Posted by JahL on July 10, 2005, at 18:32:20
In reply to Re: Opioids. Thanks Ed... » JahL, posted by ed_uk on June 1, 2005, at 17:28:16
Hi Ed.
Hope this finds you well.
Thanks for your post. It's hard to know quite how to respond; it's all so very frustrating.
I have been banging on about opioids ever since I started Methadone - which heralded for me the potential of full opioid agonists - and became friends with a couple of (now ex-) posters here, who used low dose Vicodin to good effect. That was about 4 or 5 years ago. However, no pdoc, and I've seen a few, has been prepared to indulge me.
My pdoc is adamant not that he won't prescribe it, but that he can't. He tells me that the hospital pharmacy would immediately flag it up and that he would have some serious explaining to do. Aside from anything else, my history of substance *use* (not Heroin, which I always knew I would enjoy too much, just everything else) does me no favours.
I am inclined to believe him because: He is the centre director of the unit and knows the hospital and its policies inside out: He has prescribed me some 30 or so different meds over the years, many of which were of course off-label: He supports my endeavours to procure opioids in so much as he has written to two renowned American pdocs on my behalf (unfortunately both were prejudiced xenophobes): He is a man of real integrity - something almost unheard of amongst psychiatrists IMO.
On the other hand, I agree that somewhere along the line, it is ultimately a question of *will*. The problem is discovering just who has the authority to help me. I have frequently made the point you kinda do; that there is really no good reason not to prescribe, *given my situation*.
In all seriousness, if you (or anyone else for that matter) know of an enlightened pdoc that would be prepared to consider such a treatment for someone who is incredibly treatment resistant, I would give my right arm to obtain an intro. Whatever it takes. £10K contribution to the charity of your choice? Whatever...
I've just got off the phone to The Old Boy, trying to explain that I probably won't be around for much longer. However, I was able to promise that I wouldn't catch the bus until I had tried Mifepristone (very exciting; I asked my pdoc to contact the guys studying this up at Newcastle University. Apparently the results were very promising, prompting further trials) and a full opioid agonist, both of which unfortunately are seemingly impossible to source (so what's a man to do?).
It's a sad indictment of society that I can't procure a handful (that's all I need to test for efficacy. Then, if my hunch is proved to be correct, it goes to a health tribunal) of Oxycodone pills, which might transform me into a happy, productive citizen (as opposed to a wretched ball of anger and hate), but could, if I wanted to (I don't), quite easily score a kilo of Smack with a couple of phone calls.
Anyway, sorry this is so morose and meandering; I don't do Happy and Concise anymore. In fact I have no recollection of what Happy feels like.
It's the deal with me these days; nothing for a few weeks and then along comes a big'un (Scott knows all about that!). I refuse to see a therapist, partly on principle, and so always have a lot to get off my chest. Thanks for listening.
Jamie.
> >As for the pdoc appt, we established that Oxycodone is *only* available for post-operative cancer!
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> That is not correct! OxyContin is licensed in the UK for post-op pain, cancer pain and chronic *non*-malignant pain. The British National Formulary (the BNF, the UK drug bible- which your doctor probably checked) has not yet been updated, despite the fact that OxyContin was licensed for non-malignant pain in 2004 and the BNF comes out every 6 months! > Anyway, it doesn't really matter what type of pain OxyContin is licensed for, it's not licensed for depression!> Your doctor has the right to prescribe it for whatever he wants to prescribe it for. The only issue is whether he is *willing* to prescribe it!
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> Ed.
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poster:JahL
thread:500631
URL: http://www.dr-bob.org/babble/wdrawl/20050611/msgs/525891.html