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I have always wondered how pain killers could be so addictive. Stimulants are physically addictive. They modify signals in your physiology to increase signal

I have always wondered how pain killers could be so addictive. Stimulants are physically addictive. They modify signals in your physiology to increase signal performance, in some way, and the body reacts to the temporary performance boost. There is a craving for the stimulant the body has becoming reliant upon and a withdrawal in the absence of that chemical. This manner of physical addiction isn't a choice and everybody is roughly equally at risk. Even laxatives are equally physically addictive in this manner even though there is absolutely no modification to behavior from laxative consumption. Pain killers, and other depressants, on the other hand, don't work this way. With a very narrow exception to extreme alcohol consumption depressants are not immediately physically addictive. They require a modification to behavior to be addictive. In this way marijuana, which has no known physically addictive properties, has shown to be addictive to a small segment of users. I have always wondered how depressant addiction occurs. Unlike with stimulants we are not all created equal. Some people are more prone to addiction from depressants than others. Some few people do not find depressants at all addicting and even detest their use. It makes me wonder what is the primary behavioral switch that enables this manner of addiction.

Nursie 8y ago
It's rather simplistic to view opiates as mere depressants. They also create euphoria. I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe, or that you can generalise across multiple, vastly different families of drugs like this...
- austincheney 8y ago
  > It's rather simplistic to view opiates as mere depressants. They also create euphoria. Perhaps for some people that is true. I was given a strong does of opiates for pain at a hospital before and I did not find the experience either pleasant or euphoric. That level of numbness and loss of motor control was actually a dreadful and even fearful experience. It really made me question which was worse between that experience and the pain it relieved. > I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe Are there exceptions?
  - Nursie 8y ago
    Different stimulants have different methods of action on the various receptors in the brain. As such they have very varying addiction profiles. I think the blanket statement "Stimulants are physically addictive" is wrong (some, like MDMA or exotics like methiopropamine have a fairly low addiction rate), and the idea that somehow depressants as a class don't have this property is bizarre. I'm not quite sure what you mean by "They require a modification to behavior to be addictive". If you take opiates for a while, you're likely to become physically addicted as the receptors in your brain start to regulate differently due to the presence of the drug. If you take crack cocaine for a while, you'll likely become physically addicted (or at least dependent) in a very similar way (though with very different withdrawal effects).
    - austincheney 8y ago
      I can accept bizarre. I think it is safe to say all drugs modify the physiology of the user in some way. The difference is if that change to the body is what induces a craving for more from a cellular level. There is no indication that depressants, as a class, achieve addiction purely in response to cell modification. You mention cocaine versus opiates. A major difference there is that cocaine doesn't require repeated use to be addictive. It is immediately addictive and may result in drug addiction even many years later: https://en.wikipedia.org/wiki/Cocaine_dependence#Risk https://en.wikipedia.org/wiki/Cocaine_dependence#Risk Opiates are not immediately physically addictive. It takes repeated dosage for addiction to set in. Typically this is a result of pathological changes resulting in a combination of modified neuron-physiology and adjusted behavior. For depressants to be addictive it seems there must be some manner of behavioral persistence that drives the user to continue consumption in addition to physiological adjustments. If the drug is not immediately addictive the user must then use it repeatedly to build addiction. There has been research that indicates this is the pattern of addiction for cigarette use even though the primary drug present is nicotine, which is a physically addictive stimulant. While nicotine is physically addictive not everybody who smokes cigarettes becomes a dedicated smoker. It takes more than the physical addiction to nicotine. This has been identified by research as well, and much of that research indicates it is a combination of certain demographics and personality profiles that most likely triggers cigarette addiction. This research indicates these individuals are identifiable and their degree of addiction prevalence is predictable. While cigarettes are not depressants the point illustrates the difference between a purely physically addictive quality and actual addiction in practice.
optionsguy 8y ago
Actually, amphetamines and cocaine do not cause physical dependence, while opioids and GABA agonists (alcohol, barbiturates, benzodiazepenes) do cause physical dependence. ‘Depressant’ addiction occurs because they’re physically and psychologically addictive. You may want to do 5 minutes of quick research before writing posts about subjects you are unfamiliar with in such an authoritative tone. Conversely, as a former heroin addict and alcoholic who also used cocaine and amphetamines without developing addictions to either, I wonder how people develop addictions to substances with no physically addictive qualities.
- austincheney 8y ago
  Methamphetamine - https://en.wikipedia.org/wiki/Methamphetamine#Addiction https://en.wikipedia.org/wiki/Methamphetamine#Addiction The addictive quality of meth lies in the physical adjustment of neuron pathways in the brain. While the specific gene triggers associated with meth are known and likely specific to this drug the physically addictive pattern is not radically different from other stimulants. Essentially meth stimulates certain specific neuron pathways in the brain. The brain becomes reliant upon the drug for a greater than normal performance in the adjusted neurons. While there are behavioral results from this adjust the changes are to the physiology of the brain. Withdrawal is present when the patient is removed from the drug in a pattern similar to all other stimulants. Even regular caffeine intake results in physiologic symptoms when consumption is halted. As for cocaine there are very many reports and research that describe the physiological addition attributed to the drug. This is about as well accepted scientifically as climate change and evolution. There are numerous research examples of red blood cells choosing cocaine attachment over oxygen studied from blood of addicts. > You may want to do 5 minutes of quick research before writing posts about subjects you are unfamiliar with in such an authoritative tone. Perhaps instead of attacking people with baseless claims you could point me in the proper direction with research.
RGamma 8y ago
Please watch this before making other plainly wrong and unsubstantiated comments like this: https://www.youtube.com/playlist?list=PL150326949691B199 https://www.youtube.com/playlist?list=PL150326949691B199 The stimulant/depressant dichotomy doesn't hold by the way. For instance alcohol's effect on the brain is not only very non-specific but also not very well understood whatsoever (see https://en.wikipedia.org/wiki/Alcohol_(drug)#Pharmacology https://en.wikipedia.org/wiki/Alcohol_(drug)#Pharmacology or the lecture). Or more precisely it (dose-dependently) acts directly or indirectly inhibitory or excitatory simultaneously in various parts of the brain. And whatever mess mixed intoxication causes in your head...
- austincheney 8y ago
  The physically addictive quality of alcohol has more to do with the liver and less to do with the brain even though alcohol is known to cause brain damage. The primary damage from excessive continuous alcohol consumption over a period of 8 years or more is in the liver resulting in a variety of metabolic and processing disorders. In some cases sudden severe withdrawal can be harmful and possibly fatal as the liver is incapable of processing a variety of normal functions has become partially reliant on the continued alcohol consumption to address some of this functionality. The most clear indicators of brain damage present in withdrawal are destruction of GABA and dopamine receptors that can result in a variety of behavior problems. The dopamine receptor damage is at least partially resultant from the liver damage. * https://en.wikipedia.org/wiki/Alcoholic_liver_disease https://en.wikipedia.org/wiki/Alcoholic_liver_disease * https://en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome https://en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome > Please watch this before making other plainly wrong Perhaps you should have your facts together before attacking people with divisive bias.
  - Nursie 8y ago
    You appear to be confusing addiction, which is happening in the brain and is to do with the GABA and other receptors, with the nature of the withdrawal symptoms.

