Once one, always will be?

[ScorpioTrey5801]

For those of us who have been prescribed medication that we have dependence on. I hear all of the time that once you've been on medications & eventually taper off, that it sticks with you for the rest of your life.


Thoughts?

[Piper]

@ScorpioTrey5801 I believe; no I know, that the tolerance to whatever particular
med you've been dependent on never goes away. Could be alcohol, could be
doc scripted meds. I think if you take a break and get clean for a while and
start again, it's like you never took them at first. But know from my experience that
tolerance rises much faster than someone who was never dependent. That's
true for me, don't know about any one else. I had minor surgery done years ago
after being clean of everything for almost 2 years. The anesthesiologists were
talking to me to gauge my state of consciousness. I heard one say to the other,
"I can't believe she's still carrying on a coherent conversation" They looked at
my chart, and one said, "oh she's two years in recovery, better up that dose!"
Leads me to believe that its medically true.

[Owlie]

This is a really interesting question. I, too, would like to know what other folks think about this.

For myself, I successfully tapered off a small codeine addiction some years ago, and was back to feeling like my old self in just a few weeks. Never had any cravings or recurring issues later on. However, as I said, I was only on a small amount of meds, and my dependency only lasted a few months. It might be different for folks who are on long-term, high-dosage meds.

[alumni]

@ScorpioTrey5801 Did you study this issue while acquiring your degree in pharmacology or especially when studying the specialty of psychopharmacology?
The answer is very complicated and typically depends on many variables including the drugs involved, length of use, purpose of treatment, genetics, addictive behaviors, etc.
I've read countless research studies on the subject that I imagine would be part of the university study of pharmacology.

[jhall93085]

Very good question.....from psychopharmacology we discussed with particular drugs of abuse, there are certain permanent changes that drugs can induce, which has been also argued that these may underlie addiction. The body is constantly trying to attain homeostasis, so when you put a particular drug in your body, it causes numerous changes (sensitization, etc). When you taper off the drug and stop taking it, sometimes your receptor number never gets completely back to baseline which can drive the addiction for years even if you never touch the drug again. Thus this is a very sticky situation. Unfortunately we cannot undo experience, so the resultant effects of the drug are remembered. Any contextual cues that surround drug (for example, where you are at taking the drug) taking become your worst enemy upon stopping. This is also why with people who abuse drugs are told to no longer remain friends with others that they did drugs with, as they will not be helpful in trying to stop. And when I'm talking about addiction, it does not necessarily mean individuals that abuse a drug. Simply put, anyone on medications/drugs for an extended period of time (especially if they work) sometimes may never lose the urge to continue to take them and can become addicted.

[alumni]

Very good question.....from psychopharmacology we discussed with particular drugs of abuse, there are certain permanent changes that drugs can induce, which has been also argued that these may underlie addiction.

That's good to hear that it was part of your course of study.
I believe that this subject is very appropriate in a college level curriculum, especially when the degree received is in pharmacology and a graduate specialty studied in psychopharmacology.
That's why I was curious about the original poster's question since it appears that this is his educational experience.

[taralumia]

@ScorpioTrey5801, you were kidding about the psychopharmacology research, weren't you? Come on now, play straight with us, and you will find there is a wealth of information and support here.

[billyboy1965]

you were kidding about the psychopharmacology research, weren't you? Come on now, play strsight with us,.

Once credibility is lost...

[Piper]

@all i don't see anywhere in his post that @ScorpioTrey says he's studied
pharmacology. reads to me that he's just wanting everyone's opinion on
the subject. kind of seems like everyone's jumpin on the new guy. JMO.

[billyboy1965]

reads to me that he's just wanting everyone's opinion on
the subject. kind of seems like everyone's jumpin on the new guy. JMO.

It was in his original profile which has since been edited away...

[Piper]

@billyboy1965 didn't see that, guess i got here after the fact. thanks for
the clarification.

[Wish]

There is a lot of mixed information on the long term of effects of prescription drug use. I have studied and read that in time the neurological aspect of prolonged rx use can in fact regenerate and heal itself. But have also researched and learned that some receptor damage is permanent.

