Harm Reduction Why do opiates cause apathy?

[ParappaTheRapper]

I was reading something in the empathogen forum here. There was a question about why does MDMA cause people to be confident.

Not connected to that really here, but I thought the why concept is a good question.

So, why do opiates cause apathy?

 

[Numb19]

Because the effects of opioids are euphoric and numbing. It aint all that easy to be sad or sympathetic when your brain is forced into euphoria.

I assume you mean while on opioids. Opioids make you feel great and euphoric but they numb you physically as well as psychologically. They slow down your system and senses. This is why one of the common symptoms of withdrawal is elevated emotion, sadness and even guilt, sometimes extreme. It's also why opioids can cause depression and anxiety when coming off them because of the opioids and their effects on the brain.

Your body goes from one extreme under opioids to the other when coming off them as the body tries to regain homeostasis.

It's like the dude in the documentary Oxycontin Express who found his wife dead from od (they did a couple of pills each before taking a nap) and when he woke up and found her he called 911. Then he snorted oxy while the ambulance was on its way and he was just totally numb.

 

[spacejunk]

Also because the reward pathways in your brain have been satisfied by getting high.
External life experiences or concerns can become less meaningful for some people.
Or, the effort to get money, score and stay well becomes more of a focus for people than other parts of life.
Probably a combination of things...
And some people remain passionate and engaged with life even with a habit.
There is no single answer, outcome or reason.

 

[Numb19]

^ Possibly, but I think that's a different issue altogether and perhaps more related to anhedonia and the effects on the mesolimbic, mesocortical and dopaminergic reward pathways, hippocampus as well as the cAMP/cAMP response element binding protein (CREB) and this is not only with opiates/oids but any drug that presents a "reward" (i.e. high). Opioids also flood the brain with dopamine from GABA inhibition which significantly enhances one's mood. They also alter the limbic system which controls emotions.

Apathy is a suppressed (i.e. numbed) response to something that would normally elicit an emotional response. Also not to be underestimated is an addicts tendency to not care about consequences, which can definitely impact other areas of life.

 

[Jesusgreen]

spacejunk said it pretty well.

There's a documentary about research chemicals, I forgot the name, but they interview the guy who apparently brought Mephedrone to popularity, and he explains it there himself - that one of the big issues with drugs is having them around is like one of those rats/mice in a lab that has a reward/pleasure lever they can pull for a dopamine kick - just like those rats/mice it's easy to just sit there pulling the reward lever and not worrying about anything else, because why move your ass and go do something productive when you can sniff/eat/plug/shoot this powder (or pull this lever in the rat/mice case) and get all the reward for no effort?

A lot of those rats/mice just end up pulling the lever until they OD or starve, which is an extreme example, but when you see how low quality some people let their lives get when addicted to something you can see how that applies to humans too.

I don't think it applies just to opiates though, but to any highly pleasurable substance that one can amass in large amounts. With opiates the effect is just more apparent than with stimulants because with stimulants they over-energise you, so you have a desire to do something to burn off the energy. It's probably still something non-productive like hours of masturbation or other compulsive behaviour but you don't feel like you've been sitting around doing nothing even if you sort of have. With opiates you're sedated rather than stimulated so on top of the lack of need to do anything else for additional reward, your energy is sapped and you want to sit around for the most part.

Mostly this applies to people using heavily/addicted though, opiates can have a stimulant and increased-productivity effect when used within reasonable boundaries. That's why opium was very popular with working folk back in the day. It's also probably why Oxycodone is so popular for example as it's quite a stimulating opiate in comparison to some of the more sedating ones, and people who want to keep leading normal lives find that beneficial.

 

[Numb19]

^ I feel it is a different principle altogether although both apathy and anhedonia have shown to be related to the pre-frontal cortex of the brain they are not one and the same (one could suffer from only one or both).

The inability to experience pleasure is not the same as "indifference" or the inability to feel or express emotion, including both sadness or happiness. One who is apathetic may also still be able to receive pleasure while one who is unable to receive pleasure may still be able to express emotions.

