![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by Shelly Dylan on October 7, 2008, at 17:21:26
I've suffered from severe refractory depression for over 21 years. The only thing that works are opiates. They make me feel normal not high. I can't find a doctor who will prescribe them to me thanks to our "wonderful" DEA. What do I do? I need help. I don't want to live the rest of my life depressed. I don't understand how physician's, in part thanks to the government, can refuse to give me medicine that will help my condition. Someone, anyone, please help.
Posted by azalea on October 7, 2008, at 19:01:56
In reply to Need Help Obtaining Suboxone, posted by Shelly Dylan on October 7, 2008, at 17:21:26
Perhaps you could provide your doctor with following research study . . .
J Clin Psychopharmacol. 1995 Feb;15(1):49-57.
Buprenorphine treatment of refractory depression.
Bodkin JA, Zornberg GL, Lukas SE, Cole JO.
McLean Hospital, Consolidated Department of Psychiatry, Harvard Medical School, Belmont, MA 02178, USA.Opiates were used to treat major depression until the mid-1950s. The advent of opioids with mixed agonist-antagonist or partial agonist activity, with reduced dependence and abuse liabilities, has made possible the reevaluation of opioids for this indication. This is of potential importance for the population of depressed patients who are unresponsive to or intolerant of conventional antidepressant agents. Ten subjects with treatment-refractory, unipolar, nonpsychotic, major depression were treated with the opioid partial agonist buprenorphine in an open-label study. Three subjects were unable to tolerate more than two doses because of side effects including malaise, nausea, and dysphoria. The remaining seven completed 4 to 6 weeks of treatment and as a group showed clinically striking improvement in both subjective and objective measures of depression. Much of this improvement was observed by the end of 1 week of treatment and persisted throughout the trial. Four subjects achieved complete remission of symptoms by the end of the trial (Hamilton Rating Scale for Depression scores < or = 6), two were moderately improved, and one deteriorated. These findings suggest a possible role for buprenorphine in treating refractory depression.
> I've suffered from severe refractory depression for over 21 years. The only thing that works are opiates. They make me feel normal not high. I can't find a doctor who will prescribe them to me thanks to our "wonderful" DEA. What do I do? I need help. I don't want to live the rest of my life depressed. I don't understand how physician's, in part thanks to the government, can refuse to give me medicine that will help my condition. Someone, anyone, please help.
Posted by Phillipa on October 7, 2008, at 23:28:14
In reply to Re: Need Help Obtaining Suboxone » Shelly Dylan, posted by azalea on October 7, 2008, at 19:01:56
Azalea I'm the same way broke my arm was on percocet l a day and was laughing and that is what the pdoc and other doc did too as they said it's addictive but it's okay for me to take benzos which no longer work for over 37 years? So a study wouldn't help me. Isn't ultram not require a script? Love Phillipa
Posted by Shelly Dylan on October 8, 2008, at 9:44:41
In reply to Re: Need Help Obtaining Suboxone » Shelly Dylan, posted by azalea on October 7, 2008, at 19:01:56
> Perhaps you could provide your doctor with following research study . . .
>
> J Clin Psychopharmacol. 1995 Feb;15(1):49-57.
>
> Buprenorphine treatment of refractory depression.
>
> Bodkin JA, Zornberg GL, Lukas SE, Cole JO.
> McLean Hospital, Consolidated Department of Psychiatry, Harvard Medical School, Belmont, MA 02178, USA.
>
> Opiates were used to treat major depression until the mid-1950s. The advent of opioids with mixed agonist-antagonist or partial agonist activity, with reduced dependence and abuse liabilities, has made possible the reevaluation of opioids for this indication. This is of potential importance for the population of depressed patients who are unresponsive to or intolerant of conventional antidepressant agents. Ten subjects with treatment-refractory, unipolar, nonpsychotic, major depression were treated with the opioid partial agonist buprenorphine in an open-label study. Three subjects were unable to tolerate more than two doses because of side effects including malaise, nausea, and dysphoria. The remaining seven completed 4 to 6 weeks of treatment and as a group showed clinically striking improvement in both subjective and objective measures of depression. Much of this improvement was observed by the end of 1 week of treatment and persisted throughout the trial. Four subjects achieved complete remission of symptoms by the end of the trial (Hamilton Rating Scale for Depression scores < or = 6), two were moderately improved, and one deteriorated. These findings suggest a possible role for buprenorphine in treating refractory depression.
