if what I've heard is correct, where one of the theories as to why adhd medication works is that it works on the dopamine system; people with adhd apparently not getting enough dopamine normally in the areas of the brain that are responsible for attention-- now I'm curious, if this is the case, then why wouldn't opiates also work in the same ways as the stimulant medications? they work in a similar way on the dopamine system despite big differences in other places..

just curious :confused:

why wouldn't opiates also work in the same ways as the stimulant medications?Good question. To the best of my knowledge, there are several opiod receptors, and as I understand it there is only one of the known opiod receptors that either acts directly on dopamine, or possibly inhibits GABA to effect dopamine levels indirectly. I think the opiod receptor I am referring to is called ORL-1.

Concerning the stimulant medications, they do not all effect dopamine the same way. Some stimulants act as a reuptake of dopamine, as where others can cause more dopamine to be released.

Hopefully someone here who has a better understanding of the effects of opiates on dopamine will be able to better answer your question.

I can only tell you my experience when I had to take hydrocodone for 3 weeks, due to a really painful multiple wisdom tooth extraction at 33.

It actually made me more alert, focused, and energized. It motivated me. I could stay on task.

It definitely didn't help my sleep much. During the 2nd week I had to start dealing with some insomnia issues.

It's not a good alternative, though. I noticed it was making my short term memory worse and it really slows down your whole digestive system (ie painful-infrequent bowel movements), and after only 3 weeks of taking around 30 to 35 mgs per day I suffered a pretty intense depression and lethargy when I decided to stop. I was pretty amazed at the severity of the "nothing matters" lethargy I went through. It was really VERY intense for such a short time on the hydrocodone.

--my two cents

Lunar.....

^^

thats interesting, I actually had similar results on opiates (tho I wasn't diagnosed at the time with add so I wasn't really looking to see how it helped my attention) -- but they kept me awake like crazy, I had some oxy from some surgury and my friend said if I took it I'd fall asleep - so I saved it for bedtime, and ended up staying awake for 4 hours later than I usually did--

interesting on the memory tho, and all the down sides.. I spose thats why its not considered then for add -- not to mention its abuse potential, its cool that it does help tho :)

I have to take opiates and opioids for pain as I am severly allergic to aspirin and meds like Ibuprofin. I do find that I am better focused as well as less anxious when I use them but, over the years, the amount required to produce good pain control and focus has increased dramatically, making opioids a poor choice for controlling my ADHD. They are also highly addictive.

Keith :faint:

Thats right. you don't want to be forced to use these long term because you body will eventually stop making ephedrines and then when you stop it, you will have a very difficult and painful withdrawel...

netsavvy...

Are you sure it's ephedrine production that is decreased? I thought it was endorphins that were replaced by the opiates.

Lunar...

yea, its endorphins I believe- tho netsavy basically had the point down; painful withdrawal :( and yea, I would never want to take opiates for add- caffeine was hard enough to quit :) dex doesn't seem addictive at all, maybe its the add? I spose the fact that opiates dont directly release the dopamine is why they dont keep working while amphetamine does ?

Too weird. I, too, have noticed that the times I have taken Lortab (after each baby was born, prior to and after a couple different surgeries) that for a short time I would be VERY focused - clean like a mad woman, organize, etc.

What in it causes this? And is there an ADD/ADHD stimulant medication that has whatever ingredient that the Lortab has?

Wonder if it's worth sharing that with my Doc that I will see on Monday - do you think it might help her make a connection with what ADD med might work well for me??

What is Lortab?

Hydrocodone is in a group of drugs called narcotic pain relievers. It is similar to codeine.

Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone.

The combination of acetaminophen and hydrocodone is used to relieve moderate to severe pain.

So does anyone know what connection the Hydrocodone or codeine has with the brain, thus causing a boost in motivation/drive?

Again, I wonder if any part of what makes up the pain killer is found in (or put in) any of the ADHD meds out there - thus possibly giving the same effect???

All I can tell you is that the Adderall is def. not doing it for me. Drive and motivation still pretty much non-existent and all the stuff in my brain is still as much in overdrive as always...maybe even more, now that I have come to realize what's going on....

