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Pharmacological options in the treatment of addiction

Sorry medievel, but until you get that you're talking about working on short-term tolerance and craving-reduction, and NOT addiction, I don't really know what else to say to you. This thread is about addiction, and you're not even remotely in a spot to be saying whether these help ADDICTION, you can only speak to between-binge efficacy, and even if you don't believe your biased here, I can assure you that you are - it's a fact and it's the reason we use things such as placebo's and double-blind approaches when doing real efficacy testing.

This just seems like partII of your other thread.
 
I cant stop taking amp when i have it, even when i got such severe vasoconstriction and looked blue wth signs of necrosis at some stops i took more amp after wards after i managed to get it under control with vasodilators (didnt call the fucking hospital as i just wanted to get high again) then afterwards what did i do? pop more amp and make matters worse, and i kept doing simula r things over and over again when ly body was in a extrelely bad shape.

I couldnt stop taking it and thus i feel qualified for this discussion.

The only difference with a true addict is the inability to get a constant supply (and thus not physical adiction) and that i never had a single tolerance issue on memantine.

My problem is a problem for many ppl suffering from addiction, so starting my log here IMO will be of definate help.
 
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Perhaps a rule..................no posting while high on stimulants. Correct me if i am wrong, but a significant amount of ADD contributers or former OD contributors (B.A.D., before advanced discussion) appear to 'drug of choice' of either opioids or depressants. This is not to say that we are not interested in stimulants, psychedelics etc.........it simply does not seem to be the DOC. Feel free to correct me if I am wrong, because I frequently am, and made a rather broad assumption. But honestly................opioids are, as they once said "Gods own Medicine".

The nature of stimulant addiction is far different in nature than that of opioids or depressants. I suppose I have been dependent on stimulants, but never experienced withdrawal consisting of anything more than a transient lethargy.

Back to my point, don’t post whilst high on stimulants.

The true bottom line is that there is no "pharmacological" means to treate a dependency that is not physical in nature (yes i know, all things are inherently physiological, etc). All i can say, is that narcotic replacement tnerapy is, statistically the most 'effective' means of treating an opioid addiction. I believe an opioid addict who does NOT have chronic pain and has been treated for underlying psychiatric disorders should be given as much methadone (or if prefered bupe, though i recommend pure agonists despite risk of fatal overdose) as wanted. The addict, especially if young, will grow weary eventually.............I've seen it happen time and time again. This may be of little help but hey...........

The future for treating addictive behaviors in general is not entirely pharmacological. Like it or not gene therapy is the future.......a brave new world of sorts..............
 
negrogesic said:
Perhaps a rule..................no posting while high on stimulants. Correct me if i am wrong, but a significant amount of ADD contributers or former OD contributors (B.A.D., before advanced discussion) appear to 'drug of choice' of either opioids or depressants. This is not to say that we are not interested in stimulants, psychedelics etc.........it simply does not seem to be the DOC. Feel free to correct me if I am wrong, because I frequently am, and made a rather broad assumption. But honestly................opioids are, as they once said "Gods own Medicine".

The nature of stimulant addiction is far different in nature than that of opioids or depressants. I suppose I have been dependent on stimulants, but never experienced withdrawal consisting of anything more than a transient lethargy.

Back to my point, don’t post whilst high on stimulants.

The true bottom line is that there is no "pharmacological" means to treate a dependency that is not physical in nature (yes i know, all things are inherently physiological, etc). All i can say, is that narcotic replacement tnerapy is, statistically the most 'effective' means of treating an opioid addiction. I believe an opioid addict who does NOT have chronic pain and has been treated for underlying psychiatric disorders should be given as much methadone (or if prefered bupe, though i recommend pure agonists despite risk of fatal overdose) as wanted. The addict, especially if young, will grow weary eventually.............I've seen it happen time and time again. This may be of little help but hey...........

The future for treating addictive behaviors in general is not entirely pharmacological. Like it or not gene therapy is the future.......a brave new world of sorts..............
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Amphetamine is my drug of choice and while i agree stimulants havent got the same withdrawal problems as downers, i had severe healthproblems and i keopt taking amp DESPITE KNOWING it will make me feel WORSE and not high.

