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Elizabeth: Buprenorphine sources?

Posted by Peter S on June 29, 2001, at 10:33:39

In reply to Re: is buprenorphine legal » karen harris, posted by Elizabeth on June 25, 2001, at 5:36:20

Hi Elizabeth,

Any ideas about finding an MD willing to prescribe Buprenorphine for depression? As I mentioned in another post, my pdoc is not willing to try it out. Enoch Callaway, who wrote the article about BU, lives in the SF bay area where I live. Apparently he's no longer at UCSF and I'm trying to track him down. Any other ideas?

Thanks!

Peter

> Buprenorphine is a legal drug in the United States. It is categorised as a Schedule V controlled substance, meaning that it is considered to have very little abuse potential. However, there is a chance that if you mail-order drugs from other countries, especially controlled substances, they will be seized by Customs. With a little red tape, you can get them legally in this way, but you need to go through the appropriate annoying bureaucratic channels. If you didn't go through channels, and your order got seized, you're pretty much out of luck. (On the bright side, you're unlikely to be prosecuted for anything as a result.)
>
> Sublingual buprenorphine (Temgesic, Subutex) has a poor reputation. People who take it via the sublingual/buccal route need to take huge doses, though, and even then they report that it's not very reliable. I take buprenorphine in the solution form which *is* available by prescription in the USA and is intended for IM or IV injection. I use it intranasally, the dose required through this route being comparable to those used when the drug is injected, although it may take longer to work. I think that the pharmaceutical industry should be working on designing a metred-dose nasal spray (like Stadol NS) rather than trying to get the SL tablets approved.
>
> > A wonderful addiction specialist detoxed me with liquid buprenex. Sadly the DEA threatened his license if he contines to use it to treat addiction.
>
> At this time, it's illegal for doctors in the US to use opioids (even partial agonists such as buprenorphine, which has little if any abuse potential) to treat opioid addiction, except in special clinics. Most people in these programs use methadone (LAAM is also sometimes used), though buprenorphine is available, at least in some places (more in Europe).
>
> It is perfectly legal to prescribe opioids for pain or for other conditions (such as mood disorders). I pick mine up at a local pharmacy each month, just as my mother does with her hydrocodone/APAP prescription (for osteoporosis). Because it is only Schedule V (and not Schedule II like morphine or fentanyl or oxycodone), I can get 5 refills on each prescription.
>
> Something you might consider would be getting into a MMT program and then, whenever it starts becoming available, switching to buprenorphine (just as you used it to detox from heroin, only you could then use it for maintenance therapy). Buprenorphine has a good reputation for blocking withdrawal symptoms and cravings for full-agonist opioids. The disadvantage here is that you'd have to rely on the eventual availability of buprenorphine for this use (which is not by any means certain).
>
> A better plan might be to get a prescription for it as an antidepressant, as I do. This would be feasible, if you can stay off opioids long enough that you'd be considered to be in remission from your addiction. A number of people who take prescribed opioids for mood disorders have histories of self-medicating, but it's not considered maintenance treatment because the disorder being treated is a primary mood disorder and any substance dependence is considered to be in full remission. It is well known that some people turn to non-prescribed drugs in an effort to feel "normal" -- for these people, medically supervised treatment with related drugs is often very effective.
>
> > I had no idea it was illegal. My grandma has been ordering heart meds for years!
>
> Heart meds aren't controlled substances. The people with a vested interest in the drug-war industry feel that they have bigger fish to fry.
>
> Something that really gets to me about the anti-drug politicians' invasion of our doctors' offices (besides my feeling that the doctor-patient relationship is sacred) is that laws that limit prescription of controlled substances don't keep addicts from getting their (street) drugs at all -- they just make it more difficult for those of us who need them for pain, depression, etc., as if we don't have to endure enough suffering in our lives already.
>
> -elizabeth


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Psycho-Babble Medication | Framed

poster:Peter S thread:17065
URL: http://www.dr-bob.org/babble/20010625/msgs/68334.html