Posted by fachad on November 5, 2002, at 21:04:51
In reply to Opiates = the Devil Amphetamines = Angels?, posted by Jerrympls on November 5, 2002, at 0:10:05
The first major point my pdoc made to me about pstims being controlled substances is that the schedule classification (C-II, C-III, CIV, etc) is a purely LEGAL, not a MEDICAL classification.
Those classifications were cooked up by law enforcement personal (the DEA), not medical professionals (the AMA).
Even though the descriptions given in the Schedule list use medical sounding expressions, like "potential for dependence, withdrawal, etc.", my doc told me that the schedule number a drug was given was more related to it's diversion potential than it's addictive properties.
He maintained that benzodiazepines, which are C-IV, are plainly much more addictive than stimulants, which are C-II. Just look at someone who has abruptly stopped BZDs vs someone who has abruptly stopped pstims. And no one advocates "drug holidays" for Paxil or Effexor, but that is common practice for stims. That pretty much blows the theory that amphetamines are addictive and SSRI's are not, and shows that a C-II can be less addictive than a C-IV.
> So - I get the impression that within the worl of psychiatry that amphetamines are "ok" while opiates (hydrocodone) are viewed more as euphoric, addictive , danger-pills reserved ONLY for severe pain?
>
> My doctors in the past have had no problem putting me on amphetamines to help combat depression, fatigue and to help augment other ADs. Of course, this is an off-label use of a Schedule II drug.
>
> Every time I've been on a pain med - like hydrocodone (Vicodin) it's always worked better than ANY antidepressant therapy I've been on - and it's Schedule III.
>
> If I would ask to be put on an opiate for my depression - I'd be laughed at and thought of as a drug-seeking addict. But, if I request a stimulant - off-lable and labled more addictive (schedule II than opiates) by the government - it's perfectly fine?
>
> Hear me correctly: I'm not complaining - I'm just wondering - why? i don't supposed there are any docs on here who'd care to respond.
>
> This leads me to this: When the last AD treatment has been reached - when 11 years of life has been lost to a depression unresponsive to all "depression" treatments and combo therapies - when seven years of cognitive/behavioral therapy yields nothing - when ECT fails - when being off medication for a while pulls you deeper into darkness - when you're friends give up and your family ignores your illness - when there's nothing else - then what?
>
> I've read that depression is a terminal illness. Cancer is too. For cancer, one is given meds - no matter how addictive, to make life feel a little bit better while cells take over organs and then body. Elderly patients in homes are usually on one pain killer or another. What makes it different for treatment-resistant depression? If my doc has 10 years of my medical history and concludes there is nothing else to try - why not put me on something like vicodin? Answer me these:
>
> 1) What's the difference between taking Vicodin (schedule III) for depression vs. amphetamine (schedule II) for depression?
>
> 2) What's the difference between taking Vicodin for depression vs. Prozac? With Prozac you have to take it every day and if you go off of it you have to go slowly because of the severe withdrawl.
>
> Perhaps opiates are seen as "feel good" pills and feel good pills are only FAKE good and they just cover up the depression. Hmm. But that thinking would also be true for amphetamines - would it not?
>
> OKk- this is too long and I'm just asking too many questions.
>
> Anyone out there have an opinion? Insight?
>
> Thanks
>
poster:fachad
thread:126471
URL: http://www.dr-bob.org/babble/20021101/msgs/126597.html