittsburgh utilizing this drug. The going $ in Mexico I've heard is $60 for 10 tablets. The DEA shut down the mexican pharmacy website as well. Things are looking grim. I had no idea it was illegal. My grandma has been ordering heart meds for years! If anyone knows anything more, please remit. Ciao
Posted by Pacha on June 22, 2001, at 8:58:35
In reply to is buprenorphine legal , posted by karen harris on June 19, 2001, at 21:35:54
Hi,very sorry to hear your story.
Me and a load of other people have ordered bupe from www.healthcarepharma.com recieved my order in 4 days (no joke). 100 tabs cost me $76 including shipping.
good luck
Posted by eoflaherty on June 24, 2001, at 16:06:10
In reply to Re: Methadone - SalArmy4me - Mexico?, posted by John Smith on June 15, 2001, at 1:21:48
I find that many psychiatric conditions respond to omega-3 fish oil and recently I tried it on three patients on methadone.Each of them reduced their methadone consumption by 10-20% without any difficulty.This was on a small dose of 1-2g of omega-3.Larger doses of up to 10g daily have been used in other psychiatric conditions and could be tried here.The FDA has determined that 3g daily is safe,except for those with blood disorders.Omega-3 fish oil is available without prescription.You may also find that you smoke and drink less while on it.The dose mentioned here is the sum of the EPA and DHA in the capsules which are typically 1000mg in size and are usually around 30% of EPA and DHA in total.The use of benzodiazepines is likely to drop too while on it.
Note that our ancestors lived in the sea and our modern diet seems to be low in fish oil which would normally make up 20% of the human brain.
Posted by Zo on June 24, 2001, at 16:10:59
In reply to Re: Methadone - AndrewB and all interested » Cece, posted by shelliR on May 9, 2001, at 20:49:23
I have allowed myself some days to split one pill (7.5mg) throughout the day. Some might say my "habit" is increasing. I think I am learning to be a bit nicer to myself.
Shelli,Beautiful. Just beautiful.
Zo
Posted by Elizabeth on June 25, 2001, at 5:36:20
In reply to is buprenorphine legal , posted by karen harris on June 19, 2001, at 21:35:54
Buprenorphine is a legal drug in the United States. It is categorised as a Schedule V controlled substance, meaning that it is considered to have very little abuse potential. However, there is a chance that if you mail-order drugs from other countries, especially controlled substances, they will be seized by Customs. With a little red tape, you can get them legally in this way, but you need to go through the appropriate annoying bureaucratic channels. If you didn't go through channels, and your order got seized, you're pretty much out of luck. (On the bright side, you're unlikely to be prosecuted for anything as a result.)
Sublingual buprenorphine (Temgesic, Subutex) has a poor reputation. People who take it via the sublingual/buccal route need to take huge doses, though, and even then they report that it's not very reliable. I take buprenorphine in the solution form which *is* available by prescription in the USA and is intended for IM or IV injection. I use it intranasally, the dose required through this route being comparable to those used when the drug is injected, although it may take longer to work. I think that the pharmaceutical industry should be working on designing a metred-dose nasal spray (like Stadol NS) rather than trying to get the SL tablets approved.
> A wonderful addiction specialist detoxed me with liquid buprenex. Sadly the DEA threatened his license if he contines to use it to treat addiction.
At this time, it's illegal for doctors in the US to use opioids (even partial agonists such as buprenorphine, which has little if any abuse potential) to treat opioid addiction, except in special clinics. Most people in these programs use methadone (LAAM is also sometimes used), though buprenorphine is available, at least in some places (more in Europe).
It is perfectly legal to prescribe opioids for pain or for other conditions (such as mood disorders). I pick mine up at a local pharmacy each month, just as my mother does with her hydrocodone/APAP prescription (for osteoporosis). Because it is only Schedule V (and not Schedule II like morphine or fentanyl or oxycodone), I can get 5 refills on each prescription.
