affects of dopaminergics while going through PAWS

[SangerRainsford]

<substances: opiate/benzo cessation = PAWS; nicotine = the dopaminergic>

i'm posting this here instead of tds, bdd, etc because i don't think i can get the answers i'm looking for there.

if i'm understanding correctly, PAWS is largely related to getting the body's dopamine systems back in-line. Also, nicotine works (at least in part) by causing dopamine release.

would nicotine sabotage recovery from PAWS in any significant ways? it's my understanding that PAWS is, in extremely generalized sense, the body getting its dopamine system back in line (allowing one to derive pleasure from normal things again).

 

[SangerRainsford]

((also, any insight into the actual dopamine mechanisms of nicotine, opiates, and/or benzos would be appreciated; ie, is it excess dopamine release? inhibited reuptake? amplification of dopamine production?))

 

[sekio]

I thought PAWS was a mix of psychologically addictive behaviors ("cravings") and general dysthymia caused by your endorphin system being seriously out of whack. I think only rest, good lifestyle, and non-drug entertainment are the best cures.

Nicotine is not directly dopaminergic, I don't think. In fact, nicotine on its own is not reinforcing and acts mostly as a cholinergic. It is only when nicotine and the harmala alkaloids (i.e. tobacco products and smoke) are combined that you see them work in tandem as a dopamine releaser and MAOI (preventing the breakdown of neurotransmitters). I don't think it interacts with the endorphin system at all and you should be fine to smoke without too much ill effect (aside from the obvious).

The dopamine system is repsonsible for a lot more than just pleasure. Parkinson's disease is one notable condition where the dopamine system is damaged and serious dopamine issues are usually present as motor tics and gait disturbances. Antipsychotics are well known for causing a milder form of disruption called tardive dyskinesia. I don't think opiates do either, even though they do enhance dopamine release in some areas. PAWS is a rather strange case that doesn't present with etiology appropriate for large-scale dopaminergic dysfunction.

 

[SangerRainsford]

i was only referring to dopamine's roles in specific regards to pleasure, cravings, etc (shoulda said 'cigarettes' instead of 'nicotine', it seems)
(and am only referring to the dopamine-effects of PAWS)

 

[sekio]

It makes no sense to treat the "dopamine" part of PAWS because it should be treated as a whole. Treat the disease, not the symptoms.

If you mean to ask if regular tobacco usage will help your mental well-being, I could not tell you that. If you are a regular smoker, cessation might be more uncomfortable than continuing your pack-a-day habit. Otherwise, of course, if you start ingesting drugs that alter monoamine concentrations very rapidly (like tobacco) you will have a 'crash' and probably want another smoke...

To be perfectly honest I think PAWS is one of those nebulous conditions defined by symptoms rather than having an actual causal mechanism behind it. The fact that it can present after a variety of drug exposures (BZD/Opiate) and has very little documentation makes me want to compare it to HPPD. In cases like that, rest, sobriety, and good-natured distractions or therapy seem to be the best.

 

[SangerRainsford]

the whole thing is being treated, it's this single, specific point i'm looking to learn about (i hope it's clear why - if the dopaminergic effects of cigs are making PAWS drag on, that's important to know)
/and paws is what you describe, it is a set of symptoms but there IS a causal mechanism (many, to be exact)
//also, it presents after most any addiction, as drugs of abuse exploit the dopamine systems of the brain, so even in the absence of other symptomology after cessation the PAWS would still be there for the dopamine recovery

((i hope this doesn't come across the wrong way, but i really don't want this to become a "what's PAWS", or "roles of dopamine in addiction" thread, i simply want to know whether cigarettes' dopaminergic action has any significant effects on someone who is months-out from ending a pretty heavy medical regimen))

 

[sekio]

Yes, cigarettes will disrupt your dopamine system. PAWS or not. They interfere with natural homeostasis of dopamine (and other monoamines) and should be avoided. They are also very unhealthy for you.

 

[SangerRainsford]

dude, no fooling, that's pretty much common knowledge

let me rephrase, maybe i can make this more clear..
person1 is going through PAWS
person2 has never had any active tolerance/dependence
they both take 100mg oxy/day for a week.
person1 experiences a more significant 'hangover' from this week than person2.

it's that mechanism that i'm curious about (specifically, does another dopaminergic product, like tobacco, affect one who's still in PAWS from opiates more than it'd affect someone NOT in paws?)

 

[sekio]

Personally I think the reasons would be down to genetic variation and higher-level psychosocial factors (see the Rat Park study, very enlightening) and it would be very hard indeed to tell. That is, I believe the positive association between administering opiates, esp. IV, and the resulting euphoria and releif of malaise is more to blame than any one deficiency or messed up monoamine system. If you stop taking opiates suddenly after relying on them for long periods of time as emotional and mental crutches you will have a hell of a time coming off them simply from learned associations.

Someone would need to do a controlled study to figure this out. All I can tell you is I would expect that using drugs that modify mood and are known to cause depression and anxiety when withdrawn would not make PAWS any better.

 

[SangerRainsford]

agreed on all fronts - maybe someone more knowledgable than us can explain the science behind (if it's there) this. im sure it's got something to do w/ why 'hangovers' are worse if you had a tolerance/dependce prior to the new hangover
/rat park RULES, love that study ;PP