Chronic Pain and Opiod Addiction

[shemp]

There is a deep-seated fundamental belief in many cultures that anything that brings pleasure must necessarily be evil, and should be fought against.

This.

 

[Pup]

Any opioid, as well as lots of other medicines like anti-depressives, anti-anxiety drugs, etc. are addictive in the sense that if you stop them suddenly, you'll have withdrawals. I think sometimes doctors don't emphasize that point enough, but surely that's not what all the fuss is about.

Apparently there's a psychological addiction, or a psychological addiction to a physical side effect, which I have never experienced, and that's what all the drug abuse and legislation is about.

When I took morphine for cancer pain, it decreased the pain to a bearable level. I specifically wanted medicine with the least side effects for the most quality of life. I was able to go about daily activities, finished up an academic book I was writing, and had minimal side effects on 100+ mg a day other than constipation. Blah. Constipation. When I had a nerve block and treatment to reduce the tumor, I quit cold turkey, went through all the withdrawals, but had zero craving for the medicine.

There must be something that other people feel, because I found morphine about as exciting as aspirin, and withdrawals like a really bad case of the flu plus anxiety, but bearable. And then the constipation was no more. Yay!

 

[Magrat]

I've had physical withdrawal from some medications that is horrible. Cymbalta for example. There was a mess up at the pharmacy and I went nearly a week without it. Vomiting, brain shocks, cold sweat, spasms, headache. It was awful! But I didn't crave cymbalta, my body had just grown accustomed to it.

My neurologist explains this very well. Its like quitting smoking. You have the physical nicotine withdrawal, and then the mental habitual withdrawal. When I quit smoking, the habit was much more difficult than the nicotine withdrawal.

 

[TomB]

I've had physical withdrawal from some medications that is horrible. Cymbalta for example. There was a mess up at the pharmacy and I went nearly a week without it. Vomiting, brain shocks, cold sweat, spasms, headache. It was awful! But I didn't crave cymbalta, my body had just grown accustomed to it.

My neurologist explains this very well. Its like quitting smoking. You have the physical nicotine withdrawal, and then the mental habitual withdrawal. When I quit smoking, the habit was much more difficult than the nicotine withdrawal.

All of those anti-depressants need to be weaned off. Cold turkey is generally not pleasant. Cymbalta's actually good for certain types of pain as well, by the way. Makes a good complement to opioids.

When I quit smoking I went cold turkey from a pack a day. The main trouble I had was the habit of putting something in my mouth. The key was that i didn't tell anyone I was quitting. There's nothing that would have made me wasn't to light up more than someone encouraging me. Smoke nazis make smokers want to smoke. Fortunately, I had already quit several weeks before anyone noticed. That was like ten years ago. My wife still smokes, though.

 

[Magrat]

All of those anti-depressants need to be weaned off. Cold turkey is generally not pleasant. Cymbalta's actually good for certain types of pain as well, by the way. Makes a good complement to opioids.

When I quit smoking I went cold turkey from a pack a day. The main trouble I had was the habit of putting something in my mouth. The key was that i didn't tell anyone I was quitting. There's nothing that would have made me wasn't to light up more than someone encouraging me. Smoke nazis make smokers want to smoke. Fortunately, I had already quit several weeks before anyone noticed. That was like ten years ago. My wife still smokes, though.

I'm on cymbalta for pain, not sure at this point it is still helping but sure as heck not going to stop it find out!

I quit in 2014 as a birthday gift to myself. I have terrible asthma, and had had pneumonia at the time. So I couldn't smoke anyway, decided to just not start back up. My children's father switched to a vape because the smell on his body made me have asthma attacks.

 

[Jules Galen]

Any opioid, as well as lots of other medicines like anti-depressives, anti-anxiety drugs, etc. are addictive in the sense that if you stop them suddenly, you'll have withdrawals. I think sometimes doctors don't emphasize that point enough, but surely that's not what all the fuss is about.

Apparently there's a psychological addiction, or a psychological addiction to a physical side effect, which I have never experienced, and that's what all the drug abuse and legislation is about.

When I took morphine for cancer pain, it decreased the pain to a bearable level. I specifically wanted medicine with the least side effects for the most quality of life. I was able to go about daily activities, finished up an academic book I was writing, and had minimal side effects on 100+ mg a day other than constipation. Blah. Constipation. When I had a nerve block and treatment to reduce the tumor, I quit cold turkey, went through all the withdrawals, but had zero craving for the medicine.
There must be something that other people feel, because I found morphine about as exciting as aspirin, and withdrawals like a really bad case of the flu plus anxiety, but bearable. And then the constipation was no more. Yay!

I took a ton of pain killers for awhile after a particularly bad operation and the constipation was horrible! Seriously, I heard Michael Jackson was addicted to Percodan and after taking the stuff myself (alongwith the constipation) I just can't see how he did it...or prefferred it.

