39 replies to this topic

[~ prometheus ~]

hi guys, I have a big exam in 4 days time, so I need to make this post short, but if people would like more detail, then I'd be happy to elaborate at a later date.

I am currently a medical student, and I wish I could divulge to you my background, education and personal life to give you the context with which I say this. In fact, I started typing it up, but have elected to delete it because even if there's only a 0.001% chance of my identity getting out, it's a risk I have no desire to take.


I have spent a long time researching the harms and long-term effects of opiate use. Even if there is no paper in the lancet that demonstrates this definitively in a RCT, I have concluded this:

with chronic opiate use, as with any chronic drug use, it's very likely that your motivation and reward pathways will be altered in a way that will affect your ability to function with your everyday life. If you take opiates but are ostensibly "functional" e.g. got a good job/studying, you probably won't even realise it's happening while you're on them. But it will be there… other things won't be as fascinating, you'll have less need for relationships. Classic anhedonia that i needn't elaborate upon.

harms to the self while taking them: taking opiates is like putting yourself in a "psychological cryostat" … there can be no personal growth while you take them. Once you stop taking them, you can now resume growing, but only as the person you were just before you commenced taking them. It's a curious phenomenon but I'm utterly convinced that it occurs.

the aftermath: In terms of drugs that can cause harms, chronic use of opiates appears to be one of the "better" ones. Moreso than say alcohol or psychostimulants. Any day of the week. But regardless of the neurotoxicity of opiates or lack thereof, you may find that the effects of your prior use stays with you for a long, long time, well after you stop taking them.

Some doors, once opened can never be closed. Now that you know what things can be like with opiates, you may never, ever, feel "normal" without opiates on board, regardless of how well you score on the WAIS-IV or how unremarkably your fMRI scan lights up.

That's the real harm with opiates.

this is not me being some new-age douche bag, and if it comes across that way, i've either conveyed my message inaccurately or your not in the headspace to understand it. if it's the latter, i bid you good luck -- experience is by far the best teacher, far, far more effective than any online discussion forum.


RE: cognition. Opiates have been shown to inhibit neurogenesis via BDNF, and may affect your memory and other cognitive abilities. There is a lot of conflicting data. Some studies have shown negative effects on healthy volunteers after acute administration, others have not. With respect to long-term use, again, conflicting data. Based upon my own data, I'd say that so long as it isn't IV, massive doses, or a stint longer than a few years, any clouded cognitive faculties should largely return after a good month's break.



correction: actually, given how long it took me to write this post, i release this was my latest round procrastination

[~ prometheus ~]

Apparently this only happens via overdose and respiratory depression builds up tolerance just like euphoric effects for example. So if you adjust your dose correctly in relation to your tolerance, respiratory depression can not happen. Someone more in the know - am I right?

generally, what you're saying is true, but it's slightly more complicated than that:

with respect to opiates and other CNS depressants, tolerance to respiratory depression is rapid and usually occurs faster than tolerance to other effects e.g. euphoria, analgesia. conversely, one can lose this tolerance faster. in other words, taking a few days off opiates might not be enough to overcome your tolerance to its subjective effects, but you may have lost your tolerance to it's depressing effects upon respiration.

effects and side effects don't always sit on the same dose-response curve.

also, beware about the potential interaction with any latent sleep apnoea.


at the end of the day, you need to take an individual differences perspective to this. just because a study reports a particular effect, doesn't mean that you're not the outlier!

[nowayout]

... you'll have less need for relationships.

...taking opiates is like putting yourself in a "psychological cryostat" … there can be no personal growth while you take them. Once you stop taking them, you can now resume growing, but only as the person you were just before you commenced taking them. It's a curious phenomenon but I'm utterly convinced that it occurs.

Very true.

During more than 2 years on opioids I did not date anybody. It was only once I came off them that I started feeling the kind of loneliness that motivated me to start trying to meet people again. (I do have close friends so I am not lonely in that way, but I feel the need for an intimate relationship now.)

I have to say that the loneliness is a painful emotion and I am very tempted to take opioids again (and from time to time I do) just to get rid of it, but I also find the loneliness strongly motivating to get out of the house and try to do something about it, precisely because it is so unpleasant.

Edited by viveutvivas, 10 November 2012 - 05:15 PM.

[noopeptisgood]

I've read too much about opioids to have any patience for inanity, so I skipped most posts in this thread. I can add that tolerance can be managed with NMDA antagonists and DLPA. Other than the psychological effects, opioid tolerance and withdrawal is non-toxic. Tolerance is relatively permanent. In my experience it will drop, but will quickly rise again in the light of more than sporadic use.

