When Pain Killers Don't Cut It

Erowid user confesses to possible addiction to opioids for kidney stone pain. Commentary to follow quote.

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http://www.erowid.org/experiences/exp.php?ID=22485

I came online tonight searching for answers to my questions about the myriad of drugs I am currently taking, and thought my experience so far with these drugs could prove useful to someone in my position in the future. I have had been passing kidney stones for the past week - the most painful experience of my life - and in between my many trips to the ER, I have been given oxycodone, toradol and dilaudid to control the pain.

I am extremely afraid of developing an addiction to these drugs, as I have an 'addictive personality' and have had drug habit problems in the past. It's been a difficult situation because the onset of kidney pain sends me into such a fright that I pop the maximum amount of pills that I am supposed to take at once. I am afraid that slight pain I begin to feel will worsen until I am in the state I was in the first day I had the stones - a pain that I would not wish upon my worst enemy. The pain had me reduced to a blabbering, crying mess. When I got to the ER that day I had no control over my words and actions, and I was screaming and moaning for painkillers. When I finally got my shot of toradol and dilaudid I was in heaven...and I tried so hard to convince myself it was just from the pain relief, not from the drugs themselves.

I finally left the hospital that day and continued to have bouts of pain that would sometimes be relieved by the prescriptions, and sometimes not. By the fourth day, I noticed the meds were having no effect whatsoever. It scared me that I already was having such a tolerance to the meds, especially because of how strong I was told dilaudid was. Was it the strength of pain or my tolerance to the meds? I don't really know. I just got home from my third visit to the hospital in the past week, except I had to stay overnight with a morphine drip to control the pain. I was later switched to oral medication - oxycodone - and I was able to handle the pain that way so I got sent home with 30 more pills.

There is no real point to my story except that I question my actions...at the slightest possibility of my beginning to feel twinges of back/abdomen pain associated with kidney stones, I take the oxycodone, toradol, and/or dilaudid. I really don't know if it's more because I am afraid of having pain like I did, or because I am developing an addiction to these pain killers. I must admit that the pain killers make it so much easier to sleep, and as soon as I feel the 'coming down' effects like increased sensitivity (crying at the drop of a hat) and increased annoyedness (especially at loud noise), I feel compelled to take the drugs. At the same time, however, these drugs do not provide all bliss to me either; I experience intense itchiness, mild nausea, and an overwhelming grogginess that brings about a depressed mental state. I personally feel much better having written this, because I think I am being a lot more honest with myself, and have realized that I have caught myself giving in to an addiction...

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Commentary: Acute pain caused by kidney stones is never remedied by opioids, except when the user is asleep. Had the Emergency doctor been on the ball, had she co-prescribed hydroxyzine or suggested an OTC antihistamine such as Benedryl (diphenhydramine), Chlor-tripolon (chlorpheniramine) or even cetirizine (which has not sedative properties but being a metabolite of hydroxyzine) does moderate opioid potentition, the user would have experienced pain relief earlier once the sedation of the antihistamine kicked in. This also implies less opioids can be taken to relieve the pain.

As shown in the above case, the person reporting his experience with opioids is under great pain, and under these circumstances, tries to dull the pain. Adding an antihistamine to lessen his dose of opioids would complicate matters i.e. scheduling when to take it and how to tell the difference between an antihistamine and an opioid. So the combination would only be useful in a hospital setting where dose scheduling could be better controlled.

This is why antihistamines, especially first-generation such as Benedryl, Chlor-tripolon and hydroxyzine, are usually not given to people with their pain medication due to the risk of overdose.

This is also why tobacco products are addictive, because of the synergy between the nicotine (an acetylcholine agonist) and harmaline, a central nervous system (CNS) stimulant and a reversible inhibitor of MAO-A (RIMA), contained in cigarettes and other tobacco products.

A RIMA prevents the breakdown of neurotransmitters, especially acetylcholine, adrenalin, dopamine, GABA, noradrenalin, serotonin, and tyrosine.

As a RIMA, harmaline also prevents histamine (a monamine) from breaking down. In high doses, with susceptible people it might cause hallucinations because of this action by preventing the breakdown of endogenous dimethyltryptamine. This is not true in all cases.

Nicotine itself too is a CNS stimulant, though its metabolite cotinine is both an anti-psychotic and nootropic.

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Original post: June 10, 2010 at 7:40 PM

XInjiang: Uyghur People Then and Now

The legacy of the Ming is found in the 100-word Eulogy praising Muhammad.

It is precisely because PRC is atheistic to the point of being antagonistic to Christianity, Judaism and Islam when their adherents operate outside the control of the CCP that leads to Beijing using Hui people to fight with Uyghur people, mainly by misleading both sides.

