Oxycodone or Suboxone or ? For Short Term (6 Month) Use As Antidepressant

[BluMan33]

I'm trying to use some combination of opiates to get me through a little bit of a rough spot.

For awhile I was on 1-2mg clonazapam + 300mg wellbutrin + ~100mg oxycodone (spread out across day)

This dosage was perfect. I wasn't nodding or anything -- just felt content and semi-enthused about life. I enjoyed my work, felt somewhat close to the people in my life and all that good stuff.

My only source of oxycodone started playing power games so I decided go off for awhile. For some reason opiates seem to be the only effective antidepressant for me, but it's completely impossible to get them prescribed for this purpose in this country. I did some reading about very small clinical trials that used bupe to treat depression/anxiety. I know it's crazy, but I was in mild wd at the time so I hopped over to sub doctor and got on maintenance program.

I started on 1-4mg a day (hard to say exactly, breaking pills initially). At first I got some version of what I was looking for. High wasn't as good as most opiates, but a bit speedier. If taken at 7.30a it got me through till about 1 or 2p feeling ok. 2-end of work day involved a bit of white knuckling but was better than being on nothing. My man/only complaint was that sub makes sex harder to enjoy for me even at this low dosage, but this seems to be a problem w all opiates for me.

Any after a few weeks @ 2-4mg a day sub dose there's absolutely no subjective anything from it. I can up my dosage all the way to 16mg eventually but is this just going go be the same deal (no real mood lift)?

What are my options here? I need some kind of combination of chemicals that will hold me together as a productive member of society for at least 6 months.

I can stay on subs, elevating dose or just trusting that it has some subtle anti-depressant effect. I can jump back to low, steady doses of oxycodone or I can quest for some other miracle substance (methadone(yuck)?)

I know this is and incredibly subjective question, but I figured someone out there might be able to give me some pointers. Short version: I went from low dose oxy to low dose bupe. Bupe no longer having much of a noticeable effect, but staying on it to avoid wd and because the counseler has lips, black hair and huge beautiful breasts. I'm trying to decide whether to ride the next 6 months out on bupe, switch back to oxycodone or get completely clean for a bit and hope I can still function.

 

[effie]

Why is 6 months your timescale? What will change in 6 months time?

A lot of people find that opioids feel like an antidepressant, at least initially, as they cushion you from the sharp corners of life and make everything more bearable, but unfortunately the effect does not seem to last and opioid addiction isn't much fun for most. I wouldn't up your bupe - chances are you enjoyed the full agonist activity you get at lower doses (from one of it's metabolites, norebuprenorphine) which isn't present at all at high doses. Buprenorphine is great for it's intended use (maintenance to replace a less safe and stable opioid habit, and killing pain) but I don't think you are going to find what you are looking for there. I certainly wouldn't move on to methadone. There is some interest in bupe as an antidepressant, but if you are already needing to increase your dose I expect it is the opioid properties that have been helping you so far...

I really do know what you mean about taking lowish dose opioids to feel "normal" and okay, but unfortunately it isn't sustainable - tolerance builds and addiction sets in. You also are in the mindset of needing *something* to get through the day, and that can be very difficult to overcome. Do you think you are actually depressed? Have you considered conventional antidepressants, or counselling, or CBT? Why is it you have slipped into the pattern of use that you have, do you think? And what is going to be different in 6 months??

(Sorry for all the questions )

 

[NeighborhoodThreat]

^effie is exactly right.

Opiates are indeed effective antidepressants and antianxiety agents for many people (me included) but you'll be hating yourself when you run out.

 

[Pegasus]

If you're going to do this, stick to bupe IMO. Trying to do it with oxycodone is a very slippery slope.

Try lowering your bupe dose. Sounds counter-intuitive, but if you read a lot of experiences around here, you'll see that most people get best effects from <2mg. Nasal administration makes the effects more pronounced as well. I was on ~0.5mg nasally for a long time and felt every single dose.

 

[muvolution]

out of the frying pan and into the fire if you ask me... 1-4mg of suboxone is alot more potent than 100mg oxycodone, i think unless you start a taper quickly you will find that your tolerance has doubled from the suboxone and you may be worse off than before.

 

[NeighborhoodThreat]

^Indeed. I was going from a halfway decent hydromorphone/codone, morphine and oxycodone habit and jumped into buprenorphine, my tolerance has since gone up but at least I'm not taking any other opiates. Drop that dosage down to below 1mg and you'll notice it feels a lot more like a full agonist (and you'll notice a lot of the nausea that high dose bupe is known for will disappear). It will be much easier to jump off from 0.5mg or 0.25mg than 1mg or 2mg buprenorphine. It's a very potent opiate and just because its a maintenance medication doesn't mean its not an opiate by itself.

