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Using opiates for anxiety and depression?
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Using opiates for anxiety and depression?

So I have had pretty serious anxiety and depression issues for as long as I can remember. I am 22 years old, and I have spent everyday of those 22 years obsessing over things that are completely out of my control. I have been diagnosed/misdiagnosed as having multiple disorders; GAD, agoraphobia, borderline personality disorder, and finally as manic depressive, which I think is the most accurate.
During college, I saw multiple university mental health doctors, most of whom just offered me a bottle of xanax, clonopin, or ativan and sent me on my way. Among these meds, I have also tried: lexapro, paxil, zoloft, seroquel, lamictal, xyprexa, buspar, and welbutrin. Currently I am taking depakote er, which actually seems to be working fairly well. It makes the anxiety bareable, but doesn't do much for my depression.
However, there has always been one thing that has relieved all my symptoms; pain medications. First I would like to say something that Im sure everyone knows; these medicines are very addictive and should not be abused. Unfortunately, they are the only things that work for me. The make me completely calm and relaxed, and not wozy and out of it like benzos do. I have never tried to obtain them illegal or without reason, but have come to this conclusion on occassions when I have been given them for legitamate pain. I am curious to know if someone can offer any scientific or medical explaination as to why opiates are so effective. I am also curious whether there are any anxiety medications that incorporate opiate therapy.
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Avatar_n_tn
What opiates are you taking?
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Avatar_n_tn
i have taking vicodin and percocet in the past. I am not taking anything currently.
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Avatar_n_tn
Not to my knowledge.  My mom is bipolar and she does the same thing you do.  She has been on all the meds you have listed.  Have you been on Lithium though?  Anyway, she seems to like opiates better than anything, but she gets into ALOT of trouble with them:  buying from neighbors, jail for one week, was locked out of the pain clinic, doctor shopping, pharmacy shopping, etc.  I feel sorry for her, so bad, but on the other hand, I have anxiety and depression and I just stick with benzos and antidepressants (lowest dose possible).  I have to say, I have anxiety/depression issues all the time, but I try to forge through them and use as many coping strategies as possible.  My mother is fried from years of drug use (never non-prescription either) and I don't want to end up like her.  Be careful about those opiates, you may end up miserable if you depend on them.  Give yourself the allowance to feel a little bad/jittery some days.  A lot more people are doing the same thing at the same time and feel the same way we do, so try to remember that you aren't alone.  Try to be as positive as possible - I am working on it, so I am no guru on how to fix it, but I am just speaking from personal experiences.  Take care!
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Avatar_n_tn
Why do you think people become heroin addicts?  It's an opiate for christ sakes.  If it were legal & acceptable why would anyone walk around without it?  Drugs, especially opiates give you that feeling where you just don't give a ****.  Unfortunately honey, it's not reality.  
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Avatar_n_tn
Hi. I have done the exact same thing as far as seeing University Doctor's and having them precribe me benzo's that do not work. What's weird is that some benzo's make me feel like I have the flew where your body is aching all over.  I am diagnosed with BPD, Panic disorder and Bipolar II disorder and am currently taking Lamictal, Prozac and Lyrica for sleep.  I am also taking percocet for the horrible panic episodes that I have because that seems to work as well for me.  I think I know why this works for some people.  In an article that I read a couple of years ago,(unfortunatly I lost it) they said that the brain produces it's own morphine. Some people's brain are actually deprived of that which is why we need opiates to feel normal and balanced.  If I find this article again I will post it.
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Avatar_n_tn
It seems to be the only thing that makes me feel stable and normal. I am very productive on opiates as well; not manic - like a lot of adderall (adderrall), but really levelheaded  and calm-  not drowsy-  just the way I think you should feel-   probably what most 'normal' stable feel like when they wake up.  Tried everything else-  its the only thing that works for me.

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285332_tn?1196558035
Well let me say this. I also have MAJOR anxiety issues. But I am also currently heavily addicted to percocet. I was prescribed them for pain from a car wreck and have been on them steadily for at least 2 years.

Its funny you say that about how you feel "pain killers" help you cope with the anxiety issues because at one point I THOUGHT the same thing. I even said to my doctor, "man these things really are helping my anxeity"...well WATCH out!!!! If you feel that way and start using these drugs your anxiety WILL increase 10 fold....What will happen is, sure, you'll feel "good" for a while because of the opiate but its all diguising and hiding the anxiety by making you "feel good" Then before you know it, you take more then viola, you're addicted to opiates.

Now you think anxiety is bad now? wait untill your heart skips beats and you face goes numb and all these adverse side effrects start happening to you and here comes the onslaught of anxiety caused by the opiates. Then when you'll find yourself WORRYING about:

How am I going to get off these?
How am I going to work and make a living using these pills?
How am I going to sleep at night?
How bad are the withdrawls?
How sick am I going to be?
How much damage did I do to my body?

You get instense headaches, cant go to the bathroom(constipation) they rob your brain of ceretonin(not sure how to spell) dizzyness, and on top of that WILL do damage to your body organs. Then your motivation level drops and even more depression sets in. More stuff to "worry" about

and the list goes on and on and on. You'll find yourself running out of your pills to early because you'll take them to often, and when I say "you" I mean in general, not actualy "you", I dont want to come across that way. You'll find intense headaches and pain caused by the same pills that are sopposed to stop that.

I find now, in my situation, these pills at first yeah I thought they were sub-siding my anxiety but in the end they cause more because now I still have the anxiety and now have to face the battle of fighting a mental and physical addiction to these pilss, the devil.

I'm telling you this because I dont want more people to fall into this trap with these pilss, they are NO GOOD, the do NO GOOD, they are EVIL aqnd NOT the answer to anxiety. I hope this post will be read by you and I truely hope it steers you away from them as a treatment for your issues. I hope you come out on the winning end, we're all here to help and intervene with. good luck to you....
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285332_tn?1196558035
I know its a lower level drug but Valium and Xanax seem to be great treatment for anxiety...I've been put on Paxil and Zoloft and Buspar and all those "anti-depressives" to me thats the doctors just writting off scripts to get paid from the pharm. companies...

next time you go into an office look at all the "promo" stuff there is for all these meds....doctors use the anti-depressants on people as if you're being tested. its like a science test to see IF and only IF it'll work for you jumping from anti d to anti d and guess what, you STILL find yourself in intense panic attacks and anxeity.

I'm sorry but the linkage between anxiety and depression makes not a whole lot of sense to me as I dont really feel that my anxiey is brought on from depression. Yes I have bouts with depression but I dont thing that brings my anxeity....Worry about health and money and paying bills are a big mainstay of causes of my anxiety. maybe I'm just speaking on behalf of myself.

