Can one be immune to opioids? I suffer from sever pain, need help please

[SaciPerere]

Hello fellow junkies, Im going to try to make a very long story as short as possible. Up until 25 years old I led a normal life, I was no jock by any mean, but i worked out and was physically active, did yoga, never smoked tobacco or drank alcohol, however I've always been heavy on the weed and had/have the sporadical use of LSD, ecstasy, and cocaine. I never used any type of opioid though, in my 30 year old life.

5 years ago I began suffering from severe back pain, it originates in between my should spine(rhomboid) and irradiates to my ENTIRE back: neck, upper back, mid back, lower back, all the way down to my ass.. spent 3 years and a small fortune visiting a bunch of different "specialists"rthopedists, physiotherapists, acupuncturists, chiropractor etc(all a waste of time and money)... until recently I found a real doctor, a board certified thoracic surgeon. He explained to me that I suffer from "Myofascial Pain Syndrome", which is one of the worst chronic pains that a human can suffer, up there with kidney stones and fibromyalgia.

I told him I needed something to make my pain stop IMMEDIATLY, and that after so many years paying for quack treatment, my patience with doctors was over(I was so angry I actually told him that). At first he gave me some codeine... I took 200mg... then 400 mg... felt NOTHING. Told this to the doc, and he was like "Oh, I suspected codeine wouldn't work, but I had to try a weaker opioid first to be sure, but now Im going to give you something that will knock you down... OXYCONTIN(apparently its pure oxycodene) please *DO NOT* take more than 10mg! even if you don't feel anything, don't take more than 10mg because this is a very dangerous medication!" I was like "OK doc"... as soon as I hit home I took 2 pills(20mg)... 90 minutes later I felt nothing, so I take another 20mg(40mg total)... finally I feel something... a very, very mild buzz, equivalent to drinking a pint of beer or smoking half a joint of Indica, but nothing close to the heroine orgasm that I should be feeling, specially considering I'm 100% opium naive.(apart from the 400mg of codeine last week that also had zero effect).

Is it possible that one can have a natural resistance to even the strongest opioids? Also, this does means that Im fucked and will feel pain for the rest of my miserable life? I would appreciate your input, thanks.

 

[sekio]

No, you're not immune to opiates. That's a one in a billion freak mutation and you obviously get effects from codeine (and even oxy)... so you're not "immune". There's two things going on here.

Firstyl: It turns out that for most trauma-type pain you really have to combine the opioids with something like ibuprofen @ 600mg (or another NSAID, aspirin, naproxen, etc - paracetamol/APAP @ ~1000mg per dose works too but not nearly as well). Oxycodone on its own is a poor painkiller in most people even though it may be euphoric, nauseating, etc. - but science has proven several times that if you combine any opioid with NSAID drugs (Non Steroidal Anti Inflammatory) they multiply the painkilling effects.

Here's the reference I base this off of, it was a large comprehensive study that was seeking the msot effective painkiller combinations. Suprisingly enough, opioids alone (especially codeine) are among the worst painkillers you can take, efficacy-wise. The :gold standard: most peiople would have access to is ibuprofen, 3 x 200mg pills = 600mg in a dose. That is equivalent to one "prescription strength" ibuprofen and despite the seemingly large dosage, it has a suprisingly low incidence of side effects if taken with food and plenty of water.

Ibuprofen and opioids are not very effective if your pain is entirely nerve-based though, in that case drugs like gabapentin or baclofen are more effective. Opioids can actually produce worsening of the pain if overused in situations of non-inflammatory pain. Your Mileage May Vary - because myofascial pain syndrome is apparently of unknown causes, what I would suggest is that if you find opioids + NSAIDs don't do anything useful, stop taking both of them and get yourself a gabapentin/pregabalin/baclofen/orphenadrine prescription(s) - they are muscle-relaxants among other actions and as such they work much better in cases of nerve-based or tension pain than opiates.

specially considering I'm 100% opium naive.(apart from the 400mg of codeine l

If you've been taking codeine in high doses you are not opiate naive. You have been taking an opiate. Roughly speaking, 400mg of codeine is equivalent to probably between 30 to 40 mg of oxycodone in the average person - so it's also not that suprising that 10mg of oxycodone doesn't do jack shit. You ain't gonna be feeling any heroin orgasms anyway: oxy is basically just another opiate that is ~10x stronger by weight than codeine, has no upper limit dose (codeine stops being quite as effective with doses above 400mg), and has slightly different effects depending on the individual (less/more itching, less/more euphoria, less/more stimulation/sedation)

So for pain control: Try adding an NSAID along with your opioid next time. If you can't handle ibuprofen for whatever reason, get some naproxen, aspirin, or whatever else is available OTC. It really is a great addition to opiods for pain control - they make Percocet / Percodan etc for a reason! Combining auxillary painkillers with opiates is the only way to go ,IMO.

