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pnwmom

(109,021 posts)
Wed Apr 25, 2018, 03:24 PM Apr 2018

Jackson overprescribed "wakefulness medication." Why is the media going along with this

Last edited Wed Apr 25, 2018, 06:14 PM - Edit history (1)

euphemism?

Wakefulness medication and sleep medication translates to UPPERS and DOWNERS. Or amphetamines and Ambien, or similar drugs.

Which would explain a lot.

And the NY Times says he kept a private stock of controlled medications. I wonder what was in the private stock.

https://www.nytimes.com/2018/04/25/us/politics/ronny-jackson-veterans-affairs-nomination.html?action=Click&contentCollection=BreakingNews&contentID=66882998&pgtype=Homepage

It says that the committee was told that physicians working with Dr. Jackson “felt uncomfortable and refused to be a part of the loose dispensing of drugs to current and former” White House staff. It also states that Dr. Jackson “also had private stocks of controlled substances.”

The document says that the committee received testimony that the White House medical unit “had questionable record keeping for pharmaceuticals” and that the committee was told that Dr. Jackson would often only account for pills after distributing them.


One former medical staff member described Dr. Jackson as a “kiss up, kick down boss,” who mistreated subordinates and created a hostile work environment.


https://www.cnn.com/2018/04/25/politics/ronny-jackson-white-house-vetting/index.html

Lawmakers said they have received information that alleges Jackson over-prescribed sleeping medication and wakefulness medication during his tenure, as well as claims that an alleged power struggle with another White House physician decimated morale under his leadership in the White House Medical Unit.


ON EDIT: The claim is being made that he is "only" passing out the stimulant-like drug, Provigil. But Provigil works on the same dopamine transporters as other stimulants. It might not be the innocuous substance its promoters want us to think.

https://www.webmd.com/brain/news/20090317/is-provigil-addictive#1

The brain scans showed that Provigil blocks dopamine transporters, the molecules that remove dopamine from brain synapses. This increases the amount of dopamine in the brain -- the brain's "reward" mechanism.

Addictive drugs such as cocaine and methamphetamine trigger the same mechanism, although they do it much faster and more powerfully than Provigil does.


"The changes we are observing in dopamine concentrations with modafinil are equivalent to those we have reported for [Ritalin] in the human brain," Volkow says. "So not only does [Provigil] increase dopamine in the human brain, but does it by similar mechanisms to Ritalin and cocaine, by directly blocking the dopamine transporter. It is not working by some distinct, different mechanism."

