Harm Reduction Suboxone for Depression/Anxiety ?

[MedicinalUser247]

Okay, So about 15 years ago my Psychiatrist wanted to prescribe me Suboxone off label for my Depression and Anxiety. I didn't want other Doctors checking out that drug on my medication list. So, I said no to my Doctor. It makes me wonder did I do the wrong thing by saying no ? I was surprised she even considered it and brought it up. What do you think about it ? And what would other Doctors think if they saw that on my med list ?

 

[RUC4]

Okay, So about 15 years ago my Psychiatrist wanted to prescribe me Suboxone off label for my Depression and Anxiety. I didn't want other Doctors checking out that drug on my medication list. So, I said no to my Doctor. It makes me wonder did I do the wrong thing by saying no ? I was surprised she even considered it and brought it up. What do you think about it ? And what would other Doctors think if they saw that on my med list ?

that's an interesting use for it. i've heard it has a few uses off label. could be helpful.

 

[DeathIndustrial88]

Do other opioids help your depression?

If so, then buprenorphine has the ability to be effective, somewhat.
I have borderline personality disorder, which means I feel my emotions incredibly robustly & things that might bother a normal person for a little bit, can bother me for much longer. I've found that buprenorphine really dampens my emotional output. Although I can still get pretty angry on it.

I'd say buprenorphine has the potential to make you more depressed after being on it long enough too. It helped my depression similar to other opioids in the beginning, but after 10 years of using it daily, it doesn't do jack shit for me as far as pain or depression goes. Still keeps my mood some what balanced though.

It's not common, but not completely unheard of for doctors to use opioids for depression. There is a theory that some treatment resistant major depression is caused by a dysfunction in the endorphin system, which opioids fix.

Depression can actually affect the part of the brain that processes physical pain. So yes, opioids can help depression.
Before SSRIs were invented, they used morphine & opium for depression. And it worked!

As far as other doctors go, some may look at it & treat you like crap for being on subs, or assume you're a drug addict.
But I had my wisdom teeth taken out a couple years ago while on Suboxone & they still gave me 15 tramadol after the fact. So it all really ends up being at the discretion of the doctor. Some doctors don't care if you were on subs & will still give you meds if you're in pain.

I recently lost my Suboxone doctor. And at my yearly physical, I brought up to my GP that tramadol worked better for me than buprenorphine. And he said he had no problem putting me back on tramadol. Except that was 2 months ago & he still hasn't done it, so I doubt I'll even get it. But I was still shocked that he even had an open enough mind to consider giving me my tramadol back.

Personally, unless you were a heavy opioid user/lover to begin with, I think avoiding buprenorphine may have been the right choice.
It may only be a partial agonist but it's almost as potent as fentanyl & can cause a big tolerance to opioids. Plus if you're on high doses & need acute pain relief, the buprenorphine will block what ever they give you for the pain. So then you would have ended up with a dependence on a shitty, potent partial agonist opioid, on top of dealing with your depression.


Tramadol & heroin use to help my major depression tremendously. So much so, that now I'm angry every single day that heroin & tramadol aren't legally available over-the-counter. Because that means I'm basically being forced to live a miserable life all because of pathetic drug war hysteria.

 

[Ozymandeus]

Okay, So about 15 years ago my Psychiatrist wanted to prescribe me Suboxone off label for my Depression and Anxiety. I didn't want other Doctors checking out that drug on my medication list. So, I said no to my Doctor. It makes me wonder did I do the wrong thing by saying no ? I was surprised she even considered it and brought it up. What do you think about it ? And what would other Doctors think if they saw that on my med list ?

Be glad you said no. Very glad.

Suboxone is a very effective antidepressant. I've also heard it being prescribed off label for bipolar. It's good for anxiety too I guess.

But the problem is it only has this effect in opioid naive people with no tolerance, and more pertinently this effect only lasts 5-7 days during the honeymoon phase. After that you will not feel much at all benefit. Tolerance is exponential and not linear like other opioids.

If you were to continue taking it past 7 days you would become hopelessly dependent on it. The withdrawals are just as bad if not worse than a lot of other opioids.

I would say its a nice relief from mental illness, but only brief or sporadic use is advisable if at all.