This is purely caused by drug adaptice changes causing severe craving and compulsion to keep on taking. (this particular issue).

In other cases ppl cant get out of sever withdrawals and so forth, there's no unified theory of addiction.

The true bottom line is that there is no "pharmacological" means to treate a dependency that is not physical in nature (yes i know, all things are inherently physiological, etc). All i can say, is that narcotic replacement tnerapy is, statistically the most 'effective' means of treating an opioid addiction. I believe an opioid addict who does NOT have chronic pain and has been treated for underlying psychiatric disorders should be given as much methadone (or if prefered bupe, though i recommend pure agonists despite risk of fatal overdose) as wanted. The addict, especially if young, will grow weary eventually.............I've seen it happen time and time again. This may be of little help but hey...........
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I agree completely its an highly effective treatment, wheter there's nothing better? probably not, but i beleive medications blocking tolerance combined with substances that target all pathways involved in addiction is the way to go, atleast something that would be highly effective. How effective? We dont know, i have issues and log ir fr my own issues, id gladly see more severe addicts try this aprouch long term and then we know how good it works.

About not posting on my doc, yes my "incredible results" was perhaps a bit too manic but the results were drastic, however it could indeed still be placebo.
 
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I havent really made my standpoints clear enough in this thread, i'm gonna prepare a big post on that.

(I also beleive replacement is excellent, dexamphetamine for meth addicts, buprenorphine for opiate addicts and so forth)

My own regime is nothing more then targetting several pathways of addiction combined with replacement (or in my own cause juse my therapeutoc doses).

While what is being researched one med targetting A3B4, another med that modulates glutamate a bit etc, polypharmac is imo the key, and i beleive with that we can have drastic succes.

My own issue is nothing compared to that of other "true" addicts but addiction can go as far as ppl taking drugs in situations that could kill them (symptons resembling myocardial infarctions).
Impulsivity, compulsivity and drug cravig are major issues for me, cant i fit in the thread then because i lack tolerance and withdrawal issues?
 
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In the US, dexamphetamine or even desoxyn is NOT kosher to prescribe for addicts. In fact, doing so is legally a vry grey area. Amphetamines are, across the board neurotoxic, but i am personally not adverse to prescribing d-amp for meh addicts. It can be (and is) easily done by using ADHD as the Dx, but is not indicated for maintenance and will draw strong controversy if prescribed for maintence. Fortunately, i am not a psychiatrist so I don't have to deal with. But my sympathy extends to all pf those battling addiction/self-medication, but in the US, our hands are tied..................
 
Aphetamine neurotxiticy cant be worse then treading ADHD patients on a lifelong basis, but thats another discussion.

The point of my thread is using polypharmacy for addiction wich IMO we can achieve extremely high succes rates for.

I also dont beleove behaveral issues are a cause of addiction, atleast not directly if someone's brain is prone to addiction, then he's behavor makes all the difference however it all goes back to the brain IMO.

Will elaborate later
 
Agreed, I've seen obscene doses of mixed salts amphetamines prescribed indefinitely for ADHD.


On a lighter note, we lost a 13 year old girl this morning during a routine appendicectomy. Man maybe im still too green but that shit still gets to me, time to break out the nitrous oxide......
 
MeDieViL said:
Aphetamine neurotxiticy cant be worse then treading ADHD patients on a lifelong basis, but thats another discussion.
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I think you mean "acute amp-administration's neurotoxicity can't be worse then - - -", and I'd disagree. The body can handle small, regular amounts of things that it simply cannot handle large, single doses of (a simple example is apap/acetaminophen, but radiation and a billion other things fit here as well).

MeDieViL said:
The point of my thread is using polypharmacy for addiction
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It seems you've set out for that, but are still at the tolerance/between-use 'phase' here.
(I know you're familiar with the term/definition of "addiction", so I'm having trouble with this miscommunication. It's almost like you're using the terms "addiction" and "tolerance" interchangably to suit your need in the post.