Anyways, my understanding from the OP was apathy caused while on opiates and not while off them? Opioids alter the limbic system, which controls emotion. This is different from stimulating the reward pathways with opioids which bind to receptors and release dopamine, which in turn eventually causes the body to stop producing its own dopamine and endorphins, possibly leading to depression and the inability to experience pleasure while off them.

Again, anyone who has detoxed from opioids knows that one of the common withdrawal symptoms is increased emotions as the body goes from one extreme to the other in order to get to its natural 'middle ground'. Some people just sob and sob while detoxing because their bodies becomes overwhelmed by emotion.

Opioids can act like a "dam" with emotions, which in turn causes a buildup of suppressed emotions that are released once the opioids are ceased. People also take opioids to numb psychological or emotional pain because that is also what they do.

 

[sekio]

People who start doing opioids have a tendency to stop doing all the other pleasurable stuff in their life, like going out and seeing friends, exercising, having a fulfilling job, etc. The opioids become your only relief, your only escape, your only solace. And it's all downhill from there. The opioids are tricky like the One ring. They convince you that all you need is just some more morphine, and you'll be OK until the next 4-6 hours are up and you need some more.

They really do fuck with the reward centers in your brain in a bad way. You have to be fully aware that opioid use will turn you to a slug if you don't control it and force yourself to go do things.

See also: the Rat Park study. Rats that are given lots of food, fun, toys, colorful shit, other rats to play with, and other generally stimulating things to do tolerate opioid withdrawal a lot better than the rats who are locked into a 6 inch by 6 inch by 6 inch box and fed nothing but morphine and sugar water while they stare at the walls and are left alone to wallow in their depression. It's really all about getting other stimuli to activate reward centers in your brain, other than opioids.

TL;DR: Sitting around all day being stoned takes all the fun out of you and nobody wants to be your friend any more and then you feel bad, do more opioids to feel better, and keep digging the pit. The chronic pain patient who exercises as much as he/she can, eats well, takes as many other painkillers as they can to mitigate the pain will undoubtedly be better off than the person who decides all they need is a steady supply of heroin and to nod out all the time and just pretend they don't exist.

Think about why rich people with support networks can abuse heroin and still be considered functional adults, whereas homeless people with no money or support net are basically fish food.

 

[Treefa]

They don't...for me.

I've always considered them the working-man's drug.
Fuck some amphetamines, they'd have me edgy, paranoid, tight muscles=even more back pain, grinding teeth, starving myself, poor quality of sleep..uh uh no siree you can keep that shit.
Opiates on the other hand, feel incredibly natural, give me energy (probably because they relieve pain which leads to less apathy, for me personally. Pain yields apathy IME.), yet also keep me feeling rather, well, normal. I don't get in such a rush when working, nor frustrated when I get stumped.

**ALSO, idk if anybody else has noticed this, but when I take even very high doses of opiates, I often don't notice much effect UNTIL I actually sit down in my recliner. Especially if you're working or socializing or something, the drugs are really in the background, but once you sit down in your desired place of relaxation, it's so easy to relax while tiny waves of euphoria lap gently at the shore of your mind.**

*id like some feedback on that whether other folks notice your dose when youre really busy? Like I said I can tell it's working for pain while working, but don't get much euphoric or "numbing" sensation as if I were relaxing sitting down..In fact if I didn't talk so much on pain meds, i'd probably forget I took anything at all..just very normal feeling.

 

[Erikmen]

They don't...for me.

I've always considered them the working-man's drug.
Fuck some amphetamines, they'd have me edgy, paranoid, tight muscles=even more back pain, grinding teeth, starving myself, poor quality of sleep..uh uh no siree you can keep that shit.
Opiates on the other hand, feel incredibly natural, give me energy (probably because they relieve pain which leads to less apathy, for me personally. Pain yields apathy IME.), yet also keep me feeling rather, well, normal. I don't get in such a rush when working, nor frustrated when I get stumped.

