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Opioids Brain damage from opiate use

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Flexistentialist

Bluelight Crew
Joined
Jun 24, 2002
Messages
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Location
.au
I was at a conference recently, and saw a presentation that challenged some of the accepted wisdom that long term opiate use is mostly harmless to the body (aside from the problems with dependence).

Cognitive deficits in long term opiate users have been described in various research. Have a read of these articles for an overview:

Is Opiate Addiction Associated With Longstanding Neurobiological Changes?

Neuropsychological Consequences of Opiate Use

Cognitive impairment in methadone maintenance patients

Short term oxygen deprivation from non-fatal opiate overdose is known to cause some of this cognitive decline. But research from the prescribed heroin services shows that injected heroin at doses not considered "overdoses" can cause a short (5 - 30 minute) drop in blood oxygen saturation to levels that could cause some degree of brain and organ damage over time.

Safety of injectable opioid maintenance treatment for heroin dependence found blood oxygen concentrations on average fell to 78% (one was recorded at 52%) for up to 30 minutes after injecting pure heroin. Oxygen saturation below 86% for any length of time can cause problems.

Rapid cortical hemoglobin deoxygenation after heroin and methadone injection in humans: a preliminary report found similar results with injected heroin and methadone.

On top of this, there is a growing body of research linking long term opiate use with higher incidence of sleep disordered breathing (sleep apnea). Falling blood oxygen saturations during sleep is known to have a range of long term health effects, including cognitive decline. Check these out to read more:

Chronic Opioid Use is a Risk Factor for the Development of Central Sleep Apnea and Ataxic Breathing

Central sleep apnea in stable methadone maintenance treatment patients (PDF)

Higher Risk Of Sleep Apnea When Patients Use Opioid-Based Pain Medications

Sleep-disordered breathing with chronic opioid use

Opioids, sleep architecture and sleep-disordered breathing

Just thought I'd share some of this research to see what Bluelighters think.
 
Is the brain damage actually from opioid use in any of these, and not oxygen deprivation?
 
Interesting. I had a quick read of the couple of the links, but when I get a little more time, I will check them all out more thoroughly. I definitely want to know more about this considering my extensive history of regular opiate use. I haven't noticed any cognitive changes - in fact, I think I've gotten smarter during the time I was using - but it's probably one of those things that is so gradual that from the perspective of the person using, they don't even notice. Kinda like when a person gains or loses weight - it happens so gradually that they don't really notice until they are 150lbs heavier.

Thanks for posting this. This could have a huge impact on how opiate users see their opiate use. Maybe it will cause some to be less ambivalent about it.
 
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Flexistentialist said:
It's from oxygen deprivation caused by opiate use, so yes the brain damage is caused by the opiate use.
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Well, it's caused by oxygen-deprivation caused by opiate use. That means that the dose has to be high enough to cause serious oxygen deprivation, which I think will exclude a large portion of opiate/oid users.
 
^ He said that one of the studies showed maintenance/normal doses (I assume that's what they mean by "doses not considered 'overdoses'") to cause 5-30 minutes of oxygen deprivation, which is enough to cause some damage.
 
^I was debating that myself. I took it to mean that they were doses that were strictly non-lethal doses, but not necessarily too far away from lethal doses (i.e. minor OD).
 
BollWeevil said:
Well, it's caused by oxygen-deprivation caused by opiate use. That means that the dose has to be high enough to cause serious oxygen deprivation, which I think will exclude a large portion of opiate/oid users.
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No, that's not correct. The sleep apnea is in people on stable doses of opiates (eg pain patients, methadone maintenance) and the short term oxygen deprivation has been seen in people injecting their regular maintenance dose of heroin as well as other opiates. These people are on the nod, they're not unconscious.
 
I've wondered this for a while. I was an IV opiate user for about 2 years. Pretty much if it could be shot, I shot it.

I used to play chess as a teenager, and when I try to play now it's like I can't think. It's like my brain has a map of how to accomplish something, but all the roads have been destroyed.

Maybe not brain damage, but intelligence deterioration.
 
