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Does heroin interact w/ Prozac (fluoxetine) or other anti-depressants? My partner wants Prozac for depression instead of heroin?


Posted by opiateissue

Hello,

My 32 year old partner / boyfriend of almost 15 years currently uses heroin for depression - quite successfully for almost a year now. He would like to start using an anti-depressant before he quits heroin to help overall with the transition / withdrawal. He needs to quit heroin ASAP for several reasons - mainly it's illegal, expensive, you have to snort it, and it's time consuming and scary to purchase.

He started his opiate addiction by taking pills like Norco, Vicodin, etc. on a regular basis for back pain and Migraines about -5 years ago and they worked really well for multiple symptoms. He noticed when taking the opiates, not only was it great for reducing pain but it actually stopped his depression or worked really well at controlling it. He slept well, was more socially active and wasn't the recluse he could be when not using opiates. He was just more himself in a way! He was happier (similar to how he was when he was younger and had less worries). He was basically the way he is when he's doing OK (if that makes sense). Using opiates for depression was kind of a phenomenon to us until we began to speak to other opiate addicts who all said the same thing. They began to use because of a legitimate pain reason and then discovered how they became more active, less socially awkward, or depressed when using the opiates. I attended several conferences on addiction and had experience with my parents so I found out after talking to many ex-users or current users that yes indeed they believe that opiates work well for managing depression. In fact many of them weren't getting high but the opiates kept them from getting low.

A little less than a year ago my partner was cut of from his opiate pill prescription and without health insurance he turned to a friend we knew that had end stage cancer and was supplementing his pain medication with heroin. He could have bought Oxycontin pills or other high end pain medication pills but it is actually more expensive than buying pure un-cut heroin. He obviously turned to heroin and immediately his tolerance for opiates went up and so did his opiate budget (although it is less than if he had turned to Dilaudid or Oxycontin - not sure if I spelled those right but they are both pills for severe pain as opposed to Vicodin or Norcos which are meant for more moderate pain).

He's been good about keeping his habit in control. Once he switched to heroin he has not upped his tolerance or budget (except for when he switched to heroin from pills). He has been using heroin just under one year and gets one gram of pure heroin which he then cuts with an inert vitamin supplement (for better nasal absorption and to make it last longer) making the one gram into 2.7 grams. Since he began he would require one pure gram for every 3-5 days. He would use more when he was sleeping less, working a bigger or higher demanding job, anything requiring difficult physical labor so that would put him more towards the 3 day. But on a typical work week it would last 5 days. Since he began his tapering several weeks ago he has gone from one gram every 3-5 days to one gram every 6-8 days. We hope to have him down to one gram every 10-12 days before switching to just one line in the afternoon (if he's feeling bad) and at night so he can sleep. Then finally switching to just a line at night to prevent insomnia. He's been good not stepping over the line or getting too out of control with the heroin because he has me to monitor his use and we don't have an unlimited budget. Already the $300 per week is not crazy expensive for us but it is not easy. He will never inject the heroin because of my parents negative experiences which is good for us.

But ultimately he still has a problem and would like to quit. The only down-side of quitting is the relatively medicinal uses he gets from the heroin - it helps with depression, restless leg syndrome, social awkwardness, etc. I am not sure why they never extracted part of the opiate molecule for an anti-depressant that doesn't have major side effects (they'd have to remove the addictive side of it - although most other drugs including anti-depressents are also physically addicting). They would also have to remove the part of it that gets you high. Although to be clear he doesn't get high anymore like he did in that first month (and even then he never took so much that he was nodding out, passing out, super high. He's not that type of user. In fact most people would never know he was using unless he or I told you. He is just maintaining his habit. They have extracted the anti-diareah medications like Imodium from the opiate molecule (opiates constipate you) so why has there not been more research on the other beneficial qualities it's good for?

