Opioids Do Opioids Increase Or Decrease Pain Tolerance?

[Eisbaer]

Do opioid drugs, like Oxycodone and Hydrocodone, increase or decrease general pain tolerance? By general pain, I mean non-chronic pain; for example if you get a cut and have a high pain tolerance, you will not feel it.

This is a very confusing topic because I have heard people say that opioids reduce pain tolerance, while other people say that opioids increase pain tolerance. So I am not sure which one to believe, and from my own experiences, I can't really tell.

Also, is there any way to increase pain tolerance (not feel pain) with any other drugs, or without drugs?

Thanks.

 

[Slow_Mobius]

It reduces your perception of pain while you're taking them, but they also reduce your tolerance for pain when you become desensitized to the opioids over time.

 

[BeachBum4u]

FWIW, I have heard or read before that long-term opiate usage can or does lead to what I think is called hyperalgesia or something like that. In other words, one becomes more sensitive to pain with long-term usage. I'm not really sure if this is true in reality. I've been on opiates for 30+ years and I don't really think it's the case with me but who knows? Just a thought though.

 

[gmlifer]

If I'm on my oxy I don't feel pain as much. If I'm off the oxy I am more sensitive to pain than I used to be which sucks cause I seem to really be blowing through my script these days.

 

[Eisbaer]

That is interesting, I always thought that using opioides increases pain tolerance in the long run.

Is there any way to increase pain tolerance back to normal levels after opioid use?

 

[gmlifer]

That is interesting, I always thought that using opioides increases pain tolerance in the long run.

Is there any way to increase pain tolerance back to normal levels after opioid use?

Oh believe me, it doesn't take long. The body is a magical thing.

 

[emkee_reinvented]

A logic result would off course be the rebound effect which would suck as it probably means more then just pain but every misery that involves the endorphins.

My heavy Kratom usage never caused me any extra misery after the withdrawal and adjustement fase. But the whole leaf consumption does not equal the effects caused by the opiate/ opiods.
I did however use Kratom for the first time to kill legitimate pain. A one side of face tooth job involving ... a lot of things. Something for which in th more decent parts of the world you would get oxycodone, dihydrocodeine or a ball of raw opium.

Does anybody have an idea on the effect of pain on tolerance to pain. Is killing pain adequate better, could it somehow block increasing ones sensetivity to it.

 

[Eisbaer]

Does anybody have an idea on the effect of pain on tolerance to pain. Is killing pain adequate better, could it somehow block increasing ones sensetivity to it.

I'm not exactly sure, but I have heard that if you experience a lot of pain (non-chronic) your body will get used to it, and you wont feel it at all. I read an article where some (not all) adolescence who cut themselves start to feel less and less pain from cutting, and eventually don't feel the cutting at all.

 

[Emptty]

I'm not exactly sure, but I have heard that if you experience a lot of pain (non-chronic) your body will get used to it, and you wont feel it at all. I read an article where some (not all) adolescence who cut themselves start to feel less and less pain from cutting, and eventually don't feel the cutting at all.

Yeah I can back this up, when I self-harmed daily my pain tolerance increased and my injuries had to become more and more severe for the pain to be noticeable. I'd imagine it's possible for your brain to grow tolerant to the chemicals released in the brain by pain in a similar way it can grow tolerant to other chemicals? That's what I always assumed.

I would guess if that's the case tolerance can also drop if you don't experience pain often enough to release the associated chemicals. So if you're using painkillers constantly it may decrease your pain tolerance when you're sober. Although I can't say I've seen any research on the subject or noticed any change in my pain tolerance due to opiate use so this is mostly speculation.

 

[Eisbaer]

Yeah I can back this up, when I self-harmed daily my pain tolerance increased and my injuries had to become more and more severe for the pain to be noticeable. I'd imagine it's possible for your brain to grow tolerant to the chemicals released in the brain by pain in a similar way it can grow tolerant to other chemicals? That's what I always assumed.

I would guess if that's the case tolerance can also drop if you don't experience pain often enough to release the associated chemicals. So if you're using painkillers constantly it may decrease your pain tolerance when you're sober. Although I can't say I've seen any research on the subject or noticed any change in my pain tolerance due to opiate use so this is mostly speculation.

