Posted by Lou Pilder on February 25, 2014, at 20:47:08
In reply to Re: Lou's response-blwnihndhawyn » Lou Pilder, posted by LostBoyinNC45 on February 25, 2014, at 12:16:19
> Lou,
>
> I have always been perplexed at how discussion of prescription opiate narcotics, prescribed "off label" for depression and anxiety...is tolerated at this forum. An example is the FDA approved drug called "bupe" for heroin addicts. While there is anecdotal evidence "bupe" has anti-depressant effects and might be useful in some TRD cases, I have for years been mildly concerned about how opiates are allowed to be discussed here.
>
> If this forum was a forum devoted to say, patients who use pain clinics or a forum devoted to substance abuse recovery, I would not have that attitude and concern. But this forum, by its very name of "psychobabble," is focused on mental illness.
>
> No opiate drug of any type is FDA approved for any mental illness and personally, I want it to stay that way.
>
> Bupe is just one example of an opiate drug that is not FDA approved for mental illness is discussed here openly. I have seen other "off label" discussions of harder narcotics discussed on this forum at times past.
>
> I can also foresee a scenario where a severely ill outpatient reads posts here from "internet psychopharmacology experts" and then going to their own psychiatrists to ask about such "off label" treatments. And the psychiatrist, knowing nothing much about psychobabble, then labels the patient as a "drug seeker" of non FDA approved drugs that are controlled substances...something that looks extra really bad on a mental patient's record.
>
> I also find it interesting that when treatment of sleep apnea as an adjunctive medical treatment is posted here for discussion, it gets moved to the "alternative" section of the forum. (CPAP therapy is a non controlled, non addictive, very safe and many clinical trials suggesting strongly CPAP is effective for depression when sleep apnea is present). Yet open and unlimited discussion of prescription narcotic painkillers is unconditionally tolerated here.
>
> I find that VERY interesting. And find it disturbing.
>
> Anyway, I wonder if the DEA has ever taken a look at this forum?
>
> Eric, AKA "LostBoyinNC"Eric,
I do agree with you in that discussion on this forum is directed for support and education and that discussion of bupe for depression could be in many jurisdictions to be illegal for bupe to be prescribed for depression. There are jurisdictions that allow prescribers to use any approved drug for anything that they want to prescribe it for. So in those jurisdictions a prescriber could prescribe bupe for anxiety/depression. I understand that the U.S. is one of those jurisdictions. But I have not read of that a psychiatrist/doctor in the U.S. does prescribe bupe for depression. But I agree with you that a discussion here about taking bupe for depression could cause one to ask their prescriber for the drug, thinking that the discussion is supportive, which could lead a subset of people to think that it is a right drug to take. The issue here is about that there is an advocacy by posters to take the drug for depression that is considered by the administration to be supportive by the nature that those type of posts remain unsanctioned so that readers could think that the advocacy to take the drug for depression is supportive here.
I guess that posters could advocate anything here as long as it is not illegal in regards to what they are advocating. But your point is that this is a mental-health forum which could limit the advocating of anything that could be harmful to one here, and I agree with you. The question is then if it could be harmful for one to take bupe for depression. Well, bupe is not approved for depression, but for pain management and in the use of substituting an addictive drug for another addictive drug.
So hypothetically, if I was the manager of this forum, I would intercede in discussions concerning the advocating of taking bupe for depression with something like:
[...please do not advocate the taking of a narcotic/addictive drug for depression, for that drug is not approved for depression even though in some jurisdictions a prescriber can prescribe any approved drug {off-label} for anything that they think is appropriate...].
Lou
poster:Lou Pilder
thread:1061277
URL: http://www.dr-bob.org/babble/admin/20131217/msgs/1061331.html