I know a guy (no really its not me) who happens to be a teacher and has been clinically depressed all of his life and has ad/hd. Nothing makes life even slightly meaningful to him or worth living except strong opiods morphine, heroin, fentanyl, dilaudid. He doesnt just get high and sit around drooling on himself like your usual junkie, he does a hit and goes straight to work and as far as the rest of the world is concerned he's just in a better mood than usual.

Im not advocating this in any way, this guy truly is a miserable person and if it were anyone else i'd say they're making exscuses for their addiction.

Mom :)...

As far as I can tell (through the very little research I have done) opiates fit into the dopamine receptor sites better than dopamine does. Essentially your body sees the opiates as dopamine.

Whereas amphetamine turn your brain into more of a dopamine pump, opiates actually sneak in and take the place of dopamine at its receptor sites. Opiates seem to be a dopamine immitator that produces some of the same results. - elevated mood, activating reward system, etc. That's the problem---if your brain sees that your dopamine receptor sites are always full it will not need to produce any and will slowly shut-down the producing "factory" - since it's not needed.

So, opiates may provided a more immediate increase in dopamine-like effects (especially motivation and mood), but in the long run it will impare your brains ability to produce the real thing. Also, opiates don't play as well with memory as dopamine does. Many long time users of opiates suffer from short term memory loss.

Hope this helps.

Lunar...

Wow, this is setting off alarm bells for me! I don't have much experience with opiates, but I do have way too much experience with off-label use of another common dopamine agonist as an ADD med. Alcohol. Pot and insanely loud music got me through high school. Booze got me through graduate school and on to an established career path. Then came payback -- suicidal depression, despair, liver disease.

Messing around with opiates seems way too likely to be the same slippery slope.

Something like 40% of us who reach adulthood without diagnosis and treatment are substance abusers. The fact that lots of abusable substances mitigate the negative aspects of ADD is (imho) the major part of the why. Escaping a sucky life is a minor part.

It makes my skin crawl to see folks standing too close to the edge of this cliff.

Something like 40% of us who reach adulthood without diagnosis and treatment are substance abusers. The fact that lots of abusable substances mitigate the negative aspects of ADD is (imho) the major part of the why. Escaping a sucky life is a minor part.

Wow. That is insightful. I don't have a problem with addiction, and maybe this is totally normal, but admittedly, I have enjoyed the (albeit very temporary) happy-all-is-right-with-the-world buzz that I've felt when I've had an Rx pain killer. I had legit reason(s) for their use, but you didn't hear me complaining either!

So...If I understood the explanation about what the opiates do to our dopamine receptors vs. what an amphetamine does, then what I'm hearing is that it's possible to FIND a medication for my ADD that could produce the relief for my symptoms (lack of motivation, inability to complete a task, not to mention the other junk that goes on in the brain, jumping thought to thought, etc.) on a more permanent basis, where the "seeming reflief" that an opiate gives would only ever be temporary and probably long-term more damaging?

Only my fellow ADD'ers would understand that crazy ongoing sentence/thought. Sorry. :faint:

@momto5monkeys - adderall seems to effect a lot of people badly despite helping many others, from what I've read dexadrine (d-amphetamine) focuses more on dopamine, and i personally believe that a nice chunk of add has to do with our dopamine systems- the stimulating side effect is just something attached to the drug you know? so if opiates help (by stimulating dopamine through whatever means) like it did for me and you when we were prescribed them, then I'm thinking dexadrine might be a better help than adderall, I really cant see what the point of l-amphetamine is in that mix (adderall is l-amphetamine and d-amphetamine), as apparently l-amphetamine focuses more on other neurotransmitters (such as epinephrine)

ask your doc, it cant hurt- especially if your current meds arent' working

I really cant see what the point of l-amphetamine is in that mix (adderall is l-amphetamine and d-amphetamine), as apparently l-amphetamine focuses more on other neurotransmitters (such as epinephrine)The reason for the l-amphetamine is that it has a longer half-life and exits your system more slowly, theoretically making the rebound less and the duration longer.

