![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 138 to 162 of 170. Go back in thread:
Posted by Peter S on June 29, 2001, at 10:33:39
In reply to Re: is buprenorphine legal » karen harris, posted by Elizabeth on June 25, 2001, at 5:36:20
Hi Elizabeth,
Any ideas about finding an MD willing to prescribe Buprenorphine for depression? As I mentioned in another post, my pdoc is not willing to try it out. Enoch Callaway, who wrote the article about BU, lives in the SF bay area where I live. Apparently he's no longer at UCSF and I'm trying to track him down. Any other ideas?
Thanks!
Peter
> Buprenorphine is a legal drug in the United States. It is categorised as a Schedule V controlled substance, meaning that it is considered to have very little abuse potential. However, there is a chance that if you mail-order drugs from other countries, especially controlled substances, they will be seized by Customs. With a little red tape, you can get them legally in this way, but you need to go through the appropriate annoying bureaucratic channels. If you didn't go through channels, and your order got seized, you're pretty much out of luck. (On the bright side, you're unlikely to be prosecuted for anything as a result.)
>
> Sublingual buprenorphine (Temgesic, Subutex) has a poor reputation. People who take it via the sublingual/buccal route need to take huge doses, though, and even then they report that it's not very reliable. I take buprenorphine in the solution form which *is* available by prescription in the USA and is intended for IM or IV injection. I use it intranasally, the dose required through this route being comparable to those used when the drug is injected, although it may take longer to work. I think that the pharmaceutical industry should be working on designing a metred-dose nasal spray (like Stadol NS) rather than trying to get the SL tablets approved.
>
> > A wonderful addiction specialist detoxed me with liquid buprenex. Sadly the DEA threatened his license if he contines to use it to treat addiction.
>
> At this time, it's illegal for doctors in the US to use opioids (even partial agonists such as buprenorphine, which has little if any abuse potential) to treat opioid addiction, except in special clinics. Most people in these programs use methadone (LAAM is also sometimes used), though buprenorphine is available, at least in some places (more in Europe).
>
> It is perfectly legal to prescribe opioids for pain or for other conditions (such as mood disorders). I pick mine up at a local pharmacy each month, just as my mother does with her hydrocodone/APAP prescription (for osteoporosis). Because it is only Schedule V (and not Schedule II like morphine or fentanyl or oxycodone), I can get 5 refills on each prescription.
>
> Something you might consider would be getting into a MMT program and then, whenever it starts becoming available, switching to buprenorphine (just as you used it to detox from heroin, only you could then use it for maintenance therapy). Buprenorphine has a good reputation for blocking withdrawal symptoms and cravings for full-agonist opioids. The disadvantage here is that you'd have to rely on the eventual availability of buprenorphine for this use (which is not by any means certain).
>
> A better plan might be to get a prescription for it as an antidepressant, as I do. This would be feasible, if you can stay off opioids long enough that you'd be considered to be in remission from your addiction. A number of people who take prescribed opioids for mood disorders have histories of self-medicating, but it's not considered maintenance treatment because the disorder being treated is a primary mood disorder and any substance dependence is considered to be in full remission. It is well known that some people turn to non-prescribed drugs in an effort to feel "normal" -- for these people, medically supervised treatment with related drugs is often very effective.
>
> > I had no idea it was illegal. My grandma has been ordering heart meds for years!
>
> Heart meds aren't controlled substances. The people with a vested interest in the drug-war industry feel that they have bigger fish to fry.
>
> Something that really gets to me about the anti-drug politicians' invasion of our doctors' offices (besides my feeling that the doctor-patient relationship is sacred) is that laws that limit prescription of controlled substances don't keep addicts from getting their (street) drugs at all -- they just make it more difficult for those of us who need them for pain, depression, etc., as if we don't have to endure enough suffering in our lives already.
>
> -elizabeth
Posted by Elizabeth on June 30, 2001, at 17:57:52
In reply to Elizabeth: Buprenorphine sources?, posted by Peter S on June 29, 2001, at 10:33:39
> Any ideas about finding an MD willing to prescribe Buprenorphine for depression?
