It binds to all receptors involved in addiction, so i still beleive that low daily doses are the key, still worried about the heart failure issue tough.
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N&PD Moderators: Skorpio
Pharmacological options in the treatment of addiction
- Thread starter MeDieViL
- Start date
23536
Bluelight Crew
^thanks. I've had DATA enforced on me in NY at the pharmacy, but not in Florida.
oh and I've also been prescribed butorphanol for opioid withdrawal (though it seemed entirely pointless)
I wonder if baclofen can be prescribed off-label for benzo addiction without consequences. Certainly the punitive (your term) drugs like disulfiram and naltrexone can be prescribed for addiction with impunity.
remember also that the metabolite noribogaine is very active and has different activity, and I think has some kinetic interplay similar to bupe/norbupe
Yes, and i beleive methadone is one of key agents in the treatment of addiction.
Yes, its metabolite does point to alpha3beta4 playing a major role in the anti addictive effects.
One of the reasons why i think pharmaceuticals are the key for addiction.
Is addiction still addiction without tolerance and withdrawals?
TheTwighlight
Bluelighter
I have to say, if it weren't for gabapentin, I don't think I would have been able to quit benzos, specifically alprazolam above all others. I was miserably and hopelessly addicted to it for 8 years, and when I decided I wanted to get sober, I got gabapentin. I was getting it from 2 doctors (yes, I was doctor shopping for Neurontin). But I believe that it was key to my now stable sobriety.
I began at doses of above 7 grams a day, then slowly lowered it. Now one of the doctors is prescribing me 3,600mg a day. I am stable now. I also am on 450mg of pregabalin and 200mg of lamotrigine per day, plus 20mg lisinopril for blood pressure. I don't crave the Xanax anymore. Of course I still think about it sometimes, but I don't actually go into 'active addiction' mode and seriously think about getting any. I'm finally better...sort of. I'm still a severe pharmaceutical polydrug addict. I was hooked on Neurontin, Lyrica, Xanax, Restoril, and Fioricet every day like a fiend and thought for sure that I was going to die. I was hoping for it.
So I came to the option: Either die or get sober. So I decided to get sober.
I am now 2 1/2 months sober and I feel secure with it. I don't know what I would have done without the gabapentin. It literally probably saved my life. And I think that Neurontin should be one of the first-line treatment options for withdrawal. It's a miracle drug in many ways. Lyrica is, too, but the idea of it being used as any sort of standard for depressant withdrawal is wishful thinking at best, for the time being.
I also thank the 12-step program, and I am not a big book thumper at all. The 12 steps have showed me where the fuck I was a selfish and discontent piece of shit and being able to look at all of that with a fucking awesome sponsor saved my life for sure. Being able to see where I was wrong in so many places, with all of the people I THOUGHT fucked me over. But I was the one who instigated the resentment. Resentments and expectations of situations and other people is where most people relapse, in my opinion. I heard one time that "expectations are premeditated resentments", and that always stuck with me, as well as definite statements like "this is the last 30-day chip I'll ever have." Of course there's the psychological/physiological addiction...but seriously, if I can quit, ANYONE can. I had 0% chance of quitting on my own. That is, without God (whoever that is to you), gabapentin, and the 12-step program to reveal myself to me and see clearly where I was in need of redemption...my biggest resentment was towards myself, and I HAD to get past that.
negrogesic
Bluelight Crew
In the training material for the DATA 2000 buprenorphine waiver exam, it SPECIFICALLY recommends AGAINST the "12-step program", AA/NA etc. Their argument was that AA/NA groups are discriminatory towards patients on "maintenance" (although their 'official stance' does not) are not "sober" or "clean", and in practice this is generally the case. I went to a few NA meetings, some AA, and I found it utterly moronic and full of disinformation. Why does one need to stand up everyday and say "I am an addict".......these people count the number of days sober for years.....so what? Do I need to hang around a bunch of fucked up, biased chain smokers to know that I once was heavily addicted to opioids?
