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Using opiates for anxiety and depression?
So I have had pretty serious anxiety and depression issues for as long as I can remember. I am 22 years old, and I have spent everyday of those 22 years obsessing over things that are completely out of my control. I have been diagnosed/misdiagnosed as having multiple disorders; GAD, agoraphobia, borderline personality disorder, and finally as manic depressive, which I think is the most accurate.
During college, I saw multiple university mental health doctors, most of whom just offered me a bottle of xanax, clonopin, or ativan and sent me on my way. Among these meds, I have also tried: lexapro, paxil, zoloft, seroquel, lamictal, xyprexa, buspar, and welbutrin. Currently I am taking depakote er, which actually seems to be working fairly well. It makes the anxiety bareable, but doesn't do much for my depression.
However, there has always been one thing that has relieved all my symptoms; pain medications. First I would like to say something that Im sure everyone knows; these medicines are very addictive and should not be abused. Unfortunately, they are the only things that work for me. The make me completely calm and relaxed, and not wozy and out of it like benzos do. I have never tried to obtain them illegal or without reason, but have come to this conclusion on occassions when I have been given them for legitamate pain. I am curious to know if someone can offer any scientific or medical explaination as to why opiates are so effective. I am also curious whether there are any anxiety medications that incorporate opiate therapy.
During college, I saw multiple university mental health doctors, most of whom just offered me a bottle of xanax, clonopin, or ativan and sent me on my way. Among these meds, I have also tried: lexapro, paxil, zoloft, seroquel, lamictal, xyprexa, buspar, and welbutrin. Currently I am taking depakote er, which actually seems to be working fairly well. It makes the anxiety bareable, but doesn't do much for my depression.
However, there has always been one thing that has relieved all my symptoms; pain medications. First I would like to say something that Im sure everyone knows; these medicines are very addictive and should not be abused. Unfortunately, they are the only things that work for me. The make me completely calm and relaxed, and not wozy and out of it like benzos do. I have never tried to obtain them illegal or without reason, but have come to this conclusion on occassions when I have been given them for legitamate pain. I am curious to know if someone can offer any scientific or medical explaination as to why opiates are so effective. I am also curious whether there are any anxiety medications that incorporate opiate therapy.
Your post rings true.
Hardly ever with mental health is there a single answer. For most people the problem is transient and will resolve without intervention. When more serious the options are psychology, pharmacology, lifestyle - probably all three.
I've had life-long problems - mainly dysthymia, with spikes of panic, self-esteem, depression. The things that have 'cured' it have been extraordinary good times (a year off between school and Uni travelling around Asia; getting married; moving abroad; drugs), psychotherapy (after 6 months, and co-inciding with marriage and believing that I sorted my life romantically and professionally - haha!); and opiate use. Anti-depressants, running stopped me from sinking but didn't do much to help me swim. When I tried opiates in my 40's I had a distinct sense of 'wow I feel normal for the first time - is this how most people feel? I felt more able to do my job, able to be authentic with people, and soon I was replanning my life given this new sense of well-being. Then I started to doubt - friends who knew of my intake were concerned (I think by the sole fact that I was taking opiates, rather than any changes in my manner). More personal worries were a 'take it or leave it' attitude to socialising, disinterest in sex, and a general preference for dreaming over reality. Then again this was offset by being/feeling more able at work, being easier with people, a general sense of enjoying life rather than getting-by. Then I found out that when I stopped, I felt very lethargic, got stomach cramps and diarrhea, depressed - uh-oh.
I went clean for a couple of weeks - all the old issues kicked in and I got bored and partook again...ahhhhh, problems over.
It reminded me of when I trekked in North Thailand - my guide explained that when the men get old, too old for work, they take opium, feel better. This memory was not reassuring for a 40 year old.
Some background - I have a good job, have no major MH problems, and, if there is even such a thing, I do not have an addictive personality (I've tried all the sins). I had some trauma as a kid (born with a hernia, 4 ops in first 6 months, and mild sexual abuse at 7-8 years).
The distillation of my wisdom on the opiate issue is that I think a mild daily dose might well be life changing... (watch this space). Psychological therapy and lifestyle changes are also essential - and there is also the question of discipline: do I have the willpower to take a low dose in the long-term? Even if I did, is such a cure delusional, or might it really be a key in a keyhole?
Hardly ever with mental health is there a single answer. For most people the problem is transient and will resolve without intervention. When more serious the options are psychology, pharmacology, lifestyle - probably all three.