Nope. Academic/research-oriented doctors are more likely to be open to it, though (the times I've needed to see a new pdoc, I've given them a copy of the Bodkin et al. paper and showed them that I already have a prescription). I'm sympathetic to your problem -- I just don't know of any sure way. You just have to be convincing, I guess; find someone who's at least open to the possibility, and show them that you can be trusted to use it properly. The trick is to make sure you don't come off looking like a "drug seeker" -- although you really can't get high on buprenorphine from what I've been told (by rec drug users as well as by doctors!), not every doctor is going to be comfortable with it (especially since you need syringes, for which they may have to write a separate prescription (I don't know the law in CA), in order to administer it -- insulin syringes should do).
Hmm...come to think of it, here's one approach: if you can track down Dr. Calloway or some other research type who's liable to be sympathetic, you could talk to them about it and they could speak to your pdoc on your behalf. I don't know if this would work, it's just a thought.
Good luck to you.
-elizabeth
Posted by jojo on July 11, 2001, at 13:47:49
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by Elizabeth on December 17, 1999, at 22:04:23
> > Elizabeth, I believe you mentioned in a few earlier posts that you were prescribed
> > Buprenorphine. Could you tell me how much the stuff costs, please?
>
> No...my insurance covered it, except for a $12 copay. You could look up an approximate price on one of those online pharmacies, though.
>
> > If I phoned a pharmacist would he tell me the price?
>
> Well, I assume so.
>
> > How much were you taking a day? What brand?
>
> There's only one brand available in the U.S., Buprenex. I was taking 1.5cc/day (0.45mg), as I recall.
>
> > _http://www.feral.org/vitality/plist_active.htm _ lists it at:
> > Buprenorphine (Temgesic) 0.2mg x 50 tabs $43.00
>
> Temgesic isn't available in the U.S. You'd have to order it.
>
> Good luck...hope it works for you, if you decide to try it.128 0.3 mg (1 ml) vials for $420
Posted by Elizabeth on July 11, 2001, at 15:29:00
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by jojo on July 11, 2001, at 13:47:49
Sorry I didn't post this earlier. I think the thread got lost somewhere.
I think it comes to about $5/cc (the concentration is 0.3 mL/cc). There is at least one generic, made by Abbott; it comes in these peculiar pre-filled syringes.
The sublingual/buccal route isn't the most efficient one, BTW. I wouldn't bother trying to get Temgesic (also known as Subutex) from overseas.
-elizabeth
Posted by jojo on July 17, 2001, at 11:23:48
In reply to Re: Methadone » Elizabeth, posted by NikkiT2 on May 13, 2001, at 16:01:26
"Yet again, i (sic) will state, by medical LAW Effexor is NOT addictive, the withdrawal symptoms are your seratonin levels re-balancing bacially (sic)."
"By medical law??? In the USA, we don't have "medical laws". We have medical texts and research papers and monographs discussing medical findings
(experience) and manufacturer's recommendations, but FDA rulings and laws passed by Congress and signed by the President are legal documents, and follow the Rule of Humpty Dumpty rather than those of science or medicine. The rule, of course, is 'When I use a word, it means exactly what I choose it to mean, no more and no less'. Hence, Congress may determine that marijuana is a narcotic and has no medical use. Never the less, in most people marijuana does not induce narcosis, and millions of people have found that it does have medical uses. Congress is free to define a word in any way it chooses. It can define the Earth as the center of the universe, but that DON'T make it so.
Posted by Elizabeth on July 18, 2001, at 0:20:51
In reply to Re: Methadone, posted by jojo on July 17, 2001, at 11:23:48
I think the "medical law" thing (I was a little confused by that expression too) was an attempt to say the following:
Effexor isn't considered to have abuse potential by the medical community. Discontinuing it can cause a withdrawal syndrome, but this is not the same thing as addiction; if it were, we'd have to consider a whole lot of people drug addicts who take antidepressants, anxiolytics, corticosteroids, antihypertensives, and numerous other common medicines.
> FDA rulings and laws passed by Congress and signed by the President are legal documents, and follow the Rule of Humpty Dumpty rather than those of science or medicine.
Well said. < g >
> Hence, Congress may determine that marijuana is a narcotic and has no medical use.
"Narcotic" is such a funny word, isn't it?
(Weird how marijuana has no "accepted medical use," while Marinol has been moved down to C-III.)
> Never the less, in most people marijuana does not induce narcosis,
"narcosis" ? (Do you mean, like, sleep?)
-elizabeth
Posted by jojo on July 18, 2001, at 22:57:12
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 18, 2001, at 0:20:51
Elizabeth- You sound like you work in conflict resolution.
