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Opioids The Development of Opiate Tolerance

S

sola

Greenlighter
Joined
Nov 12, 2012
Messages
41
I've tried searching for an answer to this question, but I haven't had any luck.

If someone is taking opiates twice weekly, and he or she notices that tolerance is beginning to develop, does this mean tolerance will continue to become higher and higher? Or will it get to a certain point and plateau?

Basically, is it kind of like a curve? If someone needs 50mg of morphine for pain management, and they are limiting themselves to using it twice per week, will 50mg turn into 60, to 70, to 80, to 200, to 300, to a gram etc. etc.?

Or it more likely that 50mg will turn into 60, to 65, to 68, and plateau around 70? These are obviously fictitious numbers, but I think they display my point.

I hope you guys get what I'm trying to say. I'm sure there's a more scientific way to ask this question, but I can't articulate it very well. I'm basically wondering if using opiates twice weekly will eventually (in the long term) will lead to someone needing like 300mg of morphine to feel any of the good effects.

I'm trying to understand the mechanism of tolerance. Is it true that if it climbs a little, it will climb a lot over the long term? Or is it possible it may just climb a little and then stay at a plateau?

TL;DR
Is a twice weekly opiate habit sustainable without a significant increase in tolerance, or will tolerance climb indefinitely?
 
No. There is no "limit" to how high your tolerance can go. Peoples habits can get enormous. The only thing that stops that from happening for most is lack of drugs.. but with a constant supply, you'd be surprised just how much the body can handle. I've personally had habits as large as 5 bundles a day of good NYC dope when money isn't an issue, know people whose oxy tolerance skyrockets to the point where they need hundreds of milligrams per dose multiple times a day, etc.

So, the point is that if you keep using, your tolerance will continue to go up until you stop. Obviously, the more often you use, the quicker it goes up.

But even for your situation using twice weekly, it will continue to rise, albeit slowly because you're not using often at all.
 
Thank you for your response.

I'm a little confused though: does this mean that if a user uses twice a week, eventually he might need 20 grams of morphine to feel anything? I know this is a ridiculous example, but I think through using reducto ad absurdum we can see that it can't possibly work like that (I doubt there's anyone who could handle 20 grams of morphine, so there has to be a maximum somewhere, right?

But more importantly, do you know if it's a curve or if it's a static increase? I know that tolerance can get very high, but do you really think someone could get to the point where they need 2 grams of dope from only using twice weekly? It just doesn't seem accurate, but maybe I'm wrong.

Not trying to disagree -- I know I'm the one asking the question here so obviously I don't understand the mechanism, but it just doesn't logically make sense that tolerance could go up FOREVER.

There's also a point where tolerance would increase negligibly, but I'm curious as to where that point is. For example, if someone used once a month, I highly doubt they would see any substantial increase in tolerance at all. So I don't think it's as simple as saying that tolerance will rise indefinitely at a steady rate;intuitively, it seems there has to be some type of curve with regard to tolerance.

Does anyone know of any studies that show the progression of tolerance if the frequency is the same?
 
When the Swiss government began allowing maintanence of heroin users, they were able to collect reliable data about exactly how much heroin was being used. The Swiss found that users offered unlimited quantities would, on average, max out at between 300 and 500 mg. of diacetylmorphine per day. One author writes "I've known people prescribed a full gram per day, but they were quite unusual, and such habits on the street are impossible except for relatively high level dealers. Remember, I'm talking about pure pharmaceutical or number 4 if on the street. There are certainly cases of pain patients receiving larger equivalent dosages of opioids, but I've never heard of one of these beating a 1000/1 ratio.

taken from the erowid heroin dosage page :)
 
There is usually no limit. As a nurse while working with hospice (terminally ill) patients I have seen doses of morphone and fentanyl get unbelievably high over a period of time. Docotors are willing to not put limits on hospice patients dosages and will give them as much as they need so that they do not suffer. Since there is a legal, easily available unlimited supply and increases in dosages as it is needed it can climb very, very high. There have been nurses that would freak and balk at giving the dosages because they were off the charts (these nurses didn't have much experience or understanding of end of life care...and end of life can be up to a year or so). These dosages were of course built up over some amount of time but not always a very long period of time when you are talking about treating very severe pain such as bone cancer etc. The only issue is you tend to get more side effects with higher dosages. Some side effects tend to become more tolerated as the tolerance for the meds grows..for example the higher tolerance you have, 900mg of morphine will cause drowsiness in correlation with your tolerance to the drug. But some side effects such as constipation does not becomer more "tolerant". You will continue to get more and more constipation as the dosages increase.

Of course this is much different than taking something twice a week. Your tolerance will grow but it will be very slow and is different for everyone.
 
So would a twice-weekly dope user really end up in the 300mg-500mg range eventually?
 
Tolerance goes up exponentially. I used to use opiates hardcore, now if i want to get high on occasion with absolutely no tolerance, my dosage is 30mg oxycodone IV. That's basically a permanent tolerance, and with consecutive use this would go up extremely fast, I'd be shooting 90mg within a few days. There is no ceiling to this.
 
sola said:
So would a twice-weekly dope user really end up in the 300mg-500mg range eventually?
Click to expand...

I'm going to go out on a limb here and say that although it is a hypothetical question, it is kind of irrelevant. I would say it is damn near impossible (read: impossible) to have used dope enough for your tolerance to be that high while continuing to only use twice a week. It would take the most determined and self-disciplined person in the world to not have their frequency of use correlate to the rising tolerance in a scenario where that much dope is being used.
 
I've heard of people doing some crazy amounts of opiates, such as 300mg oxycodone a day or over a gram of heroin daily. Opiate tolerances can get out of hand, there is no plateau.
 
missmeyet? said:
Wow..is 300mg of oxy a day considered ridiculously high? I've known many people use that much and much more on a regular basis.
Click to expand...

To some people it might seem high. But I know people who do that much in a single dose multiple times a day. Ask Mrflowers00, a member here on BL, how much oxy and dilaudid he has to shoot now to get high. It's insane.

A gram of H isn't much either honestly. I've had habits personally of more than triple that.
 
Yeah, 10-20mg oxy is the starting dose so I would venture to speculate that 300mg + is approaching the heaviest side of use. I don't know how so many people can maintain such an expensive habit, that's what heroin is for.
 
sola said:
I've tried searching for an answer to this question, but I haven't had any luck.

If someone is taking opiates twice weekly, and he or she notices that tolerance is beginning to develop, does this mean tolerance will continue to become higher and higher? Or will it get to a certain point and plateau?

Basically, is it kind of like a curve? If someone needs 50mg of morphine for pain management, and they are limiting themselves to using it twice per week, will 50mg turn into 60, to 70, to 80, to 200, to 300, to a gram etc. etc.?

Or it more likely that 50mg will turn into 60, to 65, to 68, and plateau around 70? These are obviously fictitious numbers, but I think they display my point.

I hope you guys get what I'm trying to say. I'm sure there's a more scientific way to ask this question, but I can't articulate it very well. I'm basically wondering if using opiates twice weekly will eventually (in the long term) will lead to someone needing like 300mg of morphine to feel any of the good effects.

I'm trying to understand the mechanism of tolerance. Is it true that if it climbs a little, it will climb a lot over the long term? Or is it possible it may just climb a little and then stay at a plateau?

TL;DR
Is a twice weekly opiate habit sustainable without a significant increase in tolerance, or will tolerance climb indefinitely?
Click to expand...

There is no plateau, it can get to the point where you can't tell the real pill from placebo.
 
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