[Luminosity]

They thought they were playing with the darkness but the darkness was playing with them.

Vieno, the real question is why you are denying what everyone already knows and inviting destruction into your life?

When you see the door clearly marked, "do not enter, death and destruction will result," don't enter that door. Don't play with the door knob. Don't look in the keyhole. Don't ring the door bell.

There is no way to make one of the most addictive substances on earth not be addictive. There is no way to make it not be harmful. There is no need for anyone to document what all of human history has already proven.

And don't take advice from people who say they are the devil.

My friend the opiate addict is 5'4" and weighs 88 pounds. She lived in her van for over a decade. She has thick files with various authorities, with the accompanying bad experiences, some of them unwarranted. Unfortunately, that can happen when you give your life over to chaos.

[~ prometheus ~]

I have to say that the loneliness is a painful emotion and I am very tempted to take opioids again (and from time to time I do) just to get rid of it, but I also find the loneliness strongly motivating to get out of the house and try to do something about it, precisely because it is so unpleasant.

totally agreed. anecdotally i have observed that this is often the case with opiate users. found an interesting study linking either polymorphisms or different receptor densities in the u opioid receptor with feelings of loneliness. in non-human primates, administration of opiate agonists/antagonists will modulate grooming and other social/affiliative behaviour. if i had more time, i'd dig them up cos they're quite neat.

a bit of tension in the opioid system can be a good thing. it creates a drive to seek the company of others and engage in affiliative behaviour. get rid of that with a bit of opiates, and you feel far more comfortable being on your own. great if you're feeling really lonely, but bad because you have no compulsion to do something about it.

we're all at the mercy of our biology -- although people on these forms are all about "hijacking" or "tweaking" this, at the present date some pathways are best left alone

When you see the door clearly marked, "do not enter, death and destruction will result," don't enter that door. Don't play with the door knob. Don't look in the keyhole. Don't ring the door bell.

bah! the forbidden fruit always tastes twice as sweet. when you hear about people sacrificing everything, losing absolutely everything: their health, jobs, family, dignity and finally their lives... sometimes you get curious to see what all the fuss is about. it's call human nature braah

[Vieno]

Thank you who answered to my questions, appreciate it!

Edited by Vieno, 11 November 2012 - 11:12 AM.

[protoject]

Ir probably depends on the person. I'm sure that many people go back to better-than-normal after a long addiction. Others may not be so lucky. Is this a result of opioid use? Who knows. The person may have had pre-existing depression, either related to the opioid system.. or not. They may have also had concominant polydrug abuse. In the end of the day, naloxone or naltrexone should fix the problem. And I'm betting you wouldn't necessarily have to do low-dose either, unless the side effects of higher dose were unbearable, but I'm figuring you could do a short course of it.

I guess a good way to know whether it has permanently desensitized the receptor is: if the person does take opioids again at a future time either weeks, months or years ahead, is their tolerance reduced? And most of the time it is. Actually many people overdose because of this. But again I can't speak for everyone. Also its possible that their receptor sensitivity only partially returned and that dosage that the overdoser took just happened to be a bit over that threshold.

[Introspecta]

I've been on Suboxone for a long time now and aside from it possibly lowering testosterone when i'm dosing too high I havn't really had any side effects. I do feel trapped and wonder how and the world I will get off this stuff. I"m trying to build my life up and my mind to get in a place where I actually have the willingness and the will to taper off. The drug has helped me go deep into opiate which would of happened if I didn't get on it at the time but now my life has gotten better and I really don't need it anymore but I stay on it. I'm In a 12step group and for the most part feel free aside the subs. I won't be completely free until I get off them. I wish I had the money for the rapid detox where they knock you out. While you still experience some withdrawals its not as long and drawn out.

Oh I did want to add that I can see the potential of Colon Cancer coming out of longterm opiate use due to the Constipation it causes. I make sure I eat tons of fruit and drink tons of water. Most of the time Its not a problem but if I bring my dose down low then back up I get Constipation. Cancer thrives in an acidic environment and if your not shitting for days or some people weeks then it really wouldn't surprise me if people got Colon Cancer. I can't really throw any links but it is pretty known that bad bowels is bad news.

Edited by joelski28, 11 November 2012 - 01:52 PM.

[kurdishfella]

Another maybe less harmful way would be to block nerve production which b vitamins are involved in a lot to decrease pain.