If you become tolerant to a drug dose that mean it still works the same and you just don't notice?

No. It means that you have raised your tolerance to that drug and you require more of it to do the same job as less of it once did.

No. Consider a drug which causes your body to release some stored chemical. If your body’s stockpile starts at 100% and each dose of the drug causes the 10% to be released then when your body is down to 20% you will need five times as much drug to release the same quantity of chemical.

Tolerance is both a psychological thing and a physiological thing. Like in the last two answers, if you’re talking about something like cigarettes, tolerance means you can’t get the same buzz from one cigarette that you used to. Your body has adjusted to deal with that amount of nicotine without giving you that buzz.

With things like some prescription medications, that’s not exactly the case. I take a combination of mood stabilizers every day, and I don’t feel like I’m hopped up on drugs all the time. I feel completely normal. However, when I don’t take the medication, however, it’s very apparent. The drug is still doing exactly what it’s supposed to do, my body is just not conscious of it until the drug is gone.

Some drugs your body develops a tolereance to (usually things like pain medications). Other drugs, there is a minimum dosage needed to get the desired effect, less than that they just don’t work (like antidepressants). The dosage levels are different for everybody.

Depends what you mean my tolerant and what kind of drug. Pain killers are often perceived as not working once the getting a buzz part from the drug fades away.

@Cruiser People who abuse pain medication would report that. The actual analgesic effect decreases over time as well. Over a period of four years, my wifes pain meds had to be increased or the medication changed to get the same pain relief; she was trying very hard to keep the dosage to a minimum, using accupuncture and massage to compliment the medication. Once the burn treatments and orthopedic work was completed, she was able to get off the pain medication very quickly.

Caffeine and alcohol are examples that a lot of people are familiar with. It takes more alcohol to get you drunk and more coffee to wake you up the more you drink them. I don’t know how this works exactly, but I drink about three coffees a day now. :(

I think it depends on the drug. I’d like to see one of the medical doctors respond to this question, but from my reading I understand that narcotic pain relievers, for example, react differently in the body over time. That is, the body develops an increasing “tolerance” for the drug so that its pain-relieving quality diminishes over time unless the dose is increased. (Again from my reading, this is one reason why many doctors refuse to treat patients—or at least “treat them effectively”—for long term pain management, because the DEA looks over their shoulders at the increasingly large narcotic prescriptions and causes trouble for the physician because of that.)

On the other hand, I don’t think that “the body” has much of an effect on drugs such as antibiotic and anti-viral drugs, which are targeted to “things other than the body itself” in a way that pain relievers cannot.

According to what I watched happen to my ex, he developed quite a tolerance to OC’s, and not only required more and more for the same effect, he started shooting them into his veins.
I say that I watched because I was witness to a lot of it, but please don’t think that I didn’t do everything I could to stop it before I finally bailed. I did, and it availed me nothing. I had to just get out of the way and watch him crash and burn.
All the people with whom he assiciated are the same way. They started snorting them in their noses, just one pill. the kept increasing the amount, then they all started shooting up. All of them.

@Trillian What are OC’s?

@faye sorry. See what I mean? I learned more about drugs than I ever wanted to know.
Oxy Contins. Very very bad stuff.

@faye Oxycontin… a bad bad drug

It depends on whether you mean tolerant of side effects or tolerant in terms of the original reason for ordering the medication.

As several flutherites have mentioned, narcotic type pain medications are well known for decreasing effectiveness over time if they’re taken frequently and chronically. The body becomes tolerant we call it habituated or in some cases addicted and the medication becomes less effective at relieving pain unless larger doses are used.

A medication like an SSRI prozac, paxil, zoloft etc is prescribed for relief of depression or anxiety, OCD tendencies or bipolar. Side effects can be quite unpleasant at first. Most people find that if they stick with it, side effects gradually improve over the first few months. They’ve become tolerant of their dose in terms of side effects. It might be working just fine for the depression, the purpose for which we originally prescribed it. But there’s a recommended dose range for a reason. Sometimes, after you’ve been on one of these meds for a couple years, you might find yourself sliding backwards moodwise. Someone might say you’ve become tolerant of your current dose. So we increase the dose, if that’s an option, although there’s a point at which I ask patients to go see an expert for medication management, if it looks like they may need to take a combination of meds to manage their symptoms.

