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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by bee happy on February 4, 2003, at 19:37:04
Laura I think possibly my answer to you disappeared..or could be my computer illiteracy at work...anyway here is the note I sent you last night. Laura Look at that Buprenorphine study again. Many of the
subjects were self medicating before the study. I did too. Until
I was 35 I would take what ever opiate i could get my hands on.
And because of the awful guilt i felt, went through a rehab to
stop. For the the next 15 years I was just"ok"...not great by any
means, but functioning. The grey returned with a vengence
about two years ago.I too started 'borrowing' an occasional
pain pill from my husband's rotator cuff surgery prescription
for Norco.(With the same response as your husband) When my
Psychologist told me about the harvard study...she said "Bee,
you present too well. Beg. Cry. Ask the Psychiatrist to use you
as a guinnea pig!" She was all for trying it and told him so. He
was tetchy at first...mostly because of the hell he would have to
go through if the government started scrutiniziing his
prescription writing. But then he read all the literature about
the new program using Buprenorphine for drug dependence, and
that it was a shedule III with little potential for abuse due to
the agonist/antagonist properties). That was it. I found the
pharmacy where it could be compunded to sublingual form and
we were off.(My husband is now totally supportive and
understands now what I was going through). Perhaps you could
try a doctor that specialized in drug dependence..and with the
help of your family doc and your Psychologist...get a trial dose.
The CDR website is
(http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm).I
hope this is some help. I really feel for you. You might even try
calling McClean Hospital in Boston where the Harvard study was
conducted....and ask for DR.Bodkin. Someone on this board was
actually able to speak with him personally when he was
desperate to find a doctor will to try this treatment. Let me
know how you're doing. If nothing else...it's good to have
somone you know understands what you are feeing. Believe me
I understand. Bee
Posted by LAURA777 on February 5, 2003, at 23:03:50
In reply to laura777 in response to your note to bee happy, posted by bee happy on February 4, 2003, at 19:37:04
hey bee thanks very much , and i have added alot of things to my arsenal of info , but i afraid to say that i don't think they will try it , but we well see , so far the provigil makes me feel lots of energy so i have to move but the good feelings that should back that up are not there , and let me stress i have gone to therapy for 3years and i used to go in my teen years and i also had a year of intensive therapy 11 yrs ago so i am doing very well on that end ,.. truly .. i am just stuck at this place of why do something if i don't get pleasure .. like i said i have been suffering since 12 ,, but i have not been aware of it .. the cage thing being very operative here .. And at the time i picked up heroin 11 years ago , i was not aware of what i was feeling and why i did heroin ,, so here i sit many years later very AWARE of how i feel .. provigil gives me energy and it has very low dopaminergic qualities though (hence the low abuse properties) there it is again !!
i think i get tired because of the boredom and the push of life ...
i am also afraid of getting a stimulant . it will enhance my dopamine , but i am afraid it will make me revved up ..i see the pdoc on febuary 21 i am going to bring all of my information to him , and let him decide and give me some input as to why he decides the way he does , because i am not stupid .. there is rational and biologocal reason behind the use of subutex in some cases ,, cases such as myself a few others on this board .. and i will not let the fact that i abused opiates before , have them tell me oh no you can't have this .. if i wanted to use drugs i would have started up again , but addiction is intolorable to me and it is not a way of life and i am way way long past that unaware dysfunctional way of life ... i just want to feel normal and do things and feel the other half of life !!!! ya know i do things that other people do because i push myself , and this is very rare , but i wonder why people do these things cause they are not fun for me .. now this has happened on variety of things . the only interest i seem to have is to read books and i think that is a intellectual exercise .. i am not an introvert either .. i just don't get what all this fun stuff is and this JOY ,, i thought when you got older that just left and here you are reality ..But this can't be because i see other people my age and older still expierencing these good things "what is wrong with me " this is all there is !!! except when .... i ingest an opiate . but some may say that is because anyone who takes an opiate feels great .. but for me it doesn't make me euphoric , only some and that is short acting , what happens in long term is motivation interest pleasure with no euphoria just normal..in a real sense , it is not out of proportion from what i believe a normal person feels .. sorry for the rambling , in fact people do not know i am on it and they know me and they say boy you look good and sound good today .. all except my husband who is so stuck on the addict shit .. his mind goes right to that . he is not used to seeing me animated ,i try to explain the biochemical thing to him , and i have info to back me up . but he lives in a world of his own and is very unaware of how he feels himself , he has had no psychotherapy , and could not even tell you how he feels .. he does absolutly no self examination or maybe the bare minimum .. he has no social life does not interact with his kids and plays a computer game 16 hours a day when he is not working .. this is normal to him , he never has any real fun and i hardly see him smile , he suffers from depression also .. he will deny this too , except that i point out every chance i get that this is not normal and take a look around will you ??
