Psycho-Babble Medication Thread 461152

Shown: posts 1 to 13 of 13. This is the beginning of the thread.

 

Holding up only for my family, and failing

Posted by musil on February 21, 2005, at 5:40:36

Greetings. I haven't posted for a long time, back when I got sucked into an anti-benzo board and basically freaked out during a cold turkey. Yay! they said, as I lost my job and cried and didn't sleep for 8 weeks. But that's well behind me now, and I'm afraid that I'm currently alone and frankly suicidal. I have chronic severe back pain due to a genetically malformed rib (#7) that nobody wants to attach to my spine due to the risks involved in the surgery (too close to major arteries, nerves, etc) and arthritis has crept into the equation so that I never know when the rib is going to decide to move forward or backward and knock me down with pain so excruciating that I can't perform my career-path activities anymore (sysadmin-programmer), especially since I got forced out of my job by an organization that has a habit of squeezing out people that have health problems.

Sorry for the rant, I'm quite discom"bob"ulated right now and frankly I'm afraid that when my wife get's back with the boys I'm going to have to go into the hospital to deal with the severe depression and pain that is not responding well to medication, as follows:

2 x 10 mg diazepam per day
1 x 10 mg Lexapro per day, night
12 mg Suboxone per day
10 mg Ambien per night
Aleive 1 tablet every 12 hours

I've been so depressed that all I can do is sleep and worry about money, because without my job our household income dropped by 2/3 and I've been trying to get a consulting firm going but it's just not working out. I'm faking it, and I'm doing work that's way under my capacity, and I'm getting the typical political pressures already at several clients who can't tell a USB port from their nostril, and I've been late for several meetings because I've simply been asleep trying to avoid my pain and depression.

The bottom line is that I think the Lexapro is pooped out, and I'd like to try Remeron and nick the Ambien, and up my dose of Suboxone to 16mg.
Man, after getting up to 180mg OContin/day, the Suboxone has been miraculous in terms of holding back the withdrawal from opiates, but Suboxone doesn't do it for the pain. And yes, I am still looking for that "peace" I found in OC, and if that makes me sick then I need help, because I don't think the peace I was seeking was an addictive /high/ peace, I think it was just relief from pain and a chance to sleep for no more than two hours before that rib began poking me in the side again. I can't really work anymore, as keyboarding just exacerbates the rib.

After all that description (thank you for reading so far), I am most worried about my dear wife and two boys, one of whom has inherited my unfortunate depressive tendency.

You know what would really help? A small disabilty check every month. I could do what I can around the house when not depressed (I have tried to suicide once, cry for help?)

But I'm too scared to head down the disability trail because that's a big decision and full of waiting, disappointment, document gathering, etc and I don't have the energy for it all, and anxiety and the waiting and the ultimate "NO" first time around and then the 2nd app and then gathering information from my old employer and I live on an island and therefore gossip spreads like melted butter so I've had enough struggling for the past 25 years and I just want to know that I can at least help pay for the groceries every month and knowing that there are other people really milking the system really angers me when I just want a simple judgement of "You've had enough for a while, here's some help" -- and then there's the emotional strain o my family, and that's painful enough for me to bear, knowing that I used to be so vital (but still prone to depression) and now I'm about ready to take all my valium and put all my suboxone under my tongue and just see if I get the ride of my life or a nice funeral. Man, I wish I was like the Hulk as Bill Bixby -- I could just walk down a nice dirt road, with music playing inthe background and then, when a truck goes by, instead of sticking out my thumb I could leap under the tires.

I just feel so damn guilty about all of this even though it's not my fault but I'm a man, and I'm supposed to suck it up like my Dad did for 40 years at Bell Labs in a windowless office and now he's got a pension and an IRA and SS and was it worth it? I won't even go into the fact that he's one reason that my psychotic mother dragged me to JW meetings 5 nights per week and told me that she would kill herself if I didn't behave like a perfect JW and make it into "the new system" where everything would be perfect and my Dad would be dead because he wasn't a JW. She told me that he wasn't my real father and that I had been immaculately conceived when I was 4, and oh yeah, when armageddon comes and you happen to be on the school bus with all your dead classmates, just wait outside the bus and I'll come get you in the car and we'll head up to the Kingdom Hall where I'm sure there will be punch and cookies and Jehovah himself will bring the dead back to life.

