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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 40. This is the beginning of the thread.
Posted by jack smith on December 7, 2003, at 13:08:29
NM
Posted by bsj on December 7, 2003, at 14:20:16
In reply to Dr Bob should rename this the opiate forum!, posted by jack smith on December 7, 2003, at 13:08:29
Really, we should be discussing theraputic opiate use in the Alternative forum; but the discussion ended up here instead.
Posted by krazybirdlady on December 7, 2003, at 16:59:16
In reply to Re: Dr Bob should rename this the opiate forum!, posted by bsj on December 7, 2003, at 14:20:16
yes i suppose it should be on the alternate site. but purely from a clinical point of view, it is very enlightening to see the difference between the threads of obvious abuse and true theraputic use. really wouldn't see the comparison on alternates.
Posted by bsj on December 7, 2003, at 18:00:56
In reply to Re: Dr Bob should rename this the opiate forum!, posted by krazybirdlady on December 7, 2003, at 16:59:16
There can be a fine line between use and so-called abuse (even thought I hate that latter term). It's quite possible that no small number of those who become addicted to opiates are self-medicating--though in a much less controlled fashion than I do. It's a difference of degree and not of kind.
There are some terrible things wrong with our innate brain chemistry; in some sense, I think we're all mentally ill. A negative feedback system exists between the mu and kappa opiod systems that keeps us from being too happy or satisfied; when we rise too high for too long, it pushes us back down. We all seek to right this flaw in some way--obsessive overeating, bad relationships, workaholism, booze, coke, opiates. The neuro pathways of pain evolved in us because they served to help us physically survive at some point in our past; but being the result of a set of very capricious and utilutarian processes, they don't always work to our emotional advantage. That's not what they came into being for.
Posted by justyourlaugh on December 7, 2003, at 20:27:31
In reply to Re: Dr Bob should rename this the opiate forum!, posted by bsj on December 7, 2003, at 18:00:56
knowing this,,
why then do you say a fine line?..
to me its a clear difference..
yourself expresssed it..
?
Posted by bsj on December 7, 2003, at 22:23:05
In reply to Re: Dr Bob should rename this the opiate forum! » bsj, posted by justyourlaugh on December 7, 2003, at 20:27:31
"knowing this,,
why then do you say a fine line?..
to me its a clear difference..
yourself expresssed it.."The comparison I made wasn't between those like me and those just looking for kicks on opiates; I compared myself to those who become heroin, etc. addicts because of brain chemistry defects. They're doing the same thing I'm doing, but without the benefit of knowing the dangers of the drugs; and they unwittingly descend into massive dose escalation and deep physical dependence. The key, really, isn't willpower; it's knowledge of and respect for the drugs. If I didn't take holidays, I know without a doubt that the effects I get from 10mg of hydrocodone wouldn't last long; I'd soon need 20mg, 50mg, 100mg to get the same effect. I've talked to people who need 200mg of hydro just to feel any effect whatsoever; and of course they've been scarfing the pills everyday for a year or more.
Posted by krazybirdlady on December 8, 2003, at 13:10:42
In reply to Re: Dr Bob should rename this the opiate forum! (nm), posted by krazybirdlady on December 8, 2003, at 13:08:16
As BSJ said "i think we are all mentally ill." Well, can anyone really prove that they are sane???
Posted by justyourlaugh on December 8, 2003, at 13:13:25
In reply to Re: Dr Bob should rename this the opiate forum!, posted by bsj on December 7, 2003, at 22:23:05
bs,,
i think i understood what you ment...
i therefore cant be a addict if i only use once a week?
are you kidding me or yourself?
only stupid people are abusers?
doesnt fly?
Posted by bsj on December 8, 2003, at 14:53:43
In reply to Re: Dr Bob should rename this the opiate forum!, posted by justyourlaugh on December 8, 2003, at 13:13:25
"i think i understood what you ment...
i therefore cant be a addict if i only use once a week?
are you kidding me or yourself?
only stupid people are abusers?
doesnt fly?"I don't know if your reading comprehension is just terribly poor or what; but I said nothing about stupid people or using once a week.
At any rate, I don't feel like rephrasing what I said more simply.
Posted by bsj on December 8, 2003, at 15:06:31
In reply to Woops...lost my message..., posted by krazybirdlady on December 8, 2003, at 13:10:42
Imagine if every moment in your life were an epiphany, if you were always excited just to exist; if all suffering were optional. It'll possible, eventually, once we unravel the genetics of the brain.
Posted by krazybirdlady on December 8, 2003, at 19:10:25
In reply to Re: Woops...lost my message..., posted by bsj on December 8, 2003, at 15:06:31
if that were to happen then how would we know we are happy? what would we measure it against?
