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  • BDD Moderators: Keif’ Richards | negrogesic

A question I have been trying to get answered for years

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Plumber101010

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Aug 17, 2016
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44
No matter how much research I cannot come up with an answer to this. Google is not what it used to be and as soon as you punch in this question some of the keywords make it come up with 1 million topics unrelated.

All I ask is please don't answer with opinions or guesswork. I'm quite capable of doing that. I'm trying to understand this from a medical and factual standpoint.

If someone has been on oxycodone for many years and in quantities of say over 100 mg a day and they quit. Then hypothetically two years go by and they break a leg.

Will the oxycodone have an original effect as it did from the first day that person started using them? Like one or two pills will be more than sufficient?

Or will that threshold NEVER be the same again and it will take a large quantities to reduce the pain?

Thanks everyone ahead of time!
 
The tolerance to the analgesic actions of opioids develops and diminishes quite rapidly. Compared to respiratory or GI effects, it takes no time at all for tolerance to pain relief to swing either way. But after 2 years, one should be back to baseline with everything and normal doses of oxy should help quell the pain of a fracture.

The problem is when someone abuses opioids, they are not only looking for pain relief. In fact, I would say quite a few have analgesia lower on the list of positive effects they look for to get high. Euphoria, a nod, less worries all probably beat analgesia for many and lower doses may not do any of that. Thus, even though the pain is reduced, an ex-user may feel that the dose is still too low because they arent feeling as good as they know they can.
 
I agree with kittycat on this one 100%. Excessive use/misuse/abuse changes a lot of brain chemistry, with severity dependent upon the substance, duration, and dosing. UCLA recently put out a study of the positive effect that exercise had on reversing the changes brought about from drug use (specifically meth). It's pretty promising actually.
 
Thank you Kittycat for a very articulate response. In fact I can't imagine it being answered any better :)

But, if what you're saying is correct, is that to mean that even though the pain has actually been relieved, in that persons mind, it won't feel like it has?

I would assume that a buzz would not be what one was looking for if they had been off of it for two years.

So let me say this another way, in addition to the pain going back to baseline, would not the "buzz" effect be at baseline also? So that one or two would make me that person "high wise" as 8 or 10 used to?

The closest I found to an answer was an article on unrelated issues, that said it's actually dangerous, as physically the body no longer has a tolerance and so taking a high dosage would kill you because the brain would need a high dosage to get a buzz.

That was confusing to me because I'm assuming that both categories would go down to baseline???
 
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From my experience with opiates the first time will be almost comparable to the first time you did opiates but tolerance and addiction comes much quicker.
 
On paper, after a long period of time you will go back to needing less to get high. But because you still have the memory/expectation of opiate experiences buried in your brain, you will never get as euphorically high as you did the first time, and tolerance will also build more rapidly than it did the first time around. Set and setting, yo.

The tolerance to the breathing-depression effects goes away with time too, so it is always safest to start back at the very lowest dose possible if you are picking up opiates after a long period of abstinence, or you are likely to OD.
 
Have you ever reminisced with your drug buddies about the first time you got high on drug X? Recalling the oh shit, I am whacked notions that went through your mind as you sat there actually feeling the physical effects of the drug?

This is kind of what I was getting at. Recreational opioid users tend to have experiences with the drugs for the experience alone or at minimum something more than pain relief. Each part of the experience gets integrated into a whole and that is what we think using opioids should feel like.

Now you need the opioid for pain after being clean for awhile. You take a normal dose and are underwhelmed. Sure some of the pain went away, but it is not living up to what you have come to know as what opioids should do from your recreational usage of them. Many therefore feel the only way to get relief is to take enough to feel like they did in the past, which is indeed dangerous as you mentioned.
 
Physiologically yes, the toleranxe to opioids will diminish but your memory of them will not. In my personal experience, after 10 years off of morphine and heroin daily, today opioids do not affect me as strongly as they used to, the duration seems shorter subjectively and yes, the euphoria is much less. In fact, I've only achieved what I would call a "high" twice since beginning use again. Once from IV dilaudid in the ER and once from really strong PST mixed with hydrocodone.

This is pure speculation but I do wonder about permanent receptor down regulation (would that be correct?) from long term use in the past.

My line of thought is similar to something like dopamine antagonists, like antipsychotics causing permanent up regulation of Dopamine receptors, leading to things like TD.

Anyway, just a thought
 
If you have been off of the painkillers for two years I guarantee you that the first time you take them again will be like the first time that you took them. From my experience it seems every time that I get some time under my belt and go back, I'm so happy and ecstatic because I'm using less and getting high for A lot cheaper but every time it seems to go away faster and faster. My tolerance doesn't stay low for long and it's my believe that it will go a lot faster especially that you have experience in it. I think that could definitely be because of the mental factor and you are already knowing what to expect. So regardless of what you do you're always going to have some kind of a tolerance
 
I feel that the tolerance goes back down completely, but will rise up again a lot more quickly than the first time around, making opiates a poor choice for pain management for opiate addicts.
 
Here's how it goes for me:

My tolerance will initially drop to baseline, a 5mg perc can get me high.

BUT

It shoots back up to the highest it's ever been (at the height of my addiction) within a few uses. I started using poppy tea weekly since I quit opiates altogether and I'm already drinking 4-5x as much as I did a few weeks ago, my tolerance just went right back up to where it used to be. I don't really mind honestly because it makes use safer, but your body never really forgets. So maybe on the first day or two, you'll be ok, but it won't take long for it to lose effect. I literally cannot feel normal rx doses right now, just as I couldn't when I was an addict.
 
aspiringchemist said:
My line of thought is similar to something like dopamine antagonists, like antipsychotics causing permanent up regulation of Dopamine receptors, leading to things like TD.
Click to expand...

I'm relatively certain that current research indicates the mechanism is substantially more complex that this, however you are correct in that polymorphisms of the DRD2 Gene (the one for the D2 Receptor) are associated with TD
 
Dopamine receptors are damaged during drug use. The damage varies from person to person and since our brain chemistry is different, it's hard to give a solid scientific answer to your question.

Will you feel the same effect? Who knows?
Will it take more? Actually it would be dangerous to start off with your old dosage due to tolerance issues dropping.

I miss the old Lorcet, banana boat percocets, etc. Those pills were so much better than the Norco (hydro) and oxycodone of today. Years ago you could take a script for a few months, take a break a few months, then get euphoria/relief your 1st 10mg dosage.
Just my opinion that I believe pill structure is something to think about as well.
 
For me my tolerance never went back to baseline, I don't want to promote large doses after stopping use for a period of time, but for me I stopped for 6 months and 90 mg of oxy barely touched me when I relapsed. I believe it goes up permanently, and it takes a shorter amount of time to redevelop a tolerance to a previous point.

Everyone is different, but my tolerance has never hit baseline.

That is not to say that is does not decrease drastically, but from 2 grams of H a day back to feeling 10 mg of vicodin, that doesn't seem plausible to me.
 
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