And if that doesn't do anything,shelve the opiates before you have serious withdrawal issues, and move to gabapentin or any of the others I listed.

 

[SaciPerere]

Hmmm.. maybe you misread me, or maybe it was my limited grasp of the english language didnt allow me to be clear... I only had 2 experiences in my entire life with Opioids... one was with codeine, another was with Oxycontin. I never, ever felt ANYTHING with EITHER medication... neither a buzz nor a pain relief...Its not like I was taking 400mg of codeine for a week, an entire week... it was just a single episode.

Also, I believe I should have been more clear... Im not just on Oxycontin, i´m on a complex anti-pain drug cocktail that includes duloxetine, ibuprophen, Myosan(strong muscle relaxant), dypirone *and* the opioids... I´ve been through so many sessions of physiotherapy I lost count... I still feel pain and its sucking the joy out of my life, I can´t even wash my hair without feeling pain, much less have sex with my girl...

Doc mentioned infiltrating Prednisolone(sp?) directly into my back(thats what NFL players do when they are in pain and cant miss a big game), but he warned its an invasive treatment with potential nasty side-effects, it should be seen only as a last resort.

I have another appointment next wednesday, I will be sure to relate your feedback to him, ask him about Lyrica etc...

UPDATE: Here is a short, cristal clear presentation of my condition. I feel *exactly* as this doc is saying, (but I´ve tried myosfascial release massage before and it didnt work) https://www.youtube.com/watch?v=9BtkP8nCvc4

 

[TRASHCANJ4LIFE]

I'm not particularly sure if you could be completely immune from opioids, but I can tell you that peoples tolerance can differ drastically. You could take two different people give them the exact same amount for the first time they've ever taken it and one person might be floored it and the other person might feel nothing. If you have taken them before especially if you have abused them, you're going to have a lesser affect. Keep in mind if you're taking them for pain that it is very common for people to be in more pain while they're taking pain medications and then if they weren't. When you're not feeling anything you're doing all kinds of stuff that you shouldn't because your body is telling you out don't do that. When you can't hear your body saying ouch don't do that you're going to go ahead and do it anyway and fuck your shit up even worse.

 

[SaciPerere]

When you're not feeling anything you're doing all kinds of stuff that you shouldn't because your body is telling you out don't do that. When you can't hear your body saying ouch don't do that you're going to go ahead and do it anyway and fuck your shit up even worse.

Thats what the physiotherapy is for, Im doing it 3 times per week now.

After 5 days on that anti-pain cocktail I mentioned, my pain has finally subsidised by about 30-40%, but it takes at least 60mg of Oxi to make just a small dent in it(not going over it though, as its already 6X over what the doc prescribed). Also, I dont get *any* of the side effects from the stuff such as sleepiness, nausea, cramps, "bug-bites" or whatever... I guess I just have a very high natural tolerance to these babies.

 

[Solipsis]

No offense but how come this surgeon prescribes opioids when a quick online search reveals that those aren't really indicated as treatment, for example here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107879/
Hindsight is 20/20 I guess but it still seems unprofessional to just make the assumption and jump to opioids.

If an opioid is used, make it tramadol because of it's secondary activity since some reuptake inhibitors that also can include certain anti-depressants are among the common treatments.

Pregabalin and baclofen are common treatments but also interestingly botox is mentioned, and - what I was going to suggest myself: dissociatives like ketamine when all else fails.

Some of these like pregabalin aren't so bad for extended use, but other pharmaceuticals are not really a safe choice to take on a regular basis - but something like ketamine can probably give you a break when it's really most needed.

Good luck, I really do hope you can get that relief.

 

[SaciPerere]

No offense but how come this surgeon prescribes opioids when a quick online search reveals that those aren't really indicated as treatment, for example here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107879/
Hindsight is 20/20 I guess but it still seems unprofessional to just make the assumption and jump to opioids.

If an opioid is used, make it tramadol because of it's secondary activity since some reuptake inhibitors that also can include certain anti-depressants are among the common treatments.

Pregabalin and baclofen are common treatments but also interestingly botox is mentioned, and - what I was going to suggest myself: dissociatives like ketamine when all else fails.

