Posted by linkadge on June 17, 2006, at 23:27:13
In reply to Re: ‘dependence’ vs ‘addiction’, posted by Hermit on June 17, 2006, at 11:37:20
What we lack, is the information to suggest that opiates can be used at a "constant dose", to achieve the same level of depressive relief. Ie, can there be a fixed theraputic dose of an opioid for depression? (Jerry's case seems to support their use, but we need more cases.)
Much literature seems to suggest that the use of opiates at any dose, will lead to tolerance after a certain point. That is no good for the depressive condition, since it requires the patient to make the difficult decision to be ever increasing their dose.
That was supposedly the benifit of antidepressants, ie a person could take a fixed theraputic dose, for the duration of treatment.
There is nothing wrong with an individual using an opiate for depression, but if tollerance develops and depression returns, then the patient will have to go through the painstaking process of opiate withdrawl in the midst of a major depressive eposide. (which would not be fun)
As far as the use of stimulants plus opiates, that is certainly getting a little questionable in my opinion. We're essentially talking about speedballing. Combining opiates and stimulants creates a synergistic effect on dopamine release in the neucleus accumbens. Sure thats pleasureable, but this can lead to major crashing.
Now while I believe that it is good that people feel better, we need to keep some common sense. There certainly are some good reasons that doctors advise against some of these combinations.
Coming off an opiate is hard, coming off an opiate plus a stimulant is harder. Throw in a benzodiazapine and you add and additional factor.
The main question though is, will ever increasing doses be requred to maintain relief.
If you didn't have much longer to live, I suppose you just keep increasing indefinately, but most of us are not that close to death.
Linkadge
poster:linkadge
thread:651514
URL: http://www.dr-bob.org/babble/20060617/msgs/658196.html