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GPs should know about clonodine. It's a blood pressure medicine that counteracts the massive norepinephrine dump you experience when you kick (and which is the

GPs should know about clonodine. It's a blood pressure medicine that counteracts the massive norepinephrine dump you experience when you kick (and which is the number one thing that makes it so unbearable). It helps a lot. Besides methadone there's also buprenorphine and Suboxone, which are opiate replacements. Not the kind of thing you take to get high, something to use to taper off so the withdrawals aren't so intense. Heroin abuse is a big problem that's only going to get bigger in the US. A lot of folks got addicted back when Purdue was pushing Oxycontin, and now that it's harder for them to obtain they've switched to the cheaper and more potent stuff. Doctors need to know how to treat withdrawal, period. There are lots of options besides methadone (which has it's own nightmare withdrawal if stopped abruptly, and which lasts three times longer than heroin withdrawal).

pmoriarty 10y ago
"Heroin abuse is a big problem that's only going to get bigger in the US. With legal weed, a lot of former marijuana producers are getting wise and starting to farm the opium poppy. Plus a lot of folks got addicted back when Purdue was pushing Oxycontin, and now that it's harder for them to obtain they've switched to the cheaper and more potent stuff." I'd really like to see some numbers on this. From what I understand, there are far, far more marijuana users than there are heroin users -- like many orders of magnitude more. So, yeah, illegal marijuana growers could certainly switch to growing opium, but they're not going to magically get anywhere near the number of customers.
- coleifer 10y ago
  I did a quick google search: * https://www.cdc.gov/drugoverdose/data/heroin.html https://www.cdc.gov/drugoverdose/data/heroin.html * http://www.cbsnews.com/news/heroin-use-in-u-s-reaches-alarming-20-year-high/ http://www.cbsnews.com/news/heroin-use-in-u-s-reaches-alarmi... * http://time.com/3946904/heroin-epidemic/ http://time.com/3946904/heroin-epidemic/ * http://www.cnn.com/2016/09/16/health/huntington-heroin/ http://www.cnn.com/2016/09/16/health/huntington-heroin/
  - pmoriarty 10y ago
    Versus the number of marijuana users, please.
    - deleted 10y ago
      [deleted]
    - ambrice 10y ago
      Also consider what the average marijuana user is spending per day vs what the average heroin user is spending.
  - adevine 10y ago
    From these links, main number seems to be "Nearly 10 million Americans, or 4.1 percent of the adult population, used prescription opioid painkillers for nonmedical reasons in 2012-2013". Numbers I've seen for marijuana were about 11.5% in a year, though that was for 2001. So certainly higher usage for marijuana, but definitely not "many orders of magnitude"
- akytt 10y ago
  Basic economics. Your most profitable product line disappears to the tune of a few billion usd. Your next move is to push up the volume of your next profitable product line and increase the margins.
  - Frondo 10y ago
    Evidence to support the theory in this specific instance, please.
- tn13 10y ago
  While I am personally totally going to try MJ once it gets legal I don't think I am going nowhere close to Heroine irrespective of its legality.
- lsiebert 10y ago
  Well, there were more deaths by overdoses involving an opiod then deaths from car accidents in 2015, the last year a quick search can find more data on. And to be clear, deaths from car accidents are growing, likely because of things like cell phone use. Here's a business insider article, and the data sources I used. http://www.businessinsider.com/heroin-vs-opioid-overdose-statistics-2015-7 http://www.businessinsider.com/heroin-vs-opioid-overdose-sta... https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm http://www.newsweek.com/us-traffic-deaths-injuries-and-related-costs-2015-363602 http://www.newsweek.com/us-traffic-deaths-injuries-and-relat...
digi_owl 10y ago
Doctors need to stop blindly following big pharma suggestions on prescriptions more like it. Supposedly a pharmacorp released a painkiller a few years ago thats supposed to last longer pr dose than then existing ones. but when patients complained that they didn't work, the corporate advice to doctors was to up the pr pill dosage rather than advice the patients to take the pills more often (as that would make a lie of their marketing claims).
FireBeyond 10y ago
"GPs should know about clonodine. It's a blood pressure medicine that counteracts the massive norepinephrine dump you experience when you kick (and which is the number one thing that makes it so unbearable). It helps a lot." Is that a labelled use? Because most physicians are restricted or prevented from prescribing drugs for "off label" use.
- joecool1029 10y ago
  > Because most physicians are restricted or prevented from prescribing drugs for "off label" use. Wrong. You have no idea what you're talking about: https://en.wikipedia.org/wiki/Off-label_use#United_States https://en.wikipedia.org/wiki/Off-label_use#United_States
  - FireBeyond 10y ago
    Upvoted because I was totally wrong. I had conflated pharma advertising restrictions with physician guidelines.
RangerScience 10y ago
Huh. I've been told that ibogaine "short-circuits" the withdrawl process, and so googled ibogaine + norepinephrine and got this paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365767/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365767/ In contrast [with Ibogaine], all other known SERT inhibitors are competitive with substrate (28). These competitive inhibitors include several compounds that also inhibit the closely related dopamine and norepinephrine transporters Does someone with enough knowledge to actually understand this paper want to chime in and maybe explain? It seems well-written, but reliant upon knowing, what, say, SERT and DAT are. Edit: This other paper also came up: https://www.ncbi.nlm.nih.gov/pubmed/7568622 https://www.ncbi.nlm.nih.gov/pubmed/7568622
- LnxPrgr3 10y ago
  I am not an expert, but since no one has answered I'll give what I know and hope somebody corrects me if I'm terribly wrong. Substrate: the thing that's supposed to bind to something normally. SERT: transporter that pulls serotonin out of synapses back into the neuron that put them there in the first place. DAT: similar, but for dopamine and to some degree norepinephrine. Competitive inhibition: inhibition depends on whether the intended substrate for a site is present—the drug and substrate interfere with each other competitively. Non-competitive inhibition: the drug inhibits the function of a site even if the intended substrate is already bound to it. As to how any of this explains or refutes claims ibogaine short-circuits withdrawal, I dunno. Feels a bit like trying to explain JavaScript in terms of quantum mechanics. Both these papers are evaluating the drug's interaction with neurons, not the drug's effect or non-effect on addiction.
shabble 10y ago
ITYM Clonidine[1]. There's also Lofexidine[2] which is available on prescription in the UK, but seems largely unknown elsewhere. From personal experience (quitting long-term morphine treatment due to intolerable side effects), it was extremely helpful in moderating some of the physical withdrawal symptoms. [1] https://en.wikipedia.org/wiki/Clonidine https://en.wikipedia.org/wiki/Clonidine [2] https://en.wikipedia.org/wiki/Lofexidine https://en.wikipedia.org/wiki/Lofexidine
lsiebert 10y ago
Speaking of only going to get bigger, The Republican Health care plan drops the mental health and addiction recovery mandate for medicare. https://www.washingtonpost.com/news/wonk/wp/2017/03/09/gop-health-care-bill-would-drop-mental-health-coverage-mandate-covering-1-3-million-americans/?utm_term=.1f50d74575f2 https://www.washingtonpost.com/news/wonk/wp/2017/03/09/gop-h...