Try getting a strong dose of Valium....when you feel an attack coming, take it, it works for me hopefully you guys as well. and its HIGHLY less physically addicting....and its only 1 pill to deal with. let me know what you guys think about this? hope it helps :)
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Avatar_n_tn
as a former opiate addict ( or rather let me rephrase, chemically dependent on opiates) I must respectfully disagree with some of what you said. I realize that your experience may have been very diff from mine. i have suffered crippling anxiety attacks for years. My boyfriend will come home to this day and find me on the floor crying because im terrified and cant breath...happened just last night.i have recently been diagnosed with ADD and OCD as well as major depressive disorder and anxiety. Opiates were the ONLY THING THAT EVER EVER made me feel normal...or what i think normal is supposed to feel like, I could work, I could go to college, I could keep appointments and multi task, I had my creativity again, I could function socially for the first time in my life and my panic attacks were few and far between. Once I voluntarily withdrew from opiates and began therapy....all that is GONE. AND I MEAN I FEEL WORSE THAN I EVER HAVE. My phychiatrist has tried zyprexa, seroquil, nuerontin....im already on xanax and have been for about four years....but I feel like I am going crazy. Nothing helps me feel any joy even though I do take celexa as well. So now that Im off of opiates I have lost my TWO jobs because I cannot funtion, have gotten into a car wreck because Im completely out of sorts, cannot go outside because of my anxiety....cannot sleep.... so please know that  I have been through the opiate phase of self medicating for years and have been off of them as well for a good amount of time...and I have secretly suspected all along that the opiates were the thing tht made me feel normal. they did not get me high. they got me to a point where i could function....so I completely feel for the people  on this board that have said the same thing Im saying.......sorry for the long reply
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Avatar_n_tn
I have seen both sides of the opiate issue.  I have been on too many psych meds to list here to help with depression and anxiety I have suffered for many, many years.  About 8-9 years ago I suffered a compression fracture of T12.  Upon taking opiates for pain I noticed instant relief from my depressive symptoms that I had never experienced through numerous meds and years of therapy EVER before.  After several years of opiate use for back pain I had become physically dependent on opiates.  They are difficult to stop in the short and long term.  I started reading about opiates and all of the horror stories from those who became addicted freaked me out.  I was convinced I had become an addict even though my prescription remained the same, I did not take more than my daily allotted dose, I never Dr. shopped, and did not run out early.  It turns out I am not an addict in the traditional sense.  I tried Wellbutrin to see if I could mimic the increase in dopamine receptor firing, but it only agitated me.  I have now been on opiates for my pain for over 8 years and still get the benefit of having my depressive symptoms, which in the past were debilitating, kept at bay or nonexistent.   Is it a great idea?  Maybe not, but opiates have changed my life for the better.  Opiates do alter brain chemistry in multiple ways as do SSRI's, SSNRI's, etc.. My opinion is that they seem to be better understood in their action than many of the newer meds that "are believed to work by" descriptions in their explanation of the way they work.  I will say that using opiates for depression is not something I would recommend, but they have worked for me.  I have a great support and monitoring system in place though.  I work in health care and have seen many people become addicted and opiates have made their lives worse.  I do not like the fact that opiates cause such a strong physical dependence, but I have been able to keep my use of them under control for many years.  If I would ever have to stop taking them, I imagine it would be difficult after reading about post acute withdrawal in combination with my mulitple diagnosed depressive disorders.  I have also read about many people having a problem getting off psych meds or even meds for BPH too.  Who knows what the answer is.  Opiates can be an evil drug for those with an addictive nature, but I also believe that I may not be here today if it were not for the way opiates have worked for me.  I would try everything and anything else first.  If a Dr. does prescribe, I highly recommend an agreement be arranged between the M.D., the pharmacy, and family.  
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Avatar_n_tn
I should mention there have been 2 occasions in 7-8 years I've run low due to stupidity, other than that, I find if I stay on schedule I do well and do not crave.  Discipline is needed and realize that the extra pills on some days makes you run short on your script.  It does take some discipline though.  Last time I ran short I posted my experience and I just make sure to stay on schedule.  No depression and no withdrawal due to stupidity.
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1041243_tn?1375234120
My biggest suggestion is go to the addiction page on this site and you can read all about what these drugs really do.There is a reason why drs done prescribe opiates as anxiety meds. Long term use even as directed WILL cause liver problems, kidney problems, changes in your brain chemistry which causes post accute withrawl syndrome and can last up to.two years (I'm going through it from alcohol, no fun), death to brain cells that control thought (that's why people who use these drugs for years hallucinate and hear voices). It can cause other permenent problems too including addiction to harder opiates (yes this means herion). I was in rehab with people who went through this and you folks who are doing this have no idea what your playing with. You've never bought it off the street...yet. You haven't dr or pharmacy shopped...yet. You haven't spent your family savings...yet. You haven't sold your body for it...yet. These things WILL happen, it's only a matter of time. Addictive drugs are nothing to play with and if you do you're playing with fire.
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1156856_tn?1262428193
I'm 18 and for a few years I have suffered from severe anxiety and depression.. which i think the depression comes from the anxiety since that's what stops me from doing what i want to do in life. This article really makes me feel less alone, i relate so much.
I'm young but i've never liked drinking, smoking pot, etc.. but realized the one thing i really liked were opiates, i would abuse them through high school and off and on for the last 2 or 3 years.. but i never felt addicted. I just loved feeling myself for once and everything was so much better. Currently i'm on xanax ER & xanax IR, they help with the physical effects of anxiety but never get me out of this slump i'm in. Moving on, my step mother is prescribed to a VERY strong opiate, 10 mg oxymorphones.. i started taking them to get a high at first but then came to realize how they made my anxiety/depression DISSAPEAR. The problem i'm having is, i have felt the withdrawals from abusing these pills, i have good self control and it helps that i'm not someone who's looking to get "****** up" all the time. My big question is, if i was to use very small amounts of the opiate to get through only my toughest anxiety attacks, which come at around this time (starting college , looking for a job) and other big events, then weaned myself off after i felt more comfortable with everything, would that be ok? like i said, i'm not looking to get messed up and i have very good self control.
sorry for such a long post & thanks SO much.
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Avatar_m_tn
The use of opiates / opioids for anxiety and depression has been suggested by many doctors and psychiatrists for decades.

As a matter of fact, my mother's psychiatrist offered her Lortab(hydrocodone/APAP) for her anxiety, but she didn't want them because they upset her stomach.

Ask your doctor and / or psychiatrist if they can subscribe some kind of opiate.  It can't hurt to ask because SOME psychiatrists have already begun subscribing narcotic pain meds for anxiety.
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Avatar_n_tn
I can tell you what I have learned from my psychopharmacology class I am currently taking.  Opiates and benzos are both CNS or central nervous system depressants.  There many types of opiates some more addictive than others so hopefully the opiates you have taken are the less addictive kind.  The opiates help deal with anxiety reduction because they bath the limbic system of the brain, most importantly the amygdala gets a good dose of anxiety reduction.  The limbic system is very complicated, but in a nutshell it is where many of our emotions come from.  The amygdala is the fear center of the brain and this in turn is where much of your anxiety comes from.  Additionally the depatoke you are taking is a mood stabilizer and is well known to help bipolar disorder also called manic depressive disorder.  You may have found that doctors won't prescribe you benzos for too long that's because the drugs that help most with panic disorders are also very addictive.  The best methodology to help with panic disorders may be to prescribe you a benzo at first for imminent panic attacks, but long term therapy is best in handling it.  Additionally you may want to do some research on lithium for bipolar disorder.  Lithium has been shown to be highly effective in reducing the number of manic episodes experienced from bipolar disorder.  The catch is you need to get your blood checked regularly when you are on lithium to find the right dosage and maintain the right dosage for you.  You should also know that you always need to keep very hydrated when on lithium because if you become dehydrated the toxicity of lithium could become dangerous.  Hope that helps you.
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Avatar_m_tn
I have been through the feeling normal only on opiates because the anti depressants did not work, injury, long term use and abuse of any pills I could get my hands on, to full blown addiction. It landed me right in a methadone clinic, which I was told I would have to go to for the rest of my life. I went for 2 years, got my take home doses like a good little junkie, and got thoroughly sick of the whole thing. I started splitting my doses, and eventually had enough to detox myself by cutting back in increments week by week. It was the hardest thing I have ever done, but it was soooo worth it. I am now 2 years using pain meds only under doctor's supervision. The thing is now, I have cirrhosis, and will not live more than a couple more years at best. Please, please, anyone taking large amounts of percocet, vicodin, loratab, anything with acetominiphin or anything found in OTC pain meds, have your liver checked regurlarly. These things can kill you.
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Avatar_f_tn
I need to preempt this with you knowing that my panic disorder, GAD, and endometriosis pain disease I treated with Dr. prescribed Klonopin, Xanax, and Oxycodone plus every freaking anti-depressive known to man ever since I was 19. Im 40 now. . Since the anit-s didn't do much  for me, I basically stuck to the benzos  which worked and the opiates which was like a gift from above, it helped oh so much but not totally, and than I found heroin.  THE ultimate opiate. It  not just cured my stomach issues, but all pain, all anxiety and every problem I had because it felt like a soft cloud enveloped me. To wonder why opiates work better than anything is like asking why when Im in heaven why dont I feel like going to hell? because heaven is oh so sweet. No brainier right? well with opiates its not so simple  because opiates work. BUT they will kill and damage you eventually, so we have a problem. You  asked for advice in incorporating opiates into anxiety treatment. the answer as far as I know, (im a casac, certified alcohol substance abuse counselor), would only be methadone which unless you  have a legitimate pain issue that would be so severe as to need a powerful pain killer, your probably out of luck. No legit doctor will put you on an opiate to deal with anxiety unless you have or had a substance abuse problem which called for you to be on methadone. Most opiate/heroin addicts who use methadone to get off using heroin , find themselves taking an anxiety controlling agent as well, such as klonopin. The methadone gives addicts some relief as well from crippling anxiety due to being off heroin but a lot still need that extra pill. (than again, some only need the methadone to provide anxiety relief.no simple answer)   SO the point is, unless you fit the criteria for a methadone patient, unless you have a proven track record as an addict needing treatment, I know of no treatment that implements opiates for anxiety tx.  If your going to choose to add an opiate to your day for anxiety which by the way definitely does work as euphoria is one of the "side effects"' u must understand that euphoria isn't going to last long. your tolerance will build to where it becomes a habit and necessary. IMHO use them sparingly if you need them badly but as soon as you feel a a bit uncomfortable when you wake up from not having them in your system, put the bottle down and prey you didn't give yourself a chip (little habit) to contend with. I felt  heroin was the best drug I ever put into my bloodstream for ten years, I never thought an inkling of all the life/personal damage I did for a decade would matter because I was so f***** numb and content for so long. AND THAN I WOKE UP to reality and its taking me over ten years to get that human feeling back. Its a matter of choice, do you want to deal with the consequences of dependency on opiates to deal with your anxiety? I have a feeling if most of us could get away with doing heroin or whatever opiate works, we all would. But we would all be walking around in a drugged out numbed out coma and after a while that's just not fun.
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Avatar_f_tn
omg....that was an insanely long post. Im sorry!!
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480448_tn?1403547723
First of all, this is a very old thread...so most likely the original poster is not around any longer.

Secondly...opiates are NEVER the answer for anxiety treatment...never...not sparingly,not moderately, nothing.  First of all, people with anxiety issues are very prone to addictive behavior and "self medicating" with substances as a means to make themselves feel better...which obviously, when you throw in something as addictive as opiates....there is only heartache ahead.  If people think they had anxiety before?  Wait until he/she withdrawals from an opiate and experiences the worst possible anxiety...compunded with horrid depression.

