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Old 01-16-2009, 03:42 AM   #1
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can antidepressants be prescribed to opiate addicts?

Hello! My boyfriend has been taking opiates for quite a few years. Until yesterday, I was unaware how serious his addiction was. He finally came clean to me and told me told me that he's been taking various opiates on pretty much a daily basis (vicodin, oxycotin, subulax). He is tired of his addiction and wants to be able to be happy without the opiates. He has an appointment with his doctor tomorrow and wants to get on antidepressants to feel better about himself.
I'm wondering if a doctor will prescribe anti's to an opiate addict. He's not sure if he should tell his doctor about his past problem with pills.
If anyone knows, I would appreciate your insight.
Thanks!

 
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Old 01-16-2009, 04:52 PM   #2
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Re: can antidepressants be prescribed to opiate addicts?

He should definitely tell his doctor and his doctor will likely prescribe an SSRI and possibly a drug called subuxone - it gives some stimulation like an opiate to relieve withdrawals, but it doesn't give you the rush and blocks additional highs from cheating with more oxycodone. The bad part: it may or may not be covered by insurance. The other option is methadone, which doesn't block additional highs but is much cheaper.

He is probably already familiar with the symptoms of opiate withdrawal, but they include muscle spasms (hence the term kicking the habit), diarrhea, anxiety and others. None are life threatening.

Last edited by RickRude; 01-16-2009 at 04:56 PM.

 
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Old 01-16-2009, 08:14 PM   #3
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Re: can antidepressants be prescribed to opiate addicts?

I would be very surprised if a doctor prescribed an AD for an opiate addict, unless of course he doesn't tell the doctor. ADs aren't going to make him feel better about himself. Nothing is while opiates are in his life. He needs rehab to get clean and sober, then when he gets that taken care of, he can see where his mind is at. He needs to make an appt with an addictions counselor or another mental health professional. Family doctors are not the ones you want to go to for this. They simply don't have the training. Good luck

 
Old 01-17-2009, 03:30 PM   #4
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Re: can antidepressants be prescribed to opiate addicts?

Why would it be surprising if a doctor prescribes ADs to an addict? The doctor won't prescribe drugs that can be abused, like amphetamine/meth, etc. Doc also won't prescribe drugs that might conflict with opiates.. in case your BF starts using.

But most antidepressants that don't conflict with opioids can be prescribed.. although if your BF is trying to replace opiates with SSRIs, he's in for a disappointment. SSRIs don't improve your mood as much as opiates do.. not even close.

 
Old 01-17-2009, 04:19 PM   #5
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Re: can antidepressants be prescribed to opiate addicts?

He needs to be completely honest with the doc. Anti-depressants won't make him feel better about himself. They aren't magic bullets and with his history he could well be looking for that.

 
Old 01-18-2009, 09:37 AM   #6
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Re: can antidepressants be prescribed to opiate addicts?

Yes, antidepressants can be prescribed to addicts. They very often are too, since depression can often be an underlying cause of addiction.

However, they are not an effective treatment for drug addiction. Many drug addicts feel very depressed, but it's usually because of the effects of the drugs they're taking and the effects the drugs are having on their lives, and then when they first quit, they're going to feel awful for a while, but antidepressants aren't really going to help with that.

If he thinks that taking antidepressants will act as some kind of cure for his addiction he's going to be very dissapointed. Unfortunately, there is no easy cure. In fact, there isn't a cure at all. He's going to be an addict for the rest of his life. There is help he can get, and if he has a serious opiate addiction, there is a relatively new drug called suboxone that many opiate addicts have had success with in helping them get off of drugs. Methadone is also an option, though that can lead to methadone addiction. Still, either of those options is better than being an addicted to painkillers.

If he's serious about stopping the drugs, I think Suboxone might be more effective than antidepressants. OF course he may also be clinically depressed as well as being addicted in which case antidepressants could he helpful, but only with the depression, not with the addiction.

 
Old 01-18-2009, 07:54 PM   #7
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Re: can antidepressants be prescribed to opiate addicts?

Quote:
Originally Posted by joebloggs2 View Post
Why would it be surprising if a doctor prescribes ADs to an addict? The doctor won't prescribe drugs that can be abused, like amphetamine/meth, etc. Doc also won't prescribe drugs that might conflict with opiates.. in case your BF starts using.

But most antidepressants that don't conflict with opioids can be prescribed.. although if your BF is trying to replace opiates with SSRIs, he's in for a disappointment. SSRIs don't improve your mood as much as opiates do.. not even close.
why would he? ADs are for depression, not for addiction. I realize there are usually tied together, and we can play the "which came first" game, but, imo, getting clean is the first step. Maybe once he's clean the "depression" will lift. He might not even need an AD, so why prescribe it.

 
Old 01-18-2009, 10:00 PM   #8
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Re: can antidepressants be prescribed to opiate addicts?

Quote:
Originally Posted by Kiasmama View Post
why would he? ADs are for depression, not for addiction. I realize there are usually tied together, and we can play the "which came first" game, but, imo, getting clean is the first step. Maybe once he's clean the "depression" will lift. He might not even need an AD, so why prescribe it.
I know quite a few people who initiate treatment for opiate addiction and depression concurrently.... a common practice to reduce anxiety that is a definite with opiate withdrawal that can hinder the path to treatment.

 
Old 01-19-2009, 07:41 AM   #9
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Re: can antidepressants be prescribed to opiate addicts?

Hi I am on Suboxone for opiate addiction and also several anti depressants. I am on Prozac and Remeron. These help me with anxiety, depression, OCD, and insomnia. I would encourage hime to ask his doctor about anti depressants. In my opinion if he needs them they will help.

 
Old 01-25-2009, 11:51 AM   #10
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Re: can antidepressants be prescribed to opiate addicts?

thanks to everyone who has cared enough to give advise! i really appreciate it!

my boyfriend went to the doctor and was completely honest with him. Although the dr woudn't prescribe him anti-depressants, my bf said it felt really good to be able to be honest with the doctor. It was 'his little secret' for so long
The doctor wants him to follow up in a week and gave him a print out of all the NA meetings in the area. (now we just have to find one that people go to by choice, not b/c they were ordered to by the System)

so far, he has been clean 9 days! we have a calendar in the basement he has been using to keep track. i think it makes him feel good to walk down there each morning and put an 'x' in the prior day's box. it hasn't been easy, but not nearly as bad as i anticipated. sleeping through the night seems to be easier...at least he's not kicking me in his sleep anymore.

although it's still hard for me to totally trust him (i catch my self checking his puples in dim light) I am proud of what he is trying to do for himself.

Thank you again to everyone who has responded to my post.
-erica

 
Old 01-26-2009, 04:59 PM   #11
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Re: can antidepressants be prescribed to opiate addicts?

You're welcome and good luck. This kind of thing is a long term process and "slips" (temporary or one time uses of drugs once he's stopped) aren't uncommon.

They're not good of course, but don't confuse them with complete failure. As long as he realizes the mistake and gets right back into his treatment again, this can can seen as more of part of the process of getting better than it is failing and starting all over again. If it last for more than a day or two though, then it's a geniune fall back into the addiction.

Be warned, that may very well happen. The road to recovery is usually rocky. I'm not saying that to scare you or to give him excuses to do drugs, it's just like I said before - it's a process that often involves some stumbles.

But overall in a sucessful recovery he should always, in general, be getting better. In a few months hopefully this will be just a bad memory for you, though for him it'll be something he has to deal with the rest of his life, but it does continue to get easier to deal with over time.

 
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