Volkow notes that Provigil has no effect on mice lacking dopamine transporters. This indicates that while the drug may have other effects in the brain, its dopamine-enhancing effect is crucial.
56 replies = new reply since forum marked as read
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Jackson overprescribed "wakefulness medication." Why is the media going along with this (Original Post) pnwmom Apr 2018 OP
Driving into work today JustAnotherGen Apr 2018 #1
MSNBC, Morning Joe Agschmid Apr 2018 #11
'wakefulness medication' sharp_stick Apr 2018 #2
"Overprescribed"? fleur-de-lisa Apr 2018 #3
Provigil is what he liked to distribute and it's not an amphetamine. NightWatcher Apr 2018 #4
Provigil might be what they ADMIT to. And researchers say it might have more serious effects pnwmom Apr 2018 #5
Provigil is used for sleep disorders & also chronic fatigue CountAllVotes Apr 2018 #54
The reports are that the Candy Man kept private stocks of prescription medications pnwmom Apr 2018 #55
I was screaming at the tv all morning when the MSNBC reporters kept saying he wasn't prescribing tulipsandroses Apr 2018 #6
My doctor is emphatic that Ambien is not addictive dixiegrrrrl Apr 2018 #51
AKA "Speed" Iggo Apr 2018 #7
I know the misconduct pre-dates Trump RockRaven Apr 2018 #8
Yes, he took Clarity2 Apr 2018 #37
Provigil is not an amphetamine Azathoth Apr 2018 #9
That's what they USED to think. pnwmom Apr 2018 #10
There are almost no reported cases of Provigil addiction Azathoth Apr 2018 #13
I have worked on a detox unit for almost 7 years. tulipsandroses Apr 2018 #16
Oh fer Christ's sake Azathoth Apr 2018 #17
Can't speak for anyone else, but my problem is that I have little reason to believe LanternWaste Apr 2018 #20
I'm not saying it was. He could have been handing out heroin for all I know Azathoth Apr 2018 #22
That's the one they will admit to, so people like you will defend him. pnwmom Apr 2018 #26
"So people like you will defend him" Azathoth Apr 2018 #32
Provigil works on the same dopamine transporters as other stimulants. pnwmom Apr 2018 #40
"So it very well could be addictive" Azathoth Apr 2018 #41
I posted from a study that shows that it works through the same mechanism pnwmom Apr 2018 #42
Yes, and I quoted ONE OF THE DOCTORS from the article YOU POSTED Azathoth Apr 2018 #44
I think you're mixing me up with another poster. pnwmom Apr 2018 #45
You didn't post the WebMD article which interviewed Dr. Weinshenker? Azathoth Apr 2018 #46
This is what Dr. Nora Volkow, the author of the study, said: pnwmom Apr 2018 #47
Yes, I know, you're referring back to the SAME 10-person study over and over and over Azathoth Apr 2018 #48
It is true that there appears to be a low rate of dependence, but it is not true that there are pnwmom Apr 2018 #49
If addiction centers were treating genuine cases of modafinil addiction Azathoth Apr 2018 #50
I think this whole issue of Provigil is a deliberate distraction on the part of Trump people. pnwmom Apr 2018 #52
Reportedly he had stashes of Percocet Azathoth Apr 2018 #53
you believe the best way to provide clarity is asking "what the hell is wrong with you?" LanternWaste Apr 2018 #33
Yes, I do. When people start citing sources that directly contradict what they're saying Azathoth Apr 2018 #35
If you care, there are more tulipsandroses Apr 2018 #39
I'm not going to spend all day crusing through those forums, but every post I see says it makes Azathoth Apr 2018 #43
The side effects and warnings lists are many OhNo-Really Apr 2018 #56
+1 yes... its a histamine.... its not speed. No heart rate increase, just keeps you awake that's it. wroberts189 Apr 2018 #36
These are the real criminals in our society. Initech Apr 2018 #12
Jim Acosta(CNN) said he gave the drugs to the press corp, too, Pathwalker Apr 2018 #14
Acosta should name names or it is made up fake news. former9thward Apr 2018 #18
Yeah, right. The Reagan and Bush 1 White House lived Pathwalker Apr 2018 #19
I too pretend fake news is whatever I call it. LanternWaste Apr 2018 #21
Unless I hear more, I think this particular accusation may be overblown EffieBlack Apr 2018 #15
+1 Azathoth Apr 2018 #24
But did your physicians have a nickname like the Candy Man? pnwmom Apr 2018 #28
The REAL ISSUE IS THAT HE SHOULD NOT BE RUNNING THE V.A.!! To me the press is anneboleyn Apr 2018 #30
Meth maveric Apr 2018 #23
I don't think the scandal with this man lies here. nt Kirk Lover Apr 2018 #25
Pretty sure Obama would have dropped the hammer on this behavior if GreenPartyVoter Apr 2018 #27
How do you know it hasn't worsened, under DT's administration? pnwmom Apr 2018 #29
It is possible, but my point is that at one time is didn't seem GreenPartyVoter Apr 2018 #31
I'm pretty sure handing out uppers and downers on international trips was common. But I also believe Kirk Lover Apr 2018 #34
Maybe Dr. Jackson is tRumps supplier??? InAbLuEsTaTe Apr 2018 #38

JustAnotherGen

(32,010 posts)
1. Driving into work today
Wed Apr 25, 2018, 03:26 PM
Apr 2018

Wasn't sure if it was msnbc or cnn on Sirius - but evidently white house staffers literally call him 'The Candy Man'.

Can't make this bullshit administration up. The hell?

sharp_stick

(14,400 posts)
2. 'wakefulness medication'
Wed Apr 25, 2018, 03:29 PM
Apr 2018

sounds so much better than amphetamines doesn't it?

I think most doctors would lose a license for this kind of shit, or at least face sanctions.

fleur-de-lisa

(14,628 posts)
3. "Overprescribed"?
Wed Apr 25, 2018, 03:30 PM
Apr 2018

I watched Tester on tv last night. He said there are witnesses who have reported that Jackson walked the aisle of a plane handing out sleep medication. Those people were not his patients. That's not prescribing or overprescribing.

