Hey guys.
I want to introduce myself in short- I'm on opioids for about 10,11 Years and I've been on buprenorphine for about 3 Years now I think. Initially I started taking opioids for battling my depression which developed soon in my youth; and I can honestly say, that, without opioids, I don't know if I had been able to achieve the things I've achieved so far (surviving, mental issues, education...). Of course, I'm also addicted - means, on one hand, I take my buprenorphine as medication, pure medication for my mental issues (depression and other things..). On the other hand I'm also addicted and sometimes I act like an addict- this is out of question. So, it is both- it is medication and it's also addiction. BUT, the question for me is, below the line, what is the outcome?? is it a plus or is it a minus? Means, it is more therapeutic and has a positive value as outcome or not? The answer is: it has a positive outcome for me and it has been like that for quite a few years.
Will this go gon like this forever? I don't know, but I don't think that's likely. I rather think that the time will come when I sense that the disadvantages will beat the advantages and then it's time to change something.
Some points on my life and my depression: I tried a lot of antidepressants, means, I tried a lot of the medication the "conservative" medicine has to offer to people with depression. I've been in psychotherapy (with few years interruption) for the last 10 years, beginning in the middle of my teenage years. I've also tried the normal range of antidepressants general psychiatry has to offer and they have done nothing for me, I haven't got along with them- the only time in my life where I've really had great benefit from antidepressants was in a perioid of deep major depression (which took me about a year to recover from- without my significant other and my doctor I don't know where this would have ended). Besides that I don't tolerate them, doesn't matter which one, I've had enough (Citalopram,Prozac/Fluoxetine,Reboxetine,mirtazapine,trazodone, list goes on)
So, essentially, there are just a few things that really help me with my depression, and that's buprenorphine, psychotherapy and a healthy social life.
Evidence grows that (not all but some) people with depressive disorders can seriously benefit from small doses of buprenorphine as a therapeutic agens against severe depression. I'm sure the most of you will know the studies which were made on this topic and which all found a great positive outcome for buprenorphine battling depression in people with severe depression. And in our days there is growing evidence that points in the same direction, slowly, more studies will follow up and build up the necessary data to establish a new way in the treatment of (mostly) severe, treatment resistant depression.
So, for one thing it is clear that buprenorphine can't become a standard solution for depression. The effect/side effect ratio is much better for the common antidepressants in the way that buprenorphine for "common depressive orders" was like taking a sledgehammer to crack a nut. I think that's clear to almost everybody.
The vast majority of people with depressive disorders will benefit from standard psychiatric medicine, means, antidepressants like SSRI and also psychotherapy (cognitive behavioural, psychodynamic, whatever it is...).
BUT: for people who suffer treatment resistant depression, who are "untreatable" with the standard arsenal of psychiatric medication, there is GREAT hope in the treatment with (mainly low doses of) buprenorphine. Most people with this condition have comordbitiy with anxiety issues, obsessive compulsive disorder, etc.
Buprenorphine has proven not only to be efficient in treating depression, but also to have anti anxiety properties (and it's likely that it will have an impact on compulsive disorders also).
So, we're talking about people who have conditions that simply drop out of the standard medical system, who suffer from serious, life threatening mental disorders like depression- and they have almost always nothing to loose anymore. So, the last thing they care about is the "Danger of getting addicted"- people like this care about surviving or not. That's it. And in this situation you can really benefit from a treatment with buprenorphine and it's worth a try as it will often cure the depression to a point where these people can reach a level of quality of live that's worth living again.
Maybe some of you are interested, so I will share some things with you about my consumption of opioids. The dose I take right now are ~2mg of buprenorphine. But I want to taper down to 1mg/ 1.2mg.
The dose hasn't changed over the years; as a matter of fact, the dose I took in the beginning of my opioid-career was even higher than the dose I take right now.
I've had my ups and downs with doses over the 10 years. There were phases where I took rather high doses but also phases where I dropped again to my "standard" dose. High doses mean: subjective high doses; high doses measured with my personal scales
.
So over the years the amount I take hasn't really changed. Like I mentioned before, over the years, especially when you have an hedonic base slope, caused by mental issues and other negative conditions in your life, you sometimes also get seduced to chase "wellbeeing"- and that's where addiction begins, for sure.
So, in my personal case, it is, like I said before, both. One part is addiction and the other part is medication. Will it be a problem when the time will eventually come to get off my medication? YES. Does it bother me? a bit. Do I regret to have started this path? having trouble someday to get off? NO. Clearly, NO. I've really had other, really more SERIOUS problems in my life then taper down or get off of my medication. That's a joke compared to the things I've had to fight with. You know, if you fight to simply survive, to stay alive, literally, then the framework in which things are related to another changes. Your perspective on life changes and also your view on life.
(no disrespect to all the people that have issues with taper down- all said from my subjective perspective of things..)
Hopefully the day comes where the affected (mostly treatment resistant) people suffering depression can get legally a try with buprenorphine- and their chance to receive a medication that eventually helps them and changes their lives to the better. Of course in a controlled, medical framework that supplies not only the necessary monitoring but also helps with additional therapeutic options.
My 2 cents on this topic
