How could clonazepam (?) have given me a sky-high opiate tolerance ?

[Kdem]

Obviously that tapering has been very difficult and harsh. I'm not even sure if that opiate tolerance has anything to do with it.

Some time ago I took an opiate at roughly the equivalent of 300 mg codeine. I felt 'something'. Increased self confidence. But it didn't work against pain.
I'm pretty much 100 % opiate naive.

I just wonder if I'm really fucked up, or if something else is going on.

 

[busted.produk]

Some time ago I took an opiate at roughly the equivalent of 300 mg codeine.

What did you take and at what dosage?
Also, how much and how often do you take clonazepam?

Being vague makes it kinda hard to effectively work towards an answer to your question....

 

[sekio]

Codeine alone is a poor painkiller even at high doses. It's why Tylenol 3 is a thing. It actually turns out that 600mg of ibuprofen is a much better painkiller than ~10mg of morphine IM.

If you are taking opioids for pain relief they really must be combined with a NSAID for maximum efficacy, or acetaminophen if you cannot tolerate any NSAIDs.

source: League table of analgesics,

 

[Kdem]

dihydrocodeine ... it did something. Clonazepam is taken every day. There has been a taper in progress. Hardcore physical dependence.
I've never experienced analgesic effects from drugs like acetominophen and ibuprofen.

I did look around a bit and it seems that opiates act on a lot. NMDA etc.

 

[busted.produk]

I just wonder if I'm really fucked up, or if something else is going on.

Nah, it just sounds like you had higher expectations for the outcome.
I feel like its also kind hard to quantify pain relief beyond "it took away my pain" or "it did nothing" unless youre in pain every day, repeating the same tasks.
Sorry for the lack of a better answer.

Seiko made a good observation to also take into account...

 

[Kdem]

But at the equivalent of 300 mg codeine ? Being completely opiate naive ?

 

[adder]

Pain relief is indeed hard to quantify and pain generally has broad and often vague meaning given that there exist many types of pain that feel different and have different roots. Opioids are not effective analgesics against all types of pain, different opioids may also work to a different degree for a given type of pain. As for euphoric effects of opioids, they don't usually come in full force during the first few tries for most people.

Unless you are suffering from benzodiazepine withdrawal for which opioids will definitely not help much, I don't think taking benzodiazepines might make opioids weaker. I took opioids along with benzodiazepines for years and I haven't seen any correlation between the dose of benzodiazepines taken and tolerance to opioids.

 

[BambooHut]

But at the equivalent of 300 mg codeine ? Being completely opiate naive ?

What

 

[Legally High]

I know mixing benzos and opiates tended to reduce the pleasurable feelings from opiates, for me. I've sworn both drugs off after many of dabbling and barely surviving becoming a addict.

 

[Kdem]

I know that there is some 'cross tolerance' although that technically may not be true, but GABA and opiate receptors can interact. I read about NMDA etc.

Anyway, one time I only felt minor pain, the second time i just took it to see if it would take 'the edge off' ('that business with clonazepam, including interdose withdrawal etc').

'But at the equivalent of 300 mg codeine ? Being completely opiate naive ?'

 

[busted.produk]

There are synergistic qualities but theres no cross-tolerence(correct me if im wrong) that ive ever heard of.

I really think you were just expecting more out of the experience than the drug and/or dose is able to produce...

 

[adder]

I think there may be some connection between your clonazepam dependence and the effects of opioids if you are tapering off clonazepam. You are certainly right about opioids and benzodiazepines having effect on the same neurotransmitting systems. Opioids mediate its dopaminergic effects by suppressing GABA release thus decreasing GABAergic activity. But if you take a look at this article, the relationship between GABA and effects of opioids is not as straightforward! How exactly benzodiazepine withdrawal could have a negative effect on painkilling properties of opioids is beyond my knowledge for sure, but the connection is there and in my opinion you're not necessarily expecting too much, the effect might indeed be diminished.

 

[Kdem]

Someone once told me that benzodiazepines downregulate (GABA?) based on CREB. I noticed that opiates also act on CREB. Could this be a common mechanism related to tolerance/dependence ? It's a bit beyond my understanding/knowledge.

 

[JK25]

Codeine alone is a poor painkiller even at high doses. It's why Tylenol 3 is a thing. It actually turns out that 600mg of ibuprofen is a much better painkiller than ~10mg of morphine IM.

If you are taking opioids for pain relief they really must be combined with a NSAID for maximum efficacy, or acetaminophen if you cannot tolerate any NSAIDs.

source: League table of analgesics,

The weirdest thing that I've come across is academic literature way back (can't quote or source a URL at all sorry) that said Paracetamol, when used correctly and exacting precise dosing in accordance with the patient's pharmacology is a better pain reliever than any opiate at any dose.

I am not claiming this as fact but I did read this sentence in some medical facilities' academic library archive years back.

 

[Kdem]

No wonder doctors don't like to prescribe opiates !

The weird thing is, paracetamol never worked for me. Neitehr did ibuprofen ... Fortunately I have never really needed a painkiller. I can only hope that in case of serious emergencies morphine will work !