**ALSO, idk if anybody else has noticed this, but when I take even very high doses of opiates, I often don't notice much effect UNTIL I actually sit down in my recliner. Especially if you're working or socializing or something, the drugs are really in the background, but once you sit down in your desired place of relaxation, it's so easy to relax while tiny waves of euphoria lap gently at the shore of your mind.**

I agree that some opiates may give an extra energy specially when one is pain and have prescribed meds. The behavior as I see, tends to be more relaxed and until certain point not distracted. I know people who increases their work productivity and become more social under due medication.
This is not an apology to use Heroin or abuse of prescribed meds. On the contrary..

 

[diver]

They don't...for me.

I've always considered them the working-man's drug.
Fuck some amphetamines, they'd have me edgy, paranoid, tight muscles=even more back pain, grinding teeth, starving myself, poor quality of sleep..uh uh no siree you can keep that shit.
Opiates on the other hand, feel incredibly natural, give me energy (probably because they relieve pain which leads to less apathy, for me personally. Pain yields apathy IME.), yet also keep me feeling rather, well, normal. I don't get in such a rush when working, nor frustrated when I get stumped.

**ALSO, idk if anybody else has noticed this, but when I take even very high doses of opiates, I often don't notice much effect UNTIL I actually sit down in my recliner. Especially if you're working or socializing or something, the drugs are really in the background, but once you sit down in your desired place of relaxation, it's so easy to relax while tiny waves of euphoria lap gently at the shore of your mind.**

*id like some feedback on that whether other folks notice your dose when youre really busy? Like I said I can tell it's working for pain while working, but don't get much euphoric or "numbing" sensation as if I were relaxing sitting down..In fact if I didn't talk so much on pain meds, i'd probably forget I took anything at all..just very normal feeling.

We're in the same boat about this.
I'm a lot more reliable, coherend, decisive, sociable when I'm on opioids.
People I know have told me I look better when I'm 'on'
I just wish the whole addiction thing didn't happen to be the dark side of it all.
It has had me wondering how I'd do if the doc would just prescribe 40mg of oxy /day and leave it up to me to manage it.

 

[oar9fi]

With non-nodding doses, I was always more motivated to get stuff done that I'd been putting off (for instance, going to take a piss I'd end up cleaning the bathroom) and also felt more sociable. When I was on methadone I would take slightly less than my RX and use the extra pills when I needed to get things done. When I was without any opioids it was hard to get much of anything done.

Fast forward 4 years after coming off methadone I use weak opioids (tramadol or kratom) once a week if I have them and that's the day I do work around the house. I know the ugly side all too well now though and stick to my once a week regimen. I admit though if I had a bunch of oxys I'd probably have a difficult time controlling my use.

 

[fizzymk]

People who start doing opioids have a tendency to stop doing all the other pleasurable stuff in their life, like going out and seeing friends, exercising, having a fulfilling job, etc. The opioids become your only relief, your only escape, your only solace. And it's all downhill from there. The opioids are tricky like the One ring. They convince you that all you need is just some more morphine, and you'll be OK until the next 4-6 hours are up and you need some more.

They really do fuck with the reward centers in your brain in a bad way. You have to be fully aware that opioid use will turn you to a slug if you don't control it and force yourself to go do things.

See also: the Rat Park study. Rats that are given lots of food, fun, toys, colorful shit, other rats to play with, and other generally stimulating things to do tolerate opioid withdrawal a lot better than the rats who are locked into a 6 inch by 6 inch by 6 inch box and fed nothing but morphine and sugar water while they stare at the walls and are left alone to wallow in their depression. It's really all about getting other stimuli to activate reward centers in your brain, other than opioids.

TL;DR: Sitting around all day being stoned takes all the fun out of you and nobody wants to be your friend any more and then you feel bad, do more opioids to feel better, and keep digging the pit. The chronic pain patient who exercises as much as he/she can, eats well, takes as many other painkillers as they can to mitigate the pain will undoubtedly be better off than the person who decides all they need is a steady supply of heroin and to nod out all the time and just pretend they don't exist.