If you think about though it once you've taken a drug it is always with you to some extent. For example if your drug of choice has a half life of 12 hours, after 12 hours of ingestion you have half the amount of that dosage(ie MG) and after 24 hours you'd have a 1/4 of that original measured amount in your system, after 36 hours and 1/8 after 48 hours a 1/16 and so on and so on. But you'd never have 0/0 of that substance in you, over years it may be .0000000000000000000000000000000012 mg but in a sense it will never be 0% of that rx medication in your body. It might be a thousandth of a percent but in some capacity will always be present none the less. Strange isn't it if you entertain the mathematics avenue of drug use...


First let me go over some basics:

Tolerance may be defined as a state of progressively decreased responsiveness to a drug as a result of which a larger dose of the drug is needed to achieve the effect originally obtained by a smaller dose.

An individual physically dependent on a drug requires that drug in order to function normally. Physical dependence is associated with tolerance in most cases. The state of physical dependence is revealed by withdrawing the drug and noting the occurrence of withdrawal symptoms some time after the drug is withheld. The symptoms of withdrawal can be terminated by re-administration of the drug.

Symptoms of drug withdrawal tend to be the opposite of the effects of the drug. If the effect of the drug is sedation, the withdrawal effect will likely be hyperexcitability. If the effect was stimulation the withdrawal effect will likely be be emotional depression.

Longer acting drugs tend to produce less intense withdrawal symptoms because the body has more time to adapt to the decreasing presence of the drug.


I will use opiate/opiod prescription drugs for this example for the sake of uniformity

One can restore opiate receptors by abstaining from opiate usage. Over time the receptor proteins will regenerate and become normal again. This amount of time will fluctuate, depending upon the person's history of opiate usage. It could take as little as a couple of weeks or last longer than one year, depending on the severity of the addiction.

Your tolerance to opiates will decrease somewhat due to incomplete cross tolerance, but will never go back down to where it was when you were opiate naive.

Your brain has to heal after long-term addiction. trust me, if you've ever been through major withdrawal and clean time, you know that this sort of fog lifts over time. that's the brain healing itself, i'm sure. it sure feels like healing.

I think your brain can return to fully normal after time without opiates, but it can take more than a year.. The thing is that most users don't wait that much time and use it before it returns to normal.

But then some doctors & scientists say what happens is that your body gets used to exogenous endorphins supplied by opiates and ceases the endogenous production of them. Its not just the ceasing of production of endogenous opioids agonists. It also is about altered receptor regulation/ sensitivity.
Also, your body will produce more endogenous opioids antagonists (like CCK, dynorphin, etc..) when you use agonists daily, so that also contributes to the altered endogenous system. And that this process may never completely reform and return to a "pure" state.

Endogenous opioid peptides are produced naturally by the body and include endorphins and dynorphins. Once the body’s opioid receptors have been desensitized because of prolonged use, users can build up a tolerance and require a higher dose to achieve the same effect. To some degree this may never fully recover and be "normal" again, better for sure overtime but never the same as it once was prior to ones first use. Who really knows? You decide.

From personal experience I have noticed that my tolerance will diminish over a period of time without use and a "lesser" dose will do much "more" compared to that doses effects before regular usage. But my tolerance rises extremely quickly compared to someone who has never used before. I think to some extent you open up Pandora's Box and will never be able to use as an opiate naive user, in reagrds to dose and frequency of administration.


Here is a cool study I was reading up on:

Scientists at the University of Edinburgh studied the brains of 34 deceased intravaneous drug abusers of heroin and methadone and compared them to the brains of 16 young people who were not drug users. Their examination revealed brain damage in the drug abusers normally seen in much older people.

The damaged nerve cells were in the areas of the brain involved in learning, memory and emotional well being, and were similar to damage found in the early stages of Alzheimer's disease.

"Our study shows evidence of an increased risk of brain damage associated with heroin and methadone use, which may be highest in the young, when individuals are most likely to acquire the habit" said co-author Jeanne Bell Professor of Neuropathology. "We found that the brains of these young drug abusers showed significantly higher levels of two key proteins associated with brain damage."

"In a previous study we found out that drug abuse causes low grade inflammation in the brain. Taken together, the two studies suggest that intravenous opiate abuse may be linked to premature ageing of the brain," Bell said.

Heroin and Methadone Cause Damage
The average age in these two groups in the study was only 26 years and included some drug abusers as young as 17.

