Misc Why are benzo/alcohol WDs potentially fatal, whereas opiate WD is not?

[Free_Man**]

But i agree with everybody about the death from benzo w/ds from having more receptors made during gaba agonist abuse and then when cut off theres not enough natural gaba to fill the extra receptors.. causing seizures and sometimes death.

fixed hood my man

 

[Sweet P]

It's the seizures. When I went cold turkey from 4mg of clonazepam a day, I fell unconscious and went into violent convulsions. I even stopped breathing and started turning blue. If the paramedics hadn't arrived in time, I wouldn't be typing this now.

 

[Captain.Heroin]

"Fits" are not seizures. Opiate withdrawal causes RLS (restless leg syndrome) and the "fits" (a slang term) are the jerking caused by that, as well as the inability to stay still due to the various pains (joints and muscles) and the sensation of your muscles burning/skin crawling. It has nothing to do with seizures or convulsions and are not fatal.

Or do you mean "fits" caused by using heroin? During an overdose, it is possible to seize, but overdose and withdrawal are two completely different things, and if that's what you're talking about, it has nothing to do with what we are talking about. I think everyone knows that a heroin overdose can be fatal, even if you don't seize.

I think you can seize during heroin WD if it gets bad enough, I remember watching a video of a heroin addict coming off of it, they handcuffed themselves to a bed. They got on the floor and started shaking a lot.

Also when I went into Suboxone intake one of the questions they asked me is if I experienced blackout or seizures, the only 2 things I got to say "no" to in the grand scheme of all of those lovely, but horrible opiate WD symptoms.

Seizing during heroin WD is pretty rare though, you must have used quite a lot to have gotten close to such a thing, or you would have to been both a benzo and heroin user to get there. Some heroin that's come up on the DEA microgram has contained benzos...so it's hard to say if that's the reason or not.

I would definitely say seizure is not the "tyipcal" opiate WD experience but then again we all take it to different degrees. As you said it is possible, but extremely unlikely.

It's the seizures. When I went cold turkey from 4mg of clonazepam a day, I fell unconscious and went into violent convulsions. I even stopped breathing and started turning blue. If the paramedics hadn't arrived in time, I wouldn't be typing this now.

I'm sorry to hear about that, and am glad you are still with us!

I'll make sure to slowly taper off benzos if I ever get a higher quantity prescription of them. %)

 

[synchrojet]

While it likely was dehydration or electrolyte imbalance that killed my cellie, one cannot logically follow with "...and therefore it was not the actual withdrawals..." To do so would be analogous to proposing that actual AIDS doesn't kill, but rather the severe pneumonia or muscle wasting, what have you.

The fact is, during the zenith of a true high dose opioid withdrawal, dehydration and electrolyte imbalance are unavoidable, period. True, those two symptoms (arguably the most dangerous) can be ameliorated to a certain degree by constant care and supervision from medical staff qualified to administer said treatment, but the reality is that vomiting and excreting at the rate attained by some people (like me, for example) simply makes it physically impossible to maintain hydration and electrolyte balance, regardless of treatment. The body simply will not accept anything orally, and there is a greatly increased difficulty/decreased practicality of intravenous maintenance - not to mention that in jail such an option doesn't exist to begin with.

It's my opinion that the gross over-scrutiny and subdivision of so called "cause of death" is the exact problem when trying to convince your typical doctor that these WDs can kill. After all, the symptoms listed are directly caused by the cessation of narcotic intake, much like landing at terminal speed on a concrete surface could be a direct result of jumping from a tall building.

It's not the fall that kills, it's the landing? The car accident wasn't fatal, cause of death was severe blood loss and secondary damage from blunt force trauma?

By that logic, one can propose that benzo and alcohol withdrawals aren't fatal, but the seizures that occasionally appear in a withdrawing person do sometimes kill. Of course this is absurd.

Fortunately, doctors are more and more publicly acknowledging that severe opioid withdrawals can be fatal - in and of themselves. There is no pre-existing medical vulnerability required. Severe enough withdrawal can do the trick all by itself.

