![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 143 to 167 of 170. Go back in thread:
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
Posted by jojo on July 22, 2001, at 23:01:52
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 22, 2001, at 15:19:09
> > > "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.
>
> -elizabethSorry, I'm having computer trouble, and I can't spell check this.
Maybe it was Nixon in the 70". Robert Altman (I think)
had just made the original movie of "Mash", with Donald Sutherland
and Elliot Gould. People were doing drugs, as they always have,
except that powdered coke was becoming popular as
the American "improvement" on the centuries old habit of leaf chewing,
which is still legal in Columbia, and more acceptable than the high tech, purified,
more potent, extract). Neither the media nor the politicians had yet discovered
the power they could wield with an additional War. Len Barney was a young professional
basketball player with a promising carreer, when he O.D. on coke and died.
This was the immediate precipitating factor in the War. The American government
had to do something, because, as I remember it, all these veterans were coming
back from Viet Nam, and had had wide experience with heroin and marijuana, and their experience with its
addictive qualities was somewhat different than the authoraties would have preferred, so Barney's death was the perfect opportunity to 'set the record straight' on the dangers of drugs, and get these
kids to be a little more ernest about imposing democracy on Viet Nam. We had already rejected the election
which we had agreed to when the Vietnameese kicked the French out, and these kids prefered getting high
to killing. Go figure out human nature. When Muhammed Ali refused to kill people in Viet Nam, they took away his boxing license. Told him if he wouldn't kill people, they wouldn't let him beat them up anymore.
This is getting long for my "Wordpad", so I'll have to add to it later when the other computer is fixed.
World Book Dictionary:"Euphoria":a feeling of happiness and well being. EU - good;PHORIA-well bearing, ease of bearing; good bearing.
More later.
Posted by Elizabeth on July 23, 2001, at 15:51:14
In reply to Re: Effexor stuff » Elizabeth, posted by jojo on July 22, 2001, at 23:01:52
> Sorry, I'm having computer trouble, and I can't spell check this.
It's ok; spell checking is overrated.
[Re the 70's]
> People were doing drugs, as they always have,
> except that powdered coke was becoming popular as
> the American "improvement" on the centuries old habit of leaf chewing,
> which is still legal in Columbia, and more acceptable than the high tech, purified,
> more potent, extract).Chewing coca leaves and making tea out of them is also common in Peru.
> World Book Dictionary:"Euphoria":a feeling of happiness and well being. EU - good;PHORIA-well bearing, ease of bearing; good bearing.
For clinical purposes, euthymia means good-normal mood, while euphoria means, well, a little better than normal. < g >
-elizabeth
Posted by jojo on July 23, 2001, at 18:53:09
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 23, 2001, at 15:51:14
> > Sorry, I'm having computer trouble, and I can't spell check this.
>
> It's ok; spell checking is overrated.
>
> [Re the 70's]
> > People were doing drugs, as they always have,
> > except that powdered coke was becoming popular as
> > the American "improvement" on the centuries old habit of leaf chewing,
> > which is still legal in Columbia, and more acceptable than the high tech, purified,
> > more potent, extract).
>
> Chewing coca leaves and making tea out of them is also common in Peru.
>
> > World Book Dictionary:"Euphoria":a feeling of happiness and well being. EU - good;PHORIA-well bearing, ease of bearing; good bearing.
>
> For clinical purposes, euthymia means good-normal mood, while euphoria means, well, a little better than normal. < g >
>
> -elizabethI know. I'd like to know when "They " took over the word, what is its etymology. What does "thymia" mean, anyway, and why wasn't euphoria, self descriptive as it is, acceptable? Is the language being used to hide somethings that we don't wan't to accept about this peculiar thing called "mood", which, my Clinical Psychologist friend has told me has no scientific definition, even though one can be diagnosed with haveing a Disorder of 'It'. When we try to define "mood", we're getting awfluly close to defining "Consciciousness", another word which we have carefully avoided. I think it was Nicholas Humphrey who defined "mood" as "what it's like to be ... something..., that thing whose "Mood" we are interested in.My supposition is, at the end, lies lack of Free Will, and I don't think "we" are able to accept that at the present time.
Posted by jojo on July 23, 2001, at 23:45:06
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 22, 2001, at 15:19:09
> 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.I'm not REALLY in favor of it either, but if that's the alternative, I'll take it.