On a side note - the opiates also help with sleeping problems such as insomnia and restless leg syndrome. Which I would normally laugh at the RLS notion except no one with restless leg syndrome really knows how bad their afflictment is until they ask their partner. I am the one who got kicked all night from the jerking. Not the falling asleep single jerk that can happen to anyone when they doze off. This would go on for hours and would be worse if he had 2-3 beers (so he stopped drinking) but the RLS was definitely there. We didn't know what it was until we saw those commercials. But the restless leg syndrome almost disappeared completely 4-5 years ago when he started taking opiates on a regular basis but I never knew why except when he would run out of opiates on occasion the RLS would come back strong.

I have quite a bit of experience dealing with heroin because both of my parents injected heroin for many years. I have also attended several conferences and my partners mother is an addiction specialist who has every book on the subject and who can speak about the subject. I know that tapering is the best method and have seen every method except the rapid detox where they knock you out for the major withdrawal or the ibogaine treatment but both are out of the question right now because that can cost anywhere from $5,000 - $10,000 or more not including the 1-2 weeks they require. We know cold turkey is debilitating and includes excruciating pain not to mention the insomnia, constant diarrhea, throwing up, hot and cold sweats, physical pain, mental cravings, etc. And unless you can take 2-3 weeks off work to deal with that it's not possible. I guess the worse part is that you're delirious from the insomnia and it's truly impossible to work in that condition.

One of the things we look forward to most after kicking his $300 a week habit is being able to afford health insurance so until then we can not fit it into our budget. the last 2 years we have seen a large decrease in business and are not able to afford anything extra because of the $300 a week heroin habit. For some they might laugh at that cost because they may have had $300 per day habits but I can witness that whether you have a $300 a week snorting habit compared to a $500 a day injecting habit (like my father did) the withdrawal is the same! So don't dismiss the size of the habit. You are still chemically dependent on heroin. And believe me when I say some of the most intelligent and kind people can be chemically dependent so this is not a moral issue. You can't out smart or out love your way out of chemical dependency. It truly is a disease and anyone who repeatedly uses will be dependent and in the same situation he is in. Of course we both regret that he made a very bad choice when he escaped a few bad nights of pill withdrawal and chose to switch to heroin for a few days because it is a much bigger ballpark when it comes to dependency. And when he never got more pills after 3-4 days he was already addicted to heroin and even if he had gotten the pills a few days later the mistake was already made. My point is that there is no going back. So without making him feel any worse about the awful mistake he made or the really bad choice we need to move on and figure out how to fix the issue and not dwell on a really big mistake he made once.

The question is that my mother has 30 40mg Prozac (generic fluoxetine) pills she wants to give us that she thought helped a lot when she kicked heroin. We researched prozac online and think it will help more than the natural options have (we've tried St. John's Wart and Sam-e). We would like to start him on 20mg per day making the prescription last 60 days instead of 30. (we plan to split the capsules in half).

Is there any danger or worry when mixing the Prozac with heroin? It is low levels of both but is there any dangerous interaction or is there any record of Prozac helping with drug or opiate withdrawal? Also, is it ok to split the capsules in half? I have read online of doctor's who suggested doing this to their patients if the dose made them nauseous. We'd like to do it for several reasons - first because the script will last twice as long and by the time he kicks the heroin he can afford to see a doctor to get another prescription if we feel the Prozac is helping the depression or over-all benefiting him. Secondly we want to split the dose because we want him to start out slowly. We don't want him to be addicted to both substances and hope the one will help him successfully ween off the other.

Please feel free to comment anyone or send me your comments, suggestions at the email depressionquestions@gmail.com or by posting your comments here.

Thanks for your thoughts, support, comments, questions, stories or advice in advance. BTW If you have complaints please shove them up you know where. I am not looking for people who want to waste my time with anything other than something that can benefit our specific situation and yelling at someone never helps in this situation.
 
