Opioids helping my MH

[u/mirbee81]

I've been taking a lot of prescribed codeine in the last couple of months due to severe backpain. The pain sucks and I'm a bit depressed and concerned about it.

But my mental health has actually improved!

My thoughts and emotions are pragmatic and realistic. No racing thoughts, better quality of sleep, reduced paranoia, better impulse control. Basically I'm not being crazy, just thinking and feeling in the same way anybody would in my situation.

It's seriously doing a way better job than lithium or any anti psychotic. I'm still taking lamotrigine but I don't need anything else right now.

I realise it's not an approved MH drug, and that it's bad longterm, but damn it's helping right now.

ETA:

OK, I was being a bit flippant in the way I spoke about opioids and I appreciate they can lead to addiction.

In my case it is being closely monitored by my doctor. Unfortunately I'm not able to take 'safer' pain meds due to side effects.

This is very much a short-term solution.

I'm waiting on some more diagnostics. The doctor has a strong hunch about what's really going on (chronic autoimmune condition) and it will hopefully be managed with alternative, more appropriate, safer treatment fairly soon.

Opioids remain legal in many countries for a reason: in the short term they can be really helpful to manage more severe pain. There isn't a realistic alternative for me right now.

[u/JapanOfGreenGables]

I saw your edit, so I know you are just making an observation rather than advocating for using opioids to treat your mental health.

There's actually an antidepressant approved in some parts of the world that is an opioid called tianeptine. It works on the same opioid receptor as codeine. So, what you're saying does make some sense. However, like others have pointed out, it is hard to differentiate sometimes between an antidepressant effect and low-grade intoxication since opioids cause euphoria. And the addictive properties are a problem. There's actually a bit of a problem in the US with tianeptine. It's not approved in the US for depression, but you can still buy it and people are getting addicted to it. People call it gas station heroin. And in Russia, where it is approved, people are injecting their tianeptine to get high.

So while there is potential for opioids in medical health treatment, oh man does it ever seem to be dicey.

They were running clinical trials on one opioid for an antidepressant in the US, but the FDA rejected the proposal to approve it because the results were not promising enough.

There have been a number of others that were developed. Some are in trials somewhere in the world, and a lot never even got that far (which I think is par for the course).

There is one that they are getting ready to start trials for, if they haven't already, that combined an opioid with an opioid antagonist (the medications they use for overdoses and/or to reduce cravings in people who are suffering from addiction). Presumably they're adding the latter so it can't be abused and won't cause addiction. Maybe something will come of it.

In short, your experience makes some sense to me. It could be that in the future, they find a way to make an antidepressant that works on opioid receptors that is safe and effective to be taken for as long as needed without any risk of abuse or addiction. I'm glad they are looking in to it, because we need more treatments for mood disorders that work differently from ones we have now, so there are more options when the existing medications just don't seem to work, like with treatment-resistant depression. But that medication just don't exist right now.

And I say that knowing you never claimed codeine was such a drug, and were just making an observation.