Mu vs Delta Agonists?

[Sentience]

I am a chronic pain sufferer who was blessed with not 1 but 2 auto-immune conditions (they are all related). One of these conditions is Crohns which lately has been causing extra-intestinal inflammation affecting the gallbladder and pancreas. The pain is pretty much constant and I need to be on opiates around the clock.
On thing I have noticed is that the medication never seems to completely take all of the pain away and I am wondering if some of the pain is neurological.

Does anyone have a list of what pain medications also act on the Delta-opoid receptors? These would be more appropriate for combating a wider variety of pain. I believe that Methadone acts on both, which might explain why the withdrawals are comparably worse.

 

[Swerlz]

Not many work directly on the DOR. Activation of delta receptors produces some analgesia, although less than that of mu-opioid agonists. Many delta agonists may also cause seizures at high doses, although not all delta agonists produce this effect.

 

[Sentience]

Does Methadone cause seizures?

Im wondering if there are any herbal remedies that I could mix with my regimen that work on the delta receptors.

 

[Swerlz]

I know Methadone has affinity to mu and NMDA receptors, but i dont know about delta.

Why do you want delta anyway? Mu is where its at regarding pain issues.

 

[Sentience]

Mu is worthless for neurological pain, or nearly so. Delta is where its at for neurological pain. Mu is for flesh and bone pain.

 

[theWorldWithin]

I believe that opium tincture is generally recognized as the best for chrons disease because it is the most effective in reducing bile motility and inflammation while having strong pain control. Maybe your doctor can consider not being a tight ass coward and actually prescribing something that has been proven effective.

 

[Swerlz]

have you considered Lyrica or Gabapenatin? My grandmother takes it for neuropathic pain and it does wonders for her

 

[Sentience]

I believe that opium tincture is generally recognized as the best for chrons disease because it is the most effective in reducing bile motility and inflammation while having strong pain control. Maybe your doctor can consider not being a tight ass coward and actually prescribing something that has been proven effective.

The thing with that is that on top of Crohns pain I also have 'biliary dyskenesis', which basically means my gallbladder is sluggish and not secreting enough bile. They wanted to remove the gallbladder but we decided against it because it would increase the pain associated with Crohns. Its really depressing because we are running out of options and I am approaching month 5 of chronic pain.

Trying one of the delta agaonists is more of an expirment than anything else. If it helps the pain more than a purely Mu agonist then the pain must be partially neurological.


I have not tried Lyrica Gabapenatin. Im not sure they would prescribe it either since there is little evidence of neurological pain. Its just a hunch. I might however be able to get them to prescribe an opiate with delta affinity since it would definitely treat the condition they know I have as well as help me test my theory.

 

[Hammilton]

Opiates are probably one of the most effective drugs for neurological pain. There are definitely better drugs, like NMDA antagonists (which is why methadone is favored) but to say that opiates aren't good for neurological pain is plain stupid.

Any centrally active analgesic will be effective at treating neurological pain, though some are better than others.

I know that delta receptors are expressed more highly in inflamed tissue, but they aren't much for analgesics.

 

[N0 W4RN1NG]

Does Methadone cause seizures?

Im wondering if there are any herbal remedies that I could mix with my regimen that work on the delta receptors.

Well, it's a little impractical, but Kratom's MOA is almost entirely via the delta receptor, IIRC.

 

[daddysgone]

Well, it's a little impractical, but Kratom's MOA is almost entirely via the delta receptor, IIRC.

That is not correct.
Delta is involved, but it is certainly not entirely, or even primarily responsible for kratom's effects.
Mu activation is responsible for the lion's share of kratom's effects. It is true though that several kratom alkaloids activate delta.-DG

 

[onmyway]

So your chrohn's is totally intractable? Have you exhausted all the options as far as managing the inflammation? Immunomodulators/Steroids/ Diet?

Could somebody school me on the difference between neurological and non-neurological pain? It seems like all pain is neurological in nature.

 

[Sentience]

There are still 2 drug therapies I can try, Imuran and Tysabri. The trick is finding something that can work for both conditions. I might have an additional yet unidentified condition that is systemic or another condition which is mimicking my current diagnosis. This confusion is making treatment a lot more complicated. I should get to the bottom of it by January.

Another point of confusion is whether I have stones or not. They dont know if my pain will get better from removing the gallbladder (but we do know it will make the other Crohns symptoms worse). If we could find a stone that the ultrasound missed, then we would have something to work with. As it stands now it appears to be auto-immune, the pain of gallstones and pancreatitis but with no stones and none of the common treatable causes of pancreatitis. Whats worse, I didnt respond to steroids.

Now with the mass in my thryoid I am officially having a rough time, and SSI still wants to deny be benefits.