My dosing theory for “scary” drugs (and a poke at the trashy values of the collective and how they affect me)

These drugs have two things in common; one is their incredible efficacy when used by rational, lucid people who want to live a full healthy life:

cocaine, amphetamine, methamphetamine, methylphenidate (narcolepsy, ADD, off-label depression)

morphine, heroin, codeine, oxy’s, opium, tramadol, buprenorphine (chronic pain, off-label depression, anxiety)

marijuana (sedation/stimulation, anxiety, pain relief, depression)

benzodiazepines, barbiturates (sedation, anxiety)

psilocybin (pain, depression)

The second thing they have in common is the difficulty getting a prescription for them because they are either illegal, or stupid people exist in the world; so instead of letting them voluntarily take themselves out of the gene pool like nature intended, the State, many moons ago, had taken upon its self the uninvited task of taking care of these dullards at the expense of my liberty and my right to procure the drug of my choice, in the name of some false “altruism” or “greater good” because maladroits get themselves into trouble with drugs (as if they wouldn’t without drugs); and somehow society would become a dangerous or less safe place otherwise, or some such nonsense.

It’s telling that, because we’re caught in this frame of nanny-statism and legalities, one of the main things drug researchers peel their eyes for, like hawks, are drugs that make us feel really good, too good, too soon. Fear of litigation is a reason we have “safe”, mediocre, usually inefficacious modern psychiatric drugs that have little value and crappy side-effects, yet are continually stuffed down the throats of trusting, half-witted souls, a few of whom actually get some benefit (bless you)… I wonder if visionary, progressive pdocs who have to dole out this junk feel any kind of guilt or frustration. I know that I would feel weary if I could not script, off-label, drugs like methamphetamine (desoxyn), laudanum (yes, it still exists in the pharm repertoire) or marijuana.

~But, I think there’s something else afoot here as well:

…”‘k, so you guys at MumsdrugCo have developed this drug that gets rid of depression. Right on; I could sure use it. Umm, can I try it? No? It makes volunteers in clinical studies too happy… so it’ll make me feel really good, and… we, don’t… want this… do we? ‘K, I guess you guys know what you’re doing… I suppose. Umm, I have to tell you though: all the antidepressants I’ve tried over the years have done nothing for me except make me feel worse. I felt better when I didn’t take them at all. I’ll tell you what did work very well, though; opium and dextroamphetamine; dextroamphetamine worked on an as-needed basis, maybe twice a week. Then I discovered that opium targeted as much of an extent what was wrong with me. Opium cycled on for a while, then cycled off for a month, then back on really does help me a lot.

“You say I shouldn’t do that? Why? I could get into trouble with it? Know something? I think you’re projecting; I think you could get into trouble with it because you would doubt yourselves in my situation. Know what else? I think, because you and the legislators who govern you don’t trust yourselves, you won’t let drugs through that could benefit so many smart people, and now we all have to suffer because of stupid people and your own self-doubt. And as usual, given the reigns of state authority, like any cop, doctor or politician, notwithstanding your fear of litigation, you feel free and qualified to impose your values upon me; and the things you value are more often than not, of little value.”

Jesus and John Galt wept.

~Certain patients who can’t take care of themselves or are not capable of thinking rationally or projecting plans for the future should follow the advice of their doctors only, and ignore the following…

…but for those of us who crave a happy productive life, “scary” drugs are, in my opinion, among the best for what ails rational people. Some get positive results from taking very small, scientific daily “lifting” doses, titrating up when necessary, then after a few months, tapering down and off for a period of time (maybe a month; maybe two); then starting again. I don’t think it’s in our interest to take any psych drug, pharm or not, continuously without cycling off (well, more serious cases like schizophrenia or bipolar might be a different story). The brain is plastic and in a state of constant homeostasis, and I think more harm than good results from a constant bombardment of exogenous chemicals… who do you want to be when you’re seventy?

…I would rather live a month or two with depression, knowing that I’m going to feel better again in a while when I resume dosing up, than take a chance that my personal chemistry hasn’t had a time of rest and a chance to get back to “normal”, as bad as “normal” might be (and who knows? maybe I’ll feel better drug-free for a while, or…?). I don’t want my neurons (at least) to be permanently twisted some day…

…so I think cycling on and off is the way to go if one doses every day. I’m in a cycling off period right now because, frankly, I think doctors are up their asses with daily scientific fixed dosing. I don’t buy into the theory that the body must take this smooth bombardment, on and on, even when the patient knows in their gut it’s time to taper off, at least for a while.

