• Select Your Topic Then Scroll Down
    Alcohol Bupe Benzos
    Cocaine Heroin Opioids
    RCs Stimulants Misc
    Harm Reduction All Topics Gabapentinoids
    Tired of your habit? Struggling to cope?
    Want to regain control or get sober?
    Visit our Recovery Support Forums

Opioids just a question of definitions...

mardoux

Greenlighter
Joined
Dec 8, 2012
Messages
26
Location
cloud cukoo land
i have noticed on a lot of the opiate pages the words 'agonist and 'antagonist'...i looked them up and not to sound totally stupid but can you give me a practical definition of these words? i've been using opiates for years and i don't know these words and i want to be more educated. i'm on suboxone/naloxone and i have seen them used with these words... thank you!:?
 
ag·o·nist /ˈagənist/
Noun
A substance that initiates a physiological response when combined with a receptor. - a substance that stimulates a certain part of your brain - e.g an opiate agonist is heroin which binds to the opiod receptors in your brain

an·tag·o·nist /anˈtagənist/
Noun
A substance that interferes with or inhibits the physiological action of another. - a substances that interfiers with an agonists ability to bind to said receptor - e.g an opiate antagonist prohibits the substance (heroin) to bind to your opiod receptors.

Think Protagonist, antagonist in terms of litterature if you are into that at all.
 
to put it as simply as I can, opiate agonists make you feel high. heroin, oxycodone, dilaudid, opana, morphine, codeine, these are all opiate agonists. opiate antagonists basically create the opposite effect of opiates, not necessarily being painful (in therapeutic doses), but they won't get you nodding off like agonists will. Most opiate antagonists have higher receptor affinity, drugs like naloxone and naltrexone, and even buprenorphine (a partial agonist, having effects of both antagonists and agonists) will cling to your receptors better than most agonists. for this reason if you take an antagonist while there are still agonists at your receptor sites, they will pull the agonist off the receptor and take it's place, causing a very unpleasant withdrawal like feeling referred to as precipitated withdrawal.

Examples: Naloxone aka narcan is an antagonist, when you overdose on heroin or a similar drug the first thing the paramedics do is inject you with naloxone. The naloxone will take the place of the opiate drug at your receptors and thus if you are lucky you will come out of the overdose. it effectively reverses the effects of whatever drug you are taking. naloxone only works for around an hour, which is why it is important to observe someone who has recently overdosed to make sure that when the naloxone wears off, they don't fall out again.

another one is naltrexone, as mentioned above. this is a longer lasting antagonist than naloxone, therefor it isn't usually used for overdoses. Instead its primary use is prevention. It's either a pill, an implant, or recently an injection containing nano particles that release the drug over time. When an alcoholic takes naltrexone it makes him crave alcohol less. Something about how having the opioid receptors filled causes people to act less on impulses. Similarly it is given to opiate addicts for 2 reasons, one is the same mechanism with alcohol, an opiate addict with his opiate receptors filled won't crave opiate drugs as much. Like if you are high on heroin, heroin won't be on your mind nearly as much as if you weren't high, so to speak. The second reason is that because of it's higher affinity than most other drugs, it will effectively block opiate drugs from having an effect.

hope I helped.
 
Well, most drugs tend to be either agonists, or antagonists, or different variations thereof, there are many different flavors of agonists and antagonists, such as partial and full agonism, inverse agonism vs antagonism, etc.

With opioids, the most commonly abused, most euphoric drugs tend to be the full agonists: Morphine, Heroin, Hydro/OxyCodone, Hydro/OxyMorphone, Methadone.

When someone is overdosing on a full agonist due to excessive CNS depression, they are administered with the opioid antagonist, naloxone (Narcan). Naloxone rips the full agonist off the opioid receptors because it has a much stronger binding affinity for the opioid receptors than the full agonist the person was overdosing on. Antagonists work in the opposite way of the agonist.

With benzodiazepines, most are full agonists on the GABAergic receptors, and in situations where benzodiazepines are part of suspected overdose, they are administered with flumazenil, a benzodiazepine antagonist, which reverses the benzodiazepine aspect of the overdose and a lot of the CNS depression is lifted.

