Opioids Can stress reduce tolerance?

[Terranaut]

I have a fairly high tolerance to opioids taken orally. I don't really get much (or anything) of a high off opioids taken this way anymore and I'm not looking to take them by any other route. This has been my situation for several years now and I really just want to come off them, which I'm working steadily towards. However I have noticed that after certain kinds of stressful event I feel some opioid effects to the point where I can get a moderate high from a dose that would normally do nothing for me except cause constipation and stave off withdrawals. Obviously nobody wants to stress themselves out for the sake of a mediocre opiate high, and the amount of stress to produce this effect has to be significant. I'm curious about the mechanism behind this though and wondered if anyone else has had a similar experience? My working theory is that after a significantly stressful experience my adrenalin levels are temporarily depleted. I wonder if chronic opioid use is causing my body to produce excess adrenalin to counteract the drugs, then when my adrenal system is temporarily exhausted, the opioids are relatively unopposed. Does this sound plausible?

EDIT: Just wanted to add that I'm not talking about normal, every day stress. I'm stressed pretty much every day. The effect I'm talking about only happens after the kind of stress where you feel physical and emotional exhaustion afterwards. Definitely not worth it for a lukewarm high.

 

[Keif' Richards]

Yea this all pretty much jives with what we know. For instance, a person is likely to perceive a drug as being miore potent if it is taken in an unfamiliar setting.

It is totally logical. If you're extremely stressed, the relief to that stress is going to feel great. I would use the analogy of a cold glass of water following a wicked heavy work out; there were other times in your life in which a glass of water was insignificant; in that moment though, it's everything.

I don't believe this effect is pharmacological though. I think it's a psychological thing.

 

[TheUltimateFixx]

I think it's both. As in the mental state somehow influencing the pharmacological action of the substance upon the body. Because I'm at a loss how to otherwise explain those strange cases of fatal opiate ODs of experienced users taking an amount that should technically not have killed them, where the only variable seems to have been an unfamiliar location.

 

[someguyontheinternet]

I think we need to remember that everything psychological is physiological. Expectation of the opiate in a familiar environment likely causes a change in receptor surface expression or something similar and without that physiological change we have a decrease in expected tolerance

 

[SoCalShordie]

Yeah I would definitely say so. I was hooked on opiates (norco, oxy, heroin, methadone) from 18 to 29 and I definitely would say that stress reduces your tolerance.

 

[snmfmy]

"Stress alters the expression of various opioid receptors in the central nervous system and sensitivity to opioid receptor agonists and antagonists."

Stress-Induced Changes in the Endogenous Opioid System Cause Dysfunction of Pain and Emotion Regulation

Early life stress, such as child abuse and neglect, and psychosocial stress in adulthood are risk factors for psychiatric disorders, including depression and anxiety. Furthermore, exposure to these stresses affects the sensitivity to pain stimuli and ...

www.ncbi.nlm.nih.gov

It may be more correct to say that stress induces changes with regard to both the expression of receptors and the sensitivity of opioid receptors to opioid agonists.

In other words, regardless of tolerance, the physiological changes induced by stress in humans makes opioid receptors more sensitive to agonists.

It is admittedly a fine line to draw, however, I think it is the correct line to draw.

In other words, I think once the stress or/ stressful situation resolves, your tolerance goes back to what it was without stress.

 

[Keif' Richards]

I think we need to remember that everything psychological is physiological. Expectation of the opiate in a familiar environment likely causes a change in receptor surface expression or something similar and without that physiological change we have a decrease in expected tolerance

You pretty much said what I wanted to say in a more concise and accurate manner. We are always forgetting that things like "emotions" an "feelings" are absolutely tied, in the end, to chemicals. Even after talking about this stuff for over a decade, I easily forget this. I think there is a feeling of killing life's essential magic and wonder by reducing the entirety of our minds to physical/chemical properties, but that's how it is.

With all of this in mind, it's easy to understand how stress could have a huge influence on what we know as "tolerance".

This is where we start to understand how limited our knowledge is regarding the world we live in, in this case I'm referring specifically to medicine and pharmacology.

We are using the same drugs to treat pain that were used before recorded history (by the cultures to whom it was available), in this case I'm referring to Opium. We have spent the past ~150 years trying to make something better than Morphine at reducing pain. This is an oversimplification, but it's easy to see that the father away we get from nature's own pain reliever, we end up fucking it up. To this day, the most effective pain medications are still going to be Morphine or its direct derivatives like Diacetylmorphine (Heroin), Hydromorphone (Dilaudid) etc.

It's like the difference between being able to make metal into objects and being able to take disparate objects and make them into metal. We only know how to do the former.

 

[Neuroprotection]

Great knowledge and theoretical perspectives from everyone and I think all are correct and compliment each other.
I would like to have the concepts of sensitisation(reverse tolerance). this is when one or more aspects of the pharmacological/psychological effect of a drug become stronger either due to repeated use or external environmental factors. actually, it is well known that stress generally makes highly rewarding drugs like opioids or cocaine considerably more rewarding/desirable.
I wonder if this is why young middle-class or wealthy individuals Who have a caring support network and exciting environment can often use cocaine occasionally without a problem. when asked how the drug feels, i’ve noticed they often describe it as quite stimulating and mildly euphoric. in comparison, individuals in poverty or those constantly stressed out tend to describe cocaine as incredibly euphoric and powerfully stimulating, at least in the early days of their use.
Of course, it’s not as simple as that and many wealthy people do become addicted to cocaine, suffering terribly from the consequences. however, there’s definitely something there in terms of a general trend.
Actually, I remember someone on this site saying that typical doses of benzodiazepines are rather boring drugs when taken in a normal/happy state. however, when taking in the context of high stress and anxiety, they feel absolutely amazing due to the temporary disappearance of anxiety.