A question about tolerance to various effects of opiates/opioids

[Forthesevenlakes]

Any opiate user knows that tolerance can build quickly to the pleasurable effects of these drugs, requiring more of the drug in order to get a similar pleasant feeling. SWIM has been wondering lately about the tolerance to negative or neutral side effects to these drugs, too. Some lab rats do not think that tolerance really builds to the negative/neutral side effects, and others say that some side effects seem to go away, while others don't. SWIM thinks that while one might be less likely to notice the absence of a negative sensation than the absence of a positive one, tolerance could certainly build to the various effects.

So, what SWIM is wondering is, what are your experiences with tolerance?

How long did it take to build tolerance to different effects of opiates (positive, negative, or neutral), and with what dosages? Everyone is different and SWIM doesn't expect people to react the same way to these drugs, but perhaps a consensus on tolerance to some effects could be reached.

SWIM first got started thinking about this when a lab rat mentioned to him that they stopped getting constipation from opiates after a couple months of use. SWIM has been using opiates, at least occasionally, for many years, and it seems that the little bastards still make him constipated. However, after using opiates once a week for about a month, he stopped getting the urinary retention problem that affects some users.

Any input? SWIY does not have to be a daily or current user of opiates to answer this question, just some info on the effect that one gained tolerance to, the time taken to reach this tolerance, the dosages, and when or if this tolerance disappeared after use stopped would be interesting to SWIM, and perhaps he could compile it into a smooth sticky thread or table when all is said and done.

[Jatelka]

SWIJ has never used opiates, however she worked in a Palliative Care setting for some time, and was responsible for (often) rapidly titrating opiate doses to ensure adequate analgesia.

In her experience, unwanted effects of opiates (nausea, sedation, hallucinations and urinary problems etc) are maximal when the dose is being titrated up, and for about 48 hours after adequate analgesic effect is achieved. After this point the unwanted effects tend to recede (this doesn't seem to be the case with the constipation though).

The above scenario seemed to be the case whatever the starting point with regards to total opiate doses, ranging from totally opiate naive to doses the equivalent of 100's of mg of morphine daily.

[Dissociative]

well, swims tolerance for oxycontin builds quickly. He hasn't given enough time to let it go down a lot, but still. When he gets them *about a week apart*, he usually is using doubled of what he blew the first time with what he just bought by the end of it, and he still doesn't get the same effects. As true as many people know, afterawhile, the itch is a great thing, not a bad thing anymore.

[Forthesevenlakes]

Interesting, thanks for those replies!

SWIM also has heard in the medical community (but never seen any research behind this) that the use of opiates in pain management results in a slowly growing tolerance to the analgesic effects of opiates, whereas recreational use creates a more rapidly growing tolerance to analgesia. Do any SWIMs out there find this to be the case?

[kailey_elise]

Originally Posted by Forthesevenlakes

Interesting, thanks for those replies!

SWIM also has heard in the medical community (but never seen any research behind this) that the use of opiates in pain management results in a slowly growing tolerance to the analgesic effects of opiates, whereas recreational use creates a more rapidly growing tolerance to analgesia. Do any SWIMs out there find this to be the case?

My friend in chronic pain says yes; only after 5 years did the need for the long-acting methadone need to be increased, and only by 15mg a day at that. The meds taken for breakthru pain, however, respond in the same way as taking them for recreation. This can be bypassed for the most part by giving a day's rest between uses (when possible).

The same friend sometimes tries to use potentiators instead of upping the dose of the breakthru dose, and even when taking up to 8-12mg of Immodium no longer experiences constipation.

~Kailey

[Fantasian]

Originally Posted by Forthesevenlakes

Interesting, thanks for those replies!

SWIM also has heard in the medical community (but never seen any research behind this) that the use of opiates in pain management results in a slowly growing tolerance to the analgesic effects of opiates, whereas recreational use creates a more rapidly growing tolerance to analgesia. Do any SWIMs out there find this to be the case?

Through direct experience SWIF can tell you as opioid tolerance increases through recreational use the analgesic tolerance grows rapidly. SWIF found after 4-6 months of acute recreational usage normal medicinal dosages of analgesia were completely inadequate causing all sorts of problems.

SWIF also found that once tolerance was gone and use was stopped for a long period of times (>6months) there was still a tolerance to analgesia although reduced still present.