Posted by Elizabeth on December 9, 2001, at 16:04:58
In reply to Re: Methadone for depression. » shelliR, posted by JahL on December 8, 2001, at 20:40:05
Jahl, would you be interested in exchanging emails? I'm curious as to how you're going about getting treatment, although your methods may not be applicable to me here on the other side of the pond. I can't recall if we've ever written each other before, but I have a Yahoo account where you can write me if you're willing (cybersquid_400@yahoo.com). I agree with your self-assessment -- you can be pretty resourceful and clever -- and I wonder if maybe you could help me figure out what to do about my own situation.
> The DP Unit is the Depersonalisation Unit at the Maudsley, which I am becoming increasingly aware of as being very psychotherapy (Eck!) orientated.
As you've probably noticed, I share your gag reflex toward talk therapy. I also feel bad for you about the troubles you've run into with red tape and bureaucrats and policies and so forth -- I've had similar troubles many times. I *hate* dealing with bureaucrats. And it's so hard to advocate for yourself and make sure your rights are respected when you're depressed, isn't it?
> I must thank you for suggesting spreading the dose; things seem quite calm and smooth. I thought it lasted 24hrs; whatever they say it is, it's probably less.
The dosing schedule for methadone is different depending on what it's being used for. According to the U.S. labelling, pain patients should take it every 3-4 hours. In contrast, addicts on maintenance therapy usually only need it once a day. (I've heard of cases where it wore off before the next morning and people couldn't get a take-home dose from the clinic. Being a regular psych patient can be hell, but I can only imagine how awful it must be for drug addicts. They're treated as though they're sub-human, or at the very best, the worst sort of criminals.)
So the question is, are depressives more like pain patients or MMT patients in their opioid dosing requirements? FWIW, I can tell you that I need to take bupe several times a day, whereas I believe that it's used once daily when it's given to addicts for maintenance therapy.
> I have a pet theory (actually I just this minute rolled a spliff and dreamt it up) that Methadone users are misinformed re: Methadone half-life so as to punish users for a couple of hours prior to their next dose for daring to be addicted to something that makes them feel good (H). I mean, who do they think they are??!
Usually once a day is enough, actually. But (see above) for people who need it more often, it can be really awful.
> If you think it's hard getting opiates in the States, try living over here.
I know that it's hard to get benzos in the UK; I wasn't sure about opioids. Here, a lot of doctors still refer to them as "narcotics." That says it all for me.
> Opiate is an obscene word, especially after 'Dr Death' aka Dr Harold Shipman was found to have been addicted to PETHEDINE-Elizabeth, if you're reading, know anything about this one?-whilst murdering maybe 500 patients with Diamorphine. Even you insular Yanks ( :-) ) must have heard about this one a year or 2 ago.)?
I actually don't know that story, no. I often lapse in following national news, let alone international. What exactly was the deal?
(BTW, U.S. readers might not recognize some of the drug names you use. Pethidine is what in the U.S. is called meperidine or Demerol -- a very short-acting opioid, not useful for our purposes; and diamorphine is of course diacetylmorphine, better known as heroin.)
> You mean start like I have? I guess you'd have to come off the opioids for a while to do that?
Yes. And from what I know, methadone can be VERY hard to get off of (especially at high doses) because the w/d, while not as intense as what you'd get from quitting heroin, goes on for an excruciatingly long time.
> Well that's something. I feel the same generally. The pdoc is almost a luxury so long as you get the meds *you* (& you only) know to help.
I know; it's so frustrating that many pdocs don't seem to believe that you know what your own subjective experience is better than they do!
> > After Christmas I hope to turn into a person again.
>
> I'm less hopeful for myself but that would be a great present 4 you.This is the fifth Christmas in a row that I've found myself wishing for the same present.
Best wishes to you.
-elizabeth
poster:Elizabeth
thread:84007
URL: http://www.dr-bob.org/babble/20011202/msgs/86393.html