![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 35 to 59 of 74. Go back in thread:
Posted by barbaracat on April 6, 2005, at 22:58:59
In reply to Peripheral opioid antagonists » barbaracat, posted by ed_uk on April 6, 2005, at 15:00:24
**I take 2 Tbs psyllium husks, 2 Tbs ground flax seeds and 1 Tbs ground pumpkin seeds and some ayurvedic herbs. Along with about 12 glasses water a day it does the trick.
Prior to this, not to be rude or anything, but months would go by before I had a satisfying evac. I knew something was terribly wrong, whether it was hypothyroidism, the opiods to treat fibro pain, or whatever. I now see how chronic digestive problems were keeping me in a spiral of toxicity.
It's difficult to say what elements contributed more than others once you start feeling well - was it getting the thyroid med right, going on my wee dose of Cymbalta, getting my sex hormones balanced, cutting way back on alcohol and committing to my health. I don't know. But having righteous poops ranks very high on the list.
>
> Interestingly, at least two peripheral opioid antagonists are in development: methylnaltrexone and alvimopan. They are effective in preventing/treating opioid-induced constipation while leaving the analgesic properties of the opioid unchanged. At the moment, many patients who take opioids such as oxycodone for the treatment of chronic pain need to take two or more laxatives on a daily basis. Lactulose + senna is a popular combination in the UK.
>
> Ed.
Posted by Paulbwell on April 7, 2005, at 1:13:14
In reply to Re: Oxycontin for mental health » jay, posted by barbaracat on April 6, 2005, at 14:29:20
> It's a wonderful AD. If it didn't bung me up I'd take it all the time. That is, if it didn't cause the tolerance issues. Too bad. I think endorphins are a gravely ignored field in our mood dysfunctions. - BCat
Hi Barb,
Yes you are right, It's 2005 not 1905 unfortunatly, no more 'mrs winslows powered opium syrup' and the like OTC anymore.
I have an acquantance who has suffered from Psychiatric 'issues' for several years, shes about 27, and had every
anti psychotic
anti depressant
lithium
and more, thrown at her, often at high doses. these seem to have not helped. after trying Methadone, 15mgs she felt more benefit than from said meds, so It seems she has suffered enought for the'medical profession' to allow her to have it legally (after saying she was buying it from the black market).She feels 'normal' on it, a term heard so often from thoes with mental 'issues' who respond well to Opiates/Opiods.
It is time this "gravely ignored field" was reopened, with respect to other conditions, than sever PHYSICAL ONLY Pain.
p
Posted by Paulbwell on April 7, 2005, at 1:44:45
In reply to Re: Peripheral opioid antagonists » ed_uk, posted by barbaracat on April 6, 2005, at 22:58:59
The BEST LAXATIVE would have to be 2 teaspoons of Epsom Salts (magnesium sulphate) disolved in hot water, with a taste hider.
try that for a "righteous poop"--classic+)
Posted by ed_uk on April 7, 2005, at 8:40:01
In reply to Re: Peripheral opioid antagonists, posted by jerrympls on April 6, 2005, at 19:12:53
Hi Jerry!
Luckily I have had no problems with constipation while on the hydrocodone. Haven't had to take any laxatives either.
:-)
Ed.
Posted by ed_uk on April 7, 2005, at 8:44:34
In reply to 1905-2005?, posted by Paulbwell on April 7, 2005, at 1:13:14
Hi P,
>'mrs winslows powered opium syrup'
LOL! That's just the sort of name that it would have been called.
Ed.
Posted by Dr. Bob on April 8, 2005, at 0:09:32
In reply to Best Laxative, posted by Paulbwell on April 7, 2005, at 1:44:45
> The BEST LAXATIVE would have to be 2 teaspoons of Epsom Salts (magnesium sulphate) disolved in hot water, with a taste hider...
Sorry to interrupt, but I'd like to redirect follow-ups regarding laxatives to Psycho-Babble Health. Here's a link:
http://www.dr-bob.org/babble/health/20050306/msgs/481431.html
Thanks,
Bob
Posted by flipsactown on April 8, 2005, at 1:31:29
In reply to Re: Oxycontin for mental health....WOW!!!!!!!!! » Larry Hoover, posted by jerrympls on April 4, 2005, at 20:31:25
I took the max dosage of Oxycontin 2 tabs 4 times daily for nearly 2 years prescribed by a Pain Management Doc. I suffer from chronic back pain after two failed back surgeries, numerous pain shots, nerve block, facet joint,cortisone,etc.
I had been taking Tylenol-Codeine 3, 60mg x 5 times daily for years and finally decided to try the Oxycontin since I heard it was long lasting. I had to keep increasing the dosage to the max and even then it was only giving me the same pain relief I was getting from the Tylenol-Codeine. So, I decided to go back to Tylenol-Codeine when I experienced, accidentally, the terrible withdrawal effects of Oxycontin when I used more Oxy then prescribed because I was trying to do more home chores. It was only a day without Oxy and already I started feeling flu like symptoms, dizziness, and on the 2nd day I felt like bugs or ants crawling all over my body and I just wanted to jump right out of my body. That was a horrible feeling, so that same day, I went to Urgent Care where, fortunatley, my Adult Med Doc gave me an emergency refill enough to last a week, until my Pain Mgmt Doc would be able to write me a refill. I read about the warnings about the horrible withdrawals of Oxycontin, but I thought it was exaggeration. Believe me when I say it was not an exaggeration.