Nursie 8y ago

It's rather simplistic to view opiates as mere depressants. They also create euphoria. I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe, or that you can generalise across multiple, vastly different families of drugs like this...

austincheney 8y ago
> It's rather simplistic to view opiates as mere depressants. They also create euphoria. Perhaps for some people that is true. I was given a strong does of opiates for pain at a hospital before and I did not find the experience either pleasant or euphoric. That level of numbness and loss of motor control was actually a dreadful and even fearful experience. It really made me question which was worse between that experience and the pain it relieved. > I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe Are there exceptions?
- Nursie 8y ago
  Different stimulants have different methods of action on the various receptors in the brain. As such they have very varying addiction profiles. I think the blanket statement "Stimulants are physically addictive" is wrong (some, like MDMA or exotics like methiopropamine have a fairly low addiction rate), and the idea that somehow depressants as a class don't have this property is bizarre. I'm not quite sure what you mean by "They require a modification to behavior to be addictive". If you take opiates for a while, you're likely to become physically addicted as the receptors in your brain start to regulate differently due to the presence of the drug. If you take crack cocaine for a while, you'll likely become physically addicted (or at least dependent) in a very similar way (though with very different withdrawal effects).
  - austincheney 8y ago
    I can accept bizarre. I think it is safe to say all drugs modify the physiology of the user in some way. The difference is if that change to the body is what induces a craving for more from a cellular level. There is no indication that depressants, as a class, achieve addiction purely in response to cell modification. You mention cocaine versus opiates. A major difference there is that cocaine doesn't require repeated use to be addictive. It is immediately addictive and may result in drug addiction even many years later: https://en.wikipedia.org/wiki/Cocaine_dependence#Risk https://en.wikipedia.org/wiki/Cocaine_dependence#Risk Opiates are not immediately physically addictive. It takes repeated dosage for addiction to set in. Typically this is a result of pathological changes resulting in a combination of modified neuron-physiology and adjusted behavior. For depressants to be addictive it seems there must be some manner of behavioral persistence that drives the user to continue consumption in addition to physiological adjustments. If the drug is not immediately addictive the user must then use it repeatedly to build addiction. There has been research that indicates this is the pattern of addiction for cigarette use even though the primary drug present is nicotine, which is a physically addictive stimulant. While nicotine is physically addictive not everybody who smokes cigarettes becomes a dedicated smoker. It takes more than the physical addiction to nicotine. This has been identified by research as well, and much of that research indicates it is a combination of certain demographics and personality profiles that most likely triggers cigarette addiction. This research indicates these individuals are identifiable and their degree of addiction prevalence is predictable. While cigarettes are not depressants the point illustrates the difference between a purely physically addictive quality and actual addiction in practice.

