How can one be not addicted after artificial coma?

[plumbus-nine]

Afaik artificial coma is prolonged general anesthesia, so they'll use the same agents like fentanyl or propofol I assume - heavily addicting chemicals when used for prolonged time and some poor individuals require long to very long times in artificial coma but eventually get woken up again. How can it be that these people don't experience a nightmarish rebound and withdrawal? Or is the medication slowly titrated over weeks or months during rehabilitation? Sorry if it's a stupid question but one I've been wondering about.

 

[TheUltimateFixx]

I don't know what drugs are commonly used to induce artificial coma, but if they're physically addictive then yes the patient would be tapered off them.

 

[Las Veghost grower]

Do the actually use fent to induce coma ? That seems wildly irresponsible

 

[Xorkoth]

I think the OP means this new anti-opiate addiction therapy they're doing where they claim to be able to put someone in an artificial coma and when they come out, they're not only cured of addiction, their systems are upregulated to the point it was like they were never addicted. I am dubious, personally. I read the coma only lasts like 2 days or something. They use a heavy round of opiate antagonists to try to upregulate the receptors. I believe they put you into the coma using NMDA antagonists and maybe like propofol or something. If indeed it is only 2 days long, then you wouldn't have time to get addicted to the anesthesia agents. But I am quite dubious about whether this would actually work. They have testimonials about it working, but who knows f those are legit. It's also very expensive.

 

[Xorkoth]

Do the actually use fent to induce coma ? That seems wildly irresponsible

No, they use it as part of an anesthesia cocktail though, generally speaking, in anesthsia. Propofol or ketamine, and fentanyl to further reduce the chance of pain breaking through the unconsciouness.

Fentanyl is actually one of the safest opioids for clinical use, because surprisingly, it has a very wide therapeutic index. That is, its effective dose is many times lower than its lethal dose. The reason it's so dangerous as a street drug is because, whereas in clinical use, the exact dosage is known, on the street, it is not, there are hot spots. And compulsive redosing leads to dangerous outcomes, too. In the hospital, the dose is being controlled by an anesthesiologist so the only risk of overdose is someone making a mistake (which has happened).

 

[Xorkoth]

Actually on second thought, maybe the OP didn't mean what I was talking about, but just generally with people needing to be put into artificial comas.

In that case, yeah, I think there must be dependence. I wonder if they slowly titrate them down until they come out of it, and then have to keep them on sub-anesthesic doses until they're tapered to nothing? And maybe then need to do a round of something like librium afterwards for the case of any GABA dependence? I imagine propofol has a pretty short withdrawal, given its extremely short half life. For example, alcohol has horrific withdrawals, but they don't last more than a few days, unlike, say, benzos.

I'm unclear whether NMDA antagonists are actually physically addictive.

 

[Nurse Ratched]

Not exactly sure what you mean by an induced coma. Normally what I think of when someone says this is someone gets a traumatic brain injury from a motorcycle accident and they are put into an induced coma to keep their heart rate even, their BP stable and their physical body motionless. It gives their brain a chance to heal if the Dr.s think they can recover from it. Or any injury where the patient needs to stay calm, cool and collected. Our bodies heal quicker when we are not in pain or stressed.

The hospital uses sedatives, tranquilizers, and hypnotics to keep the patients in that state. When they start to come around they are weaned off the drugs because they have become physically dependent but not addicted. If you mean a coma to get off of opioids I have no clue...but probably something similar.