Becoming addicted to suboxone simply to alleviate depression or something is extremely dubious in my opinion, and to most doctor's, which is why its off label.

 

[AlphaMethylPhenyl]

The main lasting antidepressant potential of certain opioids has more to do with blocking kappa receptors than anything mu

 

[MedicinalUser247]

The main lasting antidepressant potential of certain opioids has more to do with blocking kappa receptors than anything mu

Maby I should have said yes, but I was too concerned with what other people would think. I'm a paranoid guy so I don't want people to think I was some junky.

 

[RUC4]

Maby I should have said yes, but I was too concerned with what other people would think. I'm a paranoid guy so I don't want people to think I was some junky.

yeah i can completely understand that. where i used to live i OD'ed twice. it was all over my medical records up there. anytime i went to the hospital for anything- which is often cause i have some health problems- i would get some kind of lecture from someone. and they would assume i was still using, which i was, but it's none of their business.

 

[ladymj]

Do other opioids help your depression?

If so, then buprenorphine has the ability to be effective, somewhat.
I have borderline personality disorder, which means I feel my emotions incredibly robustly & things that might bother a normal person for a little bit, can bother me for much longer. I've found that buprenorphine really dampens my emotional output. Although I can still get pretty angry on it.

I'd say buprenorphine has the potential to make you more depressed after being on it long enough too. It helped my depression similar to other opioids in the beginning, but after 10 years of using it daily, it doesn't do jack shit for me as far as pain or depression goes. Still keeps my mood some what balanced though.

It's not common, but not completely unheard of for doctors to use opioids for depression. There is a theory that some treatment resistant major depression is caused by a dysfunction in the endorphin system, which opioids fix.

Depression can actually affect the part of the brain that processes physical pain. So yes, opioids can help depression.
Before SSRIs were invented, they used morphine & opium for depression. And it worked!

As far as other doctors go, some may look at it & treat you like crap for being on subs, or assume you're a drug addict.
But I had my wisdom teeth taken out a couple years ago while on Suboxone & they still gave me 15 tramadol after the fact. So it all really ends up being at the discretion of the doctor. Some doctors don't care if you were on subs & will still give you meds if you're in pain.

I recently lost my Suboxone doctor. And at my yearly physical, I brought up to my GP that tramadol worked better for me than buprenorphine. And he said he had no problem putting me back on tramadol. Except that was 2 months ago & he still hasn't done it, so I doubt I'll even get it. But I was still shocked that he even had an open enough mind to consider giving me my tramadol back.

Personally, unless you were a heavy opioid user/lover to begin with, I think avoiding buprenorphine may have been the right choice.
It may only be a partial agonist but it's almost as potent as fentanyl & can cause a big tolerance to opioids. Plus if you're on high doses & need acute pain relief, the buprenorphine will block what ever they give you for the pain. So then you would have ended up with a dependence on a shitty, potent partial agonist opioid, on top of dealing with your depression.


Tramadol & heroin use to help my major depression tremendously. So much so, that now I'm angry every single day that heroin & tramadol aren't legally available over-the-counter. Because that means I'm basically being forced to live a miserable life all because of pathetic drug war hysteria.

That’s interesting about the heroin helping your depression. I believe it helped my son who ended up on fentanyl and tranq. He is in his late 30s and he has always been “miserable” most of his life. The problem was as most know who are users that you have to keep going up in dosage for it to be effective. He thought he could casually use all of that, but you can’t. So the only thing he does now is weed, nicotine vapes, and drinks at times, but he seems so miserable most of the time I don’t even want be around him at tmes. It really breaks my heart. I wish he would try regular pharmaceutical antidepressants.

 

[DeathIndustrial88]

That’s interesting about the heroin helping your depression. I believe it helped my son who ended up on fentanyl and tranq. He is in his late 30s and he has always been “miserable” most of his life.

I'm really sorry to hear that! It very well could have been helping your son. Fentanyl is a different beast & lacks that antidepressant effect altogether for me personally, so I would think he'd probably be miserable on that as well.

I think opioids help more people than the world wants to admit. I know so many people who have drinking problems & they have told me that if they could just get pain meds they could quit drinking. I'm the same way, I have zero interest in alcohol if I am on pain meds or opioids. So technically opioids are keeping me from using a more toxic & physically destructive drug.