While opiates have their place as a SHORT term method of treating moderate to severe pain, and in cases where long-term opiate therapy is needed to treat chronic pain conditions...one indication it is totally inapproriate for is the use of treating mental ilness conditions.  It will take a problem and make it 200% worse...and add on a whole host of other new problems.
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Avatar_m_tn
Please realize that though much of what you say is true for many, unless you walk in someone's shoes, you have NO IDEA what you are talking about.  There are many different people out here, and not all of them lack the discipline or integrity to manage opiate use.  I am a forty year old man who have been dealing with anxiety and depression since March 99.  I remember the day it started - with what I now know was a panic attack.  I'd NEVER had anxiety before this, and was rushed to the ER thinking I was having a heart attack.  Since that evening I've never felt normal, though it led me through the guinea pig march of trial and error with every anti depressant mentioned above.  Well, never again until after a herniated disc leading to chronic pain, I was prescribed opiates.  Initially, I had to battle the doctors' suspicion that I was enjoying the 'high'.  But, eventually after they saw I wasn't needing extra meds - and after I finally convinced them that the 'high' part would take a double or triple dose - my doctor believed me.  I found that methadone was the best thing because it stays in your system a long time, and it doesn't take much to help with the balanced mentality.
I've only since battled within myself, fighting off the feeling that I must be a junkie.  I weaned off of them at one point, and the anxiety came right back.  Without self discipline though, you WILL end up worse off.
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Avatar_f_tn
No matter how much self discipline you have opiates are still very harmful to your PHYSICAL health. People can go on SSRIs for life but opiates will cause liver, kidney, cardiovascular and all other sorts of damage to your body. They are not a long term solution.
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Avatar_f_tn
look at becca117's post!
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Avatar_n_tn
This is a controversial issue that people change their minds about a lot. I have been on too many medications to count for bipolar disorder. Eventually, I was so sick of the side-effects of the bipolar meds (Zyprexa, Abilify, and Prozac cocktail at that time) that I took myself off them and suffered the worse withdrawal period of my life... and I'm a recovered heroin addict. When I was finally through the withdrawals from those medications which made me dysfunctional beyond my normal episodes of depression and hypomania, I obviously did not feel good. The depression and anxiety came back with all that lovely lack of motivation, panic attacks, etc. I then turned to street drugs and tried just about all of them, and hated all of them... except opiates. Once I discovered those, I had become an addict in 2 years and it took me 2 years on suboxone to get off of the opiates. Now that I've been clean for 6 months, all of those bipolar symptoms are starting to come back and again my opinion of opiates is shifting. What hasn't shifted is my opinion of the major tranquilizers, benzos, SSRIs, and other pysch meds.

Being an opiate addict is and was terrible... when I became addicted to heroin. Before I was addicted and the 2 years I was on suboxone, those were the best time-periods of my mental health. So what I learned while on suboxone was that I hated the high from opiates... the nod, all that garbage - and I learned that the non-high but still opiate suboxone not only helped me get off of heroin and other opiates, but I didn't feel the need for any other drug or medication: not alcohol, not psych meds, not street drugs. In-fact, I haven't gone to a bar for years now. In short, I learned that I really don't get any stability from anything except very low doses of opiates or the partial agonist that is suboxone or subutex. I got my life together while on it, held jobs longer than I was ever able to, started a relationship that I have been in longer than any other, had financial independence, went on road trips... lived well.

Here is where things get interesting... the relationships. My psychological problems have always disappeared when I've "fallen in love" - or in other words, when my endorphin levels increased. Of course, infatuation isn't stable either. What is hardly ever discussed about opiates is that they mimic your endorphins ...your love chemicals. Yes, they kill pain both emotionally and physically and have terrible tolerance records. Yes, they are not good for your organs and they alter your brain chemistry (duh, that's the goal). But once I made this connection between the way I responded to opiates and the way I responded to infatuation, I realized that it is the endorphin levels in my brain that are low - not the dopamine or serotonin. How do I know this? Because I've been on so many SSRI's and Benzos without experiencing relief from the crippling effects of whatever this disorder is. Further, because I'm a writer and I've been documenting my life for over a decade and can reference the few times I've felt "normal" - when infatuated and when on the opiates. And finally, because I've studied developmental psychology (among other fields) for the past 10 years and this sort of relationship between the brain developing in a way that is low on the endorphin end and opiate addiction is documented in many addiction studies.

So what's the real problem? Physical health and tolerance. Suboxone and possibly methadone (which I've never been on) solve the tolerance problem. As for the physical health problem... do you know what the typical life-span is for bipolar patients? Aside from that... do you realize that major tranquilizers (including lithium) cause terminal illnesses as well? So really - there either isn't a good psychiatric answer to this issue (when it is really this strictly related to endorphin levels) or safer opiates like suboxone are just as viable as some of the garbage that the US permits psychiatrists to prescribe.

at this point - I'm trying a non-medication approach (any sort) and trying other therapies and meditation. Doesn't work that great but to be honest, suboxone is expensive as hell and regulated rather strongly. My life isn't good... I am fairly dysfunctional and despite the numerous times I've been through opiate withdrawals (and yeah, they suck), I am fairly certain about what my real options are. I'm not willing to risk more psychotic episodes from psychiatric meds (which I've never experienced off of them) and I'm not willing to use heroin, pain pills, or any opiate that is mixed with other pain medications. I still hate even the thought of trying any other street drug, including pot (which affects me horribly). And, if I am still on the brink of homelessness in another 6 months I'll probably go back on suboxone for the sake of not relapsing.

Either way it's survival.
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I am 31 years old and was in a fatal car accident when I was 18, in 1998.  I was driving and my close friend who was 17, died in the wreck.  I was critically injured and actually died a few times, my heart kept stopping and the EMT's and doctors were having a hard time getting it started again and keeping it beating.  I also lost 2/3rds of my blood and broke both legs among numerous other bones in my body.  I remember being out of my body and that feeling of peace and happiness, only to come back to my physical body and be in excruciating pain.  Since all this happened, I have been on and off of pain medications, (opiates), and I have to agree with all of you that say that the opiates are the only thing that makes me feel normal.  I always suspected that I may have some OCD and bi-polar issues, even before the wreck happened.  I never felt normal and happy like people should and once I was taking pain meds, for the first time in my life, I felt normal and wanted to do things and enjoy life.  I have never had an addiction problem with it and when I had a prescription for vicoden or lortab, I never abused it; was never taking more than 2-3 a day.  I have never felt "high" off of it, it just makes me feel normal....almost but not quite to the feeling that I had when I was out of my body.  I have been diagnosed with severe PTSD and my doctors continue to force me to take anti-depressants, but I continue to tell them and try to explain to them how those only make me feel 20x worse, and that I feel better not taking them.  Right now, I am taking Lyrica and it helps to keep my feet and hands from falling asleep and going numb, and a little pain, but it does not help to make me feel "normal" and happy with life.  I am not clinically depressed, or else the anti-depressants would make me feel better.  No matter how I explain to my doctor that they make me feel worse, he just does not understand it and says, "that is odd because usually people taking Lyrica HAVE to take cymbalta too"  and he continues to try to convince me to take it even after I tell him that it makes me feel worse and makes me actually feel like I want to die, when before (not taking them) I do not feel like I want to die, I am just in chronic pain and don't feel like doing anything and am not happy with life.  I have a beautiful 5 year old daughter who I love more than anything in the world, and the only times that I feel like I have energy and want to play with her or go on walks and do things, is when I am taking vicoden or norco.  I have tried to research this online, and find a possible reason that the opiates make me feel normal, not high, and that I get energy from them and do not feel drowsy.  So far this is the only place that I have found other people who experience the same thing as I do...but still no explaination for why it does this.  I have taken a few psychology courses and still cannot figure out why.  I know that it has to be something that has to do with your brain, but I want to know why.  I cannot find a doctor that will understand me and not think that I am a drug addict trying to "score" pain meds.  I just want to feel normal, and the only thing that works is the opiates..and I have never done hard drugs like heroin, never wanted to and still don't want to.  I just want an answer for why that is the only thing I have found that makes me feel normal, and I want a doctor who will actually listen to me and understand what I am saying and not treat me like an addict and refuse to prescribe the pain meds for me.  All the doctors I have seen know that I am in chronic pain and they will treat me for a while, then decide that they don't want to be the "one" who could be responsible for me "overdosing" or something like the celebs that have died from prescription overdoses.  
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I'm a little late to the discussion but as I was have just had 2 of the worst panic attacks in my life in the past 4 days I searched and found this site and certainly have a few things to say/add.

First my story; I started getting panic attacks around age 18 (I am 25 now)...they have always ranged from being absolutely debiliating..horrible to the point I would literally do anything (short of suicide because i do actually love living) to make them stop and  they might last up to 24 hours or so in length , or some are relatively minor and gone in anywhere from 30 seconds to 10 minutes. I tried just about every drug known to man through my psychiatrist....Some helped a little, some made me worse. I tried just about every SSRI (paxil, prozac, zoloft, etc), I tried Buspar (absolutely no help.) The SSRIs helped a little bit with the anxiety but seemed to make me depressed and the side effects were hard to deal with (sexual issues, brain zap type feelings, out-of-body type sensations). The drug that seemed to work best was actually the "old-school" trycilic Pamelor but it did not stop all of my panic attacks and it made me VERY VERY tired all the time and basically a walking zombie.