>
> > I've suffered from severe refractory depression for over 21 years. The only thing that works are opiates. They make me feel normal not high. I can't find a doctor who will prescribe them to me thanks to our "wonderful" DEA. What do I do? I need help. I don't want to live the rest of my life depressed. I don't understand how physician's, in part thanks to the government, can refuse to give me medicine that will help my condition. Someone, anyone, please help.
>
> I've already shown my doctors and psychiatrists the "Bodkin Experiment" along with pages of other documents that support the idea of a subtype of depression that involves the endogenous opioids be it a lack of enkephalins or some problem with the opioid receptor sites, etc. They immediately get defensive. I work in the medical field myself and doctors don't like patients who "try to dictate their own treatment". It doesn't even matter to these doctors that I have been on every antideppressant, antipsychotic, antianxiolytic, and combinations of all the above over the past 21 years. My current psychiatrist is telling me that I need to try ECT and if that doesn't work then she will "think about opiates". I'm not undergoing ECT when the medical community can't even give anyone an explanation for how ECT works. I also feel my rights are being violated by my doctor telling me to go get ECT and then if that doesn't work opiates "might be tried". It's like some sort of sick bribe.
Posted by azalea on October 8, 2008, at 14:35:49
In reply to Re: Need Help Obtaining Suboxone, posted by Shelly Dylan on October 8, 2008, at 9:44:41
Have you tried mood stabilizers such as Lamictal (lamotrigine) or Lithium?
Just a thought.
I have been on every antideppressant, antipsychotic, antianxiolytic, and combinations of all the above over the past 21 years. My current psychiatrist is telling me that I need to try ECT and if that doesn't work then she will "think about opiates". I'm not undergoing ECT when the medical community can't even give anyone an explanation for how ECT works. I also feel my rights are being violated by my doctor telling me to go get ECT and then if that doesn't work opiates "might be tried". It's like some sort of sick bribe.
>
>
Posted by Shelly Dylan on October 8, 2008, at 20:15:46
In reply to Re: Need Help Obtaining Suboxone » Shelly Dylan, posted by azalea on October 8, 2008, at 14:35:49
I've tried Lithium, Tegretol, Neurontin, Topamax, Depakote, and Lamictal.
Posted by azalea on October 8, 2008, at 21:13:49
In reply to Re: Need Help Obtaining Suboxone, posted by Shelly Dylan on October 8, 2008, at 20:15:46
Sounds like you've tried many meds and are still symptomatic.
Any improvement or worsening with any of the meds you've tried?
Another option might be Vagal Nerve Stimulation.> I've tried Lithium, Tegretol, Neurontin, Topamax, Depakote, and Lamictal.
>
Posted by Shelly Dylan on October 10, 2008, at 21:25:36
In reply to VNS? » Shelly Dylan, posted by azalea on October 8, 2008, at 21:13:49
Why would I want to try something intrusive like vagal nerve stimulation? Opiates aren't dangerous and they work.
Posted by mattye on October 11, 2008, at 6:48:54
In reply to Need Help Obtaining Suboxone, posted by Shelly Dylan on October 7, 2008, at 17:21:26
Here's an easy way. Get addicted to oxycontins or heroin and then check into a Subuxone treatment center. Make sure you have good insurance though. That Sh8ts expensive.
Posted by Shelly Dylan on October 11, 2008, at 11:44:19
In reply to Re: Need Help Obtaining Suboxone, posted by mattye on October 11, 2008, at 6:48:54
Man, you must be a genius, I never would have thought of that.
Posted by cowan78 on October 11, 2008, at 18:54:55
In reply to Re: Need Help Obtaining Suboxone, posted by Shelly Dylan on October 11, 2008, at 11:44:19
I get very touchy with this sort of subject, so forgive me in advance if I come across as rude.