We (the human race) have already debased ourselves,and we continue to do so, and bring shame
to ourselves as a comunity, every day that the penal systems of the "Developed Countries"
continue to dehumanize our children and those of others (read that as all human beings). Let's start paying more attention to
the chain of events (the causes) which lead to behavior, instead of relying on Wittgenstein's non existant "Little Man Within", who knows RIGHT from WRONG, and therefore deserves to be punished
'to the full extent of the law' for his transgressions."Maybe, but I think it would not be clinically correct to make no distinction."
Medicine cannot always be "clinically correct". If I remember correctly, the few autopsies that are being carried out these days seem to indicate that it is usually clinically incorrect. Even Pathology, more of a Science than Clinical Medicine, has its built in defects. My mother had a "Pleomorphic Salivary Adenoma" growing on the base of her tongue. After it was first described, possibly a hundred years or so ago, it was found that in about 1 or 2 % of the time, it metastasized. Possibly it should more properly have been labled a Pleomorphic Salavary Adenocarcinoma", but we can't change a hundred years of Pathologic nomenclature. Similarly with a "Nevus", defined as an overgrowth of normal cells. It was thought that the pigment cells that make up the common "mole" were normal cells. They were later found to be abnormal, and were called "pigment cell nevi". A Pigment Cell Nevus is therefore not a nevus! This we can live with, but I don't think that we can continue living with the belief that "good" and "bad" choices are always made by "good" and "bad" people.
Posted by Elizabeth on July 26, 2001, at 23:18:18
In reply to Re: Effexor stuff, posted by jojo on July 23, 2001, at 18:53:09
> I'd like to know when "They " took over the word, what is its etymology. What does "thymia" mean, anyway, and why wasn't euphoria, self descriptive as it is, acceptable?
I don't know Greek. Anyone?
> Is the language being used to hide somethings that we don't wan't to accept about this peculiar thing called "mood", which, my Clinical Psychologist friend has told me has no scientific definition, even though one can be diagnosed with haveing a Disorder of 'It'.I think that moods are recognised as being real by all conscious beings, and that emotions can break down just like other bodily functions can.
> My supposition is, at the end, lies lack of Free Will, and I don't think "we" are able to accept that at the present time.
Free will, and the sense of being a "self," may be illusions, things that we experience because they're useful to us as human beings, not because they actually exist.
-elizabeth
Posted by halldor on July 27, 2001, at 2:05:37
In reply to Re: Effexor stuff [major sidetrack] » jojo, posted by Elizabeth on July 26, 2001, at 23:18:18
> > I'd like to know when "They " took over the word, what is its etymology. What does "thymia" mean, anyway, and why wasn't euphoria, self descriptive as it is, acceptable?
>
> I don't know Greek. Anyone?
>
>
Gr. "thymis" means mind or mood. The Gr. prefix "eu-" is the combining form of "eus" = "good", used in neuter form "eu"."Euthymy" is a rather old English word - now obsolete - for cheerfulness, tranquillity.
See OED. As for why "they" took over this form, I for one don't know. "Euthymia" is not in the OED, doesn't even make it to the supplement.
-halldor-
Posted by desertflower on August 9, 2001, at 16:25:06
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by Elizabeth on December 17, 1999, at 22:04:23
> > elizabeth, we had great success with buprenorphine (subutex) in France.It is fantastic and reduces pain and suffering. Do you have any idea how it can be found? Thank you.
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.
Posted by Elizabeth on August 9, 2001, at 21:04:00
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by desertflower on August 9, 2001, at 16:25:06
> 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?
One month's supply (90 mL) costs around $250 retail. (That's the generic by Abbott, not Buprenex(R).)
-elizabeth
Posted by desertflower on August 9, 2001, at 21:40:51
In reply to Re: cost of Buprenorphine ? » desertflower, posted by Elizabeth on August 9, 2001, at 21:04:00
Thank you for the info, elizabeth. You are referring to the injectable, but is it possible to order from foreign pharmacies the sublingual tablet? His doctor would write the prescriptions, and his mom would send them to us here in the US.It was great-but now we've been out of France too long, and couldn't continue under his care.
Thanks. desertflower
> > 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?