Yeah, I've got a history, and I'm tired of struggling, and I obviously feel sorry for myself, and I deserve all of this pain I have because I failed to be a man and just suck up to the emotional and physical pain. I really wish I didn't have a family because then it would be easy. But I love my boys very much and it would be not a great thing to grow up with a self-offed Dad , so I fake it.

 

Re: Holding up only for my family, and failing

Posted by banga on February 21, 2005, at 7:36:39

In reply to Holding up only for my family, and failing, posted by musil on February 21, 2005, at 5:40:36

That's your depression more than anything saying that you deserve the pain. Try and ease yourself with that thought. I am sorry for all the difficulties you are facing. I am sure your family would support your going to the hospital...
sometimes it does come down to that--hanging in just for family. I have been there....

Lexapro pooped put on me too, and quite quickly. I wonder if that is the case--that its effectiveness can go quicker than other than other meds. There is help out there, and in terms of meds -there are plenty other meds that can help you with the intensity of the depression.

You are obviously dealing with so much...has counseling and therapy ever helped, just so you have someone to talk to openly about all this? It sounds like such a burden to carry all by yourself. You clearly feel deeply about your family and I am sure they care deeply about you and want you to do what you need to to get better. I too sometimes am wracked with grief and guilt that my family has to deal with my depression and difficulty working up to my capacity. I even think--they just dont realize they'd be better off without me. But it isnt true, not at all. Especially for kids. When I start getting out of the depression my viewpoint does change, as I am able to cope with things better and give a little back to my family. I see that I am a part of them, and see what pain I'd cause if I did not keep trying to find ways to help myself, so I can be with them and share life with them.

If it is at the point that hospital seems the way to go, go for it. They can help you get to a med that helps quicker. Did Lexapro work for you for a while adequately? There are so many options out there, hang in! it's worth it.

 

Re: Holding up only for my family, and failing

Posted by musil on February 21, 2005, at 9:18:47

In reply to Re: Holding up only for my family, and failing, posted by banga on February 21, 2005, at 7:36:39

I am really only staying alive for my family: 4 people whose lives would be impacted adversely if I died. My wife would be consumed by anger at me and grief, my father wouldn't be able to enjoy his retirement (earned at my expense, I might add, by ignoring me, but hey, he's all I've got) and my boys, to whom I owe a live father. I find it hard to believe that a live but depressive paternal figure is better than an absent one, especially well screw it. I've had enough of this self-indulgent chatter and I hate myself more than ever for clicking "Submit your post".

Been in true analysis with one of the last remaining subscribers of the couch -- he's the only one who will write me meds without argument since this place is full of benzophobes and addictophobics (like on Family Guy, when the pharmacist claims he was addicted to antihistimines for a week) but my analyst (H.) scares me sometimes because he's at least 65 and he has no peer review. He categorizes himself as a rebel analyst with his own practice and his own technique, which is based on personal responsibility, proportionality and gradual changes in biochemistry through analysis. He believes that all illegal drugs should be legalized, including all Prescription meds that are typically addictive.

H. shows an obvious hatred toward all pharmaceutical companies, and therefore, as he hands me an Rx, he says "I doubt this will work, it's hardly more effective than placebo" when I need all the placebo effect I can get.

