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Given the extremely strong negative reaction to alcohol that patients who are taking Disulfiram experience and given that this is apparently the sole effect tha

Given the extremely strong negative reaction to alcohol that patients who are taking Disulfiram experience and given that this is apparently the sole effect that alcohol abuse cessation treatment using it relies on, it is my belief that the treatment is unconscionable and inhumane. I quit drinking after more than 25 years of problematic drinking using naltrexone (The Sinclair Method) and, given my experience with alcohol, it was the easiest thing I've ever done. I urge people who have a problem with drinking and wish to quit, who for whatever reason do not feel that 12 step programs like Alcoholics Anonymous are right for them to find a doctor who is willing and able to prescribe naltrexone and have a serious discussion with them. Had I known it was effective as it is I probably would have been able to stop drinking 20 years sooner than I did.

okareaman 4y ago
Antabuse is a way to stop drinking for a period for whatever reason, maybe you have surgery in two weeks and the doctor says you must stop but you can't. No one in danger of having seizures from withdrawels should suddenly stop. I took Antabuse when I wasn't a very bad alcoholic and I stopped for two weeks. Later, when I was much worse, I would shake in the morning until I got a drink. At that point cessation therapy would be dangerous. I did a medical detox.
- raptorraver 4y ago
  Antabuse helped me quiting few years a go. It wasn't THE solution but one of the components in my success. It felt liberating that I didn't have to think that could/should I have a drink. That door was closed.
heavyset_go 4y ago
As long as it's voluntary, it should remain a tool for those who choose to use it. I don't like the idea of court compelled psychiatric or addiction treatment possibly putting people in situations where they might have to take it or otherwise be considered non-compliant to the courts. The Marchman Act in Florida is particularly worrying in that aspect, as it doesn't require someone to have committed a crime at all to be involuntarily ordered into rehab, and non-compliance can mean being in contempt of court. It's cliche, but it reminds me a little too much of the Ludovico technique.
teirce 4y ago
One anecdote to another: Naltrexone isn't all that different from what you're describing Disulfiram as here - it's an opiod blocker so when you drink you get the poison and not the happy chemicals. That doesn't help with addiction, it's subjecting yourself to negative effects / conditioning for drinking. Naltrexone doesn't work for me. It is not very effective for some people.
- anon9001 4y ago
  - deleted 4y ago
    [deleted]
  - eurasiantiger 4y ago
    As long as it’s actual medicine and not street pills laced with fentanyl.
  - xanaxagoras 4y ago
    Xanax is about the worst choice for this because the half life is so short. Most often people receive ativan or librium for the taper you describe.
    - anon9001 4y ago
      Any of them work, and it probably depends how deep you're in. If you can't fall asleep without a drink, xanax would be a good choice. If you need a drink in your hand all day, I'd guess librium. If you're drinking from shift end until you pass out, probably ativan. Alcoholism takes a lot of different forms, and obviously a doctor should come up with a taper plan. But I think the reason these drugs (which actually work) aren't first line treatments is puritanical. They feel good, so giving them to alcoholics to feel just as good (or better) than they did with their drinks feels uneasy. But it really works, and it can be much more easily tapered and controlled. It's frustrating to watch after having seen multiple people successfully taper themselves off booze with other drugs (without doctor's supervision, sadly).
bin_bash 4y ago
As a counterpoint, I tried Naltrexone 3 times in my life and it made no lasting effect on my drinking. I was religious about taking it before drinking as well. I eventually quit last fall but I am not actually sure what I did differently that made it seem to “stick” this time. I didn’t take naltrexone though.
deleted 4y ago
[deleted]
throwaway20382 4y ago
"I urge people who have a problem with drinking and wish to quit, who for whatever reason do not feel that 12 step programs like Alcoholics Anonymous" I urge people to see an addiction specialist first. Do not see AA first. See a doctor asap. This disease is serious and has a high fatality rate. AA meetings are like a club after you have it under control (EG. don't attend drunk). Disulfiram: An old military drug. This will stop you drinking but you need a significant other or parent involved. Each morning you must take the pill and your significant other needs watch to double check. Doctors are scared to prescribe this and the drug companies are ramping down it's production. Hoarding the drug is common. naltrexone: This comes in two forms. The pill and the shot. When you first take this you should do the shot form. The