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Opioids Does anyone else think that opiates aren't actually that good painkillers?

I agree that for me, opioids don't seem to be fantastic painkillers, though perhaps like others have said it's the pain, dose or type of opioid I've used which has made the difference. I got an injection of morphine at the hospital once for a bad toothache once and it didn't alter the pain one bit. When I broke my foot last year and was using opioids (recreationally), I'd experiment to see if the pain was less after taking them but never found it made much difference.

burn out said:
I am just saying this because opiates have some kind of mythic status as a painkiller, which I think is not fully deserved because in my opinion alcohol is a better painkiller. Of course alcohol isn't used medically because you wake up the next day with a hangover and you feel even worse, whereas with opiates as long as you have a supply you can just keep taking them and never experience the full consequnces until you try to stop taking them, voluntarily or involuntarily.
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I agree too, alcohol is great for helping you ignore pain, or at least dulls the urgency of it. I broke my foot when I was drunk and don't even remember doing it, though that's not to say I didn't feel it at the time. The previous time I injured my ankle I was on mdma and alcy and although I felt it when I did it, after that I was able to walk on my foot for the rest of the night, which I definitely paid for with 6 weeks unable to walk on it from the next morning.
 
cook said:
Agreed, except for the "always will be" -part. I am sure that somewhere in time the medical science will come up with a method that 100% cuts down all the pain signals in your body. Maybe even in our lifetime.
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When I was hospitalized after a horseback riding accident I found a fentanyl drip to be the most effective. It was far to sedating for me, however, so I was switched to morphine.
 
belfort said:
opiates are also known for making pain worse in the long run..they do change the way your nervous system deals with pain but after a long time on them, it almost shifts in some people and makes the pain worse..there is a term for this but i forgot the name.. it did for me, i started taking oxy and it worked for pain but after awhile my pain got worse..i got off them and pain lessened..
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Hyperalgesia is the one where opiates are making your pain more severe, not less. Allodynia is the one where non-injurious stimuli start registering as pain.
 
epiks said:
I do IV heroin and its the best pain killer i've ever had. I have extreme lower back pain, its not even noticeable in the least when I'm on dope. Same with oxy. But anything lower than oxy can't normally touch my back pain. The weaker pills work for all other pain related things on my body but not my lower back. I'd prob kill myself from the pain in my back if i didnt have dope!
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I've had exactly the same experience: high strength pain relievers (oxy, bupe, morphine, fentanyl) can each, in a high enough dose, make the pain in my abdominal cavity (due to messed up organs and scarring and stuff) just melt away. They gave me ketamine in hospital once, immediately after an op, and I didn't think it was great. And low strength pain relievers are useless for the chronic pain stuff; codeine & tramadol don't even touch it.

But if I get a headache or toothache or whatever minor pains, tylenol does the trick. Seriously. And I do still get headaches & toothaches, and it hurts if I stub a toe etc., even on bupe patches. It's a different kind of pain.

Opiates work great for some types of pain; not so great for others. Opiates work great for some people, but not others. Different opiates work great for different people -- except the people opiates don't work for at all. There's no pharmacological 'magic bullet' for anything, including pain, but what all the studies say is that opiates do work really well for a lot of (not all) people for pain.
 
burn out said:
They are supposedly such good painkillers that they continue to be widely prescribed even they have a high potential for abuse and many are diverted to the black market. YOu would think that if doctors could find an equally effective but nonabusable painkiller, they'd switch to it right? But luckily that wont happen, for a while at least, because opiates are supposedly so effective.

Yet I have not experienced this to be the case. For instance, I burned my hand tonight and it hurts like hell. So what did I do? I went and shot up heroin and guess what? My hand STILL hurts like hell. I can feel pain just fine under the influence of opiates, they really dont help very much at all. Granted, I have a major tolerance. But the again, so do many pain patients and even when I didnt, I felt the same way. Opiates do not make your body numb.

My theory is that opiates get the patient high and provide some minute pain relief. But really the way they work is by getting you high, providing a bit of pain relief and calimg you down/relaxing you. They make you feel a lot better, so you're no longer freaking out about the pain. Thats also why its so hard to find a drug that competes with opiates. Because if it doesnt get the patient high, the patient is gonna prefer opiates.

The implications of what I am saying though, are that doctors could use other drugs to treat pain. I mean, I bet if you gave somene in pain MDMA they would feel a lot better too. Being high is what eases the pain. Anyone agree?

Now there are drugs which actually kill pain. For instance, ketamine, nitrous oxide and large doses of alcohol are capable of rendering you numb such that you would not feel the pain of a burn on your hand. I think if was really desperate for pain relief, I would reach for the K and not opium. The problem though, is the duration.
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I have always felt that while mild pains become unnoticeable, opioids have little effect on the sensory... sensation of more severe pain. Instead, at least personally, I lose all interest in said pain. I am aware that a part of my body hurts, but the part that normally gets distressed about it doesn't give a fuck.
So yes, in a way being high does ease the pain, but being high on most other drugs doesn't reduce the pain nearly as much. Local anesthesia or dissociative anesthesia have their very obvious problems as well, and it's better to have people walking around on opiates than being partially completely numb, or worse, a vacant shell.
 
