Understanding the Variability of Opioid Effects: Why Do Chronic Pain Medicines Not Make Me Feel 'High'?

Opioids affect individuals differently, and what works for one person may not work for another. Not everyone who takes opioids for chronic pain feels euphoric or 'high'. This variability can be influenced by a variety of factors, including genetics, other medications, organ function, and personal tolerance.

The Role of Additional Medications and Organ Function

It's important to consider any additional medications you may be taking, such as Suboxone, Methadone, or others. These can interact with opioids and affect their efficacy. Your kidneys and liver, which are vital for metabolizing and eliminating opioids, must function properly. If either of these organs is not functioning correctly, the effects of opioids may differ significantly. My grandfather experienced this during his hospice care; despite being on morphine, his kidneys were failing, leading to diminished pain relief.

Individual Tolerance and Perception of Pain

The reasons for not feeling 'high' with opioids can vary. The body's response to opioids is not solely genetic; it can also be influenced by personal characteristics and current health conditions. Some individuals may not be predisposed to seeking euphoric effects. Being in pain management does not automatically make you a 'fanatic,' but a fanatical response might develop in the presence of real pain and consistent, unmanaged pain signals. If you are taking your pain medication as prescribed and experiencing appropriate pain relief, you should not feel 'high'.

The Nature of Opioid Effects

Opioids are primarily central nervous system depressants, which means they can reduce the perception of threats in the brain, leading to a feeling of relaxation. However, after prolonged use, tolerance to the sedative effects can develop, but other side effects like constipation and respiratory depression persist.

Addiction and Substance Use Disorder

Chronic use of opioids can lead to addiction or substance use disorder, a complex condition involving genetic predisposition, psychological factors, and environmental influences. Some individuals experience psychic effects of opioids, such as a lessened perception of pain, despite the presence of negative consequences in their lives.

The Risks Associated with Opioid Use

Besides the reduced euphoric sensation, opioids can also have serious risks. For example, taking more than the prescribed dose can result in a “low” feeling, with reduced cognitive function, respiratory depression, and other symptoms like itching and difficulty sleeping. This can be miserable for the individual and potentially dangerous.

It is important to manage chronic pain responsibly, with thorough medical supervision, and always follow the prescribed regimen. If you are experiencing any concerning side effects, it is crucial to consult your healthcare provider for further evaluation and assistance.