Bottomline: Oxycontin did not act as an A/D for me, as I was taking several different A/D's including Prozac, Remeron, Lithium and Lamictal. Lamictal was used to enhance Prozac's A/D effects. Currently, I am on Lexapro and just recently add Wellbutrin to enhance Lexapro's A/D effect after I felt the Lexapro losing it's effectiveness after 9 months of use. Fortunately, although it has only been 6 days since adding Wellbutrin SR, I am starting to feel less depressed.
As far as Oxycontin is concerned, I would never use it again because of the horrible withdrawals and the many hoops one has to jump to continue getting refills or an increase in dosage. I did not experience any withdrawals from my years of taking Codeine. I went for weeks or months without taking any Codeine, just to prove to myself that I was not addicted. I can't say the same for Oxycontin. I am still taking Codeine.
This is just my own personal experience.
FST
> > > Last weekend at a friends place, and he gets giant pills of Oxycontin every month for a work-related disability. So, I have a *wee* headache (ha, nice excuse!) and decided to pop 2 back. (I think that was 20 mg's..not sure..doh!) Well, I never, ever felt better than ever, all of my tension released, relaxed, got home and had the best sleep ever. I am so confused about this...in their use for mental illness, would we develop a tolerance? What do you guys think?
> > >
> > > Thanks,
> > > Jay
> >
> > Here's the problem for psych use. Tolerance.
> >
> > You will only get the effect you describe if you use the drug occasionally. Occasionally can mean different things to different people, but once weekly may be too often for most.
> >
> > The active ingredient, oxycodone, is very addictive. Next to heroin, (and maybe even ahead of it now), oxycodone is the most abused opiate or opiate-related drug. It is a very slippery slope, and you have one foot firmly planted on it. Taking two is already drug-abusive behaviour. Beware.
> >
> > Lar
> >
> >
>
> I disagree that taking 20mg of Oxycontin is drug abuse behavior - and while tolerance is an issue - it doesn't happen all the time. I'm going on 5 months continuous treatment with an opiate PRESCRIBED by my pdoc for my depression. Still works like day #1.
>
> Jerry
Posted by Paulbwell on April 8, 2005, at 22:08:44
In reply to Re: Oxycontin for mental health....WOW!!!!!!!!! » jerrympls, posted by flipsactown on April 8, 2005, at 1:31:29
Hi Flip,
You say you took/take 300mgs+ Codeine Daily for years and you could quit anytime, without trouble?
*no withdrawal symptoms*?
-Sore joints
-Sleep trouble
-Anxiety?
even after long term use?I find Codeine usefull sometimes, but dependence concerns me.
You apparently find the natural Opiate Codeine, a different animal, from synthetics like the notorious Oxycontin?
Posted by flipsactown on April 8, 2005, at 22:38:00
In reply to Flip???, posted by Paulbwell on April 8, 2005, at 22:08:44
That is my experience, no sore joints, no sleep trouble, no withdrawals and no anxiety. In fact, on my last refill, I had to wait a week before I was able to get a refill and had no withdrawals. Now if that was Oxycontin, I would have been in the emergency room begging for emergency Oxy refill!!
Codeine works for my chronic pain! Oxycontin was very addictive and in the long run provided only as much relief as codeine. Of course, everyone reacts differently to medication.
FST
> Hi Flip,
>
> You say you took/take 300mgs+ Codeine Daily for years and you could quit anytime, without trouble?
>
> *no withdrawal symptoms*?
> -Sore joints
> -Sleep trouble
> -Anxiety?
> even after long term use?
>
> I find Codeine usefull sometimes, but dependence concerns me.
>
> You apparently find the natural Opiate Codeine, a different animal, from synthetics like the notorious Oxycontin?
Posted by Paulbwell on April 9, 2005, at 0:58:57
In reply to Re: Flip??? » Paulbwell, posted by flipsactown on April 8, 2005, at 22:38:00
Thanks Flip,
Comforting to know.
You take 60mgs 5x a day=300mgs?
and find pain relief better than Oxy?-No Euphoria/stimulation from Oxy?
-Apparently Oxycontin is a stimulating Opiod,
thou I'm guessing when abused, not when used medically, as in your case.If I may ask, what dose of Oxycontin did you use for your injuries?
Thanks for your relpy
Cheers
Posted by flipsactown on April 9, 2005, at 2:37:28
In reply to Flip-Codeine, posted by Paulbwell on April 9, 2005, at 0:58:57
Paulbwell,
> You take 60mgs 5x a day=300mgs?
