Morphine Hyperalgesia & Delayed Heroin Withdrawal?

[fairnymph]

I was using morphine, usually 2-3 times a day, often as little as 15 mg a day and very rarely more than 30 mg a day, for 3-4 months. This was prescribed, for severe chronic back pain that is largely due to muscle tension. This was in Spring/Summer 2008. Midway through last summer I stopped using the morphine because I developed full-blown hyperalgesia; the morphine no longer helped my pain at all, and in fact, morphine now (still) makes my pain significantly worse, and I get a fuckton of side effects from it that were mild or nonexistent formerly.

I had no trouble coming off the morphine - I basically did a very slight taper and went through very mild, barely noticeable withdrawal. For years I used codeine 1-3 days a month for severe menstrual cramps, and more recently I have used hydrocodone (vicodin then later norco) as my cramps worsened. I have never experienced withdrawal symptoms from either, though I've also never used either regularly.

Skip to just over 3 months ago; I found a heroin source, for bags of white powder. I do not have a scale so I have no idea what the dose is. I am positive it is heroin as I have done heroin before, both street and lab-made. I made my own nasal spray; initially I would dilute 3 bags in 10 ml of water, but after 2 months nearly doubled the concentration. I would do anywhere between 2 and 10 puffs a night, usually not more than half the days of the week, but it varied. I went through maybe three periods during which I used rather heavily for 4-7 days straight. Twice I made myself stop for 5-7 days because I got a little scared, and I could tell my tolerance was rising rapidly. The first time I bought 3 bags, the second time I bought 10 bags. So I have used 13 bags total in 3 months.

It works wonderfully for my pain (by far the best opiate for my back pain) and it has almost no side effects for me; and while I wouldn't say I *quite* enjoy the 'high' - I don't dislike it. It is unlike all other opiates in that I almost sorta like it. Possibly this is in part an association because it helps my pain so much and is so free of side effects relative to all other opiates.

About two weeks ago I completely ran out. For various reasons I cannot obtain, but I of course saw that I was running low before I ran out and tapered my usage accordingly. 2-4 puffs of a very dilute solution every couple days for about a week or 10 days. My back pain varies significantly in severity; it can range from about a 7 (this is about the lowest it ever gets these days) to 10 on 1-10 scale, 10 being the worst. It's not always clear why my pain is worse; there isn't usually an obvious cause. Unfortunately, for the past 3-4 weeks it's been outrageously bad, 9-10 virtually all the time. Bad time to come off heroin, right?

So 12-14 days ago was the last time I used any heroin at all. A few days later, I'm so unable to deal with my pain (which is just back pain - not pain anywhere else, not any WD symptoms) and I'm so desperate I try some of my morphine in hopes that maybe I'm no longer hyperalgesic. That fails, and my pain's way worse. I do this one more time a couple days later. Yeah, I'm stupid.

A week ago was the last time I took any significant amount of morphine (both aforementioned times I took one 15 mg tablet). Last Friday I went into what based on everything I've read, and what I witnessed my late husband go through several times, seemed exactly like opiate WD. Horrible pain, just not in my back, but throughout my body. Muscle spasms that would crawl through my body, or last in a single muscle for 12+ hours on end. Nausea, the shakes, inability to maintain any sort of comfortable temperature (either chills or extreme fever), dizziness, greatly reduced coordination (I injured myself several times, not insignificantly, due to extreme clumsiness), peeing constantly and a sort of burning in my bladder (as if my urine is very concentrated, and in fact it smelled foul) and worst of all - sweating BUCKETS.

I tried taking 1/4 of a 15 mg morphine pill, which doesn't seem to have any effect one way or another. Saturday was just as bad. Sunday I tried another 1/4 tablet of morphine with no obvious improvement, once again. I had a few glasses of wine and THAT seemed to help. Monday, yesterday, I was noticeably better, and I'm still better today, though I'm sweating slightly more than normal and I still have the urinary symptom (though with much less odour), extreme pain, and most problematically, muscle spasms. Various muscles (pec, bicep, tricep) in my right upper body have been spasming for nearly 40 hours now, and I have nothing that I can take for them.

