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Opioids Anyone had post-surgery meds unlock old addiction issues?

Deryn

Greenlighter
Joined
Jun 11, 2025
Messages
9
Has anyone else found that medical fentanyl — even just one dose — reactivated something massive? I was given it during surgery recently and it’s like it woke up a craving I wasn't expecting.

I used to take codeine, and I’ve recently quit after 15 years of it. I'm only 30 days off that.

But what hit me post-op is deeper and older than codeine. It feels like it triggered something from the one time I had heroin when I was 17.

It’s honestly pretty bad. Just wondering if anyone else has had fentanyl flip a switch like that?
 
Can't directly answer your question but I've personally known two people relapse after getting post-surgery meds and in one case he'd been clean over 20 years - ouch

It's common knowledge that the exact same has happened to many, many people - and also that many people have not relapsed due to post-surgery meds. Luck of the draw probably
 
It has to do with the neurology of addiction. The extreme dopamine release from your first hit of heroin produces an equally extreme glutaminergic pathway (memory) response... Basically, it triggers your brain into thinking heroin is extremely important for survival, and the brain NEVER forgets this, thus the extreme trigger even after so many years sober.

Once an addict, always an addict. No amount of sober time changes this.
 
Thank you. One time heroin use though? It was honestly the most profoundly intense and incredible experience I've ever known. I think if it often.

At least, I think it was heroin. I wrote it off as some crazy joint for a lot of years but surely it couldn't have been cannabis. I'll do a separate post to try to find out about that. I really need to work it out in my head.

The heroin stuff was 30 years ago. Could that really affect me now? I just have no idea.

I was taking codeine for the last 15 years. Only over the counter stuff but really struggled to keep it at that level. (Not much -- 100mg/day, sometimes up to 150mg/day). In 4-6 doses every single day. So damned carefully doled out to myself.

After the surgery, I was waking up and the nurse said "you're okay, I'm injecting you with fentanyl". I felt it kinda start hitting and my brain just went "yessss!!" and instantly was like "need to get more". But then it's like it didn't hit? I don't know, it just sort of evaporated.

I just feel like it's done something though, like woken up some awful thing. It's sounds silly when I type it.

After the surgery, I was on higher codeine (not much 150mg/day) but it just didn't touch the sides. I can't source what I'd need to feed that craving, I have no hope.

The idea of suddenly running out really scared me, and what I'd need to feed it. So I tapered. In 3 weeks I came off totally, whereas I literally couldn't for 15 years before.

It was okay at first. Now I'm on day 31 and this week is hell. I don't even feel like it's codeine I'm craving, like that won't touch the sides and I know it. I feel like my brain is dismissing that as an option but I don't know what I need.

I don't even know what I'm craving but it's so awful. Like I'm on fire. God sorry, I sound a bit mental. Probably not even making sense. I just want it to stop.
 
It has to do with the neurology of addiction. The extreme dopamine release from your first hit of heroin produces an equally extreme glutaminergic pathway (memory) response... Basically, it triggers your brain into thinking heroin is extremely important for survival, and the brain NEVER forgets this, thus the extreme trigger even after so many years sober.
This is the crux of the matter.

Dopamine is a mediator of learning. It signals to us that an experience was good and we should do it again. Of course with strong drugs, we are learning harder than normally possible (that the drug was good and we should do it again). Over time, you develop whole arrays of neurons connected in circuits which preserve this memory.

As drug addiction often takes quite a while, we have been exposed to these super-normal learning signals quite a bit, so not only are there a lot of neuronal connections, but these connections are going to be strong and more resistant to pruning, so will be persistent.

Hitting those receptors in or after surgery is basically the same experience in character if not in valence of getting on a bike after decades and still being able to ride it.

It was okay at first. Now I'm on day 31 and this week is hell. I don't even feel like it's codeine I'm craving, like that won't touch the sides and I know it. I feel like my brain is dismissing that as an option but I don't know what I need.
One month in is a pretty difficult time for getting sober. The really bad memories of the acute withdrawal begin to soften, and around the same time, insidious cravings tend to show their head. The mantra of “I will just feel this way later and more strongly if I relapse” can be pretty powerful, as it is true.

