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Opioids Opiates effect on immune system?

hey it's cool. i like to see mature conversation and people digging for evidence while taking into account every possibility. keeping an open mind.

i think back to the debates (debate is a light word) about loperamide binding affinity, the blood brain barrier, and people screaming and yelling back and forth between opinions. doesn't really get anyone anywhere. it's about hard evidence, repeated studies, and an open mind.

regardless, i look at the info and i don't have an opinion either way about getting sick or not and opiates. sure there is plenty of evidence saying corticotropin is inhibited while plenty also says it's exacerbated. some areas of the body react this way, some react that way. this opioid does this, that opiate does that and this, with some of that there and a little of this here. not only that, but if it is inhibited, does it have the same effect when its inhibited by x compound compared to y compound, under these conditions or those conditions.

i dont think the answer to this question is really something that can be achieved easily, if at all.

obviously things like this are very hard to measure and quantify. the closest way to prove something like this would have to be identical twins that have lived and experienced the exact same microbes, then introduce opiates to one and the same microbe to each individual. this is just not going to happen and there are still factors that are going to change the outcome which cannot be measured and/or controlled. the study would also have to be repeated many times and you would need 'fresh' and literally identical twins each time.

what i do know is that there are quite a few studies of compounds from morphine to loperamide that suggest (mostly) an inhibition of corticotropin. with that being said, when corticotropin serum level is decreased, stress response is reduced and the immune system fires up. but that is normally. this may not be the same when it's induced by opiates. in fact, it probably is not the same. there are a lot of other hormones affected by opioids. there is a lot going on in the body and it's just too much to find out the answer to the general question "is my immune system better or not now that i took morphine", for instance.
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114769/

http://www.ncbi.nlm.nih.gov/pubmed/1301643

I think looking at one hormone that is known to be an immunosupressant doesn't quite give an accurate picture. Opiate withdrawal dramatically increases noradregenic tone which would increase sickness susceptibility. Opiate WD and long term sobriety are two separate things. It's probably better to look at more accurate portrayals of immune system function. The evidence seems fairly overwhelming that opiates cause immunosuppresion despite a decrease in cortisol. I maintain that analgesia, cough suppression , modulating effects on digestive function, temperature regulation and control, and euphoria are the main reason people feel that opiates reduce the incidence of illness. I would eagerly accept contrary evidence if someone presented a study that directly measures immune system parameters.
 
ferinox:
looking specifically at apoptosis (your second link) doesnt give us an accurate picture either.

"thereby activating the neuroendocrine system with a subsequent increase in serum glucocorticoid levels"
this is controversial as seen by many studies

"...sympathetic nervous system, via which opioid-induced activation could result in noradrenergic inhibition of the immune system"
activation of sympathetic activity by ANY compound could result in noradrenergic inhibition. this is also very controversial with opioids.

that first article presumes opioids are putting HIV carriers at a higher risk to AIDS. im sure they didnt account for lifestyle and behaviours. if youre in the slums IVing drugs your lifestyle is putting you at risk for HIV/AIDS and many other problems.

like i said, this is just not going to be answered easily if at all and there will be tons of research going back and forth seemingly forever...
 
i noticed a significant decline in my immune system during heroin use, and it's still weaker than it used to be. it literally went from my feeling proud of never getting colds, to feeling like they would kill me.
 
I think that regardless of what the exact scientific understanding is at this point, it is clear just by looking at the reports of users that there is something to the claim. Even if opiate use is merely disguising the effects, if someone doesn't feel sick, can they really be considered sick? Another thing to think about is that when someone quits opiates, they are pretty much guaranteed to be sick. The feeling of withdrawal is so much like the feeling of sickness, I can't see how the underlying processes aren't similar.
 
http://www.ncbi.nlm.nih.gov/pubmed/9610671

Here's an abstract describing the vast amounts of literature on opioid induced immune system dysfunction. I wish I had access to the literature. It's seems to be scientifically accepted that they suppress the immune system but if you examine the evidence linking saturated fats to heart disease, it's tenuous at best. There was the 22 country study which was cherry picked to 7 countries to vilify saturated fats. Ancel Keys of that study later went on to become a member on the American Heart Association board. Guess what happened then, The AHA changed their warning about SFs from limited to being very devastating to heart health. Considering his pioneering role in dietary effects on disease, It just goes to show you how a pre-existing assumption can modify an entire realm of studies. Now years and years and years later, their role in heart disease is a highly debated topic. It's very hard for me to find a study or find a review on opiods that doesn't start out with, overwhelming evidence suggests......