Eventually after all of these drugs failing I turned to opiates (illegally) as they were the only thing that could ever make me feel normal, good, not too tired to function etc. However the downside was and is obvious; being an illicit opiate user I inevitably would run out and would have to go through withdrawals, not to mention the fear of jail etc. Personally I would compare withdrawls almost exactly to the worst panic attacks I've ever had except for the fact that the withdrawals last up to 5-10 days whereas the longest panic attack I've had was about 12-24 hours.

I eventually turned to Suboxone (buprenorphine) to stablize me from the cycle of withdrawals. Suboxone was never quite as effective at curing my panic attacks as a conventional opiate (oxy, hydro, etc) but litterally gave me my life back from the withdrawals and minimized my panic attacks to a point where they were finally bearable. The problem is that only lasted about 4 years. I will have been on subxone for 5 years in april and starting about 4-6 months ago I started getting full blown horrible panic attacks again (although they only come about once or twice a month as opposed to nearly daily before using suboxone). It may be a naive thought but I am very confident that a conventional opiate would cure almost any panic attack ever. Suboxone never did that for me as I never get any kind of "euphoric" feeling from it, I just feel normal (that was until 4-6 months ago). I have read that sometimes suboxone users suffer from some kind of "hitting a wall" where use after anywhere from a year to 5 years starts to minimalize the anti-depressant and anti-anxiety effect. I should note I have read literature that says that suboxone is being explored as a depression treatment and I believe (but am not sure) that in certain parts of Europe it is already accepted as a depression/panic disorder treatment.

So my bottom line is a mixed message. I do believe conventional opiates and Suboxone (which is actually a partial agonist, meaning it only partially effects your mu receptor) are probably some of the most effective drugs out there to combat depression/anxiety/panic disorder....BUT in all but the worst cases of panic/depression I would say the negatives likely outweigh the positives. Alot of users would probably crave more to get high instead of just to rid their depression/panic etc and the withdrawals would be worse than the original problems.....However, having said that, I think that if I (and a Dr.) were to accept that I would have to basically be on an opiate for the duration of my life (or until I was willing to go through the hell of withdrawals for whatever reason) and there were a way to monitor the use to ensure that the drugs did not become abused (taking larger and larger doses just to get high, buying street drugs, doing heroin instead) that would be a real miracle cure for the aforementioned conditions. The current dillma in the medical community is just that...And most if not all (maybe 99percent plus) of dr's would not prescribe or reccomend opiates to treat psycological symptoms.

On the other hand, I believe systems where opiates are legalized (like portugal the netherlands) might be on to something in that they destigmatise the use of opiates, taking the users off the street and closely monitoring the use thereby allowing users to take opiates in an environment with close oversight to help ensure overdose is less likely.

The problem is basically the addictive nature of the drugs. The reason they work on depression/panic/etc is because they make you feel good. This causes cravings and people wanting more and more which raises risks of overdose etc and anyone who takes opiates on a regular basis is going to need them to avoid withdrawals. Maybe I am naive but I believe that I could subside on a dose large enough to simply cure my panic attacks although tolerance does build and this could create a problem as well. Or I suppose the best scenario would be if opiates were available on an "as-needed" basis for those few days per week/month that I have a horrible panic attack. But in reality that probably would not work, it would have to be a constant daily dose (possibly increasing overtime as tolerance does until a ceiling is reached)

I guess I am repeating my self at this point but my bottom line is that I believe that if you have seriously debilitating depression or panic and the only thing that really cures you is opiates then you should be allowed to take them assuming you recognize the risks (which are great).
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Im glad i found this forum, I have been on opiates for 5 years now. First let me give you a little bit of my back round. Ive always been against drugs, and tried most everything. Well alcohol and weed mainly, luckily, my anxiety made me stay away from these drugs. I wouldnt smoke a hit of weed for 100 dollars no way! Weed to me is HELL ON EARTH! Im trapped in a living hell which is my mind, its like my own mind is torturing me. When i drink and get buzzed or drunk, its fun at first, but when i go home and im all alone i start having a serious nervous break down. I think i have alcohol poisoning, i always convince myself im dying, i get incredibly depressed, and usually work myself up so bad that i get horrible cramps and throw up. Haven't drank in years. Then i found xanax, i was in love, i thought it was the answer to all my prayers, after about two years i realized xanax made my anxiety 100 times worse, i was ok on it, but as soon as it started wearing off my anxiety and panic attack became SO BAD that i almost became psychotic until i took another xanax. When i was on xanax i took like 10 naps a day, failed out of school couldnt concentrate, couldnt work, i was a vegetable. Life was truly hell and i was trapped between a rock and a hard place, one thing was for sure, i had to quit xanax. Quitting xanax was the hardest thing i ever had to do in my life, and it wasnt like i had any cravings, once i stopped it i stopped, It was the psychological agony! My mind was a black hole of nothingness, crying spells, i could see no light at the end of the tunnel, i was too afraid to die because i was sure i was going to hell, even though i was a christian, but i was suffering to much to live. Finally once i got off i stayed off, and stayed on my lexapro, which took me from 0% to 50%. Lexapro helps A LOT, but the paranoia and anxiety was still there. My life was very very limited. Then i found opiates. Opiates are GREAAATTTT but they do have some down falls. Let me tell you the ups and the downs. Opiates are a lot better for the first couple of years, the high is better, and when you wake up withdrawing and then take an oxy and lay back down and waiting for it to start taking away your body aches and making you feel warm and fuzzy to me thats the best part of the day. Opiates is a game of self control to the MAX. They are DEFINITELY not for everyone. Also, whether they truly make you feel better or not, if you cant find a dirty doc to prescribe you them, DONT DO THEM, they WILL destroy you financially which is the absolute worst thing about opiates. If you have to buy them off the streets you will hit rock bottom, because they are expensive and take everything you own. The best thing you can do is get them legitimately from a doctor and dont sell them either, because honestly the government doesn't give a **** about you getting high, neither does the doctor, they just dont want you getting other people addicted, plus its wrong, because not everyone has anxiety and depression, well SEVERE anxiety and depression and they dont need them, it will only make there life worse. That being said, im 5 years going strong on oxy, tolerance DOES go up but it reaches a plateau at around 90-150mg's a day. If youre doing over 150mg's a day youre over indulging and its too much and its bad. If you want to use them for anxiety and depression like me, then RESPECT THEM, because if you dont respect opiates, they will destroy you even with a prescription. My besty advice is to wake up in the morning, take an average dose to pick you up make you feel good, then go to work, around lunch time take another dose when withdrawals are coming back, THEN in the evening after youve done all your daily responsibilities, and when anxiety and depression is at its worst (at least for me it is) take a nice dose to get you feeling mellow and sleepy. Also opiates DO NOT DAMAGE YOUR LIVER!!! Tylenol does, if youre going to take opiates every day do not take percocet or loratab the ones with tylenol in it, you dont need the tylenol, youre only taking it for the opiates. Ask your doctor for the higher milligram ones without tylenol, and break it up into pieces into the dose your normally take. Like i said i have been on 5 years and get blood work twice a year and my liver kidney and other organs are perfect! My blood pressure and cholesterol are perfect too, im very healthy and i work out too. Opiates if taken RESPONSIBLY which 90% of people cant do and dont have the self control to do, but if you have strong will power and take them responsibly instead of just getting ****** up out of your mind all day, then they are MUCH better for you than xanax and other benzos. Benzos long terms are 1000000 times worse than opiates. Xanax will destroy your liver, and after years of use turn you into a soulless zombie, DO NOT TAKE XANAX LONG TERM. For all the people out there self medicating their anxiety with opiates good luck!! Im a new man and im so happy my life is so much better, where as my sober life, which was all my life, was hell and i was very suicidal and constantly having paranoia and had to be comforted by other people. I shutter to think about how much hell my sober life is. Im so glad i found opiates, and as for the side effects like a little bit of lack of motivation, constipation, lower sex drive, and of course being dependent on them and having to bring them everywhere you go or be in a world of severe withdrawal, yeah every addict has that, but that stuff is such a small sacrifice for peace of mind. Sanity and peace of mind is the MOST important thing in life, people without TRUE mental illness, anxiety and depression cant understand what we go through, its worse than cancer, because at least with cancer you die. With anxiety, depression, and other mental illness, its a life long struggle. GOOD LUCK TO EVERYONE! P.S. before you resort to something extreme like opiates to treat your anxiety and depression, make sure thats your LAST resort, but definitely chose it over long term xanax use, because youll become an empty shell and eventually go psychotic gauranteed. But FIRST if you havent tried it, i beg you to try Lexapro. I have tried all the other medications lexapro REALLY REALLY WORKS. I know everyone is different, but lexapro is the most described and it especially works for people who suffer from constant panic attacks. Also for about the first month of taking lexapro, 99% you will encounter side effects. The side effects can be very uncomfortable, like dizziness, and other strange and uncomfortable feelings. Do not give up! Take it for at least 2 months before you make the decision to not take it. 1 month of side effects while your brain gets used to the lexapro is well worth a life time of living a panic attack free life. People like use who have panic attacks have extremely low serotonin levels in our brains. Not having enough serotonin wreaks havoc on the mind and body, lexapro gives levels out peoples serotonin when they dont have enough, so thats why you feel weird while your body is getting used to the extra serotonin, god bless.
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Ya, opiates are very addicting and harmful is taken with acetaminophen/aspirin to your liver and stomach (do your research people), but you know what else is.....benzos.  Dr's prescribe benzos which cause much worse withdrawal if taken for a long time, and can even result in death when withdrawing, unlike opiates.  People acting like opiates are more dangerous than using benzos and ssris long term are kidding themselves and should do some real research.  The only way opiates do bodily harm to your liver and stomach is if you getting pharmaceuticals with tylenol and aspirin in them, which is what causes the dmg.
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OMG! I have panic disorder and when my nose was broken they prescribed me Vicodin and it cured that horrible feeling of helplessness, panic, and anxiety. I think opiates ARE the cure, and I'd rather die from taking Vicodin than die with that feeling. But I don't want to ask my doctor because I fear he will think I'm a drug seeker.
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exactly...I am an artist who has suffered with ADD And Anxiety my entire life. My first real day of living came about after breaking my shoulder and being prescribed oxy. I quit self medicating, my normal diet for the last 6 years was a 1/5 of vodka approximately 3 to 4 grams of coke, 3mg of Xanax, and often times crystal meth...none of which I ever felt high on...the anxiety trumped them all...then I quit them all...oxy made me feel whole...not high...but what can you do? The medical community wont prescribe them. Cant blame them...I feel forced to move somewhere anywhere that I can live as a whole person. I hope you make it. There is a book called The Opiate Cure.
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Of course opiates make anxiety go away.  That's the effect they have on the brain.  Problem is, it is just NOT a reasonable treatment option, for about a thousand reasons.

