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Can anyone explain thru what mechanisms can amphetamines lower opioid tolerance

boti420

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May 20, 2006
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So I have made an unusual discovery over the past few years, one that I've been unable to come up with an explanation for. Basically it's this I'm a long time heroin addict tho I occasionally dabble with other substances. I had a short period a while back where I used methamphetamine for 3-4 days straight binges n then wouldn't do them again for months. Well during these binges I encountered a very unusual side effect. I noticed that after 2bor 3 days of methamphetamine use with little sleep that my tolerance to heroin dropped dramatically. Where I might normally use 3 or 4 bags and barely catch a nod if I used on day 3 of using amphetamines I would only have to use 1 bag and even just this 1 bag would have me utterly tore up. Borderline overdose. At first I took it as a fluke caused by my lack of sleep and poor nutrition during the days of using the stimulant. But over the years this would repeat every time, in some cases dangerously in that doses even i considered miniscule would just have me floored. Another related effect I noticed is that when using methamphetamine I would simply forget that I had to take an opioid to prevent withdrawal. The meth would not conceal the symptoms of WD but flat out increase the amount of time I could go before WD started to kick in and then when I used my tolerance would be unbelievably low.

So here's my best hypothesis. Tolerance and withdrawal are intimately tied together. So it makes sense if it lowered my tolerance that means my physical dependence at least temporarily was lower than usual. My first thought was simply that the lack of sleep and nutrition has weakened my system to where I'm affected much more strongly by the opioid, it makes sense but I still feel there's a lot more going on. Next I started thinking that perhaps the increased metabolism might speed up the receptor upregulation and so they would be replaced faster than normal so when I used I would be using with a receptor load that I haven't had in a long time since my tolerance was low. I keep thinking that there must be some pharmacological action in the brain that for some reason increases the number of opioid receptors that are expressed on the neurons in the synapses. If my understanding is correct the higher the number of opioid receptors expressed on the surface of the neuron the lower the dose of an opioid is required to elicit an effect. Or perhaps there is some other mechanism im unaware of that's causing this effect.

Anyways I decided to come here where there are people much more knowledgeable in the actions of receptors and how they're up/down regulated and the effect on tolerance. I can state 2 things that are absolutely true. 1- methamphetamine does somewhat alleviate opioid withdrawal as counterintuitive as that may sound.
2-using methamphetamine for 72hrs, not necessarily nonstop or in large doses lowers my tolerance to opioid by a staggering 75%+.

Can anyone provide any insight as to why this may be? I've spent a great deal of time on Google scholar as well as medical journals trying to find anything related to this with no success. If there is some previously unforeseen action taking place here then it may lead to some beneficial uses such as a new way to quickly lower opioid tolerance as well as perhaps make the withdrawal a much less painful experience. Thank you.
 
I wonder if it isn't more a matter of the meth potentiating the opiate rather than a lowering of your tolerance.

Were you back to your normal dose of H shortly after stopping the meth and getting some sleep?

Lots of things can potentiate opiates. Caffeine, cocaine, anticholinergics, gabaergics, etc.
 
^Yup

Also anything that promotes b-endorphin, which is most known recreational psychoactives apart from benzos and some other GABAs
 
I wonder if it isn't more a matter of the meth potentiating the opiate rather than a lowering of your tolerance.

Were you back to your normal dose of H shortly after stopping the meth and getting some sleep?

Lots of things can potentiate opiates. Caffeine, cocaine, anticholinergics, gabaergics, etc.
Yes, basically after a good night's rest and a hearty meal n back to normal. Tell me if I understand this correctly. So by introducing artificially high levels of an opioid once it attaches to the receptor it changes its shape which had the receptor drop another messenging chem like G protein etc... Then the receptor actually enters the neuron and is destroyed there tho some return to the surface. For unknown reason when they are activated too often what happens is that the number of receptors on the surface decreases and this is why it takes a larger dose of opioid a to have the same effect. Am I understanding correctly? I don't believe it was the meth potentiating the opioid as normally the two mixed together do not produce this effect. It's only after pretty much all my dopamine has been released and depleted that the drop in tolerance occurs.
 
I have an extensive history of using a wide range of chems from street drugs to rare RC's and I just never had such a dramatic effect. There is one other instance that was similar but this was 25yrs ago so my memory might be flawed. I once did a water fast for several days and when I used several days into the fast I also experienced a significant tolerance drop. This points to my body being tired, worn out, and just exhausted as being the cause of the tolerance drop. I'm trying to find a much more specific explanation because once I have that then perhaps that knowledge could be useful to discovering some way of manipulating that effect to make the drop permanent. Anyways thanks for input, I anxious to hear any other thoughts.

PS- so if simply being physically exhausted has that effect how would exhaustion go about causing this from a neurochenical perspective? Wouldn't the neurons have to see an increase in receptors in order to have a more powerful effect with less drug? Does stressing the body somehow lead to more receptors or receptor up(down?) regulation? Presumably my dopamine is very depleted at the time as well would that in anyway affect this? Less dopamine means less euphoria normally but opioid a while activating the dopamine reward circuits seem to cause a different kind of euphoria which stems from the opioid pathways itself. Urrgh, so many questions. I just know that there's something undiscovered to this effect as I've never encountered it before nor have I seen any reference to it either. If we can just narrow it down to a probable mechanism we can start the process of figuring out how to use that mechanism to produce very beneficial effects. I mean drastically reducing tolerance as well as making withdrawal significantly less painful has countless benefits. Not to mention whatever other unknown uses might be found here.
 