> and find pain relief better than Oxy?Yes on the dosage. Initially, like the first couple of months, Oxy was superior in pain relief. After that, pain relief dropped down to the level of relief I was getting with Codeine.
> -No Euphoria/stimulation from Oxy?None
> -Apparently Oxycontin is a stimulating Opiod,
> thou I'm guessing when abused, not when used medically, as in your case.Exactly
> If I may ask, what dose of Oxycontin did you use for your injuries?
Max daily dosage my Paindoc RXed was two 20mg x 4 = 160mg/day
> Thanks for your relpyYour welcome.
FST
Posted by greenhornet on April 9, 2005, at 8:09:05
In reply to Re: Flip-Codeine » Paulbwell, posted by flipsactown on April 9, 2005, at 2:37:28
This entire discussion makes me want to weep! Using opiates to "feel better" is not all that much different than the rest of biopsychiatry. For over twenty years of my over sixty years of life, I too was a prisoner of "psychotheraputic" treatment. At the time it seemed the right thing to do. After all, I am a nurse/therapist and my husband a physician.
Slowly, over the years, through my own experience and that of those around me (clients and coworkers), it bergan to dawn on me that I was not reallly facing up to life, not taking responsiblilty for my own behaviour, and was running from reality through drugs (prescribed) and "therapy"....
I have posted most of this before and it usually get lots of really angry responses from folks who are just sure that; "Well, that worked for her, but "I have" or "I am" or what ever. That's called "I Disease" people! Put the stuff down, and take charge of your own life! I finally did and what a difference! The whole world is a different/better place. Stop letting the American Psychiatric Association label you and call it "illness" and trying to fix what "ain't really broke" to begin with!!
It was two decades of not feeling emotions that simply fed into my not learning how to deal with them. Every time you get off medicatioon you "relapse"?? That's what I though too, until until the whole debacle with first Effexor then Lexapro. What have people (myself included ) experienced there? Painful, often prolonged withdrawal - not relapse. So what does the physician do? Give out another drug!! But you can live through it (the withdrawal), and you can live without dumping chemicals into your body. I finally am able to live that way.
A therapist from another culture once shared this with me:
"Of course Americans are depressed -- you are raised to believe that you are entitled to the good things in life and that pain is to be avoided at ALL cost. Then when tough times hit, you are surprised and becoome "depressed"
In some other cultures the people grow up EXPECTING pain and suffering, so when it happens there is no big shock, and the "good things" are seen as rare and not a way of life.
I have been drug free for a year now and it's wonderful. Try it, you might be amazed. GH
PS Coming off took me over a year -- do not rush it! By the way,in those twenty-plus years, I took something like twenty-five psychoactive substances, antidepressants, stimulants, anxiolytics, antipsychotics - the whole pharmacopea, So please, don't tell me I don't know what I am talking about..Paulbwell,
> > > You take 60mgs 5x a day=300mgs?
> > and find pain relief better than Oxy?
>
> Yes on the dosage. Initially, like the first couple of months, Oxy was superior in pain relief. After that, pain relief dropped down to the level of relief I was getting with Codeine.
>
> > -No Euphoria/stimulation from Oxy?
>
> None
>
> > -Apparently Oxycontin is a stimulating Opiod,
> > thou I'm guessing when abused, not when used medically, as in your case.
>
> Exactly
>
> > If I may ask, what dose of Oxycontin did you use for your injuries?
>
> Max daily dosage my Paindoc RXed was two 20mg x 4 = 160mg/day
>
> > Thanks for your relpy
>
> Your welcome.
>
> FST
>
>
Posted by flipsactown on April 9, 2005, at 10:05:50
In reply to Re: Flip-Codeine, posted by greenhornet on April 9, 2005, at 8:09:05
GH,
In my case, I was not taking Codeine to "feel better" mentally, I was taking it to feel better physically. Chronic low back pain, from 2 failed back surgeries, numerous injections to the spine, having had tried many different treatments, including acupuncture, TENS unit and biofeedback, I had no choice, but to take narcotics, mainly Codeine, to get some pain relief.
I had tried for over a year to go without any medications or talk therapy and that nearly cost me my marriage. When I came close to being physical with my wife, I decided to seek psych therapy, which I have to say saved my marriage. My therapist of over 10 years had recommended I take Prozac. I was very hesitant at first because of all the bad press I had read about. Fortunately, I tried Prozac and in less then 3 weeks, I realized I was feeling like my normal self, a happy-go-lucky guy with a wonderful wife and three sons. I have now been married 32 years to the same woman, who put up with me when I was in constant physical and mental pain.
Bottomeline: Chronic physical pain is very real which from my research, usually results in depression. Apparently, chronic pain uses up certain chemicals in the brain, like serotonin, which in turn causes depression. Without having had tried narcotics with regular talk therapy, I would not now be still, happily married. Again, this is my own personal experience.
FST
> This entire discussion makes me want to weep! Using opiates to "feel better" is not all that much different than the rest of biopsychiatry. For over twenty years of my over sixty years of life, I too was a prisoner of "psychotheraputic" treatment. At the time it seemed the right thing to do. After all, I am a nurse/therapist and my husband a physician.