Some of these like pregabalin aren't so bad for extended use, but other pharmaceuticals are not really a safe choice to take on a regular basis - but something like ketamine can probably give you a break when it's really most needed.

Good luck, I really do hope you can get that relief.

Thanks!! As I said on my initial post, doc didnt want to prescribe me with any opioids... I had to yell, cry, curse, and throw a general tantrum to manage get him to give me the meds. Cocaine is certainly much easier to buy, at least here in South America

PS: I´ll ask him about Lyrica today.

 

[MeDieViL]

Hello fellow junkies, Im going to try to make a very long story as short as possible. Up until 25 years old I led a normal life, I was no jock by any mean, but i worked out and was physically active, did yoga, never smoked tobacco or drank alcohol, however I've always been heavy on the weed and had my sporadical use of LSD, ecstasy, and cocaine. I never used any type of opioid though, in my 30 year old life.

5 years ago I began suffering from severe back pain, it originates in between my should spine(rhomboid) and irradiates to my ENTIRE back: neck, upper back, mid back, lower back, all the way down to my ass.. spent 3 years and a small fortune visiting a bunch of different "specialists"rthopedists, physiotherapists, acupuncturists, chiropractor etc(all a waste of time and money)... until recently I found a real doctor, a board certified thoracic surgeon. He explained to me that I suffer from "Myofascial Pain Syndrome", which is one of the worst chronic pains that a human can suffer, up there with kidney stones and fibromyalgia.

I told him I needed something to make my pain stop IMMEDIATLY, and that after so many years paying for quack treatment, my patience with doctors was over(I was so angry I actually told him that). At first he gave me some codeine... I took 200mg... then 400 mg... felt NOTHING. Told this to the doc, and he was like "Oh, I suspected codeine wouldn't work, but I had to try a weaker opioid first to be sure, but now Im going to give you something that will knock you down... OXYCONTIN(apparently its pure oxycodene) please *DO NOT* take more than 10mg! even if you don't feel anything, don't take more than 10mg because this is a very dangerous medication!" I was like "OK doc"... as soon as I hit home I took 2 pills(20mg)... 90 minutes later I felt nothing, so I take another 20mg(40mg total)... finally I feel something... a very, very mild buzz, equivalent to drinking a pint of beer or smoking half a joint of Indica, but nothing close to the heroine orgasm that I should be feeling, specially considering I'm 100% opium naive.(apart from the 400mg of codeine last week that also had zero effect).

Is it possible that one can have a natural resistance to even the strongest opioids? Also, this does means that Im fucked and will feel pain for the rest of my miserable life? I would appreciate your input, thanks.

This usually is more common with schizophrenia, complete opiate immunity, ill post more later.

 

[Kdem]

Lyrica isn't that safe either, don't be too carefree with that stuff ...

Is it some kind of neuropathic pain ? I did not read any articles about your issues, but for that type of pain other drugs are often indicated. Gabapentin/Lyrica. Duloxetine ? Probably somewhat similar to tricyclic ADs. I'm not too fond of that stuff !
Maybe carbamazepine ? All that stuff isn't harmless ... you could even try clonazepam, but i wouldn't start taking it daily because it is so dangerous ...

@MeDieViL,

'This usually is more common with schizophrenia, complete opiate immunity, ill post more later.' When you say that, do you mean a condition of chronic use of dopamine antagonists, strong anticholinergics, or a combination of both ? In statistics, 'schizophrenia' equals the use of antipsychotics.

 

[SaciPerere]

Hey guys, thanks for the support! Went to the doc yesterday, he gave me a bunch of "trigger point injections"(xilocaine + a mix of corticoids)... it made me feel great!! I'd say that the pain has diminished 70% by now, if it comes back in a couple of months, doc mentioned I could do a Rhizotomy, which is the surgical killing of a nerve. I did an Electromyoneurography and we've established that the major problem in my back lies in a dorsal scapular nerve entrapment, which eventually fucked up my entire back causing the myofascial pain syndrome. when he blocked that nerve with the meds it gave me instant relief, the type of relief I thought was impossible by now.

STAY HEALTHY AND WATCH YOUR BACKS IN FRONT OF THAT COMPUTER!(99% sure this began because of decades of shitty posture using the PC)

 

[Solipsis]

Glad to hear it's helping! Can I ask whether there are other issues you think might have been involved like body weight, weakened core muscles etc?