Stimulants, even caffeine, increase signaling all over the brain. Maybe the increased consumption of stimulants, combined with sleep deprivation, causes increased signaling on opioid pathways and that accounts for the decrease in tolerance?
 
I have felt this as well.


Methamp can turn boring buprenorphine into a fun, relaxing, euphoric, almost full agonist-opioid.


However, opioids after drugs like Ritalin, Concerta or Wellbutrin seem to be blunted. I believe this has something to do with their DRI actions (though this is what I believe and experienced, not saying it's fact).



They did studies way back in the day too where opioid/stimulant combos potentiated each other and caused more dopamine release, analgesia, etc.. than either drug by themselves. I bet this works better with neurotransmitter releases though, rather than the uptake inhibitors.
 
Interesting. I too found prolintane to stop or mask morphine withdrawal but didn't get much reduction in tolerance, didn't do multiple days binges though so maybe over time it gets more pronounced.

Yeah, tolerance and withdrawal are deeply coupled. NMDA antagonists do the same, mask withdrawal and reduce tolerance. With them I was able to get off morphine without any withdrawal, after years of using.

Maybe I'll have to try buprenorphine + meth if I'm able to get a script..
 
Just some random info on this topic...

I'm not sure if stimulants truly lower tolerance, but rather they are kicking your opioids up a notch with their own effects.

"It has been long-established that amphetamines and other stimulants have an analgesic effect in their own right and significantly enhance the analgesic effects of opioids. 1-9"


"In reality, multiple neurochemical systems are at play in pain relief. 22 They include, among others, the serotonergic, gamma-amino-butyric acid (GABA-ergenic), and adrenergic (norepinephrine-dopamine)systems. 8,21-23 Pain relief with stimulants appears to be primarily mediated by norepinephrine and not dopamine. 23 It is the simultaneous triggering of the endorphin and adrenergic neurochemical systems that gives the combined administration of opioids and stimulants a pain-relieving effect much greater than either one alone. 8,13,17 
"
 
I find this is true as well, I am actually on Vyvanse + Subutex right now, I love mixing the two, been high all day
 
Scientific research is not at the point where anyone here has the current knowledge to confidently and definitively answer this question. But that does not mean that the methamphetamine may not somehow be affecting tolerance.

Methamphetamine is a (as far as most recreational drugs go) a somewhat potent sigma (σ) receptor agonist. Sigma receptors are hypothesized to play a role in drug tolerance, among many other cognitive processes. The likelihood that methamphetamine's sigma agonism is a large factor here is very slim, but it is interesting to think about.

For now, @DeathIndustrial88's answer is the best you'll get:
I'm not sure if stimulants truly lower tolerance, but rather they are kicking your opioids up a notch with their own effects.

"It has been long-established that amphetamines and other stimulants have an analgesic effect in their own right and significantly enhance the analgesic effects of opioids. 1-9"
https://www.practicalpainmanagement...l/opioids/simultaneous-use-stimulants-opioids
 
Scientific research is not at the point where anyone here has the current knowledge to confidently and definitively answer this question. But that does not mean that the methamphetamine may not somehow be affecting tolerance.

Methamphetamine is a (as far as most recreational drugs go) a somewhat potent sigma (σ) receptor agonist. Sigma receptors are hypothesized to play a role in drug tolerance, among many other cognitive processes. The likelihood that methamphetamine's sigma agonism is a large factor here is very slim, but it is interesting to think about.

For now, @DeathIndustrial88's answer is the best you'll get:
I wanted to go to University of Wisconsin to study sigma receptors, but Arnold Ruoho had retired while I was still in high school.

I think the sigma1 receptor is one of the most interesting receptors in the human body. So complex and understudied. I think the future of pharmacology is harnessing and identifying receptors with subtle modulatory roles (like sigma receptors or trace amine associated receptors), rather than hitting with a hammer so to speak.

 
I think the future of pharmacology is harnessing and identifying receptors with subtle modulatory roles (like sigma receptors or trace amine associated receptors), rather than hitting with a hammer so to speak.
Yeah there's so much waiting to be discovered/explored.
Characterizing all of those receptors is going to get easier thanks to alpha fold, even with its current limitations.

Developing new drugs is pretty tricky though. High selectivity and efficacy combined with metabolic stability (or at least low toxicity) is kinda like the holy grail in drug discovery.
 
Well if you go longer between opioid doses (which you did on amphet) your tolerance will begin to reduce. the sheer pleasure of amphetamines can sort of make you forget about opi withdrawal and lead to a loss of some tolerance if it goes on long enough
 
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TAAR1 agonism.


-GC
Looks like GC found the needle in the haystack and got the answer to this one! Skimmed through the full paper, fascinating read!

I think the sigma1 receptor is one of the most interesting receptors in the human body. So complex and understudied. I think the future of pharmacology is harnessing and identifying receptors with subtle modulatory roles (like sigma receptors or trace amine associated receptors), rather than hitting with a hammer so to speak.
Agreed. I have a few different areas chemistry and neuroscience that I am considering researching post-undergrad, and after reading the papers linked in this thread, said fields definitely include working with Sigma receptors and/or TAARs.
 
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