>
> One month's supply (90 mL) costs around $250 retail. (That's the generic by Abbott, not Buprenex(R).)
>
> -elizabeth
Posted by Elizabeth on August 10, 2001, at 12:12:47
In reply to buprenorphine is almost free in france..., posted by desertflower on August 9, 2001, at 21:40:51
> Thank you for the info, elizabeth. You are referring to the injectable, but is it possible to order from foreign pharmacies the sublingual tablet?
I would imagine so. I don't know much about ordering drugs from overseas, as I've never tried it myself. One thing I do know is that it's much harder to get controlled substances (such as benzodiazepines, stimulants, opioids, etc.) from overseas than it is to get noncontrolled prescription drugs. With a U.S. prescription, it's legal to import a 3-month supply for personal use, which isn't bad. If an order is mailed to you from overseas and is seized by Customs, you can pick it up if you have some sort of proof that it's legitimately prescribed. I'm a bit confused as to what kind of red tape you have to go through and what counts as a legitimate prescription, though.
> His doctor would write the prescriptions, and his mom would send them to us here in the US.
I'm not sure how legal that is. French doctor, right?
> It was great-but now we've been out of France too long, and couldn't continue under his care.
I think you could run into trouble trying to get it prescribed by an American doctor. The import option might be easier, if you can find a doctor in France who's willing to continue the prescription.
How long were you in France, BTW, and in what part?
-elizabeth
Posted by desertflower on August 10, 2001, at 13:50:41
In reply to France vs. USA: no contest » desertflower, posted by Elizabeth on August 10, 2001, at 12:12:47
> > Thank you for the info, elizabeth. You are referring to the injectable, but is it possible to order from foreign pharmacies the sublingual tablet?
>
> I would imagine so. I don't know much about ordering drugs from overseas, as I've never tried it myself. One thing I do know is that it's much harder to get controlled substances (such as benzodiazepines, stimulants, opioids, etc.) from overseas than it is to get noncontrolled prescription drugs. With a U.S. prescription, it's legal to import a 3-month supply for personal use, which isn't bad. If an order is mailed to you from overseas and is seized by Customs, you can pick it up if you have some sort of proof that it's legitimately prescribed.yes, sometimes my husband's package was siezed at customs, and we would have to fax a copy of the prescription to this guy at JFK, who would then clear it! Yes, his French doctor was prescribing the meds for him, and now it is part of a maintanence progrmam, though which is about to end, because the doctor in france couldn't continue.
I'm a bit confused as to what kind of red tape you have to go through and what counts as a legitimate prescription, though.
>
> > His doctor would write the prescriptions, and his mom would send them to us here in the US.
>
> I'm not sure how legal that is. French doctor, right?
>
> > It was great-but now we've been out of France too long, and couldn't continue under his care.
>
> I think you could run into trouble trying to get it prescribed by an American doctor. The import option might be easier, if you can find a doctor in France who's willing to continue the prescription.
>
> How long were you in France, BTW, and in what part?
>
> -elizabethI was in france one year- but he is a frenchman, so he has always been there, right outside of Paris. Today we talked to his primary care physician who said he can't even give him bupe for depression, and the only alternative is to go into a methadone clinic. I told him my husband is not using drugs, and a methadone clinic is not what he needs. He is functioning perfectly well with subutex(buprenorphine) and needs to go to work everyday! He apologized, and said there was nothing he could do. Try Scandanavia, he said. Right.
Posted by Elizabeth on August 10, 2001, at 17:17:11
In reply to Re: France vs. USA: no contest, posted by desertflower on August 10, 2001, at 13:50:41
> Today we talked to his primary care physician who said he can't even give him bupe for depression, and the only alternative is to go into a methadone clinic.
"Can't" is a strong word. "Won't" would be more accurate -- a doctor *can* prescribe buprenorphine for any condition *except* opioid dependence. It's arguable, though, that your husband is being treated for opioid dependence.
That said, a GP is very unlikely to prescribe buprenorphine for depression. You might have more luck with a psychiatrist. Take a look at the following article:
http://balder.prohosting.com/~adhpage/bupe.html
The primary author is the doctor who originally suggested buprenorphine to me.
> I told him my husband is not using drugs, and a methadone clinic is not what he needs.