 

[BluMan33]

The 6 month timescale has to do with my work, which is partly project-based. If I successfully complete the stuff I'm doing now (in ~6 mos) I feel like I'll have proved myself enough to maybe ask for a month off unpaid to get my head straight (not sure why that will work).

Re: your other questions. I'm definitely chemical-dependent. I had 5 years of abstinence from illegal substances, during which I relied on wellbutrin and strong social connections. Wellbutrin stopped working and I lost friends, and have been dibbing and dabbing with different things (mainly benzos and opiates) for about 2 yrs now. I have weird reactions to many ssri and snri antidepressants, but have not tried anything outside of these classes besides wellbutrin. I'm pretty sure I was actually depressed at some point (I remember being treated for being bipolar before I ever got high for some reason??), but at this point it's hard to separate out what is what.

I've tried cbt at different points with varying levels of success. I hadn't done it in a few years before seeing the counselor at the sub clinic.

Based on your input an the input of other people here, I think I'm going to drop to ~.5mg of sub daily and stick with that regardless of whether I feel anything. That will allow me to continue to see counselor at sub clinic (they do urine checks to make sure you're on), possibly get me mildly high, and help with any temptations to fuck around (since I'll have to wait to get high). I'll figure out what to do from here after stabilizing for a few months.

Thanks for all the input, I think more than anything just needed to vent a bit to some people who understand this whole deal.

Why is 6 months your timescale? What will change in 6 months time?

A lot of people find that opioids feel like an antidepressant, at least initially, as they cushion you from the sharp corners of life and make everything more bearable, but unfortunately the effect does not seem to last and opioid addiction isn't much fun for most. I wouldn't up your bupe - chances are you enjoyed the full agonist activity you get at lower doses (from one of it's metabolites, norebuprenorphine) which isn't present at all at high doses. Buprenorphine is great for it's intended use (maintenance to replace a less safe and stable opioid habit, and killing pain) but I don't think you are going to find what you are looking for there. I certainly wouldn't move on to methadone. There is some interest in bupe as an antidepressant, but if you are already needing to increase your dose I expect it is the opioid properties that have been helping you so far...

I really do know what you mean about taking lowish dose opioids to feel "normal" and okay, but unfortunately it isn't sustainable - tolerance builds and addiction sets in. You also are in the mindset of needing *something* to get through the day, and that can be very difficult to overcome. Do you think you are actually depressed? Have you considered conventional antidepressants, or counselling, or CBT? Why is it you have slipped into the pattern of use that you have, do you think? And what is going to be different in 6 months??

(Sorry for all the questions )

 

[effie]

No worries, thank you for your full answer!

If you need some general emotional support you can try The Dark Side forum - full of lovely people who will understand what you are going through.

I understand about needing a temporary holding measure til you have the time and space to sort things out, but often things don't work out that neatly. I always thought that way too - if I can get through x then when I get to y I will fix myelf. It was my way of putting everything off..

Can you still use your CBT skills now, or don't they work at the moment?

 

[Baldwin]

I'd definitely try to stick to low dose bupe, and if at all possible, try to completely stay off benzos except for emergencies. Tapering down from bupe has always been comparatively easy for me (ymmv of course), full agonists like oxy are way more difficult to get rid off. Also, bupe has provided me with much better antidepressant effects than dope or oxys, quite remarkably so.

Regarding benzos, you really need to be careful with those fuckers, they sneek up on you and benzo WDs are a very special version of hell, even worse than opiate WDs by a long shot after all I've been told (I use them extremely sparingly, I've been through heroin WDs a couple of times, and benzos addiction seems a LOT harder to get rid off).

Half a year on bupe sounds very manageable if you've got a secure supply, especially if other traditional anti-depressants don't work well for you. Just try to not raise your dose if not absolutely necessary, and you should be able to taper off without much difficulty or discomfort.

But this is just my personal opinion, I've made great experiences with bupe, it's been kind of a miracle drug for me, so I may be somewhat biased

 

[unsettled]

I agree with effie's post, however, I'm on Bupe and I know firsthand that you can take a small dose daily and it works great as an antidepressant, just don't raise the dose. try and keep it under a milligram or two, if you can do that without upping your dose or abusing it you're potentially in a good place to be as far as opies go.

I think the oxycodone is a BAD idea, it's too easy to just want to take more and get high. Bupe lifts your mood in a subtle way and lasts forever. I have many friends who stay on bupe for the antidepressant effect.

Just be prepared, even at doses under a milligram you'll probably have some withdrawals to deal with, just use some loperamide when that time comes.

Normal antidepressants don't work for me either so I understand where you're coming from, just be careful.

Oh yeah, I'd leave out the benzos if you can or only use them when absolutely needed. I'm speaking as a clonazepam dependent person, I have a script but it's not something you want to get hooked on, the wd's are hell and it fucks with your life in subtle ways when you're on it for a long time.