I'd really like to attempt Remeron, but it doesn't really matter to me at this point because my immune system is so shot from years of depression (or, is it the other way around?) and I'm so physically sick from the influenza, which of course turned into a bacterial infection of some sort, leading me to Zithromax and then Augmentin, and my liver feels like it's swollen, and all my lymph nodes are swollen, and my entire robust health went down the tubes 7 years ago when I had an atypical glandular fever (not Epstein Barr) that dropped me like a rock for 16 weeks after which I was never the same: depression, lymph nodes swollen, lethargy, pneumonia 4 times per year, and an analyst who just stares at me and says that the only cure is 5 days per week on the couch will change the microarchitecture of my brain. I like H. well enough, but he's frankly old and grumpy and f*rts a lot and charges $250/hour and grumbles about pharmaceutical companies constantly at least 15 minutes per session. Problem is, he's the best I can get around here.

 

Re: Holding up only for my family, and failing musil

Posted by Phillipa on February 21, 2005, at 17:53:49

In reply to Re: Holding up only for my family, and failing, posted by musil on February 21, 2005, at 9:18:47

Sometimes if you go into the hospital they can help you get disability. I had, what I now know to be a pdoc who will do anything to get his pts disability. He got it for me, and I don't know how, I'm just grateful as I've been unable to work for 8 years. I now see someone else as he is under investigation for medical fraud and other charges. Fondly, Phillipa

 

Hang in there

Posted by up'n'down on February 24, 2005, at 1:38:33

In reply to Holding up only for my family, and failing, posted by musil on February 21, 2005, at 5:40:36

> Greetings. I haven't posted for a long time, back when I got sucked into an anti-benzo board and basically freaked out during a cold turkey. Yay! they said, as I lost my job and cried and didn't sleep for 8 weeks. But that's well behind me now, and I'm afraid that I'm currently alone and frankly suicidal. I have chronic severe back pain due to a genetically malformed rib (#7) that nobody wants to attach to my spine due to the risks involved in the surgery (too close to major arteries, nerves, etc) and arthritis has crept into the equation so that I never know when the rib is going to decide to move forward or backward and knock me down with pain so excruciating that I can't perform my career-path activities anymore (sysadmin-programmer), especially since I got forced out of my job by an organization that has a habit of squeezing out people that have health problems.
>
> Sorry for the rant, I'm quite discom"bob"ulated right now and frankly I'm afraid that when my wife get's back with the boys I'm going to have to go into the hospital to deal with the severe depression and pain that is not responding well to medication, as follows:
>
> 2 x 10 mg diazepam per day
> 1 x 10 mg Lexapro per day, night
> 12 mg Suboxone per day
> 10 mg Ambien per night
> Aleive 1 tablet every 12 hours
>
> I've been so depressed that all I can do is sleep and worry about money, because without my job our household income dropped by 2/3 and I've been trying to get a consulting firm going but it's just not working out. I'm faking it, and I'm doing work that's way under my capacity, and I'm getting the typical political pressures already at several clients who can't tell a USB port from their nostril, and I've been late for several meetings because I've simply been asleep trying to avoid my pain and depression.
>
> The bottom line is that I think the Lexapro is pooped out, and I'd like to try Remeron and nick the Ambien, and up my dose of Suboxone to 16mg.
> Man, after getting up to 180mg OContin/day, the Suboxone has been miraculous in terms of holding back the withdrawal from opiates, but Suboxone doesn't do it for the pain. And yes, I am still looking for that "peace" I found in OC, and if that makes me sick then I need help, because I don't think the peace I was seeking was an addictive /high/ peace, I think it was just relief from pain and a chance to sleep for no more than two hours before that rib began poking me in the side again. I can't really work anymore, as keyboarding just exacerbates the rib.
>
> After all that description (thank you for reading so far), I am most worried about my dear wife and two boys, one of whom has inherited my unfortunate depressive tendency.
>
> You know what would really help? A small disabilty check every month. I could do what I can around the house when not depressed (I have tried to suicide once, cry for help?)
>
> But I'm too scared to head down the disability trail because that's a big decision and full of waiting, disappointment, document gathering, etc and I don't have the energy for it all, and anxiety and the waiting and the ultimate "NO" first time around and then the 2nd app and then gathering information from my old employer and I live on an island and therefore gossip spreads like melted butter so I've had enough struggling for the past 25 years and I just want to know that I can at least help pay for the groceries every month and knowing that there are other people really milking the system really angers me when I just want a simple judgement of "You've had enough for a while, here's some help" -- and then there's the emotional strain o my family, and that's painful enough for me to bear, knowing that I used to be so vital (but still prone to depression) and now I'm about ready to take all my valium and put all my suboxone under my tongue and just see if I get the ride of my life or a nice funeral. Man, I wish I was like the Hulk as Bill Bixby -- I could just walk down a nice dirt road, with music playing inthe background and then, when a truck goes by, instead of sticking out my thumb I could leap under the tires.
>
> I just feel so damn guilty about all of this even though it's not my fault but I'm a man, and I'm supposed to suck it up like my Dad did for 40 years at Bell Labs in a windowless office and now he's got a pension and an IRA and SS and was it worth it? I won't even go into the fact that he's one reason that my psychotic mother dragged me to JW meetings 5 nights per week and told me that she would kill herself if I didn't behave like a perfect JW and make it into "the new system" where everything would be perfect and my Dad would be dead because he wasn't a JW. She told me that he wasn't my real father and that I had been immaculately conceived when I was 4, and oh yeah, when armageddon comes and you happen to be on the school bus with all your dead classmates, just wait outside the bus and I'll come get you in the car and we'll head up to the Kingdom Hall where I'm sure there will be punch and cookies and Jehovah himself will bring the dead back to life.
>
> Yeah, I've got a history, and I'm tired of struggling, and I obviously feel sorry for myself, and I deserve all of this pain I have because I failed to be a man and just suck up to the emotional and physical pain. I really wish I didn't have a family because then it would be easy. But I love my boys very much and it would be not a great thing to grow up with a self-offed Dad , so I fake it.
>