I've been through 10+ years of opiate addiction and after many unsuccessful attempts at quitting was finally able to do so with Suboxone maintenance. This is NOT a drug for depression, it is a drug used as an out patient treatment for opiate/opioid dependency. I know off label use is rampant and in many cases is justified, but I do not believe off label prescribing for buprenorphine is. Ritalin, Dexedrine, Adderall etc. I would rather see used for deprssion than opiates. A minor study linking bupe with improvement in depression is not justifiable reason to prescribe this drug for your case. The ramifications of long term opiate use will far outweigh any immediate effect, and tolerance will hit fast and hard. And no doctor will continue to climb up an opiate dose to treat anything beyond chronic, severe, unremitting pain.
You do need to alleviate your depression, and I recognize that, but opiates have destroyed civilizations and inumerable lives way more than they have benefited mental anguish. VNS is actually a MUCH safer procedure, IMHO, as is ECT. Please, please, please do yourself a favor and get off of the 'only opiates can help' mentality...noone, myslef included, wants to see the nightmare your walking straight into and depression will seem like a fuzzy dream from the bottom of the canyon that opiates will put you in.
Posted by Phillipa on October 11, 2008, at 19:49:26
In reply to Re: Need Help Obtaining Suboxone » Shelly Dylan, posted by cowan78 on October 11, 2008, at 18:54:55
Very true I guess but what about the benzos as been on them over 37 years and just recently they stopped working. Never have raised my doseages during those years actually was med free for quite a while. I am not looking for an argument just clarification of how they are different. See have two neighbors prescibed fentnyl patches for pain and vicodin for breatk through pain so seriously don't know the differece. Thanks for any knowledge you have as haven't seen you post before. And I see how strongly you feel. Must have had a horrible experience. Phillipa
Posted by cowan78 on October 11, 2008, at 21:59:35
In reply to Re: Need Help Obtaining Suboxone » cowan78, posted by Phillipa on October 11, 2008, at 19:49:26
Hey phillipa...i can understand how a 37 year benzo script can be confusing considering the situation. if i recall correctly, youve been on 15mg of diazepam for that length of time? anyhow, not important...just wondering.
I do think that benzos are a different breed of monster altogether, albeit no less troublesome for many people. I myself take Klonopin, so i understand how readily docs prescribe benzos vs. opiates, esp. for psychiatric purposes.
In terms of opioids, fentanyl is about as strong as one can get, and breakthrough pain meds are commonplace, since patches arent always the most reliable form of dosing...I would hope that your neighbors have the type of pain that would require such powerful analgesics, or else overkill might be an understatement.
In all honesty, I wish there was a very tightly controlled drug for depression, much like the tightly controlled drugs for pian, because there are people who ARE unresponsive to the run of the mill AD's. Unfortunately, those controlled psych meds are barbiturates and benzodiazepines...not at all helpful for depression! As I said, I would much much rather have the stimulant class of drugs be used in lieu of opiates because there is a longer history of treatment with them and much more clinical evidence to backup their use in treatment resistant depression. I still believe that even methamphetamine (Desoxyn) is still in use for some disorders, and while I'm certainly not condoning meth for depression, I do think that opiates are a very poor choice for depressives in that a)they are in and of themselves, depressants and b)tolerance to their effects is so much more rapid an insidious than most nearly any other substance.
At this point, I cannot see any clinical reason to resort to opiates for depression, even if 60 years ago it was common practice. Nembutal and Tuinal were also 'effective' anxiolytics and sedatives at the time. I don't think I would stand by using those drugs for anxiety/sleep anymore =)
I'm going to wrap this up because at this point I'm boring myself, so in conclusion, I think you're right, phillipa, and 37 years is a long course of treatment, esp. if it stopped working long ago. I liked your comment earlier on how the percocet had you laughing while you were on it...it is an effective mood-brightener at first, but oh how quickly that effect fades. And buprenorphine, while structurally a bit different in its actions on the opioid systems, is no better for long term treatment of anything except opiate addiction maintenance therapy. And in a few cases, its used in patch form for chronic pain, with all the same downfalls of all other opiates, im afraid.
