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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Zo on August 31, 2001, at 16:46:21
Just this morning sucked my first buprenorphine troche. Kind of like a gummy bear.
Results so far: my head feels warm. . .and I forgot (forgot!!) to drink my Treasured Daily Must Have cup of coffee. I forgot? (I can't believe it.)
My pdoc had them sent from Santa Clara Drugs, "Pharmacy to the Forty-Niners" (I am so impressed). . . any Northern Californians looking for a compounding source.
I'll keep you posted. (Get it? Posted?)
Okay, maybe it's making me a *leeetle* loose. But loose is a hell of a lot more fun than .. . .terminal blahs.
Zo
Posted by shelliR on August 31, 2001, at 17:49:16
In reply to Buprenorphine - just started trial - Elizabeth, posted by Zo on August 31, 2001, at 16:46:21
> Just this morning sucked my first buprenorphine troche. Kind of like a gummy bear.
>
> My pdoc had them sent from Santa Clara Drugs, "Pharmacy to the Forty-Niners" (I am so impressed). . . any Northern Californians looking for a compounding source.
>
> Zo
Hi Zo,If you would write out the exact prescription that your doc wrote, I would greatly appreciate it. I may become very insistant with my pdoc if I am forced again to increase his opiate of choice. Also (gulp), how much do you pay for each gummy bear?
Good luck,
Shelli
Posted by Zo on September 1, 2001, at 18:04:31
In reply to Re: Buprenorphine - just started trial - Elizabeth » Zo, posted by shelliR on August 31, 2001, at 17:49:16
Hi Shelli, how are you doing? I'm not sure exactly what you need. . I didn't see the prescription, he called it in. . .but here's what's on the box:
Buprenorphine 1mg gel troche
Compounded Rx
Dissolve 1/2 troche sublingually twice a dayWhat pharmacist said: Do not chew or swallow, takes 10-15 min. to dissolve. Onset is 30 minutes. Refrigerate.
(It's sent with ice.)I only ordered seven, to start. Their price for #30 1mg troches (1mg troche = 3mg ampule) is $122.50.
Pdoc's instructions: First 1/2 troche, then increase to 1/2 troche twice a day for next three days, then increase to 1 troche twice daily. "Ultimate ideal dosage varies from 0.45 to 1.8mg daily, with onset of action within 5-10 days." Take during day, can be activating.
Yesterday, my first gummy-troche, immed. felt relaxed, life smoother and easy to process, instead of jerky and difficult. A little stoned, in a pleasant way. Seem to feel more energy/strength in my body, too, I'm usually dragging around. . .
*Definitely* feels better than Vicodin.
Zo
Posted by shelliR on September 1, 2001, at 19:24:09
In reply to Re: Buprenorphine - just started trial » shelliR, posted by Zo on September 1, 2001, at 18:04:31
> Hi Shelli, how are you doing? I'm not sure exactly what you need. . I didn't see the prescription, he called it in. . .but here's what's on the box:
I actually don't know what I need either. If I decide to "insist" that my pdoc put me on buprenorphine because of my growing tolerance to oxycontin, I sort of just wanted to know what I was insisting.
>
> Buprenorphine 1mg gel troche
> Compounded Rx
> Dissolve 1/2 troche sublingually twice a day
>
> What pharmacist said: Do not chew or swallow, takes 10-15 min. to dissolve. Onset is 30 minutes. Refrigerate.
> (It's sent with ice.)Thanks for that information.
> I only ordered seven, to start. Their price for #30 1mg troches (1mg troche = 3mg ampule) is $122.50.
Ouch, $245 per month. (assuming you don't develop a tolerance). So for me it would either be screen my tiny deck in (always covered with pine needles presently) or take compounded buprenorphine. Of course, oxycontin is pretty expensive also.
>> Yesterday, my first gummy-troche, immed. felt relaxed, life smoother and easy to process, instead of jerky and difficult. A little stoned, in a pleasant way. Seem to feel more energy/strength in my body, too, I'm usually dragging around. . .