~So in one week I’ll be opiate-free, and will not take it for at least one month. I’ll keep you posted on how I feel during this time. It has not been hard to taper; I should say rather, it hasn’t been hard because I’ve had some great help from benzo’s for anxiety, trazodone to knock me for the night, and baclofen (an amazing wonder drug) for everything else; wow, this combo works well.

~Another dosing schedule is possible; if one prefers to not dose every day, dosing every three days, or twice a week can work too. It’s not “scientific”, in that the body doesn’t have a constant level of chemical within, but who can tell me that a doctor knows best what works for me if I achieve acceptable results taking a substance on an as-needed basis?… and besides, how do we know that it is not healthier to keep the body on alert and “guessing” what’s going to happen next, instead of on a predictable course of action that the body sees through, laughs at and compensates for?…

…so, when I start dosing again in about five weeks, I’m going to try this theory and let you know how it goes…

…I think we’re going to be pleasantly surprised.

~Now, if only these market products were available, unscripted, from legal vendors, would we finally be free to experiment openly and share our results with each other instead of having to skulk about on the net, like criminals. Imagine the added bonus of lower prices thanks to competition and no Organised Crime dictating cornered markets.

…oh well. I can dream for that day.

~Let me know what works for you. Feel free to talk about any drug used off-label for the last six months at least, and what your system is. I’m curious.

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Separation distress and the importance of valued people

I stumbled onto two interesting authors, Jaak Panksepp and Douglas Watt…

“‘Big Pharma,’ as big business, seeks antidepressants that may become billion-dollar blockbuster drugs. Accordingly, it may neglect drugs that are off-patent (e.g., buprenorphine) as well as those that only serve a small subset of the population. Many authors (ever since Valenstein, 1998) have argued that the pharmaceutical industry may be exercising an increasingly distorting influence on prescription and treatment landscapes for the whole of medicine in the United States. This may be particularly true in relationship to depression, where many depressed patients are never referred to psychotherapy and instead are only put on first-line antidepressant drug regimens under the simplistic aegis that depression is “just a chemical imbalance.” These trends take place despite evidence that pharmacology is often only partially effective in depression (see recent STAR*D reports: Rush, 2007; Rush, Trivedi, & Fava, 2003) and despite evidence that patients suffering from trauma-related depressions do quite poorly treated alone with psychopharmacology without psychotherapy”

 Far be it from me, an academically untrained but round-eyed acolyte of the big world, to feel at all qualified to take on the authors’ implication that depression may be the result of anything but “a chemical imbalance” though an initial “trauma” may have initiated the process, and the chemical imbalance following the trauma can’t be fixed wholly pharmacologically. But I’ll state modestly that some day soon, almost every state of depression, whatever the cause, will be cured chemically sans psychotherapy…

…psychotherapy definitely has a purpose… probably always will; intelligent people understand that they have subjective limitations regarding self-awareness, and some have an interest in resolving recurring, stunting issues, or simply gaining insight for the sake of growth with the help of trained facilitators. But some day drugs will blow away our depression, regardless, with remaining only a curious interest in why we do the things we do and think what we think, for the sake of treating ourselves and others better.

~But my little declaration is not the reason for this post. Jaak Panksepp and Douglas Watt really have their stuff goin’ on, and are speaking my language. My personal theory of depression (…depression not caused by an innate anomaly) involves three roots: an unsuitable industrial diet, inappropriate exercise (not enough and chronic cardio), and stressors, including modern stressors (pollution, lifestyle etc). In this piece, the authors deal with separation stressors leading to a “protective” state of depression (do I smell the pernicious stench of dynorphin again?).

Whether or not this thesis is correct, the thing that jumps out and reminds me is the importance of keeping one’s self as engaged and socially involved as possible. Clearly (if only for the production and cultivation of calming oxytocin, which is known to sustain opioid reward in the brain), the importance of maintaining and nurturing relationships with people we value and who give us value in return can’t be overstated in a world that increasingly creates and promotes options for insularity and “aloneness”.