It doesn't seem possible to me that I could be in heroin withdrawal, time-wise, but I don't have a better explanation for my symptoms. I'm not sure that morphine would reduce my WD symptoms if I'm hyperalgesic to it, but I honestly have no idea.

Thoughts/ideas?

ETA: I'm currently running (7 mi 4-6 days a week) & doing yoga/pilates (1 hr 2-4 days a week). Somehow I was able to run Friday (it was dreadful), but couldn't muster the willpower Sat or Sunday, though I ran last/Monday night. Because of my fucking muscle spasms in my arms, I haven't done yoga since Thursday.

 

[pallidamors]

It sure sounds like heroin withdrawal, but I've never heard of heroin WD occurring more than about a day after use. I mean, I usually start getting sick after about 12 hours after not dosing...I cant imagine delaying it 12 days. Did you use anything that could be an opiate in the meantime that would have tided you over til the wds started?

Also I dont think 1/4 of 15 mg morphine taken orally would do much to take the edge off withdrawal. Maybe the whole thing, plugged, but not a fraction of the pill. But since youre at 40+ hours, have you started feeling better at all yet? Heroin withdrawal usually only lasts 2-3 days, sooo you should start feeling better soon. If that IS what it is and I'm not totally sure that it is withdrawal?

 

[Komatose]

12-14 days should be long enough to get through heroin WD...especially from how much you said u were doing, It usually takes me only 7-10 days but the PAWS are always there but they have no physical pain associated with them...I hope you condition gets better. Best of luck to ya. sorry if i could be of no more help..

 

[Captain.Heroin]

It sounds like you went through heroin withdrawal...but I don't know why it happened 2 weeks after not using any. That is weird.

 

[fairnymph]

It sure sounds like heroin withdrawal, but I've never heard of heroin WD occurring more than about a day after use. I mean, I usually start getting sick after about 12 hours after not dosing...I cant imagine delaying it 12 days. Did you use anything that could be an opiate in the meantime that would have tided you over til the wds started?

Also I dont think 1/4 of 15 mg morphine taken orally would do much to take the edge off withdrawal. Maybe the whole thing, plugged, but not a fraction of the pill. But since youre at 40+ hours, have you started feeling better at all yet? Heroin withdrawal usually only lasts 2-3 days, sooo you should start feeling better soon. If that IS what it is and I'm not totally sure that it is withdrawal?

That's exactly why I think it's so weird - it just doesn't seem POSSIBLE with the time frame. I am 100% positive that nothing remotely opiate-like was taken within this period other than the morphine as mentioned. I DID take some loperamide Sunday night and just now; I don't have diarrhea but I'm desperate for anything. I've also been taking psuedoephedrine once or twice a day since Saturday - it seems to sort of help with the urination, a little bit at least.

I didn't take ANYTHING other than my vitamins and ibuprofen from the time I stopped the heroin to until last Friday night. Maybe a 1-2 glasses of wine a few nights, which is normal drinking for me.

I've been feeling better since yesterday, but...I'm still sweating. I'm still peeing too much, I still can't control my body temperature, and I'm still having muscle spasms and aches. I feel less like I want to die, but still pretty miserable, and today isn't any better than yesterday - I'm just in a holding pattern.

If it's something else, I have no idea what. I actually have never plugged morphine (is that really much better?), but I'm trying to use as little as possible if I use it at all since what if that's what I'm WDing from. See my reasoning? I have not taken more than 15 mg of morphine in at least six months, so 1/4 of that still seems like it should have some effect, but I don't know how my hyperalgesia complicates things.

12-14 days should be long enough to get through heroin WD...especially from how much you said u were doing, It usually takes me only 7-10 days but the PAWS are always there but they have no physical pain associated with them...I hope you condition gets better. Best of luck to ya. sorry if i could be of no more help..

What is PAWS? And thank you, I appreciate any input, really.

It sounds like you went through heroin withdrawal...but I don't know why it happened 2 weeks after not using any. That is weird.

I'm glad you agree, if only cause it means I'm still sane.