> *Definitely* feels better than Vicodin.Wow, sounds like heaven.
Shelli
Posted by Neal on September 2, 2001, at 22:27:31
In reply to Re: Buprenorphine - just started trial » shelliR, posted by Zo on September 1, 2001, at 18:04:31
I believe the FDA is set to approve the use of buprenorphine as treatment for drug addiction. If that happens, sublingual tablets will be much more common in the U.S.
-Neal
Posted by Zo on September 3, 2001, at 16:52:26
In reply to Re: Buprenorphine - just started trial, posted by Neal on September 2, 2001, at 22:27:31
Posted by Zo on September 5, 2001, at 20:35:46
In reply to Re: Buprenorphine - just started trial, posted by Neal on September 2, 2001, at 22:27:31
I just don't feel like eating. My mother is in a fury of envy, but it's true. Visible weight loss in 5 days. . . .
Besides this overwhelming peace and joy -- I'm painting again, I feel like a human being -- Buprenorphine is, well, the weight is just falling off.
My body feels *so* good. After 21 yrs of feeling shitty, I don't. The days are long and interesting. Everything feels "right". . .instead of Off, out of kilter or worse.
All in all, I'd say this is Heaven. . . Inner Peace in a troche.
Zo
Posted by MB on September 6, 2001, at 16:53:12
In reply to I'm losing weig. . .Help! Stampede!, posted by Zo on September 5, 2001, at 20:35:46
What you describe as your experience with buprenorphin is the same as my experience with opoids. It makes me sad, in a way, to hear you describe how good you feel...I've felt that way too: lack of fatigue, lack of anxiety, lack of depression, motivated and enthusiastic about life, interested in artistic projects, etc. To sit here fatigued, depressed, heart pounding, head aching, sad and hopless (when I know that that feeling--the feeling that life is worth living--is out there for me) is so upsetting.
I am surprised that you and shelliR have been treated with opioids (buprenorphine and oxycodone, respectively) by a psychiatrist. Don't they get in trouble with the DEA? One psychiatrist told me that if he gave me codeine, he could go to jail. He was later arrested when a pharmacist reported him for writing "too many" (whatever the hell that means) benzo prescriptions. What's the deal? How did you guys luck out with a doctor willing to prescribe something that most physicians are afraid to prescribe even for pain??? I'm a recovering opiate addict, and I think that most doctors would think I was crazy if I asked to be put on something like buprenorphine. The really upsetting thing is that most people who become dependent on opiates report that when they first tried opiates, it was the first time in their lives that they felt "normal" or "like a human being." I think these people are self medicating with one of the only things that might be effective against their depression. I know for me, opiates were the only thing to give me relief after I had tried almost all antidepressants.So, how did you guys manage to find a doctor willing to prescribe these kinds of medications?
> Besides this overwhelming peace and joy -- I'm painting again, I feel like a human being -- Buprenorphine is, well, the weight is just falling off.
>
> My body feels *so* good. After 21 yrs of feeling shitty, I don't. The days are long and interesting. Everything feels "right". . .instead of Off, out of kilter or worse.
Posted by shelliR on September 6, 2001, at 22:09:15
In reply to Re: I'm losing weig. . .Help! Stampede! » Zo, posted by MB on September 6, 2001, at 16:53:12
> What you describe as your experience with buprenorphin is the same as my experience with opoids. It makes me sad, in a way, to hear you describe how good you feel...I've felt that way too: lack of fatigue, lack of anxiety, lack of depression, motivated and enthusiastic about life, interested in artistic projects, etc. To sit here fatigued, depressed, heart pounding, head aching, sad and hopless (when I know that that feeling--the feeling that life is worth living--is out there for me) is so upsetting.Speaking for myself, I would say that oxycontin is not going to be the solution to my depression because I am getting habituated and have had to raise my dose twice. I will be interested to see whether Zo develops a tolerance to buprenorphine.