RE: "Effexor isn't considered to have abuse potential by the medical community.
Discontinuing it can cause a withdrawal syndrome, but this is not the same thing as
addiction; if it were, we'd have to consider a whole lot of people drug addicts who
take antidepressants, anxiolytics, corticosteroids, antihypertensives, and numerous
other common medicines."OK, let's consider these people drug addicts. I don't think that I know what an "addict" is anyway.
If we DO consider these people "drug addicts", maybe our government will be forced to consider
their War on Drugs in a more rational way, especially if someone close to them suffers from one
of these "addictions".
Posted by Elizabeth on July 19, 2001, at 11:03:54
In reply to Re: Effexor stuff, posted by jojo on July 18, 2001, at 22:57:12
> Elizabeth- You sound like you work in conflict resolution.
Oh, not at all. < g >
> OK, let's consider these people drug addicts.
I think there's a relevant distinction. The existence of a withdrawal syndrome used to define "addiction," but now the word has a more behavioural meaning (some authorities, notably Goodman & Gilman, recommend dropping it from the medical vocabulary altogether).
> I don't think that I know what an "addict" is anyway.
I think I do. And I don't like seeing the word tossed around as an insult.
> If we DO consider these people "drug addicts", maybe our government will be forced to consider
> their War on Drugs in a more rational way, especially if someone close to them suffers from one
> of these "addictions".That's possible, but I don't think it would be intellectually honest or medically pragmatic to drop the distinction between drug addiction and pharmacologic dependence -- even though it might be politically beneficial. There are so many good reasons for dropping the war on [some] drugs, we really don't need to invent reasons. :-)
-elizabeth
Posted by jojo on July 20, 2001, at 13:19:35
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 19, 2001, at 11:03:54
"RE: "(some authorities, notably Goodman & Gilman, recommend dropping it from the medical
vocabulary altogether)."That seems to imply that they don't know what it "means", i.e., have an acceptable definition, either.
> I don't think that I know what an "addict" is anyway.
"I think I do. And I don't like seeing the word tossed around as an insult."
If it were used more, possibly to apply to everyone who is pharmacologically dependent, such as diabetics or people dependant on anti rejection drugs, it might loose its pejorative power, similar to the
emasculation ; >) of the word "fuck".If you do use the word, what do you understand it to mean?
> If we DO consider these people "drug addicts", maybe our government will be
forced to consider their War on Drugs in a more rational way, especially if someone close to them
suffers from one of these "addictions".That's possible, but I don't think it would be intellectually honest or medically
pragmatic to drop the distinction between drug addiction and pharmacological
dependence -- even though it might be politically beneficial. There are so many good
reasons for dropping the war on [some] drugs, we really don't need to invent reasons.
:-)Certainly there are so many good reasons for dropping it, but as they haven't been effectual for the past
….. what? Certainly before the death of Len Barney, around 1983, when the War was declared. Possibly since prohibition, or the passage of the Harrison Narcotic Act in 1914, or the Federal Marijuana Tax Act, in 1937. This is not about being "intellectually honest" or "medically pragmatic", it is about politics, the art of the possible. Part of that art is forcing one's opponents, and I use that word advisedly, into an untenable position, which is what I am suggesting. Anyway, what is the distinction between "drug addiction" and "pharmacological dependence"? Pleasure? Also, do you know anything of the replacement of the word "euphoria", meaning "normal mood", by "euthymic", which I guess means "not abnormal mood"? Could the meaning of "normal" be the problem?
Posted by Elizabeth on July 22, 2001, at 15:19:09
In reply to Re: Effexor stuff » Elizabeth, posted by jojo on July 20, 2001, at 13:19:35
> > "RE: "(some authorities, notably Goodman & Gilman, recommend dropping it from the medical
> vocabulary altogether)."
>
> That seems to imply that they don't know what it "means", i.e., have an acceptable definition, either.No, they say that because "addiction" has become a very loaded word with political and legal connotations. G&G uses a definition that's very close to the APA's definition ("substance dependence" in DSM-IV).
> If it were used more, possibly to apply to everyone who is pharmacologically dependent, such as diabetics or people dependant on anti rejection drugs, it might loose its pejorative power, similar to the
> emasculation ; >) of the word "fuck".Maybe, but I think it would not be clinically correct to make no distinction. I believe that there really is a separate phenomenon of "addiction" (what used to be called "psychological addiction") that is largely unrelated to substance-specific withdrawal symptoms.