This review covers incubation of cravings both in humans and some more neurological aspects in animals. Cravings tend to worsen for about 3 months (independent of the specific drug used), and then wane over the next three months. This period will be difficult but it will pass.

I would recommend you gove yourself more time. Treat yourself gently, use supplements (even if they are placebos they give you a feeling of agency), and treat this like the final boss fight against addiction. You made it a whole month, and in some ways are at the hardest and trickiest part of getting clean for two more months. It will get better, and your brain will begin to return to homeostasis, but it takes a lot of time.

Godspeed
 
Can I just add that while almost every source will state that codeine is 10-12 times less potant than morphine AS AN ANALGESIC, it's potency regarding preventing AWS or indeed producing euphoria are a lot closer. to M.
 
Thank you so much for your replies. Honestly, they're really helpful.

So I know this might be a silly question, but do you think it's the codeine causing this or the *one time* of heroin?

The codeine was 100mg/day every day for 15 years. Sometimes up to 150mg but not really that much. It's not a lot, right?

The heroin was literally once, 30 years ago. Totally floored me.

I just feel like I don't know what my body is craving. If it's woken up anything from the heroin. Forgive me if I'm being thick... Brain just not working tonight.
 
Thank you so much for your replies. Honestly, they're really helpful.

So I know this might be a silly question, but do you think it's the codeine causing this or the *one time* of heroin?

The codeine was 100mg/day every day for 15 years. Sometimes up to 150mg but not really that much. It's not a lot, right?

The heroin was literally once, 30 years ago. Totally floored me.

I just feel like I don't know what my body is craving. If it's woken up anything from the heroin. Forgive me if I'm being thick... Brain just not working tonight.
I would guess it is the codeine. I always think about addiction as being the factor of drug strength * duration of habit/total number of doses used.

The brain learns through reinforcement, and while heroin is a lot stronger and more intense than codiene, 15 years of daily codeine is more than 5,000 doses. That is going to have a way stronger effect on building up those pathways than a single use of heroin would.

If I were you, I would carve out more space for self care and keep your mind occupied even if it means binging a show or two. It is going to suck, but it will fade eventually.
 
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I would guess it is the codeine. I always think about addiction as being the factor of drug strength * duration of habit/total number of doses used.

The brain learns through reinforcement, and while heroin is a lot stronger and more intense than codiene, 15 years of daily codeine is more than 5,000 doses. That is going to have a way stronger effect on building up those pathways than a single use of heroin would.

If I were you, I would carve out more space for self care and keep your mind occupied even if it means binging a show or two. It is going to suck, but it will fade eventually.
Thank you. God, it's 27,000 doses 🫣 When you put it like that ... !

Thank you so much. I actually feel less insane knowing it's just how it is.
 
Yes

This is 100% a thing. It is not something an addict should fuck around with. There will be times in life in which pain will be too great and the choice is required for relief in one wants to enjoy life, but don't take that choice lightly. A lot of us who spend years developing confidence in ourselves and in the good are all to ready to jump right back down the rabbit hole when a guy with 12 years of college and a lab coat tells you he is giving you Hydromorphone (Dilaudid) tablets.

This is a relatively true story. I have had many attempts at sobriety in my life before getting on this current path. At that point, I had been clean from Heroin for about 10 months. I was going to meetings, doing the right things, you all know the deal, I was on my game. I wouldn't have even lied to my dentist about fucking flossing every night. Had to have some relatively serious sinus surgery. One conversation, 10 minutes of my life. I played the doctor hard. I had spent years developing a medical chart that had my favorite Opioids put into the limelight. Oxycodone makes me sick. Morphine makes me sick. There was this one that worked perfectly, shit what was it Dilantin?

Not only was it my favorite, I knew I would be tripling the relative prescription by injecting those tablets. I went into that situation with a plan. In one moment, the conversation, I remember it so crystal clear, when the surgeon came in, I don't remember any other word but him saying "Pain?" and then coming to once the conversation was over. I used the entire prescription in less than 48 hours and was using Heroin within 50 hours and would continue for another half-dozen years.

