Opiate Burn-Out

[IanB]

I wondered if anyone out there had heard of such a thing as opiate burn-out? My brother has been addicted for 12 years to opiates, the last 10 years dihydrocodeine. He has tried to kick many times but couldn't hack the withdrawal (which I witnessed and wouldn't wish on any one).

Anyway, it seems that now his dose is tumbling downwards and there a vry few withdrawal symptoms. Like all addicts he uses this news to take a little more next time, but the fact is it seems the withdrawal is getting less severe. is this something anyone has heard of? Can the body get to the point where it just doesn't react the same as before. Your comments welcome.

[Ontherooftops]

Swim is a little confused by your post, but this might help a little:

Long term opiate use decreases the amount of opiate receptors in the brain. Opiates serve the purpose of allowing more dopamine to stay in the synaptic cleft. In the areas of the brain which opiates act, dopamine is responsible for feelings of satisfaction and reward. So over time certain parts of a users brain suffers from some dopamine depletion.

[IanB]

Apologies for very unclear posting - I'll try again.

Can someone who has used opiates for a long time reach a point where coming off them is easier than it was x years before? I've read of 60 year-old heroin addicts gradually reaching a point - long after any highs were possible - of simply stopping use. Maybe a bit of taper, but basically reaching a point of saying 'fuck it I've had enough'

Any views

[Politicalchalk]

Yes. After a while, one reaches a point where it's more a matter of economics, as most opiates have no ceiling effect. The body gets taxed too highly -- and you WILL ALWAYS pay in some way for a chemical high -- to the point where one either ODs or becomes more rational about their substance use. The term "rational addiction" has been used to describe the substance user who continually increases their dose never or very little.

One hypothesizes that the choice to use or not use a substance depends on the "why" it was used in the first place, although some would argue that consciousness-alteration is as much a natural drive as food or sex. For certain substances, like psychedelics, one may simply take in as much as they can from the experience before it becomes run-of-the-mill. Or, in the case of addictive drugs such as opiates, a phrase commonly heard in recovery groups is: "I stopped because I was sick and tired of being sick and tired."

Tapering is highly recommended as it's just safer that way. But there are those who resolve to just not use.

[shembelial]

I call this point x. When kicking becomes easy. Reaching point X means there are no consequences to opiate addiction. You get addicted and come off easy. Actually I think people just get tougher or maybe there is some long term damage to the receptors in the brain. Maybe a huge tolerence also means that you develop a tolerance to withdrawl pain.

[Songcycle67]

SWIM's father has been addicted to 60mg++ per day of hydrocodone for 16 years, and addicted to roxycodone 90mg per day for the past 6 of those 16. Now he takes 20mg of hydrocodone + 90mg of roxycodone on the rare days that he keeps to his prescribed amount. Most of the time he takes double these amounts which leave him in withdrawal for several weeks every month after his script is gone.

SWIM's dad is a pretty strong guy and he has legitimate harsh pain, but as of yet he has been unable to kick the habit or even taper it back; even after going through so many agonizing monthly withdrawals. He claims the withdrawals get more manageable every time, but they're still hell: he still gets the same effects as the first time he ever detoxed and the symptoms feel the same if not worse than the first time.

There is definitely a point where your body will stop responding to opiates, but, depending on tolerance, one would have to use large amounts of a strong substance over a very long period of time. I'd say most addicts die before they reach this point.