Sorry for belaboring the point, but the sight of the guy in jail with his arms crossed over his face, expression still twisted in obvious pain, fists clenched, shit stains all over the sheets, other unrecognizable fluids everywhere...this coupled with the recollection of how his whimpering just sorta faded out the night before and me thinking, "...thank God he finally fell asleep and shut the fuck up..." drove the point home to me forever.

 

[DrugOmen]

While it likely was dehydration or electrolyte imbalance that killed my cellie, one cannot logically follow with "...and therefore it was not the actual withdrawals..." To do so would be analogous to proposing that actual AIDS doesn't kill, but rather the severe pneumonia or muscle wasting, what have you.

The fact is, during the zenith of a true high dose opioid withdrawal, dehydration and electrolyte imbalance are unavoidable, period. True, those two symptoms (arguably the most dangerous) can be ameliorated to a certain degree by constant care and supervision from medical staff qualified to administer said treatment, but the reality is that vomiting and excreting at the rate attained by some people (like me, for example) simply makes it physically impossible to maintain hydration and electrolyte balance, regardless of treatment. The body simply will not accept anything orally, and there is a greatly increased difficulty/decreased practicality of intravenous maintenance - not to mention that in jail such an option doesn't exist to begin with.

It's my opinion that the gross over-scrutiny and subdivision of so called "cause of death" is the exact problem when trying to convince your typical doctor that these WDs can kill. After all, the symptoms listed are directly caused by the cessation of narcotic intake, much like landing at terminal speed on a concrete surface could be a direct result of jumping from a tall building.

It's not the fall that kills, it's the landing? The car accident wasn't fatal, cause of death was severe blood loss and secondary damage from blunt force trauma?

By that logic, one can propose that benzo and alcohol withdrawals aren't fatal, but the seizures that occasionally appear in a withdrawing person do sometimes kill. Of course this is absurd.

Fortunately, doctors are more and more publicly acknowledging that severe opioid withdrawals can be fatal - in and of themselves. There is no pre-existing medical vulnerability required. Severe enough withdrawal can do the trick all by itself.

Sorry for belaboring the point, but the sight of the guy in jail with his arms crossed over his face, expression still twisted in obvious pain, fists clenched, shit stains all over the sheets, other unrecognizable fluids everywhere...this coupled with the recollection of how his whimpering just sorta faded out the night before and me thinking, "...thank God he finally fell asleep and shut the fuck up..." drove the point home to me forever.

I agree 100% and i think more people should take dehydration into consideration.

 

[OntarioGuy]

My friend was in severe IV oxy w/d,in jail.they took him to the hospital where he tried to escape and was tasered.He died.another girl I know tried to detox and simply vomited until she ruptured her asauphogus(sp?)which killed her.I attended the funerals of both of them.like other posters have said its not typically the w/d,but a pre-existing health problem made worse by the opiate w/d...I have a colostomy which makes me have loose stool,my doctors won't make me CT because of the intense diarrhea,and therefore dehydration that would occur,and possibly could be fatal.again not the w/d but my health that would cause the problems.and being a native canadian,I've seen several people from my home community(reservation)die from alcohol withdrawal,since alcohol has always been a problem in many native communities.

 

[Cane2theLeft]

I respect the losses people in this thread have suffered, but its a misnomer to blame the opioid withdrawal.

If there are pre-existing health conditions or exigent circumstances, a *cold* can be fatal and probably kills more people annually but you aren't going to hear people use cold and cancer in the same breath.

To whomever claimed that opioid withdrawal has a 5% mortality rate, that's just ludicrous. Benzos which can be fatal aren't even close to this. I've read about 1 case of fatal benzo withdrawal and the patient was consuming something like 50-80mg of alprazolam per day. Although fatality is possible, in medical literature its still quite rare.

Alcohol withdrawal fatality is far more common largely due to the length and severity of many alcohol addictions.

Lastly, I just want to say how fucking immoral it is to subject people in jail withdrawing from nearly anything to endure it cold turkey. I think in the US this should be considered a violation of the 8th amendment.

 

[OntarioGuy]

I believe my cousin told me the jail doctors were giving tramadol to opiate addicts to help ease the symptoms.this is in northwestern Ontario Canada.he went in with an oxy habit and I think he got 5 mg's of diazepam and 37.5 mg's of tramadol twice a day,not much but better then CT.I think that its a lot more humane and not as cruel as a jail cell kick

 

[Levvytation]

Good thread.