shot lasts 30 days and there is not a possibility of skipping out on pills. Naltrexone will ruin the Euphoria feeling of alcohol and opioids (so it's a kind of two for one). No addiction specialists back the 'the Sinclair Method' but do back daily use of Naltrexone. Rehab: Good short term, bad long term. Rehab failure rate is over %90. A normal rehab will run 10-30k per incident. Do not leave unless you had a Naltrexone shot. Longer stays will impact work, an unemployed Alcoholic is dangerous. Alcoholics Anonymous: Very* difficult for people with social anxiety. People that succeed here find a sponsor which is like dating. You will be rejected literally by tens of potential sponsors until one says yes (hang in there!). AA has a very high success rate for extroverts who become a sponsor - caring over others going through alcoholism seems to rewire the brain. Baker Acted/Marchman: If you have a family member (or a friend but you have family contacts) drinking to a point where they are unable to make decisions - you can file a Baker act. [Name varies wildly state to state]. A court can determine the individual needs intervention and can use state authorities to detain. Depending on your court appearance after 72 hours (don't be drunk lol) - the judge orders more jail time or programs.
- QuantumYeti 4y ago
  Another problem with AA is you don't know who is there voluntarily trying to get better, and who is there because they're a physically abusive alcoholic that was court-ordered to be there. There was also an uncomfortable amount of "thirteenth stepping" going on in my groups, where the single males running them ended up in relationships with women in the groups.
giantg2 4y ago
Interesting side note, shaggy mane mushroom has a similar effect to disulfuram.
- ghostly_s 4y ago
  I think you mean Coprinopsis atramentaria, common name Inkycap, not the similar Coprinus comatus (Shaggymane).
  - giantg2 4y ago
    Ah, true. A search brought up this interesting thing. https://pubmed.ncbi.nlm.nih.gov/34347998/ https://pubmed.ncbi.nlm.nih.gov/34347998/
thenerdhead 4y ago
Good on you! That's an amazing feat in itself.
CyanDeparture 4y ago
I absolutely agree that Disulfiram is an awful drug to treat alcohol abuse with, it feels like conversion therapy for taking a drink. Also, there is no fixing of the underlying issue at all with this drug (I'm pointly saying that conversion therapy is used to fix a problem that doesn exist). I've seen a family member successfully win over an alcohol abuse issue by changing their job and getting therapy after detoxing safely in a hospital. Disulfiram should be bottom of the list for anyone, I've not heard of Naltrexone, but a quick google makes it sound like a superb option too.
photochemsyn 4y ago
Alcoholism and opiate addiction have some underlying biochemical similarities that a lot of people seem unaware of, even though this explains the effectiveness of naltrexone. For background: > "Opioid Systems. Endogenous opioids are small molecules naturally produced in the body that resemble morphine and have long been implicated in the actions of opiate drugs and alcohol. There are three classes of endogenous opioids: endorphins, enkephalins, and dynorphins. They all exert their effects by interacting with three subtypes of opioid receptors—μ, δ, and κ. Researchers have hypothesized that positive alcohol reinforcement is mediated at least in part by the release of endogenous opioids in the brain. This hypothesis is supported by numerous studies demonstrating that opioid antagonists acting either at all opioid receptor subtypes or only at specific subtypes suppress alcohol drinking in a variety of species and models (for a review, see Ulm et al. 1995). Moreover, complete inactivation (i.e., knockout) of the μ-opioid receptor blocks alcohol self-administration in mice (Roberts et al. 2000b). The agent naltrexone, a subtype-nonspecific opioid receptor antagonist, currently is approved as a treatment for alcoholism in humans and is particularly effective in reducing heavy drinking." Neurobiology of Alchohol Dependence, Focus on Motivational Mechanisms https://pubs.niaaa.nih.gov/publications/arh313/185-195.htm https://pubs.niaaa.nih.gov/publications/arh313/185-195.htm Psychedelic drugs have also been used very effectively under controlled conditions (clinical settings) to break both opiate and alcohol addiction with remarkably high success rates. This is an entirely different approach than using blockers like naltrexone. For example: "Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review " https://pubmed.ncbi.nlm.nih.gov/33231817/ https://pubmed.ncbi.nlm.nih.gov/33231817/ > "It is believed that these agents allow for the reorganization of disordered neural pathways in the default mode network and attenuate maladaptive signaling in mesolimbic reward circuitry. The aim of this review is to examine the current standing of evidence regarding psychedelic psychopharmacology and to provide an overview of the use and effectiveness of these drugs in the treatment of SUD, alcohol use disorder, and for smoking cessation."
hilbert42 4y ago
