Opiate-Induced Hyperalgesia (OIH) Table of Contents The following is a transcription from the above video on Opioid Induced Hyperalgesia. Hi, everybody. Welcome back to the channel. I’m Dr. B, Dr. B addiction recovery. The question I’m going to briefly dissect today is opiate-induced hyperalgesia. I’ve been asked this question many, many times, and for some
Shooting Meth Vs Smoking Meth: The Dangerous Differences
Table of Contents
The following is a transcription from the above video on Shooting Meth VS. Smoking Meth.
Hi, everybody. Welcome back to Dr. B Addiction Recovery. As you know, on this channel, we deal with substance abuse. We try to take scientific information, combine it with clinical experience and distill those two, and bring down some meaningful information to you, that you can work with, chew and digest, whether you’re the addict, a loved one or the public at large, so that we can demystify a very mysterious area so you can make better decisions. In addition, we do try to decrease the stigma of substance abuse, because we believe that we can get better care that way. We can get better health policy and public policy. The topic for today is a continuation of our methamphetamine addiction series. The particular question that presented to me is, what is the difference between intravenous use of methamphetamines versus the smoking route? That’s a great question. I’m going to slightly frame it differently.
First Question: Differences Between shooting meth and smoking meth?
Number one, there are several routes of taking in methamphetamines. There’s snorting it. There is smoking it. There’s the intravenous route and there’s ingesting it. There’s something that the intravenous route and the smoking route have in common. They both reach the brain much more rapidly than the other routes. In fact, in addition to the general euphoria of methamphetamine use these two routes produce what’s called a rush, and this is also called a flash amongst users. Okay. It comes on very rapidly, couple of minutes, maybe even shorter. It dissipates very rapidly, and it’s a little bit different than the usual methamphetamine euphoria.
This issue is really of concern, because anything that comes on that fast and produces this effects, causes an issue with their receptors, in this case, the psychological issue as well, which is it increases your abuse potential and likeliness to become an addict.
That’s the theoretical framework that we use clinically. Let me give you an example with benzodiazepines and sugar. Okay. With benzodiazepines, the way it’s looked at clinically is that Xanax has more of an abuse potential than a long-acting benzodiazepine. Why? It comes on really quick, gets you high, and then it wears off really quick. This is the same thing. With diabetes, when we use very simple sugars, it increases your chance of diabetes, actually over the long run. But also think of this. You get a sugar rush. You get a high, and then you crash, and that’s not what we want. This is the same idea. Let’s go back to other issues with this. We have pointed out the similarities, and that is that they produce an intense, rapid rush, not like the usual euphoria methamphetamine use. It comes on really quickly. It’s also called a flash, and then it goes away really quickly. Then [inaudible 00:03:13] to increase abuse potential and addiction. There are some differences between these two as well, and they should be considered as well.
Some of those differences are the fact that, to put a needle in your arm and to escalate to that level, really, there’s a different description of your disease, than someone who’s smoking it or ingesting it or snorting it. In fact, people often start off smoking it, but they graduate to intravenous drug use. Well, we’ve already described that they produce the same kind of rush and high. That graduation, what are we talking about? It’s really, it’s a physical ritual that there are certain barriers psychologically for a person to overcome, to take the step of putting a needle in their arm. That really should be laid out and discussed in the treatment plan and evaluation of a first-time patient to say, I’m actually putting a foreign substance that hurts my body into my arm to get a rush, is really something foreign to any normal human being. It’s why it is important to get a good history from your patient about how their use evolved.
In addition, you’re taking a lot more risks by using the intravenous route, because now it comes with what we call comorbidities and that’s other associated diseases, hepatitis C, hepatitis B, HIV, broken needles, local infections. So, as you can see, although the purely chemical route is about the same, in that it goes into your brain about the same time, which is quite rapid, less than a couple of minutes versus the other routes, snorting or eating the substance or oral ingestion. There are some differences, and one is an escalation of your problem, your abuse potential and your addiction. Those need to be considered. As you can see, from a clinical perspective, there are differences and it’s really important, whoever’s going to history or the intake, or if you’re seeing a physician, they really should be asking you about the history of your use and how it evolved and the route of use, because this information tells them a lot about where your addiction is at, your disease activity is at and what needs to be done.
One more final issue to consider with this. When you’re doing the intravenous route nowadays, depending on your geographic location, many of these guys are polysubstance users. This also tells you quite a bit about where their abuse potential and addiction is at. This is mixed with your opiates, meaning usually heroin or fentanyl, and it’s a concoction that’s referred to on the street as goof ball. Back in the day, long time ago, I think it was speed ball when you’re using crack cocaine or cocaine. In the ’70s, this kind of mixture, depending on which stimulate you were using, any people probably won’t know this, but some guys would call it heroin ball. Okay.
[inaudible 00:06:50] produces a whole different kind of euphoria. So, you can see the intravenous route tells you quite a lot about your addiction, where you’re at and what kind of intensity of care that you need. I hope that clarifies some questions regarding this issue. I hope it demystifies some concepts. I hope you found this video informative. There are other videos related to methamphetamines, if you click above to my left. If you did like our video, and if you think this was informative, please go ahead and click down below on the subscribe button, as well as the like button. See you guys next time.
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