I'll give you just a few reasons.  First, people with anxiety disorders are VERY prone to addiction issues because a lot of us seek to self medicate, with alcohol, drugs, etc.  Secondly. opiates have the issues of dependency and tolerance, which makes them not suitable for long term use.  They were never made to be used on a long term basis.  Sure, there are people with chronic pain that need something stronger, and for those people, there are some newer opiates on the market better suited for longer term use.  Lastly, it is not an "inidcation" given for a physician to prescribe them.  They are classed as an analgesic, or pain medication.  They would not be allowed to Rx them for anxiety or depression.  Not without a lot to answer to, possibly with risk to their license and DEA number.  That would be like a doctor precribing Xanax for a yeast infection.  The diagnosis and medication have to be compatible to some degree, especially with controlled substances.

I've also noticed, through the years, when I've been on pain medication for various things...how much better I  felt....my anxiety would be gone, I had LOADS of self confidence, the list is endless.  But,it just is NOT the answer.

I know many of us struggle for years to find something that will work for our anxiety...it takes time and patience.  If you keep fighting the fight, you'll get there too, like so many of us have.  There is something for everyone in terms of treatment for anxiety,  It's not opiates.
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Nursegirl6572-

Allow me to take a moment to point out the numerous oversimplifications and cliched inaccuracies in your statements regarding this topic.  :)
1.) Self medicating- this happens sometimes before people go to Doc's and get treatment. However it also happens because the response and remission rates for most mental illnesses are sub par (even in ideal circumstances). Of course this cuts right to the core of the issue, which is people not getting sufficient relief from currently approved treatments.

2.)Dependence and tolerance- Are you against SSRI's? SSNRIs? Trycyclics, wellbutrin? Tolerance, dependence and withdrawal are a fact of life for these, not to mention BENZOS. Also, let's make a distinction between popping Vicodins or Heroin, and the controlled use of a PARTIAL AGONIST such as buprenorphine. Bupe is meant to be used long term (though for maintenance in 'addicts') and has minimal tolerance/withdrawal. Also very importantly, Bupe is also a Kappa opiate receptor antagonist. The Kappa receptor is the 'bad' nasty opiate receptor which makes people feel like crap. Regular opiates cause a vicious cycle by downregulating u-opiate receptors (tolerance/withdrawal) and an upregulation of the kappa system, causing more dysphoria and making the problem worse. In fact, kappa system is elevated in most all types of drug addiction. With Bupe, the u-system is consistently and partially bound, assisting with anhedonia, malaise, pain (physical and psychosocial) and anxiety. The blocking of kappa system also helps keep stress/anxiety in check, as well as reducing risk of substance abuse.There are currently clinical trials looking at both Bupe, and another Kappa antagonist (JDTic) for cocaine addiction. Overly simplified statement here, but in essence, please go educate yourself before making such sweeping statements. If you'd like, I can give you a bibliography of journal articles on this topic for you to read. I've got 100+ peer reviewed journal articles on the opiate system in psychiatric disorders. Harvard also did a small pilot study in the 90's with Bupe for treatment-refractory depression/anxiety and many people were helped. These were people who tried every med, every therapy, ECT, etc etc and no relief.

Also you should probably realize that there are opiate based psych meds in Phase II clinical trials right now. One is an Enkephalinase inhibitor (inhibits enzyme that breaks down Enkephalin, an ''endorphin'' for laypeople speak).

Pardon my apparent sarcasm or rudeness. I've been angry for years that people who are treatment resistant can't get access to something that might help. I'd love to hear your response, but preferably after you've gone to pubmed and done at least a few days worth of reading. Let me know if you'd like those articles, I could email them to you as PDF's..

Also on personal note, I've been through the psychiatric maze of life, tried every treatment, Bupe works for me at low doses used controlled, legally and consistently while in conjunction with Lexapro, high dose Fish Oil, exercise, meditation etc etc. I've been on this regimen for 5 years, had no increase in tolerance, do not feel 'high', have felt the best ever. Also, my cognitive functioning under opiates is leaps and bounds beyond taking benzos. Did you read the many people's posts with similar complaints. Benzos help quell anxiety sure, but then you can't think clearly etc. Also, you can die from benzo WD's, that doesn't happen with opiate WDs. Also, I'm qualified to say these things both from my personal experience as a patient, but also because I've done biomedical science research in many top labs investigating opiates, mood disorders and pharmacology/molecular biology. Not to mention I spend more time on Pubmed than any other human being alive.
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Sorry to disappoint you, but I don't have the time to spend a few days reading articles to appease you, and make you think I'm worthy enough to have an educated discussion about this.  I have enough of a knowledge base to know what I'm talking about.  I apologize if you think that somehow takes away from my response.

I totally agree with most of what you've said.  I already understand what a full vs partial agonist is, but thanks for the info.  I've never, not once argued that opiates DONT help anxiety and depression, quite the contrary, they do.... quite well.

What you've failed to explain away is how a physician legally can get away with prescribing meds (that require their DEA # no less) with very specific indications, for something completely different than intended?

Also, if I may ask.  How are you Rx'd the Bupe?  In the form of Suboxone or Subutex?  If so, similar to my above question, if you don't have a problem with opiate addiction, how does your doctor get away with Rx'ing that to you?  Or, has he just been lucky thus far, or is he Rx'ing it an dlying that you have an addiction problem?  Considering that doctors have to be specifically certified to Rx Suboxone, I'd be really interested in knowing the answers to that.

Also, even though bupe is a partial agonist, not a full agonist like other opiates, it also comes with some pretty wicked withdrawal.  Actually, if you read a bit on the Substance Absue forum, you'll see that more often that not, the Sub w/d was WAY worse than the w/d from the original opiate.  There are also a lot of newer concerns popping up about people using Sub more long term, as it is really optimally intended as a short term course of treatment to help detox off opiates to minimize w/d.  If I were you, I'd be concerned about those issues, and asking my doctor those questions.

Hey, I'm THRILLED you found something that works to treat your anxiety, and I don't judge anyone based on what their treatment modality is, however, like I've said from the beginning of this thread, opiate therapy for anxiety is just imapproppriate, in so many ways.  You obviously disagree, and that's fine.  It's obvious that my words struck a chord with you, due to your pretty abrasive and insulting tone. That's also fine, I have pretty thnk skin.  

I hope you continue to find relief with your current regimen, but I fear that somewhere down the line, you're going to be put in a precarious position because either your doctor is going to not be able to continue Rx'ing the bupe for you, or, when and if you decide to come off of it, you're going to realize that the w/d's are just hellish.  Even with controlled slow tapers, a lot of people really struggle to get off Subs.  I do sincerely hope for you, that none of the above occurs

Very best to you.  
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I apologize, I shouldn't have taken such a tone. As I hinted in the previous post, my bristling tone is more the result of frustration on the topic in general than your particular post. I too agree with many of the things you've said, with qualifiers and disclaimers etc. My problem is with someone saying " this should not be used for anybody, ever''. I suppose where we differ is that I think severe treatment-resistant cases should be a place for careful, controlled attempts at symptom relief. To answer your questions-

1.) I began self-medicating with opiates initially in a 'grey market' sort of fashion after failed success with traditional means over a long course of time. After using them for a while and realizing the sub-optimal nature of treatment I looked into Sub. I was taking opiates daily which qualified as opiate dependence, so I made an appointment with qualified sub doc. Told them what I took, got me on Sub. Although most maintenance patients take much larger doses (unless tapering) I've been taking no more 2mg/day.

2.)Yes legally/sociologically the problem is complicated. From a science standpoint I'd argue it is much less so. Sure you still have abuse potential, but again the same goes for numerous other psychiatric meds. Bupe is schedule III in US (if I recall correctly), mixed amphetamine salts (adderall (adderrall)) is schedule II and it is sometimes used "off label" for fatigue, problems with executive dysfunction etc, in patients with various psychiatric disorders. Stimulants are by far more physiologically toxic and have higher abuse potential (as defined by their being Schedule II) and yet there is no controversy by comparison to the opiate situation. I'd argue that it is so because of social reasons, not scientific/medical ones.

