MAMa FAQ's #11

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More information can be found in Crystal Meth: They Call it Ice.

What is the connection between pain pills and meth use?

Many meth addicts have a concurrent addiction to pain pills like Lortab or Vicodin, and/or tranquilizers like Valium or Xanax. They use the pills to blunt the side effects of methamphetamine, the jumpiness and jitteriness, rapid heart rate and palpitations. Addicts also commonly mix their methamphetamine with Heroin or Dilaudid to enhance the high, a process called 'speedballing.'

The combination of meth and heroin is far more addictive than either drug taken alone. John Belushi died speedballing heroin and cocaine, and his death drew national attention to the problem. The breakpoint for rats addicted to speedballs was much higher than for any dose of methamphetamine tested. They would press that lever till they died to get another speedball, where they gave up after awhile if all they got was ice.

Tolerance to heroin is rapid, even the second dose doesn't feel as good as the first dose did. The brain acts immediately to protect itself from the overstimulation of opioid receptors. The receptors for heroin undergo the same phosphorylation, sequestration, degradation pattern seen with dopamine receptors exposed to methamphetamine. It takes more and more heroin to get a rush, and eventually you require a toxic dose just to get high. The result is death by overdose. It's not that the guy made a mistake and took too much. The amount he needed to get high was enough to make him quit breathing, and he died.

Chronic exposure to narcotics, even mild narcotics like Lortab or Vicodin, causes hyper-sensitivity of the nerves all over the body. They become ten times more sensitive to pain than normal. They took some rats and got some of them hooked on heroin. Then, they dissected out the little spinal cords of these rats, exposed the neurons to caustic chemicals, and measured the sensitivity of these neurons to painful stimuli. The narcotic addicted rats were ten times more sensitive to painful stimuli than non-addicted rats. That's not somebody complaining about their backache. That is real pain transmission in the dorsal horn of the spinal cord of a rat. It really hurts.

Withdrawal from heroin is the most painful withdrawal of any drug. Combined with the withdrawal from methamphetamine, it is almost unbearable. In withdrawal from heroin, everything hurts. Your hair hurts, your eyeballs hurt, your teeth hurt, even the food moving through your gut hurts. You get intense bone and muscle pain as all your muscles go into spasm. You have intense anxiety and irritability. You get sweaty and nauseated. Your nose runs and you vomit. You get dehydrated from the diarrhea and you can die in withdrawal. This is not to be taken lightly. Heroin withdrawal needs to be carefully supervised. Combine all that with the misery of methamphetamine withdrawal, and you are faced with a true horror.



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