> Slowly, over the years, through my own experience and that of those around me (clients and coworkers), it bergan to dawn on me that I was not reallly facing up to life, not taking responsiblilty for my own behaviour, and was running from reality through drugs (prescribed) and "therapy"....
> I have posted most of this before and it usually get lots of really angry responses from folks who are just sure that; "Well, that worked for her, but "I have" or "I am" or what ever. That's called "I Disease" people! Put the stuff down, and take charge of your own life! I finally did and what a difference! The whole world is a different/better place. Stop letting the American Psychiatric Association label you and call it "illness" and trying to fix what "ain't really broke" to begin with!!
> It was two decades of not feeling emotions that simply fed into my not learning how to deal with them. Every time you get off medicatioon you "relapse"?? That's what I though too, until until the whole debacle with first Effexor then Lexapro. What have people (myself included ) experienced there? Painful, often prolonged withdrawal - not relapse. So what does the physician do? Give out another drug!! But you can live through it (the withdrawal), and you can live without dumping chemicals into your body. I finally am able to live that way.
> A therapist from another culture once shared this with me:
> "Of course Americans are depressed -- you are raised to believe that you are entitled to the good things in life and that pain is to be avoided at ALL cost. Then when tough times hit, you are surprised and becoome "depressed"
> In some other cultures the people grow up EXPECTING pain and suffering, so when it happens there is no big shock, and the "good things" are seen as rare and not a way of life.
> I have been drug free for a year now and it's wonderful. Try it, you might be amazed. GH
> PS Coming off took me over a year -- do not rush it! By the way,in those twenty-plus years, I took something like twenty-five psychoactive substances, antidepressants, stimulants, anxiolytics, antipsychotics - the whole pharmacopea, So please, don't tell me I don't know what I am talking about..
>
>
>
> Paulbwell,
> > > > You take 60mgs 5x a day=300mgs?
> > > and find pain relief better than Oxy?
> >
> > Yes on the dosage. Initially, like the first couple of months, Oxy was superior in pain relief. After that, pain relief dropped down to the level of relief I was getting with Codeine.
> >
> > > -No Euphoria/stimulation from Oxy?
> >
> > None
> >
> > > -Apparently Oxycontin is a stimulating Opiod,
> > > thou I'm guessing when abused, not when used medically, as in your case.
> >
> > Exactly
> >
> > > If I may ask, what dose of Oxycontin did you use for your injuries?
> >
> > Max daily dosage my Paindoc RXed was two 20mg x 4 = 160mg/day
> >
> > > Thanks for your relpy
> >
> > Your welcome.
> >
> > FST
> >
> >
>
>
Posted by Larry Hoover on April 9, 2005, at 10:31:37
In reply to Re: Flip-Codeine, posted by greenhornet on April 9, 2005, at 8:09:05
Thanks for weighing in, greenhornet.
If I may be so bold, I would draw the following theme and conclusion from your post....
Medication is not the only answer to depressive symptoms, if cognitive coping strategies are actually promoting depression. Therefore, changing cognitive processes can lead to remission of depression, and relieve the need for medication.
I'm with you on that, but....
Cognitive therapy can be reduced to a very simple concept, IMHO.....
Same input, different output.
What happened, happened. Life is life. What you feel about it is largely a matter of choice, habit, training, internalization, experience, attitude, belief, expectations, faith, and similar.
So, there's a lot to work with in that list (and I certainly missed some). That's what cognitive therapy is for. To work with the list of interpretive cognitions we all employ.
That said, it may also be an inappropriate expectation to assume that modification of cognition alone can lead to remission. Medication has a place in recovery (and maintenance) for some people. You really can't generalize about that.
Lar
Posted by greenhornet on April 9, 2005, at 13:08:57
In reply to Re: Flip-Codeine » greenhornet, posted by flipsactown on April 9, 2005, at 10:05:50
FST,
I am sorry --I do owe you an apology. You are right about chronic pain, I'm afraid that in my "passion" I overlooked your situation. Please accept my apology. I hope things continue to go well for you. You seem to have good insight into, and an understanding of your problem.
It is also good to hear from someone else who has been married 30+ years. My husband and I will celebrate thirty eight years soon. GHGH,
>> In my case, I was not taking Codeine to "feel better" mentally, I was taking it to feel better physically. Chronic low back pain, from 2 failed back surgeries, numerous injections to the spine, having had tried many different treatments, including acupuncture, TENS unit and biofeedback, I had no choice, but to take narcotics, mainly Codeine, to get some pain relief.
>
> I had tried for over a year to go without any medications or talk therapy and that nearly cost me my marriage. When I came close to being physical with my wife, I decided to seek psych therapy, which I have to say saved my marriage. My therapist of over 10 years had recommended I take Prozac. I was very hesitant at first because of all the bad press I had read about. Fortunately, I tried Prozac and in less then 3 weeks, I realized I was feeling like my normal self, a happy-go-lucky guy with a wonderful wife and three sons. I have now been married 32 years to the same woman, who put up with me when I was in constant physical and mental pain.