You have an intolerable burden to bear. I believe you are already aware of this, but I want you to know that we see it that way too. You are indispensible to your family; I'm glad you realize what devastation you would produce for your family, if you harmed yourself.
Now, my problem is that I don't have any solutions for you, other than to get as much rest as you can, do positive self-talk, like, "I am vital to my family. I am worthwhile as a person, even if physical and mental ill-health are my lot in life right now," and do some walking if you can for exercise and clearing the brain somewhat. Keep us posted. U'D

 

Re: Holding up only for my family, and failing

Posted by Bill LL on February 24, 2005, at 9:06:55

In reply to Holding up only for my family, and failing, posted by musil on February 21, 2005, at 5:40:36

musil- You are only taking 20 mg Lexapro per day! You need to increase it. I started on 20 mg and it worked for a while. Then I increased it to 30 mg and it worked for another 6 to 8 months. Then I increased it to 40 mg and it kept working great.

Please have your doctor double your Lexapro immediately before giving up on it.

 

Re: Holding up only for my family, and failing

Posted by Phillipa on February 24, 2005, at 16:57:24

In reply to Re: Holding up only for my family, and failing, posted by musil on February 21, 2005, at 9:18:47

Musil, What Island do you live on? Just curious as we live at Emerald Isle, NC. If you're on an Island, there probably isn't a lot to do, or places for you to get tx, or even work. Fondly, Phillipa

 

Re: Holding up only for my family, and failing

Posted by musil on February 24, 2005, at 18:46:40

In reply to Re: Holding up only for my family, and failing, posted by Phillipa on February 24, 2005, at 16:57:24

Well, it does have a road connecting it to the mainland: Mount Desert Island off the coast of Maine, the home of Acadia National Park. A ghost town in winter, with millions of people in a small town in the summer. It's an island that used to have a strong community of locals, which has changed with the tremendous influx of money with rich summer folks that have decided to make it a year round residence. Lots of imported non-anglo non-local help brought with the entire clans, which in and of itself it not a problem except that it takes work away from what used to be assigned traditionally to local folks. So there is now a clear divestiture of rich folks staff and locals. You're right, there's not anything to do 10 months out of the year, especially when house-locked with pain. I'm not whining, at least I'm not ferry-locked to the mainland.