All it takes is one taste. They call it a "taste", but it's a lot more than that. To have that taste is to taste it with every sensory organ in your body all at once. We don't have a word for this other than, "feel".

The human mind, even at its dumbest is faster than any computer that any of us are sitting at by exponents. We sometimes doubt our abilities to think. How much memory can transpire in a single second, a shit ton. What's it like to remember what it was like to feel safe? I know when I think of Opioids, I'm not too afraid to tell you that my experience of comfort and safety was like hugging my Mother after my Father had behaved badly. I can still call my Mother. I can write her a card. I can even hug her. I can never get that feeling back though. My point is, do not ever question what you would do to feel safe.

The cravings will subside after a few days but they will be heavy. If you really care about staying good, I highly advise you to tell someone how you're feeling. Look, I'm a junkie too. It's not our proudest moment to admit to those we love that we are the dregs of society. The ones we love though are the ones we love because they would never judge us like that.

Tell your people about how you're feeling. Do not do anything stupid like start watching Intervention on marathon or trolling Erowid experience reports of injecting Heroin for the first time. Why don't you read a book instead?

The Lord of the Rings will teach any person all that there is to know about addiction.
 
I've NEVER understood why, in the US, hydromorphone appears to be so common. Morphine doesn't work for me AT ALL so I've asked for dihydrocodeine instead of morphine because for me, it works. Yes, obviously the dose will need to be higher, but if it's any given amount of morphone OR DHC, I go with the DHC.

I've been given quite a few odd looks by doctors but someone asking for a weaker opioid.... that, apparently, does not compute as 'drug seeking behaavior' but rather 'patient displayed opiophobia' or SOMETHING.

After surgeries I've been given M and it may as well have been water for all the good it did me, but DHC, well, it's ENOUGH.

In the UK hydromorphine is in theory available, but few clinicians have any experience with it. I suppose we use diamorphine in cases where it's appropriate to treat 'unacceptable himan suffereing' because you know what? THE BNF doesn't even mention pain when strong opioids are discussed Pain is fine - unacceptable human suffering is not.
 
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Yes

This is 100% a thing. It is not something an addict should fuck around with. There will be times in life in which pain will be too great and the choice is required for relief in one wants to enjoy life, but don't take that choice lightly. A lot of us who spend years developing confidence in ourselves and in the good are all to ready to jump right back down the rabbit hole when a guy with 12 years of college and a lab coat tells you he is giving you Hydromorphone (Dilaudid) tablets.

This is a relatively true story. I have had many attempts at sobriety in my life before getting on this current path. At that point, I had been clean from Heroin for about 10 months. I was going to meetings, doing the right things, you all know the deal, I was on my game. I wouldn't have even lied to my dentist about fucking flossing every night. Had to have some relatively serious sinus surgery. One conversation, 10 minutes of my life. I played the doctor hard. I had spent years developing a medical chart that had my favorite Opioids put into the limelight. Oxycodone makes me sick. Morphine makes me sick. There was this one that worked perfectly, shit what was it Dilantin?

Not only was it my favorite, I knew I would be tripling the relative prescription by injecting those tablets. I went into that situation with a plan. In one moment, the conversation, I remember it so crystal clear, when the surgeon came in, I don't remember any other word but him saying "Pain?" and then coming to once the conversation was over. I used the entire prescription in less than 48 hours and was using Heroin within 50 hours and would continue for another half-dozen years.

All it takes is one taste. They call it a "taste", but it's a lot more than that. To have that taste is to taste it with every sensory organ in your body all at once. We don't have a word for this other than, "feel".

The human mind, even at its dumbest is faster than any computer that any of us are sitting at by exponents. We sometimes doubt our abilities to think. How much memory can transpire in a single second, a shit ton. What's it like to remember what it was like to feel safe? I know when I think of Opioids, I'm not too afraid to tell you that my experience of comfort and safety was like hugging my Mother after my Father had behaved badly. I can still call my Mother. I can write her a card. I can even hug her. I can never get that feeling back though. My point is, do not ever question what you would do to feel safe.

The cravings will subside after a few days but they will be heavy. If you really care about staying good, I highly advise you to tell someone how you're feeling. Look, I'm a junkie too. It's not our proudest moment to admit to those we love that we are the dregs of society. The ones we love though are the ones we love because they would never judge us like that.