any way i have poured through pages of data and even though i do not understand every damn brain chemical of every medical term , i understand the gist of things very well .. i believe that some of us are born with a dopamine deficit opiate deficit , just like someone who responds to an ssri because they have a serotonin deficit or like effexor because they have a neuroepinephrine deficit . or it can be a combo of these two or maybe a combo of dopamine and serotonin , but dopamine is understudied in the pleasure principle factor because of the stigma of abuse and opiates also , the threw the baby out with the bath water ..And i know if they tried they can chemically alter the opiate like they did with bup SUBUTEX but i am encouraged to see the correlation of dopamine and the mesolimbic system studies about lack of motivation ..REWARD is a great motivator , but if you expierience none in normal life , in normal things , motivation is illusive and hard...so very hard to come by and i won't even mention interest .. i have much more to say but this is too long already , thanks for listening , laura
Posted by LAURA777 on February 6, 2003, at 16:57:12
In reply to laura777 in response to your note to bee happy, posted by bee happy on February 4, 2003, at 19:37:04
hi bee , the wheels are turning , i have been doing research , provigil is not for me .. i am very sensitive to any stimulant .. the reason being i have a very high level of norepinephrine. this i know because i have a fast metabolisim , At the dentist they add epinephrine to the novicaine so you stay numb longer , if they give this to me , my heart races out of my chest i shake and i see halos around my vision .. when i took pseduoephedrine that are in cold meds i got such a bad reaction literal depression but on a much smaller scale than what happened to me with coke ,, these are all stimulants and they all affect norepinephrine which regulates metabolisim , energy , this is why prior to prozac i was so revved up .. go go go ... serotonin is the breaks for our body .. so with the taking of prozac i got to slow down .. my treatment is incomplete i still have this anhedonia ..
anyway bee i think i have a pdoc that will look into this .. i have so much data to back me too !! my question is , Is suboxone just as affective as subutex ???? i do hope so because suboxone is the only thing available in the united states right now ... Bee please let me know , many many thanks laura
Posted by bee happy on February 6, 2003, at 23:12:21
In reply to BEE HAPPY PLS. READ SUBUTEX OR SUBOXONE » bee happy, posted by LAURA777 on February 6, 2003, at 16:57:12
Laura. May I ask you a question? When you wrote your post of Feb 5th had you taken the provigil that day? I ask bacause I think I dectected a bit of manic thought...not your usual coherent self (from the little I know of you from reading you posts of the last week or so.)To answer your question re Suboxone. It is my understanding that the "oxone" addition keeps one from abusing the drug as in snorting or injecting it. This is of course to keep addiction maintainance patients from abusing it themselves or selling it on the street to other street addicts. I would imagine that someone taking it for depression as prescribed would not be influenced by the added ingedient but I may be wrong. My prescription is compounded and contains no Naloxone.Where do you live? Most major cities have at least one pharmacy that is capable of making compounds. For instance some patients have trouble swallowing pills or can't keep medicine down...many different formulas are available ...from lollypops to nasal inhalers to sublingual troches. Look in the phone book. Call the pharmacy, behonest and tell them you are researching Buprenorphine as a treatment for depression and ask if they are making buprenorphine for anyone else and if so which doctor is prescribing it. Then you could call that doctors office and ask him more about it. It's my guess that very few doctors are even aware of Buprenorphine at all let alone as an anti depressant.This is a shortcut to finding the ones who at least know about it. When My Pdoc and I first discussed this drug he got out his PDR and said "oh, too bad only available in injectable form". But I noticed his PDR was 2 years old. So I called the only compunding pharmacy in my town and asked them the same questions I just suggested. They were very helpful and yes they had been making it for a few years...and gave me the name of the doctor who was prescribing most of it. It ended up I never needed to call him because as soon as my Pdoc realized it was available we started the treatment. But I had to do the leg work, Laura. I found out which strengths were available and how many times per day to take it. He then called to verify all my info. He's a busy guy and I'm just one of many patients...plus he teaches...a very busy guy. As I said before I was very motivated. Suicidal thoughts were creeping into my daily life....they are powerful little motivaters.May I ask another question or two?How old are you ? How often did you use heroine and for how long?(Feel free to tell me it's none of my damn business). Is there some insurance related reason why you don't want to bring that into this equation?Have you given any thought to consulting with an addiction specialist? And if not, why not? My family doctor was once a rehab specialist and understood completely when I was describing how opiates made me feel. She also agreed that trying the buprenorphine made sense for me. I was soo lucky to have had her for my primary care physicain for the last 17 years...She knew me verrrry well. I wish you well, Laura. Keep me up to date,ok? Bee
Posted by LAURA777 on February 7, 2003, at 0:59:40
In reply to Re: BEE HAPPY PLS. READ SUBUTEX OR SUBOXONE, posted by bee happy on February 6, 2003, at 23:12:21
hey bee, yes i did take provigil and yes it made me revved up and not able to work smoothly .. stimulants always did that to me . i have either a high norepinephrine or i am very sensitive to it .. here is the post that explains it all in good detail .. it is quite interesting ..
