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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Festus on April 12, 2003, at 0:15:42
.....Facts are that ,well,suppose we seperate the good/bad and see.First,the good:
1.May alleviate,dull,or smother the undesirable symptoms that occur due to BP/Depression,enhance the sense of "well-being".Now,the bad:
1.In some people,Depression is a side-effect of Opiates.Could"double"symptoms.
2.These "feelings of well-being"start to diminish after a few hrs.then generally produce a ragged,tired,shaky,or crabby feeling in some.
3.They constipate almost everyone that takes them.That,s almost a "gimme"with Opiates.
4.Most certainly would be the difficulty in getting them,the reluctance of Dr.,s to Rx them even for Pain is un-real!The DEA hangs on these Dr.,s necks waiting to nab one for "suspicion of over-prescribing"Class 2 and 3 drugs.They love to prey on Dr.,s cause they are too afraid to go after the Dealers on the street.
5.Tolerance to Opiates is very likely to occur.Usually,in rare times it does not,is when a chronic pain patient is on a proper dosing schedule and his pain receptors are in-sync with the opiate intake and the drug is working as it is suppose to .In these cases"euphoria"or the sense of well being does not take place,only the dulling of the pain occurs.The drug of choice would have to be increased every so-often to be able to achieve the sense of well-being as this is considered a "side-effect" of the drug and normally,as with most drugs,will subside in time.This fact alone scares the Dr. that rx,s the meds.I ain,t against ANYONE trying to feel better from any ailments.I,m just statin the facts.Festus
Posted by Caleb462 on April 12, 2003, at 1:37:29
In reply to Rxing Opiates for BP,Depression:the facts are..., posted by Festus on April 12, 2003, at 0:15:42
> 1.In some people,Depression is a side-effect of Opiates.Could"double"symptoms.This has never been my experience, perhaps it does occur for some folks, but it is probably quite rare.
> 2.These "feelings of well-being"start to diminish after a few hrs.then generally produce a ragged,tired,shaky,or crabby feeling in some.
Again, this doesn't happen to me. I do feel tired after opiate/opiod experiences... but it is a relaxed, feel-good tired. I will say, however, that opiates/opiods can cause irritability, particularly in social situations.
Anyway... I've been self-medicating myself with hydrocodone the last few days... man I sure do love the stuff... if I wasn't gonna run out soon, I'd be headed for addiction.
Posted by FredPotter on April 12, 2003, at 4:22:40
In reply to Re: Rxing Opiates for BP,Depression:the facts are..., posted by Caleb462 on April 12, 2003, at 1:37:29
What opiates are we talking about here? A friend gave me a few methadone pills and I think my evening anxiety and depression is somewhat alleviated by it. I don't know the strength. Does this make sense? I don't feel dulled by it, rather the opposite. Perhaps I'm imagining it
Posted by judy1 on April 12, 2003, at 11:54:00
In reply to Rxing Opiates for BP,Depression:the facts are..., posted by Festus on April 12, 2003, at 0:15:42
Hi,
I've been taking narcotics for several years- both as a pain reliever and an AD. I have never had a problem with worsening depression- although i concede just about any drug can cause different effects in different people. also, no problem with increasing doses- I've been on the same dose for 2 years. at times during a manic episode, i feel no pain and often stop or slow down on narcotics w/o realizing it. I'm not chasing a high here, just sometimes alleviating pain symptoms and as a benefit helping depression- to the point where I'll take them strictly as an AD. take care, judy
Posted by Caleb462 on April 13, 2003, at 23:39:13
In reply to Methadone, posted by FredPotter on April 12, 2003, at 4:22:40
> What opiates are we talking about here? A friend gave me a few methadone pills and I think my evening anxiety and depression is somewhat alleviated by it. I don't know the strength. Does this make sense? I don't feel dulled by it, rather the opposite. Perhaps I'm imagining it
Makes total sense. When we refer to opiates and opiods, we are reffering to any drug that is a mu-opiod receptor agonist. These include morphine, hydrocodone, oxycodone, methadone, propoxyphene, fentanyl, etc.As for not being dulled... yes, that makes lots of sense too. For me, opiods provide a mix of sedation and stimulation. High doses tend to be the most sedating, lower doses the most stimulating.
Posted by BrittPark on April 16, 2003, at 13:37:40
In reply to Rxing Opiates for BP,Depression:the facts are..., posted by Festus on April 12, 2003, at 0:15:42
> 5.Tolerance to Opiates is very likely to occur.Usually,in rare times it does not,is when a chronic pain patient is on a proper dosing schedule and his pain receptors are in-sync with the opiate intake and the drug is working as it is suppose to .In these cases"euphoria"or the sense of well being does not take place,only the dulling of the pain occurs.The drug of choice would have to be increased every so-often to be able to achieve the sense of well-being as this is considered a "side-effect" of the drug and normally,as with most drugs,will subside in time.This fact alone scares the Dr. that rx,s the meds.I ain,t against ANYONE trying to feel better from any ailments.I,m just statin the facts.Festus
Festus, do you have any references for what percentage of people develop tolerance to opioids, and more importantly what percentage of people become so tolerant of opioids that they are no longer effective at treating pain?