Lyrica can cause plenty of side effects in some (especially at higher doses for longer time) like many pharmaceuticals can, but it didn't for me - withdrawals vary and weren't pretty for me but it's certainly all manageable compared to taking benzos, opioids or dissociatives like K a lot, that's a different league of unsafe I'd say.

If non-pharmaceutical therapies like trigger point injections wouldn't be effective, say you'd have a chronic serious pain condition on your hands then acceptability of unsafety of pharmaceuticals are evaluated differently and weighed...

There aren't that many drugs to be nonchalant with unless it's OTC type stuff, so I don't think recommending pharms should ever been done lightly, for me that's implied...

I've learned the hard way though that it may be more important to do everything you can to get every type of medication under supervision, assuming that your medical supervision is scrupulous about it and that is not always a safe assumption. When supervised, you wean off or stop meds that are causing too many problems and you avoid problems of dependency as much as possible under the circumstances...

Not trying to burn you kdem, wanted to add nuance.

 

[SaciPerere]

I have minor scoliosis and my right leg is slightly shorter than the left(less than 1 cm, no big deal). I have normal/slim weight, used to be a decent swimmer in HS. I also did a Pectus Excavatum correction surgery when I was 15(15 years ago), and both my doc and my PT believe my current pain could be somehow connected to that

I have none of the usual suspects though(such as herniated discs), and MRIs never showed anything wrong with my back, which led several different Docs to claim that there was nothing wrong with me and that my issue was mostly psychological. This last accusation was particularly hurtful, especially considering I was pulling night and weekend shifts just to be able to afford those charlatans.

The Rosetta stone in my case really was doing an Electromyoneurography, for the first time I had a rational, scientific explanation for just what the hell was wrong with me. Both my Dorsal Scapular Nerve(DSM) and my Long Thoracic Nerve(LTN) are entrapped around the C5 vertebra due to a fibrosis on the scalene muscle, which causes those nerves to send pain signals to my brain 24 hours a day, even though theres nothing "majorly" wrong going on. Due to the nature of those 2 nerves, I also suffer referred pain in my left arm and at a bunch of other seemingly random places of my body(always on the left side though, all my pains are unilateral, and yes, im left-handed). Its a bit like a pain system malfunction, I suffer a lot more pain than I should.

PS: As for my resistence to opioids, I guess I really just have a very strong natural tolerance for them. I need to crush and rail 60 mg of Oxycontin just to get a decent amount of pain relief, and I get neither nausea nor dizziness, the only noticeable side effect is the itching. I didnt talk with the doc about this though, for obvious reasons.

 

[Poppalicious]

Lyrica isn't that safe either, don't be too carefree with that stuff ...

Is it some kind of neuropathic pain ? I did not read any articles about your issues, but for that type of pain other drugs are often indicated. Gabapentin/Lyrica. Duloxetine ? Probably somewhat similar to tricyclic ADs. I'm not too fond of that stuff !
Maybe carbamazepine ? All that stuff isn't harmless ... you could even try clonazepam, but i wouldn't start taking it daily because it is so dangerous ...

@MeDieViL,

'This usually is more common with schizophrenia, complete opiate immunity, ill post more later.' When you say that, do you mean a condition of chronic use of dopamine antagonists, strong anticholinergics, or a combination of both ? In statistics, 'schizophrenia' equals the use of antipsychotics.

I disagree respectfully'. In Stat's, It's not always how it seems. Schizophrenia could also equal a carrier. Some strand of DNA with the code for schizophrenia that will end up as messenger RNA.
,

 

[Keif' Richards]

Hey guys, I happened upon this thread and thought it would be irresponsible to not share my experience. Now, in regards to being "immune" to Opioids, I can tell you that it is posible. It's a very freak thing and I can admit that I've never encountered another person like myself. Oxycodone has essentially no effect on me. It's odd, as 200mg say will give me a fairly pleasant high with no tolerance. I'd say I probably process Codeine at about 10% the rate of the normal population.

When I've been sick overseas, I've consume grams and grams of CWE Codeine, just to stave off withdrawal a little bit. However, Morphine I experience normally, albeit with a slightly higher tolerance than the rest of the population. I just thought that this might be an interesting point of reference.

 

[sekio]

That's hardly "immunity" to opioids. If you can manage to get a narotic effect off of pretty much any dose. that's not immunity to the effects.

 

[Keif' Richards]

^No, you're right. If we're talking about immunity in an absolute sense, then you are probably right. I was speaking more in terms of varying immunity, although I'm now feeling that immunity is probably not the appropriate term.