Something you might consider would be getting into a MMT program and then, whenever it starts becoming available, switching to buprenorphine (just as you used it to detox from heroin, only you could then use it for maintenance therapy). Buprenorphine has a good reputation for blocking withdrawal symptoms and cravings for full-agonist opioids. The disadvantage here is that you'd have to rely on the eventual availability of buprenorphine for this use (which is not by any means certain).
A better plan might be to get a prescription for it as an antidepressant, as I do. This would be feasible, if you can stay off opioids long enough that you'd be considered to be in remission from your addiction. A number of people who take prescribed opioids for mood disorders have histories of self-medicating, but it's not considered maintenance treatment because the disorder being treated is a primary mood disorder and any substance dependence is considered to be in full remission. It is well known that some people turn to non-prescribed drugs in an effort to feel "normal" -- for these people, medically supervised treatment with related drugs is often very effective.
> I had no idea it was illegal. My grandma has been ordering heart meds for years!
Heart meds aren't controlled substances. The people with a vested interest in the drug-war industry feel that they have bigger fish to fry.
Something that really gets to me about the anti-drug politicians' invasion of our doctors' offices (besides my feeling that the doctor-patient relationship is sacred) is that laws that limit prescription of controlled substances don't keep addicts from getting their (street) drugs at all -- they just make it more difficult for those of us who need them for pain, depression, etc., as if we don't have to endure enough suffering in our lives already.
-elizabeth
Posted by Peter S on June 29, 2001, at 10:33:39
In reply to Re: is buprenorphine legal » karen harris, posted by Elizabeth on June 25, 2001, at 5:36:20
Hi Elizabeth,
Any ideas about finding an MD willing to prescribe Buprenorphine for depression? As I mentioned in another post, my pdoc is not willing to try it out. Enoch Callaway, who wrote the article about BU, lives in the SF bay area where I live. Apparently he's no longer at UCSF and I'm trying to track him down. Any other ideas?
Thanks!
Peter
> Buprenorphine is a legal drug in the United States. It is categorised as a Schedule V controlled substance, meaning that it is considered to have very little abuse potential. However, there is a chance that if you mail-order drugs from other countries, especially controlled substances, they will be seized by Customs. With a little red tape, you can get them legally in this way, but you need to go through the appropriate annoying bureaucratic channels. If you didn't go through channels, and your order got seized, you're pretty much out of luck. (On the bright side, you're unlikely to be prosecuted for anything as a result.)
>
> Sublingual buprenorphine (Temgesic, Subutex) has a poor reputation. People who take it via the sublingual/buccal route need to take huge doses, though, and even then they report that it's not very reliable. I take buprenorphine in the solution form which *is* available by prescription in the USA and is intended for IM or IV injection. I use it intranasally, the dose required through this route being comparable to those used when the drug is injected, although it may take longer to work. I think that the pharmaceutical industry should be working on designing a metred-dose nasal spray (like Stadol NS) rather than trying to get the SL tablets approved.
>
> > A wonderful addiction specialist detoxed me with liquid buprenex. Sadly the DEA threatened his license if he contines to use it to treat addiction.
>
> At this time, it's illegal for doctors in the US to use opioids (even partial agonists such as buprenorphine, which has little if any abuse potential) to treat opioid addiction, except in special clinics. Most people in these programs use methadone (LAAM is also sometimes used), though buprenorphine is available, at least in some places (more in Europe).
>
> It is perfectly legal to prescribe opioids for pain or for other conditions (such as mood disorders). I pick mine up at a local pharmacy each month, just as my mother does with her hydrocodone/APAP prescription (for osteoporosis). Because it is only Schedule V (and not Schedule II like morphine or fentanyl or oxycodone), I can get 5 refills on each prescription.
>
> Something you might consider would be getting into a MMT program and then, whenever it starts becoming available, switching to buprenorphine (just as you used it to detox from heroin, only you could then use it for maintenance therapy). Buprenorphine has a good reputation for blocking withdrawal symptoms and cravings for full-agonist opioids. The disadvantage here is that you'd have to rely on the eventual availability of buprenorphine for this use (which is not by any means certain).
