I really just cannot buy the idea that chronic pain patients do not feel the euphoria of the pain medicine they are taking. I just think that some people interpret the sensations as good and therefore euphoric or, as more people who are truly trying to achieve functionality and relief would do, look at the sensations as a side effect and therefore bad. It also causes a slurry of other side effects which both recreational and medical users experience. What really makes it difficult for me to believe is that the same receptor that opioids bind to in order to cause analgesia, the mu receptor, also mediates euphoria, and you cannot create a molecule (so far) which binds to the mu and only activates the analgesia but does not deliver euphoria. The two are intrinsicly intertwined, though you can create molecules with less abuse potential, they also tend to have less analgesic potential. The mu receptor also mediates respiratory depression, nausea, and itching, all of which are experienced by both recreational drug users getting high and CP patients in true pain trying to relieve it. I, for one, think that the reason many pain patients do not feel any euphoria from their medications is that the doses (when a non-tolerant patient starts on opioids) are much smaller than doses taken by even non-tolerant recreational opioid users, and also they do not interpret what they feel as euphoric. Just as some drug users do not like opioids but prefer instead benzos or stimulants. Why? Because not everyone interprets the same stimuli in the same way (I see black you see navy blue kind of idea). Along these lines I think that the majority of chronic pain patients, as this is a non-drug using community mostly, may not notice the euphoria or interpret it as good. But if someone is in real pain, is non-tolerant, and is suddenly slammed with morphine in the hospital after breaking a leg, they most definitely will report the experience as being euphoric, despite the presence of real pain (and I have had multiple people tell me this happened to them when it happened, all the way from age 11 or so). Thus the idea of the drug JUST helping the pain, seems, in my mind, to be a gross oversimplification of a much more complicated dynamic at work.
When people on here talk about
how they changed to oxycodone and they were 'all jazzed up' or that 'I felt weird' or more commonly, 'I did housework all day.' This is one of the properties of oxycodone that drug-users seek so much, THAT IS THE EUPHORIA! It is not some magical place of bliss, drug addicts become addicted to exactly those kinds of feelings. Or when people on morphine or dilaudid or methadone say that they were doing something but they had trouble staying awake and that they were nodding off, that is what drug users seek. In fact an opioid high is called 'nodding' because you nod in and out of sleep during it, just like I am sure many patients here did when they were starting their meds. The difference is that most of you probably did not enjoy it because you were trying to gain back your life, and 'nodding' is not exactly conducive to that. That is what I think the major reason is that most chronic pain patients dont become addicts, because they interept the 'high' as a bad thing, whereas addicts crave it. (BTW I have read MANY MANY stories like those above about
the patients, here and on some other chronic pain sites, and also I have seen with my own eyes my friend who was in terrible pain with cancer do this exact thing, and she was very very 'high' and it was apparent, but she did not enjoy it particularly, except for the pain relief.) I hope people understand, I am not saying that chronic pain patients take their meds to get high. I am merely saying it is a bit rash to suggest that being in more pain somehow eliminates one of the primary effects of a drug. I am just trying to say that people, for the most part feel the same effects from the drugs they take, despite the reason, but interpret those effects in vastly different ways. I hope you guys understand.
I also hope everyone is having a pain-free day,
Post Edited (Circa1988) : 2/3/2008 6:35:25 AM (GMT-7)