Why are nearly all downer physically addictive but no uppers are?

[Berdo tm1]

Wanted to repost it here because I only got juvenile answers over at BDD so thought I might get some more intelligent discussion over here.
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I don't get it. Even the 'weakest' downer drugs like phenibut are physically addictive but even the strongest uppers like meth and crack aren't.

Is it just cos you burn out your neurotransmitters with uppers long before you would get serious physical side effects? Surely crackheads take their stuff every day and many with ADD take their prescription everyday.

What gives?

 

[cg9256]

A friend of mine who i work with every day takes 70mg of add meds every day. But sometimes he runs out early due to selling them to me or other people. And he definately shows physical symptoms when he doesnt have any. They include extreme sluggishness and he says his body aches when doing our everyday tasks. I imagine these symptoms are on a whole other level with crackheads and heavy meth users. There definately are some signs of physical addiction.

 

[miguelsanders]

I think it's because how opiates are involved in the perception of pain so disrupting the system will cause you a lot of pain. Dopamine and norepinephrine are just motivational and learning chemicals that so they don't cause massive pain and withdrawl when you disrupthem

 

[AlphaMethylPhenyl]

I felt physical pain throughout my body when I went twelve days without my 40mg vyvanse. The second (and last) time I got off of it I didn't notice much of anything.

 

[sekio]

I think it's because drugs that reduce neuronal activity/excitement (GABAergics, opioids) are more disruptive to the natural baseline, that is to say they make your brain more electrically active rather than less when you withdraw, and thereby promote more nasty shit like seizures and anxiety over just general malaise.

 

[BallsStapledToLeg]

There are a couple reasons, I'll try to cover the main ones short form:

1) Most traditional downers target the GABA-A receptor, we'll ignore the non-CNS ones now. In the brain GABA-A is one of the main inhibitory neurotransmitters, and has an important role in preventing over-excitation of neurons. If the balance of excitation-inhibition shifts too far to the excitation side you'll end up with seizures, that's what kills you.

2) Stimulants mainly effect dopamine and noradrenalin, these transmitters are involved in all kinds of things but can be massively reduced without many life threatening issues. You might end up with hypotension, drowsiness, and rebound symptoms like hypersalivation coming off stims long term but there are very few acute withdrawal symptoms that can kill you. Now you may be thinking, what about heart rate? There has to be some kind of decrease in that! Well for the most part heart rate is controlled by an acetylcholine mediated process through the vagal nerve (cranial nerve 10). You may see a reduction in the force of the heart's contractions due to a reduction in beta-adrenoceptor activation, but that will likely just reduce someone's cardio for a bit.

 

[Berdo tm1]

ok you guys are implying that physically addictive means its life threatening if you stop?

Is the only distinction between physically addictive and not that it will kill you when you stop abruptly, and/or causes a more lengthened and severe malaise then non physically addictive substances?

Isn't it a false dichotomy between physically addictive and non physically addictive? Isnt it just more accurate to think of it of a sliding scale that you are definitely gonna feel like shit if you overdo ANY drug tho some will cause more severe and lasting effects upon cessation than others.

Mr Balls, sir ballsy, if I may address you as such , isn't it rather a contradiction though that the negative (as well as the postive) effects of uppers vs downers are inverted. Ie that even one night of use of stims, without a downer to help you land you're gonna feel like utter dogshit and crawling up the walls though they have less long lasting effects. On the other hand with downers if you take them for just a night or two the next day you feel just fine cos there isnt a crash, simply cos you didnt go up, so maybe a bit groggy but not the mental blitzkrieg (if you overdo it a little you just drift into a deep sleep) that stims cause. Tho for downers the negatives are more insidious since maybe cos there isnt that immediate slap you are more apt to take them on a regular basis and thus attain some physical dependancy.

So in that sense I say it is somewhat the opposite of what you say about disrupting in the short term at least in that downers are less likely to fuck with circadian rythms/appetite and general daily routine.