Because they are opposites, just like how most benzodiazepine agonists have anti-convulsant properties, and protect against seizures, if one were to administer too much of a benzodiazepine antagonist, such as flumazenil, it will act as a convulsant and induce seizures.

Anyways back to the opioids, suboxone = buprenorphine / naloxone. Both of these drugs have an extremely high binding affinity for the opioid receptors, buprenorphine's binding affinity is even higher than naloxones, which is what discredits the claims made by pharmaceutical company that marketed Suboxone, they said it would be hard to abuse due to the naloxone content, but this was rapidly disproven as many addicts proceeded to inject Suboxone tablets anyways, without inducing the precipitated withdrawals the pharmaceutical company claimed they would, so the whole abuse-proof aspect of Suboxone is bullshit.

Buprenorphine, the active ingredient in Suboxone, is a partial opioid agonist. At low doses, it acts as a potent opioid agonist, which can produce euphoric sensations almost like the full agonists (morphine, oxycodone, hydromorphone, etc) but buprenorphine has a ceiling effect. It's a partial agonist because at low doses, it behaves as a full agonist, but at higher doses, like 2mg and up, it begins to naturally antagonize itself and other opioids, producing a blockade effect where you reach a limit, reducing the ability to feel euphoria. During the induction phase of Suboxone maintenance, doctors may prescribe 24-32mg per day, even though many studies have shown that there is no therapeutic benefit to dosing higher, most people will be just fine on less than 8mg per day.

Buprenorphine is extremely potent and raises the users tolerance very quickly and has a very long half life, making it a good candidate for a maintenance drug, however due to it being a partial agonist (behaving like an agonist at low doses, and an antagonist at higher doses), it's not like methadone, which is a full agonist where you can raise the dose indefinitely if need be.

It is very uncommon for patients to need more than 8mg per day, and the lower the dose of Suboxone you can get down to, the better...

Make any sense?

edit:

bupfig01-en.jpg

http://issues05.emcdda.europa.eu/en/page032-en.html
Source: Adapted from Jones, H. E. (2004), 'Practical considerations for the clinical use of buprenorphine', Science & Practice Perspectives 2, no. 2, pp. 4-20.
 
Last edited:
To put it simply -


Agonist - activtae something, turn it on.

Antagonist - block something, turn it off.


Opioid agonists activate or turn on opioid receptors. Opioid antagonists block the receptors preventing opioid agonists from having an effect.

Think of it like a key - agonists are keys that fit perfectly in certain receptors and unlock those effects. Antagonists are like pouring glue into the lock so keys can't get in.

As tri mentioned, buprenorphine is a mixed agonist-antagonist (or partial agonist) - it fits into the receptor like an agonist but only unlocks it part way and then, to use the earlier analogy, breaks off in the lock so other keys can't fit in and further activate the receptor.
 
Thank you everyone for schooling me. i kept reading the scientific definitions and thanks for putting it plain for me. Much appreciation:)
 
Never. I'm not throwing a monkey wrench or anything but it's never a good time. It's either time, or it isn't.

Klonopin 12 years, sucks to be you sweetie, and on top of that 5 years of a shitload of bups. Yeah you are in it deep. You feel ready? You wanna do it? I mean do you really want to do it? If yes, who's stopping you? Lets get the party started right now, what you got to lose? Nothing. What you got to gain, one day being sober sooner. That's kind of a no brainer if you ask me.

And you are gonna relapse, but at least it'll be fun. Ready for some yoga? Swimming? Sauna time? Massages? All that extra cash works wonders for doing shit once you get comfortable. I'd ask you something personal but I don't want the other guys getting a wrong idea, but you know your ready to get the feeling back from that depressed CNS for years. Uh baby is it good. Strap in it's fun time.
 
i am ready for the suboxone to go away...how do you taper? how long does it take? i suck with pain, hence the five years...and i'm not ready to get rid of the kpins yet. they help me keep my sanity. both my parents have cancer, i live with my mom to help her thru it, and have a two year old...so kpins are essential...just wondering yr thoughts on how fast, how much on the tapering of subs?
 
i did have a bit of a relapse a few days ago with a fent patch but it barely worked so i know what you mean about 'at least it'll be fun'...
 
