• N&PD Moderators: Skorpio | thegreenhand

Why is it that benzos potentiate opiates?

Thank you Shugenja. So does that mean that they just potentiate the nod from opiates or the euphoria too? That's what I'm looking for. To potentiate the euphoria.
Ho-Chin-Minh, I wasn't talking about drinking? I'm confused.
 
I'm not sure competitive inhibition of liver enzymes is the cause, as there are benzos that aren't metabolized by CYP enzymes that still potentiate opioids. Also if that were the case, you'd just have elevated blood levels of both, but the interaction is clearly more complex than that.

BZDs increase all effects of opioids, good and bad, however the euphoria of drugs tends to be highly subjective - just because you make the drugs stronger may not make them any more enjoyable, and even taking the same drug in two different situations could be the difference between a good and bad experience.

It is generally recommended against trying to increase the euphoric potential of opioids with benzos because it carries a greatly increased risk of uncontrolled respiratory depression and death from assorted causes (accidents, apnea in sleep, aspiration of vomit, seizure from w/d) as well as forming a nasty polysubstance dependancy (trying to stop opis+benzos is a lot harder than either alone). It also doesn't help that if you're chasing euphoria, most people increase their doses over time as the euphoria wears off, so there will likely come a point where you will be on the edge of lethality. There are far more deaths from combining opioids and benzos than there are from just taking opioids.

It's also worthwhile noting that some people claim that BZDs actually reduce euphoria from opioids due to their emotional blunting/"don't-care" effect and memory suppression. Your mileage may vary...
 
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In my experience they purely potentiate the nod, plus help with stress reduction (which if you have a very high opiate tolerance like I unfortunately do, May not totally supress) which itself may enhance the euphoria. But they don't enhance the euphoric feelings that opiates alone give you (warmth, rush, etc).
 
They obviously increase sedation along with their muscle relaxant effects there is no doubt that mixing the two greatly increases the "body" high, along with the anxiolytic effects which can help you forget all the other problems in your life (probably related to the fact that you are a junky and all that entails, or at least forget the stigmas associated with opiate abuse) there is without a doubt a great deal of synergism between the two...but true potentiation, probably not. Potentiation implies increasing plasma levels or duration of action which AFAIK doesn't occur; except possibly in certain cases of enzyme inhibition which I doubt plays a large enough role to matter.

The question you should be asking is in what ways do benzos and opiates synergize, not potentiate each other.

For example, WGFJ potentiates many benzos(among other drugs) but no synergism occurs.
 
The odd thing about it is http://www.ncbi.nlm.nih.gov/pubmed/9403690
The midbrain region periaqueductal grey (PAG) is rich in opioid receptors and endogenous opioids and is a major target of analgesic action in the central nervous system. It has been proposed that the analgesic effect of opioids on the PAG works by suppressing the inhibitory influence of the neurotransmitter GABA on neurons that form part of a descending antinociceptive pathway. Opioids inhibit GABA-mediated (GABAergic) synaptic transmission in the PAG and other brain regions by reducing the probability of presynaptic neurotransmitter release, but the mechanisms involved remain uncertain.
So shouldn't benzos decrease the analgesic effects of opioids
 
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