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The comment implied that repeated doses to a given person are wildly unpredictable. This is false. Further, you absolutely can approximate how long tolerance l

by nnfy 10y ago

The comment implied that repeated doses to a given person are wildly unpredictable. This is false. Further, you absolutely can approximate how long tolerance lasts, but my point was that you can predict that your tolerance is reduced after abstinence, as opposed to the original comment which suggested that all dosing was unpredictable.

darpa_escapee 10y ago
> The comment implied that repeated doses to a given person are wildly unpredictable. This is false. I didn't imply that repeated doses are unpredictable. Regular repeated dosages can be predictable as long as the patient remains stable with regards to infection/health and other drugs they ingest. Initial dosages, dosage increases and returning to a previously safe repeated-dose after cessation are not at all predictable. This is why I mentioned titration in a previous comment: subjective response to drugs and subjective tolerance cannot be accurately predicted or measured. This is also why drugs like Subutex are titrated when beginning suboxone treatment: a doctor cannot accurately measure tolerance to determine how much of the drug is needed to keep a person out of withdrawals. > you absolutely can approximate how long tolerance lasts Naloxone or naltrexone induced withdrawal rapidly diminishes tolerance faster than it would naturally. This suggests that there's a function that can accurately output a safe and effective dose of opioids based on the variables of previous dosage and time since cessation. I'm arguing that there is a missing variable that's unable to be measured accurately: each person's subjective tolerance. That subjective tolerance depends on a multitude of factors that cannot be determined clinically.
- nnfy 10y ago
  I've only been trying to respond to this statement above, which wasn't yours >The exact same 'homogenized' batch can kill you at any time. One dose you can slam half a syringe, next dose a day or two later, you can do 1/4 that amount and die. Based on your elaboration, I suspect you agree with me that it is nonsense, and that opioids are far more predictible than it implies. Still, I believe you are overstating the danger associated with opioid dosing. This subjective tolerance you speak of likely falls within a reasonable narrow normal distribution and is the reason that based on your weight and gender, doctors may estimate a safe effective dose without titration. Also, I don't believe morphine injections are titrated.
  - lightedman 10y ago
    "Based on your elaboration, I suspect you agree with me that it is nonsense, and that opioids are far more predictible than it implies." You go tell that to my dead pal Carl Mauk, dead from Fentanyl patch. Proscribed, always changed on-time and never abused. Died getting it changed in the hospital.
lightedman 10y ago
"The comment implied that repeated doses to a given person are wildly unpredictable." A. You missed the word 'homogenized' and B. I've had the mispleasure of watching people die on hospital-proscribed opiates taken at proscription times and amounts. Tolerance can change rapidly. The joys of drug counseling.

by nnfy 10y ago

darpa_escapee 10y ago

> The comment implied that repeated doses to a given person are wildly unpredictable. This is false. I didn't imply that repeated doses are unpredictable. Regular repeated dosages can be predictable as long as the patient remains stable with regards to infection/health and other drugs they ingest. Initial dosages, dosage increases and returning to a previously safe repeated-dose after cessation are not at all predictable. This is why I mentioned titration in a previous comment: subjective response to drugs and subjective tolerance cannot be accurately predicted or measured. This is also why drugs like Subutex are titrated when beginning suboxone treatment: a doctor cannot accurately measure tolerance to determine how much of the drug is needed to keep a person out of withdrawals. > you absolutely can approximate how long tolerance lasts Naloxone or naltrexone induced withdrawal rapidly diminishes tolerance faster than it would naturally. This suggests that there's a function that can accurately output a safe and effective dose of opioids based on the variables of previous dosage and time since cessation. I'm arguing that there is a missing variable that's unable to be measured accurately: each person's subjective tolerance. That subjective tolerance depends on a multitude of factors that cannot be determined clinically.

nnfy 10y ago
I've only been trying to respond to this statement above, which wasn't yours >The exact same 'homogenized' batch can kill you at any time. One dose you can slam half a syringe, next dose a day or two later, you can do 1/4 that amount and die. Based on your elaboration, I suspect you agree with me that it is nonsense, and that opioids are far more predictible than it implies. Still, I believe you are overstating the danger associated with opioid dosing. This subjective tolerance you speak of likely falls within a reasonable narrow normal distribution and is the reason that based on your weight and gender, doctors may estimate a safe effective dose without titration. Also, I don't believe morphine injections are titrated.
- lightedman 10y ago
  "Based on your elaboration, I suspect you agree with me that it is nonsense, and that opioids are far more predictible than it implies." You go tell that to my dead pal Carl Mauk, dead from Fentanyl patch. Proscribed, always changed on-time and never abused. Died getting it changed in the hospital.

lightedman 10y ago

"The comment implied that repeated doses to a given person are wildly unpredictable." A. You missed the word 'homogenized' and B. I've had the mispleasure of watching people die on hospital-proscribed opiates taken at proscription times and amounts. Tolerance can change rapidly. The joys of drug counseling.