Equally, one must have a healthy hierarchy of values…

…if not, being depressed and alone might actually be a better situation than being depressed with people who don’t elevate us… don’t challenge us to go higher, but erode our quality of life, sense of self-esteem and our quest for happiness. In this case, until one has redeveloped a healthy sense of worth through proper diet, appropriate exercise, a low-stress lifestyle, and insight perhaps helped by psychotherapy, I think sometimes we can wait until we are in a better state to nurture rewarding relationships with quality people…

…just relax, and be good to yourself first.

The Helpless Lamb & other pernicious lies

I’m a libertarian of the right, so have little patience for those who wish to coddle parasites and “victims” with my cash.

It’s curious that many of these takers keep their hair meticulously unkempt and dreadlocked, and make damn sure that they are seen to be “keepin’ it real” and living the romance and despair of it all. Ironically, they’re making an effort to do something. Guaranteed though, if my legally extorted money wasn’t keeping them alive, they would be either dead or cleaned up and supporting themselves with work.

This guy takes on the lie of the helpless lamb pretty well, though I don’t agree with his pragmatism and contemporary Canadian conservative tendency to give up and shrug in exhaustion…

So what’s the solution? Well, I think radical change is needed.

And that should include the distribution of both hard and soft drugs, such as  marijuana, – or their substitutes – through regular medical channels, via  doctors and pharmacists.

In other words, they should be dispensed in the same way as painkillers,  sleeping pills and other potentially addictive “medicines.”

Certainly, such a change would inevitably mean further expense for our public  health system. But those costs should be offset by savings in our criminal  justice system – keeping addicts out of clogged courts and crowded jails.

…”should be offset”? bullshit…

…you don’t just quasi-legalise drugs, expand the welfare state and hope things will work out. Things won’t. They’ll just get worse and more expensive. This line of thinking serves only to damage the person and the nation; and let’s admit it: what one permits, one promotes. So lets all take a deeeep breath and just legalise the damn stuff. The author of this piece isn’t a flaky socialist liberal, but as bad as any bleeding-heart who believes in the inherent goodness of maladroits are moralists who thoughtlessly and irrationally push pandering conservative politicians to ban these market products. Besides smarmy conservative pols, organised crime, the cops and pharmaceuticals are the only ones who benefit from illegal or “controlled” drugs. The fact that they’re illegal or controlled, and therefore bloody expensive, definitely doesn’t benefit me.

Want to make big cash real quick? Sell an illegal product with a huge demand, jack up the prices because the markets are so twisted by legislation and rake it in!

Want to be a happy police chief? Push to keep a product illegal, then because it’s a great excuse, grab more arbitrary power over the citizen and because more resources are needed, rake it in!

Want to be a happy drug company? Push to legalise illegal drugs on your terms, monopolise and rake it in!

…why do I vote?

SSRI fail…

I stumbled onto this 2008 meta-analysis regarding the efficacy of fluoxetine (Prozac) and related SSRI antidepressants…

Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included [!!!], the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores. The purpose of this analysis is to establish the relation of baseline severity and antidepressant efficacy using a relevant dataset of published and unpublished clinical trials.

(my emphasis)

This study was looking for a depression baseline for efficacy: the researchers concluded that how down you feel is positively correlated with how well the drugs work… sort of.

If you’re moderately depressed, you can pretty much forget it and save your cash. Spend it on candy or unicorn rides or whatever it is happy people spend their money on; if you’re severely depressed, you might get something out of it… maybe; and if you’re muttering-to-Jesus-walking-in-the-middle-of-a-busy-road-in-pajamas, severely, with whipped cream and chocolate sprinkles depressed, there’s a fair chance you’ll get something out of it. But here’s the kicker… the efficacy of treatment for this extreme type of depression was attributed not as much to the drugs as to decreased responsiveness to placebo.

…hope you have faith in your doctor’s dope.

Too bad looking for answers for depression outside of the serotonin/norepinephrine/dopamine axis and studying the endogenous opioid system seem to be evil and taboo. Or something…

…too bad I had to turn my back on the Establishment and find my own answers.

The story so far…

This isn’t a detailed autobiography, just an outline of one person’s life with dysthymia/depression, so things will be kept general.

