Maybe the word is getting out
Those of you who have read my book, Curing Chronic Pain or my blogs on the subject know of my enthusiasm for the use of opiates in the treatment of the bipolar with chronic pain. The opiates, particularily methadone, can be not only analgesic but also antidepressant and mood stabilizing. I first witnessed this effect in October, 2006 and since then have seen it dozens of times. The effect is real and others have witnessed it also. Still, it remains largely unrecognized by the psychiatric community. I have done everything I can to correct this in my writings and in my correspondence with other physicians, but progress has been slow. I do understand. The use of opiates for the treatment of bipolar disorder is, in the kindest word I can employ, contraversial.( Heretical might be a better descriptor)
Several psychiatrists in my community have witnessed the "opiate cure" in their bipolar patients who were also under my care for the treatment of chronic pain. Their reaction has been strangely muted. Only one psychiatrist,and that from a distant city, has actually called me to discuss the ressurection she witnessed in her bipolar patient that I treated with methadone. From the others..nada. In order to satisfy my curiosity about my collegues seeming indifference, I often ask my patients about their psychiatrist's reaction to my therapy. Most often, they tell me there is no reaction at all, even though they repeatedly tell the doctor that the opiate (usually methadone) prescribed by me has been their best bipolar drug ever. Sometimes the reaction is one of disdain or disbelief and occassionally outright hostility to the patient, and perhaps also to me. I do understand. I'm encroaching on their territory and unfortunately or fortunately, depending on the way you look at it, curing their patient.
But maybe the word is getting out. One of my patients has been under the long term care of a very competent psychiatrist, expert in bipolar disorder. She told me that on a recent visit, he initiated conversation with her about her very evident improvement on methadone therapy.
"He actually seemed interested, Dr Cochran. This was the first time he had been willing to talk about it. He even took notes, lots of them, and when he finished he smiled and told me that there was some talk in psychiatric circles about the effectiveness of opiates in bipolar disease.
So maybe the word is, indeed, getting out.
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Reply #1 on : Mon July 26, 2010, 06:35:11
Reply #2 on : Sun September 12, 2010, 15:32:25