I also experienced the same thing. And after using a lot of opioids, I was surprised that a simple scratch (not even a cut) caused immense pain (more than a cut would before I started using opioids.)

I wonder if there are any drugs which could reverse this effect, and release the chemical in the brain which causes pain, thus increasing pain tolerance back to normal levels.

 

[Theroux]

This phenomenon is called ' Opioid-induced hyperanalgesia', the mechanisms that cause this are still in debate but generally, long-term use of opioids DOES lead to increased sensitivity for pain. Due to the mechanisms not being completely understood it is hard to identify what drugs could reverse this, however, your body WILL correct itself with time.

Pro tip: if you get pain from a small scratch, try rubbing the area lightly, there is scientific backing that this slightly numbs the pain.

 

[karambit]

Hyperalgesia usually occurs when tolerance to a given dosage ensues which causes Rapid firing of the A-Delta fibers(Fast pathway) that course through the Thalamus to the periaqueductal grey matter of the brain.These fibers also transmit Glutamate(NMDA receptors) . Supplementing with a NMDA antagonist such as Memantine is a wise choice, as it greatly reduces the rate and incidence of dose tolerance and prevents any Hyperalgesia. I started with memantine (Ebixa ) at 5mgs/day and over the course of one year have taken it to 40 mgs/day. It also helps with my weakness and tremors.

The Slow pathway : C- Fibers, go from the Amygdala > hypothalamus > and terminate in the pre-frontal cortex. This is experienced and emotional pain since birth. In most people the slow pathway; control and hypoexcitation cause higher pain tolerance overall if the fast pathway is kept in check. If tolerance goes on and Fast pathway fires without resolve or solution then overall pain will feel worse than baseline BUT this is deception. The brain wants the highest degree attainable in ones lifetime.

I've been on OCD80 q4h for many years following left sided hemiparesis from a car accident in 2005. I can attest to burns , cuts , dings and muscle tears occurring without any immediate sensation. It's not until a few minutes or a day or two that I see boils and lacerations and severe bruising to help remind me when I'm absent minded.
This could be very dangerous which I protect myself from by having necessary family with me at all times.

 

[Eisbaer]

Hyperalgesia usually occurs when tolerance to a given dosage ensues which causes Rapid firing of the A-Delta fibers(Fast pathway) that course through the Thalamus to the periaqueductal grey matter of the brain.These fibers also transmit Glutamate(NMDA receptors) . Supplementing with a NMDA antagonist such as Memantine is a wise choice, as it greatly reduces the rate and incidence of dose tolerance and prevents any Hyperalgesia. I started with memantine (Ebixa ) at 5mgs/day and over the course of one year have taken it to 40 mgs/day. It also helps with my weakness and tremors.

The Slow pathway : C- Fibers, go from the Amygdala > hypothalamus > and terminate in the pre-frontal cortex. This is experienced and emotional pain since birth. In most people the slow pathway; control and hypoexcitation cause higher pain tolerance overall if the fast pathway is kept in check. If tolerance goes on and Fast pathway fires without resolve or solution then overall pain will feel worse than baseline BUT this is deception. The brain wants the highest degree attainable in ones lifetime.

I've been on OCD80 q4h for many years following left sided hemiparesis from a car accident in 2005. I can attest to burns , cuts , dings and muscle tears occurring without any immediate sensation. It's not until a few minutes or a day or two that I see boils and lacerations and severe bruising to help remind me when I'm absent minded.
This could be very dangerous which I protect myself from by having necessary family with me at all times.

Memantane seems to be a Rx drug, and I wouldn't be able to get that. Interestingly, another NMDA antagonist is DXM, which is widely available, and has proven to reduce pain by 30% according to this source: http://www.medscape.com/viewarticle/744071_3

But I wonder, would NMDA antagonists reverse the effects of opioid induced Hyperalgesia? And if someone takes it, who doesn't have Hyperalgesia, then would that increase their pain tolerance overall?

 

[karambit]

Memantane seems to be a Rx drug, and I wouldn't be able to get that. Interestingly, another NMDA antagonist is DXM, which is widely available, and has proven to reduce pain by 30% according to this source: http://www.medscape.com/viewarticle/744071_3

But I wonder, would NMDA antagonists reverse the effects of opioid induced Hyperalgesia? And if someone takes it, who doesn't have Hyperalgesia, then would that increase their pain tolerance overall?