Elvis was addicted to Pain Killers too and all the constipation enlarges his colon to epic proportions. It was sad.

 

[casebro]

It would probably, but it is too limited and impossible for me to get. There's not even doctors within an hour of me who prescribe it.

Impossible? I thought you have teenage kids around the house. They have friends....
Oh, wait- the disadvantage of home schooling?

 

[Magrat]

I took a ton of pain killers for awhile after a particularly bad operation and the constipation was horrible! Seriously, I heard Michael Jackson was addicted to Percodan and after taking the stuff myself (alongwith the constipation) I just can't see how he did it...or prefferred it.

Elvis was addicted to Pain Killers too and all the constipation enlarges his colon to epic proportions. It was sad.

I have celiac and IBS and OIC (opiod induced constipation, cuz doctors like acronyms). I struggle so much. It is a balancing act between diarrhea and constipation...too much *cure* is just as bad. I have to be careful to limit the amount of roughage I eat or all hell can break loose

 

[casebro]

Re: recreational use of opioids, I was curious when they were first prescribed. Aouple make me sleepy, I couldn't see how anybody could abuse them. The SOP for recreational use is 7-10 hydrocodone, and a half pint of 86 proof. Which just does not sound like a fun time to me.

Though I did have one oxycodone once. I felt a little happier than the situation warranted. Not enough to make up for straining on the toilet later though.

 

[Babbylonian]

The SOP for recreational use is 7-10 hydrocodone, and a half pint of 86 proof. Which just does not sound like a fun time to me.

That may (or may not) be the SOP for full-time recreational addicts but you definitely don't need to push that hard to get a nice high unless you've already built up a serious tolerance.

 

[Pup]

That may (or may not) be the SOP for full-time recreational addicts but you definitely don't need to push that hard to get a nice high unless you've already built up a serious tolerance.

Dumb question, but what does a high feel like? I've never felt anything that I would call pleasant or worth repeating after taking opiates, other than relief of pain. Not anything unpleasant usually either.

I was given too much dilaudid in the ER once, and my vision started flipping like an old TV set, but after the nurse reassured me it was the medicine and not a seizure or something and it would stop in fifteen minutes or so, I didn't feel anything emotionally, just normal, except I threw up for the next five hours.

So what is the actual sensation of a high? Why do people enjoy it? Are some, like me, actually immune to it?

 

[Magrat]

Re: recreational use of opioids, I was curious when they were first prescribed. Aouple make me sleepy, I couldn't see how anybody could abuse them. The SOP for recreational use is 7-10 hydrocodone, and a half pint of 86 proof. Which just does not sound like a fun time to me.

Though I did have one oxycodone once. I felt a little happier than the situation warranted. Not enough to make up for straining on the toilet later though.

This would make me tired, not high. I have a pretty good tolerance, though not from recreation.

I am under the impression oxy can be crushed and snorted? Never had any desire to stick **** up my nose so idk for sure.

 

[Babbylonian]

So what is the actual sensation of a high? Why do people enjoy it? Are some, like me, actually immune to it?

It depends on the source of the high. Opioids, when used recreationally, tend to offer a relaxed, euphoric feeling. Alcohol can enhance these sensations. Amphetamines and cocaine also produce the euphoria (and some numbing), but they're stimulants and so are less relaxing and won't put one to sleep.

That said, it's impossible to recommend any of these for recreational use. There are any number of negative side effects from the above substances/substance categories. They're addictive and continued use in the absence of a doctor's supervision will probably mean negative outcomes, not to mention the potential of overdose or just getting dangerous stuff when purchased on the black market.

For me, marijuana works just fine for increased relaxation and a generally pleasant tweaking of my brain. I don't feel the need for anything more potent and I don't have to worry about overdosing, getting something dangerous (thanks in part to legalization here and in part to the nature of marijuana), or physical addiction.

 

[Pup]

It depends on the source of the high. Opioids, when used recreationally, tend to offer a relaxed, euphoric feeling. Alcohol can enhance these sensations. Amphetamines and cocaine also produce the euphoria (and some numbing), but they're stimulants and so are less relaxing and won't put one to sleep.

That said, it's impossible to recommend any of these for recreational use. There are any number of negative side effects from the above substances/substance categories. They're addictive and continued use in the absence of a doctor's supervision will probably mean negative outcomes, not to mention the potential of overdose or just getting dangerous stuff when purchased on the black market.

For me, marijuana works just fine for increased relaxation and a generally pleasant tweaking of my brain. I don't feel the need for anything more potent and I don't have to worry about overdosing, getting something dangerous (thanks in part to legalization here and in part to the nature of marijuana), or physical addiction.

Thanks. Well, I've definitely never felt any euphoria, and if I've had relaxation it's a negative thing, like being too tired, and I reduced the dose till it went away but there was still pain control.