The problem was as most know who are users that you have to keep going up in dosage for it to be effective.

This can definitely be a problem. This is where people need discipline, self responsibility & the need to want to make it work.
For example, if your tolerance is starting to get too high, it is possible to take doses for a few days that just "hold" you, so that you're not sick, but you're not gonna be feeling as great as you usually do. But your tolerance will still go down & then you can get the effects back. Some times people hit a dosage on an opioid & seem to do fine on that same dosage for years. It can vary a lot. And some of it comes down to the person using them & why they are using them. Are they using them as tools to enhance their life, or are they just trying to destroy themselves with anything they can get their hands on? Cause there can be all kinds of reasons for people using drugs. Some of them positive & quality-of-life bringing & some of them negative & destructive.

It sucks to hear your son is suffering so much though. People shouldn't have to be miserable their whole lives. And I believe in better living through chemistry, so I really hope he's able to find something that helps him. But I know how hard it can be, especially if psychiatric meds don't help, which they never did for me.

Also gotta be careful too, cause I've had numerous doctors try to put me on antipsychotics for my depression. Antipsychotics work by blocking or only partial agonizing dopamine receptors. And this can actually cause some one to feel worse & more depressed if they're already deficient in dopamine, which many depressed people most likely are. So hopefully he doesn't end up zombified by some doctor either.

 

[cnnka]

I'm really sorry to hear that! It very well could have been helping your son. Fentanyl is a different beast & lacks that antidepressant effect altogether for me personally, so I would think he'd probably be miserable on that as well.

I think opioids help more people than the world wants to admit. I know so many people who have drinking problems & they have told me that if they could just get pain meds they could quit drinking. I'm the same way, I have zero interest in alcohol if I am on pain meds or opioids. So technically opioids are keeping me from using a more toxic & physically destructive drug.


This can definitely be a problem. This is where people need discipline, self responsibility & the need to want to make it work.
For example, if your tolerance is starting to get too high, it is possible to take doses for a few days that just "hold" you, so that you're not sick, but you're not gonna be feeling as great as you usually do. But your tolerance will still go down & then you can get the effects back. Some times people hit a dosage on an opioid & seem to do fine on that same dosage for years. It can vary a lot. And some of it comes down to the person using them & why they are using them. Are they using them as tools to enhance their life, or are they just trying to destroy themselves with anything they can get their hands on? Cause there can be all kinds of reasons for people using drugs. Some of them positive & quality-of-life bringing & some of them negative & destructive.

It sucks to hear your son is suffering so much though. People shouldn't have to be miserable their whole lives. And I believe in better living through chemistry, so I really hope he's able to find something that helps him. But I know how hard it can be, especially if psychiatric meds don't help, which they never did for me.

Also gotta be careful too, cause I've had numerous doctors try to put me on antipsychotics for my depression. Antipsychotics work by blocking or only partial agonizing dopamine receptors. And this can actually cause some one to feel worse & more depressed if they're already deficient in dopamine, which many depressed people most likely are. So hopefully he doesn't end up zombified by some doctor either.

Opioid dosage can be tricky the same exact dosage sometimes feels like isn’t enough whereas another day feels like it just hits the spot.
When you feel it’s not enough you tend to dose more so there’s an upward trend long term.

As far as antidepressants I mostly hear very good things in real life it’s on forums and Reddit who I mostly see they’re not working or horror stories. I thinks the general consensus about them it’s that they work good.

 

[DeathIndustrial88]

As far as antidepressants I mostly hear very good things in real life it’s on forums and Reddit who I mostly see they’re not working or horror stories. I thinks the general consensus about them it’s that they work good.

The whole "serotonin imbalance" theory that antidepressants are based on, is just a theory. There's been no actual evidence presented that people who have depression, "have low serotonin levels".

No evidence that depression is caused by low serotonin levels, finds comprehensive review

After decades of study, there remains no clear evidence that serotonin levels or serotonin activity are responsible for depression, according to a major review of prior research.

www.sciencedaily.com

The serotonin imbalance theory is just used to sell SSRI's & SNRI's.