What is the point in going to meetings 3x (some go daily....addiction?) a week, becoming responsible to a "sponsor", go through the humiliating steps of labeling ones-self an "addict for life" and "apologizing" to people for your addiction (all while accepting a "higher power" and all the other BS)? The fact is, like it or not, most people discriminate against "addicts", and I see no reason why one must share this with the world, and wear it on your fucking sleeve. Honestly, I have no clue how many months or days its been since I quit methadone.....I think it was sometime in 2007, who fucking cares....its been years.
And yes, I still use recreational drugs sometimes, but I cannot personally take opioids with any sort of consistency because they are, personally, too addictive. I remember trying a year or two ago to take a few hundred milligrams of oxycodone once every 10 days (yes, my tolerance is still high, I have to snort the equivalent of 3 80mg tablets to get a buzz, and more to nod out) . While I was able to stick to once every 10 days, I found myself counting down the days in anticipation of the one day of use. So, while not physically at risk for addiction, I didn't like the anticipation, so I decided I can never really take opioids with any sort of regularity. But, some 10 months ago I binged for a good 5 days on 0-desmethyltramadol. I hit it so hard that I felt pretty burnt out the afterward, so I decided that big binges were probably not a great idea either. But still, if I really want to, I can snort a few oc-80's, bang a vial of hydromorphone, burn through a bottle of morphine etc (I will not take street opioids, aka heroin, not because its more addictive, but because it is "dirty"). I also made a rule that I cannot take opioids as a "reward" for something or in response to stressful stimuli, because this could lead to addiction). I also don't have an issue abusing other drugs if I so desire, but only in moderation. The big exception is benzodiazepines. While I do not find them very enjoyable (sure, 4-6mg of alprazolam is nice), I have to avoid taking them entirely; I was once addicted to huge amounts of diazepam, and the withdrawal was sheer hell. The issue however, is that due to my past abuse, I appear to have somewhat permanent sensitivity to BZD's, and a mere 5-7 days of usage will begin to bring back some of the withdrawal symptoms, which continue for weeks after stopping. Barbs are ok, carbamates are fine, z-drugs don't seem to cause the WD's but are too similar to BZD's.
Do I consider myself a drug addict........."sort of".....I simply recognize that I have some rather addictive behaviors when it comes to opioids in particular, so I have to use them rarely and with no pattern or consistency. Do I get tempted when I see barely expired numorphan ampules in the "to be destroyed" bin in the hospital pharmacy.....yes, sure. Would I ever steal drugs or divert the narcotics I administer to patients.......no fucking way. Is it an accident that I choose anesthesiology.......no, but it was not for enhanced access to narcotics. I had extensive experience in veterinary anesthesiology, and am "good at it". I had some initial concerns, but I found that I can cope with access to huge amounts of narcotics, and it is not something that "haunts" me or is a daily obsession.
If my colleagues knew that I am actually a rather notorious (and even published, quoted as "negrogesic") addict, I probably would not be in the position I am. I took great efforts through the course of my addiction to never get arrested, hospitalized for, or be "flagged" as an addict. I don't think of it as a disease, because I am not sick......Sure, I have a strong neuropsychiatric predisposition for opioid abuse, but I see merely as a flaw of sorts. Did I relapse by using some opioids sparingly.....who fucking cares, the bottom line is, I did not retain a physical dependency.
Sorry for the rant, I'm dictating this message on my phone while on the freeway (my phone is actually a small computer). Obviously I have some strong and controversial views regarding "addiction". I know I have weakness for narcotics, but it does not define me. Perhaps I am lucky......the dreams of poppy fields ended years ago......I am still susceptible to physiologic dependency, I am under no delusions that I 'could' become dependent, but I do not live in fear of this possibility.
