Harm Reduction Cross drug dependency?

[Xorkoth]

Is it possible to develop a physical dependency by switching between different related drugs - say, gabapentinoids, alcohol, benzos, etc, but always having something occupying shared receptors? Or for example if someone switched between like tramadol and hydrocodone (though these are more closely related than say, phenibut and alcohol) just often enough to avoid dependency?

My experiences with this are as follows. All drugs cause tolerance to themselves (obviously). Different drugs within the same families, that hit the same receptors, cause cross-tolerance and cross-dependence, but to a lesser degree than using the same drug over and over. However, rotating opiates is going to lead to opiate dependency. Likewise, using another opiate to get off of an opiate doesn't work, for the most part, you just prolong the addiction, and switch dependencies to the new one if you dose it more than a few times.

As for different classes of drugs that affect the same systems, rotating them helps a lot to reduce tolerance buildup and dependence, but it is my experience that over time, even if you escape acute withdrawal (say, by rotating benzos and alcohol), you will still cause downregulation of GABA receptors, and you will experience rebound and light dependence, which is less severe than if you dose one or the other every day, but which nevertheless is dangerous and will lead to suffering.

The most sustainable way to get high every day on addictive drugs is to rotate drugs which have totally different mechanisms of action, and use as many classes as you can, to put more time between each type of drug. For example, benzos one day, opiates the next, stimulants the next, alcohol the next, gabapentin the next, dissociatives the next... if you can throw something not physically addictive, like weed (or stims, or dissos) or skip some days altogether, that is going to help make it more sustainable. But this is a very slippery slope and it takes herculean effort to avoid slipping into a serious problem, and this sort of thing often leads people into being physically dependent on multiple drug classes at once, which is a trap you really do not want to fall into. Also over time this will lead to greater and greater difficulty just not taking anything, and will long-term downregulate your receptors in various systems so that if you try to stop, you will be feeling all sorts of off, even if you escape acute withdrawals.

It's playing with fire, and the more you do drugs, the more you want to do drugs. It's best to try to work on spending more time sober, as really, the only long-term sustainable way to use drugs is to use them occasionally, rather than all the time. But, as they say, do what I say, not as I do...

Gabapentin and alcohol wouldn't due to both working on nmda and gaba receptors? And couldn't gabapentin and benzos, just in a different way?

Gabapentin doesn't have any effect on GABA or NMDA receptors, it is purely an antagonist of voltage-gated calcium ion channels (that is the definition of a gabapentinoid, something that does that). The mechanism for why it gets you high isn't fully understood, but it probably leads to an increase in various neurotransmitters downstream. It may indirectly lead to an increase in GABA (I have read conflicting information about this), but it's not at all the same as a benzo or alcohol. Although actually alcohol does have some ion channel blocking properties (alcohol hits a wide array of receptor sites, it is a slutty chemical), but I'm not sure if it's voltage gated calcium ones.

 

[Xorkoth]

I might be dealing with some rebound effects from moderate benzo usage. Can they last 2-3 weeks? So phenibut might interfere with the rebound effects going away, but alcohol won't? Does alcohol effect gaba in the same way as benzos?

No, alcohol is a direct GABA-A agonist, and benzos are positive allosteric modulators of GABA-A. So the mechanism is different. They do give benzos to get through alcohol withdrawal, so the two do not have direct cross-tolerance, though it is my belief that past dependence on one or the other makes it easier to get dependent on the other one, as both sensitize and downregulate the GABA system in some way.

I will say that in my experience, alcohol briefly helps to mitigate other GABAergic drug withdrawals, but then it rebounds and causes the symptoms to worsen and the agitation to increase. I find it counterproductive for dealing with GABAergic withdrawals. On the other hand, benzos help a lot with other GABAergic withdrawals, though you have to be really careful to avoid becoming dependent on them.

 

[Zephyn]

My experiences with this are as follows. All drugs cause tolerance to themselves (obviously). Different drugs within the same families, that hit the same receptors, cause cross-tolerance and cross-dependence, but to a lesser degree than using the same drug over and over. However, rotating opiates is going to lead to opiate dependency. Likewise, using another opiate to get off of an opiate doesn't work, for the most part, you just prolong the addiction, and switch dependencies to the new one if you dose it more than a few times.

As for different classes of drugs that affect the same systems, rotating them helps a lot to reduce tolerance buildup and dependence, but it is my experience that over time, even if you escape acute withdrawal (say, by rotating benzos and alcohol), you will still cause downregulation of GABA receptors, and you will experience rebound and light dependence, which is less severe than if you dose one or the other every day, but which nevertheless is dangerous and will lead to suffering.