http://www.dr-bob.org/babble/20030204/msgs/139866.html
also i called the bup company today and spoke with the pharmocolgist.. , As for my past addiction , i am very willing to talk about it , it is more likely to be a positive .. in fact the pdoc specializes in it .. and like i said i did alot of digging and found alot of info that supports that this would be a way to go ..
provigil sent me flying ..and feeling horrible.. i took one earlier today in the morning and here it is 2.00 am and i am still up .. but i am winding down .. i will never take any stimulant again , but what was very good about this expierience is that it got me to investigate why stimulants effect me this way .. and i found the reason for which you will see in the link that i pasted above .. i will keep you informed .. thanks and i am very grateful , laura
Posted by LAURA777 on February 7, 2003, at 1:02:33
In reply to Re: BEE HAPPY PLS. READ SUBUTEX OR SUBOXONE, posted by bee happy on February 6, 2003, at 23:12:21
hey bee i am 38 yrs old and i used heroin for 3 1/2 years the last 1 1/2 years i used heavily .. thanks laura
Posted by bee happy on February 7, 2003, at 22:16:39
In reply to Re: BEE HAPPY PLS. READ SUBUTEX OR SUBOXONE » bee happy, posted by LAURA777 on February 7, 2003, at 0:59:40
Ah. That explains alot. Although I was never into your particular drug of choice, your addiction history parallels mine. I often wonder if I was always predisposed to this or if my drug use caused something to tweak.Hopefully someday they will be able to test for that and tell me. You mentioned things changing for you from onset of adolesence. Me too, me thinks. I'll bet you do as well as I did with this treatment. And then look for your life to take on a whole new dimension. Just be patient. The doctors are just being careful. Good luck Laura.
Posted by LAURA777 on February 9, 2003, at 14:46:05
In reply to Re: BEE HAPPY PLS. READ SUBUTEX OR SUBOXONE, posted by bee happy on February 7, 2003, at 22:16:39
hey Bee , do you expierience tolerance with bup. ? do you have any info on this ?? and also suboxone is what is available here which is fine with me , but what dosage should i consider ??? please let me know , thanks , laura
Posted by bee happy on February 9, 2003, at 19:48:27
In reply to Re: BEE HAPPY PLS. READ SUBUTEX OR SUBOXONE » bee happy, posted by LAURA777 on February 9, 2003, at 14:46:05
Well I guess that depends on what you mean by tolerance. I have been taking this for 6 months now. When I first started taking it, the difference between how I felt before taking it and after taking it was such a huge improvement....I went from total inability to feel to feeling good and interest and motivated and so in the moment almost immediately.It was all that I had hoped it would be and more. Now that I've been in that state of mind for 6 months it's hard to remember how horrible I felt before. I am still thrilled to be motivated and in the moment every day but that intial feeling of wow what a difference has ebbed somewhat. But when I try to remember how bad I felt I am again dumfounded by how good I feel, even though feeling good has become routine and my usual state of mind. Does that make any sense? It's more subltle now. And to answer your question about dosage. I cannot say what you should start with.Have you suggested that your Pdoc call the Pdoc at McClean Hospital in Boston? I'm sure he would have alot more information about dosage now that he's been using it for several years. I can only tell you my experience. Remember, I did alot of reading about maintance too...so as I said it was sort of a silly pride thing that I not take any more than the low end a maintainance patient would take which is 8 mg per day. I started with .3mgs 3X's daily escalated over the next 3 months to 2mgs 4X's daily.It wasn't that I needed more and more to feel good it was that I kept feeling better and better as I slowly increased the dose. I had read that in treating maintainance patients, two little was as bad or worse than too much...and apparently this is true with methadone maintainence as well. As I said I have edged back a little to 2mg 3X's daily because I was feeling a little too sleepy on nights that I wanted to stay awake later...but I sort of take it as needed in the evening now...I have also forgotten to take it a few times and was pleased that I felt no real break in mood or the squirrely feeing of a "jones". At first I hated the taste of the troches, like sucking on nutra-sweet. But now I actually like it. Pavlovian,perhaps. Sucking on nutra sweet= feeling brilliant ergo suck that nutra sweet!! Once in this escalation period my pdoc warned me that if I was building a tolerance...he would be concerned...but when he reread the maintainence dosing info...and I told him that I would rather stop now than loose his trust and abuse this drug. It may have helped that he knew that when I was self medicating with codeine years earlier I was taking what would probably kill the average person. Those Mu receptors want what they want!!!(I have no idea what that means....it is my understanding that we are lacking in dopamine because of either a shortage or a glut of Mu receptors.) You seem to understand all that alot better that I. So...patience,my friend. I hope this has been of some help.
