General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsJackson 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
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.
JustAnotherGen
(32,010 posts)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?
Agschmid
(28,749 posts)sharp_stick
(14,400 posts)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)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)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)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)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)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)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)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.
Iggo
(47,586 posts)RockRaven
(15,068 posts)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)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 hes a workaholic who sleeps 5 hrs, and yet was on twitter all day and wee hrs of morning way before the campaign.
Azathoth
(4,611 posts)It's a unique and non-addictive drug.
pnwmom
(109,021 posts)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)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
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)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)The first post I clicked on
...
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)"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)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)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)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)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)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)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)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.
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)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)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)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?"
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)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)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)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)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.
Azathoth
(4,611 posts)So we're already in much more serious waters.
LanternWaste
(37,748 posts)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)The only response is "what the hell is wrong with you?"
tulipsandroses
(5,131 posts)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)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)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)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...
Initech
(100,132 posts)Pathwalker
(6,600 posts)in case anyone's wondering why they're burying it.
former9thward
(32,125 posts)Pathwalker
(6,600 posts)on Halcyon. This ain't exactly new news.
LanternWaste
(37,748 posts)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)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.
pnwmom
(109,021 posts)anneboleyn
(5,611 posts)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 couldnt 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.
Kirk Lover
(3,608 posts)GreenPartyVoter
(72,384 posts)he had seen a problem with it.
pnwmom
(109,021 posts)GreenPartyVoter
(72,384 posts)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)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.