I've had life-long problems - mainly dysthymia, with spikes of panic, self-esteem, depression. The things that have 'cured' it have been extraordinary good times (a year off between school and Uni travelling around Asia; getting married; moving abroad; drugs), psychotherapy (after 6 months, and co-inciding with marriage and believing that I sorted my life romantically and professionally - haha!); and opiate use. Anti-depressants, running stopped me from sinking but didn't do much to help me swim. When I tried opiates in my 40's I had a distinct sense of 'wow I feel normal for the first time - is this how most people feel? I felt more able to do my job, able to be authentic with people, and soon I was replanning my life given this new sense of well-being. Then I started to doubt - friends who knew of my intake were concerned (I think by the sole fact that I was taking opiates, rather than any changes in my manner). More personal worries were a 'take it or leave it' attitude to socialising, disinterest in sex, and a general preference for dreaming over reality. Then again this was offset by being/feeling more able at work, being easier with people, a general sense of enjoying life rather than getting-by. Then I found out that when I stopped, I felt very lethargic, got stomach cramps and diarrhea, depressed - uh-oh.
I went clean for a couple of weeks - all the old issues kicked in and I got bored and partook again...ahhhhh, problems over.
It reminded me of when I trekked in North Thailand - my guide explained that when the men get old, too old for work, they take opium, feel better. This memory was not reassuring for a 40 year old.
Some background - I have a good job, have no major MH problems, and, if there is even such a thing, I do not have an addictive personality (I've tried all the sins). I had some trauma as a kid (born with a hernia, 4 ops in first 6 months, and mild sexual abuse at 7-8 years).
The distillation of my wisdom on the opiate issue is that I think a mild daily dose might well be life changing... (watch this space). Psychological therapy and lifestyle changes are also essential - and there is also the question of discipline: do I have the willpower to take a low dose in the long-term? Even if I did, is such a cure delusional, or might it really be a key in a keyhole?
not true. Opiate dependent for 15 years. Opiates are a great anti depressant. They are not harmful to your body other than if you take too much or ingesting the wrong way. Then the damage is caused by breathing suppression and cns depression. Reversible though as long as you seek help.
The binders/fillers may have reactions to people but usually very very minimal if non existent.
The only damage usually caused by opiate products are from the additional drugs or additives. For instance vicodin has tylenol in it. If you have a high tollerance from long term use or take too much then you can damage your liver and other organs. Heroin is bad because of the cuts and ways of ingestion causing complications. Pure opiates are actually quite safe.
On the other hand they can be very harmful to your life. If you lack the control or are looking to have a high all the time then you become dependant and your dosage will go up. This causes distress from finances, rebound pain from abuse and then tapering down, and the usual addictive self destructive nature and events that happen to any addict.(whether its opiates or sex. Everything in moderation. No gain without some pain.
I use suboxone at .25 to .5 mg per day. Only drug that helps my depression and anxiety. life saver. But it took years to find myself and to practice self control. Though I am an addict I am an educated addict. This has led to better practices for easing my pain and minimalizing my addictive nature..
Good friends and family are the only other cure for some people. Everyone needs to feel important and its a necessity( for humans to have close bonds with others to have a fulfilling life.) Thats why AA works. Having caring people who u respect and like or love makes all the difference in this harsh world. seek companionship
The binders/fillers may have reactions to people but usually very very minimal if non existent.
The only damage usually caused by opiate products are from the additional drugs or additives. For instance vicodin has tylenol in it. If you have a high tollerance from long term use or take too much then you can damage your liver and other organs. Heroin is bad because of the cuts and ways of ingestion causing complications. Pure opiates are actually quite safe.
On the other hand they can be very harmful to your life. If you lack the control or are looking to have a high all the time then you become dependant and your dosage will go up. This causes distress from finances, rebound pain from abuse and then tapering down, and the usual addictive self destructive nature and events that happen to any addict.(whether its opiates or sex. Everything in moderation. No gain without some pain.
I use suboxone at .25 to .5 mg per day. Only drug that helps my depression and anxiety. life saver. But it took years to find myself and to practice self control. Though I am an addict I am an educated addict. This has led to better practices for easing my pain and minimalizing my addictive nature..
Good friends and family are the only other cure for some people. Everyone needs to feel important and its a necessity( for humans to have close bonds with others to have a fulfilling life.) Thats why AA works. Having caring people who u respect and like or love makes all the difference in this harsh world. seek companionship
I wish I could agree with you. Actually I don't. Because if I did agree with you I would be curled in a ball depressed in the dark corner of my van down by the river.