This has a lot to do with the Soviet Union's support of Uighur militants when they tried to interfere with Communist China after Mao split with Moscow over Chinese Communist policies during the Cold War era.

When the First East Turkestan Republic tried to gain Uighur independence in 1933, Ma's forces massacred many Uighurs, and overran the British embassy.

As well, corrupt Chinese warlords such as Jin Shuren frustrated the Uighurs by favoring the Chinese people in Xinjiang over Uighurs. In response to threats by the Uighurs, the White Russian garrison under Shuren's command revolted due to their treatment when faced with the Uighur rebel forces.

In response, Shuren fled to Moscow, leaving Sheng Shicai to rise to power in Xinjiang.

Prior to the First East Turkestan Republic, Xinjiang was a defacto Soviet Satellite state run by the Urumqi consul of the Soviet Union. In effect, the Soviet embassy ran the state with warlord Shicai in charge, provided that he consult with them on internal matters.

Four years after the East Turkestan Republic fell (1937) Shicai purged Xinjiang of forces hostile to Soviet interests to coincide with Stalin's Great Purge. This was referred as the Xinjiang War.

During the latter part of the 1930s, Xinjiang was nominally part of China but was actually part of the Soviet.

By Shicai designating Turkic Muslims into ethnicities, it may have been a Soviet attempt to create disunion among the Turkic people of Xinjiang. The use of the term "Uighur people" was objected to by Turkic Uighur leaders Mohammad Amin Burgha and Masud Sabri, with Burgha concerned about Turkic ethnicities designation and Sabri concerned about Shicai designating Turkic people as "Uighur people".

1942 marked the beginning of the end of warlord Sicai's rule in Xinjiang when he purged Urumqi of the Soviets and even had Mao's brother Mao Zemin killed. Now currying favor with the KMT (Nationalists), he may have felt frustrated by the slow response of KMT troop movement into XInjiang and erred by changing sides again in support of the Soviets when their war efforts turned the tide against the Germans in 1944.

By this time, Stalin refused to support Sicai's request for their aid and sent Sicai's request to the KMT, which led to him losing governship of Xinjiang shortly afterwards.

Both Burgha and Sabri are pan-Turkic rebels wishing to establish Western Chinese provinces such as Xinjiang as part of the East Turkestan Republic. Today PRC would rather Western China be a part of China, despite the practice of unpaid forced labor still being practised there.

Even though Western China is a vital part of China today, it is at the expense of the Turkic people there, most of whom are poor due to Beijing favoring the Han people over non-Han.

Unpaid forced labor is a means used by corrupt CCP officials to profit from "free labor", rather than providing promised monthly wages to girls seduced by the false employment scheme.

In the aftermath of a false employment scheme, PRC continually oppressed Turkic parents whose girls had "defected" back to Urumqi by forced unpaid labor in an irrigation project, once again showing that CCP officials there are illegally profiting from "free labor."

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Reference:

100-word Eulogy praising Muhammad: https://en.wikipedia.org/wiki/The_Hundred-word_Eulogy

Islam in China: https://en.wikipedia.org/wiki/Islam_in_China

Ma Shaowu: Official in Xinjiang: https://en.wikipedia.org/wiki/Ma_Shaowu#Official_in_Xinjiang
during Ma's rule in Xinjiang, he gathered Hui conscripts to suppress Uighur rebels who had been trained by the Soviet Union to subvert Communist rule in Western China.

Jin Shuren: https://en.wikipedia.org/wiki/Jin_Shuren

Sheng Shicai: https://en.wikipedia.org/wiki/Sheng_Shicai

Xinjiang War: https://en.wikipedia.org/wiki/Xinjiang_War

Mumammad Amin Bughra: https://en.wikipedia.org/wiki/Muhammad_Amin_Bughra

Masud Sabri: https://en.wikipedia.org/wiki/Masud_Sabri

Unpaid Forced Labor Separates Girls From Homes in Western China: http://www.rfa.org/english/uyghur/uyghur_labor-20070711.html

Dreams Dependent on DMT

The fact that MAO-A and MAO-B oxidizes both neurotransmitters and DMT so we don't go mad is not common knowledge.

Insomnia probably leads to neurotransmitters' levels changing which might lead to MAO not oxidizing DMT.

Hallucinations result, resulting in more stress.

At the root of this is cortisol, which reduces receptors from doing their job.

It is known that high levels of neurotransmitters leads to psychosis while low levels may explain depression.

However, anxiety may be a learned response to uncertainty.

DMT is naturally expressed in the brain, but is quickly metabolized, possibly by MAO.

IMHO it explains dreams.