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Opioids Heroin/opioids as antidepressants - why not?

H

Hotncold

Greenlighter
Joined
Mar 30, 2022
Messages
13
why don’t they use opioids for extreme cases of depression that can’t be treated by other methods?

Give an extremely depressed person some high quality heroin and I am sure they will start feeling better. I honestly don’t see what the problem would be if it was done under a docs supervision and was pharma grade opioids. I don’t see what would be wrong with this if you explained the risks to the person doing it and made sure they understood that they would become dependent on it. I think it would greatly increase a lot of peoples quality of life.
 
I don't have any sort of moral/ethical problem with this at all, I think all drugs should be legal and regulated. So with that out of the way, I can see two problems right off the bat:

1) the beneficial psychological aspects of any drug wear off significantly if you use it on a regular daily basis and tolerance increases, which I'm assuming would take place if you were to take opioids as part of an antidepressant regiment, and 2) (this one is more specific to the legal status of opioids presently) a dependency upon opioids, which would certainly occur eventually after regular, daily usage, necessitates regular availability and access to the drug in question, which isn't the case as the law currently stands
 
because addiction… perfect example: opioid crisis. opioids arent even first line analgetics for that reason (esp in europe where pharma lobby isnt as crazy as in the us)
 
Yeah, the problem with opioids is that while acutely they exhibit solid antidepressant effects so do they induce depression when used chronically. At least they (morphine, methadone, probably even buprenorphine, and the latter is sometimes prescribed against depression alone or together with the mu antagonist samidorphan) did it for me and I've read numerous similar experiences. I don't have any problem seeing opioids prescribed for long times and off-label diagnoses, why should I? If it works for you, fine, go with it but usually the honeymoon period ends with a harsh landing and then, when one realizes that the opioids cause worsening in the long run, then addiction has you already in its claws.

Imo are dissociatives (ketamine et.al.) the best bet for resistant depression at the moment. They have their downsides too but inducing depression isn't among them. By coincidence they also do help with opioid addiction and withdrawal.
 
I guess people take that decision into their own hands lol….a Speedball seems the ultimate mood-boosting temporary fix

Oral Oxycodone had the most uplifting mood-boosting antidepressant properties ….over those sleepy morphine derivatives

Oxycodone plus Ritalin 20mg tablets for me
 
What people who are relatively new to using drugs don't understand, and I fell victim to this too, is that the effects of drugs aren't static. (Also apologies if you aren't new to drug use) Tolerance doesn't just dull the effects of a drug, it changes the nature of it's effects. While the first 1-3 years of using a drug might yield only euphoria, at the 5 year point of regular use it's going to feel very different.

So essentially it's a gamble on whether or not it will harm someone in the long term. I chose to take up this mentality of "opiates will fix my depression" and maybe if I had an unlimited supply of my choice opioid I'd be happier. But the reality of the situation is that you will never have a steady supply of what ever opioid "helps you" the most, and will inevitably end up addicted to whatever is cheapest and/or most available.
 
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The basic problem with opiates is tolerance. Tolerance, tolerance, tolerance.

Daily use never fucking goes well.

But yeah if they could just use it maybe 1x2 times a week with some occasional breaks it would definitely be helpful.

But again to do it at that rate they better off doing 1 trip of DMT a month. It's going to be more effective and less controlling-your-habit consuming.
 
I've seen a million posts about how depression is a lead trigger for opiate use--but its so overlooked that loneliness is also a huge reason for opiate abuse disorder. It makes you feel surrounded by love and feel like you are as well--its different than being surrounded by love and not feeling it. In time it turns you into a hermit and as it happened to myself--opiates stopped working as an antidepressant in time anyway.

Your depression will in time be worse than when you were ever sober. Something occurs within the body when testosterone is obliterated from long-term use. If anyone thinks depression stays gone from opiate use, just wait until the 20 mins of euphoria from IV'd high quality dope never goes on longer than 20 mins until you repeatedly redose. The loneliness of that situation will kill someone before they actually die.
 
ItsclearlyFake said:
The basic problem with opiates is tolerance. Tolerance, tolerance, tolerance.
Daily use never fucking goes well.

But yeah if they could just use it maybe 1x2 times a week with some occasional breaks it would definitely be helpful.
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It's not just tolerance but specially tolerance to the beneficial effects. While I've seen heavy tolerance with others (a girl maintaining a habit of mind boggling 2.4g morphine every second day for example) and myself (was up to 600mg but with serious side effects, yet not much different from 60mg before tolerance) so tend these opioids to retain some activity as sedatives and depressants (in the literal sense). They sedate one and begin to induce depression, possibly by suppressing testosterone production, a side effect which is quite strong and lasts long over withdrawal when it once began. I'm more than a year off any opiates and my sex drives still on an all time low.

Wonder if anybody managed to use opiates sparingly enough to not get caught in tolerance and withdrawal, and if dissociatives might aid with that. Like 1-2 days per week on opioids and the following 1-2 days on a lower dose of a dissociative to mitigate tolerance development.

But as has been said, it'll be incredibly difficult to maintain sparing use of opioids, this might go well as long as one isn't in (mental) pain but once the right/wrong opportunity comes, a down, and use will increase. Just one more day. Just one. And one. And another one.

Even with dissociatives I couldn't let my hands off opioids, I'd always take them until I was out.
 
Tincture of opium, and later morphine, were at one time quite commonly (and successfully) given to treat depressive and panic states in patients; however with certain caveats.