MeDieViL said:
I also dont beleove behaveral issues are a cause of addiction, atleast not directly if someone's brain is prone to addiction, then he's behavor makes all the difference however it all goes back to the brain IMO.

Will elaborate later
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Behavioral issues ARE the cause.
Brain chemistry and prone-to-addiction ARE the causes.

Behavioral issues have a seating in neurochemistry. We're puppets to our genetic makeup, well, that and our environment (nature/nurture). But, that's delving outside of this discussion. In this paradigm, for all practical purposes, there's no point in trying to seat the initial behavior in neurochemical terms (ie "addictive personality"'s chemical-factors). Once chemicals are introduced, sure, introduce neurochemistry, it's required, but we've already done/are doing that.
 
negrogesic said:
Agreed, I've seen obscene doses of mixed salts amphetamines prescribed indefinitely for ADHD.


On a lighter note, we lost a 13 year old girl this morning during a routine appendicectomy. Man maybe im still too green but that shit still gets to me, time to break out the nitrous oxide......
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Sry dude :\
>>edit - that isn't a lighter note :( <<
 
It seems you've set out for that, but are still at the tolerance/between-use 'phase' here.
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Ive been out that phase for a year now, i did get tolerant to stuff because of running out of memantine, so untill i have that back i dose higher to get the same effects.

If i have a stimulant in pocession intendet for therapeutic use i will binge on it (with no increase in tolerance at all, can binge for 5 days and then the next day take 5mg dex wich worked as well as my first 5mg dex, but it never stays at those doses). I need therapeutic ADHD relief but i cannot stop myself from taking more then i planned too.

If i do take drugs to get high i have on a shitload occasions overdosed because i compulsively keep taking more even if i dont need anything anymore leading to a extreme heartrate and severe paranoia making the experience unpleasant.

If i want to get high and i get severe healthproblems i dont give a shit and only think about taking more instead of calling the ambulance in a situation where i had symptons i needed to.

If you think this is just tolerance and craving we do have a misunderstanding phase, you also seem to beleive that one phase DIRECTLY goes to another one, its not as simple as that.

All those issues are issues in addiction and my log is certainly relevant in this thread.

I will answer your other questions in a bit.

What i pmed to SangerRainsford:
I was sleep deprived and completely fucked in the weekend, because i dont want to stop drugs in the weekend, i want to be able to stop my compulsive binging on amphetamine once i have it, its only 2 or 3 weeks per months i have it, but all i do then is listen music and sit behind my computer and i cant control not taking more amp, this is why i call my issue addiction.

benzo's but i usually dont sleep for several days a week when i have my amp in pocession, i wouldnt want anything for sleep as i want to get high more and stay up!

If i had to force myself to sleep ambien works, but not at the max dose or something, i keep popping them like tic tacs till i fall asleep.
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Im tolerance protected thx to memantine and all my drugs keep working(a binge on GBL and amp then) without any dose escalation that is needed, there is a withdrawal with the amp but gbl reverses it and i take that everyday so no issue, due to me allready succes in tolerance those things didnt lead me to where other ppl would go.
 
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I dont think we should make this thread strictly about true addicts, addiction is a multitude of factors and disussing those seperately is a great part of this discussion, for example someone that stopped drugs but just wants to stop craving then id be interested in what drug or combination made the craving go away and wheter its possible without substitution etc.

The reason i dont give a shit about GBL right now is because of substition (baclofen and possible ami agonizing the ghb receptor, but i dont see any difference to that with meds that fix it in another way, this discussion is about pharms that work against addiction, i dont give a fuck wheter its substitution or not.

Ive been taking GBL on and off daily since 2008, the off weeks was usually because i allways ordered to late, i take 100ml a week however i dont want to get rhid of this, it enhances my life, i'm not physically addicted at all (why not? not dosing is 24/7 NEVER for sleep, i dont have any tolerance issues at all, same effects as initially (untill i ran out of memantine but i still dont get physically addicted).
 