Hahahaha that is so bullshit
My own view with regards to addiction is rather controversial too, as i beleive addiction is completely neurochemically mediated, but i actually dont consider anyone that has no tolernace or withdrawals problems addicted.
negrogesic
Bluelight Crew
And as the song goes......non, je ne regrette rien.......Regret is perhaps among the most pointless state of consciousness, as one cannot change the past. And no, I am not a sociopath, I can and do feel guilt, remorse etc. But I regret nothing.......things happened.....such is nature of life, hopefully one learns from their mistakes.......live in the present. 500 days "clean" is no achievement, move on....take heed....but move on......if you have been taking count for 500 days, you should re-think your approach, because that means you have been continually ruminating over the subject for 500 days.....
The mentality of "living one day at a time" and notions such as, "addiction is an incurable disease, of which i am infected.....I am an addict, and I will always be an addict" are inherently self-defeating, and ultimately disenfranchising.
I am not violent towards women out of courtesy (and I try to avoid violence in general, but I have been a fighter, and enjoy watching it as a sport). While on methadone maintenance, i was hospitalized to surgically treat an extremely nasty and painful compound fracture, and i had my clinic call to instruct them to give me methadone instead of the futile morphine drip. Instead of giving me the normal 380mg dose orally, they gave it to me intravenously (all 380mg), which was actually getting me very high and was causing constipation. Because I could not walk and was fully "plugged and wired in", the nurse had to help me to the toilet. Because of the constipation from the IV methadone, one Filipino nurse got impatient and said "hurry up you junky". Even though I was catheterized (in more ways than one!), weakened by the invasive surgery and heavily sedated, I was able to punch the woman in the face (ripping out a catheter, etc) in reaction to her comment. Fortunately, i couldnt hit very hard (it was like a punch in slow motion), but it still knocked her down and busted her lip. She got up, crying, and ran out of the room. Obviously, she never returned to my room. I do not regret doing this.......nor do I feel remorseful or "sorry". My long-winded point......do not label yourself, nor allow anyone else to do so. I am glad that i was very sedated, and am fortunate that I did not seriously hurt her, but I do not regret clocking the bitch. Hopefully she learned something from that......
TheTwighlight
Bluelighter
I never said I agreed with the CA/AA dogma. I just think it's good to be able to have self-discovery of that type, which I never would have done otherwise. I completely agree with what you say about alot of the shit being self-defeating. I had to choose to become sober outside of the program to be successful. I love having a sponsor, because he's not a normal sponsor. He's my friend and a really fucking cool guy who really has a vested interest in my well-being as a human. He has helped me out financially in ways that I cannot thank him enough for, as well.
The 12-steps are just a means to an end which is different for everyone. I'm not a big book thumper but there are a whole lot of poignant statements in that book, regarding addiction. I didn't HAVE to do any sort of 12-step program. I chose to, and I always thought it was complete and total bullshit before. And some of it is, some of the attitudes of the people in the program are retarded. The program isn't going to work for 1 motherfucking person if they honest-to-god don't want to be sober; that is the delusion that most people suffer from in the AA/CA program. It doesn't matter how much you do what they tell you to do, it doesn't matter whether or not you do all the self-inventory or amends or pray or any of that shit. You can't force yourself into WANTING to be sober. It's black & white: either you want to or you don't.
I go to meetings, because every once in a while, someone says something that really hits me hard. For me personally, my addiction was a matter of life and death. They say in the program that everyone is gonna die if they don't work the program cuz it's the only way they can ever get clean. That's wrong in 2 ways. The first being because, plain and simple, it's not the only way. The second being that, in all honesty and truth, not everyone is going to die because of their addiction or dependence on alcohol/drugs. Some people just like to get fucked up, plain and simple. That doesn't mean they are going to "die". For me, it's true; if I don't find SOME way to get sober, I will physically die. But that's just me, and putting others in the program on the same level as me is just, well...bullshit. I'm 20X worse than most people who get wasted. I am suicidally depressed with a drug addiction. That's the worst combo possible. Plus, I'm a polydrug addict. I honest-to-god can't even smoke weed or I'll end up shooting meth and heroin in the same syringe in a crackhouse bathroom after swallowing a whole script of Xanax. Once again, not everyone is like that. That's just me.
