Just chiming in with the anecdotal statements about opiates - when I broke my wrist, they sent me home with a Vicodin prescription. I filled it and took one at home. My perception is that although my wrist still felt like it hurt, I realized I really didn’t care, and felt pretty good in general; this after being stressed about breaking my dominant wrist and in a good amount of pain.
20 minutes later I threw up, and immediately realized this was an excellent deterrent to addiction. Vicodin is a pretty wussy opiate as things go, and the stress release it gave was really pleasant (while it lasted). I can see someone with issues with stress, anxiety, etc., finding it and stronger drugs to be extremely appealing.
Yes, it’s my understanding that people who are given the drug after they are hurt still feel the pain but just don’t care, while people drugged before pain is inflicted don’t feel the pain in the first place.
Sorry for not being clear in my alcohol analogy. My point being, that despite your intentions, drugs usually have a host of typical effects. Drinking enough alcohol will get you toasted whether or not you were drinking it just to go with dinner, or because you just want some sedation to fall asleep. Likewise, taking Vicodin gives most people a euphoric high, physical pain or not. Hence the recreational abuse potential. In that sense, logic doesn’t follow that you’d expect only one aspect of a drug to manifest, and none of the others, despite what you’re taking it for.
I think the deal with House was that they removed an entire muscle, not a portion of one. There was nothing to regenerate. According to wisegeek.com, the effects of the surgery (called a myectomy) might include damage to surrounding nerve tissue and blood vessels. That would explain the pain, though I’d think it would also be painful to force other muscles to compensate. Here’s the link: http://www.wisegeek.com/what-is-a-myectomy.ht
Personally, I don’t like Vicodin. Even with food, it upsets my stomach, and instead of euphoric, I just feel woozy and crummy. No danger of addiction there. But when I was on Demerol during eye surgery–well, I’ve decided if I’m ever in a lot of pain, I’d ask NOT to be put on Demerol–I felt so blissful on it, I almost cried when the doctor disposed of the unused portion in the ampule. I can see how I could get addicted to that one. No thanks.
I was prescribed dihydrocodeine for pain relief after I badly broke my leg. After taking it for about three months, and realising I wasn’t going to be prescribed any more I was aware that I had developed a bit of a habit.
I remember in the first few days sitting up in bed, with my leg hurting like hell thinking “I’m really happy! I know I shouldn’t be feeling happy but tra la la!” They reduced the dosage after that and it wasn’t quite so much fun but the pain was less by then too. Not much less however, due to the way* they were giving out pain relief one time it was some seven hours after I first asked that the meds actually arrived. In the last hour I was pretty frantic, using every mental resource I had to cope and still ended up banging my hands on the edge of the table to distract myself.
So when they sent me home with a prescription for three pills a day I was relieved that I could take them at regular intervals. Now, to complicate things, I have a lot of hand and arm pain too, which made using the crutches very painful. I became dependent on the dihydrocodeine to get around during the day and to sleep at night. And even as the pain diminished my tolerance of pain decreased with it. Here comes the silly bit: when the second month of my prescription was running out a friend who lives with chronic pain gave me another months supply, to save me having to go back to the doctor. At this point I was taking them more for the arm pain than the leg pain, and to be honest I was taking them because I was scared of being in pain.
By this time I had had a second op to take out the pins and was finally free of the cast and it was dawning on me that I was getting pretty twitchy every time a pill was due and that it wasn’t so much down to physical pain. With a week’s worth left, rather than go and admit the situation to my doctor (or go back to my friend) I decided to taper the pills off over about a week. When I was down to half a pill a night I had two left. At this point I looked at the one I was about to cut in half and thought nah, these pills are actually what is making me feel so shitty, and never took them.
It was horrible, not as horrible as say coming off full blown heroin addiction (I’ve seen someone go through that) but basically cold turkey lite. I had the sweating and shivering, the shits and the depression. I’ve actually taken dihydrocodeine since for pain relief (most recently after a knee replacement) but I’ve always cut them out as soon as I could bear it.
So, getting back to the OP, it wasn’t that clear cut the first time where the line between taking pills for pain and taking them not to feel bad was, and I failed the test.
*I first asked around four o’clock and they said ask the next shift. So after dinner I asked again and they said wait til night rounds. That evening night rounds were about two hours late.
He’s not saying that people don’t drink for the taste. He’s saying that the intent of drinking for the taste doesn’t stop you from getting drunk. If you drink three bottles of wine because it tastes really good, you’ll still get drunk.
As others mentioned above, there’s a big difference between opiates ad libitum and no pain meds, so it’s a false dichotomy on House, probably used to increase drama and make the medical stuff simpler. Chronic pain can be treated with a number of modalities, e.g., anticonvulsants, which reduce transmission of aberrant nerve signals (as in neuropathic pain), topical capsaicin, which depletes substance P (a neurotransmitter prominent in pain conduction), ablation of specific nerves in some cases, tricyclic antidepressants (which also affect transmission and perception of pain), etc.
On a personal note, I have found that morphine and Vicodin both relieve pain, as opposed to just making me not care. Morphine made me a bit floaty-happy, although I was immediately post-op and still metabolizing the anesthetics, but Vicodin made me a bit happy and a fair bit sleepy.
I was hospitalized for several months in 2008 for gallstones with various complications. There were times when I was in a lot of pain and they gave me various pain meds. They knocked out the pain and sometimes they made me fall asleep. But as far as I could tell, they had no mental effects - I didn’t feel “high” or anything like that. When I recovered and wasn’t in pain, I stopped taking the meds and had no desire to take any more of them.
Do many of you posting feel like you have an “addictive personality”, if that actually exists? Particularly those of you who say the pain meds make you high?
I ask because I’ve been dealing with a back/hip issue for about 9 years now, been on some type of pain meds the entire time, and currently take about the max daily of Vicodin and a few other meds) Have the Fentanyl and butrans patch, Valium and various other pain meds, but have never had the effect some of you are describing from them. Also have a dorsal column stimulator implanted, and all those are really necessary to even be able to be moving each day.
The only thing that ever even remotely made me float or feel “high” or loopy is the IV injection they give you to put you out, and that’s only for about 20 seconds, and then you’re out. I’ll grant you, for chronic, extreme pain, when sleep is about 2-3 hrs a night on a good night- that is a great 20 seconds and however long you’re out.
SSRIs are not a narcotic. They affect serotonin levels in the brain to try to maintain more normalized feelings of your moods in those with serotonin neurotransmitter disorders (serotonin being responsible for your general sense of well being), whereby chronic depression and anxiety result.
Opiates hit your central nervous system, and wash your brain in dopamine, which among other things is responsible for feeling pleasure, hence the common euphoric effect. But is typically only prescribed for its analgesic properties (it’s a cough suppressant too).