Think about why rich people with support networks can abuse heroin and still be considered functional adults, whereas homeless people with no money or support net are basically fish food.

OH, How I agree with this!! Since I have been using, my social life has gone downhill, sex life has gone downhill, basically I have lost all desire to even meet another GF right now...My main concern is H and methadone, if I have enough of either, I generally am pretty good off, can go to work, and perform, but in the back of my head, I know im just working for more dope, and to maintain my current lifestyle, no desire to get ahead or make something of myself anymore.

When I would run out of methadone a few years ago, I would suffer for up to 5-6 days, then the very morning I could fill my script, I was suddenly in a much better mood, I was confident, ready to get on with my life, meet people, go out and talk to friends, but lately, even when I have a full bottle of methadone, or 3 grams of good H, Im finding Im not in this good mood anymore, Im just existing, and thinking about the next time I will be out...its like Im never truly happy anymore, no matter how much of any drug I have.

 

[Numb19]

I agree there's nothing to disagree with, to the contrary, but I'm not sure what you're describing is apathy. Seems more like lethargy and depression as well as fixation on your substance/habit of choice. For example, when you suffer those 5-6 days would you agree that your emotions are much more heightened? People have expressed for example when coming off opiates that even just a sad-sounding song (or even nothing at all) can cause them to sob and sob because their emotions have been suppressed (i.e. apathy) from using opiates.

Anyway, that's what I thought the OP's premise was. I suppose it doesn't really matter since if one goes deeper and deeper then eventually they will be going through all of the above.

 

[diver]

http://www.prohibitionkills.blogspot.com

Here's a link to a site that I origanally found here. It's something that some opiate users could possibly benefit from, so I'm sharing it again.

It says a lot to me about why some opiate users become more productive on their DOC and others get lazy.

 

[rave_itsrealfun!!!]

Personally, opioids - although creating a form of "blissful apathy" - allow me to function at a much higher level than normal, and I find myself highly motivated while in the "here and now" while on opioids. I use very low doses - 1 mg of dilaudid a day - for a slight but extremely profound alteration of my mood, and also for the relief of chronic physical pain.

I think it has a lot to do with level of dose, of course "nodding out" is going to make people lazy and consumed by the high. Judging from my low dose experiences, it is extremely powerful stuff. I have never once nodded out though, I have no desire to use opioids for that purpose and I never will. I consider high doses a threat to my body and mind.

I think they can be highly effective medications if they are not abused.

When I take opiods, there are no physical effects to be noted apart from the total relief of the agony of my years of debilitating spinal nerve pain that cannot be dealt with in any other way. I will be able to get out of bed, cook myself food, and even get a little physical exercise or have sex. Otherwise I am crippled in agony with nerve pain, so obviously I am self medicating in a sense.

Cannabis does not work for me and believe me I have tried. It did way more harm than good (actually it never did anything good whatsoever for me at all... it completely set me off course in life in pursuit of a pointless addiction that fucked me up for many years). With cannabis I am lazy, anxious, and useless, no matter how much I am smoking. I am not normally this way, although abusing cannabis and smoking an ounce a week did have some long term effects.

Psychedelics do not work for me - although I am spiritually inclined, I do not like having my consciousness altered because it's almost always unconstructive in my case and I consider it dangerous to the brain personally, I'm not the most stable guy. I'd much rather read the Tibetan Book of the Dead and meditate than take a hit of acid which again just sets me off course, screws with my physiology. I got nothing out of those. Stimulants cause me too much anxiety, even coffee. I'm just sensitive to most drugs and they are pointless for me.