I also don't believe in living one day at a time, or even really counting the days sober. I pick up my chips at my favorite meeting, because for me it's an accomplishment. I am very grateful and happy to be sober today. I hated my life and truly wanted to die, and honestly attempted suicide several times. Not "cry for help" suicide attempts. Real, true "didn't tell anyone and just did it" attempts, and every time someone ended up finding me and I ended up being revived. To me, that's God. To me, that's proof that I have a reason to be here. And I won't be here if I go back out and do drugs again. I have done most everything I ever wanted to, in ridiculous excess. I suppose I've had my fun. And I'm okay with that.
And negrogesic: I've been seeing your posts on here for at LEAST the last 7 years. You are a highly intelligent guy that I respect very much. I always, always love reading what you have to say on, really, any topic. I just wanted you to know that. Peace & Love forever, brother.
negrogesic
Bluelight Crew
Yea, don't think I was criticizing you or being punitive in anyway. I have "chips" on my shoulder like everyone else.
If it legitimately helps you to get better or improves your life I am no one to discount that.....I just had a bad experience with it........
TheTwighlight
Bluelighter
You know, I respect that. It's one of those things...however it comes to you, just take it and be grateful. That's my personal experience with this thing. Many of us won't make it. I feel that I was one of those. So I just take what works for me and run like hell with it. I have alot of problems with the program myself. But you know...I don't know...I'm sober now so I guess it's what the fuck ever.IamMe90
Bluelighter
I've basically agreed with your ideologies concerning addiction up until this point, but I really have a lot of disdain for violence, which is generally a terrible approach to get anywhere in the long term in the context of whatever the aim of your trajectory is. Really, I understand why you hit that nurse for her stupid and inconsiderate remark, but if you and others in such a position would simply be secure in your conviction that to be labeled is wrong, then you wouldn't need to punch a woman, which really results in no palpable benefit, really in general no palpable impact at all (if anything, you might just make another link in the chain of cyclical violence).
It just amazes me how generally reasonable and intelligent people can really feel justified in violent acts such as this without being somewhat sociopathic. Eh, w/e. I just don't think we need more pain and negativity going around that serves literally no end except some petty psychological ones.
And really, violence in the context of controlled games as a competition of skill can't even be called violence - the word implies intent which is not present in this context. It's not justification for clocking a woman in the face for being rude to you. That is just childish lack of impulse control, or lack of empathy.
Edit: And I don't want this to sound like a sanctimonious attack on you as person on the whole, because from all of your posts you seem like a reasonable and pretty cool person, I am just deeply bothered on a personal level by these kind of acts and even more at attempts to justify them. Everyone makes mistakes, but not everyone unfortunately owns up to them.Last edited:
negrogesic
Bluelight Crew
Hey just because i am in telligent doesn't make me wise or incapable of foolishly. In fact excessive intellignece often comes wirh a" price". I do not advocate violence, but i am an imperfect being and have my own weaknesses. But i acknowledge it and am working on it. Now as a physician i have become very non-violent. But i am still full of testos, am a risk taker, and like a good fight. And sorry to break your ideological bubble, but man are animals, and on a primal level, h. Sapien is prone to violence. No. Amount of "hippy love" will or can undue this. Man is a violent animal, sorry to tell you. World peace is literally and figuratively a pipe dream. But no, i don't like hurting people, i am very compassionate.......i am just an" alpha-male" by nature and anyone foolieh enough to provoke me enough to make me get violent has to really push my buttons. I know physical violence is not good, but it is a part of life and intrinstic to mankind. Again anyone foolish enouh tonh world preace is possible needs a rewality chedk,IamMe90
Bluelighter
if you had just kept your post to the former half, then I would have applauded you for admitting to your own flaws, but it seems odd to me to spend half of your post admitted to your flaws and then another half justifying them on a basic level.
at any rate, I'm certainly not stupid enough to think world peace is an option and i never mentioned the concept once. just because man is naturally violent to a degree, though, does not mean that you individually can't control your impulses and that doesn't really have any bearing on how right or wrong the action is anyway.