pmoriarty 10y ago

"Heroin abuse is a big problem that's only going to get bigger in the US. With legal weed, a lot of former marijuana producers are getting wise and starting to farm the opium poppy. Plus a lot of folks got addicted back when Purdue was pushing Oxycontin, and now that it's harder for them to obtain they've switched to the cheaper and more potent stuff." I'd really like to see some numbers on this. From what I understand, there are far, far more marijuana users than there are heroin users -- like many orders of magnitude more. So, yeah, illegal marijuana growers could certainly switch to growing opium, but they're not going to magically get anywhere near the number of customers.

coleifer 10y ago
I did a quick google search: * https://www.cdc.gov/drugoverdose/data/heroin.html https://www.cdc.gov/drugoverdose/data/heroin.html * http://www.cbsnews.com/news/heroin-use-in-u-s-reaches-alarming-20-year-high/ http://www.cbsnews.com/news/heroin-use-in-u-s-reaches-alarmi... * http://time.com/3946904/heroin-epidemic/ http://time.com/3946904/heroin-epidemic/ * http://www.cnn.com/2016/09/16/health/huntington-heroin/ http://www.cnn.com/2016/09/16/health/huntington-heroin/
- pmoriarty 10y ago
  Versus the number of marijuana users, please.
  - deleted 10y ago
    [deleted]
  - ambrice 10y ago
    Also consider what the average marijuana user is spending per day vs what the average heroin user is spending.
- adevine 10y ago
  From these links, main number seems to be "Nearly 10 million Americans, or 4.1 percent of the adult population, used prescription opioid painkillers for nonmedical reasons in 2012-2013". Numbers I've seen for marijuana were about 11.5% in a year, though that was for 2001. So certainly higher usage for marijuana, but definitely not "many orders of magnitude"
akytt 10y ago
Basic economics. Your most profitable product line disappears to the tune of a few billion usd. Your next move is to push up the volume of your next profitable product line and increase the margins.
- Frondo 10y ago
  Evidence to support the theory in this specific instance, please.
tn13 10y ago
While I am personally totally going to try MJ once it gets legal I don't think I am going nowhere close to Heroine irrespective of its legality.
lsiebert 10y ago
Well, there were more deaths by overdoses involving an opiod then deaths from car accidents in 2015, the last year a quick search can find more data on. And to be clear, deaths from car accidents are growing, likely because of things like cell phone use. Here's a business insider article, and the data sources I used. http://www.businessinsider.com/heroin-vs-opioid-overdose-statistics-2015-7 http://www.businessinsider.com/heroin-vs-opioid-overdose-sta... https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm http://www.newsweek.com/us-traffic-deaths-injuries-and-related-costs-2015-363602 http://www.newsweek.com/us-traffic-deaths-injuries-and-relat...