If they work for some people, that's great! They didn't work for me & made me feel like a shell of my former self. Not to mention all the side effects & the withdrawals.

We are aware that people have to increase their SSRI doses as well right? Everyone keeps trying to point out that opioids are these fiendish drugs where if your tolerance goes up, you have to take more. Which while not technically untrue, that rule doesn't just apply to opioids. People often have to keep increasing their SSRI/SNRI dose until they feel "held".

I've known people on 300mg of venlafaxine a day, which is a crazy amount.
If we were talking about addicts & abusing the hell out of opioids, then yeah that can be a big problem. But for somebody using opioids as tools, it's possible to get to a dose & stick with that dose daily, just like a person would with antidepressants or anything else.

I think depression is not a "one-size fits all" model, so society needs to start broadening it's horizon's & letting people make more choices. Depression is one of the leading causes of disability in America right now. And it's time we stop demonizing medicines & let people find what works for them.

If using heroin keeps some one from wanting to kill themselves or helps them get up & go to work or take care of themselves, I see nothing wrong with it.

Switzerland did a study & gave prison inmates heroin daily for 15 years. And their conclusion showed that the people on heroin were able to work just like the other inmates. And there were zero adverse effects on health.

Fifteen years of heroin-assisted treatment in a Swiss prison—a retrospective cohort study - Harm Reduction Journal

Background In the context of the current US opioid crisis and the compelling fact that a quarter to a third of all those addicted to heroin pass through its prisons and jails each year, the care of incarcerated opioid-using individuals (OUI) needs to be improved. Aims Little has been published...

link.springer.com

"No serious heroin-related medical complication occurred during the 15-year window of observation among inmates with heroin-assisted treatment. Their work performance was comparable to that of the reference group."

Now this was obviously in a "controlled" setting in a prison, but it does show that long term use (when used as a tool/medicine) doesn't cause any damage to your organs or brain (especially if you're not using needles either).

Now I'm not telling people to go out & use heroin for their depression, far from it (cause I know some one will try & misconstrue what I say here)...
I'm just saying, I think that because society demonizes drugs so much, that there could be millions, if not billions of people who might actually benefit, depression-wise from illegal/controlled substances. And because the drug war & drug hysteria has created such barriers to these medicines, a lot of people never get the help they need & deserve.

 

[ladymj]

I'm really sorry to hear that! It very well could have been helping your son. Fentanyl is a different beast & lacks that antidepressant effect altogether for me personally, so I would think he'd probably be miserable on that as well.

I think opioids help more people than the world wants to admit. I know so many people who have drinking problems & they have told me that if they could just get pain meds they could quit drinking. I'm the same way, I have zero interest in alcohol if I am on pain meds or opioids. So technically opioids are keeping me from using a more toxic & physically destructive drug.


This can definitely be a problem. This is where people need discipline, self responsibility & the need to want to make it work.
For example, if your tolerance is starting to get too high, it is possible to take doses for a few days that just "hold" you, so that you're not sick, but you're not gonna be feeling as great as you usually do. But your tolerance will still go down & then you can get the effects back. Some times people hit a dosage on an opioid & seem to do fine on that same dosage for years. It can vary a lot. And some of it comes down to the person using them & why they are using them. Are they using them as tools to enhance their life, or are they just trying to destroy themselves with anything they can get their hands on? Cause there can be all kinds of reasons for people using drugs. Some of them positive & quality-of-life bringing & some of them negative & destructive.

It sucks to hear your son is suffering so much though. People shouldn't have to be miserable their whole lives. And I believe in better living through chemistry, so I really hope he's able to find something that helps him. But I know how hard it can be, especially if psychiatric meds don't help, which they never did for me.

Also gotta be careful too, cause I've had numerous doctors try to put me on antipsychotics for my depression. Antipsychotics work by blocking or only partial agonizing dopamine receptors. And this can actually cause some one to feel worse & more depressed if they're already deficient in dopamine, which many depressed people most likely are. So hopefully he doesn't end up zombified by some doctor either.

thank you so much for your reply

 

[Althodius_Trismegistus]

Okay, So about 15 years ago my Psychiatrist wanted to prescribe me Suboxone off label for my Depression and Anxiety. I didn't want other Doctors checking out that drug on my medication list. So, I said no to my Doctor. It makes me wonder did I do the wrong thing by saying no ? I was surprised she even considered it and brought it up. What do you think about it ? And what would other Doctors think if they saw that on my med list ?