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On the miscommunication, I'm not saying that someone just goes through one phase to reach the next. I'm saying that addiction almost always includes physical tolerance and physical dependence, BUT that people can have physical tolerance and physical dependence w/o having addiction.
And this is definitely about tolerance/dependence, not addiction. I definitely understand that addiction is present, and that fixing tolerance and/or dependence will help with said addiction, but the approaches we're talking about are only the beginning step for addiction.
I think there was confusion because of the fact we had been discussing addiction itself, and are now focusing on a specific part of addiction (tolerance and/or dependence - you seem to have low tolerance, but the dependence is psychologically there, yknow?)
 
MeDieViL said:
I dont think we should make this thread strictly about true addicts, addiction is a multitude of factors and disussing those seperately is a great part of this discussion, for example someone that stopped drugs but just wants to stop craving then id be interested in what drug or combination made the craving go away and wheter its possible without substitution etc.

The reason i dont give a shit about GBL right now is because of substition (baclofen and possible ami agonizing the ghb receptor, but i dont see any difference to that with meds that fix it in another way, this discussion is about pharms that work against addiction, i dont give a fuck wheter its substitution or not.
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I don't think it is strictly about addicts, nor do I think it should be - I think we just had some confusion on the terms there, we went from addiction to a specific factor of addiction, but I agree that factor is integral to the greater picture here w/o question.

And re substitution, it is a very important factor. Taken to an extreme, if substitution doesn't matter, then one could "solve" their coke addiction with crack, one could 'solve' their codeine addiction with heroin. Substitution may help a ton, and may be worlds better for the patient. However, and this is subjective to a degree, when replacing one chemical with another one should look at the new chemical *completely* objectively and ask if there's an addiction. If I needed 1g of oxy daily, and am now on 0.0001mg of bupe, I would still consider myself an addict since I NEED my daily bupe, if that makes sense. Most would not go so far as that, and obviously that's just an extreme example, but it should illustrate why substitute/maintenance drugs must be acknowledged here.
 
Taken to an extreme, if substitution doesn't matter, then one could "solve" their coke addiction with crack, one could 'solve' their codeine addiction with heroin.
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I mean substites where the person feels sober, i just feel anti anhedonia and a mood boost froml the ami and baclofen combo which completely cured my GBL craving, i was never physically addicted tough, but you get my point.

If you arent high after a certain degree, then you just are dependent on a substance, and not an addict anymore.

I NEED my regime too, even tough i'm not dependent, if i didnt take it today all my amp would have been gone today, now i just feel satisfied on a therapeutic dose.
 
If you're saying "substitutes where the person feels sober", then someone who manages a steady habit of any sort isn't an addict so long as they get their daily dose and don't binge, right? Most any definition of addiction disagrees with that. Addiction is the inability to stop compulsive usage, and most people need to go through the uncomfortable period and experience that before being sober, and eventually, conquering addiction. Just feeling sober isn't much more than 'maintenance', at best.
/anti-anhedonia? Like "euphoria"? Anhedonia's a bitch, arguably worse than depression, but that's prolly veering off-topic ;PP
 
In response to your question - yes, in the immediate effects of the small dose, my impulsive cravings have been suppressed. I realize that if I really thought about how opiates make me feel, I would want to take them, but in this state the cravings were almost primal in being the only way to fix my then current mood, which was lethargic and apathetic.
 
kmatrixg said:
In response to your question - yes, in the immediate effects of the small dose, my impulsive cravings have been suppressed. I realize that if I really thought about how opiates make me feel, I would want to take them, but in this state the cravings were almost primal in being the only way to fix my then current mood, which was lethargic and apathetic.
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Baclofen COMPLETELY supresses my craving for GHB, atleast in combination with amisulpiride (witich is a GHB agonist) and my other anti addiction meds, i have it at home and know it will make me high but i dont even bother taking it, i beleive can be COMPLETELY cured with pharmaceuticals. Good luck, i have made a full list of all meds with effiacy, i beleive a combination of several pharmeceuticals targetting differend pathways is the key and that way you would completely prevent relapse.
 
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