Isn't it illegal for a physician to give medication, CONTROLLED SUBSTANCES, no less, to anyone who is technically not a patient?

NightWatcher

(39,343 posts)
4. Provigil is what he liked to distribute and it's not an amphetamine.
Wed Apr 25, 2018, 03:32 PM
Apr 2018

I used to love Provigil because it promotes wakefulness but doesn't make you feel jittery as though you had a lot of caffeine. Pilots and others were given this for 24 hr bombing runs back in the early 2000's.

He also gave out ambien which is the replacement for what they used to distribute freely to "help" you sleep. They don't even sell what they used to hand out like candy to knock your ass out.

pnwmom

(109,021 posts)
5. Provigil might be what they ADMIT to. And researchers say it might have more serious effects
Wed Apr 25, 2018, 03:37 PM
Apr 2018

than people think.

https://www.webmd.com/brain/news/20090317/is-provigil-addictive#1

The brain scans showed that Provigil blocks dopamine transporters, the molecules that remove dopamine from brain synapses. This increases the amount of dopamine in the brain -- the brain's "reward" mechanism.

Addictive drugs such as cocaine and methamphetamine trigger the same mechanism, although they do it much faster and more powerfully than Provigil does.


"The changes we are observing in dopamine concentrations with modafinil are equivalent to those we have reported for [Ritalin] in the human brain," Volkow says. "So not only does [Provigil] increase dopamine in the human brain, but does it by similar mechanisms to Ritalin and cocaine, by directly blocking the dopamine transporter. It is not working by some distinct, different mechanism."

Volkow notes that Provigil has no effect on mice lacking dopamine transporters. This indicates that while the drug may have other effects in the brain, its dopamine-enhancing effect is crucial.

CountAllVotes

(20,879 posts)
54. Provigil is used for sleep disorders & also chronic fatigue
Thu Apr 26, 2018, 01:50 AM
Apr 2018

It is an expensive medication.

https://en.wikipedia.org/wiki/Modafinil

It works well at first but seems to lose effectiveness quickly.

In order to get an RX for it for a sleep disorder, you have to have a sleep study to confirm that you do have a sleep disorder. If you do, it can be a life-saver for an afflicted person.

It has a cousin named Modafinil. It is cheaper but not nearly as effective.

Neither of these medications are speed. Modafinil was invented by the French to be used by their soldiers to provide wakefulness.



pnwmom

(109,021 posts)
55. The reports are that the Candy Man kept private stocks of prescription medications
Thu Apr 26, 2018, 01:57 AM
Apr 2018

and had "questionable record keeping."

So it really doesn't matter how hard it is supposed to be to get a prescription for it.

tulipsandroses

(5,131 posts)
6. I was screaming at the tv all morning when the MSNBC reporters kept saying he wasn't prescribing
Wed Apr 25, 2018, 03:37 PM
Apr 2018

Opioids. As if these were not addictive medications as well.

Opioids are not the only addictive medications. WTF is wrong with people???

And like I said in my other post, many of my patients, abuse multiple substances.

Among the addict's list of meds you will find Percocet, Xanax, Adderall, Ambien to name a few when doctors are careless about prescribing meds. They've got pain so they need Percocet, anxiety so they need Xanax, Adult ADHD, so they need Adderall, Insomnia so they need Ambien. and if they happen to work night shift and have Shift work disorder then throw in Provigil/Nuvigil for that too.

I see this quite often. So these allegations are serious and need to be investigated.

dixiegrrrrl

(60,010 posts)
51. My doctor is emphatic that Ambien is not addictive
Thu Apr 26, 2018, 12:12 AM
Apr 2018

and she says it has no withdrawal effects.

So I asked her....when people who have used Ambient for more than a month stop taking it, can they fall asleep ok?
and she said.." You might have a "bit" of insomnia but it goes away in a few day, maybe up to a week.."

SO glad it is not addictive.

RockRaven

(15,068 posts)
8. I know the misconduct pre-dates Trump
Wed Apr 25, 2018, 03:40 PM
Apr 2018

but I also wonder if he isn't feeding Trump pills too. Didn't Trump use prescription amphetamines in the 80s?

It would help explain how he can tweet all hours of the night.

Clarity2

(1,009 posts)
37. Yes, he took
Wed Apr 25, 2018, 04:55 PM
Apr 2018

amphetamines to keep weight off. Ive noticed from the beginning this whole administration seems all hopped up. Even Pence at the beginning at the CIA headquarters after inauguration...he was sweating profusely along with trump.