Never. I'm not throwing a monkey wrench or anything but it's never a good time. It's either time, or it isn't.

Klonopin 12 years, sucks to be you sweetie, and on top of that 5 years of a shitload of bups. Yeah you are in it deep. You feel ready? You wanna do it? I mean do you really want to do it? If yes, who's stopping you? Lets get the party started right now, what you got to lose? Nothing. What you got to gain, one day being sober sooner. That's kind of a no brainer if you ask me.

And you are gonna relapse, but at least it'll be fun. Ready for some yoga? Swimming? Sauna time? Massages? All that extra cash works wonders for doing shit once you get comfortable. I'd ask you something personal but I don't want the other guys getting a wrong idea, but you know your ready to get the feeling back from that depressed CNS for years. Uh baby is it good. Strap in it's fun time.
Straight creepin....
 
^^^

I second that.


For the suboxone you can taper relatively quickly until you get to about closer to the end of 0 than 16, at which point the discomfort will begin. It's really up to you and how much discomfort your willing to handle, I always ask myself when tapering, would I rather feel mild-moderate discomfort during a long taper/withdrawal, or would I rather feel moderate-severe withdrawal during a faster taper/withdrawal.

The same applies for the clonazepam/klonopin, and I would have been able to give you little more detail about the taper but you've provided no dosages. Don't try to get off both drugs at once as it will be a failed disaster both physically and psychologically. Ditch the opioid first, so you can use the clonazepam to deal with its symptoms.

Also, since you've been on both drugs for quite a long time, I wouldn't attemp anything without your doctors supervision. Another thing to consider is you have a young boy at home and your going through a lot, so it's best to be courageous and put a lot of thought into how you plan to get off these drugs without shouldering the extra burden of withdrawal.

Talk to your doctor about using pregabalin for both the benzodiazepine and opioid withdrawal as it can eradicate most of the withdrawal symptoms from both substances. Also, try discussing clonidine or gabapentin(the cheaper and less potent alternative to pregabalin). If he approves these drugs I'd be more than happy to share with you how I've utilized them on several occasions to get off benzodiazepines and opioids relatively easily.

Good luck.
 
Game recognize game playah. Nah, just kidding (: I got a fucked up sense of humor, you will notice that about me.

Glad you were kidding! I have a twisted sense of humor too, but it cant get in the way of me doing my job here, so don't play around like that others might not think it's funny, it was straightttttt creeeeepiiiiin hahaha.
 
yes if you got it for fun then My vote is for swimming, this is why because it make you fit as well and its a natural game. Gym some time have negative effect.
So we should to prefer bit lose over a big lose . Swimming is best exercise according to me at least one time in two days.

Gold Coast surfboard rentals
 
Last edited:
Glad you were kidding! I have a twisted sense of humor too, but it cant get in the way of me doing my job here, so don't play around like that others might not think it's funny, it was straightttttt creeeeepiiiiin hahaha.

Lol, I concur with that statement Tri <3
 
Your brain has different receptors in it, each with specific jobs. IIRC, the opioid receptors are for pain relief (but don't take my word for this). An agonist will bind to a receptor and increase the likelihood of it doing its specified action, whereas an antagonist will bind to this receptor but not to anything. While the receptor is binded to an antagonist, agonists can't get access to it, preventing it from doing its job.

Example:

Drug A is an agonist.
Drug B is an antagonist.

Receptor C makes person D happy.

When A binds to C, D is extremely happy.
When B binds to C, D isn't as happy as usual. C has been blocked.

I think that's the way it basically works but it could be wrong, I haven't gotten into learning pharmacology yet.
 
I always wondered what happens when somebody takes an irreversible opiate agonist? Will this person be opiated forever?
 
Top