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Substance Abuse
Mon At the End of My Rope
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<blockquote data-quote="Rumpole" data-source="post: 552072" data-attributes="member: 15255"><p>Yes, I can answer that. Glad you asked; To explain it, I'll need to go a little in detail into the neuropharmacology, but it should put your mind at ease that he's not getting high on them.</p><p></p><p>Drugs like heroin and morphine are called opiates (because they come from the opium poppy), and more broadly drugs with that type of chemical structure are opioids (this includes synthetic substances such as vicodin, suboxone, etc). When opioids pass into your bloodstream, and then across the "blood brain barrier", they attach to brain cells called "opioid receptors". Drugs like heroin, morphine, methadone, vicodin and codeine are known as "agonists", because they activate the receptors.</p><p></p><p>Naltrexone/naloxone etc are "antagonists", because they reverse the effects of agonists. Suboxone is actually a bit of both; it's made up of two drugs, buprenorphine and naloxone. Buprenorphine is quite unique in opioids because it's only a "partial-agonist"; this means you don't really get the full on opioid effects, you don't get any euphoria, and so on. However, it does go and "sit" on the receptors and so it makes you feel like you've taken heroin insofar as you don't crave it, but you don't get the effects.</p><p></p><p>Now, you mentioned that he's quite nice when he's on it. I've tended to notice it has something of a slight anti-depressant and anxiolytic effect. I tend to be less anxious, more motivated, more comfortable, as it were. Also, it's a long-acting drug (48 hour half-life) and so if he is taking it, he won't be having the ups and downs of the effects of heroin peaking and troughing in 4 to 8 hours in his bloodstream. As to the question about why one would stop taking suboxone for a day or two... it's far more common to do that early in treatment. Though it is also true that suboxone won't provide the full "make everything okay" effect of heroin, and so if the underlying anxiety/depression etc issues remain unresolved, he may feel tempted.</p><p></p><p></p><p><span style="color: #000000"></span></p><p><span style="color: #000000"></span>I suppose I tend to have a different view of that. I think kids tend to tune parents and educators out when they feel that what they're being told is exaggeration. A bit like Reefer Madness. And I think that message is so dramatic it's very easy to shut out and ignore. If I were to go back and speak to the 17 year old version of myself, I'd say, how badly do you want to have a <em>good </em>life? Do you want to have a nice house, a good job, an education, a spouse? Because the longer you use drugs, the further away that stuff gets.</p><p><span style="color: #000000"></span></p><p><span style="color: #000000">Clean or dead makes it sound like an almost Rebel Without a Cause blaze of glory. What should really scare young addicts is asking them if they want to be a 40 year old addict? Do they want to get to that age and not have a spouse, not have assets, not have travelled and met interesting people, not to have pursued a university education, just drifted for years? But that's just how I'd couch it. Everyone's different.</span></p><p><span style="color: #000000"></span></p><p><span style="color: #000000">Edit: I wrote another post earlier responding to the original post in some detail, I think it's awaiting approval.</span></p></blockquote><p></p>
[QUOTE="Rumpole, post: 552072, member: 15255"] Yes, I can answer that. Glad you asked; To explain it, I'll need to go a little in detail into the neuropharmacology, but it should put your mind at ease that he's not getting high on them. Drugs like heroin and morphine are called opiates (because they come from the opium poppy), and more broadly drugs with that type of chemical structure are opioids (this includes synthetic substances such as vicodin, suboxone, etc). When opioids pass into your bloodstream, and then across the "blood brain barrier", they attach to brain cells called "opioid receptors". Drugs like heroin, morphine, methadone, vicodin and codeine are known as "agonists", because they activate the receptors. Naltrexone/naloxone etc are "antagonists", because they reverse the effects of agonists. Suboxone is actually a bit of both; it's made up of two drugs, buprenorphine and naloxone. Buprenorphine is quite unique in opioids because it's only a "partial-agonist"; this means you don't really get the full on opioid effects, you don't get any euphoria, and so on. However, it does go and "sit" on the receptors and so it makes you feel like you've taken heroin insofar as you don't crave it, but you don't get the effects. Now, you mentioned that he's quite nice when he's on it. I've tended to notice it has something of a slight anti-depressant and anxiolytic effect. I tend to be less anxious, more motivated, more comfortable, as it were. Also, it's a long-acting drug (48 hour half-life) and so if he is taking it, he won't be having the ups and downs of the effects of heroin peaking and troughing in 4 to 8 hours in his bloodstream. As to the question about why one would stop taking suboxone for a day or two... it's far more common to do that early in treatment. Though it is also true that suboxone won't provide the full "make everything okay" effect of heroin, and so if the underlying anxiety/depression etc issues remain unresolved, he may feel tempted. [COLOR=#000000] [/COLOR]I suppose I tend to have a different view of that. I think kids tend to tune parents and educators out when they feel that what they're being told is exaggeration. A bit like Reefer Madness. And I think that message is so dramatic it's very easy to shut out and ignore. If I were to go back and speak to the 17 year old version of myself, I'd say, how badly do you want to have a [I]good [/I]life? Do you want to have a nice house, a good job, an education, a spouse? Because the longer you use drugs, the further away that stuff gets. [COLOR=#000000] Clean or dead makes it sound like an almost Rebel Without a Cause blaze of glory. What should really scare young addicts is asking them if they want to be a 40 year old addict? Do they want to get to that age and not have a spouse, not have assets, not have travelled and met interesting people, not to have pursued a university education, just drifted for years? But that's just how I'd couch it. Everyone's different. Edit: I wrote another post earlier responding to the original post in some detail, I think it's awaiting approval.[/COLOR] [/QUOTE]
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