I know one person who took a fairly heavy dose of codeine throughout most of his teen years for chronic pain. His dosage remained effective and constant over several years. I'd like to know if his experience was exceptional or common.
Britt
Posted by maryhelen on April 17, 2003, at 17:47:23
In reply to Re: Methadone, posted by Caleb462 on April 13, 2003, at 23:39:13
I can only speak from my own personal experience. I can't figure out the difference between opiates, amphetamines, narcotics, etc. but I certainly got addicted to pain medication. I first took them (firional) for migraines and over the years slowly began to realize that they helped with the depression. I am treatment resistant and have been on a multitude of meds over many years without relief. The only relief I ever got were from the pills - fiorinal, percocetts, dilaudid, even Tylenol 3's. As time went on I needed more and more for the same effect. When I didn't have them, the depression was exacerbated, sometimes suicidally, especially withrawing from dilaudid.
I eventually ended up going to 3 substance abuse programs, besides my 5 pyschiatric hospitalizations and 2 rounds of ECT treatments. Yet, I sit here today, depressed, off work for 2 years, clean of pain meds. I hate to admit it though but I would put my hand out in a minute if someone offered me pills because I know that, even briefly, I would feel great, not stoned, but certainly not depressed.
I do not believe that everyone has a problem with opiates. I definitely have an addictive predisposition. I do not think I will ever be able to control taking these drugs. I wonder a lot about what would happen when I really need to have pain pills for an illness. In fact, right now I am suffering quite a bit with degenerative disc disease in my back. The only thing I can take is Extra Strength Tylenol and it really doesn't help.
Just be careful what you ask for you may get it.
Maryhelen
Posted by Festus on April 20, 2003, at 21:29:11
In reply to Opiates and depression, posted by maryhelen on April 17, 2003, at 17:47:23
Hi Brit,
In response to your question,I have no stats on how many do or do not develop tolerance to Opiates.I can only convey a bit of info I,ve learned over the years of being a Chronic Pain patient and being in Forums that other CP folks participate in.I do know that CP folks are MUCH less likely to get a tolerance than,say,recreational users,because people that take these meds for pain don,t get the "Highs" that others get.Your friend probably took the codiene for pain,as prescribed.These folks can and do often stay on a steady dose for long periods of time,yet others in pain still develop tolerance to the same drug because of genetic tendencies or physical make-up.Then there are some Opiates that are easier to develop tolerance to.If you,ve ever heard of Oxycontin,this is one of those drugs.I know of folks that went from 10-20mg a day to over 400-500mg a day within a year!That,s why the Dr.,s are so scared to Rx them a lot of times.Hope this helps a bit.Festus
Posted by ayuda on April 20, 2003, at 21:46:42
In reply to Opiates and depression, posted by maryhelen on April 17, 2003, at 17:47:23
maryhelen, your story is kind of interesting, because I am going through the opposite problem right now. I've been on ADs for a few years now, currently on Lexapro and my depression is fine. But my pain doctor put me on oxycodone for some massive pain I'm in (hydrocodone was not strong enough), and it is making me weepy and depressed. I feel like the narcotic is depressing me, and I can't wait to go off it! It's so odd how people react differently to meds.
Posted by maryhelen on April 20, 2003, at 23:47:46
In reply to Re: Opiates and depression » maryhelen, posted by ayuda on April 20, 2003, at 21:46:42
Hi Ayuda:
I am sorry you are feeling so horrbile while having to take the oxycodone. Hopefully, you won't have to take the pills for long.
It is very interesting the way we all seem to react differently to medications. I know that if I was taking oxycodone I would feel great. My problem would be when I had to stop my depression would become exsacerbated.(sp)
I have mixed feelings about opiates being prescribed for depression. For the very reason that we are all so different in our reactions. However, for those who could control it and would get relief from their depression and it is a choice they want to make, I wish there could be some consensus among the doctors. Except for the odd doctor who will take that risk, I don't think we will see it. Doctors are so wary of prescribing these drugs, especially long term, because of the strict regulations.
I hope you are feeling better soon. Maybe your doctor could try yet another pain medication for you.
Posted by ayuda on April 22, 2003, at 12:04:42
In reply to Re: Opiates and depression, Ayuda, posted by maryhelen on April 20, 2003, at 23:47:46
> I am sorry you are feeling so horrbile while having to take the oxycodone. Hopefully, you won't have to take the pills for long.
>Thanks -- I am waiting on getting clearance from my insurance company for a custom-made brace for my foot, and until then my gait is so off, and my tendons so out of whack on the right side, that I am in pain all over just from getting up and around, so it's going to be a while until all this gets resolved. Sigh.....
>
> I hope you are feeling better soon. Maybe your doctor could try yet another pain medication for you.Believe it or not, they already tried everything else that is not as strong or narcotic as oxycodone, and nothing helps. So, I am grinning and bearing it! But thank you for the well-wishes, and I hope that you get to feeling better soon, too!
This is the end of the thread.
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