I do not find that a low dose of opioids is numbing to my brain at all. It numbs my physical agony, but I warmly welcome that. All my mental problems are still there, it's not like I'm all high and pretending that I'm living in some dreamworld, like with weed how I transformed into a completely different person. I am still myself, in no way am I delusional or out of it, and in no way do I lack control over myself. I am able to handle my problems, I am able to control my emotions. I am happier and more confident, it is quite uplifting. I have a better grip on feelings such as powerful lust, anger, jealousy, frustration, and other negative emotions. The emotions are not being blocked out, I am still experiencing them. It's just that I have a new perspective on them. I am transcending them, and much better able to direct my energy accordingly. I also find that it is mentally stimulating - I'm not one for caffeinated beverages, but my brain works really hard when I'm on opioids - and I actually get a little anxious from it, but I love to study and challenge my brain while on this class of drugs. It is the opposite of laziness, lethargic feelings for me.

I would hardly call it getting high. I would call it medicating all of my life issues that are bringing me down, so that I can be the person I want to be, which has nothing to do with being a drug addict - my normal self, the pursuit of my career path and all my hobbies and interests, which isn't possible without drug use anymore since I destroyed myself mainly through abusing cannabis over a decade. Yes it can happen, that weed can DEFINITELY fuck with your head just like any other drug. You can get insanely hooked and lose yourself, obviously I am aware that this can be an issue with opioid use as well for some people. Possibly even myself, since I use them. I do not consider myself immune to their power, and I approach with caution. I learned a lot from being a drug addict in the past as well, that abusing drugs gets you nowhere good. I think I have finally found what I was looking for in the world of drugs though, this stuff is right up my ally. I've been at it for months, and there has been no increase in tolerance, and I have not once considered smoking or using a needle or upping my dose. That just seems silly to me, like someone trying to abuse the medication and aiming for the overpowering experience of the drug itself. I'm through with getting high, that shit fucked me up. My goal is to be normal, which ironically involves getting a little high.

 

[diver]

Personally, opioids - although creating a form of "blissful apathy" - allow me to function at a much higher level than normal, and I find myself highly motivated while in the "here and now" while on opioids. I use very low doses for a slight but extremely profound alteration of my mood, and also for the relief of chronic physical pain.

I think it has a lot to do with level of dose, of course "nodding out" is going to make people lazy and consumed by the high. Judging from my low dose experiences, it is extremely powerful stuff. I have never once nodded out though, I have no desire to use opioids for that purpose and I never will.

I think they can be highly effective medications if they are not abused.

When I take opiods, there are no physical effects to be noted apart from the total relief of the agony of my years of debilitating spinal nerve pain that cannot be dealt with in any other way.

I have various mental problems exacerbated by recreational drug use. Cannabis abuse ruined a decade of my life and left me with a panic disorder after the withdrawal. It really amped up my social anxiety to a whole new world of panic. Back then, I was pointlessly addicted to an idiotic, retarded high that completely set me off course in life and that I had developed unbearable psychological obsession and dependency with, and a horrible physical dependency via appetite suppression. The habitual of cannabis was for me, pointless. I fiended it way too hard, and no matter how much I was smoking it was in no way constructive whatsoever. It made me lazy and anxious. If I wasn't that way before I got high, it would just zap my energy. But I was still addicted somehow, it never made sense.

Psychedelics do not work for me - although I am spiritually inclined, I do not like having my consciousness altered because it's almost always unconstructive in my case and I consider it dangerous to the brain personally, I'm not the most stable guy, I'd much rather read the Tibetan Book of the Dead and meditate than take a hit of acid which again just sets me off course. I got nothing out of those. Stimulants cause me too much anxiety, even coffee.

I do not find that a low dose of opioids is numbing to my brain at all. It numbs my physical agony, but I warmly welcome that. All my mental problems are still there, it's not like I'm all high and pretending that I'm living in some dreamworld, like with weed how everything just melted away. I am still completely myself, in no way am I delusional, and in no way do I lack control over myself. I am able to handle my problems, I am able to control my emotions. I am happier and more confident, it is quite uplifting. I have a better grip on feelings such as powerful lust, anger, jealousy, frustration, and other negative emotions. The emotions are not being blocked out, I am still experiencing them. It's just that I have a new perspective on them. I am transcending them, and much better able to direct my energy accordingly. I also find that it is mentally stimulating - I'm not one for caffeinated beverages, but my brain works really hard when I'm on opioids - and I actually get a little anxious from it, but I love to study and challenge my brain while on this class of drugs. It is the opposite of laziness, lethargic feelings for me.

