![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 98 to 122 of 170. Go back in thread:
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)
Posted by Elizabeth on May 24, 2001, at 21:43:26
In reply to Methadone to all interested, posted by DianeD on May 24, 2001, at 13:24:17
> > > 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.People who take methadone as part of treatment for an addiction are completely tolerant to the dose they are on. It doesn't elevate their mood; its only purpose is to prevent the protracted opioid withdrawal syndrome. If you're taking it for depression, you are trying to get an effect (not just to maintain homeostasis), and it's quite possible, though not certain, that you could become tolerant to this effect.
> 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.
I don't recall how long you used heroin (did you mention it?). There are long-term changes (the protracted abstinence syndrome that I mentioned above) that have been documented in long-term opioid users.
If you're suffering from protracted abstinence syndrome, you'll probably know it. My guess is that you are, since you've been in MMT. Have you ever been free of all opioids for a year or more, and if so, did you still feel a continuous lingering discomfort? That's the best I can describe it. Like I said, if you've experienced it, you'll probably know.
> 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.
It has -- no doubt about that. But some do find that, at the doses they require, it is sedating or concentration-impairing. And some people do abuse it -- it is possible to get high on methadone (although it doesn't cause a "rush," the high is supposed to last all day). You're right that it doesn't get people high who are in MMT and are taking it as directed.
> Water is probably the only thing one could safely say is right for everyone.
< g >
> Methadone has been around for what, 50+ years? Death and/or illness from Methadone is rare.
Yes. OTOH, its potential lethality in overdose is a disadvantage of methadone as an AD.
> 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......Sounds familiar.
> 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.
(Thanks :) )
I agree with you -- it's unfair that you have to take extraordinary measures just to feel normal.
re HMOs:
> I'm quite sure they wouldn't either and I find that a real shame.My prescription plan (through an HMO) pays for my buprenorphine.
> In my mind, everything has abuse potential and can be addictive. Methadone has the least abuse potential of all the pain killers. See above.
"...of all full opioid agonists" is what I think you mean, and if so, I agree. Buprenorphine has less abuse potential, and NSAIDS like Toradol and Advil have none. To say a drug has "abuse potential" just means that you can get high on it. Even MAOIs have (*very* modest) "abuse potential."
> Can a psychiatrist prescribe methadone? Can a psychiatrist prescribe methadone for pain?
A psychiatrist can prescribe methadone, but not for maintenance treatment of opioid dependence. That has to be done through a methadone clinic. Also, if a psychiatrist (or any other sort of doctor -- even *pain* specialists!) prescribes methadone "too often," the DEA might show up questioning the necessity of it.
> 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.Fears that are still held by many people, even physicians -- the result of government propaganda. Nobody should have to lie to their doctor to get adequate treatment.
-elizabeth
Posted by Dr. Bob on May 25, 2001, at 3:30:29
In reply to Methadone to all interested, posted by DianeD on May 24, 2001, at 13:24:17
> > >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.I'm sorry you haven't had more luck, but sarcasm isn't civil. If you think you should apologize for something, better just not to post it in the first place. I've already warned you, so now I'm going to try to block you from posting. Best wishes,
Bob
PS: As before, follow-ups regarding civility or being blocked, if not redirected to Psycho-Babble Administration, may be deleted.
Posted by JahL on May 25, 2001, at 12:16:03
In reply to Re: Nutcase fellowship or maybe not..... » JahL, posted by dougb on May 23, 2001, at 11:24:17
Hi Doug.
> ---Spanish nicks - please translateSpanish *jails*, where Brits are routinely beaten for the crimes committed by the hoards of obstreperous, drunken Brits (& I've been one! ) who annually descend en masse upon Spanish shores, leaving in their wake a trail of vomit & destruction.
> 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....Yeah I hear what you're saying. I'm not against the whole 9-5, wife & 2.4 kids bit per se. But you're right; too many people sail thru life, oblivious to the beauty that surrounds them, self-interest their prime motivation. Who knows, were I not ill maybe I'd be doing the whole 'respectable' bit, but having been depressed all my life I've learnt to take nothing for granted. It's one powerful lesson.
J.
Oh & re: Hicks. Some of it's too dark to be labelled 'comedy'. I find it pretty cathartic listening. Someone actually probing the *truth* about govt, society, drugs, with no regard for political correctness. & funny to boot!
Posted by NikkiT2 on May 29, 2001, at 11:32:16
In reply to Re: blocked from posting » DianeD, posted by Dr. Bob on May 25, 2001, at 3:30:29
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 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.
Actually, I see you're just pathetically jealous.
> > > >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.
>
> I'm sorry you haven't had more luck, but sarcasm isn't civil. If you think you should apologize for something, better just not to post it in the first place. I've already warned you, so now I'm going to try to block you from posting. Best wishes,
>
> Bob
>
> PS: As before, follow-ups regarding civility or being blocked, if not redirected to Psycho-Babble Administration, may be deleted.
Posted by Elizabeth on May 29, 2001, at 12:23:32
In reply to Re: blocked from posting - DianeD, posted by NikkiT2 on May 29, 2001, at 11:32:16
> 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 Willow on May 29, 2001, at 14:44:02
In reply to Re: blocked from posting - DianeD, posted by NikkiT2 on May 29, 2001, at 11:32:16
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!
Willowps 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! : )
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