Note: If I remember, and I also feel like it. I will hyperlink to the various research papers I discuss below. If you are reading this, and you want me to update, just leave a comment. Don’t worry about the age of the post, I will see your comment.
This is a semi-private place for me to discuss personal findings. Maybe at some level provide useful information to someone looking for info on the 12th page of a google search.
If you are here, Welcome! I hope my ramblings can help you at some level.
I have been doing a bit of a amphetamine fueled research spree these past 14 or so hours. Though its unhealthy, I am once again trying to fix my sleep schedule by staying up through the night. I woke up around 5pm yesterday, and its about 12am now. I will try to pass out around 8pm tonight. Hopefully I can get that to work without the use of benadryl. I don’t want to use dementia causing anticholinergics, if I can help it.
In any case. I am have been researching options for treating the anxiety and depression I seem to be suffering from. I am currently prescribed generic adderall, at 45mg, 15mg 3 times daily. Along with generic guanfacine ER.
Its been about 3 months now, give or take. The effects of the amphetamines are wonderful. Increased focus, motivation and quality of life. Unfortunately the stress is still there and the suicidal ideation is still there. I hoped that a dopaminergic drug like amphetamine could cure these problems, and it certainly seemed to help for the first month or two. However, I have adjusted to the substance, and it doesn’t help with the depression or anxiety much anymore.
The guanfacine is barely noticable, it might be helping with anxiety at some level, but it certainly isn’t significant enough to ameliorate the stress, especially stress induced from social interaction.
So I have been researching the use of anti-depressants, opiates, and other options to reach some base level of sanity.
Though I realize that the source of the depression/anxiety is likely tied at some level to my childhood. My shitty parents being what they were. I can’t deal with that right now. I also can’t really afford a quality therapist.
I am searching for an effective medical solution to keep me functional in the meantime.
Surprisingly, in opposition to our current societies collective opinion, and perhaps even the majority of the medical community, I have found that opiates are not really as dangerous as they have been made out to be. At least in regards to addictive potential. Apparently less than 1% of patients, prescribed opiates for treatment resistant pain, become would could be qualified as “abusers”. On top of this, the dreaded tolerance you see spoken of, either in medical papers, or in online opiate user communities, doesn’t seem to be a problem specifically for the treatment of pain. The papers that I have seen state that dosage stabilizes, and even is reduced in many cases, after initial stabilization. This apparently holds for years. With certain patients being on a stable dosage of opiates for decades.
More research is needed of course. And anxiety/depression is different than chronic pain. But it is surprising to see peer reviewed research flying in the face of commonly accepted medical knowledge.
On top of this, I have discovered that the use of a “speedball”. Namely, the mixture of either amphetamines such as dexamphetamine, or methylphenidate, can be mixed with opiates with minimal risk, at least in the short term treatment of cancer patient’s pain.
As an aside, this is known as a Brompton cocktail. A mixture of a stimulant and an opiate. It was popular apparently during the 18th and 19th centuries for various treatments. With our current societies very strict view on both narcotics and stimulants, it is unsurprising that this has fallen out of favor.
The amphetamine treats the somnolence (daytime sleepiness) of the opiate, reduces the “mental fog” caused by the sedative effects, and also reduces the required opiate dose needed for therapeutic effect, due to boosting the analgesic properties of the opiate.
From what I can tell, the two drugs do not counteract in other, or cause deadly or even problematic symptoms in the vast majority of patients.
Once again, the negative stigma tied to a “speedball” seems to be due to the relatively small percentage of drug abusers who fail to measure dosage, and cause either opiate toxicity or amphetamine toxicity due to overdose. This seems to be the cause of most stigma tied to “hard” drug use. A small percentage of morons, cause over-anxious moral busybodies to limit the freedoms of the rest of the populace. Both amphetamine and opiates seem very safe to both organs and the brain, as long as dosages are kept lower than what might be considered “recreational”. This seems to be at least under 2mg/kilogram for the amphetamines. For the opiates, its as low a dose as is needed to ameliorate felt pain.
On top of this, several studies have shown that the use of Buprenorphine(suboxone, but without naloxone which “kills the high”) is incredibly effective at treating treatment resistant depression (TRD). As well as reducing suicidal ideation in those at high risk of suicide. This isn’t particularly surprising. Opiates generally make you feel good.
However, this gives me a sort of nuclear option, that is relatively safe. If I am prepared for some level of dependency and I have a “stack” of sorts to treat withdrawal if cessation is needed, I can use a combination of buprenorphine and either methylphenidate or dexoamphetamine to simultaneously keep me active, alert, calm, and happy.
I will write a post of minimization of withdrawal symptoms later perhaps. If I do I will link it here.
It is risky at some level, I am mixing two separate classes of drugs known for their addiction and abuse potential. But if I use dosage schedules taken from research papers as well as publicly available titration tables from places like http://www.pdr.net or UpToDate.com. I can stay at safe levels, and probably use this longterm.
There is some concern for amphetamine toxicity as mentioned in the paper detailing treatment of cancer patients with both amphetamines and buprenorphine. However, according to the paper, the toxic symptoms were only found in the first trial that used a non-amphetamine stimulant. Methylphenidate was found to be safe, and caused no toxicity among the tested population. However, if toxicity occurs, I can simply cessate use.
The largest issue at this point would be getting a reliable supply of the buprenorphine. It is only schedule III, so I am less likely to be targeted by law enforcement if I went with DarkNet options. But I would prefer to follow the legal route to minimize both cost and risk. However, I find it unlikely I could find a doc that would be comfortable with prescribing an opiate off-label, even if it is a safe-ish one like buprenorphine. Especially alongside an amphetamine. There is a reason the paper discusses cancer patients. Good luck getting prescribed the combo without having a painful, chronic and likely fatal condition like cancer.
However it could be possible. Though it would probably be worth getting my hands on a supply of bupe first to test efficacy, and then going from there. Once again this is the nuclear option. I should try an SSRI or SNRI first, and then maybe progress to Tianeptine, which is unscheduled and easily purchased online. It probably would even be better to get a prescription of benzodiazapines before I went with opiates as a treatment option.
However, buprenorphine or another opiate is probably the most powerful solution to my anxiety and depression issues, though it also carries the most risk. Either in the form of a jail sentence, or addiction and abuse.
It is frustrating to me the lack of research on opiates in the treatment of depression and anxiety. If addiction and abuse rates truly are so low, then the aversion of the medical community as a whole to the use of opiates in treatment is irrational at best.
Jesus, I hope this account is as anonymous as I think it is. I doubt the NSA gives a fuck about my drug habits though.