Today's visit to the pdoc indicates that he wants me to up my suboxone (he loves that stuff) but he has nothing but contempt for SSRIs. We've agreed to startup intense analytic ptherapy 3 days per week as he firmly believes in the healing effects of traditional Freudian theatre coupled with his own brand of senile comments and occasional naps at $250/hour. He's just a nice old guy with delusions of grandeur coming from a successful Manhatten practice and retiring to the coast of Maine, bringing his pricing and obstinate attitude with him. It scares me that he has no association with other therapists, no peer-review, nobody to check his activities: he calls himself the last analytic rebel and he almost died last month with a gut twist and called me from his hospital bed and loaded me up with Rx for all my meds knowing that he might not make it through the night. But he made it through and continues to sit complacently in his chair and it kills me that in this small town he really raised his rates from 200 to 250/50 minutes. He's the best I've got, but unfortunately I've developed a strong transference toward him as a grandfather figure and I can stand to be honest with him about how I feel. I'd rather make him happy than disappoint him, and his example is as a non-medicated former depressive who apparently bulled his way out of his depression with his own will and that's what he wants out of me. Frankly, he's never had anybody suicide on his long watch (perhaps because he avoids and transfers patients long before they get to that point) and so as long as he thinks I'm safe to his rep he keeps me on. I wonder if I should keep him as a pdoc for meds and find a masters level therapist for ptherapy.

Physical pain and depression are clearly linked. It's a chicken and egg scenario, not easily resolved.

I've been watching comedy now for almost 9 straight days, through sleepless nights and extreme psychotic anxiety: fear of losing family, fear of ending up on the street, fear of being a failure, anger at my former employer. So I either decide that I've hit bottom and plan to rise from their, or end my life. It's that clear, and I choose to rise from the bottom. At least right now. But as you all know well, and William Styron writes about best, the dark beast comes over like a storm and bring forth black thoughts of death.

 

Re: Holding up only for my family, and failing musil

Posted by Phillipa on February 24, 2005, at 19:12:16

In reply to Re: Holding up only for my family, and failing, posted by musil on February 24, 2005, at 18:46:40

Muslin, Where you live sounds like it is here. My husband is without work also and is looking through Management Recruiters. They have called him about a job in the mountains. I don't want to live there, but it starts at 75-80thousand a year. That would take the pressure off me to work. But, it's only in the beginning stages. How can you afford these fees? You sound very intelligent so I suspect you had a very lucritive profession. I do feel that you are definitely doing yourself a disservice by not actively seeking out a 2nd opinion and seeing a really good therapist. By the way, what is suboxone? I've never heard of it, but I don't profess to know as much as others on this Board. It's really hard to be unemployed. I know myself. My identity was my nursing. Hang in there and "seek and the seeker will find". From the Edgar Casey Institute in VA Beach. Fondly, Phillipa

 

Re: Holding up only for my family, and failing

Posted by musil on February 24, 2005, at 19:15:03

In reply to Re: Holding up only for my family, and failing, posted by Bill LL on February 24, 2005, at 9:06:55

Good idea about the Lexapro; though my pdoc hates ssri and loves maoi, I've saved up enough Lexapro to doubl my dose for a long time, so it's worth a shot.

Do you split the dose during the day, all at once, or more at night? Does it energize you, or is it a sleeper? I've always taken it at night.

I felt so wierd on Parnate; like I was artificially high and not "me". And with my psychotic thinking, I stopped eating out of fear of a reaction. Highly unlikely, I know, but it just gave me the willies. Purely psychological, probably, but the "up" I felt was not my up, it was Parnate's up. What's the word on the newer non-destructive MAOIs (pardon the ignorance, I know that Parnate is one of those MAOIs that fully destroys MAO whereas the new ones don't).