Posted by Phillipa on October 12, 2008, at 18:38:56
In reply to Re: Need Help Obtaining Suboxone, posted by cowan78 on October 11, 2008, at 21:59:35
Cowan very helpful post. One of the ladies has heart disease, diabetes, forget what else and other pain meds pooped out on her it took over a week for the fentynl patch to work. The other one has chronic shoulder and backpain. I have backpain also but just go with it. And you are correct about the valium dose. Think klonopin is any better seriously as seems the docs like it? Love Phillipa
Posted by merry-dove on October 13, 2008, at 13:15:51
In reply to Re: Need Help Obtaining Suboxone » Shelly Dylan, posted by cowan78 on October 11, 2008, at 18:54:55
I started taking Vicodin over 5 years ago for pain in the mid right section of my back for which they can find no cause. I discovered it lifted my mood and helped make me feel more like a normal person. (I still need the antidepressants though) I take no more than 2 1/2 pills a day - 1/2 half pill at a time - for my back. It only slightly helps my mood anymore but at least it does something. I have been on this same dose for all this time without increasing it or becoming addicted. If I am super super depressed (which is becoming the norm for me lately) I can at least take 1/2 vicodin and be able to get through the day. At this point I am going to have to find another antidepressant or something to augment it.
Posted by cowan78 on October 13, 2008, at 14:51:39
In reply to Re: Need Help Obtaining Suboxone » cowan78, posted by merry-dove on October 13, 2008, at 13:15:51
I'm sorry to hear that youre in a bad way...I'm not a chronic pain sufferer, so I can only offer my sympathy, not my experince. It must be awful to have any type of chronic pain. Depression is, as most of us know I'm sure, also chronic pain, just in a different form.
I'm glad Vicodin has helped both of your conditions, and you are part of a *very* lucky group of people to which you haven't form any sort of dependency on painkillers, and who also do not require an escalating dose to maintain the same analgesic effect. As an augment to a traditional AD, in your specific situation, the Vicodin side effect of a 'mood lift' is a bonus. But bear in mind that it is being prescribed for chronic pain. I think what really hit a nerve with me about this thread was "NEED HELP OBTAINING SUBOXONE" title, which threw up so many red flags in my mind that I couldn't let it pass without seriously warning about the potential threat opiates possess. As a user of Suboxone myself, I can say that, like you, it may 'occasionally' give me a tiny mood boost, but its certainly not long lasting or dramatic. In fact, one of the main attraction of Suboxone for opioid dependence is its lack of typical opioid euphoria.
Again, I'm glad to hear you're reaping some benefit from the Vicodin even after all this time, but I still stand firm in my opinion that opiates should never be used as any sort of mood brightener, except those occasional short bursts when taking a painkiller following surgery, accident, etc...than just enjoy the show for those few days.
Posted by cowan78 on October 13, 2008, at 15:04:51
In reply to Re: Need Help Obtaining Suboxone » cowan78, posted by Phillipa on October 12, 2008, at 18:38:56
> Cowan very helpful post. One of the ladies has heart disease, diabetes, forget what else and other pain meds pooped out on her it took over a week for the fentynl patch to work. The other one has chronic shoulder and backpain. I have backpain also but just go with it. And you are correct about the valium dose. Think klonopin is any better seriously as seems the docs like it? Love Phillipa
Hey Phillipa...wow, I feel bad for your neighbor =( what awful pain she must be in. I can understand now why fentanyl was used in her case...seems very appopriate give her illnesses.
About the benzos, I was taking Valium, like you, for about 6 years (which completely dwarfs your 37 years, I know). I was using 10mg once daily at bedtime, and like you, it TOTALLY stopped doing anything. I told my doc that honestly it was like taking a sugar pill, but without the benefit of being sweet! So we brainstormed for a bit, went back over the SSRI options (of which I'm NO fan of), and came up with trying out Klonopin. So we did the switchover without any fanfare (ie no slow cross-over, esp. seeing how I was on such a low dose of Valium) and lo and behold it worked beautifully. The 'sedative' effects were very pronounced the first several days, but those faded quickly and the anxiolytic effects took full effect in about 2 weeks, if I remember correctly. I'm currently on 1mg. BID and haven't hd any major anxiety issues to speak of, and more importantly, no panic. Ive been on Klonopin for about 4 years now. And you're right, Klonopin is the benzo flavor of the month right now, and in my opinion, rightfully so. I think it is a better option for those with chronic anxiety vs. occasional. Hope this helps!