Anyway, that's the last I'll say about this since it's obviously getting pretty off the topic of addiction. I apologize if I offended you at all too, we all have our hot button issues and this tends to be one of them for me.Last edited:DooMMooD
Bluelighter
Thats a pretty pessimistic outlook man. I cannot accept those things as true, because if so then im resigning myself to a world I do not want to live in. If those things are true, than mankind cannot and will not go anywhere as a species. And i refuse to accept that humanity cannot go anywhere.
Just because its idealistic doesn't mean we shouldn't strive for it, and give up before its realized. You may think your tough but resigning yourself on humanity and people on such a level is really nothing more than a cowardly excuse for your own violent tendencies imo.
I believe mankind can pull its shit together. Not everyone is as violent and animalistic as you claim. Do you know everyone and everyones thoughts on the whole planet?
Sorry to derail...this is a great thread i've been following it reading everything everyones posted just haven't contributed myself.
Regarding the topic of AA/NA....it shares a key point with all other options: admitting powerlessness. This admission allows the person to (hopefully) accept a different path in life. Maintenance treatment requires a similar step: the admission of powerlessness over the drug allows the person to "submit to a higher power", in these scenarios, Methadone or Bupe treatments (and all that goes along with them).
In addition, as i mentioned in another thread, its thought that AA/NA creates a different mindstate; that is to say, it creates a mindstate in such that endorphins are produced via the social connections and setting of the meeting. The setting and everything there triggers a mindstate in an addicts brain, in something that can almost be argued to be akin to, well, using drugs.
Maintenance meds are simply amazing, and IMO may be required for most opiate addicts on a long term to permanent basis. the brain is severely damaged (and split hairs if you want, but i consider this damage plain and simple) because of the "rewiring" of pathways which lasts on a very long to permanent basis, plain and simple.
And it is these rewired, unnatural, "pathways" in the brains system that the maintenance meds "cast" so to speak....that is to say, without the medication, the brain is not working in the original manner, and will not go back to doing such for a LONG time, if ever. So, which is worse: a "cast" for an "injury", or leaving it "castless" allowing it to become further damaged (further damage in this case is relapse). Opioid dependency is not some short term thing that can be overcome IMHO: it is I believe, a lifelong, permanent change to your neurobiological functioning, and as such would require lifelong treatment.
Your brain pathways do not just "go back to normal" once you get clean. It takes months upon months, years upon years, for your brain to get even close to normal again. And throwing away medicines that allow you to do things and live your life free from these burdens of addiction...
The maintenance medications remove the "crave", which most feel is the ultimate problem regarding addiction: the crave and inability to control it. The fact that the addict screams that they want to be clean, and yells for help, but cannot treat it on their own, proves this to be oneproblem where addiction is concerned.
Once this is treated (which bupe/methadone do) well the person is much better off, although this is not the only thing. However, this makes bupe/done very effective tools in treatment; to target addiction at its core...well you'd have to be crazy to pass up that tool in saving your life.
The changing of pathways though is why i find ibogaine (and other drugs such as LSD, mushrooms, etc) a very interesting, novel, wonderful, and possibly (semi-)permanent treatments. Long term studies must be assessed but the fact that these drugs "rewire" your brain and pathways in a way much as they have been "rewired" in the past by drug abuse. Not saying that everytime you trip is gonna cure you, but it is possible.
Ever notice how people have breakthrough trips on LSD/DMT/DXM/Ibogaine and are seemingly 'cured"? or how similarly one has a totally different outlook and lease on life after a nice ol' trip? Rewiring and changes in brain pathways, possibly back to a good state (though not guaranteed by any means)...interesting approaches to be sure.
TheTwighlight
Bluelighter
^ This.
atara
Bluelighter
You can probably find a drug to make an old Tibetan monk violent: it's a part of being human, you can hide it, but it's never gone.
TheTwighlight
Bluelighter
^ Meth.