Someone mentioned how the brain grows more receptors in order to try and adapt to what is an 'abnormal' substance constantly being administered to it.

The classic example of this is nicotine which is actually a poison that the tobacco plant produces to protect itself from being eaten by animals/insects.

But, by unfortunate chance, it happens to have the ability to mimic the acetylcholine receptors in humans, resulting in a dopamine release causing a pleasurable feeling in the user. Because nicotine is so toxic, the brain rapidly grows new receptors in order to try & disperse it, far faster than it does with other substances.

This is why nicotine is so addictive, & why addiction develops so quickly. Nicotine withdrawal is of course not life threatening, just unpleasent, and the cravings last for a long time....basically as long as it takes for those new receptors to become 'dormant'....they never actually die. Hence a long-term ex smoker is on 'lifetime probation'....re-introducing nicotine will quickly re-activate the receptors, & the ex-smoker is back to full addiction.

Which suggests that opiates must be in some way toxic as it (I think) works on the same principle in the same part of the brain...so are long-term ex opiate addicts on 'lifetime probation' in a similar way to ex smokers?

And why do other drugs not work on the brain in a similar way (cannabis for example)?

Its my belief that if science can find a way to *control* receptor growth, then we will have taken a HUGE step towards dealing with tolerance/dependance.
problems...its the root of the cause.

 

[JASS92]

The receptors die off because they are not being used, yes. Your body returns to it's normal state over time because it only produces the amount of whatever neurotransmitter is needed which is dictated by body chemistry, and since that is less than what is needed to fill all the new receptor sites that have sprung up during the period you were using drugs, those extra receptors die off.

The withdrawal effect causes seizures because there is no longer enough neurotransmitter to fill all the receptors which would prevent the seizure. Since there isn't enough, not all the receptors are being activated, thus normal functioning of the receptors is not taking place, resulting in abnormal/adverse side effects (i.e. seizures). The risk of seizure is there until all the extra receptors disappear, but the risk diminishes over time as they gradually die off and the body returns to stasis.

From what you've written, you do seem to understand it. I just explained it in different words just in case.

this is completely wrong. receptors do not "die off". Where would you even get off saying something like this? Do you have some substantiated reference? No, of course you don't. And the reason you don't is this:

Receptors are recycled. When the lipid membrane has an excess of receptors, a vesicle will pinch off with the receptor integrated inside. This is the manner by which your body stores receptors, so that if necessary, the vesicle can reintegrate with the lipid membrane and dock the receptor in it.

 

[jamesBrown]

I believe my cousin told me the jail doctors were giving tramadol to opiate addicts to help ease the symptoms.this is in northwestern Ontario Canada.he went in with an oxy habit and I think he got 5 mg's of diazepam and 37.5 mg's of tramadol twice a day,not much but better then CT.I think that its a lot more humane and not as cruel as a jail cell kick

That sounds like a walk in the park compared to what I had to endure when I went to jail.

I went in while I was just beginning to withdraw from IV'ing $200 worth of black tar heroin every day for several years. You cant imagine the pain from those withdrawals. The experience was more intense than the most potent acid trip I have ever had. Not to say I was hallucinating(atleast not in the good sense of the word), it was just soooo overwhelming. I literally wanted to die. I even asked a cellmate to punch me in the face a few times to release endorphins.

I ended up curled up in the fetile postion for days without eating.....all I could do was grimace and scream for help. Guess what they gave me?....

...high dose ibuprofen. 800 mg's I think. I spit it in there face....

...then promptly fell back to the floor and started crying. I had been promised methadone by the stupid ignorant lying bastard bitch jail nurse. Turns out they only had the methadone delivered once a month and the next shipment wasn't for another 2 and a half weeks. Sounded like some bullshit to me.

Anyway, after 3 days of an experience i could only imagine was several times worse than hell....I got bailed out somehow and promptly went to a suboxone clinic. And never looked back.....

To me....heroin is the devil. Atleast thats how I view it now after that experience. I also don't have many kind words for the staff of jail I was in.