 

Re: Holding up only for my family, and failing

Posted by musil on February 24, 2005, at 19:49:19

In reply to Re: Holding up only for my family, and failing musil, posted by Phillipa on February 24, 2005, at 19:12:16

With my pristine references and experience, I could land a job similar to your spouse's opportunity anywhere but here, easily around $90k if not more. But I've never survived long in the rat race -- I get sick and get squeezed out. My references on paper and my performance reviews are outstanding, but secretly my health record is permeating the HR offices of the places I might work.


Due to my congenital deformity with my rib and scoliosis, pain was a chronic problem. Therefore, I decided to try opiates, starting with oxycodone (short half-life, around 4-6 hours), with a high probability of steadily increasing tolerance as the number of opiate receptors naturally decrease in proportion to the increased opiate agonists present in the brain. Hence OxyContin, which is a specially formed time-release pill that releases oxycodone gradually over a period of 12 hours via a plastic matrix that the pill is made of. After reaching a maximum of 180mg of OxyContin/day, my doc cut me off at that level and I was left with pain due to opiate tolerance and a heavy amount of withdrawal ahead of me to knock down my opiate tolerance.

Enter suboxone, which was approved last year (though it's been in use in Europe for many years, of course, Damn USA medicine). Essentially buprenorphine (opiate, strong) and naloxone (opiate agonist, like Anabuse), it is a sublingual tablet and the naloxone is included in the tablet to avoid diversion of the pill to the street users (shooting up suboxone with the naloxone will make you very sick, as naloxone is an opiate antagonist, filling up the opiate receptors so that there's no room for the opiate agonists).

But Naloxone can't pass through the gut or sublingual barrier, so if taken correctly under the tongue, the tablet permits the buprenorphine to pass into the bloodstream while the naloxone passes through the intestines and is hardly metabolized in the body. There is a version of the sublingual tablet called Subutex, which is bupe without the naloxone, but the FDA is very afraid of this med being diverted for abuse on the street, so unlike Europe where bupe alone is often prescribed, suboxone with naloxone is the standard here in the USA.

In order to transfer from OxyContin to Suboxone, you have to at least get down to 80-90mg OxyContin , which is extremely difficult to taper and is just about the worst experience since the pain isn't being treated any more and the withdrawal is a horrible experience. Then you can switch over to suboxone from OC (or other compatible opiate dosage, like heroin, morphine, methadone, etc) and the swap eliminates the withdrawal symptoms while also taking away much of the pleasure or euphoria associated with opiates.

The good news is that suboxone is actually great for treating depression, IMHO, and it has an extremely long half life of around 30-40 hours so dosage can even occur every other day.

An MD must participate in an 8 hour seminar and pass a simple test to Rx Suboxone, and the MD is then put on a National Registration List (at
http://buprenorphine.samhsa.gov/bwns_locator/index.html)
and the MD cannot accept more than 30 suboxone patients.

I myself have tapered down to 2mg per day, but I'm back up to 12mg to maintain pain control. Fortunately, it's much easier to taper from suboxone than from oxycontin, even though it does suck and will usually bring on an underlying depression. As it does always in my case.

So my pdoc loves suboxone (I wonder if he likes it himself?) and if this diatribe helps anybody then great, cause it'll still be here when I'm good and gone. The question is when I'll be gone for good. I can't leave my kids with an self-offed-Dad, and so it must be that my perception of my worthlessness is not based in reality even though it feels so strong to me.

 

Re: Holding up only for my family, and failing musil

Posted by Phillipa on February 24, 2005, at 20:12:43

In reply to Re: Holding up only for my family, and failing, posted by musil on February 24, 2005, at 19:49:19

I'm so sorry about the chronic pain. I can see why you continue to see this pdoc. I still believe your money could be used more wisely by also incorporating an excellent therapist. Maybe even a stay in a prestigious place like the Betty Ford Institute might help you. I forgot, sorry, they make you go cold turkey. I know my former brother-in-law who was so addicted to alchol and drugs spent a month somewhere above Ct[where I'm originally from] and is sober to this day. What about pain clinics, and nerve blocks, etc. Fondly, Phillipa

 

