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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Dr. Bob on May 29, 2004, at 7:18:51
In reply to What exactly happens re: opiate tolerance?, posted by kittencat on May 28, 2004, at 5:39:21
Posted by kittencat on May 28, 2004, at 5:39:21
> Perhaps the wrong forum...but I'm just curious. Has anyone experienced tolerance to opiates such as Vicodin (increasingly larger doses, less effective pain relief, less of a sense of well being, etc.?) I know these effects will happen to anyone who is on any kind of synthetic opiate-based narcotic pain reliever for any extended period of time, but what I don't understand is why, when you completely taper off of the drug, & don't take it again for say, two months, the tolerance is still as high as if you had been continuously taking it when you begin again? (at least for me, it is). We all know there is a pretty enjoyable high (for most...not all) on these drugs...why does it subside, even after a long vacation from the drug? What happens in your brain that you continue to tolerate high doses & no longer feel "high", if you will? Does long term opiate use actually permanently alter the brain's chemistry?
>
> Any thoughts, facts, or guesses? Thanks...
Posted by Impermanence on May 29, 2004, at 15:33:45
In reply to What happens re: opiate tolerance? « kittencat, posted by Dr. Bob on May 29, 2004, at 7:18:51
Mental addiction, it's a bitch... Heroin is still with me after two years....... It's not something you can drop like that, it's something that stays with you your whole life... Damn it's so good......... Are you one of us or one of them????
Posted by Anthony Quest on May 29, 2004, at 15:35:32
In reply to What happens re: opiate tolerance? « kittencat, posted by Dr. Bob on May 29, 2004, at 7:18:51
Vicodin and other strong pain medications are pure Mu agonists. They work by stimulating endogenous opioid receptors throughout the body primarily in spinal cord and brain. The Mu, Kappa, and Delta opioid receptors are the best understood but there are likely several others.
Anyways, it is believed that repeated use desensitizes the opioid receptors and they become "upregulated". Why this happens is not known for sure. It is positied that the number of spare receptor becomes fewer, the receptors themselves become less dense, and the signaling between opioid molecule and the receptor is weaker. This is not gospel and hasn't been proven.
Herion addicts do die all the time because they lose their tolerance by taking a holiday or using something else.
It was thought that dextromethorphan hydrobromide (active ingredient) in over the counter cough syrup. There was a drug company I forget which one that was doing FDA clinical trials on a drug called Morphidex (Morphine and Dextomethophan) but the data showed no effect on tolerance.
Anyhow, a lot of people don't get euphoric from pain medication. Chronic pain suffers don't get buzzed from their pain meds, yet the medication is still quite efficicious for its analgesic effect. This is how addicts typically present - by frequent requests for increased dosage, seldom occurs in stable pain patients.
Hope that all helped.
> Posted by kittencat on May 28, 2004, at 5:39:21
>
> > Perhaps the wrong forum...but I'm just curious. Has anyone experienced tolerance to opiates such as Vicodin (increasingly larger doses, less effective pain relief, less of a sense of well being, etc.?) I know these effects will happen to anyone who is on any kind of synthetic opiate-based narcotic pain reliever for any extended period of time, but what I don't understand is why, when you completely taper off of the drug, & don't take it again for say, two months, the tolerance is still as high as if you had been continuously taking it when you begin again? (at least for me, it is). We all know there is a pretty enjoyable high (for most...not all) on these drugs...why does it subside, even after a long vacation from the drug? What happens in your brain that you continue to tolerate high doses & no longer feel "high", if you will? Does long term opiate use actually permanently alter the brain's chemistry?
> >
> > Any thoughts, facts, or guesses? Thanks...
>
>
Posted by Impermanence on May 29, 2004, at 16:04:24
In reply to Re: What happens re: opiate tolerance?, posted by Anthony Quest on May 29, 2004, at 15:35:32
When you've been a heroin addict all he^^^ says goes out the window.... Heroin in any form is very hard to get off. Locked in a room or going to a treatment center, it's all the same, the easy part is the hell of the withdrawals. It's the few days after you get the shit out of your system you can show how strong you are.... I lasted two days but after months of therapy I'm stronger than smack. How long can you last????
Posted by kittencat on May 30, 2004, at 12:04:13
In reply to Re: What happens re: opiate tolerance?, posted by Impermanence on May 29, 2004, at 16:04:24
I'm not sure what "one of us" or "one of them" means... I am new to this board...aren't we all the same? I have depressive issues, but also addiction issues.
I think the chemical aspect of what happens in the brain was well explained, or at least well hypothesised. Thank you both...it does concur with my experience, in that I have been taking opiates for years & along with the obvious increased tolerance, have completely lost "the high", even after stopping for months.
I have never experienced heroin. I applaud you for being such a survivor. Good luck.
Posted by Dr. Bob on May 31, 2004, at 21:57:46
In reply to Re: What happens re: opiate tolerance?, posted by Impermanence on May 29, 2004, at 16:04:24
> It's the few days after you get the sh[*]t out of your system you can show how strong you are....
Sorry to be such a prude, but please don't use language that could offend others.
If you have any questions or comments about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
or redirect a follow-up to Psycho-Babble Administration.
Thanks,
Bob
Posted by Impermanence on June 2, 2004, at 17:17:24
In reply to Re: What happens re: opiate tolerance?, posted by kittencat on May 30, 2004, at 12:04:13
Sorry Kittencat I was well out of it when I wrote "one of us or one of them", I'm not sure what I ment but I'm sure it was important to me at the time *coughs* lol. I think my heroin experience doesnt appily much to what you're going through but it's all opiates at the end of the day. Good luck on your journey..
And Dr. bob, sorry for my constant use of the s**t and F**k word, I wont use any profanities again, It's just a habit, no offence intended.
This is the end of the thread.
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