Respiratory Depression. Opiates For Suidicidal Depression ?
Q: I am agnostic to the use of opiates for depression. However, I have
no preconceptions that would prevent me from considering their usage.
It sure as hell sounds like you do. What is your "beef" against
opiates??
A:Opiates ameliorate pain. Depression isn't just metaphorical
pain, and it will respond to narcotics. Through numbing and
oblivion.
But it's tricky, and you walk a fine line between feeling better
and feeling strung out. Morphine is the standard narcotic, and
it works as follows.
There are two distinct pain thresholds, physical and psychological.
A plain analgesic dose blocks pain transmission at the physical
threshold. This is the lower, more sensitive of the two.
What exactly is your personal vendetta against opiates? I've said that
this is an area where I think more experimentation should be done.
That way some firm conclusions may be drawn about the feasibility of
using opiates in *some* cases of depression. I'm not in the
position, nor would I be inclined if I were, to substitute opioids
for any other successful treatments of depression.
I would not have expected such arrogance and biased reporting from anyone but
a pusher. Excuse my error. Why do you not lobby the DEA to get the
"indications" changed? (I would suggest a tactful approach - and data re the
number of sufferers as well as a clinical trial demonstrating the
effectiveness of opiates for depression.)
Wrong, little one. They and other considerations support my argument. A
wiser guy than you has pointed out that there are some intrepid souls who
will prescribe opiates for non-terminal chronic pain - more power to them,
though I'm not sure how long they sustain this therapy without becoming
depressed. (That may be in the articles he posted, which I have not read yet.
The articles I HAVE read, say that while tolerance is developed to the
pain-relieving aspect, it is not developed to the respiratory depression
aspect. There is, unfortunately, in science, much of this sort of
disagreement.) Another more, cool-headed type has indicated the difference
between using opiates for chronic pain - as opposed to using it for
depression, where the temptations to abuse it will be greater.
people DO develop tolerance to the respiratory depression from
opiates. I had a patient once who was addicted to Dilaudid, and her