I would hardly call it getting high. I would call it medicating all of my life issues that are bringing me down, so that I can be the person I want to be, which has nothing to do with being a drug addict - my normal self, the pursuit of my career path and all my hobbies and interests, which sadly isn't possible without drug use anymore since I wrecked myself through abusing cannabis for a decade. I think I have finally found what I was looking for in the world of drugs, this stuff is right up my ally. I've been at it for months, and there has been no increase in tolerance, and I have not once considered smoking or using a needle. That just seems silly to me, like someone trying to abuse the medication and aiming for the overpowering experience of the drug itself. I have very little cravings for them, and no physical dependency since I am using such low amounts.

You cannot generalize the users of any one class of drugs. The majority function just fine on cannabis. However, that drug ruined a decade of my life and I had the obsession of a crackhead and a physical dependency of a junkie.

For those with mental and physiological ailments, who are not in it to get a rush or a high, I believe that opioids could be highly effective in improving ones quality of life.

Good post - Thanks - it's always good to hear the viewpoint of someone who's brain chemistry is similar to my own.
I go to a therapist right now and I try explaining to her how pain meds can sometimes help me become more productve and improve concentraton. The only thing she has to tell me about that is that I'm just imagining that I'm more coherent on PKs 'cos PKs just make people numb.
I'll be reading that a second time

 

[rave_itsrealfun!!!]

Thank you - I was more expecting a "here's a budding junkie" response. "He'll be on the needle in no time." Or something irrelevant about how marijuana is great and does no harm. I've used heroin, it was nothing special in comparison to the other opioids. I certainly did not become an instant fiend. I've been a drug addict before, and I know that's not what I am now. I just want to be normal. High doses of opioids are not going to make me normal, I would become a junkie again and most likely fuck myself up or possibly even die. I think I know what I'm getting into here... opioids are very serious drugs. But I am a person with a lot of potential, who is getting seriously fucked around by physical pain, and some mental illness.

After I quit being a drug addict, which was one year ago, I tried a variety of other pharmaceutical drugs to try and help me get back to my good old self, because I was in physical and mental agony. Really powerful forms of suffering that I had absolutely no control over and that were zapping my potential. Anti-psychotics made me more psychotic than less, and they didn't help with my constant panic attacks. SSRI's, I wouldn't even touch because I learned my lesson after the anti-psychotics (do not blindly trust pill pushing doctors). I didn't think they were going to help. Anti inflammatories and muscle relaxants didn't touch the agony of my spinal nerve condition. They didn't have any way to treat or even diagnose my chronic pain, although I'm presently waiting a fucking YEAR to see a specialist doctor. Many of these drugs would make me too sedated in order to function. The last thing I need is to be sedated. I need to be free of physical pain and the extreme anxiety that I have as a sober individual, and I would like to be happy, vibrant, and full of energy as a young adult should be.

I'm a little more concerned about my moderate benzo use than my light opioid use. I use them to effectively eliminate my extreme panic disorder and for no other purposes. Again, nothing else works, and I have yet to experience any serious side effects or tolerance increase so I will probably just keep on them for the next few years at least. Some people consider them the devil, but my quality of life has drastically improved since I no longer suffer from unbearable, uncontrollable panic attacks brought on by weed abuse. I was crippled by anxiety before I even knew what a benzo was, and I would probably not be here writing this post if I had not discovered them. I was FED UP with the thousands and thousands of panic freak outs, showing up at the ER begging for mercy, that's no way to live...

I've given friends light doses of opioids, and they say things like "man, I don't know why you'd ever want to be addicted to this, I just feel lazy." My brain chemistry is quite clearly different from the norm, and most young people do not have to deal with chronic physical agony.