"...it is my belief that the treatment is unconscionable and inhumane." Likewise. Fortunately, I'm not an alcoholic nor have I ever been one but it's always been my understanding that disulfiram was a pretty brutal way of dealing with the problem. I've seen pharmacology texts written in the 1960s warn of the dangers of disulfiram (I had the impression that by the end of the 1950s it was already recognized as a brute force method that was not that effective). Moreover, as disulfiram inhibits acetaldehyde dehydrogenase, the build up of acetaldehyde in the body alone is pretty nasty and ought to be avoided (there's nothing subtle about this chemical. (I hesitate to use the word 'drug' even though it may have effective uses in completely different areas of medicine.) Making someone feel ill by essentially 'pickling' - or should that be 'poisoning' - him/her from the inside strikes me as a treatment that should have gone out with Galen.
- staticautomatic 4y ago
  My recollection is that accumulation of aldehyde is also the danger of consuming methanol.
  - chimeracoder 4y ago
    > My recollection is that accumulation of aldehyde is also the danger of consuming methanol. I assume you mean ethanol, because methanol is highly poisonous (even a fraction of a shot will make you go blind). But yes, alcohol is broken down into acetaldehyde.
    - staticautomatic 4y ago
      No, my recollection was that methanol is metabolized into something which “pickles” you but I may well be wrong.
      - hilbert42 4y ago
        No, you're not wrong if you're referring to methanol, you could well say methanol 'pickles' the liver and you'd be correct. With ethanol it's somewhat different, chimeracoder is correct when he says alcohol (i.e.: ethanol) is metabolized into acetaldehyde. Here's a slightly more detailed account: From my understanding acetaldehyde is formed in the body by the partial oxidation of ethanol—if one's body oxidized it completely then I guess there would be little problem (but it doesn't)! Instead, the body has two goes at 'neutralizing' ethanol, acetaldehyde being the first metabolite and the second is that acetaldehyde is converted into vinegar (acetic acid) which is essentially harmless. Methanol is worse—much more so. It's first-pass metabolite is formaldehyde (right, it's an excellent 'pickling' preservative), and the second-pass metabolite is formic acid (that's the stuff ants sting you with). Thus methanol double-whammies you and unfortunately it does it par excellence. Methanol is damn horrible stuff really, less than 100ml can kill one outright and if you survive then, as chimeracoder says correctly, you'll likely be left permanently blind not to mention ending up with other serious problems. In fact, one of the emergency procedures for methanol poisoning is to repeatedly give copious quantities of ethanol for quite some length of time—as in the first instance it substitutes for methanol, ethanol's delaying action then gives the body much longer to metabolize methanol and this delay has the effect of ameliorating some of the damage it causes. Here, ethanol is much the lesser of two evils. That said, acetaldehyde is more toxic than ethanol and it's far from being benign (for starters it's what gives you your hangover but that's not the end of it). Whilst it doesn't have the immediate punch of formaldehyde, acetaldehyde is nevertheless still dangerous for several reasons, first the body is capable of metabolizing ethanol in the liver with the enzyme acetaldehyde dehydrogenase however this process is not exactly straightforward nor is the metabolism of ethanol completely benign; second, the dangerous aspects of acetaldehyde dehydrogenase's metabolism of ethanol is that it often results in cumulative damage to the liver over the long-term, especially so when ethanol is taken in large amounts. There's a few Wikis on this but they're a bit complicated for a quick understanding, nevertheless the second link on alcoholic liver disease has a nice diagram that illustrates how long-term liver damage happens: https://en.wikipedia.org/wiki/Acetaldehyde_dehydrogenase https://en.wikipedia.org/wiki/Acetaldehyde_dehydrogenase https://en.wikipedia.org/wiki/Alcoholic_liver_disease https://en.wikipedia.org/wiki/Alcoholic_liver_disease Right, I shouldn't have used the word 'pickling' but I was using it in the vernacular and, as here, I did actually use it in inverted commas. Another way of looking at it is that long-term ethanol/acetaldehyde damage to the liver leads to cirrhosis of the liver—and cirrhosis is in effect the death of liver cells which are then replaced by scar tissue (that's close enough to 'pickling' methinks).
whiddershins 4y ago
What happens if you are on naltrexone and you get hit by a bus and need surgery. Is there a problem where the anesthetic won’t work?
- teirce 4y ago
  There are anesthetics specifically designed to blow through opiate blockers or tolerance. They, coincidentally, are also some of the most dangerous opiods to consume. Fentanyl is an example. This question is also why it's important to have your prescriptions you're taking up to date with your emergency information / contact.

