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Re: opiates » ShelliR

Posted by Elizabeth on April 14, 2001, at 4:49:52

In reply to Re: opiates » dougb, posted by ShelliR on April 11, 2001, at 16:30:08

> Doug, I am not meaning to judge you, and at some points during the last year when my therapist and pdoc gave me hard times about the hydocodone, I also thought: well, the worst that can happpen is I become dependent, or addicted. And then I will get unaddicted.

Shelli -- my experience is that when people become truly addicted (will discuss this some more later on), they remain that way possibly indefinitely -- they don't get "unaddicted," that is, they can't return to moderate use without getting sucked into pathological use again.

> I agree some antidepressants do seem to be addictive (nardil, which I take isn't, since I can get off easily with no side effects.)

This isn't the actual meaning of the word "addiction" (see my post, "Re: opiates » ShelliR," posted 4/11), but MAOIs do in fact have very bad withdrawal symptoms (panic attacks, abnormal REM sleep and intense dreams or nightmares, moodiness and hyperreactive mood, exaggerated startle response, hypersomnia, etc.) for many people, if discontinued abruptly. ADs are not really addictive at all, although there has been a small number of cases of AD addiction (mainly MAOIs) reported in the literature.

> But generally ADs have a ceiling over which an increase is not going to increase the sense of feeling good so there is a limit to the addiction possible.

Buprenorphine, a partial mu opioid agonist (which I take), has this property.

> (BTW, I call it addiction if there is a negative physical response in discontinuing the drug/med--I don't always associate addiction with inappropriate or negative behavior).

I think I addressed this in the post I referred you back to. (My info, incidentally, comes from standard pharmacology textbooks.)


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