I think if I had an anti-depressant that was working for me, and using oxycontin as an adjunct, I would not need to raise my dose. When nardil was basically working for me, I self-medicated with vicodin and never raised my dose. Right now I am so desperately depressed that the oxy is helping me stay alive and working, until hopefully something else kicks in. I believe, if I recall correctly, that buprenorphine is a supplement for Zo; not her main antidepressant.
> One psychiatrist told me that if he gave me codeine, he could go to jail.
That is absolutely not true. I think the worst that could happen is a loss of license, and that is the medical community policing itself. As far as I know, the only way a doctor could be legally prosecuted is by selling prescriptions for narcotics. My psychiatrist is using a narcotic as a last resort; my impression is that he has only a few patients on it.
>He was later arrested when a pharmacist reported him for writing "too many" (whatever the hell that means) benzo prescriptions. What's the deal?
I don't know what the story is with this doctor, but if he is your pdoc, I would call the American Psychiatric Association and check him out.
>How did you guys luck out with a doctor willing to prescribe something that most physicians are afraid to prescribe even for pain??? I'm a recovering opiate addict, and I think that most doctors would think I was crazy if I asked to be put on something like buprenorphine.
I did luck out. You might try meeting with another pdocs to discuss the possibility of trying buprenorphine. You could go armed with the few small studies regarding depression and buprenorphine; they can be found
on the internet. There is also information and studies using buprenorphine instead of methodone for heroin addiction. If you live in California or Boston you have a good chance of finding someone; if not you may need to call and/or meet with many doctors until you find one willing to take the risk. And I'm not sure what the risk is with you because I don't know a lot about your drug history (and don't really need to know). I would say that before you retry opiates, I would make sure there isn’t something you have missed in the way of ADs or mood stabilizers.Good luck,
Shelli
Posted by MB on September 7, 2001, at 0:03:48
In reply to Re: pdocs prescribing buprenorphine » MB, posted by shelliR on September 6, 2001, at 22:09:15
> Good luck,
>
> ShelliThanks for the extra information regarding your situation. Good luck to you, too. I hope you find some relief.
Posted by Zo on September 7, 2001, at 23:41:34
In reply to Re: I'm losing weig. . .Help! Stampede! » Zo, posted by MB on September 6, 2001, at 16:53:12
> I am surprised that you and shelliR have been treated with opioids (buprenorphine and oxycodone, respectively) by a psychiatrist. Don't they get in trouble with the DEA?
No, bupe is legal to prescribe for off-label use.
>How did you guys luck out with a doctor willing to prescribe something that most physicians are afraid to prescribe even for pain???
Been with my pdoc 9 years, he's seen everything else fail, he saw my dramatic improvement on Vicodin. He's an expert with meds. The fear you describe is lazy/bad doctoring.
>I'm a recovering opiate addict, and I think that most >doctors would think I was crazy if I asked to be put on >something like buprenorphine.
Unless you find one whose expertise is DRUGS. Behavioral Medicine. Few pdocs actually know anything about meds. . .when they do, a case like yours would be fascinating. Their whole paradigm is different, how they approach things.
Wish I could help, and wish you luck,
Zo
Posted by MB on September 8, 2001, at 13:12:49
In reply to Re: I'm losing weig. . .Help! Stampede!, posted by Zo on September 7, 2001, at 23:41:34
Thanks, Zo...and I wish you luck. I hope the bupe works for you. I only tried it once for heroin detox (I learned the lesson the hard way that medicating with street drugs is a bad idea...and with that drug, tolorence soon ensued along with obligitory dose increase). Anyway, bupe (I've stolen your abbreviation because it's cute and handy < g >) seemed to help the heroin withdrawal. I wonder what bupe would feel like by itself (without withdrawal from another drug to alter it's effect). I always thought if there was a drug that had the antidepressant efficacy of vicodin and heroin, but that didn't induce a tolorance or a need to keep upping the dose, it would be what my brain needed. Your story gives me hope. Keep us posted as to how it works for you.
ps. the only fear I have is that my past addiction to opiates might adversly affect my response to buprenorphine (e.g., I might get compulsive with it or build a rapid tolorance). I guess these are worries only a good psyc-pharm could address.