Posted by krazybirdlady on December 8, 2003, at 19:12:25
In reply to Re: Woops...lost my message..., posted by bsj on December 8, 2003, at 15:06:31
Wow...
Posted by bsj on December 8, 2003, at 19:45:42
In reply to Re: Woops...lost my message..., posted by krazybirdlady on December 8, 2003, at 19:10:25
Ah, the "We must know darkness to know light" question. Well, it's a non-issue, really. Consider people who know depression but have never been manic: they know what it is to be depressed without knowing what mania is like. Happiness is not a state defined by unhappiness; in other words, we can describe sensations or states of happiness without referring to unhappiness at all.
Posted by krazybirdlady on December 8, 2003, at 20:00:59
In reply to Re: Woops...lost my message..., posted by bsj on December 8, 2003, at 19:45:42
suppose that's true..never thought of it like that, i guess. still can't help but wonder if you could feel happiness as intensely without the counterweight. Stuck on an old Eagles tune...Desparado. Loosin' all your highs and lows, ain't it funny how the feelin' goes away? sorry for rambling..rough day..
Posted by Lindsay Rae on December 13, 2003, at 12:40:40
In reply to Re: Woops...lost my message..., posted by krazybirdlady on December 8, 2003, at 20:00:59
Isn't it possible that you've fabricated this philosophy to appease your own mental misfortune? I like the sound of it though. I too have researched opiates and the difference between dependence and addiction. I was taking the same amount of Hydrocodone as you are, for three years without ever needing more because I didn't know any better. So it must have been in my head, thinking I felt euphoric from just one pill. Or was it?
Lindsay
Posted by justyourlaugh on December 13, 2003, at 14:22:29
In reply to BSJ...interesting theory but..., posted by Lindsay Rae on December 13, 2003, at 12:40:40
even though i have no reading skills..
j
Posted by craig allen on December 19, 2003, at 16:33:33
In reply to Re: Dr Bob should rename this the opiate forum!, posted by bsj on December 7, 2003, at 22:23:05
> "knowing this,,
> why then do you say a fine line?..
> to me its a clear difference..
> yourself expresssed it.."
>
> The comparison I made wasn't between those like me and those just looking for kicks on opiates; I compared myself to those who become heroin, etc. addicts because of brain chemistry defects. They're doing the same thing I'm doing, but without the benefit of knowing the dangers of the drugs; and they unwittingly descend into massive dose escalation and deep physical dependence. The key, really, isn't willpower; it's knowledge of and respect for the drugs. If I didn't take holidays, I know without a doubt that the effects I get from 10mg of hydrocodone wouldn't last long; I'd soon need 20mg, 50mg, 100mg to get the same effect. I've talked to people who need 200mg of hydro just to feel any effect whatsoever; and of course they've been scarfing the pills everyday for a year or more.i haven't taken opiates for several years. during that time, i've tried too many anti-depressants to list - mood stabilizers, anti psychotics and benzos too. nothing has been significantly helpful. recently, i tried to find a doctor who would prescribe buprenorphine for me (as an anti-depressant) but i was not successful. opiates are the only thing that have ever helped my mood, but, like many, i've never been able to beat the whole tolerance/withdrawal game. when i use opiates, things ultimately get worse. recently i ordered up some ultram and i'm expecting it to arrive any day now. assuming that the ultram works for me (i've never taken it), i want to be able to get the anti-depressant benefits from it consistently. i think your method of "opiate holidays" is the only way i'm going to be able to do this. please let me know how often you take these holidays and how long you abstain for. any other tips would be greatly appreciated. thanks.
Posted by Lindsay Rae on December 19, 2003, at 21:52:37
In reply to question on opiate holidays for bsj, posted by craig allen on December 19, 2003, at 16:33:33
Hi Craig--I know you weren't addressing me with this question, but I would like to take a stab at it since I have too much experience and knowledge concerning this topic. I did both: I took opiates consistently for three years with the antidepressant effects working well without upping my dose, and after the three years I met someone who introduced me to Oxycontin and Heroin, respectively. I had a child with this man and lost him within two years. He was 27, and he died four weeks ago today from an opiate/benzo combination (I think) just before entering rehab. That said, Ultram doesn't work like Vicodin, Percoset, and the like. I don't even think it's an opiate; it was just recently classified as a narcotic, and even that is questionable. I know a couple of people who like taking them because they've experienced weight loss, but that's about it. I had a bottle of it and traded it for Darvocet back in 2000. Perhaps it's all in the mind, but I distictly remember feeling "an exaggerated sense of wellbeing," which is an actual warning under "side effects." Now how can you beat that for depression? I wholeheartedly want to believe that people like you and I NEED a synthetic opiate to feel "normal," but unfortunately it's not at the top of the Medical Journals' lists to prove or even research this theory. And until they do, it remains just that--a theory. I would give anything to go back to '99, when I first discovered that taking one Darvocet was the hidden key to unlocking peace and comfort in my own head. I could take one before class and really enjoy discussing the various literature pieces I studied on the path to getting my English Lit BA degree. In one fell swoop, I became pregnant, was placed on Methadone, and lost my fiance to the drooling jaws of addiction. Sorry to get off topic, but I guess that's how I introduce myself now. Shoot me an email if you think I'm qualified to answer your questions about opiates.