 

[pallidamors]

Plugging morphine is more effective, but if heroin withdrawal IS what you're going through then you're already so far into it that you'd want to just ride it out and not brown-route any pills. Maybe wait another day before trying to alleviate the symptoms with any opiates, see if you feel better at all? And be sure to drink a ton of gatorade if you've been peeing alot =P

 

[fairnymph]

I drink 4-5 L of water a day (I don't like sweet drinks, but eat a little sea salt if I seem low on the electrolytes) - that's normal for me or I get dehydration headaches and my drymouth (a chronic problem for me) becomes unbearable. And forget about trying to run - I will overheat in minutes if I'm not extremely hydrated.

My inclination is also to ride it out as much as possible, but if I could taper in any way and reduce my symptoms significantly, I'd prefer to draw out my WD. I'm just afraid that since my WD is so delayed (if it is indeed WD), it won't last a normal length of time either. I have literally no idea what to expect since I clearly am not responding like any normal person.

 

[Captain.Heroin]

What is PAWS? And thank you, I appreciate any input, really.

Post-acute withdrawal syndrome.

I'm glad you agree, if only cause it means I'm still sane.

I must admit, this is a puzzler. I can't wait for other people's thoughts on this.

 

[stringtheory]

The brain and nervous system is such an enigma. No one has really come even close to figuring out how it handles pain in any kind of exact way so much of the science is a best guess scenario tied to the few things we know. My pain doc simply loves me because I have an intractable pain syndrome working that he has not seen in over 20 years as a pain specialist. It's just uncharted territory - mostly because they have condemned research on the really interesting drugs by making them schedule I.

It has been documented that LSD users have taken years to eliminate the drug from users systems because it links to other chemicals in the body and occasionally surfaces months or even years later. Although I have never heard of it happening with opiates, I suppose it would be possible to have either an opiod or opiod-like chemical stored in the body and released a bit later as whatever matrix was holding it finally dissolved or broke apart for some reason. That would account for late withdrawals.

But it could be a host of other things, many of them brought on by the body's attempt to equalize all its chemicals and neurotransmitters while being bombarded by both pain signals from back pain on one side and opiates from the other. It's all so personal, no one can really do anything but guess what might be going on. Sorry you're having such a hard time, but as others have already said, you've got to be getting close to the end of it.

 

[Captain.Heroin]

It has been documented that LSD users have taken years to eliminate the drug from users systems because it links to other chemicals in the body and occasionally surfaces months or even years later.

Let's see some links.

 

[fairnymph]

The brain and nervous system is such an enigma. No one has really come even close to figuring out how it handles pain in any kind of exact way so much of the science is a best guess scenario tied to the few things we know. My pain doc simply loves me because I have an intractable pain syndrome working that he has not seen in over 20 years as a pain specialist. It's just uncharted territory - mostly because they have condemned research on the really interesting drugs by making them schedule I.

It has been documented that LSD users have taken years to eliminate the drug from users systems because it links to other chemicals in the body and occasionally surfaces months or even years later. Although I have never heard of it happening with opiates, I suppose it would be possible to have either an opiod or opiod-like chemical stored in the body and released a bit later as whatever matrix was holding it finally dissolved or broke apart for some reason. That would account for late withdrawals.

But it could be a host of other things, many of them brought on by the body's attempt to equalize all its chemicals and neurotransmitters while being bombarded by both pain signals from back pain on one side and opiates from the other. It's all so personal, no one can really do anything but guess what might be going on. Sorry you're having such a hard time, but as others have already said, you've got to be getting close to the end of it.

I thought of some 'old stores being released' theory - especially with my exercise regime & diet (I eat 95% of my calories on alternate days, so I'm in ketosis a lot of the time)...but my weight has been stable within +/- 2 lbs for the past month. I do think I've replaced some of my fat with muscle during this period, but not crazy amounts. Not something that would explain such a dramatic time-shifted onset of WD.

I've never heard that about LSD, or opiates, but I feel like I've heard something along those lines about weed? Because it's fat soluble?

Your last paragraph is certainly true. As individual as many things are - I still like to have an explanation.