Posted by Phillipa on October 13, 2008, at 19:37:40
In reply to Re: Need Help Obtaining Suboxone, posted by cowan78 on October 13, 2008, at 15:04:51
Cowan very helpful as see pdoc on Thursday. First time tried it years ago was trying to wearn from xanax to klonopin but for some reason out of the blue felt suicidal and wasn't so pdoc put me back on xanax which worked well til about 5 years ago and then the switch to valium. Currently on 12.5 at bedtime and .5 xanax but am stopping xanax tonight as I simply fall asleep. Just plain tired I hope from a lot of stress. So I will ask for klonopin and see what she says as I'm afraid she will think I'm drug seeking with the switching from valium to xanax and didn't make the switch didn't really want to take meds during the day. But I'm hoping the tiredness is due to high anxiety which is hidden inside my body and not manifesting as the anxiety of the past like I swallowed it or something like that. Thanks Cowan. Love Phillipa
Posted by cowan78 on October 13, 2008, at 20:21:02
In reply to Re: Need Help Obtaining Suboxone » cowan78, posted by Phillipa on October 13, 2008, at 19:37:40
I understand the concern regarding med-seeking...pdocs especially have an arsenal of meds that are controlled, so they see a fair share of shopping, I'm sure. I've read conflicting reports on what benzo is seen as the most abuseable, most all agreeing xanax tops the list, but number two is always a debate. Valium, supposedly due to its high lipophicilty, or Klonopin due to its high potency. Or temazepam (restoril), which actually I think is a much bigger issue in the UK. Oy...its no wonder patients and doctors alike are confused. IMHO, Klonopin has very, very little abuse potential, as its come on is so gradual, and its half life so long. These same properties, I believe, are what make it such an ideal long term anxiolytic.
As far as depression, I have read some anecdotal evidence that Klonopin can aggravate depression more than other benzos, although take that with a grain of salt, as studies done by Upjon (sp?)m Pfizer etc. all have their own benzo to push and would love to prove their's as 'superior' to another. I know that most of us can recall Xanax's furious campaign to reign supreme benzo of the world, and it did, mainly due to studies that it had antidepressant properties along with the only official FDA stamp of approval for PD (at the time). And look at what a mess Xanax turned out to be in terms of dependency/withdrawal. Yikes. Anyhow, I'm rambling...good luck with your pdoc phillipa, nd keep us all posted on how things turned out!
Posted by Phillipa on October 13, 2008, at 21:04:47
In reply to Re: Need Help Obtaining Suboxone, posted by cowan78 on October 13, 2008, at 20:21:02
Cowan thanks again. Love Phillipa
Posted by Shelly Dylan on October 19, 2008, at 20:31:58
In reply to Re: Need Help Obtaining Suboxone » Shelly Dylan, posted by cowan78 on October 11, 2008, at 18:54:55
> I get very touchy with this sort of subject, so forgive me in advance if I come across as rude.
> I've been through 10+ years of opiate addiction and after many unsuccessful attempts at quitting was finally able to do so with Suboxone maintenance. This is NOT a drug for depression, it is a drug used as an out patient treatment for opiate/opioid dependency. I know off label use is rampant and in many cases is justified, but I do not believe off label prescribing for buprenorphine is. Ritalin, Dexedrine, Adderall etc. I would rather see used for deprssion than opiates. A minor study linking bupe with improvement in depression is not justifiable reason to prescribe this drug for your case. The ramifications of long term opiate use will far outweigh any immediate effect, and tolerance will hit fast and hard. And no doctor will continue to climb up an opiate dose to treat anything beyond chronic, severe, unremitting pain.