okareaman 4y ago

Antabuse is a way to stop drinking for a period for whatever reason, maybe you have surgery in two weeks and the doctor says you must stop but you can't. No one in danger of having seizures from withdrawels should suddenly stop. I took Antabuse when I wasn't a very bad alcoholic and I stopped for two weeks. Later, when I was much worse, I would shake in the morning until I got a drink. At that point cessation therapy would be dangerous. I did a medical detox.

raptorraver 4y ago
Antabuse helped me quiting few years a go. It wasn't THE solution but one of the components in my success. It felt liberating that I didn't have to think that could/should I have a drink. That door was closed.

heavyset_go 4y ago

As long as it's voluntary, it should remain a tool for those who choose to use it. I don't like the idea of court compelled psychiatric or addiction treatment possibly putting people in situations where they might have to take it or otherwise be considered non-compliant to the courts. The Marchman Act in Florida is particularly worrying in that aspect, as it doesn't require someone to have committed a crime at all to be involuntarily ordered into rehab, and non-compliance can mean being in contempt of court. It's cliche, but it reminds me a little too much of the Ludovico technique.

teirce 4y ago

One anecdote to another: Naltrexone isn't all that different from what you're describing Disulfiram as here - it's an opiod blocker so when you drink you get the poison and not the happy chemicals. That doesn't help with addiction, it's subjecting yourself to negative effects / conditioning for drinking. Naltrexone doesn't work for me. It is not very effective for some people.

anon9001 4y ago
- deleted 4y ago
  [deleted]
- eurasiantiger 4y ago
  As long as it’s actual medicine and not street pills laced with fentanyl.
- xanaxagoras 4y ago
  Xanax is about the worst choice for this because the half life is so short. Most often people receive ativan or librium for the taper you describe.
  - anon9001 4y ago
    Any of them work, and it probably depends how deep you're in. If you can't fall asleep without a drink, xanax would be a good choice. If you need a drink in your hand all day, I'd guess librium. If you're drinking from shift end until you pass out, probably ativan. Alcoholism takes a lot of different forms, and obviously a doctor should come up with a taper plan. But I think the reason these drugs (which actually work) aren't first line treatments is puritanical. They feel good, so giving them to alcoholics to feel just as good (or better) than they did with their drinks feels uneasy. But it really works, and it can be much more easily tapered and controlled. It's frustrating to watch after having seen multiple people successfully taper themselves off booze with other drugs (without doctor's supervision, sadly).

bin_bash 4y ago

As a counterpoint, I tried Naltrexone 3 times in my life and it made no lasting effect on my drinking. I was religious about taking it before drinking as well. I eventually quit last fall but I am not actually sure what I did differently that made it seem to “stick” this time. I didn’t take naltrexone though.

deleted 4y ago

[deleted]

throwaway20382 4y ago

"I urge people who have a problem with drinking and wish to quit, who for whatever reason do not feel that 12 step programs like Alcoholics Anonymous" I urge people to see an addiction specialist first. Do not see AA first. See a doctor asap. This disease is serious and has a high fatality rate. AA meetings are like a club after you have it under control (EG. don't attend drunk). Disulfiram: An old military drug. This will stop you drinking but you need a significant other or parent involved. Each morning you must take the pill and your significant other needs watch to double check. Doctors are scared to prescribe this and the drug companies are ramping down it's production. Hoarding the drug is common. naltrexone: This comes in two forms. The pill and the shot. When you first take this you should do the shot form. The shot lasts 30 days and there is not a possibility of skipping out on pills. Naltrexone will ruin the Euphoria feeling of alcohol and opioids (so it's a kind of two for one). No addiction specialists back the 'the Sinclair Method' but do back daily use of Naltrexone. Rehab: Good short term, bad long term. Rehab failure rate is over %90. A normal rehab will run 10-30k per incident. Do not leave unless you had a Naltrexone shot. Longer stays will impact work, an unemployed Alcoholic is dangerous. Alcoholics Anonymous: Very* difficult for people with social anxiety. People that succeed here find a sponsor which is like dating. You will be rejected literally by tens of potential sponsors until one says yes (hang in there!). AA has a very high success rate for extroverts who become a sponsor - caring over others going through alcoholism seems to rewire the brain. Baker Acted/Marchman: If you have a family member (or a friend but you have family contacts) drinking to a point where they are unable to make decisions - you can file a Baker act. [Name varies wildly state to state]. A court can determine the individual needs intervention and can use state authorities to detain. Depending on your court appearance after 72 hours (don't be drunk lol) - the judge orders more jail time or programs.