Peace,
Lindsay
> i haven't taken opiates for several years. during that time, i've tried too many anti-depressants to list - mood stabilizers, anti psychotics and benzos too. nothing has been significantly helpful. recently, i tried to find a doctor who would prescribe buprenorphine for me (as an anti-depressant) but i was not successful. opiates are the only thing that have ever helped my mood, but, like many, i've never been able to beat the whole tolerance/withdrawal game. when i use opiates, things ultimately get worse. recently i ordered up some ultram and i'm expecting it to arrive any day now. assuming that the ultram works for me (i've never taken it), i want to be able to get the anti-depressant benefits from it consistently. i think your method of "opiate holidays" is the only way i'm going to be able to do this. please let me know how often you take these holidays and how long you abstain for. any other tips would be greatly appreciated. thanks.
Posted by craig allen on December 23, 2003, at 22:58:24
In reply to Hey Craig, posted by Lindsay Rae on December 19, 2003, at 21:52:37
wow, that's some story you've got. thanks for sharing it. i did receive the ultram - they did absolutely nothing. i obtained some hydrocodone and have been taking that for the past several days. as always, the effect it has on my mood is profound. to actually be in a good mood is such a wonderful thing. i'm walking on a tightrope though, the jaws of addiction are going to do their thing i'm afraid. my only hope at the moment is that i found an online source for burpenorphine. i ordered 75 0.2mg tablets. hopefully, i'll be able to use that drug successfully. i'll believe it when i see it. i'll keep you posted if you're interested.
Posted by Lindsay Rae on December 25, 2003, at 11:37:32
In reply to Re: Hey Craig » Lindsay Rae , posted by craig allen on December 23, 2003, at 22:58:24
That sounds great Craig, although Bup is mainly used as a tool for getting off opiates with little to no discomfort. This drug is a partial agonist, which basically means that it has a ceiling level (usually around 32 mg), and you don't want to go above that level or it will start to work against itself. This is because it is also a partial antagonist. Here is a really good explaination by someone who has taken the drug and has researched it extensively.
http://www.geocities.com/nephalim1327/Bupe-FAQ-Final-2.htm
Just copy and paste that address into the window.
Lindsay
Posted by krazybirdlady on December 26, 2003, at 16:00:57
In reply to Re: Hey Craig, posted by Lindsay Rae on December 25, 2003, at 11:37:32
hi craig...yes it is a tightrope walk..are you up to that? ultram won't do anything if you are already acquainted with opiates. bup may be OK, but with a history of dependancy then i'd be leery. it can take you right back if you're not careful. if you feel that you can take the "drug holiday" then that would be best...
Posted by craig allen on December 29, 2003, at 19:30:49
In reply to Re: Hey Craig, posted by krazybirdlady on December 26, 2003, at 16:00:57
well, keeping you posted as promised. because of my history of opiate addiction, i haven't told any of my family or friends about my current "relapse." it's nice to have somewhere to go to tell what's going on, even if it's a message board. just to re-cap, i have struggled with depression for years and i've been sober for the last 3 years plus. a couple weeks ago i got to feeling real desperate to feel like a normal human being, so i scored some vicodin. it worked great for a week or two, but over the past several days, the wheels have come off. i was up to 12-15 vicodin E.S. per day. then feeling strung out and constipated shortly after that. i cut back yesterday to 4 pills, but felt so bad today that i took a total of 9 pills throughout the day. i'm getting brief periods of relief after i take a few pills, but the rest of the time i feel that weird, horrible opiate withdrawal depression. it makes my regular depression seem like a walk in the park. all this in just a few weeks and with a relatively modest habit. i'm pretty scared. i'm thinking that tomorrow i'll call around and see if i can get in to see an "addictionologist" to get on buprenorphine on an out patient basis. i hope i can get into to see someone quickly.