I honestly dont think trump ever stopped amphetamines. He was tweeting all hours of the night for YEARS. Minimum, at least from 2013/2014. Didnt pay a lot of attention to him, but I always thought “theres something really off about this man”. It was sort of chronic bipolar/manic behavior. Claims he’s a workaholic who sleeps 5 hrs, and yet was on twitter all day and wee hrs of morning way before the campaign.

pnwmom

(109,021 posts)
10. That's what they USED to think.
Wed Apr 25, 2018, 03:44 PM
Apr 2018

Now it turns out its not as unique or non-addictive as has been promoted. It operates by blocking dopamine transporters, like some other addictive drugs.

https://www.webmd.com/brain/news/20090317/is-provigil-addictive#1

The brain scans showed that Provigil blocks dopamine transporters, the molecules that remove dopamine from brain synapses. This increases the amount of dopamine in the brain -- the brain's "reward" mechanism.

Addictive drugs such as cocaine and methamphetamine trigger the same mechanism, although they do it much faster and more powerfully than Provigil does.


"The changes we are observing in dopamine concentrations with modafinil are equivalent to those we have reported for [Ritalin] in the human brain," Volkow says. "So not only does [Provigil] increase dopamine in the human brain, but does it by similar mechanisms to Ritalin and cocaine, by directly blocking the dopamine transporter. It is not working by some distinct, different mechanism."

Volkow notes that Provigil has no effect on mice lacking dopamine transporters. This indicates that while the drug may have other effects in the brain, its dopamine-enhancing effect is crucial.

Azathoth

(4,611 posts)
13. There are almost no reported cases of Provigil addiction
Wed Apr 25, 2018, 03:51 PM
Apr 2018

It has a mild and very targeted affect on dopamine transporters (which has been known for years), but it also affects other wakefulness mechanisms in the brain including histamine levels. To quote the doctor cited in that article

"What is Provigil's street value? It is zero. There are not addicts walking around buying and selling modafinil," Weinshenker tells WebMD. "Most people who take Provigil don't report euphoria or being high. They don't even report feeling particularly stimulated, like caffeine. In terms of addiction and withdrawal, it just doesn't do that."


I know someone who takes it for a mild case of narcolepsy. It's not an addictive or dangerous drug. I really wish people wouldn't demonize it for cheap political points.

tulipsandroses

(5,131 posts)
16. I have worked on a detox unit for almost 7 years.
Wed Apr 25, 2018, 04:10 PM
Apr 2018

My education not only comes from book knowledge but - what. I know about drug abuse comes directly from patient care and the knowledge from my patients of how they use various drugs.

Provigil is definitely not one of the most abused drugs but it is being abused. To say that it has zero street value is not true either. I'm also an avid reader of drug forums - where addicts speak to each other. And yes, they talk about abusing Provigil on those forums. Blue light is one forum I frequent.

[link:http://www.bluelight.org/vb/threads/629628-Provigil-or-Adderall-for-a-speedy-boost|

[link:http://www.bluelight.org/vb/threads/781773-provigil-modafinil|

Azathoth

(4,611 posts)
17. Oh fer Christ's sake
Wed Apr 25, 2018, 04:16 PM
Apr 2018

The first post I clicked on

It's a good wakefulness promoter, keeps you awake, but don't expect it to be a replacement for amphetamine

...

It won't get you high but it will make short work of fatigue in most cases without making you all tweaked out.

...

I take modafinil five days a week on prescription for fibromyalgia fatigue. There's no withdrawal to speak of, but on my first "day off" for the week I do tend to sleep all day. I've never been sure if that's because of the modafinil or if it's just rebound fatigue from pushing myself too much during the week.

It does help a bit with concentration, but much, much less than when I first started taking it. I think these effects wear off pretty quickly. The only real effect is wakefulness, which in my case means less fatigue. It doesn't make you feel speedy or impact your mood.


These are statements apparently from drug abusers who have tried to get high/addicted to Provigil and can't. What the hell is wrong with you people?
 

LanternWaste

(37,748 posts)
20. Can't speak for anyone else, but my problem is that I have little reason to believe
Wed Apr 25, 2018, 04:21 PM
Apr 2018

"What the hell is wrong with you people?"