I thought I was the only one! (I'm sure I'm not, I just haven't read the replies yet.)

For what it's worth, opioids fail to alleviate almost any pain for me, no matter the origin/neurological processes involved: burns, blunt-force injuries/muscle pain, cuts, sprains..

(This is without tolerance to opioids.)
 
That would be a miraculous drug that would make some lucky pharmaceutical company billions. Hell, if they could isolate the analgesic properties of morphine without the side effects and intoxication, that would be amazing.
 
^Agreed. If they could do this and take all my pain away I would be one happy camper. If it gave me energy with out jitters or come downs ever better.
 
Treating pain with chronic daily use of most (if not all) substances create problems.
The choice is made after weighing up the options and pro and cons of each.
Normally productivity is a big part of the equation - If the patient use the substance for chronic pain relief, will they be more productive/successful/enjoying life, or less? And can this be maintained for years on end whilst minimising toxicity?

Alcohol is not something one can use in proper anelgesic dosages every day without severe problems arising, many of which we are all aware.
Also, use of ketamine or other disassociatives do just that, disassociate you. Which is EXTREMELY useful in surgeries and absolute agony eg. Box Jellyfish sting, etc, but in regards to chronic daily use, disassociatives would most like be terrible for the patient's social and sexual life, their mental health, chance to work, etc.
Hence why opiates become so attractive and helpful. With the well-chosen opiate, many types of chronic debilitating pain can be 'relieved' enough that patients can actually get back to living their normal life (or as close as possible), going back to work, study, with minimal cognitive/physical impairment. Keeping in mind opiates do not work well for all types of chronic pain, or at least certainly not by themselves, but in my experience they work amazingly for treating certain types of pain, normally such pain that would be described as "deep, heavy, throbbing, chronic, musculoskeletal" and so on.

I mean personally, NSAIDS never did a thing except hurt my stomach after a while and make my kidneys feel horridly clogged, and my heart always felt weird. I do however take one 275mg Naproxen sometimes as long as I've got a full stomach. I also can't really tell a difference when I do take one.

Paracetamol/Acetaminophen is good for headaches, and if I'm in super bad pain I'll eat 2 panadeine extras (just for paracetamol content, codeine is almost useless for me nowdays after oxycodone...) with my morning oxycodone.

Benzodiazepines are definately not something I would want to take every day due to tolerance/addiction/hellishWD, though some valium definitely helps HUGELY with my muscle tightness/spasms on a rare occasion I ask for a few from my Doctor.

I have tried Lyrica (pregabalin) though not (Gabapentin or Baclofen) but I think personally my oxycodone keeps me far more productive and just well... Lyric made Me into a complete Moron with no sexual ambition whatsoever. No thankYou.

If Legal - Cannabis can apparently help hugely with not too much detrimental effects when ued in correct dosages.

All in all I'm super thankful for my prescribed oxycontin, even if it is only 2x 20mg a day, it definately makes my life so much easier.

Then again maybe in 10 years I'll have a different opinion, when tolerance plays a big part. I have used opiates for 5 years to treat pain, since around 18 till now (I'm 23) and I have tried very hard not to let my tolerance skyrocket... never let myself down more than 20mg IR at once but that's beginning to slip as my pain/tolerance gets worse.. such a pity, without tolerance oxycodone feels like Brave New World's "soma", the perfect drug...
 
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chase_in_56ace said:
the vast majority turns to heroin when they can't afford the pills they have been overprescribed and now have developed immense tolerances to. This leads everywhere from prescribing even higher doses, to obtaining more opiates for many. Prices have skyrocketed. They turn to heroin.

Blame the DEA. FL and our clinics. But blaming MDs for underprescribing? Lets be real here :)
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very true my friend
 
i've always wondered the exact same thing being on heroin. i've found myself pinching myself and being like "oww" but hey...millions and millions of people cannot be wrong...it is definitely pain killing in a way. it dulls your pain receptors.
 
I figure until medical science makes something better, morphine will be the go to standard for moderate to severe pain. It is after all what other opioids meds are compared to in terms of equianalgesic potency. IME, taking opiates doesnt really help with pain, i get migrainges for example, have been for over 20 years now. opiates suck for migraines and actually can cause rebound headaches. i think it has something to do with the intercranial pressure opiates can produce? anyways, i guess it does depends on the kind of pain, like if you are shot in the leg or something i dont think an nsaid would do anything lol. its all about altering the perception of the pain signal, find a way to manipulate that without causing addiction, resp depression or any other negative side effect and you will have invented a better mousetrap.
 
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