>
> Bottomeline: Chronic physical pain is very real which from my research, usually results in depression. Apparently, chronic pain uses up certain chemicals in the brain, like serotonin, which in turn causes depression. Without having had tried narcotics with regular talk therapy, I would not now be still, happily married. Again, this is my own personal experience.
>
> FST
>
> > This entire discussion makes me want to weep! Using opiates to "feel better" is not all that much different than the rest of biopsychiatry. For over twenty years of my over sixty years of life, I too was a prisoner of "psychotheraputic" treatment. At the time it seemed the right thing to do. After all, I am a nurse/therapist and my husband a physician.
> > Slowly, over the years, through my own experience and that of those around me (clients and coworkers), it bergan to dawn on me that I was not reallly facing up to life, not taking responsiblilty for my own behaviour, and was running from reality through drugs (prescribed) and "therapy"....
> > I have posted most of this before and it usually get lots of really angry responses from folks who are just sure that; "Well, that worked for her, but "I have" or "I am" or what ever. That's called "I Disease" people! Put the stuff down, and take charge of your own life! I finally did and what a difference! The whole world is a different/better place. Stop letting the American Psychiatric Association label you and call it "illness" and trying to fix what "ain't really broke" to begin with!!
> > It was two decades of not feeling emotions that simply fed into my not learning how to deal with them. Every time you get off medicatioon you "relapse"?? That's what I though too, until until the whole debacle with first Effexor then Lexapro. What have people (myself included ) experienced there? Painful, often prolonged withdrawal - not relapse. So what does the physician do? Give out another drug!! But you can live through it (the withdrawal), and you can live without dumping chemicals into your body. I finally am able to live that way.
> > A therapist from another culture once shared this with me:
> > "Of course Americans are depressed -- you are raised to believe that you are entitled to the good things in life and that pain is to be avoided at ALL cost. Then when tough times hit, you are surprised and becoome "depressed"
> > In some other cultures the people grow up EXPECTING pain and suffering, so when it happens there is no big shock, and the "good things" are seen as rare and not a way of life.
> > I have been drug free for a year now and it's wonderful. Try it, you might be amazed. GH
> > PS Coming off took me over a year -- do not rush it! By the way,in those twenty-plus years, I took something like twenty-five psychoactive substances, antidepressants, stimulants, anxiolytics, antipsychotics - the whole pharmacopea, So please, don't tell me I don't know what I am talking about..
> >
> >
> >
> > Paulbwell,
> > > > > You take 60mgs 5x a day=300mgs?
> > > > and find pain relief better than Oxy?
> > >
> > > Yes on the dosage. Initially, like the first couple of months, Oxy was superior in pain relief. After that, pain relief dropped down to the level of relief I was getting with Codeine.
> > >
> > > > -No Euphoria/stimulation from Oxy?
> > >
> > > None
> > >
> > > > -Apparently Oxycontin is a stimulating Opiod,
> > > > thou I'm guessing when abused, not when used medically, as in your case.
> > >
> > > Exactly
> > >
> > > > If I may ask, what dose of Oxycontin did you use for your injuries?
> > >
> > > Max daily dosage my Paindoc RXed was two 20mg x 4 = 160mg/day
> > >
> > > > Thanks for your relpy
> > >
> > > Your welcome.
> > >
> > > FST
> > >
> > >
> >
> >
>
>
Posted by greenhornet on April 9, 2005, at 13:20:36
In reply to Re: Flip-Codeine » greenhornet, posted by Larry Hoover on April 9, 2005, at 10:31:37
> Thanks for weighing in, greenhornet.
>
> If I may be so bold, I would draw the following theme and conclusion from your post....
>
> Medication is not the only answer to depressive symptoms, if cognitive coping strategies are actually promoting depression. Therefore, changing cognitive processes can lead to remission of depression, and relieve the need for medication.
>
> I'm with you on that, but....
>
> Cognitive therapy can be reduced to a very simple concept, IMHO.....
>
> Same input, different output.
>
> What happened, happened. Life is life. What you feel about it is largely a matter of choice, habit, training, internalization, experience, attitude, belief, expectations, faith, and similar.
>
> So, there's a lot to work with in that list (and I certainly missed some). That's what cognitive therapy is for. To work with the list of interpretive cognitions we all employ.
>
> That said, it may also be an inappropriate expectation to assume that modification of cognition alone can lead to remission. Medication has a place in recovery (and maintenance) for some people. You really can't generalize about that.
>
> Lar
Larry,
Thank you for putting it so well. Relating my experience/opinion has often only caused totally negative and/or defensive reactions. I appreciate others positive input and correction.
By the way, I should have mentioned this to FST too, but I cannot tolerate many opiates at all(morphine, codine, Dilaudid, Talwin) -- I become violently ill. So in some ways I suppose I envy those of you for whom these medications work for physical pain.