Posted by Lindsay Rae on December 30, 2003, at 10:03:18
In reply to i fell off the tightrope , posted by craig allen on December 29, 2003, at 19:30:49
I'm right there with you Craig! There are a couple of other message boards I take solace in, and those are WeSpeakMethadone (also about Bup) and the Methadone Interzone. The people on those boards really understand what it feels like to need opiates as antidepressants. I've been on Methadone for pain as well as a crutch for my mood disorder, but I think Bup is right up your alley.
As for the questions directed at me, I've been on Methadone for just over two years. I took Vicodin and the like for about three years, but oddly, I never exceeded three pills per day. Granted, I would go out and drink at night, but it never occured to me to take more pills. I know that sounds odd, but it's just what I needed to feel right--one pill at a time. In October of 2001, I met Chris, who introduced me to crushing Oxycontin and snorting them, then directly to it's shady cousin, H. I had just gotten myself in over my head financially, with a lease car payment, new appartment, and all that goes with it, blindly making commitments before I had secured a job in this area. I just knew I had friends there, and I made erratic decisions in my manic state. Chris' house was like an escape to heaven. He'd tie me off and shoot that warm liquid in my vein, and the problems disappeared. We became junkie lovers, but after only a month I was sucked dry, in worse financial shape than ever. Chris brought me to his Methadone clinic so I wouldn't be sick when we couldn't score, but I kept going up on my dose until I couldn't feel the dope anymore. So I was actively looking for employment, and he was still spending every waking moment hustling for more drugs, dragging me through the hood to score crack to melt with lemon juice and inject. Thousands of dollars worth of crap at a time. I became pregnant, and I left for obvious reasons. But there is no detoxing off Methadone when you are pregnant. The fetus could not survive the withdrawal. As the pregnancy progressed, my dose kept rising, from a modest 70 mg to a whopping 120 mg. But like many others in my shoes, it was a life saving drug for me. I don't get "high" from my daily dose. But I don't feel sick or crave opiates either.
In order to get on Bup, I would have to taper down to 30 mg and still withstand painful withdrawal as the Bup flushes the Methadone off of those receptors. Bup is best for someone on a very low dose of Meth, or someone just coming off of Heroin. I hope I cleared that all up!
Peace,
Linds
Posted by Lindsay Rae on December 30, 2003, at 14:57:40
In reply to Re: Hey Craig » Lindsay Rae , posted by craig allen on December 23, 2003, at 22:58:24
Yeah, definately keep me posted on the Bup. Do you know if it is Subutex or Suboxone? Suboxone contains Naltrexone, but it's antagonist properties are only there to keep you from going above the "ceiling" level. So far, that's the only one that is approved in the U.S., but there really isn't a difference between the two. Most people level off at around 8 mg, with a maximum of 32 mg, but unlike other opiates, "the more the better" doesn't apply with Buprenorphine, so find your dose and stay there! Otherwise it can have adverse effects and send your body into withdrawal. You sound like me though; without the opiate, you just don't feel good about life. My family argues that I did that to my own wiring by taking the drugs in the first place, but I know how I felt when I was a teenager on up, until I was 22 and discovered the painkillers. I figured out real quick that they blocked the signals that allow you to feel pain and also triggered the dopamine and endorphins that make you feel good. I did a lot of research on opiates and ecstacy, since most of my friends were getting heavily involved in the latter.
Anyway, sorry to go on and on...I had the flu with pneumonia last week and took a trip to the ER when my fever spiked to 104 with Tylenol. They gave me this cough syrup that supposedly has Codeine in it, but it's called Hycodan (hydrocodon/HOM, whatever that means). Codeine makes me sick, but it doesn't sound like it has Codeine in it. I don't know...I'm sure I'll try it.
Take Care,
Lindsay> wow, that's some story you've got. thanks for sharing it. i did receive the ultram - they did absolutely nothing. i obtained some hydrocodone and have been taking that for the past several days. as always, the effect it has on my mood is profound. to actually be in a good mood is such a wonderful thing. i'm walking on a tightrope though, the jaws of addiction are going to do their thing i'm afraid. my only hope at the moment is that i found an online source for burpenorphine. i ordered 75 0.2mg tablets. hopefully, i'll be able to use that drug successfully. i'll believe it when i see it. i'll keep you posted if you're interested.
Posted by krazybirdlady on December 30, 2003, at 19:30:58
In reply to Re: i fell off the tightrope , posted by Lindsay Rae on December 30, 2003, at 10:03:18
hi lindsay...just a note to let you know that Hycodan is hydrocodone. much stronger than the codiene but maybe not quite as bad as oxycodone. anyway it is a narcotic. as for the sub, yes that is the latest form of detox, but i have read on many boards that it is harder to come off than meth or bup, don't really know for sure as it's other peoples opinions...
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