Question: Hello Dr. Grief, I have been in multiple car accidents that led me to drugs such as tramadol, vicoprofen and then roxicodone. I was on these medications for about 10 years. After that 10 years adderall was added to the mix and it caused me long term psychosis. I stopped taking all medications for the past 3 years, started to exercise, eat healthier, etc. I have tried at least 8 SNRI's for severe lack of energy, motivation, pain and all these things creating depression. I went from owning a very successful business when I was on the opiate based medicines and I am trying to get back to "Normal!" I am not looking to get high, I want normal energy, but can't take any stimulants as it was determined I could not metabolize them correctly and at a normal dosage my blood levels of adderall were found off the charts. Again this explains the voices that this medicine caused and most likely increased a general anxiety problem that I had before and didn't even realize it. My Pdoc after trying many medications SNRI's, etc (Which some I have had some really bad reactions to) now has me on (7) 50mg Tramadol a day and I also take 4mg of Subutex a day as well. He said that it has become clear that the opiate part of my brain needs to be regulated and this should do it. That said I have not worked in 3 years now and I have two little girls and a wife that I can't provide the love or support that I always envisioned I would be able to. My PDoc did have me on Norco 10/325 for about 7 months, but that was not a long term plan. During this period that was the only time I had any normal amount of energy, motivation and could enjoy my family. I knew this was not going to be long term so I did not embark on partnering up again with my old business partners or starting my own online business. I really don't think that there is a SSRI or SNRI out there that is going to work for me. I don't think my Pdoc realizes how tired and unmotivated I am. I have never abused or called my Pdoc for ANY script early and respect the medicine more than I ever had. That said after talking with a few doctors it seems that it will be impossible for them to give me a chance to go on an opiate based treatment. I have heard from many doctors also that I most likely have a low amount of endorphins due to the long term use of opiate based drugs. Even though this might be the case I can't find a very caring and understanding doctor that is willing to work with me. I know that if a Doctor was going through what I have in the past three years and they were a very good person in family and business life before they would realize how severe my condition is! I am located in Chicago, IL and I am in a very desperate situation as the years are adding up of unhappiness and suffering for me. Again, I believe I am a very good and honest person and I am in great need of an understanding doctor that is willing to give me a chance and work with an opiate treatment. It just doesn't seem fair that I know this will allow me to work, smile and make my kids and wife happy. It isn't right that I dread family vacations and countless other activities that I used to be reliable at and enjoyed doing. I don't even enjoy golfing anymore for several reasons, but this was something that I was a MVP in High School for. Sorry for the long description, but the fact is I could go on and on. I just want a doctor that will give me an opportunity to see if this treatment will work long term. I can't keep living the way I am now.

Hello Dr.Gulati, Thanks for the detailed answer. When you start out by saying Narco should be fine are you referring to the Norco that I was on previously that was working or is Narco another drug name for the subutex that I am currently on? I am familiar with pregabalin "Lyrica" as that was one of the first approaches docs used and continue to bring up in conversation. I believe that all the levels you mentioned of thyroid, b12, D3, etc were fine in my last physical about 7 months ago. I have also had a sleep test that showed I slept fine with the exception of clenching my Jaw.