> If you do use the word, what do you understand it to mean?
Pretty much the same thing as Goodman & Gilman and DSM-IV say. I can quote them if you like. Once I started studying the current medical approach to addiction, it became very clear to me that it wasn't about withdrawal symptoms or tolerance. That doesn't mean that I think drug addicts should be considered criminals; I think that's an abomination.
> Certainly there are so many good reasons for dropping it, but as they haven't been effectual for the past
> ….. what? Certainly before the death of Len Barney, around 1983, when the War was declared.I guess I'm not old enough to remember that: who was Len Barney? My understanding is that Nixon was the first president to declare a "war on drugs." (I don't see the drugs fighting back much. Although there was this article in the Onion in which it was reported that the war on drugs had ended, with the drugs as victor.)
> This is not about being "intellectually honest" or "medically pragmatic", it is about politics, the art of the possible. Part of that art is forcing one's opponents, and I use that word advisedly, into an untenable position, which is what I am suggesting.
Beating our opponents by playing as dirty as they do? I'm not really in favour of that, even if it's the only way. I think we would debase ourselves and betray our own values if we did that.
> Anyway, what is the distinction between "drug addiction" and "pharmacological dependence"? Pleasure? Also, do you know anything of the replacement of the word "euphoria", meaning "normal mood", by "euthymic", which I guess means "not abnormal mood"? Could the meaning of "normal" be the problem?
Euphoria doesn't mean "normal mood;" it means unusually high mood (e.g., hypomania or mania can be said to be "euphoric" if it's not a mixed state; some drugs, the so-called "drugs of abuse," can cause euphoria as well). Euthymia means normal mood. They're both words of Greek origin; I'm not sure what they mean literally in Greek.
-elizabeth
Posted by jojo on July 22, 2001, at 23:01:52
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 22, 2001, at 15:19:09
> > > "RE: "(some authorities, notably Goodman & Gilman, recommend dropping it from the medical
> > vocabulary altogether)."
> >
> > That seems to imply that they don't know what it "means", i.e., have an acceptable definition, either.
>
> No, they say that because "addiction" has become a very loaded word with political and legal connotations. G&G uses a definition that's very close to the APA's definition ("substance dependence" in DSM-IV).
>
> > If it were used more, possibly to apply to everyone who is pharmacologically dependent, such as diabetics or people dependant on anti rejection drugs, it might loose its pejorative power, similar to the
> > emasculation ; >) of the word "fuck".
>
> Maybe, but I think it would not be clinically correct to make no distinction. I believe that there really is a separate phenomenon of "addiction" (what used to be called "psychological addiction") that is largely unrelated to substance-specific withdrawal symptoms.
>
> > If you do use the word, what do you understand it to mean?
>
> Pretty much the same thing as Goodman & Gilman and DSM-IV say. I can quote them if you like. Once I started studying the current medical approach to addiction, it became very clear to me that it wasn't about withdrawal symptoms or tolerance. That doesn't mean that I think drug addicts should be considered criminals; I think that's an abomination.
>
> > Certainly there are so many good reasons for dropping it, but as they haven't been effectual for the past
> > ….. what? Certainly before the death of Len Barney, around 1983, when the War was declared.
>
> I guess I'm not old enough to remember that: who was Len Barney? My understanding is that Nixon was the first president to declare a "war on drugs." (I don't see the drugs fighting back much. Although there was this article in the Onion in which it was reported that the war on drugs had ended, with the drugs as victor.)
>
> > This is not about being "intellectually honest" or "medically pragmatic", it is about politics, the art of the possible. Part of that art is forcing one's opponents, and I use that word advisedly, into an untenable position, which is what I am suggesting.
>
> Beating our opponents by playing as dirty as they do? I'm not really in favour of that, even if it's the only way. I think we would debase ourselves and betray our own values if we did that.
>
> > Anyway, what is the distinction between "drug addiction" and "pharmacological dependence"? Pleasure? Also, do you know anything of the replacement of the word "euphoria", meaning "normal mood", by "euthymic", which I guess means "not abnormal mood"? Could the meaning of "normal" be the problem?