Here's a couple extracts from historical literature :

"Several hundred patients suffering from the depressed stage of manic depressive insanity were given large doses of opium orally in many instances for periods of from six months to one year. Not one of these patients ever knew what drug he was taking or ever showed any untoward results when it was withdrawn, or in any other way gave evidence of a desire to continue its use."
- Journal of the American Medical Association, 1920

"Opium is indispensable in dealing with the fear states of the melancholic individual. But here we make the surprising discovery that the continued administration of opium, in the form of opium tincture, during the melancholic mental disturbances, even when continued over a long period of time does not produce drug addiction. That is, it does not, provided that the dosage is adapted to the diseased mental state of the patient and provided that the doctor is careful to withdraw the drug at the correct time. " - Dr. Paul Wolff, Weekly Journal of German Medicine, 1931

" Opium is indispensable in many cases of endogenous depressions. The prescription of opiates for states of depression is unobjectionable also because we know from experience that the depressed persons feel no need for narcotics when the depression has passed away, and practically never become addicts. " - Dr. Karl Bonhoeffer, Weekly Journal of German Medicine, 1931

... in response to this particular discussion (published under the line 'When is the prescription of opiates medically justified?'), another physician, director of the Berlin Sanitarium where morphine was used for some psychiatric patients, pointed out :

"... but also ONLY in endogenous, that is in periodic melancholy arising from a constitutional basis. Warning must be issued against the administration of opiate preparations in cases of reactive depression - that is, depression in reaction to the vicissitudes of life. In these cases, it leads with especial ease to the development of addiction. "

... Makes perfect sense to me.
 
TheUltimateFixx said:
. .. Makes perfect sense to me.
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Remarkable that opium didn't cause dependency in these cases of depression treatment. Do you think this is true? That it depends on your state of mind whether you become (quickly) addicted to opioids or not? Or did they possibly just give the opium for a few weeks until remission or switch to mania in manic-depressive cases etc?
 
plumbus-nine said:
Remarkable that opium didn't cause dependency in these cases of depression treatment. Do you think this is true? That it depends on your state of mind whether you become (quickly) addicted to opioids or not? Or did they possibly just give the opium for a few weeks until remission or switch to mania in manic-depressive cases etc?
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I don't believe it , if for instance you look at the initial reports on heroin it was flaunted as a magic non-addictive cure for morphinism which was probably the cure for opium addiction
 
plumbus-nine said:
this might go well as long as one isn't in (mental) pain but once the right/wrong opportunity comes, a down, and use will increase. Just one more day. Just one. And one. And another one.
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I think it's also because of lack of drug education. (although sometimes that education means having to experience physical dependence and realizing how dumb that is).

In my opinion, its because the rest of your life its so fucking painful and unbearable that you still choose to at least get a 10 minute high (which in the first days were 5-6 hours), than sober life, no withdrawals, but feeling really miserable and depressed. For lots of people, even a 10 minute break from the hell of the mind its worth it. But they shouldn't call it addiction. Its a choice.

Once you see that a drug loses like 80% of its beneficial effects once you have get a daily habit for some time, then what is the point in keep doing it? I loved kratom and even I do it from time to time (not too much because it doesn't let me enjoy the other opiates since cross tolerance) but I dont get the craving of using daily ever again because I know the drug just stops working like I wanted to to work.

You get withdrawal and dependent but the good effects just do down and down. I prefer to do it from time to time so the time I do it really works like it should. And the rest of the time I work on sober methods to create this joyfulness and peacefulness on my own without external chemicals.

Of course the ideal shit would be to not do it ever. But currently I literally cannot do what I want in life without opiates or some similar drug. So I can either stay at home and try to get enlightened by meditating for 2 years without going out ever, or pop an oxy each Friday and actually be able to socialize and get laid LoL. Life is short so there has to be a balance I think...
 
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I've been on methadone maintenance twice (one of them reaching 13 take homes) for my lifelong depression. Oh. Also 8 years of Suboxone. For depression. Now I take a few grams of poppy powder, 6 grams of kratom, and about 500 micrograms of isotonitazene every day. The wonderful thing about isotonitazene is it's literally too cheap to meter and there's no external monitoring with daily attendance and counseling to get a daily methadone dose.

Just forget about getting high! It's chasing a high in my opinion that creates tolerance. Take only what you need to feel good and you'll be fine and not need dose escalation.
 
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For extreme cases of depression there are better treatments that goes beyond the pharmacological ones. Like ECT, brain implants etc... All with extremely good success rate.
 
I would rather try opiods before getting a brain 🧠 implant or electroconvulsive 'therapy'. Better yet ketamine therapy, it's proven to work and non-addictive if done right. Also lacks the side effects of other pharmaceutical options because it's only done once or twice a week. But that's just me. And prolonged use of opiates indeed caused depression in me.

I do think that ECT is a leftover of a dark era of psychiatry. I know some swear on it, patient as well as docs, for to control otherwise resistant stuff but so does ketamine and I wonder whether in some case it might be the general anesthesia which helps instead of the electric shocks. I know of people who lost a good deal of their memory after getting ECT, permanently. Think of forgetting your marriage or similar stuff. Can be devastating. And with brain implants I imagine it will be sheer luck which protects you from the surgery damaging important brain structures.
 
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plumbus-nine said:
I would rather try opiods before getting a brain 🧠 implant or electroconvulsive 'therapy'. Better yet ketamine therapy, it's proven to work and non-addictive if done right. Also lacks the side effects of other pharmaceutical options because it's only done once or twice a week. But that's just me. And prolonged use of opiates indeed caused depression in me.
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Extreme cases of depression=stupor, inability to talk, staying all day in a room watching a wall, psychosis(in some cases!). So who cares about memory lost in those cases.
 
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