I'll take the studies on immune function with a grain of salt. A myriad of factors can effect the immune system in addicts including perpetually shifting supply of exogenous chemicals, unhealthy diet, IV use increasing infectious disease susceptibility, comorbidities, smoking, and I'm sure anyone can throw in a huge amount of other unhealthy addict specific behaviors. I don't usually care too much about in vitro studies. In vivo, I see studies mentioning transient decreases in immunity with tolerance to that specific effect. Transient once again doesn't mean much. Studying chronic human users of opiates would probably have to be done on pain patients with comorbidities confounding the results or maintenance patients which has the aforementioned issues regarding addicts and the unique natures of buprenorphine and methadone. They're not going to study chronic opioid use on a healthy human not already using an opiate. There's a possibility that chronic use induces compensatory mechanisms that actually increase immune response opposite transient decreases similar to tolerance withdrawals with benzos.

There's a certain amount of bias that's sure to be present when studying an addictive drug. I just gave a cursory glance at the first few pages that popped up on pubmed. Personally I'm biased as well too bc I get sick on sub maintenance just as much if not more than I did in my pre-opiate days. I never IVd, did CWEs, and ate a healthy diet even when I was using non maintenance opioids regularly. I would be pleased if data did come up that showed no decrease in immune function. For now, this post is filled with a lot of speculation. I'm still going to lean towards immunosuppressive effects but I could be wrong. When i was taking opiates and I was sick, after my dose, the extreme sense of well being was not even slightly diminished which is why I tend to believe it merely masks the symptoms quite effectively. For all I know, Immune system reaches complete homeostasis after a period of time at a stable dose. Stable dose is just another variable.

My point is the transcendental well being induced by opiates and the similarity of wd to illness makes it hard for me to believe anecdotal reports. The only way I can truly be satisfied is to see studies examining in depth immune system function markers. These studies all seem to assume compromised immune function. I would love to see contradictory studies examining the immune system and opiates. I hold a viewpoint and the foundation of that viewpoint isn't set in stone. It would be nice if someone with access to a wider range of data could chime in. Pubmed has it's limitations.
 
Not only is there a great sense of well-being induced by opiates, there are also antitussive and analgesic effects. I think we may be looking at the wrong thing by looking at immune system response. The bulk of what we're describing could still fall predominantly under CNS/PNS effects, which of course impress upon the immune system.
 
Like I said before, I never got a cold or anything all those years I was on buprenorphine, but now that I've been off of it for a while, I just caught my first cold in ages. Just a little data for those researching this.

I guess one could argue you don't notice when you get sick while on opioids and I suppose that's possible, but right now I could be heavily intoxicated on any opiate you could throw at me and I'd still notice how sick i am right now.
 
this cannot be determined nor quanitified without a LONG and EXTENSIVE investigation. maybe in another 20 years.

there are WAY too many factors involved when attempting to find a definite answer with something so broad and complicated such as an individuals immune system and the wide spectrum of opioids. no bump.
 
Hiya....Ive been using opiates for many many years and cant remember the last time i was sick...I work in a school full of germs and grotty, snotty kids so maybe i have a great immune!!! Excellent thread too.....
 
Good thread.

I've been on opiates on and off for about the last 5 years and I didn't catch the cold at all in that time, if I did, I didn't notice. In fact, the only time I ever recall begin sick while on opiates was a really bad "stomach flu" that was going around at the time. Even then, everyone else was out of it for days, while I just had one bad day of throwing up everything I'd eaten the night before and begin restricted mostly to the bathroom and bed.

I rarely got sick before I started using opiates anyway. Like others, I've noticed that I hardly ever feel sick when using them (and if I do, its nothing a little extra oxycodone wouldn't fix ;)) but when I kicked I would catch colds and was more likely to get sick.

There is defiantly something to this, and honestly, I hadn't even thought about it til I saw this thread. I'll ask some other people I know and report back.
 
I also have wondered this exact same thing for soooo long! It has been years since I have gotten any kind of cold, and I have been using heroin and more recently suboxone for almost 5 years now. Its true, dope is the cure for anything. Even suboxone makes me feel better in a lot of situation, if I don't get a lot of sleep and I'm feeling pretty worn out my suboxone will make me feel 150% better.

btw I am on Suboxone maintenance, 2 8mg Films a day.
 
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