Tell your people about how you're feeling. Do not do anything stupid like start watching Intervention on marathon or trolling Erowid experience reports of injecting Heroin for the first time. Why don't you read a book instead?

The Lord of the Rings will teach any person all that there is to know about addiction.
Thank you so much. Your reply is really helpful. I have literally no one I can tell. I don't even understand what I'm craving. I know it sounds silly but I was kinda okay until the post-surgery fentanyl. It's like it's made everything go mental.

I was on the same level of codeine for 15 years. Not even loads. Just stable. It was always a struggle but I maintained it okay. Now it's just insane.

I never thought I'd manage to stop taking it but it's like the fear of this out of control craving was enough to kick me into stopping.

Now I just feel like I'm climbing the walls in my head constantly. I felt okay before this week!

Family and friends know nothing about any if it. Honestly, I'm not going to find help or sympathy there. It's not their fault, just it would be more "wtf have you been doing?!" And "get your shit together". It would make it far worse. There's literally no one I can talk to.
 
As I have said - codeine appears to produce tolerance and dependence out of all proportion to it's analgesic activity. I would guesstimate that although only 10% the potency of morphine, the tolerance and dependence are more like 25% that of morphine.

I learnt this through bitter experience. You think taking 90mg of codeine phosphate per day is nothing. But just try stopping after years of consuming 90mg/day. You WILL experience quite nasty AWS symptoms. The way I've gone is 'by the book' i.e. reducing my codeine consumption by 10% per week. Yes it's slow but for me at least, it worked. I think that is what defets some people who seek to detox. They cannot imagine spending six months or a year detoxing so they go faster and it's OK for a few days... THEN they get very sick and are overwhelmed with the thought that they are cursed and will never succeed.

But 10% per week is the fastest one can possibly go. At lower doses I would even say go slower.

You wouldn't think dropping from 100mg to 95mg COULD be an issue. But on day 3 or day 4 - THEN you will be amazed how you feel it.
 
As I have said - codeine appears to produce tolerance and dependence out of all proportion to it's analgesic activity. I would guesstimate that although only 10% the potency of morphine, the tolerance and dependence are more like 25% that of morphine.

I learnt this through bitter experience. You think taking 90mg of codeine phosphate per day is nothing. But just try stopping after years of consuming 90mg/day. You WILL experience quite nasty AWS symptoms. The way I've gone is 'by the book' i.e. reducing my codeine consumption by 10% per week. Yes it's slow but for me at least, it worked. I think that is what defets some people who seek to detox. They cannot imagine spending six months or a year detoxing so they go faster and it's OK for a few days... THEN they get very sick and are overwhelmed with the thought that they are cursed and will never succeed.

But 10% per week is the fastest one can possibly go. At lower doses I would even say go slower.

You wouldn't think dropping from 100mg to 95mg COULD be an issue. But on day 3 or day 4 - THEN you will be amazed how you feel it.
I hear you, I totally hear you. Everyone thinks it's a minor thing but it eats at you.

7 weeks ago I was on 150/day. Now week 4 of zero. It's like standing on top of a cliff on fire. I don't know how to do it.

I can't even give in to be honest, because after the fentanyl, even 150mg/day wasn't touching the sides with the craving. It's just so bad.

That's what made me look back at that (potential) one time heroin experience and wonder if it's linked. I know it probably doesn't even matter. I just feel fixated.

What you say makes a lot of sense.

Achievements today that feel awful right now:

1. I spent 90 minutes (!!!) in a pharmacy queue today (collecting a prescription for someone) right next to the over the counter codeine.
2. Got a really bad migraine. Genuinely need pain relief. Haven't done it.
3. My other half asked me to pass him codeine from the packet. I couldn't say no without explaining why, so I did. The feel of the packet, the sound... I held them in my hand and I could hear him crunching them up. God, I feel on the floor 😭 The box is literally six feet away from me and I can't move them without explaining a lot of stuff.

On the surface I'm making lunch, working, chatting about the weather. Inside I'm just on the floor screaming.
 
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