>
> A better plan might be to get a prescription for it as an antidepressant, as I do. This would be feasible, if you can stay off opioids long enough that you'd be considered to be in remission from your addiction. A number of people who take prescribed opioids for mood disorders have histories of self-medicating, but it's not considered maintenance treatment because the disorder being treated is a primary mood disorder and any substance dependence is considered to be in full remission. It is well known that some people turn to non-prescribed drugs in an effort to feel "normal" -- for these people, medically supervised treatment with related drugs is often very effective.
>
> > I had no idea it was illegal. My grandma has been ordering heart meds for years!
>
> Heart meds aren't controlled substances. The people with a vested interest in the drug-war industry feel that they have bigger fish to fry.
>
> Something that really gets to me about the anti-drug politicians' invasion of our doctors' offices (besides my feeling that the doctor-patient relationship is sacred) is that laws that limit prescription of controlled substances don't keep addicts from getting their (street) drugs at all -- they just make it more difficult for those of us who need them for pain, depression, etc., as if we don't have to endure enough suffering in our lives already.
>
> -elizabeth
Posted by Elizabeth on June 30, 2001, at 17:57:52
In reply to Elizabeth: Buprenorphine sources?, posted by Peter S on June 29, 2001, at 10:33:39
> Any ideas about finding an MD willing to prescribe Buprenorphine for depression?
Nope. Academic/research-oriented doctors are more likely to be open to it, though (the times I've needed to see a new pdoc, I've given them a copy of the Bodkin et al. paper and showed them that I already have a prescription). I'm sympathetic to your problem -- I just don't know of any sure way. You just have to be convincing, I guess; find someone who's at least open to the possibility, and show them that you can be trusted to use it properly. The trick is to make sure you don't come off looking like a "drug seeker" -- although you really can't get high on buprenorphine from what I've been told (by rec drug users as well as by doctors!), not every doctor is going to be comfortable with it (especially since you need syringes, for which they may have to write a separate prescription (I don't know the law in CA), in order to administer it -- insulin syringes should do).
Hmm...come to think of it, here's one approach: if you can track down Dr. Calloway or some other research type who's liable to be sympathetic, you could talk to them about it and they could speak to your pdoc on your behalf. I don't know if this would work, it's just a thought.
Good luck to you.
-elizabeth
Posted by jojo on July 11, 2001, at 13:47:49
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by Elizabeth on December 17, 1999, at 22:04:23
> > Elizabeth, I believe you mentioned in a few earlier posts that you were prescribed
> > Buprenorphine. Could you tell me how much the stuff costs, please?
>
> No...my insurance covered it, except for a $12 copay. You could look up an approximate price on one of those online pharmacies, though.
>
> > If I phoned a pharmacist would he tell me the price?
>
> Well, I assume so.
>
> > How much were you taking a day? What brand?
>
> There's only one brand available in the U.S., Buprenex. I was taking 1.5cc/day (0.45mg), as I recall.
>
> > _http://www.feral.org/vitality/plist_active.htm _ lists it at:
> > Buprenorphine (Temgesic) 0.2mg x 50 tabs $43.00
>
> Temgesic isn't available in the U.S. You'd have to order it.
>
> Good luck...hope it works for you, if you decide to try it.128 0.3 mg (1 ml) vials for $420
Posted by Elizabeth on July 11, 2001, at 15:29:00
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by jojo on July 11, 2001, at 13:47:49
Sorry I didn't post this earlier. I think the thread got lost somewhere.
I think it comes to about $5/cc (the concentration is 0.3 mL/cc). There is at least one generic, made by Abbott; it comes in these peculiar pre-filled syringes.
The sublingual/buccal route isn't the most efficient one, BTW. I wouldn't bother trying to get Temgesic (also known as Subutex) from overseas.
-elizabeth
Posted by jojo on July 17, 2001, at 11:23:48
In reply to Re: Methadone » Elizabeth, posted by NikkiT2 on May 13, 2001, at 16:01:26
"Yet again, i (sic) will state, by medical LAW Effexor is NOT addictive, the withdrawal symptoms are your seratonin levels re-balancing bacially (sic)."