I found that I needed the norepinephrine for activation. I tried Dexedrine, it worked well for mellowing me out, but it didn't work as well as adderall for on-task focus and activation. I guess I need the norepinephrine for my brain to work right. I know another innattentive add friend who reacted the same way to dex and adderall.

Dex does have some effect on norepinephrine, but theoretically not as much.

It is interesting that scientists are experimenting with the effect of norepinephrine (adrenaline) on memory. They are finding that if there is too much norepinephrine at the time of an incident, the memory can be so powerfully etched that it causes flashbacks and trauma, but if there is too little, there will essentially be no memory of the incident. Which could explain my problems with short term memory.

Here's a few related articles:

They aren't the best, but they're all I could come up with quickly.

http://www.sciencedaily.com/releases/2004/04/040402073226.htm

http://www.apa.org/monitor/apr04/vagus.html

Lunar...

Opioids work on the opioid system, not so much on dopamine. (At least not directly.)

Various painkillers (anesthetics) such as opiates/opioids, alcohol, cocaine, etc will make one FEEL better, however, but only in the short term. And there is a certain emotional payback when they wear off, and excitation/emotion/pain/anxious distress returns.

I say "emotional" b/c there is a certain amount of emotional brain dysregulation or malfunctioning occuring in ADHD and Executive Function problems. (e.g. limbic system, PFC, amygdala, etc.)

@lunarfrog - thats really interesting, I guess it just goes to show that ADD can be a result of a number of imbalences ? or at least some of what people get with add, very cool with the memory issues, and it makes sense from what I've learned about memory and adrenaline etc in psych class :) - as a real life example, I'm usually pretty bouncy and dont tire very easily (without meds especially), I also have really good memory 'and' react badly to adderall-- maybe adderalls better for people who also have epinephrine/norepinephrine shortages too? and people with enough/too much normally would be getting way too much of said chemicals and get thrown into feeling like crap or something... or maybe its something completely different eh :) - as for lasting longer, dex feels the same when it wears off as the adderall did, only adderall kept me awake way into the night- far past when it wore off and didn't do its job for focus at all, I can see how that might be useful to people who wouldn't have enough tho...

@queensu_girl : yea, I watched a video on how drugs effect the mind a while ago http://learn.genetics.utah.edu/units/addiction/drugs/mouse.cfm :) -- which basically said the opiod system when activated then triggers dopamine (the reward center)-- I wasn't 100% sure tho, since its a flash animation with mice lol but if you agree then I'll say thats more likely it also?

and hrm, as far as your statement on the various substances, cocaine in theory would work as well as ritalin if taken in a time release oral way-- the fact that it was demonized and banned so long ago for everything but dental work makes me think that getting made into a medication for add very unlikely, but technically it could be thought of as the dexoxyn(methamphetamine) for ritalin-- but yea, recreationally, definitely no long term good effects, and 100% agreement for the others too; alcohol = parties here and there and opiates = low doses for wisdom teeth etc :)

the fact that it was demonized and banned so long ago for everything but dental work makes me think that getting made into a medication for add very unlikelyDo you mean regulated?
From: http://en.wikipedia.org/wiki/Codeine

In Australia (http://en.wikipedia.org/wiki/Australia), New Zealand (http://en.wikipedia.org/wiki/New_Zealand) and Canada (http://en.wikipedia.org/wiki/Canada), codeine is regulated; however, it is available without prescription in combination preparations from licensed pharmacists in doses up to 10 mg/tablet (8 mg/tablet in Canada, 13.8 mg/tablet in Australia).

In Canada, codeine can only be sold over the counter in combination with 2 or more ingredients, which has resulted in the prevalence of AC&C (aspirin (http://en.wikipedia.org/wiki/Aspirin), codeine, and caffeine (http://en.wikipedia.org/wiki/Caffeine)), and similar combinations using acetaminophen (paracetamol (http://en.wikipedia.org/wiki/Paracetamol)) rather than aspirin. Caffeine, being a stimulant, tends to offset the sedative effects of codeine.

