Posted by pseudoname on June 17, 2006, at 8:52:20
In reply to Opiates for Depression - YAY!, posted by Hermit on June 16, 2006, at 14:49:30
Thanks, Hermit.
I’m really glad you posted your story. Lately I’m starting to wonder if maybe a national movement supporting opioid treatment of depression might be starting right here!
> In my case, I just let the use of this substance get out of hand, so I stopped. (I had a 3 week withdrawal to deal with.)
I’m glad you were honest about that experience — and good on you for managing it so well. I think we opioid supporters have to be honest about the downsides. Although it’s not a competition, it would put us morally ahead of the SSRI sales reps, LOL.
But I’m a little concerned about the phrasing here:
> Yes, you WILL get physically addicted to them
I agree that sweats & other opioid-typical withdrawal symptoms are a very likely outcome in varying degrees of intensity when abruptly discontinuing longterm use of an opioid. I experienced mild sweats for a few days going without my low doses of buprenorphine. But it’s not quite a foregone conclusion for all people in opioid treatment, and it can be managed by gradual dose reduction.
Also, rather than the word “addiction”, the term currently promoted for use in the U.S. related to those withdrawal symptoms is “physical dependence”.
The American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine got together and produced the following definitions in 2001:
“ADDICTION … is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
“PHYSICAL DEPENDENCE is a state of adaptation that is manifested by a drug class-specific withdrawal syndrome…”
I think maintaining that distinction can help us combat some of the stigma against opioid use. “Being addicted” triggers all the worst negative connotations in popular thinking. But putting up with physical dependence just means you're tough and willing to do what you gotta do.
:-)Rush Limbaugh aside, addiction does not usually develop in those treated with opioids for pain. AFAIK, no opioid-naive depressives treated with buprenorphine reported any addiction characteristics, even if they had withdrawal symptoms.
I don’t mean to criticize. I loved your post, your enthusiasm, your insights, and your honesty. I’m just suggesting a little clarification on an issue that might be misleading to readers.
Thanks again!
• “Definitions Related to the Use of Opioids for the Treatment of Pain” (2001) http://www.ampainsoc.org/advocacy/opioids2.htm
poster:pseudoname
thread:651514
URL: http://www.dr-bob.org/babble/20060617/msgs/657941.html