No, of course not. Just like someone who doesn't have cognitive decline or motor defecits wouldn't be able to increase their cognitive skills or perfect their motor skill attributes by lowering glutamate excitation via memantine etc...
The glutamate and other excitatory Amino Acids would have to be hyper stimulated with deadly transmission rates for the inhibitors to have any impact.

Mitigation or Reversal are symantics which could only be revealed during experimentation.

Here are a few solutions that one can try : 1) Supplement with an A-2-Delta modulator ~Lyrica and Gabapentin.

2) Switch from the problematic Phananthrene Opiod: Codeine, Hydrocodone, Hydromorphone, Morphine, Oxycodone, Oxymorphone to a NON- Phananthrene Opiod : Fentanyl,Meperidine, Sufentanil OR more easily attainable : Buprenorphine, Methadone and Tramadol.

3) Supplementing with a cyclo-oxygenase (COX-2) inhibitor ~ Celebrex which is selective or NSAID's which are not. COX-2 inhibitors have demonstrated the ability to antagonize the NMDA receptor,blocking glutamate, substance P and other excitatory Amino Acids. Independant of this, NMDA receptor activation can up-regulate COX-2 expression.

You are correct in that methadone and DXM can be potentially used BUT they are pretty weak and in the case for DXM, it is unknown the dosage necessary to either augment opiod analgesia or prevent Opiod induced Hyperalgesia, caused by NMDA activation. However it is cheap and can't hurt to try.

I think an ideal method if one was serious about coming off would be to taper then switch over to Bupe (Sub's) . This way you can get a robust De Novo pain response, provided you start with the right dosage, then you can slowly taper the sub's, switch to Lyrica and then be done with it.

HGH if attainable/affordable should be run as soon as possible, as there are many sources showing the cognitive damage caused by glutamate's inhibitory effect of Neurogenesis of the Hippocampus can be mostly reversed.


Cheers

 

[Eisbaer]

No, of course not. Just like someone who doesn't have cognitive decline or motor defecits wouldn't be able to increase their cognitive skills or perfect their motor skill attributes by lowering glutamate excitation via memantine etc...
The glutamate and other excitatory Amino Acids would have to be hyper stimulated with deadly transmission rates for the inhibitors to have any impact.

Mitigation or Reversal are symantics which could only be revealed during experimentation.

Here are a few solutions that one can try : 1) Supplement with an A-2-Delta modulator ~Lyrica and Gabapentin.

2) Switch from the problematic Phananthrene Opiod: Codeine, Hydrocodone, Hydromorphone, Morphine, Oxycodone, Oxymorphone to a NON- Phananthrene Opiod : Fentanyl,Meperidine, Sufentanil OR more easily attainable : Buprenorphine, Methadone and Tramadol.

3) Supplementing with a cyclo-oxygenase (COX-2) inhibitor ~ Celebrex which is selective or NSAID's which are not. COX-2 inhibitors have demonstrated the ability to antagonize the NMDA receptor,blocking glutamate, substance P and other excitatory Amino Acids. Independant of this, NMDA receptor activation can up-regulate COX-2 expression.

You are correct in that methadone and DXM can be potentially used BUT they are pretty weak and in the case for DXM, it is unknown the dosage necessary to either augment opiod analgesia or prevent Opiod induced Hyperalgesia, caused by NMDA activation. However it is cheap and can't hurt to try.

I think an ideal method if one was serious about coming off would be to taper then switch over to Bupe (Sub's) . This way you can get a robust De Novo pain response, provided you start with the right dosage, then you can slowly taper the sub's, switch to Lyrica and then be done with it.

HGH if attainable/affordable should be run as soon as possible, as there are many sources showing the cognitive damage caused by glutamate's inhibitory effect of Neurogenesis of the Hippocampus can be mostly reversed.


Cheers

That makes sense.

Wow, all of those methods seem very expense since I don't have access to a doctor for prescriptions... However, would NSAID such as Aspirin, or Ibuprofen work at reducing opioid induced hyperalgesia? Those would seem like less expensive options, and quicker to get, since they are OTC drugs. And at exactly what dosage should they be taken to fully reverse the effects of opioids?

 

[kingshawaiian]

In my personal experience everything hurts way more now off of opioids. Might be a mental thing though, who knows.