> You do need to alleviate your depression, and I recognize that, but opiates have destroyed civilizations and inumerable lives way more than they have benefited mental anguish. VNS is actually a MUCH safer procedure, IMHO, as is ECT. Please, please, please do yourself a favor and get off of the 'only opiates can help' mentality...noone, myslef included, wants to see the nightmare your walking straight into and depression will seem like a fuzzy dream from the bottom of the canyon that opiates will put you in.I've been through twenty years of severe debilitating depression. Forgive me if I come off sounding "rude" but it seems like there is a bit of "favortism" shown toward addicts while people with mental problems slip through the cracks. Why and or how do you presume that you need Suboxone but I don't? What's the neurobiological difference between my brain and yours? You think my depression will ever seem "like a fuzzy dream" in comparison to "the bottom of the canyon?" I've lived in hell for a long time and the "canyon" is starting to sound pretty good or maybe you think suicide is better? Opiates never "ruined" civilizations and/or lives. People ruined civilizations and lives by allowing themselves to be controlled by opiates. By the way, don't cite me a "minor or major study" about how "addiction is genetic and a disease that you can't control" when you don't believe depression could be a neurochemical imbalance of the endogenous opioid system. Hey, if opiates are so bad why don't you come off that maintenance dose of Suboxone? By the way, I'll never "drop the only opiates can help mentality." The Suboxone is helping you isn't it? By the way, how can you suggest that a schedule two stimulant is less addictive than Suboxone?
Posted by Shelly Dylan on October 19, 2008, at 20:52:16
In reply to Re: Need Help Obtaining Suboxone, posted by cowan78 on October 11, 2008, at 21:59:35
> Hey phillipa...i can understand how a 37 year benzo script can be confusing considering the situation. if i recall correctly, youve been on 15mg of diazepam for that length of time? anyhow, not important...just wondering.
> I do think that benzos are a different breed of monster altogether, albeit no less troublesome for many people. I myself take Klonopin, so i understand how readily docs prescribe benzos vs. opiates, esp. for psychiatric purposes.
> In terms of opioids, fentanyl is about as strong as one can get, and breakthrough pain medsare commonplace, since patches arent always the most reliable form of dosing...I would hope that your neighbors have the type of pain that would require such powerful analgesics, or else overkill might be an understatement.
> In all honesty, I wish there was a very tightly controlled drug for depression, much like the tightly controlled drugs for pian, because there are people who ARE unresponsive to the run of the mill AD's. Unfortunately, those controlled psych meds are barbiturates and benzodiazepines...not at all helpful for depression! As I said, I would much much rather have the stimulant class of drugs be used in lieu of opiates because there is a longer history of treatment with them and much more clinical evidence to backup their use in treatment resistant depression. I still believe that even methamphetamine (Desoxyn) is still in use for some disorders, and while I'm certainly not condoning meth for depression, I do think that opiates are a very poor choice for depressives in that a)they are in and of themselves, depressants and b)tolerance to their effects is so much more rapid an insidious than most nearly any other substance.
> At this point, I cannot see any clinical reason to resort to opiates for depression, even if 60 years ago it was common practice. Nembutal and Tuinal were also 'effective' anxiolytics and sedatives at the time. I don't think I would stand by using those drugs for anxiety/sleep anymore =)
> I'm going to wrap this up because at this point I'm boring myself, so in conclusion, I think you're right, phillipa, and 37 years is a long course of treatment, esp. if it stopped working long ago. I liked your comment earlier on how the percocet had you laughing while you were on it...it is an effective mood-brightener at first, but oh how quickly that effect fades. And buprenorphine, while structurally a bit different in its actions on the opioid systems, is no better for long term treatment of anything except opiate addiction maintenance therapy. And in a few cases, its used in patch form for chronic pain, with all the same downfalls of all other opiates, im afraid.
Opiates are not "depressives". Ultram acts as a SSRI. Percodon, Darvon, and Meperidine can cause serotonin syndrome if taken with a SSRI or SSNRI. Think there just might be a link between the serotonergic system and the enkephalins? Fentanyl isn't really the "strongest" opiate out there either. It sort of depends on the particuliar opiate receptor site the drug acts as an agonist for. Buprenorphine is the strongest kappa opioid receptor agonist.