 

[Xorkoth]

BallsStapledToLeg... I vote for you as the winner of the most hilarious new username I've seen in quite a while. :D

 

[WSH]

ok you guys are implying that physically addictive means its life threatening if you stop?

Nope, these two have to be seperated:
Opioids ARE physically addictive, but a cold turkey is NOT life-threatening.
Benzodiazepines/ethanol/barbiturates ARE physically addictive and a cold turkey CAN BE life-threatening.

For comparison:
Stimulants are NOT physically addictive, they ARE psychologically addictive and a cold turkey is NOT life-threatening.

 

[BallsStapledToLeg]

BallsStapledToLeg... I vote for you as the winner of the most hilarious new username I've seen in quite a while. :D

Tales from the ER man... Don't use your thigh to brace something while you're staple gunning things together. Edit: I was shadowing in the ER, I didn't staple my junk to my leg

Physically and mentally addictive are really just general terms that are thrown around to describe withdrawal symptoms. I wish there was a better descriptor but alas no such luck. Kinda boils down to how physically obvious the signs are.

 

[endotropic]

Nope, these two have to be seperated:
Opioids ARE physically addictive, but a cold turkey is NOT life-threatening.
Benzodiazepines/ethanol/barbiturates ARE physically addictive and a cold turkey CAN BE life-threatening.

For comparison:
Stimulants are NOT physically addictive, they ARE psychologically addictive and a cold turkey is NOT life-threatening.

In general, you're correct, opioid withdrawal is usually not life-threatening. You can find plenty of cases though where opioid addicts died during withdrawal without any other complicating factors. I don't think it's fair to say that opioid withdrawal is absolutely not life-threatening.

 

[Berdo tm1]

I think the main thing Im asking is what is the difference between 'comedowns' from stims and physical withdrawal from other drugs? I dont know why there is this idea that 'physically addictive' drugs will make you feel worse than stims on their cessation? You can feel like shit for seemingly the same amount of time from stims alone. Also they say serotonin takes MONTHS to get back to its baseline level after only one MDMA use. You can have bad comedowns that can last for weeks if you really overdo stims and very painful in their own right. Arent both to do with screwing up your brain chemicals i dont see why there is a distinction between withdrawal and comedowns.

 

[endotropic]

I think the main thing Im asking is what is the difference between 'comedowns' from stims and physical withdrawal from other drugs? I dont know why there is this idea that 'physically addictive' drugs will make you feel worse than stims on their cessation? You can feel like shit for seemingly the same amount of time from stims alone. Also they say serotonin takes MONTHS to get back to its baseline level after only one MDMA use. You can have bad comedowns that can last for weeks if you really overdo stims and very painful in their own right. Arent both to do with screwing up your brain chemicals i dont see why there is a distinction between withdrawal and comedowns.

Medically there's no distinction. Any effects following removal of a drug are characterized as withdrawal effects, and as cg9256 mentioned above there are clear physical withdrawal symptoms for stimulants, and this is increasingly recognized in the medical literature: Intravenous abuse of methylphenidate. -see case 2

The most important difference might be that only a relatively small proportion of people will develop a physical withdrawal syndrome even with heavy stimulant abuse (see cases 1 + 3 above), whereas with downers, if you push it long enough you can pretty much guarantee some serious after effects.

 

[Berdo tm1]

I think one of the main reaosns i have been asking is because i was interested in trying kratom but was afraid of it being 1. an opiate type drug and 2. with that bringing physical withdrawals.

Now i wonder, since ive tried many 'harder drugs' such as coke and crack, if the risk of addiction is worse with something like kratom.

Another fear is of it opening up the gates of valhalla/pandoras box in the true sense of a gateway drug in that it would cause me to acquire a taste for opiates. So prima facie it is said that kratom is 'milder' but i have been worried that the trouble it may cause might end up being alot more insidious.

I think most ppl will just end up saying the old catch all of 'no1 can tell until you try it but indeed is it worth the risk'. I like to err of the side of (perhaps extreme) caution these days so thusfar I have not tempted fate.