>
> Euphoria doesn't mean "normal mood;" it means unusually high mood (e.g., hypomania or mania can be said to be "euphoric" if it's not a mixed state; some drugs, the so-called "drugs of abuse," can cause euphoria as well). Euthymia means normal mood. They're both words of Greek origin; I'm not sure what they mean literally in Greek.
>
> -elizabethSorry, I'm having computer trouble, and I can't spell check this.
Maybe it was Nixon in the 70". Robert Altman (I think)
had just made the original movie of "Mash", with Donald Sutherland
and Elliot Gould. People were doing drugs, as they always have,
except that powdered coke was becoming popular as
the American "improvement" on the centuries old habit of leaf chewing,
which is still legal in Columbia, and more acceptable than the high tech, purified,
more potent, extract). Neither the media nor the politicians had yet discovered
the power they could wield with an additional War. Len Barney was a young professional
basketball player with a promising carreer, when he O.D. on coke and died.
This was the immediate precipitating factor in the War. The American government
had to do something, because, as I remember it, all these veterans were coming
back from Viet Nam, and had had wide experience with heroin and marijuana, and their experience with its
addictive qualities was somewhat different than the authoraties would have preferred, so Barney's death was the perfect opportunity to 'set the record straight' on the dangers of drugs, and get these
kids to be a little more ernest about imposing democracy on Viet Nam. We had already rejected the election
which we had agreed to when the Vietnameese kicked the French out, and these kids prefered getting high
to killing. Go figure out human nature. When Muhammed Ali refused to kill people in Viet Nam, they took away his boxing license. Told him if he wouldn't kill people, they wouldn't let him beat them up anymore.
This is getting long for my "Wordpad", so I'll have to add to it later when the other computer is fixed.
World Book Dictionary:"Euphoria":a feeling of happiness and well being. EU - good;PHORIA-well bearing, ease of bearing; good bearing.
More later.
Posted by Elizabeth on July 23, 2001, at 15:51:14
In reply to Re: Effexor stuff » Elizabeth, posted by jojo on July 22, 2001, at 23:01:52
> Sorry, I'm having computer trouble, and I can't spell check this.
It's ok; spell checking is overrated.
[Re the 70's]
> People were doing drugs, as they always have,
> except that powdered coke was becoming popular as
> the American "improvement" on the centuries old habit of leaf chewing,
> which is still legal in Columbia, and more acceptable than the high tech, purified,
> more potent, extract).Chewing coca leaves and making tea out of them is also common in Peru.
> World Book Dictionary:"Euphoria":a feeling of happiness and well being. EU - good;PHORIA-well bearing, ease of bearing; good bearing.
For clinical purposes, euthymia means good-normal mood, while euphoria means, well, a little better than normal. < g >
-elizabeth
Posted by jojo on July 23, 2001, at 18:53:09
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 23, 2001, at 15:51:14
> > Sorry, I'm having computer trouble, and I can't spell check this.
>
> It's ok; spell checking is overrated.
>
> [Re the 70's]
> > People were doing drugs, as they always have,
> > except that powdered coke was becoming popular as
> > the American "improvement" on the centuries old habit of leaf chewing,
> > which is still legal in Columbia, and more acceptable than the high tech, purified,
> > more potent, extract).
>
> Chewing coca leaves and making tea out of them is also common in Peru.
>
> > World Book Dictionary:"Euphoria":a feeling of happiness and well being. EU - good;PHORIA-well bearing, ease of bearing; good bearing.
>
> For clinical purposes, euthymia means good-normal mood, while euphoria means, well, a little better than normal. < g >
>
> -elizabethI know. I'd like to know when "They " took over the word, what is its etymology. What does "thymia" mean, anyway, and why wasn't euphoria, self descriptive as it is, acceptable? Is the language being used to hide somethings that we don't wan't to accept about this peculiar thing called "mood", which, my Clinical Psychologist friend has told me has no scientific definition, even though one can be diagnosed with haveing a Disorder of 'It'. When we try to define "mood", we're getting awfluly close to defining "Consciciousness", another word which we have carefully avoided. I think it was Nicholas Humphrey who defined "mood" as "what it's like to be ... something..., that thing whose "Mood" we are interested in.My supposition is, at the end, lies lack of Free Will, and I don't think "we" are able to accept that at the present time.