"Tau protein, which in its soluble form is essential for communication and transport within brain cells, had become insoluble in some cells, causing nerve cell damage and death in selected areas of the brain," the authors reported. "Other nerve cells showed an accumulation of the amyloid precursor protein, which suggests that protein transport had been disrupted and the nerve cell functions affected."

Severe Nerve Cell Damage
"This study shows that drug abuse can lead to a build up of proteins which cause severe nerve cell damage and death in essential parts of the brain. This is very worrying as there are strong indications that drug use in the UK, in particular opiates like heroin and methadone, has continued to rise in recent years" says Professor Bell.

"The drug abusers we looked at in the study sadly died at a young age, but there are many others who don't realise the long-term effects that these drugs may be causing."

Source: S. N. Ramage, I. C. Anthony, F. W. Carnie, A. Busuttil, R. Robertson, J. E. Bell, "Hyperphosphorylated tau and amyloid precursor protein deposition is increased in the brains of young drug abusers," Neuropathology and Applied Neurobiology, June 2005.

The 2007 Times Higher Education Supplement [THES] World University Rankings ranked the University of Edinburgh as follows

* 23rd in the world


Read more: Brain Damage Similar to Alzheimer's from opiate use. - Drugs Forum

Read more: How to Restore Opiate Receptors | eHow.com How to Restore Opiate Receptors | eHow.com


Just my take on things,

-WISH

[kdesain]

I was prescribed benzos for 26 years. I got off of them a year ago, and am back on them again. When I restarted them, my tolerance was zero, but it went up quickly. The year that I was off them was miserable. I couldn't think straight, couldn't get anything done. I'm afraid they are with me for life.

[Perromaldido]

Benzos are a bitch. whatever you're on try to dwitv something with a longer half life. If you're on an hypnotiv try and switch to an anxiolitc. One CAN beat benzos...check Welcome to benzo.org.uk : Main Page the best source of info I know to understne how they work and how to getrid of them. It's worth a visit.

Take care,
Perromaldido

[Wish]

@kdesain I am in a similar position. I decided to get off of my pain medication for a while earlier this year to purposely lower my tolerance in an attempt to have the medicine be more effective, when I resumed usage my tolerance quickly started to climb with in mere weeks at a much faster rate then that of an opiate naive patient. As I stated above, when I initially began using my pain relief meds again after not using for 5-6 months I was able to gain aid at a much lower dose then what was needed while I had been using consecutively for a long period of time. However my tolerance grew at a hyper-accelerated rate especially when compared to someone who has just began using PK's.

Later,

-WISH

[betsky]

@Wish
Post number 12 is quite well thought out. Iagree with your model of dependence /tolerance

[Wish]

@betsky is that a nice way of saying I ramble? :-)

Thanks... I think?

-WISH

[betsky]

@Wish
Well if u do ramble it's done well

[angel eyes]

So sort of off topic and random, however, now that I have been on pain meds for a few months what is even considered a low dose? As Owlie said above "a small codeine addiction some years ago" I've taken a break periodically, but how do I know if my intake is getting to be too much? Just another random thought. I seem to have alot of them.

[ScorpioTrey5801]

@ScorpioTrey5801 Did you study this issue while acquiring your degree in pharmacology or especially when studying the specialty of psychopharmacology?
The answer is very complicated and typically depends on many variables including the drugs involved, length of use, purpose of treatment, genetics, addictive behaviors, etc.
I've read countless research studies on the subject that I imagine would be part of the university study of pharmacology.

During the acquiring process. I know, all too well, about this subject wanting to learn and hear what other people would like to say about it.

*This post was auto-merged. The following text was added 13 minutes after the last post:*

@ScorpioTrey5801, you were kidding about the psychopharmacology research, weren't you? Come on now, play straight with us, and you will find there is a wealth of information and support here.

I don't quite follow what you mean about kidding. Are you trying to insult my intelligence? I've posted this thread for discovery purposes and wanting to know how people have personally dealt with this situation. I'm clearly well aware of this topic in many studies. So, could you please elaborate on what you're trying to get across?

*This post was auto-merged. The following text was added 4 minutes after the last post:*

It was in his original profile which has since been edited away...

My original profile which has since been edited away? Could you, as well, explain what you mean? I've been a member of this forum for less than a week and I'm being talked about in very accusatory manners. This is definitely not what I expected when signing up.