"By medical law??? In the USA, we don't have "medical laws". We have medical texts and research papers and monographs discussing medical findings
(experience) and manufacturer's recommendations, but FDA rulings and laws passed by Congress and signed by the President are legal documents, and follow the Rule of Humpty Dumpty rather than those of science or medicine. The rule, of course, is 'When I use a word, it means exactly what I choose it to mean, no more and no less'. Hence, Congress may determine that marijuana is a narcotic and has no medical use. Never the less, in most people marijuana does not induce narcosis, and millions of people have found that it does have medical uses. Congress is free to define a word in any way it chooses. It can define the Earth as the center of the universe, but that DON'T make it so.
Posted by Elizabeth on July 18, 2001, at 0:20:51
In reply to Re: Methadone, posted by jojo on July 17, 2001, at 11:23:48
I think the "medical law" thing (I was a little confused by that expression too) was an attempt to say the following:
Effexor isn't considered to have abuse potential by the medical community. Discontinuing it can cause a withdrawal syndrome, but this is not the same thing as addiction; if it were, we'd have to consider a whole lot of people drug addicts who take antidepressants, anxiolytics, corticosteroids, antihypertensives, and numerous other common medicines.
> FDA rulings and laws passed by Congress and signed by the President are legal documents, and follow the Rule of Humpty Dumpty rather than those of science or medicine.
Well said. < g >
> Hence, Congress may determine that marijuana is a narcotic and has no medical use.
"Narcotic" is such a funny word, isn't it?
(Weird how marijuana has no "accepted medical use," while Marinol has been moved down to C-III.)
> Never the less, in most people marijuana does not induce narcosis,
"narcosis" ? (Do you mean, like, sleep?)
-elizabeth
Posted by jojo on July 18, 2001, at 22:57:12
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 18, 2001, at 0:20:51
Elizabeth- You sound like you work in conflict resolution.
RE: "Effexor isn't considered to have abuse potential by the medical community.
Discontinuing it can cause a withdrawal syndrome, but this is not the same thing as
addiction; if it were, we'd have to consider a whole lot of people drug addicts who
take antidepressants, anxiolytics, corticosteroids, antihypertensives, and numerous
other common medicines."OK, let's consider these people drug addicts. I don't think that I know what an "addict" is anyway.
If we DO consider these people "drug addicts", maybe our government will be forced to consider
their War on Drugs in a more rational way, especially if someone close to them suffers from one
of these "addictions".
Posted by Elizabeth on July 19, 2001, at 11:03:54
In reply to Re: Effexor stuff, posted by jojo on July 18, 2001, at 22:57:12
> Elizabeth- You sound like you work in conflict resolution.
Oh, not at all. < g >
> OK, let's consider these people drug addicts.
I think there's a relevant distinction. The existence of a withdrawal syndrome used to define "addiction," but now the word has a more behavioural meaning (some authorities, notably Goodman & Gilman, recommend dropping it from the medical vocabulary altogether).
> I don't think that I know what an "addict" is anyway.
I think I do. And I don't like seeing the word tossed around as an insult.
> If we DO consider these people "drug addicts", maybe our government will be forced to consider
> their War on Drugs in a more rational way, especially if someone close to them suffers from one
> of these "addictions".That's possible, but I don't think it would be intellectually honest or medically pragmatic to drop the distinction between drug addiction and pharmacologic dependence -- even though it might be politically beneficial. There are so many good reasons for dropping the war on [some] drugs, we really don't need to invent reasons. :-)
-elizabeth
Posted by jojo on July 20, 2001, at 13:19:35
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 19, 2001, at 11:03:54
"RE: "(some authorities, notably Goodman & Gilman, recommend dropping it from the medical
vocabulary altogether)."That seems to imply that they don't know what it "means", i.e., have an acceptable definition, either.
> I don't think that I know what an "addict" is anyway.
"I think I do. And I don't like seeing the word tossed around as an insult."