Posted by jojo on July 23, 2001, at 23:45:06
In reply to Re: Effexor stuff » jojo, posted by Elizabeth on July 22, 2001, at 15:19:09
> This is not about being "intellectually honest" or "medically pragmatic", it
is about politics, the art of the possible. Part of that art is forcing one's
opponents, and I use that word advisedly, into an untenable position, which
is what I am suggesting.Beating our opponents by playing as dirty as they do? I'm not really in favour
of that, even if it's the only way. I think we would debase ourselves and
betray our own values if we did that.I'm not REALLY in favor of it either, but if that's the alternative, I'll take it.
We (the human race) have already debased ourselves,and we continue to do so, and bring shame
to ourselves as a comunity, every day that the penal systems of the "Developed Countries"
continue to dehumanize our children and those of others (read that as all human beings). Let's start paying more attention to
the chain of events (the causes) which lead to behavior, instead of relying on Wittgenstein's non existant "Little Man Within", who knows RIGHT from WRONG, and therefore deserves to be punished
'to the full extent of the law' for his transgressions."Maybe, but I think it would not be clinically correct to make no distinction."
Medicine cannot always be "clinically correct". If I remember correctly, the few autopsies that are being carried out these days seem to indicate that it is usually clinically incorrect. Even Pathology, more of a Science than Clinical Medicine, has its built in defects. My mother had a "Pleomorphic Salivary Adenoma" growing on the base of her tongue. After it was first described, possibly a hundred years or so ago, it was found that in about 1 or 2 % of the time, it metastasized. Possibly it should more properly have been labled a Pleomorphic Salavary Adenocarcinoma", but we can't change a hundred years of Pathologic nomenclature. Similarly with a "Nevus", defined as an overgrowth of normal cells. It was thought that the pigment cells that make up the common "mole" were normal cells. They were later found to be abnormal, and were called "pigment cell nevi". A Pigment Cell Nevus is therefore not a nevus! This we can live with, but I don't think that we can continue living with the belief that "good" and "bad" choices are always made by "good" and "bad" people.
Posted by Elizabeth on July 26, 2001, at 23:18:18
In reply to Re: Effexor stuff, posted by jojo on July 23, 2001, at 18:53:09
> I'd like to know when "They " took over the word, what is its etymology. What does "thymia" mean, anyway, and why wasn't euphoria, self descriptive as it is, acceptable?
I don't know Greek. Anyone?
> Is the language being used to hide somethings that we don't wan't to accept about this peculiar thing called "mood", which, my Clinical Psychologist friend has told me has no scientific definition, even though one can be diagnosed with haveing a Disorder of 'It'.I think that moods are recognised as being real by all conscious beings, and that emotions can break down just like other bodily functions can.
> My supposition is, at the end, lies lack of Free Will, and I don't think "we" are able to accept that at the present time.
Free will, and the sense of being a "self," may be illusions, things that we experience because they're useful to us as human beings, not because they actually exist.
-elizabeth
Posted by halldor on July 27, 2001, at 2:05:37
In reply to Re: Effexor stuff [major sidetrack] » jojo, posted by Elizabeth on July 26, 2001, at 23:18:18
> > I'd like to know when "They " took over the word, what is its etymology. What does "thymia" mean, anyway, and why wasn't euphoria, self descriptive as it is, acceptable?
>
> I don't know Greek. Anyone?
>
>
Gr. "thymis" means mind or mood. The Gr. prefix "eu-" is the combining form of "eus" = "good", used in neuter form "eu"."Euthymy" is a rather old English word - now obsolete - for cheerfulness, tranquillity.
See OED. As for why "they" took over this form, I for one don't know. "Euthymia" is not in the OED, doesn't even make it to the supplement.
-halldor-
Posted by desertflower on August 9, 2001, at 16:25:06
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by Elizabeth on December 17, 1999, at 22:04:23
> > elizabeth, we had great success with buprenorphine (subutex) in France.It is fantastic and reduces pain and suffering. Do you have any idea how it can be found? Thank you.
Elizabeth, I believe you mentioned in a few earlier posts that you were prescribed
> > Buprenorphine. Could you tell me how much the stuff costs, please?
>
> No...my insurance covered it, except for a $12 copay. You could look up an approximate price on one of those online pharmacies, though.
>
> > If I phoned a pharmacist would he tell me the price?
>
> Well, I assume so.
>
> > How much were you taking a day? What brand?
>
> There's only one brand available in the U.S., Buprenex. I was taking 1.5cc/day (0.45mg), as I recall.