Do you mean regulated?
From: http://en.wikipedia.org/wiki/Codeine

In Australia (http://en.wikipedia.org/wiki/Australia), New Zealand (http://en.wikipedia.org/wiki/New_Zealand) and Canada (http://en.wikipedia.org/wiki/Canada), codeine is regulated; however, it is available without prescription in combination preparations from licensed pharmacists in doses up to 10 mg/tablet (8 mg/tablet in Canada, 13.8 mg/tablet in Australia).

In Canada, codeine can only be sold over the counter in combination with 2 or more ingredients, which has resulted in the prevalence of AC&C (aspirin (http://en.wikipedia.org/wiki/Aspirin), codeine, and caffeine (http://en.wikipedia.org/wiki/Caffeine)), and similar combinations using acetaminophen (paracetamol (http://en.wikipedia.org/wiki/Paracetamol)) rather than aspirin. Caffeine, being a stimulant, tends to offset the sedative effects of codeine.
I think prurigro was referring to cocaine.

@imnapl : codeine is regulated for sure-- I was talking about cocaine tho :) demonized, but it works in the same way as ritalin (its also more potent)-- if it was in an XR it would probably work well for add, however the abuse potential would be far too great for the fda to allow that

but yea, that whole codeine/asa/caffeine thing is kinda stupid- my dad gets migraines that tylenol/advil cant fix, but cant take aspirin due to a conflict with some other medication hes taking, they should have used acetemenofin or ibuprofine for the mix instead - far more useful for headaches from my experience and less conflicts/danger- also, caffeine causes headaches as a side effect of use, so mixing it in, despite keeping people awake isn't the best in the long run

edit : lars beat me to it :)

I think prurigro was referring to cocaine.:eek: OMG! Thanks, lars.

but yea, that whole codeine/asa/caffeine thing is kinda stupid- my dad gets migraines that tylenol/advil cant fix, but cant take aspirin due to a conflict with some other medication hes taking, they should have used acetemenofin or ibuprofine for the mix instead - far more useful for headaches from my experience and less conflicts/danger- also, caffeine causes headaches as a side effect of use, so mixing it in, despite keeping people awake isn't the best in the long run

edit : lars beat me to it :)We have a really smart dentist: awards, top of the class, etc. When my daughter got all four wisdom teeth removed, she was sent home with a prescription for Tylenol3 (standard pain killer here), which we filled. It did nothing for her pain so we went to plan B from the good dentist: normal dose of ibuprofen and tylenol together. It worked.

You know what? You all must be on PERFECT doses of your respective ADD meds, because reading all this totally makes my brain HURT!!!! :faint: LOL

Y'all are verrrry smart lil' cookies, that's for sure!!! ;)

@imnapl - yo thats interesting, I also find opiates do pretty much nothing for pain asside from making me not care about it-- they also dont really make me feel very good/euphoric at all, just focused :) (wonder if its an add thing?) - and yea, ibuprofin does wonders for all my ailments it seems, the lack of addictiveness is nice too

@MomTo5Monkeys - I make the majority of my posts on days off meds / after they wear off; taking dexadrine makes me focused enough not to slack off and go reading/posting forums =D

I much prefer morphine as a painkiller. I was told by a pharmacist that codeine is metabolized as morphine in our systems, but I would rather hurt than feel blah from Tylenol3.

...Weird. I've taken a prescription cough medicine before that had 10mg of codeine in it, and it KNOCKED. ME. OUT. For hours. After making me see colored lightbulbs swimming under the sea, and hear the angelic choir singing. No joke.

I'm pretty sure it wasn't any other ingredient in the medicine that did that.

Stims work fine, though. Hmm.

@Imnapl : yea, both heroin and codeine are metabolized into morphine-- one more efficiently than the other (can you guess?) its interesting you feel blah on codeine and good on morphine tho, I guess methamphetamine and amphetamine both get metabolized into amphetamine and those are pretty different...

Bean Delphiki : hrm, cough syrope also has dxm in it... is it possible you're really sensitive to that? I dont think I've ever heard of opiates causing hallucinations (tho its not impossible I'm sure) - but DXM would definitely be able to pull that off at a decently sized dose-- and I believe 10mgs of codiene should do about as much as the dxm in the syrope (you shouldn't feel much :))