FWIW, I'm not looking for a high, and have never used drugs or marijuana recreationally. When I needed morphine for cancer pain last year, I definitely needed it, but fortunately (or unfortunately) that pain has been controlled by chemo, but I now have severe pain from post herpetic neuralgia which isn't helped by opiates, so the palliative care doctor is trying all the various nerve pain stuff.

But opiates seemed so boring that I couldn't figure out why anyone would crave them or enjoy them. Apparently my brain is missing the "get high" switch, which is actually kind of nice, because there's no worry of psychological addiction if i need pain medicines.

 

[Babbylonian]

But opiates seemed so boring that I couldn't figure out why anyone would crave them or enjoy them. Apparently my brain is missing the "get high" switch, which is actually kind of nice, because there's no worry of psychological addiction if i need pain medicines.

What I'd say is most likely is that you just haven't enjoyed the highs you've had and so aren't interested in doing it again.I've found that to be a very common reaction.

I did LSD once with 5 friends (only one of them had used it before). At the end of the night, two people pledged never to do it again because it was "too weird," one enjoyed the experience but didn't find it that compelling, and three of us (including me) enjoyed ourselves thoroughly. In other words, everybody got high but everybody experienced it differently.

For the record, that's the "hardest" drug I've done and it was only the one time - it was fun but I've always been leery about illegal drugs that aren't marijuana.

 

[Hlafordlaes]

Pot relieves pain, and helps go to sleep, and stay asleep, by golly-gosh, which is a yuuuuge problem with chronic pain. I smoke pot. It is a good way to lessen the amount of NSAIDs I have to take every day. Though now tolerant, I still seem to enjoy music and jokes more. And I get an appetite when other medication or whatever is taking it away. Not altogether bad side effects.

RogueKitten, IANAD, so no way I can help. For myself, as a long-term patient, I know that the side effects can become more important the longer you take any medication. After decades on NSAIDs, I take them with great reluctance. My own strategy, FWIW, has been to always stay as close to the minimum dose and/or skip whenever possible, which might only come a few days a year. As for opoids, between you and the doctors. Science is your friend.

 

[deadrose]

What I'd say is most likely is that you just haven't enjoyed the highs you've had and so aren't interested in doing it again. I've found that to be a very common reaction.

I dunno, that's my reaction to cocaine. Nothing happens, never has. Different times, different people, different product, never any reaction. So when people have offered it to me, I just tell them not to waste their money.

People have different brain chemistry and some of us may have wonky receptors in the bargain. It would be an interesting topic to research, and especially to correlate with mood disorders.

 

[Magrat]

I dunno, that's my reaction to cocaine. Nothing happens, never has. Different times, different people, different product, never any reaction. So when people have offered it to me, I just tell them not to waste their money.

People have different brain chemistry and some of us may have wonky receptors in the bargain. It would be an interesting topic to research, and especially to correlate with mood disorders.

Whoa that's a great question! Not just mood disorders, but what about ADHD? I strongly suspect cocaine would make me very calm. My daughter takes adderall, which is a major stimulant, and it calms her mind down.

 

[Fudbucker]

Physical withdrawals from pain-pills aren't that big a deal (speaking form experience). Heroin withdrawals (speaking from friends' experiences) are horrible and people who are dope-sick will do a lot of terrible things to not be dope sick.

PAWS is the worst though. It stands for Post Acute Withdrawal Syndrome and comes after the physical withdrawals, as your brain adjusts to the absence of whatever you were doing to get high. It can last a long time, it's a low-grade sucky feeling that won't go away, and it's when most addicts relapse.

 

[Pup]

Physical withdrawals from pain-pills aren't that big a deal (speaking form experience). Heroin withdrawals (speaking from friends' experiences) are horrible and people who are dope-sick will do a lot of terrible things to not be dope sick.

There are lots of "pain pills," so not sure which ones you mean. I was prescribed morphine extended release pills, and the physical part of withdrawal included four days of vomiting and diarrhea, and restless legs a couple evenings, plus anxiety attacks. I didn't get the insomnia that some people talk about. It wasn't a big deal in the sense of seizures or life-threatening symptoms, but I couldn't leave the house or eat much of anything.

PAWS is the worst though. It stands for Post Acute Withdrawal Syndrome and comes after the physical withdrawals, as your brain adjusts to the absence of whatever you were doing to get high. It can last a long time, it's a low-grade sucky feeling that won't go away, and it's when most addicts relapse.

PAWS was the easiest for me, but maybe because I didn't actually crave the drug, and didn't associate it with a better mood. I wasn't in pain so didn't need it, and I thought about asking for a short term mood-elevating drug like an anti-depressant, but the PAWS wasn't constant and I didn't want to risk withdrawal from something else, so I just got through it. Lasted a few months as I recall, improving over time.