>
> > _http://www.feral.org/vitality/plist_active.htm _ lists it at:
> > Buprenorphine (Temgesic) 0.2mg x 50 tabs $43.00
>
> Temgesic isn't available in the U.S. You'd have to order it.
>
> Good luck...hope it works for you, if you decide to try it.
Posted by Elizabeth on August 9, 2001, at 21:04:00
In reply to Re: Elizabeth-cost of Buprenorphine ?, posted by desertflower on August 9, 2001, at 16:25:06
> Elizabeth, I believe you mentioned in a few earlier posts that you were prescribed Buprenorphine. Could you tell me how much the stuff costs, please?
One month's supply (90 mL) costs around $250 retail. (That's the generic by Abbott, not Buprenex(R).)
-elizabeth
Posted by desertflower on August 9, 2001, at 21:40:51
In reply to Re: cost of Buprenorphine ? » desertflower, posted by Elizabeth on August 9, 2001, at 21:04:00
Thank you for the info, elizabeth. You are referring to the injectable, but is it possible to order from foreign pharmacies the sublingual tablet? His doctor would write the prescriptions, and his mom would send them to us here in the US.It was great-but now we've been out of France too long, and couldn't continue under his care.
Thanks. desertflower
> > Elizabeth, I believe you mentioned in a few earlier posts that you were prescribed Buprenorphine. Could you tell me how much the stuff costs, please?
>
> One month's supply (90 mL) costs around $250 retail. (That's the generic by Abbott, not Buprenex(R).)
>
> -elizabeth
Posted by Elizabeth on August 10, 2001, at 12:12:47
In reply to buprenorphine is almost free in france..., posted by desertflower on August 9, 2001, at 21:40:51
> Thank you for the info, elizabeth. You are referring to the injectable, but is it possible to order from foreign pharmacies the sublingual tablet?
I would imagine so. I don't know much about ordering drugs from overseas, as I've never tried it myself. One thing I do know is that it's much harder to get controlled substances (such as benzodiazepines, stimulants, opioids, etc.) from overseas than it is to get noncontrolled prescription drugs. With a U.S. prescription, it's legal to import a 3-month supply for personal use, which isn't bad. If an order is mailed to you from overseas and is seized by Customs, you can pick it up if you have some sort of proof that it's legitimately prescribed. I'm a bit confused as to what kind of red tape you have to go through and what counts as a legitimate prescription, though.
> His doctor would write the prescriptions, and his mom would send them to us here in the US.
I'm not sure how legal that is. French doctor, right?
> It was great-but now we've been out of France too long, and couldn't continue under his care.
I think you could run into trouble trying to get it prescribed by an American doctor. The import option might be easier, if you can find a doctor in France who's willing to continue the prescription.
How long were you in France, BTW, and in what part?
-elizabeth
Posted by desertflower on August 10, 2001, at 13:50:41
In reply to France vs. USA: no contest » desertflower, posted by Elizabeth on August 10, 2001, at 12:12:47
> > Thank you for the info, elizabeth. You are referring to the injectable, but is it possible to order from foreign pharmacies the sublingual tablet?
>
> I would imagine so. I don't know much about ordering drugs from overseas, as I've never tried it myself. One thing I do know is that it's much harder to get controlled substances (such as benzodiazepines, stimulants, opioids, etc.) from overseas than it is to get noncontrolled prescription drugs. With a U.S. prescription, it's legal to import a 3-month supply for personal use, which isn't bad. If an order is mailed to you from overseas and is seized by Customs, you can pick it up if you have some sort of proof that it's legitimately prescribed.yes, sometimes my husband's package was siezed at customs, and we would have to fax a copy of the prescription to this guy at JFK, who would then clear it! Yes, his French doctor was prescribing the meds for him, and now it is part of a maintanence progrmam, though which is about to end, because the doctor in france couldn't continue.
I'm a bit confused as to what kind of red tape you have to go through and what counts as a legitimate prescription, though.
>
> > His doctor would write the prescriptions, and his mom would send them to us here in the US.
>
> I'm not sure how legal that is. French doctor, right?
>
> > It was great-but now we've been out of France too long, and couldn't continue under his care.
>
> I think you could run into trouble trying to get it prescribed by an American doctor. The import option might be easier, if you can find a doctor in France who's willing to continue the prescription.
>
> How long were you in France, BTW, and in what part?