Posted by LAURA777 on February 9, 2003, at 20:27:34
In reply to Re: BEE HAPPY PLS. READ SUBUTEX OR SUBOXONE, posted by bee happy on February 9, 2003, at 19:48:27
hey bee yes your post helped tremendously.. and the thing about the mu receptor is true pluse the dopamine , also if you have alot of gaba in the nucleus accumbens it inhibits release of dopamine in the nucleus accumbens .. theres more to it , but also you stated about a glucose receptors being in short supply for the serotonergic sys to activate the opiate peptides in the hypothalmus ..
you said ...."I went from total inability to feel." does this mean you did not feel the unpleasant emotions ?? becasue i feel them !! just not the pleasant ones .. please let me know , thanks laura
Posted by bee happy on February 10, 2003, at 18:13:36
In reply to Re: BEE HAPPY PLS. READ more questions » bee happy, posted by LAURA777 on February 9, 2003, at 20:27:34
I'm not exactly sure what you mean by unpleasant emotions. For instance I love a good cry. But I felt so bad I couldn't even cry. Yes I guess I still felt what you call unpleasant emotions. It would really bother me that my husband was so tunnel visioned. Yes I felt annoyance at annoying things I guess. But mostly I felt numb.
Posted by LAURA777 on February 10, 2003, at 19:21:27
In reply to Re: BEE HAPPY PLS. READ more questions, posted by bee happy on February 10, 2003, at 18:13:36
hi bee , what i mean by unpleasant emotions is annoyance , frustration, unmotivated , bored , sad , everything is a push , (everyday normal activities ) and when you go places that are suposed to be fun and you see other people enjoying them selves .. but you still don't , it is like you are numb to joy, fun , exiloration , and contentment and satified.. the former emotions i can feel , mostly boredom , but the latter feelings ..???? i feel numb to them ..
have you found this to be you expierience ?? thanks for your time Bee i really apprieciate it , laura
Posted by bee happy on February 11, 2003, at 12:04:46
In reply to Re: BEE HAPPY PLS. READ more questions » bee happy, posted by LAURA777 on February 10, 2003, at 19:21:27
Yes I felt all those things too.And like you, for the last two years only those things. But that's the depression talking,Laura. Once the depression lifted those emotions were moot. When you can feel the good things the 'bad emotions' are there only when something bad happens. Your lifelong depression is making you concentrate on the negative things.It seems to me you think too much.The medication will mellow out your thoughts. Trust me. You'll see.
Posted by LAURA777 on February 11, 2003, at 13:17:37
In reply to Re: BEE HAPPY PLS. READ more questions, posted by bee happy on February 11, 2003, at 12:04:46
Yes bee , i do think too much .. i went to see my psycologist today and showed him all the info and he is going to talk with the psychiatrist before my appointment... suboxone looks like a good plan to my physchologist so i hope that i will be able to get it soon .. i will keep you posted dear lady and i thank you from the bottom of my heart , laura
Posted by bee happy on February 11, 2003, at 17:39:31
In reply to Re: BEE HAPPY PLS. READ more questions » bee happy, posted by LAURA777 on February 11, 2003, at 13:17:37
Reading over our conversations of the past week or so gave me such a good feeling. ...As the West Indians say...made me eye water. I hope hope hope that you are one of the folk who can be transformed by the miracle of modern medicine. It is not a perfect world...but when it's good it's very very good. I will look forward to your posts in the future. Your sappy friend, Bee
Posted by LAURA777 on February 11, 2003, at 19:03:09
In reply to Re: BEE HAPPY PLS.Water come to me eye, posted by bee happy on February 11, 2003, at 17:39:31
> Reading over our conversations of the past week or so gave me such a good feeling. ...As the West Indians say...made me eye water. I hope hope hope that you are one of the folk who can be transformed by the miracle of modern medicine. It is not a perfect world...but when it's good it's very very good. I will look forward to your posts in the future. Your sappy friend, Bee
hey you are not sappy , just very compasionate and i think that is direct result from the suffering .. empathy is another quatlity that is a result of this .. i think my phsycologist is going to find someone to get me suboxone .. or at least talk to my doctor or find any doctor , i know he will help, i do not produce endorphins normally , i know this as i know misery ..endorphins are what gives you the ability to enjoy .. and yes i am going to speak out against the OPIATE PHOBIA .. concerning opiates they threw the baby out with the bath water .. i will let you know whats going on as it comes , again i want to thank you so much , your equally sappy friend , laura
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