Posted by cowan78 on October 20, 2008, at 1:45:59
In reply to Re: Need Help Obtaining Suboxone, posted by Shelly Dylan on October 19, 2008, at 20:52:16
Wow, get defensive much? You act like I personally attacked you, Shelley. I didn't. I attacked the notion of opiates being used for depression. Frankly, you seem to know way to much about opiates/opioids, and that is in and of itself worrisome. You know names, receptor sites, pathways, etc...if i were to drop a study on addiction, I'd drop it here. Take a look around you. I mean REALLY look...you only see opiates, don't you? Yeah, so did I. Take some other suggestions instead of just brushing them off as if you know they wont work...your drive towards what you want is incredible, and in some ways, thats good. I never proposed suicide, so don't place words in my mouth, please. Suboxone is the most potent kappa receptor ANTAGONIST, btw...if it were an kappa agonist, youd throw yourself off the nearest bridge as soon as it hit youd be so insane. And yes, Suboxone helps me with opiate abstinence. I dont notice any antidepressant effect whatsoever. You need help, anyone can see that, and youve been nothing but rude, unresponsive, flippant, defensive, avoiding, crass and negative. If you want help obtaining Suboxone, maybe you can score some opiates from your local drug dealer, get hooked, and then get on maintenance. Honestly, in this whole thread, that advice about getting yourself addicted to oxycontin might be your best shot at getting the opiates your dead set on getting. Now I'm being rude, but you need a wake up call. You ask for help, and you turn down EVERY SINGLE ANSWER offered, because none of them are what you want to hear. Maybe someone else will come along and tell you what you want to hear, and then you'll finally be cooperative. So long as you can get your opiates, i suppose.
Posted by cowan78 on October 20, 2008, at 2:16:56
In reply to Re: Need Help Obtaining Suboxone, posted by Shelly Dylan on October 19, 2008, at 20:52:16
Your disturbing knowledge of opiates continues even into the next post, i see. If Ultram, Darvon, Percodan and Demerol can all cause serotonin syndrome, then take some prozac and exercise. Boom, got your enkaphalins your so convinced you need from narcotics. And I never said schedule two stimulants were less addictive, I said there was much more evidence backing up their use in resistant depression. Another case of you putting words in my mouth...you need to stop that, please. And fairness towards addicts has nothing at all to do with this...Suboxone is only one of 2 treatments for addiction. Mental illness has hundreds of treatments, so dont talk to me about fair. Yap away all you like, because I will never condone opiate use for depression, no matter what you think you know.
Posted by cumulative on October 21, 2008, at 2:45:11
In reply to Re: Need Help Obtaining Suboxone, posted by cowan78 on October 20, 2008, at 2:16:56
There are several long-time posters here who have had magnificent results from buprenorphine, often after running out of other options to try. And many of them have not found tolerance/dependence to be a problem (the reasons for this are debated), or to be less of a problem than other opioids or even other agents they have tried , such as withdrawal-heavy SNRIs -- e.g., I know of several posters who drop in occasionally with continuing good results who have been taking buprenorphine for depression, at a stable low dose, for 5+ years. Perhaps your personal experience with opioids has been different, but this is not a reason to respond in this way to anyone.
Your abusive, intolerant tone in this thread is NOT appreciated by people at the dr-bob forums.
Abusing someone for knowing a lot about opioid science is also extremely unnecessary. It is EXCELLENT when patients inform themselves of the issues at hand.
"if it were an kappa agonist, youd throw yourself off the nearest bridge as soon as it hit youd be so insane"
Incorrect. Some kappa agonists (i.e. salvinorin) seem to have a certain breed of psychedelic effects (which are not analogous to insanity, and also you should be ashamed of yourself for the suicide imagery) but note that "classic" opiates and opioids: morphine, oxycodone, etc. are all also kappa agonists in addition to their mu affinity. Many of the intricacies of the mechanisms in question are still fairly mysterious.
"take some prozac and exercise. Boom, got your enkaphalins your so convinced you need from narcotics."
Boom ... No. While helpful, the results that one can get from exercise are not equivalent either in magnitude or exact makeup as an opioid depression treatment. I believe you understand this. Again, your tone is unnecessary.
"because I will never condone opiate use for depression, no matter what you think you know. "
Fortunately, you do not seem to be in charge here.
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Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
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