Well, he is being treated for opioid addiction, so I can see their point. The question is, if he went off buprenorphine, became depressed, and sought treatment without a relapse of his former addiction, would it be reasonable to reinstate the buprenorphine treatment?
It's a curious situation. I'll ask my ethics consultant. < VBG >
-elizabeth
Posted by desertflower on August 10, 2001, at 20:56:24
In reply to Re: France vs. USA: no contest » desertflower, posted by Elizabeth on August 10, 2001, at 17:17:11
> > Today we talked to his primary care physician who said he can't even give him bupe for depression, and the only alternative is to go into a methadone clinic.
>
> "Can't" is a strong word. "Won't" would be more accurate -- a doctor *can* prescribe buprenorphine for any condition *except* opioid dependence. It's arguable, though, that your husband is being treated for opioid dependence.Exactly- he is seeking treatment,the only one he knows, for maintenance. I would honestly say, though, that though his dosage was minimized gradually over time, he has a bit of a psychological addiction to it.
>
> That said, a GP is very unlikely to prescribe buprenorphine for depression. You might have more luck with a psychiatrist. Take a look at the following article:
>
> http://balder.prohosting.com/~adhpage/bupe.html
>
> The primary author is the doctor who originally suggested buprenorphine to me.Yes, I will speak to a psych. about this next Thursday.
>
> > I told him my husband is not using drugs, and a methadone clinic is not what he needs.
>
> Well, he is being treated for opioid addiction, so I can see their point. The question is, if he went off buprenorphine, became depressed, and sought treatment without a relapse of his former addiction, would it be reasonable to reinstate the buprenorphine treatment?
>
> It's a curious situation. I'll ask my ethics consultant. < VBG >
>
> -elizabethFor some reason, I am guessing you are either a med student, or a doctor interning-your knowledge is impressive!
desertflower
Posted by Elizabeth on August 11, 2001, at 12:16:46
In reply to Re: France vs. USA: no contest, posted by desertflower on August 10, 2001, at 20:56:24
> Exactly- he is seeking treatment,the only one he knows, for maintenance.
Personally I think it's much better for to use buprenorphine if it suffices, rather than methadone.
> I would honestly say, though, that though his dosage was minimized gradually over time, he has a bit of a psychological addiction to it.
What do you mean?
> > http://balder.prohosting.com/~adhpage/bupe.html
>
> Yes, I will speak to a psych. about this next Thursday.I'd suggest printing out a copy of the article.
> For some reason, I am guessing you are either a med student, or a doctor interning-your knowledge is impressive!
Well, thank you. I'm glad if I could be of help.
-elizabeth
Posted by skeet on October 17, 2001, at 0:40:28
In reply to Re: France vs. USA: no contest » desertflower, posted by Elizabeth on August 10, 2001, at 17:17:11
hi there i seen ur post on buprenorphine..and depression..Im sure its ok for depression side but im on 3mg..daily..and take zoloft too..for panic disorder.the bup doesnt take that away at all..and depression is due to being limited.through panic..If depression is ur primary condition cant you take zoloft? luv/peace freshman
Posted by sally green on June 11, 2002, at 7:29:51
In reply to Buprenorphine, My experience , posted by DianeD on April 22, 2001, at 15:12:49
Hi: I am sorry to hear that you feel the way that you do. You say that you got your hands on some Buprenex? Was it supervised by a caring and qualified doctor? Some one who practices use of Buprenex for depression?
I am currently using Buprenex for Withdrawel of Opiate Addictions and long time suffering of severe pain, pain and addictions certainly cause their own level of depression and lack of self-worth. The problem that I see is, first, doctors are not allowed to arbitrarily prescribe Buprenex for opiate detox. They must be in a state that has approved this treatment or has been issued an Investigational New Drug Certificate for those clinics that want to use Buprenex for detox.
Subject at hand, I have started and have friends attending a clinic that is illegally promoting their detox program, prescribing Buprenex, never detoxing anyone, not following their promised protocals and eventually and very quickly getting patients addicted to Buprenex. When I found this info on the web, I was very excited and so were my friends, many who had long histories of addiction due to recreational drug use, not pain or injuries. Unfortunately, they are never getting detoxed! I believe that Buprenex, used correctly could definitely help the addict, pain sufferer, or depressed person. However, this clinic also says that they offer mental counseling. No such treatment is ever mentioned once you begin the program. It is important to talk about your problems and get involved with people who have similar.
