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    Old 07-09-2006, 11:59 PM   #1
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    opiate receptors and metabilism question

    Someone on a post I was reading ealier mentioned methadone binds to different opiate receptors then oxy and morphine . What areas does meth go to and what areas does the oxy and morphine go to? Can you explain this further please???
    Also if you have a very high metabilism, will pain med's go through your system faster. Or leave your system faster rather??? My grandmother's Dr. told her she had a high metabilism (as I do) and that the med's will not last as long comparred to people with low or normal metabilism. Think this is true, or has anyone ever heard this??? Thanks for the info and any answers to my qusetions

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    Old 07-10-2006, 05:11 AM   #2
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    Re: opiate receptors and metabilism question

    The methadone molecule is quite a bit larger than all other opiates except maybe buprenorphene.When someone is stable on methadone then most opiates become useless because 1.The other opiates can't so to speak get past the methadone molecule and 2. Methadone has an extremely long half life 24-36 hrs.You would need to have a test to determine if your a fast metabolizer.Very few people actually are fast metabolizers but the few that are do require different doses and dose times for sure.That's the way I understand things but there are people here who are much better at articulating questions then I do.Good luck....Dave

    Old 07-10-2006, 04:50 PM   #3
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    Re: opiate receptors and metabilism question

    But is methadone better for some conditions??? The methadone binds to different opiate receptors then oxy and morphine is what the person said in a different post, what exactly does that mean? Does it mean methadone is better for certain kinds of conditions? Does it mean methadone will go to a certain area in your body more than other parts??? I believe it was Scotty12 who posted something about this under "tolerance with oxycodone". I am just very curious as to what this means. Thanks much for info

    Old 07-10-2006, 07:46 PM   #4
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    Re: opiate receptors and metabilism question

    As I understand it, there seem to be 3 main opiate receptors and it is the first that most narcotics attach to, including methadone. My doctor said the methadone also attaches to a NMDA receptor to help reduce or slow tolerance that develops with narcotics. There are a lot of things on the web about the NMDA receptors, but I developed tolerance anyway, but over years.

    Old 07-11-2006, 06:13 AM   #5
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    Re: opiate receptors and metabilism question

    HI Mili, There are 3 classes of opiate recetors, Mu, Delta and Kappa, but in each class there are subclasesss. Like Mu1, Mu2, Mu3, Kapa 1, Kappa2 ,Delta 1, delta 2, delta 3 and so on. The NMDA receptor is not an opiate receptor, it's a different link in the neuro chemical changes that activate and regualte when experiencing pain.

    When they were trying o discover how people on PCP could take the beatings and gunshot wounds and keep coming they dscovered the NMDA receptor and have made attempts to mimick this reponse to increased tolerance to pain.

    As far as fast metabolism, that may come to a quick end with the use of long acting opiates long term. However if you go into PM thinking you are somehow different and will require more than the avergae person, which there really is no such thing, you likely won't be satisified with the relief opiates are able to provide, particluarly iof your pain is neuropathic. I've seen 90 lb women on doses that would kill 300 lb football players. It has nothing to do with metabolism and everything to do with previous exposure and tolerance. If you haven't been exposed to high dose opiates around the clock for years your not going to have instant high tolerance or need frequet dosing to meds you have never been exposed too with release sytems designed not to be effected by high metabolizers.

    Your metabolism may be what it is, but it doesn't short cut the long acting relase systems these meds use. High metabolism doesn't equate to high levels of stomach acid to disolve polymer coating systems or transdermal delivery systems. If anything, you may metabolize short acting meds faster but long term use of opiates generally slow your metabolism and slow production of neuro chemicals. These meds may very well end your high metabolism.

    Self fulfiling prophecies do come true. If you go in with the expectation that the meds won't work or you will need higher levels than people you read about but can't compare yourself too, you likely won't be satisfied with a mere 50% relief most of us have to learn to live with. However you do have the makings of a good excuse for rapid increases and unrealisic expectations of meds that don't regulate based on metabolism.

    Since I began using LA opiates my metabolism has slowed to a standstill, meds haven't started working longer or better. I wrestled for years at lower weight classes and could control my wieght to the ounce and drop or increase weight moving freely up or down 20 lbs as needed for the next match. Now its a bear to loose a single lb. I can't think of why meds that inherently slow metabolism and pain that causes a more sedentary lifestyle and that slow or completely stop bowel contractions that would move an oral med through your sytem would be effeted by your fast metabolism. I don't believe a high metabolism would somehow shorten the haf life of meds and limit their ability or duration to bind to opiate receptors.

    More than likely your metabolism will be slowed, your bowels will slow to a standstill that needs daily management, your hormone levels will drop and become an issue and you will gain weight from these completely benign meds everyone is entitled too.

    I don' doubt metabolism has an effect on some drugs and the way we process them, but you're not talking about buring through insulin faster. Engineered LA opiates are an entirely different animal. You might want to wait until you have tried a slow release med befor you decide you won't be happy with the dose your given. Starting low with a new med is just part of the titration process. No doc can say you have a 3mm disc bulge so 15 mgs of oxycodone should manage yorur pain well. It doesn't work that way either.

    Good luck, Dave

    Old 07-11-2006, 08:58 AM   #6
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    Re: opiate receptors and metabilism question

    Dave - I always enjoy a refresher course in Opiate Receptors 101!! Thanks for posting it again. KathyMac

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