Most Dr's would NOT prescribe suboxone like that because of all the red tape. I dont think there is a single person that would argue that medication would be a perfect match for depression and anxiety.

 

[map_dap]

Before taking 16 mg of suboxone sublingually (pill format) 8mg in the morning and 8 at night was so addicted to 7-OH and Kratom. I was addicted to Kratom for at least 6 years as I dabbled with heroin circa 2011-12 and afterwards most painkillers -- you name it, I tried it. I can say with 100% confidence that this regiment listed above has completely knocked out my desire for Kratom. I still miss getting faded but the urge is not NEAR as strong as it was before. The results come on pretty fast. I am thinking of asking to go up to 24mg/day as 16mg after 2.5 months my cravings for actual opiates have come back, due to the pain I suffer daily -- though on the suboxone it is lessened substantially.

TL;DR: If you truly want to get off of the opiates or like legal alternatives like 7-OH or Kratom seriously give suboxone as shot. It has not only saved me so much money from not spending it on a bag of Kratom every other 3 days but also likely has spared me from having seizures.

P.S., I do NOT think Kratom should be federally controlled or even controlled on a state level, as it is in many states in the USA. Many of my friends that served in the military use it responsibly as an alternative to opiates.

cheers,

mapdap

 

[MedicinalUser247]

Thanks for all the Opinions.

 

[Keif' Richards]

Hey @MedicinalUser247

It's not wicked common for Buprenorphine (Suboxone; Subutex) to be prescribed off-label for these indications. A big reason is the hysteria that surrounds the prescription of Opioids in this country to this day. I am pretty familiar with Buprenorphine. I have used it extensively myself and God knows I have spent a lot of time reading and talking about others' experiences.

As a layperson, I would never pretend to know the right or the wrong for a person's treatment. If you ask me, I do not feel that Buprenorphine is a bad choice for depression if other treatments have no been successful. It is of course and Opioid and you will become Opioid-dependent in the course of your treatment. That is a major life decision that should not at all be taken lightly. Tolerance is elastic in many ways, however it is like any elastic substance in that stretching it does cause permanent wear even if that rubber band appears to shrink back to normal.

Buprenorphine, as a mixed agonist/antagonist is much less potent than say, Morphine. It does not trigger the full agonism of the Mu receptor that we know is the major component of Opioids' addictive qualities. It is, in perhaps over-simplified terminology, "lighter".

I believe that the "lighter" qualities of Buprenorphine could make it a good choice for depression, provided it Is administered with extreme care and forethought. You want the smallest possible dose. Even if the dosage is kept small, it is still a distinct possibility that tolerance could lead to diminished efficacy following chronic usage. In fact, I would expect it to be a factor in one's treatment.

This would mean a strategic administration and potentially involved taking breaks from the drug in some way. Does this mean a lower dose for a time period, complete abstinence for a time period, who knows. These are all questions that we could spend a lot of time thinking about. However, the only real metric to make these judgements would be your response to the drug specifically.

I am almost completely against SSRI therapy. This is opinion, based on my own experience, those of others and what I know about the effects of chronic SSRI administration. I do not knock anyone who has had positive experiences. I just have little faith in those drugs and consider the side-effects (no libido) to be intolerable as a human being. It is not ever okay for a human to not have a sex drive. It cannot lead to happiness, connection and/or love when a critical component of your being is not even there.

If you ask me, shooting from the hip, I would probably put someone on real low-dose Buprenorphine before I would suggest they take an SSRI. I truly feel the negative effects of the SSRI are outweighed by the risks of the Buprenorphine. This is all just opinion guys.

I say try it if you want to. If you find that it works for you, there are so many delivery systems for this drug now, so you wouldn't even have to worry about the potential for misuse. You could get a patch, do the depot injection etc. I have read studies that have a relatively positive disposition toward Buprenorphine in cases of depression. I don't doubt it could be effective. I'd love to know how this goes and what you decide.

 

[MedicinalUser247]

I take a lot of Meds.. And they work for me just fine now.