-To reiterate a point made in my previous post, what is your opinion of other medications such as SSRIs, SSNRIs, Benzos, and even stimulants. These meds can all have hellish WDs and even 'dependence' though rarely addiction except in the case of the latter two. For instance, the only drug I've been unable to completely stop in my 5 years of the regimen I'm on is Lexapro. I stopped taking Sub for several months about a year after taking it. After my original symptoms returned I decided to go back on. I have read  about many people having serious WDs from sub, but as with many things it varies from person to person. Also many people are tapering from large amounts (all the way up to 32mg/day) who were serious opiate addicts before Sub. If someone were taking no more than ~2mg/day and stopped, it can be difficult to determine if their experience upon stopping is 'opiate withdrawal' and 'post acute withdrawal '  or simply the return of the person's  original psychiatric symptoms. This last point is something I rarely hear people attempt to distinguish within such a debate.

Naturally, the solution is personalized medicine and much more sophisticated treatments than the crude chemical tools of today. But until then, a crude stopgap is better than nothing at all. Kappa antagonist + Enkephalinase inhibitor will be a slightly better stopgap hopefully available in a few years.

Thanks for the reply :)
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Opiates can work long term.  Please visit www.theopiatecure.com

I just finished his book and it is very interesting.
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Hi Reshtel,

Thanks for the link. Yes, I have actually seen this book before. This may be an interesting book since he offers his own experience with patients and opiates. He probably also builds a scientific case for his book with citations from the literature. In a similar vein, I will post the titles of some of the more pertinent journal articles I've read (most of which are available for free download from internet or I can email them as PDFs to anyone who is interested).

Below I'm going to post a link to a blog post by Dr. J Burson, where she asks the question is Buprenorphine an antidepressant? Following the article she and I get into a civil discussion which is similar in many regards to what I have posted on this thread. In both instances though, many of the arguments I make are not actually addressed by the people who disagree.

http://addictionblog.org/the-news/is-buprenorphine-an-antidepressant/#comment-10398
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References to scientific studies/journal articles on opiates in psychiatry-

The following are human studies:

• Buprenorphine treatment of refractory depression. Journal of Clinical Psychopharmacology. February 1995- Volume 15- Issue 1- pp 49-57

• Dysregulation of Endogenous Opioid Emotion Regulation Circuitry in Major Depression in Women  Arch Gen Psychiatry. 2006;63:1199-1208

• Opioid receptors and limbic responses to aversive emotional stimuli. 7084–7089 PNAS May 14, 2002  vol. 99  no. 10

http://www.womensradio.com/articles/using-Buprenorphine-(subutex-suboxone)-for-treating-severe-depression/4390.html


• Stress Responsivity, Addiction, and a Functional Variant of the Human Mu-Opioid Receptor Gene. Molecular Interventions.  April 2007 Volume 7, Issue 2
• Regulation of Human Affective Responses by Anterior Cingulate and Limbic µ-Opioid Neurotransmission. Arch Gen Psychiatry. 2003;60:1145-1153
• Psychotherapeutic Benefits of Opioid Agonist Therapy. Journal of Addictive Diseases, Vol. 27(3) 2008
• Altered levels of basal cortisol in healthy subjects with a 118G allele in exon 1 of the mu opioid receptor gene. Neuropsychopharmacology (2006) 31, 2313-2317
• Emotional perception modulated by an opioid and a cholecystokinin agonist Psychopharmacology (2008) 197:295–307
• The Dysphoric Component of Stress Is Encoded by Activation of the Dynorphin -Opioid System The Journal of Neuroscience, January 9, 2008 • 28(2):407– 414 • 407

• Variation in the -opioid receptor gene (OPRM1)is associated with dispositional and neural sensitivity to social rejection PNAS  September 1, 2009  vol. 106  no. 35  15079–15084

Will list additional human studies and some good animal studies as well...
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Thank you so much for the information NN30!  I'm at work or I'd pontificate a bit! Just wanted to say thanks very much for the reply!
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I have been taking an opiate for tention headaches.  I have cut way back and now I have noticed arthritis in my knees and a tendonitis in my foot that comes and goes... and I'm having break thru crying jags that last a minute or so... I have been on a meds for depression for years.... it took me three years to get off the pot.... I needed something and became expossed to the opiates intentionally.  I actually worked very hard to get off them after a car crash shorly after getting thru the worst of the dope addiction.... I don't want to go thru PAWS with opiates. The first time I only took them for seven weeks. I haven't taken a drink in almost 25 years.  I lived with two alcoholics, or they lived off me.  Physical pain or emotional pain?  Be careful with anything that is addicting!

I lived vicariously thru them and am quite fimiliar with the recovery process.
I just had my first tooth pulled from bone loss in my gums.... my teeth are fine. I forget to floss every night.  ouch.
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First off, How can you generalize ANY drug??  Its chemestry!  None of us are identicle, so we can not expect identicle reactions to a drug.  It pisses me off to see people post that "all opiates are bad for all people" and that " the high is just that, a high".  If you suffer from Major Depression Disorder, or Bipolar Disorder or Mood Disorders of any kind, you can testify that there is NOTHING on this earth that compares to the HELL that you live with everyday.  You are stuck in a body that has a dysfunctioning organ(the brain) that just so happens to control your mood and how you process information coming in and going out.  It is the worst thing  that has ever happened to me and I can honestly say that I would WELCOME cancer (as I have many family and friends fighting cancer) in place of depression.  Why? Because you know your enemy and you can fight with your heart and soul still intact.  As for depression, you are ROBBED of your very soul.  It is truely HELL ON EARTH. And I will go down fighting if someone keeps me away from ANYTHING that will stave off dpression and its nasty choke hold.  I can not function in life with this desease.  I can not "talk myself into" feeling better.  I can not meditate my way to feeling happy or relaxed.  Its like asking some one to meditate thier severed leg back on. Its just not possible....for me.  Vicodin, in plain english, gives me my life back.  It LETS me feel something other than despair.Would you tell a loved one that you would rather watch them suffer slowly and agonizingly under the curse of depression rather than give them a chance to feel good??? I would take 5 years of happiness over 30 years under the heavy blanket of Depression Disorders.  If taking a med is considered dangerous to my health, but lets me have the quality of life I so desprately crave (and that so many just naturally have) then I say, sign me up.  They always say it is quality not quantity in life and I firmly believe that,  Give me the tool to really LIVE and I will take the consiquence that comes with it.  But God in heaven, dont deny me the oppertunity to see life as it was meant to be, not the torturous hell that this desease inflects on its desprate victims.  And all of you out there looking at this opiate option for depression as it is disgusting and drug seeking filth, you most obviously DO NOT have this debilitating desease.  You are just bummed out and need to go exercise.  Us fighters of this desease will carry on and continue to be the bravest people in the world. Next to our solders of course.  God bless all of you fighters of Depression.  No one really knows what you go through and no one ever will unless they are cursed like we are.  And if get a chance to live life, even for a limited time, live it and dont regret!! Good luck to us all, we are going to need it in this ignorant society that judges so abruptlyand  that simply doesnt understand.  
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Avatar_f_tn
I need to discuss my condition with a doctor that believe opiate help pain and despression/anxiety.  Any help would be appreciated.
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480448_tn?1403547723
You would be better off starting your own thread, as you can see this one is quite old.  You can do so by scrolling up and clicking on the orange "post a question" button.

Just a quick comment, I fervently stand by my earlier comments in this thread.  While I do not deny that opiates work wonders for mood disorders, it is just not a practical solution, both from a legal and logical and logistical standpoint.  As it stands now, a doctor REALLY wouldn't be allowed to Rx an opiate with a dianosis of anxiety and depression, because opiates do not have an approval for an off-label use to treat such conditions, and recently, with the crackdown, and tightening up of narcotic dispensing, it's becoming harder and harder for docs to be able to Rx them for PAIN, which is their intended, approved indication.  A doctor must back up any diagnosis of pain to be able to justify a chronic opioid prescription.  Unless a doctor lied and said you were being Rx'ed an opiate for pain, he would be putting his license and DEA# at risk, and not too many docs want to do that.

So what I'm telling you is, seeking an opiate medication for a mood disorder is not a wise idea, and not realistic.  You will have a hard time finding a doctor who would even consider this at all.  There ARE many treatments for anxiety and depression out there that ARE reasonable however, have you tried any other medications?  Therapy?

If you can include a bit of your history in your new thread, that would be great, we'll be better able to advise you.  Lastly, while doing your homework is good, it's important not to have tunnel vision about treatment...it's never good to go into a doctor's office with one med in mind that you're going to request, and expect.  Doctors are doctors for good reason, and we're not.  You should be 100% involved in the discussions and decisions, and you don't have to accept anything a doctor has to say, but it IS in your best interest to go in with an open mind and be willing to TRY different things.  You are limiting yourself by only seeking out info about one kind of treatment option, and that's true even if you HAVE tried many other things.

Look forward to seeing your thread, I'll keep my eye out for it.
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Avatar_m_tn
I had to repost your comment it literally left me in tears because I completely understand.