GH
Posted by Larry Hoover on April 9, 2005, at 13:32:04
In reply to Re: Flip-Codeine » Larry Hoover, posted by greenhornet on April 9, 2005, at 13:20:36
> Larry,
> Thank you for putting it so well. Relating my experience/opinion has often only caused totally negative and/or defensive reactions. I appreciate others positive input and correction.You're welcome.
Also, I was not correcting you. I never had that sense.
> By the way, I should have mentioned this to FST too, but I cannot tolerate many opiates at all(morphine, codine, Dilaudid, Talwin) -- I become violently ill. So in some ways I suppose I envy those of you for whom these medications work for physical pain.
> GHThat is one reason for the fentanyl patches. That bypasses the stomach.
Just a thought, if acute or chronic pain is a significant impediment to daily living.
Lar
Posted by flipsactown on April 9, 2005, at 14:01:15
In reply to Re: Flip-Codeine » flipsactown, posted by greenhornet on April 9, 2005, at 13:08:57
GH,
No apology necessary. I totally understand and congratulate you and your husband for 38 years of marriage, which is quite an accomplishment in this day of 50% divorce rate.
FST
> FST,
> I am sorry --I do owe you an apology. You are right about chronic pain, I'm afraid that in my "passion" I overlooked your situation. Please accept my apology. I hope things continue to go well for you. You seem to have good insight into, and an understanding of your problem.
> It is also good to hear from someone else who has been married 30+ years. My husband and I will celebrate thirty eight years soon. GH
>
> GH,
> >> In my case, I was not taking Codeine to "feel better" mentally, I was taking it to feel better physically. Chronic low back pain, from 2 failed back surgeries, numerous injections to the spine, having had tried many different treatments, including acupuncture, TENS unit and biofeedback, I had no choice, but to take narcotics, mainly Codeine, to get some pain relief.
> >
> > I had tried for over a year to go without any medications or talk therapy and that nearly cost me my marriage. When I came close to being physical with my wife, I decided to seek psych therapy, which I have to say saved my marriage. My therapist of over 10 years had recommended I take Prozac. I was very hesitant at first because of all the bad press I had read about. Fortunately, I tried Prozac and in less then 3 weeks, I realized I was feeling like my normal self, a happy-go-lucky guy with a wonderful wife and three sons. I have now been married 32 years to the same woman, who put up with me when I was in constant physical and mental pain.
> >
> > Bottomeline: Chronic physical pain is very real which from my research, usually results in depression. Apparently, chronic pain uses up certain chemicals in the brain, like serotonin, which in turn causes depression. Without having had tried narcotics with regular talk therapy, I would not now be still, happily married. Again, this is my own personal experience.
> >
> > FST
> >
> > > This entire discussion makes me want to weep! Using opiates to "feel better" is not all that much different than the rest of biopsychiatry. For over twenty years of my over sixty years of life, I too was a prisoner of "psychotheraputic" treatment. At the time it seemed the right thing to do. After all, I am a nurse/therapist and my husband a physician.
> > > Slowly, over the years, through my own experience and that of those around me (clients and coworkers), it bergan to dawn on me that I was not reallly facing up to life, not taking responsiblilty for my own behaviour, and was running from reality through drugs (prescribed) and "therapy"....
> > > I have posted most of this before and it usually get lots of really angry responses from folks who are just sure that; "Well, that worked for her, but "I have" or "I am" or what ever. That's called "I Disease" people! Put the stuff down, and take charge of your own life! I finally did and what a difference! The whole world is a different/better place. Stop letting the American Psychiatric Association label you and call it "illness" and trying to fix what "ain't really broke" to begin with!!
> > > It was two decades of not feeling emotions that simply fed into my not learning how to deal with them. Every time you get off medicatioon you "relapse"?? That's what I though too, until until the whole debacle with first Effexor then Lexapro. What have people (myself included ) experienced there? Painful, often prolonged withdrawal - not relapse. So what does the physician do? Give out another drug!! But you can live through it (the withdrawal), and you can live without dumping chemicals into your body. I finally am able to live that way.
> > > A therapist from another culture once shared this with me:
> > > "Of course Americans are depressed -- you are raised to believe that you are entitled to the good things in life and that pain is to be avoided at ALL cost. Then when tough times hit, you are surprised and becoome "depressed"
> > > In some other cultures the people grow up EXPECTING pain and suffering, so when it happens there is no big shock, and the "good things" are seen as rare and not a way of life.
> > > I have been drug free for a year now and it's wonderful. Try it, you might be amazed. GH
> > > PS Coming off took me over a year -- do not rush it! By the way,in those twenty-plus years, I took something like twenty-five psychoactive substances, antidepressants, stimulants, anxiolytics, antipsychotics - the whole pharmacopea, So please, don't tell me I don't know what I am talking about..
> > >
> > >
> > >
> > > Paulbwell,
> > > > > > You take 60mgs 5x a day=300mgs?
> > > > > and find pain relief better than Oxy?
> > > >
> > > > Yes on the dosage. Initially, like the first couple of months, Oxy was superior in pain relief. After that, pain relief dropped down to the level of relief I was getting with Codeine.