Can't speak for anyone else, but my problem is that I have little reason to believe his distributions were limited to merely one or two different types of medication... though I don't really see that as a problem.

Azathoth

(4,611 posts)
22. I'm not saying it was. He could have been handing out heroin for all I know
Wed Apr 25, 2018, 04:24 PM
Apr 2018

But the only "upper" I've heard mentioned is Provigil, and I'm trying to make clear that isn't an addictive amphetamine.

pnwmom

(109,021 posts)
26. That's the one they will admit to, so people like you will defend him.
Wed Apr 25, 2018, 04:35 PM
Apr 2018

But videos of DT exist like this:

Upper? Downer? Who knows. But this isn't normal.

https://www.theatlantic.com/health/archive/2018/01/trump-cog-decline/548759/

Azathoth

(4,611 posts)
32. "So people like you will defend him"
Wed Apr 25, 2018, 04:42 PM
Apr 2018

So you're wrong, but I'm the asshole for pointing it out? lol

I have no idea what is being pumped into the orange gibbon, but I'll bet my life it's more than Provigil.

pnwmom

(109,021 posts)
40. Provigil works on the same dopamine transporters as other stimulants.
Wed Apr 25, 2018, 05:47 PM
Apr 2018

So it very well could be addictive, especially if it was misused.

But they toss out the word Provigil to distract people's attention from the fact that Candy Man could have been passing out anything he wanted to.

Azathoth

(4,611 posts)
41. "So it very well could be addictive"
Wed Apr 25, 2018, 05:56 PM
Apr 2018

Except clinical trials and decades of evidence say it isn't.

Jesus, just give it up. You're trying to argue against the body of medical literature all just to score a political point that is going to be meaningless by next week. Provigil is less dangerous and less addictive than cough syrup. It's not a dangerous "amphetamine" like this thread claims.

Jackson apparently isn't wrapped too tightly. Handing out doses of Ambien and Provigil to people while on trips sounds like the least of his "issues."

pnwmom

(109,021 posts)
42. I posted from a study that shows that it works through the same mechanism
Wed Apr 25, 2018, 06:01 PM
Apr 2018

as other drugs that are addictive.

Here is more on that:

https://theoakstreatment.com/risks-modafinil-abuse/

In the Journal of American Medical Association,Dr. Nora D. Volkow, Director of the National Institute on Drug Abuse (NIDA), said that modafinil has the same effect on the dopamine centers of the brain as cocaine, methamphetamines and amphetamines. This suggests that modafinil is as addictive as those substances because it forcibly triggers the brain to release a neurotransmitter (dopamine) that is normally associated with feelings of pleasure. Under natural circumstances, the brain reabsorbs dopamine after a period of time, but powerful drugs (like cocaine, methamphetamines, etc.) make the brain continually pump out dopamine.

Dr. Volkow is the co-author of a March 2008 study published in JAMA, which says, in part, that modafinil “significantly increases dopamine in the human brain.” And the fact that it continues to be used for reasons beyond its prescribed intent poses a danger for addiction in at-risk individuals.9

RxList lists it as a reinforcing drug.10 Once the body and mind get accustomed to the presence of modafinil in the system, cutting off the supply results in typical withdrawal symptoms. To alleviate these symptoms, users seek out more of the drug, sometimes going to great lengths to secure their next dose.

Azathoth

(4,611 posts)
44. Yes, and I quoted ONE OF THE DOCTORS from the article YOU POSTED
Wed Apr 25, 2018, 06:18 PM
Apr 2018

who said experience shows it wasn't addictive. Now you're posting from the business website of a freakin' treatment center (which is simply referring back to the single study you posted previously). Want to know how many people need to be admitted to a treatment center for modafinil addiciton? None.

RxList lists it as a reinforcing drug
That's based on a single study of monkeys who were trained first to self-administer cocaine. This nonsense goes on and on.

This is a drug that has been on the market for 20 years. There are no -- ZERO -- medical studies showing real-world addiction to modafinil at therapeutic doses. Maybe you can find someone who took fifty times the recommended dosage and ended up with weird effects, but that is true for any drug, including cough medicine.

It's not an amphetamine. It's not addictive. Just let it go.

pnwmom

(109,021 posts)
45. I think you're mixing me up with another poster.
Wed Apr 25, 2018, 06:19 PM
Apr 2018

This is what the author of the study said:

http://content.time.com/time/health/article/0,8599,1885825,00.html

That was the thinking, at least — but the thinking now turns out to be wrong, according to a new study published on March 17 in the Journal of the American Medical Association. The authors say modafinil is not only the latest in a long line of chemical stimulants designed to keep users awake, alert and happy; it's also the latest to go straight to the brain's addiction centers in the process.