I have had severe social phobia and major depressive disorder for more than 12 years. They have put every poison test medication in me that they legally could and it still feels like a 300 pound man is laying on my back. Try getting up in the morning with a hippo on your hip. IMPOSSIBLE!!!
I am a nurse and was prescribed a simple 20 mg oxycontin pill for a spine injury and immediately noticed after my first dose that it worked better fthan any pill I had taken in the last 12 years. It worked for everything! The pain was almost gone but the depression and anxiety were completely non existent.
I realized that half of my dose which is 10mg works wonders for the depression and the anxiety, I did not even have to take my wholw dose because at higher doses it seems to cooperate with the anxiety rather than eliminate it.
I have had severe social phobia and major depressive disorder for more than 12 years. They have put every poison test medication in me that they legally could and it still feels like a 300 pound man is laying on my back. Try getting up in the morning with a hippo on your hip. IMPOSSIBLE!!!
I am a nurse and was prescribed a simple 20 mg oxycontin pill for a spine injury and immediately noticed after my first dose that it worked better fthan any pill I had taken in the last 12 years. It worked for everything! The pain was almost gone but the depression and anxiety were completely non existent.
I realized that half of my dose which is 10mg works wonders for the depression and the anxiety, I did not even have to take my wholw dose because at higher doses it seems to cooperate with the anxiety rather than eliminate it.
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I have found the exact same thing. I am depressed every day and am on antidepressants and mood stabilizers. But there are worse days where I actually consider it. I do not want to die I just want the feeling to go away. On those days I take 1/2 oxi left over from a couple of surgeries. This is rare. Like 2 time a month tops. But it takes care of depression suicidal thoughts anxiety lack of motivation self hatred. I understood that it is addictive by so is Xanax. So are all benzos. You even have to wean off of most anti depressants. I would rather die than live every day wanting to die. So if this works why are we not using it. I use Xanax as needed. I would love to use oxi as needed on the really bad days.
I generally agree in that I'm not inclined to recommend kratom because of it's incomplete chemical characterization- i.e we don't know all the different receptors to which it binds, and therefore what drugs it might interact with and any possible toxicity etc. I just put the information out there so people are aware of all possibilities.
I would like to make a comment/observation combined with a question: Do you work in addiction treatment, or research or counselling? I ask because I've noticed your primary concern regarding any mentioned substance is it's abuse potential/liability etc. I have found in the past when discussing this topic (or similar ones) that people who specialize in addiction in any regards or who have dealt with it themselves or with someone close to them, tend to place the emphasis on addiction.
Well as the old saying goes, if the only tool you have is a hammer, everything looks like a nail. I am probably just rehashing previous comments I've made on this thread but a few of the points I made I don't think you addressed and I'd be curious to hear your reply to them.
1.) Addiction/dependence: You have stated people should avoid opiates on this thread because of the risk of dependence. While I agree that drug dependence can be a tough ordeal that does occur, the reality is that the actual percentage of people who use prescription opioids who then become dependent is actually very low. Exact figures would be hard to quote, but I'd say between 10-35% would be a rough guess. Would you be inclined to agree with me thus far?
-Tolerance: You have also suggested that people taking opiates will inevitably have to escalate their dose, requiring higher and higher amounts. This is another misconception in some regards. Yes the above scenario does happen, but usually it is in two different situations. One is a person with chronic pain who needs increasing doses for adequate analgesia. In this instance the actual mechanisms leading to need for a higher dose is actually the progression of pain, or perhaps so called opiate-induced hyperalgesia. The second would be a recreational user trying to get high and constantly upping the dose, a scenario everyone is likely familiar with. However if someone is consistently taking the same optimal dose of an opiate and adheres to this regularly they will not need to increase the amount (unless still in the stage of titrating to the proper dose).
2.)The reason why many seek opiates (or other alternatives)- current response and remission rates for mood disorders are low. Even in the most optimal situations, in clinical trials with experts, excellent patient compliance, and combination of multiple approved treatments (see for example the STAR*D trials) the response and remission rates are not much above 50-65%. So many people are left with few other choices other than the 'experimental'.
3.)I mentioned the off-label prescribing of stimulants, what is your feelings on that subject?
4.)Aside from addiction, your main objections seemed concerned not with efficacy, but with the problematic nature of obtaining a prescription in the current legal and cultural milieu.
~Hopefully my tone is perceived as respectful ;) I mean no ill will and I enjoy having civil but enlightened discussions on contentious topics.