" It pisses me off to see people post that "all opiates are bad for all people" and that " the high is just that, a high".  If you suffer from Major Depression Disorder, or Bipolar Disorder or Mood Disorders of any kind, you can testify that there is NOTHING on this earth that compares to the HELL that you live with everyday.  You are stuck in a body that has a dysfunctioning organ(the brain) that just so happens to control your mood and how you process information coming in and going out.  It is the worst thing  that has ever happened to me and I can honestly say that I would WELCOME cancer (as I have many family and friends fighting cancer) in place of depression.  Why? Because you know your enemy and you can fight with your heart and soul still intact.  As for depression, you are ROBBED of your very soul.  It is truely HELL ON EARTH. And I will go down fighting if someone keeps me away from ANYTHING that will stave off dpression and its nasty choke hold.  I can not function in life with this desease.  I can not "talk myself into" feeling better.  I can not meditate my way to feeling happy or relaxed.  Its like asking some one to meditate thier severed leg back on. Its just not possible....for me.  Vicodin, in plain english, gives me my life back.  It LETS me feel something other than despair.Would you tell a loved one that you would rather watch them suffer slowly and agonizingly under the curse of depression rather than give them a chance to feel good??? I would take 5 years of happiness over 30 years under the heavy blanket of Depression Disorders.  If taking a med is considered dangerous to my health, but lets me have the quality of life I so desprately crave (and that so many just naturally have) then I say, sign me up.  They always say it is quality not quantity in life and I firmly believe that,  Give me the tool to really LIVE and I will take the consiquence that comes with it.  But God in heaven, dont deny me the oppertunity to see life as it was meant to be, not the torturous hell that this desease inflects on its desprate victims.  And all of you out there looking at this opiate option for depression as it is disgusting and drug seeking filth, you most obviously DO NOT have this debilitating desease.  You are just bummed out and need to go exercise.  Us fighters of this desease will carry on and continue to be the bravest people in the world. Next to our solders of course.  God bless all of you fighters of Depression.  No one really knows what you go through and no one ever will unless they are cursed like we are.  And if get a chance to live life, even for a limited time, live it and dont regret!! Good luck to us all, we are going to need it in this ignorant society that judges so abruptlyand  that simply doesnt understand."  
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(1) I'm not an expert but I think I would do a couple things.
Don't use Opiates unless its for actual pain.  Wondering where your going to get more pills can't help but increase your MI issues.

(2) Work out.  Walk or run do whatever.  I know a ton of you are all rolling your eyes (I would have been not long ago)   I've been doing mood tracker and days I walk for 20 or 30 minutes are always a bump up on the "depressometer."

(3) Work on your meds.  And by that I mean start journaling (Mood Tracker really is a good resource) and noting your anxiety and depression.  Give some clear feedback to whoever prescribes your meds.  Measure and adjust.  It makes it more science then "art"  Don't stop doing this until it works.  There are dose changes, frequency you take the meds (Like Buspar 3x a day vrs 2x a day)  And then there are drugs that just don't work for you.  So medications can be changed.    *Your meds may stop working.   The 2mg of XXX might need to go to 5 or 10mg.  

And even after you find the right drug in the right dose its probably going to change at some point.  They might start working too good.  Or maybe your vegging out and can't function.   The doctors who prescribe this deal with a ton of people that take the prescription and aren't heard from for a year (Or whatever)  

*And when you find a drug (or drugs) combo that works for God's sake KEEP TAKING THEM!  Whats the most common problem?   Is it  - "I feel good now so I don't need to take my meds anymore"
BTW Don't be afraid to talk to your doc about things like Vitamin D (Or other OTC)

(4) Make sure your DX (Diagnosis) is correct.  If you have a TDoc make sure she/he is communicating with whoever prescribes your meds.   Be on them about this.  Almost everyone I've talked to had an initial diagnosis then a revised one later.

One last thing.  If you have more then one person writing scripts be SURE that they both know exactly what you take (In total)   Some drugs just don't work with others and the combos can be confusing even when they do know what your taking.
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Avatar_m_tn
I have PTSD pretty sever, I too am on or have been prescribed Lithium, Xanax, Zoloft, Quitipan, Trazadone, and a slew of other worthless pills. I took a Percocet for an injury, super long story short, I believe soley in my heart that there are absolute positive benefits for opiate users for PTSD. For me, and I can only speak for myself and I am not a doctor, the use of percocet didn't "mask" a thing.

I'm able to address the actual drama issue that did take place in my life. I am desperately seeking a physician to take a long or short term test or study on me. Can Percocet be abused? Absolutely! But if administered correctly, I do believe you can benefit from the calmness and realism it provides.Can it be abused?? Yes, so can Zoloft and Xanax. I would honestly rather drop all of my current meds for a 3-4 dose per day of Oxycodone.

It HAS helped me beat out depression, anxiety, withdrawn issues and suicide thoughts/attempts. Speaking on my behalf! I am NOT A DR. My family on the other hand, would rather me be in turmoil than take a an opiate. Some are surely mistaken and uneducated. My words are strictly from experience. I would the first in line for such study.
However, stop taking opiates is misery! Hell on earth for some. Always seek several DR.s opinion, not just the ones you'r family FORCES you to see to get their answers repeated.
My PTSD came from an accidental shooting leading to the death of another. Flashbacks and sleep deprivation in my case, along with other meds, has helped with the use of Percocet.
I am a firm believer that there are positive affects for Oxycodone use, in a NON abusive way.
A.sk more then 1 Dr. do your homework and research. IMO, I believe this research will eventually come to light that in some cases, there are big benefits to come. Email me back if you have anything to share regarding this comment
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480448_tn?1403547723
HI there!  I'm so sorry to hear what you've gone through, surely it must be so rough.  It sounds like you've been trying everything to keep the PTSD to a manageable level.

The problem with taking opiates regularly doesn't just involve abuse of the medication.  Tolerance (where you need a higher and higher dose to maintain the same level) and dependency are inevitable, even in people who don't abuse the meds and only take them as prescribed.  Then, the very med that helped you will actually make you feel worse, because along with the physical w/ds come the emotional ones.  Opiates create the "happy" chemicals in the brain that the brain is supposed to make for themselves.  After long enough use, the brain will stop producing those chemicals if they are being produced artificially.  When it would be time to stop, or cut down due to tolerance...the depression and anxiety would be severe.

One could argue that meds like antidepressants do the same thing and they wouldn't be wrong, but for one, they ARE suitable for longer term use, with only occasional needs for dosage increases, versus the very frequent increases with opiates that become necessary once tolerance kicks in.  Also, like I mentioned early on...the other issue is that currently, (and I would imagine indefinitely), there is no LEGAL way to Rx an opiate for mood disorders.  The indication is for pain.  There is no off label acceptable uses like there are with other meds.

I totally understand where you're coming from, and if there WAS a way to combat the tolerance and dependency, then maybe it COULD be something that could be considered, but they just aren't appropriate for long term use, and they would end up making the emotional state worse in the long run.  Taking them on an "as needed" basis would only provide temporary, in the moment relief that would be short-lived, and to be honest...a person who was seeking a mental reprieve would have a hard time being able to "choose" when they most deserved to feel "happy".

I just wouldn't want anyone to put their focus on this being a reasonable alternative.  Maybe some day they will find a way...but until then, it's just not a suitable option.  Evebn chronic pain sufferers that need opiates have a lot of difficulties due to the tolerance and dependency issues.  These meds just aren't designed for long term use.

I hope you DO find something that helps you deal with what you've been through.  Best of luck to you.
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Avatar_m_tn
Hi Getweller,

I'm sorry to hear about your PTSD. You may also want to research the endocannabinoid system (i.e your body's own marijuana-like chemicals). Research in animals and humans has demonstrated that one of the functions of cannabinoids is help us FORGET bad memories. Tada, that is a huge part of PTSD. They also down regulate the stress response/HPA axis over-activation, and augment the body's opiate system. Also can reduce opiate tolerance. There are many lifestyle and nutritional factors which can boost them, among them exercise and high-dose fish oil (which in earlier posts on this thread I've recommended to all people, especially with mood disorders).

You also have the option of THC and CBD. Depending on which state you live in, you may be able to get medical cannabis legally. Also the VA (vets admin) has had a change in policy recently and now informally "allow" patients to use cannabis. It is more like tolerate..you can read about this google-it. You can get legal THC prescription pill (Marinol) but it is very expensive and is less effective with more side effects than herbal cannabis. Ideally, look for a variety that has been lab tested and contains equal amounts of THC and CBD (or ~ 1:1 ratio). I could go on, I'll leave it at this but if you have any questions let me know.

Apologies for quasi-tangent away from opiates and to the cannabinoids but just wanted to offer that tidbit.
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5876680_tn?1376189781
I've also been on every ssri, xanax etc. And the only thing that helped me was oxycodone. Not hydrocodone, methadone etc. And if your nodding off etc, your taking waaaay to much. I take 1 15mg pill  twice a day & have energy, motivation, am not sleepy. If I don't take it, I may have a panic attack or more likely, just sleep all day. I don't know what the answer is & I doubt anyone else does either. I'm just trying to live.
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480448_tn?1403547723
I totally understand what you're saying, but unfortunately, the very pills that are helping you to feel better will eventually turn on you.  Taking then every day will build your tolerance and it won't be long before you'll need more and more for the same effect, and if you don't frequently increase your dose (which of course leads to more tolerance issues) to deal with the tolerance issue, the oxycodone (which is a pretty strong opiate) will cause an INCREASE in anxiety for you and depression even.  It really is a double edged sword.

