Posted by blueboy on July 6, 2008, at 7:00:00
In reply to Opiates, oxycodone, posted by cactus on June 22, 2008, at 4:07:10
It's ironic, isn't it, that the most helpful drugs are addictive? I have a little bipolar problem, and the only thing that brings me relief during painful mixed states is clonazepam -- not as addictive as oxy, but 'tis enough, 'twill suffice. I'm also an alcoholic and like you I'm extremely careful.
I will say, I often wonder if some of the drug laws are not puritanical in nature rather than rational. Many of the commonly prescribed psychoactive drugs seem to me to be "addictive": one becomes increasingly tolerant as they are taken over time and so one needs higher doses, they make you feel better, and sudden discontinuation can cause very uncomfortable withdrawal symptoms.
I suppose one difference is that illegal or "scheduled" drugs (the US term for drugs that not only require a prescription, but have stricter criminal penalties for nonprescription use) are used for pleasure by people without a diagnosed illness.
(There are five levels of scheduled drugs. Heroin is Schedule 1, meaning that a doctor cannot prescribe it for any reason, and it can only be possessed for experimental purposes with a special license. Oxycodone is Schedule 2 (very strictly controlled), Clonazepam is Schedule 4.)
It seems rather silly, in some ways, that oxycodone cannot be prescribed to you for your lifetime, since it helps you so much. So what if you get "addicted"? That just means that you have to take it for the rest of your life.
My (layman's) understanding of opiates is that they have fairly mild long-term damage compared to a lot of drugs prescribed over a person's life. If heroin were discovered today, and administered over a period typically required by the FDA to find a medication safe, it would be approved.
Its deleterious effects , at least compared to other addictive recreational drugs like meth, cocaine, alcohol, etc., seem comparatively minor. In fact, as far as I can tell, heroin addiction is dangerous almost entirely because it is illegal. Overdose is uncommon unless it is taken with another drug, and the greatest dangers come from adulterants, ingestion problems (HIV, damage to blood vessels), and fluctuations in purity. In other words, most of the danger of heroin usage stems from its extreme illegality.
Long term, the problems associated with opiate use are less severe than a great number of drugs commonly taken over one's lifetime, including both legal recreational drugs (alcohol, tobacco, even sugar) and prescription drugs.
Assuming that oxycodone relieves your symptoms better than anything else, I'd be interested in a rational comparison of the damage it would do if taken over a long period, compared to other drugs you might take. Also, it would be interesting to see a profession cost/benefit analysis.
I have faced this problem myself. The only drug that has given me full relief from hypomanic and mixed states of Bipolar II is clonazepam, which is certainly habituating and arguably "addictive". It is, however, a controlled (scheduled) drug.
My thought is that, perhaps, an ongoing course of treatment from clonazepam in whatever amount is needed to control my symptoms would be as safe as, and more effective than, unscheduled prescription drugs that a doctor is much more willing to prescribe over a long duration.
This is especially interesting because, if a doctor in the US prescribed oxycodone for a long period of time to a person to treat a "psychological" condition, he would lose his license and be sent to prison.
(Oh well, who expects the government to make sense? Just look at the tax laws.)
poster:blueboy
thread:835899
URL: http://www.dr-bob.org/babble/20080706/msgs/838332.html