Hm, interesting. When I used to use high dose morphine I would experience symptoms of sleep apnea according to my mother and the many nurses who have watched me sleep because I used to sleep/take naps in a hospital where I used to work. Also, when I first started on MMT I again experienced symptoms of sleep apnea in my sleep but apparently they have resolved according to my relatives around me; either way I have not done a sleep study to prove a diagnosis. So increased sleep apnea occurrence caused by opioids seem to be quite a common phenomenon.

The report posted on MMT patients having worsened cognitive/motor functioning is interesting because I've noticed a dramatic increase in ADHD symptoms ever since starting on MMT. Typical psychostimulant therapy helps to alleviate some of these symptoms and haven't had as many ADHD-esque issues since re-starting on d-amphetamine. This is an interesting topic that I'd like to look into more in the future, as there were a few other studies linked to the initial study stating that detoxification from MMT is hypothesized to not help in alleviating any of the cognitive/motor decline caused by MMT.

I noticed that the issues are moreso from executive cognitive function decline rather than intelligence or IQ decline. This is why I noted the increase in ADHD symptoms after starting MMT, as ADHD is linked to a decline in executive functioning (decision making, impulsiveness, organizational behaviors, etc.)
 
So you said this is regarding people nodding, not overdosing...so does this apply to people who take their prescribed dose (or a little more) of opiates every day? I never take enough to nod or experience any significant recreational effects except maybe once a month...

Also I noticed these were all in reference to injecting heroin/methadone/whatever. Does it make any difference if you do not inject?
 
God this isn't what I wanted to read about when I'm trying to get clean. I could certainly see how large doses might be damaging over time. I used poppy tea for pain and recreationally, I don't think that I was high enough most of the time to really experience that kind of drop in oxygen levels or have that kind of disturbance of sleep. Although poppy tea did have a tendency to make me not sleep, just kind of lay there feeling relaxed but not actually dozing off completely.

I usually had a tolerance and it seemed to prevent me catching a good nod or getting very high. I certainly don't feel any dumber but who could really notice something like that in the first person?
 
Also I noticed these were all in reference to injecting heroin/methadone/whatever. Does it make any difference if you do not inject?
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I don't think so, I think it has more to do with a dose big enough to cause sleep apnea... I am going to check out those links the OP posted, this is interesting...
 
Ive been on opiates for 18 months now, daily use and I certainly go beyond my perscribed dosages quite often (if not only from the fact that I plug my opiates, which has a far higher BA than swallowing them). I can't say ive noticed a drop in intelligence, although I don't see where I would have been deprived of oxygen as part of my use (I rarely take enough to nod, let alone pass out). I do think I may have developed sleep apnea over the last 6 months, but then again ive never been a very sound sleeper, often waking up 3 or 4 times a night at random intervals, even before opiate use.

Also note that I've recently gained some weight (about 25lbs) which may be more of a contributor to apnea than my opiate use).
 
^Opiate abuse, or even non-abuse, has been known to contribute to weight gain due to the fact they can change your appetite and alter your diet along with having effects on energy, desire, and motivation.

Ive gained a lot of weight in the three years I have been a daily user, but this also is due to the fact I was terribly injured and have been unable to do the things I did before. But my diet has changed much more towards junk food thats for sure.

I am finally in the process of trying to get back to my natural fit weight.
 
Magic_Hobo said:
Also I noticed these were all in reference to injecting heroin/methadone/whatever. Does it make any difference if you do not inject?
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I would imagine it does, especially regarding the drop in oxygen levels.
 
so the solution is to take those extra oxygen-cargo genes from that other thread, and put them in opiate addicts. opiate addicts will then get no brain damage, and be able to climb mountains without running out of breath (due to genes) or coughing (due to opies)

but seriously, this is such a sad article. i'm quitting right now though so maybe it was good to read it

i always get sleep apnea (or maybe just snoring, but my gf finds it pretty loud--to the point where i'm on the couch lol) from depressants, opiates, pot
 
So this "brain damage" could come from any CNS depressant, and not just opiates? Like alcohol, benzos, barbs, etc? I don't see how this is from "opiate use", it's just from excessive CNS depression, which can be due to more than just opiates.
 
^ No, this research is looking specifically at respiratory depression from opiate use. If you can find any equivalent research showing massive drops in blood oxygen while drinking alcohol, I'd be happy to read it.
 
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