Narcotics create artifical happiness and sense of well being.  If it didn't come with tolerance, dependency and addiction, it would be a viable option.  Also, it makes the underlying problem worse, because after you come off of it, your brain struggles to restore the natural "feel good" chemicals.

People could make similar arguments about antidepressants, but the truth is, you CAN be on them long term, and while occasional dosage increases are needed, they don't share the tolerance issue with opiates.

I welcome you to start your own thread here in the forum outlining your history and describing what all you've tried to date, including any meds, therapy, alternative treatments.  We can then make some recommendations for you for your anxiety.

I can promise you that narcotic pain medication is simply NOT the answer for treating anxiety, and you're going to end up in a worse way in the long run, having to detox off, dealing with both physical AND mental w/ds (which can be a living nightmare, just read a few threads on the addiction or pain management forum).

We'll help however we can.  Take care!!
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Avatar_m_tn
An artificial sense of well being and happiness? Would you say the feeling of happiness or well being you have from relationships, meaningful pursuits in life and all the sensory pleasures (eating, sex etc) are real/authentic? I'm going to sound a bit reductionist here, but all those 'natural' feelings are communicated in the brain with the same systems (opiates, oxytocin, cannabinoids). Of course they all impact neurobiology a bit differently.

Just saying :)
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Avatar_m_tn
Just to quickly emphasize to people. There are legal things you can do which directly or indirectly boost the activity of your brain's own opiate system and also happen to be beneficial for your health in numerous ways. Some of them are almost a cliche but they do work.

1.) Exercise- even just a few minutes a day can do something. Ideally strive for 20-60 mins of mild-moderate aerobic activity each day. Stationary bike, working in the garden, going for a walk, taking the stairs etc. This has been shown in numerous studies to help with depression and anxiety (along with health benefits for everything from diabetes, heart disease, pain, etc etc).

2.)Social support/activity- boosts opiates and oxytocin. Good for stress, depression, anxiety etc It may be difficult to engage in this or exercise if dealing with mental illness, but if you can, do it. Also all around amazing for health.

3.)Fish Oil- boosts opiate and endocannabinoid levels, good for overall health. Take a minimum of 1-2000mg of EPA+ DHA per day. In larger doses can help with pain. Helpful for inflammation (which is higher generally in mood disorders), mood disorders, and just like #1 &2 above, helps with countless health conditions.

-I also agree with other posters suggesting 'health journaling'. Keeping a calendar with a record of as many variables related to your condition as possible truly helps you see what contributes to helping and hindering. I print out a blank copy for each month. I write down my sleep, exercise, social support, meds + supplements (and any changes if any), my general subjective mood and specific symptoms. You would be amazed the things you can learn about yourself through this technique that you couldn't figure out just by thinking about it or drawing from
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480448_tn?1403547723
"An artificial sense of well being and happiness? Would you say the feeling of happiness or well being you have from relationships, meaningful pursuits in life and all the sensory pleasures (eating, sex etc) are real/authentic?"

I totally get what you're saying, but I'm comparing the realistic medicinal treatment of anxiety, and the fact that opiate medications create a false sense of "happiness" and make it difficult for a person to readjust once those medications are gone.  I wouldn't (again) disagree that similar arguments could be made when discussing meds like antidepressants, but they are much more viable choices for long term use, plus they don't share the really big issue of tolerance that opiates do.  It's apples and oranges IMO.

I agree completely with your second post and would always encourage people to incorporate as many of those kinds of measures into their treatment plan as they can, unfortunately for a lot of people, those measures simply aren't enough.

When it comes to the topic of THIS  thread however, I maintain my position about treating anxiety/depression with opioid medications.
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Avatar_m_tn
I hope I wasn't implying that the methods listed would be sufficient for helping people's problems. I could list tons of other complimentary or cutting edge things to further augment mood/anxiety disorder treatment, but was just listing a few things which can help boost the opiate system.

Speaking of which, more tidbits I left out from the list I mentioned in the previous post...

4.) D-Phenylalanine: not L-phenylalanine or D/L-Phenylalanine. The D-isomer is thought to be an inhibitor of the enzyme enkephalinase, which is responsible for breaking down the brains natural opiates , i.e "endorphins" and enkephalin. I believe dose range 500-1000mg 1-3x/day.

5.)Mitragyna speciosa- aka Kratom. Perhaps Nursegirl and others may object to listing this. However in most places in the US, it is legal to purchase etc. The alkaloids (of which there are many) have differing effects, with some acting on opiate receptors, and possibly others involved in the serotonin, NMDA and nor-epinephrine systems. Do plenty of research on your own to determine if this may be an option for you. Also check to ensure that it will not interact with any medications or supplements that you are taking etc.
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480448_tn?1403547723
Yeah, I wouldn't recommend Kratom, as it's addictive.  I post on our addiction community, and Kratom comes up a lot.  

http://drug.addictionblog.org/kratom-addiction-signs-and-symptoms-of-kratom-abuse/
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Avatar_m_tn
I generally agree  in that I'm not inclined to recommend kratom because of it's incomplete chemical characterization- i.e we don't know all the different receptors to which it binds, and therefore what drugs it might interact with and any possible toxicity etc. I just put the information out there so people are aware of all possibilities.

I would like to make a comment/observation combined with a question: Do you work in addiction treatment, or research or counselling? I ask because I've noticed your primary concern regarding any mentioned substance is it's abuse potential/liability etc. I have found in the past when discussing this topic (or similar ones) that people who specialize in addiction in any regards or who have dealt with it themselves or with someone close to them, tend to place the emphasis on addiction.

Well as the old saying goes, if the only tool you have is a hammer, everything looks like a nail. I am probably just rehashing previous comments I've made on this thread but a few of the points I made I don't think you addressed and I'd be curious to hear your reply to them.

1.) Addiction/dependence: You have stated people should avoid opiates on this thread because of the risk of dependence. While I agree that drug dependence can be a tough ordeal that does occur, the reality is that the actual percentage of people who use prescription opioids who then become dependent is actually very low. Exact figures would be hard to quote, but I'd say between 10-35% would be a rough guess. Would you be inclined to agree with me thus far?

-Tolerance: You have also suggested that people taking opiates will inevitably have to escalate their dose, requiring higher and higher amounts. This is another misconception in some regards. Yes the above scenario does happen, but usually it is in two different situations. One is a person with chronic pain who needs increasing doses for adequate analgesia. In this instance the actual mechanisms leading to need for a higher dose is actually the progression of pain, or perhaps so called opiate-induced hyperalgesia. The second would be a recreational user trying to get high and constantly upping the dose, a scenario everyone is likely familiar with. However if someone is consistently taking the same optimal dose of an opiate and adheres to this regularly they will not need to increase the amount (unless still in the stage of titrating to the proper dose).

2.)The reason why many seek opiates (or other alternatives)- current response and remission rates for mood disorders are low. Even in the most optimal situations, in clinical trials with experts, excellent patient compliance, and combination of multiple approved treatments (see for example the STAR*D trials) the response and remission rates are not much above 50-65%. So many people are left with few other choices other than the 'experimental'.

3.)I mentioned the off-label prescribing of stimulants, what is your feelings on that subject?

4.)Aside from addiction, your main objections seemed concerned not with efficacy, but with the problematic nature of obtaining a prescription in the current legal and cultural milieu.

~Hopefully my tone is perceived as respectful ;) I mean no ill will and I enjoy having civil but enlightened discussions on contentious topics.
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Avatar_m_tn
I wish I could agree with you. Actually I don't. Because if I did agree with you I would be curled in a ball depressed in the dark corner of my van down by the river.

I have had severe social phobia and major depressive disorder for more than 12 years. They have put every poison test medication in me that they legally could and it still feels like a 300 pound man is laying on my back. Try getting up in the morning with a hippo on your hip. IMPOSSIBLE!!!

I am a nurse and was prescribed a simple 20 mg oxycontin pill for a spine injury and immediately noticed after my first dose that it worked better fthan any pill I had taken in the last 12 years. It worked for everything! The pain was almost gone but the depression and anxiety were completely non existent.

I realized that half of my dose which is 10mg works wonders for the depression and the anxiety, I did not even have to take my wholw dose because at higher doses it seems to cooperate with the anxiety rather than eliminate it.
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Please repost. I am very fit and health. But I have struggled with feelings of lethargy and motivation no matter how hard I try. I have begged Docs to help and have tried all their suggestions. Life is to be lived at its fullest. I am very ambitious and successful but again no matter how hard I push, no matter therapy sought my back pain and causes me to become overwhelmed panicked and eventually depressed. I truly believe my brain is lacking what opiates provide. Opiates never make me sluggish, lazy, or non productive. I have been on and off for over five years clean for 1 year at a time and never get back to having a sweet productive happiness by that I have when taking. I never abuse them but I have a far more caring loving productive life while taking them. Doc are all to eager to prescribe some many drugs for all sorts of thing and these are often more deadly than most. I want to live a life full of joy, giving, peace, and productivity and do when taking opiates. Conventional medicine is very hypocritical when it comes to this subject. Quality of life is what we should be striving for. Anyone else out there like me? Would love to hear from you!
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