 

[endotropic]

I think one of the main reaosns i have been asking is because i was interested in trying kratom but was afraid of it being 1. an opiate type drug and 2. with that bringing physical withdrawals.

Now i wonder, since ive tried many 'harder drugs' such as coke and crack, if the risk of addiction is worse with something like kratom.

Another fear is of it opening up the gates of valhalla/pandoras box in the true sense of a gateway drug in that it would cause me to acquire a taste for opiates. So prima facie it is said that kratom is 'milder' but i have been worried that the trouble it may cause might end up being alot more insidious.

I think most ppl will just end up saying the old catch all of 'no1 can tell until you try it but indeed is it worth the risk'. I like to err of the side of (perhaps extreme) caution these days so thusfar I have not tempted fate.

If you're that worried about developing a dependency then you answered your own question, why risk it?

You have to take the non-pharmacological factors into account as well. Unlike the other drugs you mentioned Kratom is legal to buy, so if you develop an addiction you will have very easy access to the drug, which will make it that much harder to stop.

As a one off experiment you don't have much to worry about, as long as you keep it at that. Once you start dosing multiple times in a given week you know you're headed down the wrong path.

 

[Berdo tm1]

The main reason is that i get bouts of mind crushing depression on a regular basis so its been a question of suffering without respite in the misery of deep depression vs 'risking' trying something which may help but may also make me worse off. Already tried the common dogshit of therapy/exercise diet blah blah with no let up.

Kratom seemed specifically up my st since it is said to be a motivator as well as an antidepressant and seems to have a long history of fairly safe use vs these new fangled antidepressants.

but ye it feels like being stuck between a rock and a hard place, cos i dont want to fall into physical addiction so i remain wallowing in misery for now.

 

[endotropic]

The main reason is that i get bouts of mind crushing depression on a regular basis so its been a question of suffering without respite in the misery of deep depression vs 'risking' trying something which may help but may also make me worse off. Already tried the common dogshit of therapy/exercise diet blah blah with no let up.

Kratom seemed specifically up my st since it is said to be a motivator as well as an antidepressant and seems to have a long history of fairly safe use vs these new fangled antidepressants.

but ye it feels like being stuck between a rock and a hard place, cos i dont want to fall into physical addiction so i remain wallowing in misery for now.

I think you should expect the same sort of benefit using Kratom as an antidepressant as you get using any opiate as an antidepressant. That is you'll find it very effective at first, and this benefit will gradually decrease until you're right back where you started, but now with a dependence.

 

[SpunkySkunk347]

When you take any kind of depressant or opiate, it has an inhibitory effect on your CNS, and your brain has to downregulate the corresponding neurotransmitter(s).
Therefore, when an individual quits taking a depressant that is physically addicting (such as benzodiazepines or opiates), the brain is already over-compensating in a way, and the inhibitory neurotransmitters which have been down-regulated due to constant exposure to the addictive substance are unable to perform their job in a way, and the entire CNS is over-excitatory. Hence, physical addiction to drugs such as benzodiazepines can cause seizures.

Stimulants such as meth or cocaine do not have such detrimental effects on the physiology of the CNS (as aforementioned depressants do), and do not cause such harsh physical withdrawals.

 

[AlphaMethylPhenyl]

I thought opiates were effective antidepressants like amphetamine if the dose isn't increased exponentially. That is, they work as antidepressants, but not nearly as well as at first.

 

[SpunkySkunk347]

I've read that opiates are a theoretical treatment for things like obsessive compulsive disorder and panic disorder, and through first-hand experimentation I'd believe that to be somewhat true, but that goes against the grain of the modern medical paradigm entirely; furthermore how are you going to prevent patients from having their 'dose increase exponentially' (as you put it) without either: A) causing them to become drug seekers; or B) constraining their freedoms?

An answer for that has sort of been things like methadone clinics, which have had limited success depending on who you talk to. Some functioning members of society will say that they would not be able to remain such without methadone clinics. It's a touchy controversial subject.