Try to find a caring doctor who will start you slowly and continue to monitor your progress. I have read many articles on the successful use of Buprenex for depression. You may have overdosed yourself. If you used an entire ampul of Buprenex, at one time, you probably used tooooo much and could have let that one ampul last you 2 or 3 days.
Try God!! He has changed my life!! I was a fat kid, have been addicted to food, alcohol, opiates, work. These are areas that need behavioral modification and learning balance. I have lost 100 pounds and kept it off for 6 years. Stopped drinking 6 years ago. Am dealing with my opiate problem, but still have my serious pain issues and surgeries to deal with. I have begun to decrease my amount of Buprenex because I can see the great injustice that is being created by this doctor and I refuse to fall subject to this farce.
Pray!! God is Faithful!!
PEACE, JOY and LOVE! Especially LOVE!!
Sally
> I eventually got a hold of some buprenorphine. It was awful.
>
> It made me extremely tired. No energy at all. Zoned out. But when it came time to go to bed, I couldn't sleep. I just laid there on my back (never moved) all night while my brain buzzed
> like radio static interspersed with waves of depression (reliving all my failures). Eyes open. By morning I had a raging headache and was vomiting. I was sick as a dog. It took three days
> for me to get right.
>
> That was my first experience with a mixed agonist-antagonist opiate. And boy you can have em! How they figure buprenorphine as a possible antidepressant is beyond me. They also
> want to use it to treat heroin addiction. HA! I don't see that at all.
>
> Methadone is the only medication that "cured" my depression, social anxiety, ADD. For the first and only time in my life (I'm 47y//o) I got motivated, had the courage and strength to go
> out and get a job. It lasted as long as I was on methadone. When I had to move here and get off methadone (no clinic for 100miles) I retreated back into my old self. I rarely even come
> out of my room now, 6 yrs later. I'm dying without it. An insecure recluse.
>
> I've wished for some kind of cancer or other terminal illness sos I could get a methadone script.
>
> The only hope for me, if I can't get back on methadone, is reincarnation. I prey that it's real.
> It's my last hope.
Posted by Elizabeth on June 13, 2002, at 20:39:31
In reply to Re: Buprenorphine, My experience » DianeD, posted by sally green on June 11, 2002, at 7:29:51
> The problem that I see is, first, doctors are not allowed to arbitrarily prescribe Buprenex for opiate detox. They must be in a state that has approved this treatment or has been issued an Investigational New Drug Certificate for those clinics that want to use Buprenex for detox.
I think the FDA has to approve it before it can be used for treatment of addiction (detoxification or maintenance), and the practitioner must have a special license to treat addiction with narcotics (these doctors mainly are found at hospitals or methadone clinics).
> Subject at hand, I have started and have friends attending a clinic that is illegally promoting their detox program, prescribing Buprenex, never detoxing anyone, not following their promised protocals and eventually and very quickly getting patients addicted to Buprenex.
How did you hear about it? And why do you say the patients are addicted to Buprenex?
> When I found this info on the web, I was very excited and so were my friends, many who had long histories of addiction due to recreational drug use, not pain or injuries.
People who take opioids for pain rarely become addicted.
> It is important to talk about your problems and get involved with people who have similar.
That's what this board is here for! :-)
> Try to find a caring doctor who will start you slowly and continue to monitor your progress. I have read many articles on the successful use of Buprenex for depression.
Many? I've only seen a few mentions of it in the literature. Can you point me to these articles?
> You may have overdosed yourself. If you used an entire ampul of Buprenex, at one time, you probably used tooooo much and could have let that one ampul last you 2 or 3 days.
I don't think so. One ampule is 1 mL of solution, which contains 0.3 mg buprenorphine. This is a reasonable amount for an adult to take in a single dose, although for an opioid-naive person who's just starting on buprenorphine I might suggest starting out with 0.5 mL to minimize side effects (especially vomiting). Addicts may actually need to take more than depressed people who aren't addicts, but addicts only seem to need to take it once a day; in my experience (and according to all the case reports I've read), depressed people need to take it several times a day, the same as if they were using it for pain.