digi_owl 10y ago

Doctors need to stop blindly following big pharma suggestions on prescriptions more like it. Supposedly a pharmacorp released a painkiller a few years ago thats supposed to last longer pr dose than then existing ones. but when patients complained that they didn't work, the corporate advice to doctors was to up the pr pill dosage rather than advice the patients to take the pills more often (as that would make a lie of their marketing claims).

FireBeyond 10y ago

"GPs should know about clonodine. It's a blood pressure medicine that counteracts the massive norepinephrine dump you experience when you kick (and which is the number one thing that makes it so unbearable). It helps a lot." Is that a labelled use? Because most physicians are restricted or prevented from prescribing drugs for "off label" use.

joecool1029 10y ago
> Because most physicians are restricted or prevented from prescribing drugs for "off label" use. Wrong. You have no idea what you're talking about: https://en.wikipedia.org/wiki/Off-label_use#United_States https://en.wikipedia.org/wiki/Off-label_use#United_States
- FireBeyond 10y ago
  Upvoted because I was totally wrong. I had conflated pharma advertising restrictions with physician guidelines.

RangerScience 10y ago

Huh. I've been told that ibogaine "short-circuits" the withdrawl process, and so googled ibogaine + norepinephrine and got this paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365767/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365767/ In contrast [with Ibogaine], all other known SERT inhibitors are competitive with substrate (28). These competitive inhibitors include several compounds that also inhibit the closely related dopamine and norepinephrine transporters Does someone with enough knowledge to actually understand this paper want to chime in and maybe explain? It seems well-written, but reliant upon knowing, what, say, SERT and DAT are. Edit: This other paper also came up: https://www.ncbi.nlm.nih.gov/pubmed/7568622 https://www.ncbi.nlm.nih.gov/pubmed/7568622

LnxPrgr3 10y ago
I am not an expert, but since no one has answered I'll give what I know and hope somebody corrects me if I'm terribly wrong. Substrate: the thing that's supposed to bind to something normally. SERT: transporter that pulls serotonin out of synapses back into the neuron that put them there in the first place. DAT: similar, but for dopamine and to some degree norepinephrine. Competitive inhibition: inhibition depends on whether the intended substrate for a site is present—the drug and substrate interfere with each other competitively. Non-competitive inhibition: the drug inhibits the function of a site even if the intended substrate is already bound to it. As to how any of this explains or refutes claims ibogaine short-circuits withdrawal, I dunno. Feels a bit like trying to explain JavaScript in terms of quantum mechanics. Both these papers are evaluating the drug's interaction with neurons, not the drug's effect or non-effect on addiction.

shabble 10y ago

ITYM Clonidine[1]. There's also Lofexidine[2] which is available on prescription in the UK, but seems largely unknown elsewhere. From personal experience (quitting long-term morphine treatment due to intolerable side effects), it was extremely helpful in moderating some of the physical withdrawal symptoms. [1] https://en.wikipedia.org/wiki/Clonidine https://en.wikipedia.org/wiki/Clonidine [2] https://en.wikipedia.org/wiki/Lofexidine https://en.wikipedia.org/wiki/Lofexidine

lsiebert 10y ago

Speaking of only going to get bigger, The Republican Health care plan drops the mental health and addiction recovery mandate for medicare. https://www.washingtonpost.com/news/wonk/wp/2017/03/09/gop-health-care-bill-would-drop-mental-health-coverage-mandate-covering-1-3-million-americans/?utm_term=.1f50d74575f2 https://www.washingtonpost.com/news/wonk/wp/2017/03/09/gop-h...