Posted by yxibow on February 22, 2007, at 1:23:47
In reply to Re: opiates for depression, posted by kelv on February 21, 2007, at 23:35:07
> Opiates were commonly used for mood/psych disorders until~1950.
>
> It's fact that some people ONLY get relief from their psychic torment with Opi's, this is a very controversial area to be sure, Opi's are medically restricted to pain relief most hardenly.
>
> It makes sense that Sero/Dopa/Norp are not the only players in mood disorders. Pain, whether from a broken leg or MDD is registered in the same brain area.
>
> Not everyone treated with Opi's seeks an ever increasing dose, Jerrypharmstudent who used to visit here often was scripted 5mgs Hydro 4x daily and maintained it for several years, with little loss of effectiveness-apparently.
>
> I wonder why Oxycontin (Hillybilly Heroin) is public enemy no1 amoung script meds in the US?
Its because its abused the most in the US to the point where most pharmacies lock up anything that isnt C-IV or so or lesser, because there have been bold and brazen holdups of pharmacies caught on tape many times.
Yes, we can blame the media cycle and all that, but the fact is, people know its available, its manufactured in fair quantities because its good for modest to fairly strong pain and if you can't treat an illness the do no wrong credo among progressive doctors is to treat pain.
And the number one way to treat pain in people who don't respond to OTC ibuprofen (People would fall asleep at the 800mg I take for pain, I guess I'm a fast metabolizer of most of what I take) or esoteric prescription NSAIDs that most people haven't even heard of like mefenamic acid and ketoprofen other wierd things that aren't prescribed much any more, is opiates.
They're restricted to pain because doctors who have advocated for it and even have had small trials of it for mood disorders recently, have had their medical license yanked or put on probation. And if your psychiatrist doesn't have a license, you're sh*t out of luck to put it bluntly.
Yes, we can all blame the DEA and the Controlled Substances Act of 1970 and the Misuse of Drugs Act in Great Britain in 1971, but the fact is for better or worse, things like oxycontin compete with meth for street drugs in the US. Xanax and Valium pale in comparison.
Should we convince the NIMH and other government agencies to have trials of things like bupenorphine for depression -- I don't see why not. A good majority of drug trials in the US don't necessarily start in big pharma -- they start in state sponsored places, universities, government health agencies, and when molecules are tested in small trials and proven effective, they're sold to drug companies. The drug companies further contract out to smaller pharmaceutical agencies to further pursue trials of medications, through phase trials and the like. I know its a royal pain to wait for the next big thing. I want the next big thing because I want my life back after it was inexplicably robbed five years ago. But some of that has to come from within.Have doctors petition the FDA to run small trials -- I know I'm sounding silly and pedantic but maybe it will work. Doctors really do want to hold on to their license and what they put on a prescription goes to a pharmacy. In fact an unnamed pharmacy who I am familiar with and like the pharmacist had a conversation with my doctor just to see what the diagnosis since I am on polypharmacy. Things go noticed by good pharmacists that prescriptions are being given for valid reasons. No worries there, but what if the pharmacist questioned your doctor about an opiate? Ultimately there are rules about having to report things, and I don't know what they are but they exist. You don't want to lose your doctor. That's all I can say.
-- tidings
poster:yxibow
thread:734151
URL: http://www.dr-bob.org/babble/20070219/msgs/735011.html