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Old 02-06-2008, 06:16 PM   #1
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Tolerance to opiods vs. opiates

I was thinking about this subject today. I don't know why just call me strange. However, does a person develop tolerance faster to an opiate medication as compared to an opiod medication? I don't know if anyone will have an answer or if anyone has even studied this.

Brian

Last edited by brianpain33; 02-06-2008 at 06:18 PM.

 
Old 02-06-2008, 08:02 PM   #2
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Re: Tolerance to opiods vs. opiates

Hi Brian, I think there is some merit too what your saying. Part of the equation is that synthetics aren't as harsh on your stomach and bowels and aren't as sedating. They were developed for that very reason and it has made them a greater target for those that abuse these meds. By removing the troubling side effects, it has to contribute to doses reached and how fast.

JMO, Take care, Dave

 
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Old 02-07-2008, 05:34 AM   #3
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Re: Tolerance to opiods vs. opiates

Ok, now call ME the stupid one!! LOL... can one of you knowledgeable gentleman fully explain the difference. If I'm understanding what I read from Dave's post, an opiate is pure, and an opiod is synthetic?? Can you give some examples of the two classes of medications in terms of names of meds. Now Brian has me curious. Thanks.
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Old 02-07-2008, 07:44 AM   #4
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Re: Tolerance to opiods vs. opiates

The two natural alkaloids used directly for PM that issue from opium are codeine and morphine. The other major alkaloid is thebaine, but this is synthesized before use in PM. So, codeine and morphine are opiates.

Pretty much, the remainder are opioids, either partially or fully synthetic. Examples of partial synthetics would be hydrocodone (Vicodin), Hydromorphone (Dilaudid), oxycodone (OxyContin) and such. Examples of fully synthetic opioids would be Methadone and Ultram. I believe that Demerol is also fully synthetic, but I'm not positive. Of course, there are other examples but hopefully these will do.

steve

Last edited by forginon; 02-07-2008 at 07:46 AM.

 
Old 02-07-2008, 07:48 AM   #5
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Re: Tolerance to opiods vs. opiates

An opioid is a synthetic opiate. An opiate would be like morphine, heroin or codeine that requires one or more of the derivetives of natural opium.

Codeine is notoriously harsh on the stomach and so is morphine and heroin, it's also notoriously sedating which does get better with time. The synthtics are the meds in The keto synthetic family, Hydrocodone, oxycododne, hydromorphone and oxymorphonne, The fents and demerol are also synthetic ans so are meds like methadone or levordromoran.

Actually no raw opium is needed to manufacturer opiates since the discovery of opiate synthesis in "79. However the drugs created after the natural model still have the harsher side effect profile and take longer to get used too as their older versions that contained an opium extract. Therefore, the negative aspect is very present with each dose increase.

In thoery more pain can be managed with less side effects using a synthetic with a milder side effect profile. Of course there will be exceptions, but this is the general rule. For example a couple tylenol 3 "an opiate/natural" will have my guts in knots 30 minutes after taking it, where 10 times the dose of oxycodone doesn't bother my stomach at all. If you remove the harsheness, a higher dose can be taken without the nasty side effects. This makes it more popular with severe CP and with people looking to abuse or use it recreatonally.

So it makes sense to see faster tolerance to oxycontin if the side effects are easier to manage. Titration would be longer and more unpleaeant if you have to wait for the nausea and sedation to deminish before increasing a dose of morphine.

Take care, Dave

Last edited by Shoreline; 02-07-2008 at 07:53 AM.

 
Old 02-12-2008, 06:02 PM   #6
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Re: Tolerance to opiods vs. opiates

"Opiate" refers to alkaloids extracted from poppy pods and their semi-synthetic counterparts, which bind to the opiate receptors. These including opium, codeine and morphine.

Semisynthetic opiates/opioids are derived by altering chemicals contained in opium. Some semi-synthetics include hydrocodone, oxycodone, buprenorphine and diamorphine (heroin). Naloxone is also a semi-synthetic opioid, although it is an opioid antagonist, not an agonist.

"Opioid" refers to any drug which binds to the opioid receptors. Opioids include all of the opiates as well as any synthesized drug that attaches itself to the CNS or gastrointestinal tract opioid receptors.

Opioids include codiene, morphine, diamorphine, hydrocodone, oxycodone, hydromorphone, oxymorphone, buprenorphine, methadone, fentanyl, etc.

Some synthetic (man-made) opioids include methadone, pethidine (Demerol) fentanyl, tramadol (Ultram), and loperamide (Imodium).

-Wren

Last edited by Wren9; 02-12-2008 at 06:07 PM.

 
Old 02-12-2008, 06:17 PM   #7
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Re: Tolerance to opiods vs. opiates

Thank you Dave, Steve, and Wren.
I guess others have thought about this too. I was using this strictly for knowledge purposes and not for any kind of abuse. It struck me as odd that the tylenol #3 that I took for dental pain would cause alot of sedation as opposed to hydrocodone which would hardly cause any sedation and I knew that the hydrocodone was stronger. I have also been on Oxycontin and knew that it was much less sedating than Percocet. I don't know exactly why that is true but even my doctor said many of his patients had reported this. It really is weird how these medications behave in our bodies, which receptors they bind to and how a medication will have markedly different side effects between two people or to various degrees. I have always liked science and math and done very well in these subjects. I have even thought about trying to become a medical assistant and I have heard commercials on the radio pretty frequently so there must be a great need and especially one's that are knowledgeable about chronic pain (like me).