> > > >
> > > > > -No Euphoria/stimulation from Oxy?
> > > >
> > > > None
> > > >
> > > > > -Apparently Oxycontin is a stimulating Opiod,
> > > > > thou I'm guessing when abused, not when used medically, as in your case.
> > > >
> > > > Exactly
> > > >
> > > > > If I may ask, what dose of Oxycontin did you use for your injuries?
> > > >
> > > > Max daily dosage my Paindoc RXed was two 20mg x 4 = 160mg/day
> > > >
> > > > > Thanks for your relpy
> > > >
> > > > Your welcome.
> > > >
> > > > FST
> > > >
> > > >
> > >
> > >
> >
> >
>
>
Posted by barbaracat on April 9, 2005, at 16:33:06
In reply to Re: Flip-Codeine, posted by greenhornet on April 9, 2005, at 8:09:05
Dear GH,
I think what you're responding to is choosing to 'get high' as a way of dealing with pain, rather than trying to 'feel better' and I definitely agree with this. But I've come to see that in my case, certain meds are necessary because 'feeling better' is necessary if I want to continue with this life. I agree with you philisophically that we shouldn't have to rely on meds and there must be another way. I've tried this in every form possible and the reality is that it hasn't worked.This has caused some struggle for me because I passionately believe in finding the root cause of a problem, doing the hard work to get to the bottom of it, learning to tolerate and grow from pain rather than make it all nice and pretty by subverting it with meds.
I also follow a Buddhist path, meditate, and appreciate the Buddha's first noble truth that 'Life is Suffering', but also the second - 'Suffering is caused by desiring', or resisting suffering and craving pleasure.
I know all this, and have tried many times over the years to slowly wean off meds believing that 'healthy living', accepting what is, being in the moment, whatever, will suffice. I've gone long times au natural. Problem is, something goes haywire with my brain after a while and I no longer have access to those noble thoughts and my life becomes a shambles. I alienate friends because I become critical and mean. My body and mind hurt from the stress of having to wade through a psychic minefield day after day. Everything is overwhelming and hard.
I'm a strong and resourceful person, have been all my life and can take alot. But that strength and resourcefulness go out the window when my brain is broken, and I feel so alone. This is no way to live. How many times must one lie in bed crying in anguish for themselves and the world, without the impulse or capacity to exeperience the joy and wonder of the world?
In my case, Lithium simply must be in my life, as must thyroxine. I will die without them, this I know. Anything else is gravy, like benzos when I need soothing and nothing else works, Ambien because I can't seem to sleep otherwise, a low dose of an AD because without it life feels too complicated. And yes, sometimes a snootful of booze and some illegal substances because heck, they feel good. As long as I know when to stop.
I guess that even with all the spiritual, psychological and just plain life experience I try to put to good use, there's something I'm missing. Everything in moderation, but if happiness lies within my reach, I'm going to reach for it. There's no nobility in senseless obsessive suffering. I think the key word is 'balance', and whatever gets you to that place has merit. Regards, Barbara
Posted by Phillipa on April 9, 2005, at 17:02:14
In reply to Meds or not » greenhornet, posted by barbaracat on April 9, 2005, at 16:33:06
Greenhornet, Good to see you bsck on the Board. It's funny, after working in the medical field, especially when I was on a surgical and medical floor, was that the nurses were always so judgemental when it came to pain. "Oh he's on the call bell again, Yep it's been exactly 4 hours, he's addicted, and he can wait l0 more minutes!" I also found myself responding like this at times. As they say "walk in the other person's shoes first". So, now when I've had some facial surgery [elective my choice], I went by my "training" refusing to take the pain meds as RX'd. I wonder if I would be having the complications I'm having as we speak if I'd listened and taken the meds. I wouldn't take percocet, but brokedown and took the tylenol #3. Now because of the complications, and a drain tube still in place I've "allowed" myself to take the meds at night only. And when I wake up I take another pill. I'm doing this because i realize how important sleep is to heal my body. I'm not going to worry about becoming an accict at the moment. So what if I'm sleeping l0 hours. Evidently my body needs it and I don't need an infection on top of this. I am on antibiotics too. The surgeon isn't sure what to do but since he's a Professor at a large teaching hospital I trust him to find out the answers if he doesn't know which he has admitted. Hasn't seen a case like this in over 20yrs. He's honest. So, now I've had to rethink my attitude on pain meds. Each day I learn a little bit more. I've always tested well and have book knowledge, but experience speaks loud and clear. Fondly, Phillipa
Posted by Larry Hoover on April 9, 2005, at 18:19:16
In reply to Re: Oxycontin for mental health....WOW!!!!!!!!! » jerrympls, posted by flipsactown on April 8, 2005, at 1:31:29
> I had been taking Tylenol-Codeine 3, 60mg x 5 times daily for years and finally decided to try the Oxycontin since I heard it was long lasting.
> I did not experience any withdrawals from my years of taking Codeine. I went for weeks or months without taking any Codeine, just to prove to myself that I was not addicted.
All I have to say is Wow!