"This drug is not safe to use the way people are using it," says Dr. Nora Volkow, head of the National Institute on Drug Abuse and co-author of the new study. "Not safe at all." (See the most common hospital mishaps.)

Azathoth

(4,611 posts)
46. You didn't post the WebMD article which interviewed Dr. Weinshenker?
Wed Apr 25, 2018, 06:24 PM
Apr 2018

The guy whose studies Volkow cites for her own research?

If that was someone else, then I apologize.

Otherwise, you're just citing, yet again, the same single study of ten people (what a sample size, lol) that does nothing to demonstrate that the drug is actually addictive.

pnwmom

(109,021 posts)
47. This is what Dr. Nora Volkow, the author of the study, said:
Wed Apr 25, 2018, 06:26 PM
Apr 2018
http://content.time.com/time/health/article/0,8599,1885825,00.html

That was the thinking, at least — but the thinking now turns out to be wrong, according to a new study published on March 17 in the Journal of the American Medical Association. The authors say modafinil is not only the latest in a long line of chemical stimulants designed to keep users awake, alert and happy; it's also the latest to go straight to the brain's addiction centers in the process.

"This drug is not safe to use the way people are using it," says Dr. Nora Volkow, head of the National Institute on Drug Abuse and co-author of the new study. "Not safe at all." (See the most common hospital mishaps.)

SNIP

"Dopamine transporters perform cleanup work," says Volkow. "They remove dopamine after it's released and recycle it." The more dopamine that gets left in the spaces between cells, the longer its rewarding effect on the brain — and the likelier it is to lay down the roots of addiction. As Volkow and Fowler suspected, the PET scans of the men who had taken modafinil showed that dopamine transporters were indeed being blocked by the drug and overall levels were rising.

"Cocaine, amphetamines and methamphetamine all block dopamine transporters and leave dopamine in the extracellular areas," says Volkow. "Modafinil does the same." (Read "Can One Drug Cure Addiction to Another?&quot

Worse, the drug does not do its work indiscriminately. Modafinil binds to the same site on dopamine transporters as cocaine does, and one of the areas where dopamine levels then begin to climb is the nucleus accumbens — a spot researchers have come to recognize as a sort of addiction central for recreational meds. "The nucleus accumbens," Volkow and Fowler wrote, is a "brain region critical for the rewarding effects of drugs of abuse."

Azathoth

(4,611 posts)
48. Yes, I know, you're referring back to the SAME 10-person study over and over and over
Wed Apr 25, 2018, 06:42 PM
Apr 2018

This is the third article that you've posted that refers to this one study, a study that does not demonstrate that the drug is actually addictive and which is at odds with some of the research it cites, Dr. Volkow's sensational quote notwithstanding.

Once again, please post something that actually demonstrates that modafinil is addictive, or just admit this is the first dangerous and addictive drug in history that we can find no addicts for.

pnwmom

(109,021 posts)
49. It is true that there appears to be a low rate of dependence, but it is not true that there are
Wed Apr 25, 2018, 06:56 PM
Apr 2018

NO addicts. Addiction treatment centers report treating them.

And here is a reported journal case. This doesn't prove there is only one case: it proves that it is possible, which means it is likely there are more out there. Most doctors in the field don't write up cases for medical journals.

There is also little research on its long term use, as opposed to short term.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319252/

Modafinil, a non-amphetamine psychostimulant, is indicated for narcolepsy, shift work sleep disorder and severe obstructive sleep apnea syndrome. Modafinil is prescribed at the dose of 100 mg once in a day or as two doses, 12 h apart in a day. It has also been found that it reduces cocaine dependence and withdrawal phenomenon. Modafinil is claimed to have very low liability for abuse and dependence. Here we report a rare case of modafinil dependence.

SNIP

Though abuse potential is claimed to be less, it should be considered serious due to increased use of modafinil among youngsters.

CONCLUSION
Our case report is one among the very few reports of modafinil dependence, it gives a call for the need of regulations on the sale of modafinil.

https://www.theguardian.com/education/mortarboard/2013/may/31/is-modafinil-safe-in-long-term

In the absence of long-term data, the media, particularly the student media, has tended to be relaxed about potential side-effects.