~All my life I felt like an outsider. From around age twelve I began to marvel at the capacity for a seemingly natural joy that people could experience, while I watched from the other side of the invisible fence. Around ’79, on the edge of my small town, one sunny, hazy Saturday afternoon behind the school overlooking a field with my friends, I experienced a profound ennui that, looking back, should never have been felt by a fourteen year old kid. How could such a romantic poetic vision and melancholy regret have been made aware by some dumb teen? Very little worldly experience, no worldly loss, no ripping trauma, yet there it was. Without the buffers of time spent in the world, how could someone so young be expected to deal with these adult impressions?

When I was about eighteen I was tired of being tired, so I decided that I should go to a doctor to try to deal with the haze I was living in. I went in, he asked a few questions, I was prescribed vitamin c tablets and booted out the office door…

…WTF… goddamn vitamin c tablets…

…no questions, no interest, no sleuthing for answers to any possible mysteries that one might want to uncover, discover and conquer; y’know… to satisfy the natural male urge to “know”.

Nope. Just vitamin c pills. This begs the query: are doctors taught to be unimaginative dullards? Are all remnants of innate curiosity drained and beaten out of them during training? Is there a liability issue involved that forces them to take an extremely conservative approach? Does this approach prevent in many cases a favorable result? If so, this doesn’t reflect well on Western practices.

With this bad taste in my mouth I realised that I would probably have to fix my problems myself, so through the years I developed a DIY approach to things. I soldiered on and did everything I could to find an answer for my state. I tried every “healthy diet” in the books until I stumbled on the concept of eating to satisfy the human genome. This meant eating, as closely as possible, pre-agricultural food; a paleoesque diet. It worked to a certain extent. In this same “paleo” vein, I started exercising in a more natural way; this meant lots of walking and very little running, and weight training using as many muscles as possible per exercise (compound exercises) and doing it less. This worked somewhat too. With this combination of diet and exercise my anxiety levels went down quite a bit, and only the dysthymia remained. This experiment began in 2007…

…before this time, I’d tried too many antidepressants to name (this would require a separate, lengthy post… maybe later), on and off label, none of which worked, and some of which performed some interesting and nasty business.

One day, while travelling the internet, I discovered the theory that, for some, depression might be caused by an anomaly within the endogenous opioid system, and not necessarily within the monoamine neurotransmitter system, despite all the myopic, narrow research that served to build an enormous, expensive research infrastructure dedicated to that. This pissed me off a bit, and all kinds of government-corporation conspiracy theories and various tie-ins floated through my reasonably lucid, non-paranoid brain.

Thus my discovery of endorphin deficiency syndrome (EDS) theory (h/t Reardon Metal for his passionate dedication to our theory). The fact that our bodies even produce natural opiates wasn’t proved until the ’70s, so this theory can be forgiven somewhat for being so young and unexplored; but that’s no excuse for the lack of enthusiasm and effort by the pharmaceuticals. I’m a libertarian, so believe in property rights and the freedom for corporations to research whatever the hell they want in a truly capitalist system of free markets (no state/corp collusion); but knowing that the government and corporations are so in bed with each other, I can’t help thinking that there exists some suppression of research and therapy (profits and monopoly), and because of this I’m pissed that there are no real signs pointing to opiate therapy research, just a few studies here and there. With the new classes of opiates like buprenorphine, because of their actions, one develops tolerance very slowly, if at all. There is no longer an excuse for ignoring this line of research and therapy.

So, while I dream of a relatively safe opiate therapy, I have to work with what I’ve got. One frustrating afternoon, shortly after I left the doctor’s office, he in a bewildered, puzzled and angry state after going through my internet research papers, I knew that I was going to have to go it alone once again. I refused to get involved with the underground for my opiates, and online non-prescription pharms were too expensive, so I hit the internet for other options. Unbelievably, I found a potent source of opium in plain view of the world, yet thankfully obscured by our lack of knowledge: poppies… the ones grandma grows… the ones that, the seeds of which, can be bought from online vendors or any supermarket spice aisle and planted in any back yard…

…my first harvest was a smashing success…

…I harvested the pods, dried them and finely ground them into a powder called dode, or doda. I developed my own dosing regimen using an accurate scale, started keeping dosing records and experienced a relief from depression that I’d never known… and an opiate dependence.

…and so begins my journey.