I would like to make a comment/observation combined with a question: Do you work in addiction treatment, or research or counselling? I ask because I've noticed your primary concern regarding any mentioned substance is it's abuse potential/liability etc. I have found in the past when discussing this topic (or similar ones) that people who specialize in addiction in any regards or who have dealt with it themselves or with someone close to them, tend to place the emphasis on addiction.
Well as the old saying goes, if the only tool you have is a hammer, everything looks like a nail. I am probably just rehashing previous comments I've made on this thread but a few of the points I made I don't think you addressed and I'd be curious to hear your reply to them.
1.) Addiction/dependence: You have stated people should avoid opiates on this thread because of the risk of dependence. While I agree that drug dependence can be a tough ordeal that does occur, the reality is that the actual percentage of people who use prescription opioids who then become dependent is actually very low. Exact figures would be hard to quote, but I'd say between 10-35% would be a rough guess. Would you be inclined to agree with me thus far?
-Tolerance: You have also suggested that people taking opiates will inevitably have to escalate their dose, requiring higher and higher amounts. This is another misconception in some regards. Yes the above scenario does happen, but usually it is in two different situations. One is a person with chronic pain who needs increasing doses for adequate analgesia. In this instance the actual mechanisms leading to need for a higher dose is actually the progression of pain, or perhaps so called opiate-induced hyperalgesia. The second would be a recreational user trying to get high and constantly upping the dose, a scenario everyone is likely familiar with. However if someone is consistently taking the same optimal dose of an opiate and adheres to this regularly they will not need to increase the amount (unless still in the stage of titrating to the proper dose).
2.)The reason why many seek opiates (or other alternatives)- current response and remission rates for mood disorders are low. Even in the most optimal situations, in clinical trials with experts, excellent patient compliance, and combination of multiple approved treatments (see for example the STAR*D trials) the response and remission rates are not much above 50-65%. So many people are left with few other choices other than the 'experimental'.
3.)I mentioned the off-label prescribing of stimulants, what is your feelings on that subject?
4.)Aside from addiction, your main objections seemed concerned not with efficacy, but with the problematic nature of obtaining a prescription in the current legal and cultural milieu.
~Hopefully my tone is perceived as respectful ;) I mean no ill will and I enjoy having civil but enlightened discussions on contentious topics.
Yeah, I wouldn't recommend Kratom, as it's addictive. I post on our addiction community, and Kratom comes up a lot.
http://drug.addictionblog.org/kratom-addiction-signs-and-symptoms-of-kratom-abuse/
http://drug.addictionblog.org/kratom-addiction-signs-and-symptoms-of-kratom-abuse/
I hope I wasn't implying that the methods listed would be sufficient for helping people's problems. I could list tons of other complimentary or cutting edge things to further augment mood/anxiety disorder treatment, but was just listing a few things which can help boost the opiate system.
Speaking of which, more tidbits I left out from the list I mentioned in the previous post...
4.) D-Phenylalanine: not L-phenylalanine or D/L-Phenylalanine. The D-isomer is thought to be an inhibitor of the enzyme enkephalinase, which is responsible for breaking down the brains natural opiates , i.e "endorphins" and enkephalin. I believe dose range 500-1000mg 1-3x/day.
5.)Mitragyna speciosa- aka Kratom. Perhaps Nursegirl and others may object to listing this. However in most places in the US, it is legal to purchase etc. The alkaloids (of which there are many) have differing effects, with some acting on opiate receptors, and possibly others involved in the serotonin, NMDA and nor-epinephrine systems. Do plenty of research on your own to determine if this may be an option for you. Also check to ensure that it will not interact with any medications or supplements that you are taking etc.
Speaking of which, more tidbits I left out from the list I mentioned in the previous post...
4.) D-Phenylalanine: not L-phenylalanine or D/L-Phenylalanine. The D-isomer is thought to be an inhibitor of the enzyme enkephalinase, which is responsible for breaking down the brains natural opiates , i.e "endorphins" and enkephalin. I believe dose range 500-1000mg 1-3x/day.
5.)Mitragyna speciosa- aka Kratom. Perhaps Nursegirl and others may object to listing this. However in most places in the US, it is legal to purchase etc. The alkaloids (of which there are many) have differing effects, with some acting on opiate receptors, and possibly others involved in the serotonin, NMDA and nor-epinephrine systems. Do plenty of research on your own to determine if this may be an option for you. Also check to ensure that it will not interact with any medications or supplements that you are taking etc.
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