My muscles are sore today but for the first time in maybe 60 hours - NO SPASMING. Yayyyyyy. Also, Monday night and last night I slept like the dead, and I slept a LONG time. I suffer from chronic severe insomnia (unrelated to any opiate use; can't fall asleep, can't stay asleep, wake up too early) and two days in a row like this is simply unheard of for me. I've almost slept more in the past two days than I did in the prior two weeks combined! So maybe this is a good sign that things are improving? There was no way for me to gauge if any of my insomnia was due to WD since no sleep is my default, but if I'm sleeping much more now, it would make sense, right?

 

[stringtheory]

Let's see some links.

Poor choice of wording on my part. I should have said "well theorized" rather than "well documented".

Back in the 70's there was a lot of discussion whether flashbacks were caused by mental imprinting or traces or LSD making their way back into the system. Many of the the psyche people were claiming some kind of imprinting while the nutrutionist/body chemistry people were claiming that the chemical stays in the system in small amounts for a very long time.

I can't say either way, but I took LSD somewhere in the neighborhood of 160 times in the span of a couple of years, and it took a long time before my brain would function in a manner that was devoid of an LSD influence. I was told by a nutritionist of 20 years that LSD stays in your system a long time, in the same way that mercury and heavy metals can only be eliminated from the body by linking them to other molecules which will finally allow them to be freed from the body. Fasting is another way to make this happen for some substances, as it forces the body to begin to cannibalize itself including the stored and locked in chemicals. Heck, it made sense to me. I ended up fasting on simply water for weeks, and that was the end of flashbacks or LSD type experiences for me. After that last fast, they were simply gone. Feel free to draw your own conclusions, but for me it seemed not only logical but it worked.

 

[Captain.Heroin]

Poor choice of wording on my part. I should have said "well theorized" rather than "well documented".

Back in the 70's there was a lot of discussion whether flashbacks were caused by mental imprinting or traces or LSD making their way back into the system. Many of the the psyche people were claiming some kind of imprinting while the nutrutionist/body chemistry people were claiming that the chemical stays in the system in small amounts for a very long time.

I can't say either way, but I took LSD somewhere in the neighborhood of 160 times in the span of a couple of years, and it took a long time before my brain would function in a manner that was devoid of an LSD influence. I was told by a nutritionist of 20 years that LSD stays in your system a long time, in the same way that mercury and heavy metals can only be eliminated from the body by linking them to other molecules which will finally allow them to be freed from the body. Fasting is another way to make this happen for some substances, as it forces the body to begin to cannibalize itself including the stored and locked in chemicals. Heck, it made sense to me. I ended up fasting on simply water for weeks, and that was the end of flashbacks or LSD type experiences for me. After that last fast, they were simply gone. Feel free to draw your own conclusions, but for me it seemed not only logical but it worked.

That's nice hearsay and all.

LSD is actually metabolized out of your system before you're done experiencing the acute effects.

"Flashbacks" are a natural occurrence due to the associative properties of the mind. This means they can happen whether you even take psychedelics or not. I do not think flashbacks have anything to do with a drug being stored inside of you at all.

 

[stringtheory]

That's nice hearsay and all.

LSD is actually metabolized out of your system before you're done experiencing the acute effects.

"Flashbacks" are a natural occurrence due to the associative properties of the mind. This means they can happen whether you even take psychedelics or not. I do not think flashbacks have anything to do with a drug being stored inside of you at all.

Had a lot of experience with LSD have you Captain?

That is the basic problem with the understanding of the mechanism of LSD. There isn't any. Personal experiences with the drug are often very subjective and rather limited. The government has forbidden research on the drug and so people are free to conjecture their hearts out. Scientists know that wires get crossed in the brain, but they don't know but a few pieces in a giant puzzle.


Flashbacks after having taken LSD are not a natural occurrence any more than popping a tab of acid into ones mouth can be considered to be "natural". LSD flashbacks can be associative but they can also be spurred chemically.

But I don't wish to get into a discussion of LSD - just wished to suggest a possible reason for why heroin withdrawal might not start for a week or so.
I have no idea why that happened, so I just made my best guess, same as everyone else.

 

[fairnymph]

Well, I haven't had sweats or muscle spasms in two days, so I guess I'm better? Very lethargic and mentally low, however, which I'm not sure is an improvement. Physically the worst if not all of it is over, so it must have been some strange delayed WD. I didn't take any more morphine, FWIW.

