kyburg: (Default)
kyburg ([personal profile] kyburg) wrote2008-11-19 09:11 am

Some kind of wonderful -

You'll hear me rant about overmedication a lot - well, it's a sore point. Giving pills is cheap - compared to long-term talk counseling with active therapy. Trouble is, the pills stop working. Oh, you can cycle through a ton of stuff - it's out there - but the expensive, labor-intensive-with-a-real-person is where long term results lie (unless you're one of the people who truly HAVE a chemical issue, and one of the hallmarks of THAT is the pills don't stop working and you don't have to cycle, yadda ya).

Then I hear about Cymbalta. Holy chrome. This stuff is being prescribed off-label right, left and center for things OTHER than depression...and damn if it isn't doing some incredible things, mostly related to pain relief (and we all know I think that's going to be HUGE when it happens).

But for depression? *wiggles hand* Not so much. Read about coming off it and UH.

...and so many, many reports are from people who came to this medication because - you guessed it - they needed to cycle from something else.

I have to wonder about what this all about - and if the cycling is a Good Thing, or a sign that this is not the right way to treat depression, period.

Yeah, maybe I do more than wonder. Like - NO.

Here's a thought for the day - isn't it still addiction when it's legal and you don't have to worry about getting it on a daily basis? You go without and you're not going to feel good, yanno. But get your drug and everything is fine.

What makes that okay?

As for me, I'll pass. And yes, I know that's a privilege.

[identity profile] zpdiduda.livejournal.com 2008-11-19 07:18 pm (UTC)(link)
Speaking as someone who depends on multiple medications to survive -- some of them being psycho-active medications -- I don't find the term "addiction" necessarily to be so offensive. Can there be healthy addictions and unhealthy addictions? Does my absolute dependence on meds qualify as a healthy addiction, given the needs of my body?

As a side note, I did see that [livejournal.com profile] kyburg added this qualifier:

...(unless you're one of the people who truly HAVE a chemical issue, and one of the hallmarks of THAT is the pills don't stop working and you don't have to cycle, yadda ya).

This is not entirely true. Even for people with imbalanced brain chemistry, the meds eventually can stop working -- and it can become a hell in itself to find a new cocktail of meds that does. There's even an accepted medical term for the phenomenon. It's called "Poop-Out Syndrome".


[identity profile] machineplay.livejournal.com 2008-11-19 07:35 pm (UTC)(link)
I find it to be extremely offensive, as someone who's been refused vital treatment on the grounds that I could become an addict. And I know that the chemical process of addiction is not the same as the chemical process of filling a void in someone's metabolism. It's not addiction. It's not the same thing. To conflate the two is beyond outrageous. I take medication that other people abuse to get high, I take it so I can walk, eat, dress, and leave my front door. I get no high. I get no pleasure from it. I am not an addict. Neither is anyone I know who takes medication to cure an illness.

Moreover, from that comment about the fact that people who really have a problem don't have to change meds, it's obvious that [livejournal.com profile] kyburg is woefully uneducated as to the mechanics of treating biochemical disorders with medication, and should not be making declarations that -- regardless of how YOU feel about it and how you'd like to candy-coat it -- threaten to further ostracize people with mental illnesses.

Further, it is also obvious that she has no idea of the emotional strain of relying on a controlled substance or a drug that could "poop-out" (sorry, but I've never heard that term used by any psych I've been to). Living your life on the kindness of people who are willing to fill out your prescriptions, being under constant scrutiny, having to fight with insurance companies, having to choose between groceries and sanity, being at the mercy of under-educated physicians who insist that you try inferior and damaging alternatives before giving you sufficient treatment, being at the mercy of physicians in Big Pharm's pocket who will lie to you and poison you because they get a kick back, being at the mercy of physicians who are too cowardly to prescribe a "potentially addictive" medication and instead allow you to lose your job and your family, choosing between employment that doesn't cover drugs and disability that does, not receiving life-saving tests and treatment because as soon as your medications are revealed your serious concerns are written off as "patient is anxious", waiting for the medication that's given you a chance to live life FAIL and plunge you back down into pain or insanity or even the brink of suicide ... none of that is simple or easy.

If I were a drug addict, I could go get more medication whenever I wanted. Same with the rest of my family. It is not simple, it is not easy, it is not fun. It is not a free ride to feeling good. It is a potentially dangerous, expensive, trying way to gain some semblance of normalcy. None of us are drug addicts with a free pass. Using a term that is inextricably connected to criminal activity and anti-social behaviour to describe the actions of people taking medication to function and live well is offensive and cruel.

Trust me when I say that as lightly as you may be able to take it, most people do not. It is a terrible, terrible thing to rely on something to survive that could be taken away from you at any time. It is not an addiction to be disabled and to require pharmaceutical treatment to function.
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[identity profile] kyburg.livejournal.com 2008-11-19 10:59 pm (UTC)(link)
One, I was married to the Type I diabetic. Two, I've been on and off the couch since I was 8 - last major depressive crisis was when I was 27, thank God. I dodged a major bullet this year - but it wasn't pretty. (Keep a job you know is bad for you because you don't want to rock the boat. Go ahead. Should have left years ago. It was painful - but it wasn't pathology.)

Every time. EVERY TIME - they wanted to add drugs. Over that long a span, you can imagine what they wanted me to 'try.' It likely would have been Seconal in 1969, it was Valium in 1978...and they thought Paxil was just the bomb the last time it was mentioned. Every time - I've refused.

And gee, I've gotten through it. Very durable, actually. Have I been Little Mary All-Is-Fine? *laughs*

One thing I know - I'm not the addict. I have a liquor cabinet that remains full of stuff that sits for years. Just not interested. There's a ton of addictive behavior in my family (there hasn't been a generation without an addict in five that I know of - Dad died of an accident overdose in 1967) - but the whole thing holds no appeal at all to me.

For the record, most of the research that developed the SSRI class of medications came out of addiction studies. Yes, they paid heroin addicts to stay addicted so they could figure out what the big deal was. Pity they didn't notice they stopped getting high - because even then, the 'poop-out' effect was very clear. Addicts stop getting high. Just before they take overdoses that kill them.

There are chemical issues that respond to replacement therapy - lithium is the best example I know of, and it's no walk in the park. As far as cycling through every SSRI ever developed - ghads, the cost in human suffering just wipes me out every time I look at it. I won't say I understand it - but what I have to do is question it. I'd love to find someone too cowardly to prescribe - most of the cases I know of have been people too busy to spend more than 15 minutes to work up a case, or working within a managed-care system that only has funds available for the cheapest possible option. 15 min visit plus $20 in drugs - or - $125 an hour, weekly counseling? HMMMM. Oh, and most would want that $20 in drugs and 15 min monitoring as well. Fat chance.

Meanwhile, the 'heavy service users' remain dependent, miserable and vulnerable. That, my friend, is extremely offensive to me.

My own family is amazed at how 'normal' I am these days. It's so nice to be considered 'damaged goods' - so don't tell I don't know about it. Faking it until you make it - believe me, I know.

It's also not hard to link criminals with mental illness, considering the penal system is now the largest provider of mental health services today, full stop. I did mention lowest cost of providing care? Right. Moving on -

My pain is not your pain - and comparing them? Please don't. No, really. Looking at your paragraphs above? Been there. I'll give you credit for it being the truth because I know it is. Yeah, I have an idea. I have first-hand experience, thank you very much.

Whatever it is for you, good on you for finding it.