> Wish I could help, and wish you luck,
> Zo
Posted by Elizabeth on September 8, 2001, at 22:10:06
In reply to Buprenorphine - just started trial - Elizabeth, posted by Zo on August 31, 2001, at 16:46:21
> Just this morning sucked my first buprenorphine troche. Kind of like a gummy bear.
Cool! Your response sounds very promising. (How does it taste? And what is a "troche," anyway?)
> I'll keep you posted. (Get it? Posted?)
< groan >
-elizabeth
Posted by Elizabeth on September 12, 2001, at 3:28:07
In reply to Re: I'm losing weig. . .Help! Stampede! » Zo, posted by MB on September 8, 2001, at 13:12:49
> Anyway, bupe (I've stolen your abbreviation because it's cute and handy < g >) seemed to help the heroin withdrawal.
There's no doubt in my mind that it does this. I hope to see it approved for that use in the USA sometime soon. (BTW, the nickname "bupe" seems to be pretty common. :-) )
> I wonder what bupe would feel like by itself (without withdrawal from another drug to alter it's effect).
(This is going on the assumption that your heroin use was self-medication.) Imagine how you were before you'd ever tried heroin. Now imagine the "not-okayness" being taken away, but without causing a rush or nodding. That's about what it's like.
> I always thought if there was a drug that had the antidepressant efficacy of vicodin and heroin, but that didn't induce a tolorance or a need to keep upping the dose, it would be what my brain needed.
No s---! I wish that there was more research being done on ways to prevent tolerance to opioids -- that would be a tremendous advance in medicine.
> ps. the only fear I have is that my past addiction to opiates might adversly affect my response to buprenorphine (e.g., I might get compulsive with it or build a rapid tolorance).
I don't think so. Buprenorphine doesn't get you high, so the risk of abuse is very low (especially if you get a formulation with naloxone, which prevents you from shooting it). The tolerance thing seems to be a matter of individual variation. I think most people in maintenance programs reach a plateau dose where they don't need any more.
-elizabeth
Posted by Zo on September 14, 2001, at 19:20:11
In reply to Re: I'm losing weig. . .Help! Stampede! » MB, posted by Elizabeth on September 12, 2001, at 3:28:07
Oh Elizabeth, this is *so* good. . .
"Imagine how you were before. . . Now imagine the "not-okayness" being taken away, but without causing a rush or nodding. That's about what it's like."
It's been very hard to explain what bupe feels like. Your description gives me a start.
Thanks,
Zo
Posted by skeet on October 8, 2001, at 2:13:09
In reply to Re: Buprenorphine - just started trial » shelliR, posted by Zo on September 1, 2001, at 18:04:31
Hi ru stil on Bup i just started it..Feel a bit heady thats it...how many months now elizabeth? scott
Posted by skeet on October 8, 2001, at 2:27:38
In reply to Re: pdocs prescribing buprenorphine » MB, posted by shelliR on September 6, 2001, at 22:09:15
Oh btw love to correspond with anyone on Bup!!?? I have panic disorder..2..I was on methadone until yesterday I didnt find that the Meth was helping in anyway for panic..I wonder if the Bup will either??? I just want to be happy and relaxed.for once...WIthout sluggish unmotivated.!! etc..and also...... deal with panic..disorder!! Do u think they will give us the BUP??? 7days a week without that chemist pickup thing..ekkk! I Hate going there.all the time.....Whats you theory on Panic and Opiods??? thanks scott
Posted by skeet on October 8, 2001, at 2:30:39
In reply to I'm losing weig. . .Help! Stampede!, posted by Zo on September 5, 2001, at 20:35:46
omg i dont feel hungry either is this normall omg!!!!!!!!!
This is the end of the thread.
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