Codeine is slowly desmethylated to morphine....at least for most people, that's what happens. It's like slow release morphine, but the rate of conversion is highly dependent on a liver enzyme that functions at different rates in different people.
Your absence of withdrawal leads me to believe that perhaps your 2D6 enzyme (the enzyme in question) doesn't work at all, and you got a pure codeine effect. If I'm not mistaken, oxycodone also is activated by that same enzyme. (Have I got that right, ed?) Total dysfunction of 2D6 might happen in 0.1 to 1% of people.
Perhaps that explains your unusual history? I'm not suggesting there's anything untrue or suchlike about what you've described....it just doesn't fit with what you'd expect.
What most amazes me, really, (I know you said nothing about this at all) is that you could take that dose of codeine and still have bowel movements. Codeine is very constipating at high doses. Maybe the worst of them all, on a mg per mg basis? If not the worst, it's near the top of that infamous list.
Total dysfunction of 2D6 might happen in 0.1 to 1% of people.
Thanks for your input. It's really important to try and understand just how variable the effects of drugs really are.
Lar
Posted by flipsactown on April 9, 2005, at 18:21:02
In reply to Just My Two Cents, posted by Phillipa on April 9, 2005, at 17:02:14
Phillipa,
"So, now I've had to rethink my attitude on pain meds. Each day I learn a little bit more. I've always tested well and have book knowledge, but experience speaks loud and clear. Fondly, Phillipa"
Been there, done that.
I had to jump through so many hoops just to increase, continue taking Codeine and get an Oxycontin RX, which my Paindoc denied and RXed MSContin instead, which promptly made me sick to my stomach, constantly vomiting and extremely constipated. Only then, did he Rxed Oxycontin and even then was not totally accommodating by not giving me a grace period in which to get a refill. He would only write a refill on the day the Rx ran out. Even some Paindocs are so afraid of abuse that they unknowingly lump all patients together. I told my Paindoc that I never abuse anything. I never smoked cigarettes or pot and didn't drink alcohol except on my wedding day, when I drank Champagne, nearly 32 years ago. Hopefully, in time, this "addiction" attitude will change. In my opinion, no one should be physically suffering, needlessly because of the "addiction" attitude, when narcotics are available, especially when it is for a chronic, lifetime physical pain such as back pain and/or arthritis.
I could have continued taking Oxycontin, but because of the withdrawal pain I experienced from not having Oxy even for just two days, and the fact that in the long run, I was only getting the same level of pain relief as Codeine, I used my common sense and voluntarily asked my Paindoc to put me back on Codeine, after very slowly tapering off Oxy to minimize withdrawals. Tapering very slowly was not totally painless, especially the last week.
FST
Posted by Larry Hoover on April 9, 2005, at 18:24:47
In reply to Re: Oxycontin for mental health....WOW!!!!!!!!!, posted by Larry Hoover on April 9, 2005, at 18:19:16
> Your absence of withdrawal leads me to believe that perhaps your 2D6 enzyme (the enzyme in question) doesn't work at all, and you got a pure codeine effect. If I'm not mistaken, oxycodone also is activated by that same enzyme. (Have I got that right, ed?) Total dysfunction of 2D6 might happen in 0.1 to 1% of people.
Oxycodone's effects are due to the parent drug, not metabolites. It only took me twenty seconds to check. (Note to self: Check references before posting.)
Lar
P.S. That leaves me more baffled than before.
Posted by Paulbwell on April 9, 2005, at 18:25:13
In reply to Just My Two Cents, posted by Phillipa on April 9, 2005, at 17:02:14
I think GH was making the point that theres too many folks taking too many pills UNNESSARILY. The APA has a duty, hell a crusade to convince folks that when thinks arn't hanky dory, as we see it, we should reach for the drugs.
We should see through their trade, and find our own resourses, with support, and heal the best we can, while taking charge of our own situation, without placing ourselves into the hands of professionals, so READILY.
Posted by flipsactown on April 9, 2005, at 18:35:48
In reply to Re: Oxycontin for mental health....WOW!!!!!!!!!, posted by Larry Hoover on April 9, 2005, at 18:19:16
Lar,
>
> Your absence of withdrawal leads me to believe that perhaps your 2D6 enzyme (the enzyme in question) doesn't work at all, and you got a pure codeine effect. If I'm not mistaken, oxycodone also is activated by that same enzyme. (Have I got that right, ed?) Total dysfunction of 2D6 might happen in 0.1 to 1% of people.
>
That sure sounds logical to me!
>
> What most amazes me, really, (I know you said nothing about this at all) is that you could take that dose of codeine and still have bowel movements. Codeine is very constipating at high doses. Maybe the worst of them all, on a mg per mg basis? If not the worst, it's near the top of that infamous list.
>
I was only slightly constipated initially. I imagine after that my system totally adjusted to it. When I tried MSContin, I was extremely constipated.
>
> Thanks for your input. It's really important to try and understand just how variable the effects of drugs really are.
>
Your welcome. That is the very reason I always include in my post that "It is my personal experience."FST
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