 

[DeathIndustrial88]

Buprenorphine, as a mixed agonist/antagonist is much less potent than say, Morphine

Not trying to be pedantic or play semantics here, since I know what you mean...

But technically, buprenorphine is much, MUCH much more potent than morphine. It's literally 45x more potent than morphine.
It's even more potent than heroin.

But it is only a partial agonist. So yes, it does not intrinsically active receptors all the way. But taking high doses does cover a shit ton of your receptors. Where as usually when a person takes a full agonists, they only have a small % of receptors covered at a time.

So while it's intrinsic activation is lower, it is definitely incredibly potent. I've seen people puke & nod for 12hrs off literal pieces of Suboxone dust.


Totally with you on the SSRI thing though. As a sufferer of major depressive, I have never found SSRI's helpful even in the slightest. In fact, I can't even make it through the constant puking & nausea from them to even stay on them long enough anymore. The whole "serotonin imbalance" theory of depression was just a lie to sell people SSRI's anyway. There's no evidence that people with major depressive disorder have "lower serotonin levels". So the whole SSRI/SNRI charade is BS. If it works for some one else, that's great. But from my experience, they didn't do squat & only caused me more side effects.

 

[agoraphobe]

and consider the side-effects (no libido) to be intolerable as a human being.

This is true from my experience with being on an ssri for 15 years now but you know what Keif, low-sex drive, side effects as well as the positive effects eventually go away after a while. tolerance rules all, even ssris.

 

[Keif' Richards]

Yea @DeathIndustrial88 I feel you completely. I appreciate your respectful approach to making your point as well. Buprenorphine gets complicated. When we are talking about straight up MOR agonists, it is pretty easy to jump from one to the other. I am always hesitant to fully explain the subtleties of Buprenorphine worrying that I am being too much of a nerd for your average reader. The explanation is important for anyone trying to understand the more eldritch qualities of their drugs, so thanks.

@agoraphobe don't worry, you're among friends. As an Opioid addict, I have been "diagnosed" with the gamut of negative human emotional states. Depression, anxiety, panic (I'm out of HEROIN!), multiple personalities (jailhouse social worker before a court appearance) etc. Like so many things in this world, we are taught even as addicts to respect the essential absolute, scientific nature of psychiatry. I believe it has become such a large practice in medicine and so relevant to our lives, that it is a very destabilizing, panic-inducing thought to realize that the entirety of it is based on nothing.

We cannot actually, definitively say what happiness is, nor depression, nor anxiety. I can't be happy and sad at the same time? How exactly do you measure the level of a person's depression? Furthermore, considering your data stream (a person) is inherently unreliable in revealing themselves, how do you have any faith in such a thing? Then when you see how quickly they are willing to throw potentially life-ruining medications, it's too frightening to look the farce of it all in the eyes. Even me, having consumed so much medicine in the course of my life, so many doctors/psychiatrists...

In the end, they were all used by a manipulative drug addict to get the drugs I wanted to fuck me up the most. That is what reams of documents, hours of time result in. If you were to read my file, it would read like the diary of a fucking madman.

It's easy to say "well it's just boners". What if that costs a person a relationship with the love of their life, because they were unable to connect sexually at the right time? It means a lot more than what they claim it does.

I know I'm now on a signature rant that nobody cares about, so I will put a bow on it. I feel it is a major sin that traditional medicine has been maligned and reduced to quackery in the face of the perfect science of modern medicine. We take an entire realm of potential cures for people that have been reduced to "supplements". There are innumerable manufacturers of said substances that make products completely devoid of actual medicine (GNC etc.). This only leads more people to "try" traditional medicine, bought from the supermarket only to tell their friends and everyone they know that it's bunk.

I can tell you guys... Rhodiola Rosea, Saffon, Reishi Mushrooms (other mushrooms, most brands are total bullshit)... if I had known what these things could do and had started taking them at an earlier part in my life, I absolutely believe my life would have been different. I do not make this statement lightly. I have experience real, powerful change in my life from these things. If anyone wants to know more, feel free to ask. I was a Heroin addict for 15 years so if you know this statement has meaning.

We are talking about how to deal with depression. I know this is Bluelight, but I would be doing you all a disservice not to bring this stuff up.