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buprenorphine » JeffH

Posted by Elizabeth on November 8, 2001, at 20:27:01

In reply to Elizabeth - Need Buprenorpine Help, posted by JeffH on November 7, 2001, at 16:27:22

> I talked to a few docs, including one that Dr. Bodkin recommended. However, all are either not taking any referrals or don't dab in opioids.

Yeah, it's difficult. I had first started taking buprenorphine back in early 1999. It was prescribed by a doctor who had been seeing me for some time and felt he knew me well enough to trust me with it; he also did some consulting with Dr. Bodkin. I quit when the side effects and difficulty of administration became too much.

In December 2000, I was very depressed after having been on Remeron for a few weeks, so I checked in to a hospital in NC (I was staying with my parents). I gave my doctor at the hospital a copy of the Bodkin et al. article and the phone number for my pdoc in Boston (the one who'd prescribed it the first time). After looking into it, they decided to give it a try. After they saw my remarkable and rapid response, they gave me a prescription and discharged me less than 24 hours after I had taken my first dose of bupe there.

If you haven't taken it in the past, it's going to be tough. Here are some ideas:
* Show them some of the articles on opioids as ADs -- not just Bodkin et al.'s study, but others too, to show that it's not just a few doctors in one place. Go to a medical library or use Loansome Doc to get articles if you need to. There are also a couple of sites online that have copies of articles.
* Give them a list of the other meds you've tried and descriptions of your responses.
* You may need to be patient: go through other medication trials while allowing the doctor to get to know you better and get a better idea for what kind of person you are and how debilitating your depression is.
* Have other ideas of things you haven't tried, and bring in supporting literature for these too. Make them things that aren't supposed to be habit-forming, such as lithium, pindolol, high-dose Buspar, Tegretol, TCA + MAOI, etc. Even if you don't think they'll help, it will make you look a lot less like a "drug seeker" if you're willing to try them. Be sure you have supporting data for these too (get an article or two that suggests that they can be helpful for refractory depression).
* Giving them Dr. Bodkin's contact information might be good also.
* If you have any recollection of times you were depressed and took opioids for pain, mention these times. Giving specific details of what your reaction was -- exactly what symptoms were relieved by the opioid -- makes your claim more credible.

I'm going to see someone in North Carolina next week (at the outpatient clinic at the hospital where I was seen last December), so I'll need to convince someone that this is an appropriate treatment for me. I'll let you know how it goes, if you'd like.

> What about your doc? Would he/she be willing to do a consult with my doctor in New Mexico?

I think Dr. Bodkin would be more appropriate, and I know he's been willing to do phone consultations with other doctors in various parts of the country about this.

I hope that this helps. Take care and good luck to you.

-elizabeth


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poster:Elizabeth thread:83458
URL: http://www.dr-bob.org/babble/20011104/msgs/83598.html