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Re: opiates and major depression

Posted by Crotale on July 25, 2008, at 22:34:00

In reply to Re: opiates and major depression » androog, posted by maree on July 22, 2008, at 21:32:13

I'm just adding my agreement with what has already been said; I think most (not all) substance abusers are, or at least, started out, self-medicating. I believe that the way to prevent this self-medication from transforming into abuse is for a doctor to prescribe and supervise the opioid rather than simply condemning opioid use. Ideally you want to stick with the lowest possible dose. I think Ultram is the best to start with, unless you are on MAOIs or have a history of seizures. Beyond that, I'm not sure. Ideally you want to use Temgesic (0.2mg buprenorphine SL). Most doctors aren't likely to be comfortable with having a patient self-inject Buprenex (IM) (0.3mg/mL). Buprenex also works IN with a metered-dose inhaler. Subutex and Suboxone, the sublingual formulations designed for drug addicts, are much higher doses. (Supposedly bioavailability is the same or close SL and IM.)
The lowest available dose in a single pill of Subutex is 4mg, which I'm sure would make me sick to my stomach.

My personal experience: I never felt anything that I'd descrine as a "high" from opioids; They just make me feel more clear (jittery initially), itchy, and sometimes nauseated. Careful because they have heavy side effects.

-Crotale


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URL: http://www.dr-bob.org/babble/20080718/msgs/842066.html