The most sustainable way to get high every day on addictive drugs is to rotate drugs which have totally different mechanisms of action, and use as many classes as you can, to put more time between each type of drug. For example, benzos one day, opiates the next, stimulants the next, alcohol the next, gabapentin the next, dissociatives the next... if you can throw something not physically addictive, like weed (or stims, or dissos) or skip some days altogether, that is going to help make it more sustainable. But this is a very slippery slope and it takes herculean effort to avoid slipping into a serious problem, and this sort of thing often leads people into being physically dependent on multiple drug classes at once, which is a trap you really do not want to fall into. Also over time this will lead to greater and greater difficulty just not taking anything, and will long-term downregulate your receptors in various systems so that if you try to stop, you will be feeling all sorts of off, even if you escape acute withdrawals.

It's playing with fire, and the more you do drugs, the more you want to do drugs. It's best to try to work on spending more time sober, as really, the only long-term sustainable way to use drugs is to use them occasionally, rather than all the time. But, as they say, do what I say, not as I do...



Gabapentin doesn't have any effect on GABA or NMDA receptors, it is purely an antagonist of voltage-gated calcium ion channels (that is the definition of a gabapentinoid, something that does that). The mechanism for why it gets you high isn't fully understood, but it probably leads to an increase in various neurotransmitters downstream. It may indirectly lead to an increase in GABA (I have read conflicting information about this), but it's not at all the same as a benzo or alcohol. Although actually alcohol does have some ion channel blocking properties (alcohol hits a wide array of receptor sites, it is a slutty chemical), but I'm not sure if it's voltage gated calcium ones.

This sounds like maybe what I am experiencing. Good to know for future reference as well, thanks. What is the best way to deal with multiple receptor downregulation from multiple classes of drugs? Any supplements that help things return to normal? Any brain hacks (like using antagonists or something)? Would something like ECT reset it? Lol, i am fucked and its probably going to take years that i cannot manage to get back to normal. I know
That at least at the 6 month mark of total abstinence i don't really feel any better.

 

[Zephyn]

Also, does downregulation directly correlate with dependency? As in, is chronic downregulation a form of dependency of its own?

 

[cosmic charlie]

This sounds like maybe what I am experiencing. Good to know for future reference as well, thanks. What is the best way to deal with multiple receptor downregulation from multiple classes of drugs? Any supplements that help things return to normal? Any brain hacks (like using antagonists or something)? Would something like ECT reset it? Lol, i am fucked and its probably going to take years that i cannot manage to get back to normal. I know
That at least at the 6 month mark of total abstinence i don't really feel any better.

Please don't start messing around with ECT I will admit I have no direct personal experience, but the other patients I saw get it in the psych hospitals seemed to be heavily effected "dulled" by it. Personally I would rather stay abit crazy than have Electronic Shock Therapy sap my personality from me. What type of symptoms are you dealing with exactly @Zephyn?

 

[Zephyn]

Please don't start messing around with ECT I will admit I have no direct personal experience, but the other patients I saw get it in the psych hospitals seemed to be heavily effected "dulled" by it. Personally I would rather stay abit crazy than have Electronic Shock Therapy sap my personality from me. What type of symptoms are you dealing with exactly @Zephyn?

I've been posting all over about it (sorry if its gotten annoying im going through the toughest part of my life ever for 3 years now). I'm experiencing, say, laying in bed with my eyes dry from dehydration yet unable to get the motivation to go across the room to the bottle that sitting right there. I procrastinate cleaning or doing dishes for a week of more until its just nasty. I am having extremely uncomfortable physical sensations in my body as if coming down from some bad drug. I have body aches all over, I have no appetite and forcing myself to eat is like it used to be trying to eat on stimulants. I am having extreme social anxiety where I feel weird even walking by a stranger on the sidewalk, when I used to be very outgoing. I am canceling plans with new potential friends. I am unable to focus on learning for my new job. My verbal fluency is shot. I am paralyzed by fear of the known and unknown. I am having daily diarrhea. I am having pain in my ass from a hemorrhoid or a fissure from getting raped. I am having sleep disturbances. I can barely function. I wake up and am instantly in physical pain, depression and anxiety. The sound of the birds in the morning upsets me rather than making me happy like it used to.

Ect is out of the question for now and probably forever due to the high demand and learning curve in my line of work and this particular position. Any memory issues or cognitive decline beyond what I'm already dealing with could be disastrous.

I have heard good things about it for depression though, and from the research it seems more effective than any other option, which I've tried and get no benefits only side effects.

 

[GetMeOutOfThisCRAP]

The only thing I've ever truly been addicted to is oxy and adderall. I've probably said that way too many times on BL.

Anything else? Morphine, fent, kratom, etc. It just never cut it like oxy. Benzos? I've had about 3 pills in the past year or more. Alcohol I can't even remember having, lol. Some say that addicts will like anything under the sun to "escape." Others have tastes and I can't find myself ever drinking or getting xanned out a thousand times like I have speeded awayyy.

I'm sure I would looove heroin. Oh, and meth. I haven't had the misfortune of being addicted to those lol. Trying to keep it that way.