If it were used more, possibly to apply to everyone who is pharmacologically dependent, such as diabetics or people dependant on anti rejection drugs, it might loose its pejorative power, similar to the
emasculation ; >) of the word "fuck".If you do use the word, what do you understand it to mean?
> If we DO consider these people "drug addicts", maybe our government will be
forced to consider their War on Drugs in a more rational way, especially if someone close to them
suffers from one of these "addictions".That's possible, but I don't think it would be intellectually honest or medically
pragmatic to drop the distinction between drug addiction and pharmacological
dependence -- even though it might be politically beneficial. There are so many good
reasons for dropping the war on [some] drugs, we really don't need to invent reasons.
:-)Certainly there are so many good reasons for dropping it, but as they haven't been effectual for the past
….. what? Certainly before the death of Len Barney, around 1983, when the War was declared. Possibly since prohibition, or the passage of the Harrison Narcotic Act in 1914, or the Federal Marijuana Tax Act, in 1937. This is not about being "intellectually honest" or "medically pragmatic", it is about politics, the art of the possible. Part of that art is forcing one's opponents, and I use that word advisedly, into an untenable position, which is what I am suggesting. Anyway, what is the distinction between "drug addiction" and "pharmacological dependence"? Pleasure? Also, do you know anything of the replacement of the word "euphoria", meaning "normal mood", by "euthymic", which I guess means "not abnormal mood"? Could the meaning of "normal" be the problem?
Posted by Elizabeth on July 22, 2001, at 15:19:09
In reply to Re: Effexor stuff » Elizabeth, posted by jojo on July 20, 2001, at 13:19:35
> > "RE: "(some authorities, notably Goodman & Gilman, recommend dropping it from the medical
> vocabulary altogether)."
>
> That seems to imply that they don't know what it "means", i.e., have an acceptable definition, either.No, they say that because "addiction" has become a very loaded word with political and legal connotations. G&G uses a definition that's very close to the APA's definition ("substance dependence" in DSM-IV).
> If it were used more, possibly to apply to everyone who is pharmacologically dependent, such as diabetics or people dependant on anti rejection drugs, it might loose its pejorative power, similar to the
> emasculation ; >) of the word "fuck".Maybe, but I think it would not be clinically correct to make no distinction. I believe that there really is a separate phenomenon of "addiction" (what used to be called "psychological addiction") that is largely unrelated to substance-specific withdrawal symptoms.
> If you do use the word, what do you understand it to mean?
Pretty much the same thing as Goodman & Gilman and DSM-IV say. I can quote them if you like. Once I started studying the current medical approach to addiction, it became very clear to me that it wasn't about withdrawal symptoms or tolerance. That doesn't mean that I think drug addicts should be considered criminals; I think that's an abomination.
> Certainly there are so many good reasons for dropping it, but as they haven't been effectual for the past
> ….. what? Certainly before the death of Len Barney, around 1983, when the War was declared.I guess I'm not old enough to remember that: who was Len Barney? My understanding is that Nixon was the first president to declare a "war on drugs." (I don't see the drugs fighting back much. Although there was this article in the Onion in which it was reported that the war on drugs had ended, with the drugs as victor.)
> This is not about being "intellectually honest" or "medically pragmatic", it is about politics, the art of the possible. Part of that art is forcing one's opponents, and I use that word advisedly, into an untenable position, which is what I am suggesting.
Beating our opponents by playing as dirty as they do? I'm not really in favour of that, even if it's the only way. I think we would debase ourselves and betray our own values if we did that.
> Anyway, what is the distinction between "drug addiction" and "pharmacological dependence"? Pleasure? Also, do you know anything of the replacement of the word "euphoria", meaning "normal mood", by "euthymic", which I guess means "not abnormal mood"? Could the meaning of "normal" be the problem?
Euphoria doesn't mean "normal mood;" it means unusually high mood (e.g., hypomania or mania can be said to be "euphoric" if it's not a mixed state; some drugs, the so-called "drugs of abuse," can cause euphoria as well). Euthymia means normal mood. They're both words of Greek origin; I'm not sure what they mean literally in Greek.
-elizabeth
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