Posted by pseudoname on June 5, 2006, at 9:04:25
In reply to Re: opioids for depression NO » MrBrice, posted by jerrympls on June 5, 2006, at 3:59:18
I'm really glad Jerry posted.
> > Please don't do it
As people in this thread can attest, Bob has previously given PBCs for statements virtually identical to that, although he's apparently refused to do so in this situation. "Don't do X" is a direct instruction and can obviously be an OVERGENERALIZATION and PRESSURE. Especially in a thread in which someone has just detailed his/her clinical use of X, such a statement can feel accusatory. In this thread, I personally felt put down by it.
However, Brice nicely followed up in this instance by acknowledging that buprenorphine may be different, and I really appreciated that admission. But Jerry's experience would still run afoul of an overall command not to use opioids prescribed by a doctor.
Opioids are very serious drugs. The clinical situations where they are appropriate can be complex. Significant risks, side-effects, stigma, legal issues, and other trade-offs are ALWAYS a part of effective opioid therapy. But opioid use is sometimes *vital* where nothing else can help. These can be life-or-death questions!
Blanket imperatives only add to the stigma, pressure, and other burdens that opioid patients are already dealing with.
poster:pseudoname
thread:651514
URL: http://www.dr-bob.org/babble/20060604/msgs/653139.html