Answers (4)
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I truly thought I was the only person who feels that opiates have antidrepressant properties, with me oxy is my choice. I have adhd and I dont understand why my doctor wants to keep me on adderall {another addictive drug} when oxycotin helps me more.I can concentrate better, stay on task,focus in school, get ALL my work done, I am not at all moody or withdrawn when I take it, but w/ the adderall, I cant sleep most nights,My hand tremble, I have heart palpitations, and my ability to concentrate n focus is limited. Antidepressants however are not addictive, u should be weaned off them though to keep your seritonin levels from dropping to fast BUT, I have tried many antidepressants and stopped taking them w/ no withdrawls.and they are helpful w/weaning yourself off drugs,,heres why...when you are a drug addict, you screw up your bodies natural,opiate system,,we all have one.when we get hurt our bodies release natural painkillers to protect us. when we abuse opiates our brains basically quit producing them, so when we stop using them your brain dosent remember "how" to produce them "hence" WITHDRAWLS.your brain stops producing dopamine when you r addicted to opiates which is why after the pains of withdrawl are over you may b mentally affected for alot longer.you have to get the dopamine flowing again SO yes antidepressants will help with the dopimine and seratonin,,but he will still have withdrawls. with his strong addiction he could have great physical discomfort for up to a month along with the depression. I suggest taking that 300.00 to a dr and getting some suboxone AND an antidepressant, when his depression is under control,, he can come off the suboxone under dr's care.and sometimes it takes a while to find the right antidepressant,,they are not all the same,,some can make u worse. I went thru 4 before I found the right one. I hope this is helpful to you..I have been addicted to one drug or another for 27 yrs, and I 've learned alot...I enjoyed reading your post
I'm killing myself tonight. Heroin helped me so much. Society and my family try to stop me feeling halfway like turning the next page. I don't have the inclination to fight this hypocritical fight any more

Anything as complicated as his situation is deserves proper medical care. Don't take these kinds of risks! It sounds like you are well aware of how awful and dangerous it can be. Make sure your honey makes it through this ok! Get him professional help, there's always a way to make the financial aspect work, in fact:

If you take him to the emergency room, they will admit him and treat him with the right meds. If Prozac is the best course of action, they can give him the correct dose. While there, ask to see a social worker. They can help you figure out how to get medical care that you can afford.  Insist that you see a social worker within the first or second day of his stay at the local hospital.

Most hospitals will reduce or waive fees if you can show that your income is under a certain level, especially if you don't have health insurance--though social workers don't get involved in that and hospitals don't make that publicly known.You'll have to call the billing department after life settles down.

The social worker should be able to help him get into rehab programs for a reduced cost or for free for the same reasons. Your county's Department of Social Services should have a lot of information about free help for him, too. Finding their number is as easy as calling 411 or Googling your county name and "Social Services". You may have to get transferred a few times or call different numbers they give you, but it's certainly better than the other phone calls you could be making if this goes badly for him.

Best of luck to you both! He's lucky to have you.

 

 

My partner who is on heroin has taken prozac when trying to quit and it has helped him.  He had a $100 dollar a day addiction, which he has weaned down to $30 a day (by subs with methadone or pain pills before coming off).  He snorts it as well.  I don't think there is any danger.  Although with any anti-depressants when first starting them, it takes awhile to work and to have the desired effects.  Until that point in time, the depressed thoughts could be worse.

My partner has had to quit cold turkey before and he was very sick.  I have seen him try to quit cold turkey with extreme sickness (including RLS, throwing up, insomnia, sweats, etc.).  It is best to substitute also with methadone or pain pills or xanax which can also be bought illegally. 

I think that prozac will help.  In fact, my boyfriend just took prozac after doing heroin like a hour ago.  He says he is a normal person on prozac.  I think normally he is depressed and anxious when not on opiates.  

His drug addiction has spanned a long time, starting with alcohol and moving to xanax and other pres meds before heroin. I think it is self-medicating.

He however, does get high on it and I have seen him on the nod frequently, although not recently.  I say go for it, and I think it is fine to split them in half.

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