>
> -elizabethI was in france one year- but he is a frenchman, so he has always been there, right outside of Paris. Today we talked to his primary care physician who said he can't even give him bupe for depression, and the only alternative is to go into a methadone clinic. I told him my husband is not using drugs, and a methadone clinic is not what he needs. He is functioning perfectly well with subutex(buprenorphine) and needs to go to work everyday! He apologized, and said there was nothing he could do. Try Scandanavia, he said. Right.
Posted by Elizabeth on August 10, 2001, at 17:17:11
In reply to Re: France vs. USA: no contest, posted by desertflower on August 10, 2001, at 13:50:41
> Today we talked to his primary care physician who said he can't even give him bupe for depression, and the only alternative is to go into a methadone clinic.
"Can't" is a strong word. "Won't" would be more accurate -- a doctor *can* prescribe buprenorphine for any condition *except* opioid dependence. It's arguable, though, that your husband is being treated for opioid dependence.
That said, a GP is very unlikely to prescribe buprenorphine for depression. You might have more luck with a psychiatrist. Take a look at the following article:
http://balder.prohosting.com/~adhpage/bupe.html
The primary author is the doctor who originally suggested buprenorphine to me.
> I told him my husband is not using drugs, and a methadone clinic is not what he needs.
Well, he is being treated for opioid addiction, so I can see their point. The question is, if he went off buprenorphine, became depressed, and sought treatment without a relapse of his former addiction, would it be reasonable to reinstate the buprenorphine treatment?
It's a curious situation. I'll ask my ethics consultant. < VBG >
-elizabeth
Posted by desertflower on August 10, 2001, at 20:56:24
In reply to Re: France vs. USA: no contest » desertflower, posted by Elizabeth on August 10, 2001, at 17:17:11
> > Today we talked to his primary care physician who said he can't even give him bupe for depression, and the only alternative is to go into a methadone clinic.
>
> "Can't" is a strong word. "Won't" would be more accurate -- a doctor *can* prescribe buprenorphine for any condition *except* opioid dependence. It's arguable, though, that your husband is being treated for opioid dependence.Exactly- he is seeking treatment,the only one he knows, for maintenance. I would honestly say, though, that though his dosage was minimized gradually over time, he has a bit of a psychological addiction to it.
>
> That said, a GP is very unlikely to prescribe buprenorphine for depression. You might have more luck with a psychiatrist. Take a look at the following article:
>
> http://balder.prohosting.com/~adhpage/bupe.html
>
> The primary author is the doctor who originally suggested buprenorphine to me.Yes, I will speak to a psych. about this next Thursday.
>
> > I told him my husband is not using drugs, and a methadone clinic is not what he needs.
>
> Well, he is being treated for opioid addiction, so I can see their point. The question is, if he went off buprenorphine, became depressed, and sought treatment without a relapse of his former addiction, would it be reasonable to reinstate the buprenorphine treatment?
>
> It's a curious situation. I'll ask my ethics consultant. < VBG >
>
> -elizabethFor some reason, I am guessing you are either a med student, or a doctor interning-your knowledge is impressive!
desertflower
Posted by Elizabeth on August 11, 2001, at 12:16:46
In reply to Re: France vs. USA: no contest, posted by desertflower on August 10, 2001, at 20:56:24
> Exactly- he is seeking treatment,the only one he knows, for maintenance.
Personally I think it's much better for to use buprenorphine if it suffices, rather than methadone.
> I would honestly say, though, that though his dosage was minimized gradually over time, he has a bit of a psychological addiction to it.
What do you mean?
> > http://balder.prohosting.com/~adhpage/bupe.html
>
> Yes, I will speak to a psych. about this next Thursday.I'd suggest printing out a copy of the article.
> For some reason, I am guessing you are either a med student, or a doctor interning-your knowledge is impressive!
Well, thank you. I'm glad if I could be of help.
-elizabeth
Posted by skeet on October 17, 2001, at 0:40:28
In reply to Re: France vs. USA: no contest » desertflower, posted by Elizabeth on August 10, 2001, at 17:17:11
hi there i seen ur post on buprenorphine..and depression..Im sure its ok for depression side but im on 3mg..daily..and take zoloft too..for panic disorder.the bup doesnt take that away at all..and depression is due to being limited.through panic..If depression is ur primary condition cant you take zoloft? luv/peace freshman
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