QuantumYeti 4y ago
Another problem with AA is you don't know who is there voluntarily trying to get better, and who is there because they're a physically abusive alcoholic that was court-ordered to be there. There was also an uncomfortable amount of "thirteenth stepping" going on in my groups, where the single males running them ended up in relationships with women in the groups.

giantg2 4y ago

Interesting side note, shaggy mane mushroom has a similar effect to disulfuram.

ghostly_s 4y ago
I think you mean Coprinopsis atramentaria, common name Inkycap, not the similar Coprinus comatus (Shaggymane).
- giantg2 4y ago
  Ah, true. A search brought up this interesting thing. https://pubmed.ncbi.nlm.nih.gov/34347998/ https://pubmed.ncbi.nlm.nih.gov/34347998/

thenerdhead 4y ago

Good on you! That's an amazing feat in itself.

CyanDeparture 4y ago

I absolutely agree that Disulfiram is an awful drug to treat alcohol abuse with, it feels like conversion therapy for taking a drink. Also, there is no fixing of the underlying issue at all with this drug (I'm pointly saying that conversion therapy is used to fix a problem that doesn exist). I've seen a family member successfully win over an alcohol abuse issue by changing their job and getting therapy after detoxing safely in a hospital. Disulfiram should be bottom of the list for anyone, I've not heard of Naltrexone, but a quick google makes it sound like a superb option too.

photochemsyn 4y ago

Alcoholism and opiate addiction have some underlying biochemical similarities that a lot of people seem unaware of, even though this explains the effectiveness of naltrexone. For background: > "Opioid Systems. Endogenous opioids are small molecules naturally produced in the body that resemble morphine and have long been implicated in the actions of opiate drugs and alcohol. There are three classes of endogenous opioids: endorphins, enkephalins, and dynorphins. They all exert their effects by interacting with three subtypes of opioid receptors—μ, δ, and κ. Researchers have hypothesized that positive alcohol reinforcement is mediated at least in part by the release of endogenous opioids in the brain. This hypothesis is supported by numerous studies demonstrating that opioid antagonists acting either at all opioid receptor subtypes or only at specific subtypes suppress alcohol drinking in a variety of species and models (for a review, see Ulm et al. 1995). Moreover, complete inactivation (i.e., knockout) of the μ-opioid receptor blocks alcohol self-administration in mice (Roberts et al. 2000b). The agent naltrexone, a subtype-nonspecific opioid receptor antagonist, currently is approved as a treatment for alcoholism in humans and is particularly effective in reducing heavy drinking." Neurobiology of Alchohol Dependence, Focus on Motivational Mechanisms https://pubs.niaaa.nih.gov/publications/arh313/185-195.htm https://pubs.niaaa.nih.gov/publications/arh313/185-195.htm Psychedelic drugs have also been used very effectively under controlled conditions (clinical settings) to break both opiate and alcohol addiction with remarkably high success rates. This is an entirely different approach than using blockers like naltrexone. For example: "Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review " https://pubmed.ncbi.nlm.nih.gov/33231817/ https://pubmed.ncbi.nlm.nih.gov/33231817/ > "It is believed that these agents allow for the reorganization of disordered neural pathways in the default mode network and attenuate maladaptive signaling in mesolimbic reward circuitry. The aim of this review is to examine the current standing of evidence regarding psychedelic psychopharmacology and to provide an overview of the use and effectiveness of these drugs in the treatment of SUD, alcohol use disorder, and for smoking cessation."