Brian

 
Old 02-12-2008, 06:27 PM   #8
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Re: Tolerance to opiods vs. opiates

I say go for it, Brian!!! The "profession" could sure use someone like you! I learned a lot in this thread, too...thanks for all the posts everybody.

 
Old 02-12-2008, 09:18 PM   #9
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Re: Tolerance to opiods vs. opiates

I'm like Brian, I just love learning. Science is cool. I work in flight simulation where math and physics rule. We have a motion simulator that travels 60 feet vertically and 40 feet horizontally - a real 'E' ticket.

Back to PM - When I began w/PM I decided to learn all there was to know about the meds, the procedures and all the intricacies of being arthritic. After finding this board, I 'learned' that I've got a long way to go after reading posts from Shoreline, Conductor, Director and, of course, Fabby.

I really appreciate everything y'all are teachin' me...

steve

 
Old 02-15-2008, 05:41 AM   #10
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Re: Tolerance to opiods vs. opiates

Hi all. I just saw a story on my local tv station about an (everyday typical) woman/mom becoming addicted to Hydrocodone after she was prescribed the med for a back injury. Long story short she ended up in the county jail for 4+ months and is now going to school so that she can counsel teenagers about drugs. Anyway, I just Google opiod vs. opiate and came across this thread.

I take Tramadol having had two cervical spine surgeries in the past 2-1/2 years and now being newly diagnosed with a previous thoracic fracture, herniations at 5 levels of my T-spine and DDD. I always stay well within my prescribed dosage of Tramadol - typically only taking 3 x day instead of the 4 that is prescribed. This is my only pain med and between my surgeon and my PM doc, there does not appear to be any talk about me coming off of it anytime in the near future.

My question is this.... Is it as easy to become addicted to an opiod as it is to become addicted to an opiate?? Thanks for your thoughts!

~Jill

 
Old 02-15-2008, 07:36 AM   #11
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Re: Tolerance to opiods vs. opiates

I would think (as explained above) the possibility is greater with an opioid than an opiate because of the side effects. But there is a difference between dependency and addiction. Dependency is when you are physically well, dependent on the medication for an illness or injury. Addiction is a mental dependency. I'm not doing well explaining this.

You could say that I am addicted to Lyrica. I will have serious symptoms if I tried to stop. I could be weaned and should my condition ever reverse itself, I would have no problem with stopping it. Ditto for hydrocodone which I take on days the pain is bad. If I didn't have pain, I would not be taking them.

But for some, the receptors in the brain make them want to take narcotics when there is no other physical reason to. Many times they get prescribed a narcotic for an injury or surgery and find they like the way it makes them feel. It is no surprise that middle aged women have one of the highest addiction rates.

 
Old 02-15-2008, 09:22 AM   #12
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Re: Tolerance to opiods vs. opiates

Jill1004,

One can become dependent and addicted to opioids and opiates. And there's a huge difference between the two (addiction vs dependence). But to answer your question directly, I think it's as wasy to become addicted on either opioids or opiates.

Addiction is both physiological and psychological. An addict is a person who has lost control of their use of narcotics and continues to "use" even in the presence of bodily harm. The narcotics rule their every waking thought and all of their time is spent either using or looking for their next dose (fix if you like).

One who is dependent on narcotics has simply taken them long enough so that their body has become adjusted to their presence and if they stop abruptly they will experience withdrawal. All chronic pain patients that use narcotics for pain relief regularly become dependent on the meds. It's totally normal, a natural physiological process. Folks who take their meds as prescribed and have control over their meds are not preoccupied with the meds. They are not living for the next dose.

steve

 
Old 02-15-2008, 09:30 AM   #13
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Re: Tolerance to opiods vs. opiates

Steve, that was a much better explanation. Tolerance is also thrown into the mix. Because the body readily acclimates itself to narcotics, tolerance can build very easily. Those who are able can take "holidays" to decrease their tolerance. Switching to another type of narcotic for a short period of time can lessen tolerance. This is something that almost all CP/IP patients struggle with.

 
Old 02-15-2008, 12:28 PM   #14
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Re: Tolerance to opiods vs. opiates

Wow-
I'm glad I'm not the only one who didn't know there was a difference between "opiate" and "opioid". I felt like a ding-bat when I read the first post in this thread.

This has been a very educational thread for me. Thanks for bringing it up.

Have a great day everyone!

 
Old 04-21-2008, 11:04 PM   #15
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Re: Tolerance to opiods vs. opiates

I have taken Tramadol before...It does nothing for me. An aspirin seems to be more potent. I am glad it works for you. Codeine and Butalbital are the only thing that works for my migraines.
Best of luck
Quote:
Originally Posted by Jill1004 View Post
Hi all. I just saw a story on my local tv station about an (everyday typical) woman/mom becoming addicted to Hydrocodone after she was prescribed the med for a back injury. Long story short she ended up in the county jail for 4+ months and is now going to school so that she can counsel teenagers about drugs. Anyway, I just Google opiod vs. opiate and came across this thread.

I take Tramadol having had two cervical spine surgeries in the past 2-1/2 years and now being newly diagnosed with a previous thoracic fracture, herniations at 5 levels of my T-spine and DDD. I always stay well within my prescribed dosage of Tramadol - typically only taking 3 x day instead of the 4 that is prescribed. This is my only pain med and between my surgeon and my PM doc, there does not appear to be any talk about me coming off of it anytime in the near future.

My question is this.... Is it as easy to become addicted to an opiod as it is to become addicted to an opiate?? Thanks for your thoughts!

~Jill

 
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