Hang in there

Posted by up'n'down on February 24, 2005, at 23:00:04

In reply to Re: Holding up only for my family, and failing, posted by musil on February 24, 2005, at 19:49:19

> With my pristine references and experience, I could land a job similar to your spouse's opportunity anywhere but here, easily around $90k if not more. But I've never survived long in the rat race -- I get sick and get squeezed out. My references on paper and my performance reviews are outstanding, but secretly my health record is permeating the HR offices of the places I might work.
>
>
> Due to my congenital deformity with my rib and scoliosis, pain was a chronic problem. Therefore, I decided to try opiates, starting with oxycodone (short half-life, around 4-6 hours), with a high probability of steadily increasing tolerance as the number of opiate receptors naturally decrease in proportion to the increased opiate agonists present in the brain. Hence OxyContin, which is a specially formed time-release pill that releases oxycodone gradually over a period of 12 hours via a plastic matrix that the pill is made of. After reaching a maximum of 180mg of OxyContin/day, my doc cut me off at that level and I was left with pain due to opiate tolerance and a heavy amount of withdrawal ahead of me to knock down my opiate tolerance.
>
> Enter suboxone, which was approved last year (though it's been in use in Europe for many years, of course, Damn USA medicine). Essentially buprenorphine (opiate, strong) and naloxone (opiate agonist, like Anabuse), it is a sublingual tablet and the naloxone is included in the tablet to avoid diversion of the pill to the street users (shooting up suboxone with the naloxone will make you very sick, as naloxone is an opiate antagonist, filling up the opiate receptors so that there's no room for the opiate agonists).
>
> But Naloxone can't pass through the gut or sublingual barrier, so if taken correctly under the tongue, the tablet permits the buprenorphine to pass into the bloodstream while the naloxone passes through the intestines and is hardly metabolized in the body. There is a version of the sublingual tablet called Subutex, which is bupe without the naloxone, but the FDA is very afraid of this med being diverted for abuse on the street, so unlike Europe where bupe alone is often prescribed, suboxone with naloxone is the standard here in the USA.
>
> In order to transfer from OxyContin to Suboxone, you have to at least get down to 80-90mg OxyContin , which is extremely difficult to taper and is just about the worst experience since the pain isn't being treated any more and the withdrawal is a horrible experience. Then you can switch over to suboxone from OC (or other compatible opiate dosage, like heroin, morphine, methadone, etc) and the swap eliminates the withdrawal symptoms while also taking away much of the pleasure or euphoria associated with opiates.
>
> The good news is that suboxone is actually great for treating depression, IMHO, and it has an extremely long half life of around 30-40 hours so dosage can even occur every other day.
>
> An MD must participate in an 8 hour seminar and pass a simple test to Rx Suboxone, and the MD is then put on a National Registration List (at
> http://buprenorphine.samhsa.gov/bwns_locator/index.html)
> and the MD cannot accept more than 30 suboxone patients.
>
> I myself have tapered down to 2mg per day, but I'm back up to 12mg to maintain pain control. Fortunately, it's much easier to taper from suboxone than from oxycontin, even though it does suck and will usually bring on an underlying depression. As it does always in my case.
>
> So my pdoc loves suboxone (I wonder if he likes it himself?) and if this diatribe helps anybody then great, cause it'll still be here when I'm good and gone. The question is when I'll be gone for good. I can't leave my kids with an self-offed-Dad, and so it must be that my perception of my worthlessness is not based in reality even though it feels so strong to me.

Your feelings of worthlessness are indeed not true. Your speaking of congenital deformity, scoliosis and rib trouble is all familiar to me. My father had polio when a young lad and he has severe kyphoscoliosis; He has been fortunate in not having an awful lot of pain to deal with [physical, that is] but has trouble with his lungs being compressed into such a small area, He is 84 years old and has done very well, considering all he has to contend with. He is in heart failure now, and has severe respiratory decompensation.
I wish I could take away all of your pain. Please stay with us. U'D


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[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
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