Sahakian's research also suggests that prolific use over a prolonged period of time could have a potentially damaging effect on sleep architecture.

"Some professionals tend to use it on specific occasions – when they're jetlagged or when they've had a particularly bad night's sleep," she says. "They don't use it every day and they don't use it in multiple doses. Whereas, if you talk to students, they've often taken a dose and then, when they feel it's wearing off, they've taken another dose.

SNIP

Morgan researches treatments for cocaine addicts with severe sleep disorders and he has a possible explanation. "If somebody takes modafinil long-term, they may develop some of the same deficits in slow-wave sleep as cocaine users," he says. "Slow-wave sleep is the deep sleep that we tend to get early in the night. But by taking a stimulant that forces the body to be awake more than it wants to be, you're disrupting its ability to regulate how much sleep it gets and the kind of sleep it gets, so it never feels properly refreshed."

Azathoth

(4,611 posts)
50. If addiction centers were treating genuine cases of modafinil addiction
Wed Apr 25, 2018, 11:56 PM
Apr 2018

there would be all kinds of cases described in the literature. There aren't.

The single case you cite (which I confess I forgot about although I did come across it long ago) refers to someone with very serious psychiatric comorbidities (he was suffering from hallucinations and was on antipsychotics) who was taking the drug at 6 times the maximum daily dosage for months, ostensibly to overcome extreme tiredness (which, incidentally, is not only a symptom of psychotic depression but also is one of the major side effects of antipsychotics like Risperdal, which he was also prescribed).

Literally *any* drug that is taken in massive overdoses for prolonged periods can produce some degree of tolerance and dependence, from decongestants to laxatives to caffeine. What's so notable is that the guy apparently didn't suffer any serious adverse effects while he was overdosing, and his withdrawal symptoms were remarkably benign (disturbed sleep, lethargy, etc.) In short, a severely mentally ill person massively overdosed on a drug for months, and was weened off the drug uneventfully and made a full recovery -- not the kind of progression you would see in, say, a person who did the same thing with amphetamines, or even Ambien.

Frankly, most over-the-counter drug and supplement manufacturers would consider themselves lucky if that was the worst the medical literature had to say about their product.

I'm not saying that it's theoretically impossible to abuse Provigil to the point where it could have negative side effects, or that it should be handed out like candy, but as I've said, that's true of any drug. There are over-the-counter medications with far worse abuse and addiction profiles. It wouldn't take us a minute to find all kinds of cases of, say, OTC cough syrup abuse.

pnwmom

(109,021 posts)
52. I think this whole issue of Provigil is a deliberate distraction on the part of Trump people.
Thu Apr 26, 2018, 12:48 AM
Apr 2018

They decided to acknowledge the most innocuous controlled substance they could think of, so people like us could fight about Provigil.

But there is no reason to accept their word that that's all Candy Man was passing out. The NY times today said he was accused of keeping personal stocks of controlled substances, with "questionable record keeping."

I bet anything they weren't talking about Provigil.

 

LanternWaste

(37,748 posts)
33. you believe the best way to provide clarity is asking "what the hell is wrong with you?"
Wed Apr 25, 2018, 04:42 PM
Apr 2018

Hence, you believe the best way to provide clarity is asking "what the hell is wrong with you?" Seems pretty damned counter-productive and irrational to believe as such.

Time for you to dig in even deeper. There's simply not enough moral high ground for everyone, and you need to defend yours.

Azathoth

(4,611 posts)
35. Yes, I do. When people start citing sources that directly contradict what they're saying
Wed Apr 25, 2018, 04:45 PM
Apr 2018

The only response is "what the hell is wrong with you?"

tulipsandroses

(5,131 posts)
39. If you care, there are more
Wed Apr 25, 2018, 04:56 PM
Apr 2018

People report getting various levels of high - not anywhere the high of other things they have used.

[link:http://www.bluelight.org/vb/threads/557849-Provigil-200mg|

I posted the Blue light messages in response to your post about it not having street value. That is incorrect. People do abuse it. They are buying it strictly to abuse it. So it does have street value. In the grand scheme of things, it is not on the top of the list of drugs being abused. However, that does not mean that it should be overlooked.


I stand by everything I have said before. If Dr. Jackson is prescribing these meds willy nilly, he needs to be investigated.