 

[adder]

It's kappa agonism that is responsible for the resulting depression (here). Buprenorphine has a unique pharmacodynamics being a partial MOP agonist and a silent kappa antagonist, and the latter action appears to be responsible for buprenorphine's antidepressant effects. However, I think there should be more research done to conclude why this effect flattens over time. From a whole lot of other orvinols, I've found only one more that is both a partial MOP agonist and a silent kappa antagonist, it's a 7-[(o-methylcinnamoyl)aminomethyl derivative and it has an even higher intrinsic activity than buprenorphine does (there is an article covering cinnamoyl derivatives of orvinols and thevinols). I think it would be very useful for those people who are mentally prepared to get off opioids and buprenorphine doesn't seem to work for them, because their tolerance is too high. Such people are given methadone and in my experience that's a terrible solution making these people more depressed in the long run. NMDA antagonism is useful for treating depression, but chronic treatment definitely have more dangerous side effects like causing memory and cognitive deficits.

 

[Erikmen]

I believe that most opiate users experience being in another dimension, to a place where nothing really matters, except the perception of yourself as being relaxed, problem-free and euphoric.
Depending on the dose, one may be able to work normally and act quite normal, while under the effects. Some say even better with family issues, as you are always pretty calm.
However you can not live this life for ever. There will always be the shortage of money and eventually the confrontation. The great challenge in this equation is how to deal with all the emotions, pain, sadness knowing that your body is not and will not produce enough endorphin so that you can carry on with a normal life. It takes a great amount of time to get back to a normal life. And when that happens, there will be always a temptation which I believe is the "cost" you pay as you cannot simply walk away. Even after withdraw, every time you watch or hear something about opiates, that can trigger a relapse which is even worse.
I really admire people who passed through this phase and had the patience to wait until depressed and sensitiveness is surpassed or dealt with.

 

[rave_itsrealfun!!!]

I think that opioids are an option for some people who are suffering from permanent brain damage, or permanent physical pain issues. There is no glory in suffering, if one is really suffering too much and there is no improvement over time then they could consider this, approaching with caution and sticking to low doses.

As a sober individual, I'm in too much pain to care about anything. I lay in bed moving as little as possible because the excruciating pain in my spine makes me want to scream in agony. There is no solution to it, I had a really bad injury and I've been this way for years. I am in so much pain that I cannot even concentrate enough to do some reading. While on opioids, I am happy to get physical exercise and cook myself healthy food. I am happy to pursue my hobbies, interests, social life, and career path. Everything matters to me because I am no longer in pain. I stopped using drugs recreationally a long time ago. That's not for me.

I've lived in another dimension, that was when I used to smoke marijuana all day. I was living on a whole other plane of existence, disconnected from everything. Nothing mattered to me - I couldn't care less about the news, science, mathematics, music, socializing - even movies or video games - pretty much anything at all other than sitting around smoking weed while listening to trippy tunes and cooking delicious meals was pointless to me. Personally, that stuff made me a space case and eventually fucked my head up nice and good. This is not the case with opioids. I am my good old self, like how I used to be before I fucked my brain and spine up to the point that I couldn't function in life anymore. I am full of energy and I do not feel "high" in any way although I guess you could say I feel "high on life."

It's hard to make generalizations or stereotypes on groups of people who use the same drug. There are just too many variables - everyone has different lives, different history, different neurochemistry, different patterns of use, different reasons they are drawn to drugs. You can ruin your life with any powerful drug by overusing it, including marijuana. Certain drugs can be used as effective treatments for some people if they are not abused.

I think that this is a viable long term option for myself. It vibes with my heart, and I don't see any shame in the avoidance of chronic suffering in order to contribute to the greater good. My doses are low and therefore very affordable. I can only speak for myself, not other opioid users. I do think that a lot of them are self medicating for some valid reason and are fully capable of hiding their habit and living completely normal lives though. And then there are the ones out panhandling on the street, but I've never met many of those people so I can't really comment. They seem to be stuck in a rut, like how I was when I needed to quit smoking marijuana because it had turned me into a bong rip fiending zombie.