optionsguy 8y ago

Actually, amphetamines and cocaine do not cause physical dependence, while opioids and GABA agonists (alcohol, barbiturates, benzodiazepenes) do cause physical dependence. ‘Depressant’ addiction occurs because they’re physically and psychologically addictive. You may want to do 5 minutes of quick research before writing posts about subjects you are unfamiliar with in such an authoritative tone. Conversely, as a former heroin addict and alcoholic who also used cocaine and amphetamines without developing addictions to either, I wonder how people develop addictions to substances with no physically addictive qualities.

austincheney 8y ago
Methamphetamine - https://en.wikipedia.org/wiki/Methamphetamine#Addiction https://en.wikipedia.org/wiki/Methamphetamine#Addiction The addictive quality of meth lies in the physical adjustment of neuron pathways in the brain. While the specific gene triggers associated with meth are known and likely specific to this drug the physically addictive pattern is not radically different from other stimulants. Essentially meth stimulates certain specific neuron pathways in the brain. The brain becomes reliant upon the drug for a greater than normal performance in the adjusted neurons. While there are behavioral results from this adjust the changes are to the physiology of the brain. Withdrawal is present when the patient is removed from the drug in a pattern similar to all other stimulants. Even regular caffeine intake results in physiologic symptoms when consumption is halted. As for cocaine there are very many reports and research that describe the physiological addition attributed to the drug. This is about as well accepted scientifically as climate change and evolution. There are numerous research examples of red blood cells choosing cocaine attachment over oxygen studied from blood of addicts. > You may want to do 5 minutes of quick research before writing posts about subjects you are unfamiliar with in such an authoritative tone. Perhaps instead of attacking people with baseless claims you could point me in the proper direction with research.

RGamma 8y ago

Please watch this before making other plainly wrong and unsubstantiated comments like this: https://www.youtube.com/playlist?list=PL150326949691B199 https://www.youtube.com/playlist?list=PL150326949691B199 The stimulant/depressant dichotomy doesn't hold by the way. For instance alcohol's effect on the brain is not only very non-specific but also not very well understood whatsoever (see https://en.wikipedia.org/wiki/Alcohol_(drug)#Pharmacology https://en.wikipedia.org/wiki/Alcohol_(drug)#Pharmacology or the lecture). Or more precisely it (dose-dependently) acts directly or indirectly inhibitory or excitatory simultaneously in various parts of the brain. And whatever mess mixed intoxication causes in your head...

austincheney 8y ago
The physically addictive quality of alcohol has more to do with the liver and less to do with the brain even though alcohol is known to cause brain damage. The primary damage from excessive continuous alcohol consumption over a period of 8 years or more is in the liver resulting in a variety of metabolic and processing disorders. In some cases sudden severe withdrawal can be harmful and possibly fatal as the liver is incapable of processing a variety of normal functions has become partially reliant on the continued alcohol consumption to address some of this functionality. The most clear indicators of brain damage present in withdrawal are destruction of GABA and dopamine receptors that can result in a variety of behavior problems. The dopamine receptor damage is at least partially resultant from the liver damage. * https://en.wikipedia.org/wiki/Alcoholic_liver_disease https://en.wikipedia.org/wiki/Alcoholic_liver_disease * https://en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome https://en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome > Please watch this before making other plainly wrong Perhaps you should have your facts together before attacking people with divisive bias.
- Nursie 8y ago
  You appear to be confusing addiction, which is happening in the brain and is to do with the GABA and other receptors, with the nature of the withdrawal symptoms.