Azathoth

(4,611 posts)
43. I'm not going to spend all day crusing through those forums, but every post I see says it makes
Wed Apr 25, 2018, 06:01 PM
Apr 2018

people feel more awake and alert, and that's it. That's why it's prescribed, and that's the same effect those people are getting from it. If they are using without a prescription, then they are self-medicating. But if they are using it to wake up because they are tired/sleep deprived, then they are using it for the same reason that doctors prescribe it. They are not using it because they want to get high or because they are addicted.

As I replied to someone else, Jackson apparently isn't wrapped too tight. I think handing out does of Ambien and Provigil while on trips is the least of his problems.

OhNo-Really

(3,985 posts)
56. The side effects and warnings lists are many
Thu Apr 26, 2018, 02:05 AM
Apr 2018
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011255/?report=details#warning

Everyone seems tired in America. Red Bull, Monster, Rockstar, and a host of other energy drinks are raking in the dough.

Idiocy is taking its toll.

wroberts189

(4,105 posts)
36. +1 yes... its a histamine.... its not speed. No heart rate increase, just keeps you awake that's it.
Wed Apr 25, 2018, 04:52 PM
Apr 2018

I been on it a year ... I easily takes breaks off it for weeks to rebuild tolerance. Not addictive to me. No ill effects... less sleep needed and mind sharper...

Pathwalker

(6,600 posts)
14. Jim Acosta(CNN) said he gave the drugs to the press corp, too,
Wed Apr 25, 2018, 04:00 PM
Apr 2018

in case anyone's wondering why they're burying it.

 

LanternWaste

(37,748 posts)
21. I too pretend fake news is whatever I call it.
Wed Apr 25, 2018, 04:23 PM
Apr 2018

I too pretend fake news is whatever I call it, and limit myself to merely two options when so many more are available to us... it's much more mentally convenient the way we do it.

 

EffieBlack

(14,249 posts)
15. Unless I hear more, I think this particular accusation may be overblown
Wed Apr 25, 2018, 04:02 PM
Apr 2018

I've done a lot of traveling for work as part of large groups that included a medical team. There were plenty of times, because of the crazy travel itineraries and grueling work schedule that the traveling physicians dispensed wakefulness meds and sleep aids of various strengths, both prescription and non-prescription - sometimes it was just a Melatonin and a Benydryl to help with the jet lag and sleep disruption. And they didn't just pass them out willy nilly. They had everyone's medical histories in advance. They were constantly with us and available for consultation or for assistance in the unlikely event there was any medical issue or problem. They never gave anyone enough to cause a dependence problem - the trips weren't long enough for that.

This sounds like what this doc was doing on the trips - a far cry from being a Dr. Feelgood.

There are lots of reasons to question his fitness for the VA post - but, without more, this particular accusation doesn't impress me much.

anneboleyn

(5,611 posts)
30. The REAL ISSUE IS THAT HE SHOULD NOT BE RUNNING THE V.A.!! To me the press is
Wed Apr 25, 2018, 04:40 PM
Apr 2018

making a mistake by focusing on whether or not he prescribed ambien or the “upper” medication on overseas trips. First, I hate the drug Puritanism that we find on this site sometimes — DU should be especially sensitive to this sort of thing. The press should be focusing on why he should not be put in charge of the V.A., which has a hell of a lot to do with very serious issues about this guy. The complaints about creating hostile work environments —those are very serious.

CNN is saying right now that Jackson was passed out drunk and couldn’t be reached when he was needed for a medical issue AND that he crashed a gov vehicle while drunk. Now that should be something to be considered. Also he was keeping “private stashes” of controlled meds to hand out without prescriptions — these are allegations but they are obviously serious.

And this guy said Trump was SO healthy!!! Lmfao.

GreenPartyVoter

(72,384 posts)
31. It is possible, but my point is that at one time is didn't seem
Wed Apr 25, 2018, 04:40 PM
Apr 2018

to merit the concern it does right now.

So the question is, what changed? Med dispensing levels or tolerance for the behavior?

 

Kirk Lover

(3,608 posts)
34. I'm pretty sure handing out uppers and downers on international trips was common. But I also believe
Wed Apr 25, 2018, 04:44 PM
Apr 2018

that Obama probably didn't even know about what shenanigans were going on. My boss doesn't know half the shit that goes on around here.

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