I did try some low dose sublingual ketamine on Wed night, with mixed results. It helped while I was dissociated, but didn't provide any more lasting relief, so I don't think it's particularly useful for WD.

 

[phr]

Considering heroin's method of action, I find it odd that you'd react so differently to morphine... And if I'm reading right, you don't react with codeine the way you react with morphine. Odd since they're all basically morphine once they're on your receptors.


Anyway...


Due to heroin's short half-life, someone dependent on it will notice wd symptoms within 24 hours of their last dose. (Well, heroin's half-life is measured in minutes since it's a morphine pro-drug, but you get the point...). There's no getting around that unless you take more heroin or some other opiate. When you're dependent, as soon as your receptors aren't engaged enough by whatever opiate, wd's will start. If I remember correctly, the wd symptoms are caused by the opiates replacing and stopping the creation of naturally occurring endorphins. So when you stop the opiates, neither are present and you're going through withdrawal.


I guess that wasn't much help.

Oh, and you don't want to leave heroin in a solution for too long. It'll hydrolise into morphine. Bad, especially since you're insufflating. Morphines intranasal BA is horrible.

 

[fairnymph]

Considering heroin's method of action, I find it odd that you'd react so differently to morphine... And if I'm reading right, you don't react with codeine the way you react with morphine. Odd since they're all basically morphine once they're on your receptors.

Yeah, it doesn't make any sense to me, either. With codeine it's hard to know - I haven't taken more than 30 mg at a time since developing hyperalgesia, and at that only a handful of times, and it has a VERY mild effect, but nothing shitty. Maybe it's placebo or just so weak (for me at this point) that I don't get the negative effects. I suspect I have some CYP450 abnormality because even when I first started taking codeine in my teens I could take disturbingly high doses (grams) with very few side effects.

Re: heroin vs morphine - no clue why they feel SO different to me and why I don't have hyperalgesia to heroin but I do to morphine. Maybe the heroin's analgesia can overcompensate for the effect of the morphine metabolite, especially since it would kick in sooner, I'd imagine?

Due to heroin's short half-life, someone dependent on it will notice wd symptoms within 24 hours of their last dose. (Well, heroin's half-life is measured in minutes since it's a morphine pro-drug, but you get the point...). There's no getting around that unless you take more heroin or some other opiate. When you're dependent, as soon as your receptors aren't engaged enough by whatever opiate, wd's will start. If I remember correctly, the wd symptoms are caused by the opiates replacing and stopping the creation of naturally occurring endorphins. So when you stop the opiates, neither are present and you're going through withdrawal.

I've never gone through anything other than extremely mild withdrawal so soon after taking any opiate. Ever. But I've also always tapered carefully and gradually from all opiates. Again, the time thing mystifies me. It doesn't seem possible.

Oh, and you don't want to leave heroin in a solution for too long. It'll hydrolise into morphine. Bad, especially since you're insufflating. Morphines intranasal BA is horrible.

This is so obvious that I feel like I deserve to be shot. *headdesk* Yeah, better to make a more dilute solution and replenish it more frequently. I definitely had it in solution for weeks (or longer) at a time, and sometimes I'd just add more to it. I wonder if that actually contributed to rapid 'tolerance'; maybe it was not so much tolerance (it seemed SO rapid) as the heroin hydrolysing. Arghhh I am retarded. Thank you for the reminder!

 

[Johnny blue]

Well whatever it was it sounds like you're done with it. If it was WD and you're sleeping like that then rest assured that its over.

 

[joeschmoe]

i dont understand how morphine could cause pain while smack would alleviate it... theyre both essentially the same after crossing the bbb, no?

 

[fairnymph]

I'd guess it's the action of heroin's metabolite, 6-monoacetylmorphine, and that this action outweighs any negative effects of the morphine also produced.

Anyone have *any* idea what kind of bullet would be best used to administer tiny doses of powder? I can't find good information and I'm not confident that any bullet/snuff rocket would deliver a small enough dose for my purposes, but I'd like to avoid hydrolysis in the future...