-elizabeth
Posted by Sally green on June 14, 2002, at 11:03:26
In reply to Re: Buprenorphine, My experience » sally green, posted by Elizabeth on June 13, 2002, at 20:39:31
I don't know where you get the idea that people who are prescribed opiates for pain rarely get addicted?? I have been in several pain management clinics. I have friends who attend the same clinic for pain related problems. EVERYONE of them are addicted to either Oxycotin or Fentanyl patches!
All of the patients, who started this detox with me , discovered over the internet, have increased their usage of Buprenex by atleast one amp per day every visit! This is contrary to the information provided by this clinic itself! Their exact words are: patients who have used opiates for longer than 6 months can benfit by the use of a minimal, regulated dosage of buprenex. I would not consider 7.25 vials of Buprenex per day and an increasing of Buprenex by 30 amps per month at each visit a minimal regulated dosage!
When I was researching Buprenex, it was much easier to find information on Buprenex usage for depressed patients than it was for its use for pain management. I do not have any problems with depression and therefore I touched on these sites because they offered information on general usage of buprenex and my concern was to find info on pain management. To recall specific sites pertaining to depression and Buprenex are unlikely. I believe alot of the information was obtained by just searching Buprenex. There you should see the studies, many for depression and detox.
In agreement with what you said, and you have answered your own questions, a person with addiction can benefit from one dose daily, while the depressed or pain suffer may better benefit from several doses daily. These patients at the detox clinic are administering the Buprenex all day!!!! Just like they did the heroin or oxycotin. Substituting one addiction for another!! With my severe pain and past problem with oxycotin, I could not imagine being able to use 7.25 amps of Buprenex per day. The fact that my friend can not even make it to his clinic visit without a vial of Buprenex, tells me he is addicted to the Buprenex! In fact, of all the people I have talked with at this clinic, not one is using the Buprenex once a day and are using it all day long. Basically because they are being given enough of the drug to do so. If this clinic followed their own stated protocals of cutting the meds in half after the first visit and then decreasing the amount of Buprenex given a patient weekly, the addict would be forced to use a minimal amount, hopefully giving way to controlling their also addictive personality! I know that this site is for the discussing of issues, unfortuantely not everyone has access to a computer or has knowledge of this site. This clinic specifically states that it offers, as part of the cost of your detox, counseling for addiction, so that people can talk with educated, trained addiction doctors. However, no such counseling is offered or available once the patient begins treatment. I was told by the DEA and FDA it is still in its investigational stages and that my state is not isssuing Investigational New Drug Certificates for Buprenex and if approved for detox there will be specific regulations governoring the distribution of the drug and the specifics around the exact protocal to be used. I was also told by the FDA and DEA that the protocals for detox surely will be nothing like the ones being practiced at the clinic that my friends are attending. This is why both of these agencies are investigating this clinic. I may have seen information on depression and Buprenex on the FDA's site and the DEA's site. Sorry I can not be more specific about the sites. As I stated earlier my main concerns were the use of Buprenex in detox and pain management.
Sally
Posted by Cisco on June 14, 2002, at 14:54:05
In reply to Re: Buprenorphine, My experience » Elizabeth, posted by Sally green on June 14, 2002, at 11:03:26
Sally:
The Buprenex Ampules under discussion here contain 300ug Buprenorphine each, correct? In my humble opinion, that is not a very large dose at all.
Schering-Plough recommends a starting dose of 0.6mg to 1.2mg total Temgesic intake per day.
Six (6) Amps a day is very close to this recommended dosage.Bup exhibits a 'Ceiling Effect', and as such is somewhat self limiting.
Although I agree that it can be addicting, it is a very small Monkey, compared to full agonist opioids.
I sent you an e-mail on the subject, hope you received it.
Cisco
Posted by Sally green on June 14, 2002, at 16:13:34
In reply to Re: Buprenorphine, My experience, posted by Cisco on June 14, 2002, at 14:54:05
Hi Cisco:
Yes I received your email and sent one back. The box says that each amp has .3mg of buprenorphine. However, if you read your PDR or the package insert, same thing, you will see that it says that the normal dose is .3mg or one amp every 6 hours. Occasionally it may be neccessary to administer .6mg to adults depending on the severeity of pain and at this time there are insufficient data to recommend single doses greater than .6mg for long term use. Furthermore in drug abuse and dependence the drug may cause withdrawel symptoms.
Thanks for your thoughts,
Sally
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