hilbert42 4y ago

"...it is my belief that the treatment is unconscionable and inhumane." Likewise. Fortunately, I'm not an alcoholic nor have I ever been one but it's always been my understanding that disulfiram was a pretty brutal way of dealing with the problem. I've seen pharmacology texts written in the 1960s warn of the dangers of disulfiram (I had the impression that by the end of the 1950s it was already recognized as a brute force method that was not that effective). Moreover, as disulfiram inhibits acetaldehyde dehydrogenase, the build up of acetaldehyde in the body alone is pretty nasty and ought to be avoided (there's nothing subtle about this chemical. (I hesitate to use the word 'drug' even though it may have effective uses in completely different areas of medicine.) Making someone feel ill by essentially 'pickling' - or should that be 'poisoning' - him/her from the inside strikes me as a treatment that should have gone out with Galen.

staticautomatic 4y ago
My recollection is that accumulation of aldehyde is also the danger of consuming methanol.
- chimeracoder 4y ago
  > My recollection is that accumulation of aldehyde is also the danger of consuming methanol. I assume you mean ethanol, because methanol is highly poisonous (even a fraction of a shot will make you go blind). But yes, alcohol is broken down into acetaldehyde.
  - staticautomatic 4y ago
    No, my recollection was that methanol is metabolized into something which “pickles” you but I may well be wrong.
    - hilbert42 4y ago
      No, you're not wrong if you're referring to methanol, you could well say methanol 'pickles' the liver and you'd be correct. With ethanol it's somewhat different, chimeracoder is correct when he says alcohol (i.e.: ethanol) is metabolized into acetaldehyde. Here's a slightly more detailed account: From my understanding acetaldehyde is formed in the body by the partial oxidation of ethanol—if one's body oxidized it completely then I guess there would be little problem (but it doesn't)! Instead, the body has two goes at 'neutralizing' ethanol, acetaldehyde being the first metabolite and the second is that acetaldehyde is converted into vinegar (acetic acid) which is essentially harmless. Methanol is worse—much more so. It's first-pass metabolite is formaldehyde (right, it's an excellent 'pickling' preservative), and the second-pass metabolite is formic acid (that's the stuff ants sting you with). Thus methanol double-whammies you and unfortunately it does it par excellence. Methanol is damn horrible stuff really, less than 100ml can kill one outright and if you survive then, as chimeracoder says correctly, you'll likely be left permanently blind not to mention ending up with other serious problems. In fact, one of the emergency procedures for methanol poisoning is to repeatedly give copious quantities of ethanol for quite some length of time—as in the first instance it substitutes for methanol, ethanol's delaying action then gives the body much longer to metabolize methanol and this delay has the effect of ameliorating some of the damage it causes. Here, ethanol is much the lesser of two evils. That said, acetaldehyde is more toxic than ethanol and it's far from being benign (for starters it's what gives you your hangover but that's not the end of it). Whilst it doesn't have the immediate punch of formaldehyde, acetaldehyde is nevertheless still dangerous for several reasons, first the body is capable of metabolizing ethanol in the liver with the enzyme acetaldehyde dehydrogenase however this process is not exactly straightforward nor is the metabolism of ethanol completely benign; second, the dangerous aspects of acetaldehyde dehydrogenase's metabolism of ethanol is that it often results in cumulative damage to the liver over the long-term, especially so when ethanol is taken in large amounts. There's a few Wikis on this but they're a bit complicated for a quick understanding, nevertheless the second link on alcoholic liver disease has a nice diagram that illustrates how long-term liver damage happens: https://en.wikipedia.org/wiki/Acetaldehyde_dehydrogenase https://en.wikipedia.org/wiki/Acetaldehyde_dehydrogenase https://en.wikipedia.org/wiki/Alcoholic_liver_disease https://en.wikipedia.org/wiki/Alcoholic_liver_disease Right, I shouldn't have used the word 'pickling' but I was using it in the vernacular and, as here, I did actually use it in inverted commas. Another way of looking at it is that long-term ethanol/acetaldehyde damage to the liver leads to cirrhosis of the liver—and cirrhosis is in effect the death of liver cells which are then replaced by scar tissue (that's close enough to 'pickling' methinks).

whiddershins 4y ago

What happens if you are on naltrexone and you get hit by a bus and need surgery. Is there a problem where the anesthetic won’t work?

teirce 4y ago
There are anesthetics specifically designed to blow through opiate blockers or tolerance. They, coincidentally, are also some of the most dangerous opiods to consume. Fentanyl is an example. This question is also why it's important to have your prescriptions you're taking up to date with your emergency information / contact.