We gave oxycontin to some of our cancer patients. Or do you mean bad for getting high on?

Oxycontin is a terrific drug. It actually works. Everyone seems to want to live in nerf world and as a result there has been a relentless assault on every useful chemical.

@malevolentbutticklish @faye It’s not about living in a “nerf” world, Oxycontin was improperly distributed and is currently one of the most abused drugs (not just prescription) in teens and young adults. It is in high demand and being sold in some instances for over $100 per pill.

The problem was that Purdue Pharma, who created and distributed it, did so irresponsibly. A drug as addictive and dangerous as Oxycontin typically is distributed to doctors educated in pain management (i.e. pain specialists, oncologists, etc.) and is done so in tandem with an education of that drug.

Purdue Pharma was over zealous and distributed the drug without education to family physicians stating only “Oxycontin would one day replace other pain medications.” They also spent a billion dollars more in doctor incentives than any other narcotic to date. These irresponsible actions along with the FDA label which said “scraping or removing the outer shell of this pill will result in a immediate release of medication and a danger of overdose” (essentially a guide for abuse) led to the gross misuse of Oxycontin.

This isn’t about changing the world into a safer (NERF-Y-ER) place this is about stopping an epidemic that is effecting the lives of millions of people (teens especially). The FDA even agrees and is adding an agent to the drug that will make it nearly impossible to abuse.

Here is the FDA’s press release on their findings into Purdue Pharma’s marketing…

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm108913.htm

~End Rant~

@drClaw I was going to get into it and saw you crafting so I left Lone. I knew you’d address it better than I could. Thank you.
What an dismissively idiotic thing to say.
I’ve heard, though cannot prove, that the drug was actually distributed in specific “test” areas to see what the addictive effects (and all that that implies) would be.
If I could get the essay written by that nine year old kid about his parents and his whole community being on drugs, I’d post it here.
Thank you. Lurve. I’d keep clicking the lurve button if it would change anything.

@drClaw I read the article. It doesn’t say when this agent is scheduled to be added. Do you have any information about that? It can’t be soon enough for me. As you might have guessed, this drug has had an indirect impact on my life.

@drClaw: If “scraping or removing the outer shell of this pill will result in a immediate release of medication” is considered a flaw in the drug because it makes the drug something other than “nearly impossible to abuse” this plays right into my nerf-world argument. Only in nerf-world would people consider intentional abuse to be a flaw with the medication and not the abuser.

Oxycontins are so incredibly addicting, and there withdrawal effects so incredibly debilitating; that to encourage their use borders on the criminally irresponsible.
Heroin and Demerol are less addicting and their withdrawal effect are mild compared to Oxys.

@Trillian I have only heard rumors, but it could be another year or two before the change is made.

@malevolentbutticklish You aren’t seeing my main point. The biggest issue wasn’t that the FDA placed the label on the drug it was Purdue’s blatant use of marketing and misinformation to distribute the drug and promote abuse. This isn’t a matter of the individual abuser, who by all rights may or may not have exhibited behaviors that brought them to said addiction, but instead it is a matter of abusing the power they have being a legal distributor of narcotics.

@drClaw: You specified “Oxycontin… a bad bad drug”. Then you say the biggest issue is Purdue marketing. How is Oxycontin “a bad bad drug” still bad if the labeling (the “biggest issue”) has been corrected? If this labeling/marketing was really the issue then don’t you agree that Oxycontin is a good drug now that it has been corrected?

@malevolentbutticklish It’s not corrected, people die every day from it. If you feel people deserve what they get form becoming addicted to it and that’s what society needs to toughen up then you are entitled to your opinion, but in MY OPINION it is a bad drug. My opinion will change once the crisis is averted and the number of people abusing the drug is lower than those being helped by it.

“My opinion will change once the crisis is averted and the number of people abusing the drug is lower than those being helped by it.” <== you believe the majority of Oxycontin users are abusers?

Of course the majority of Oxycontin users are abusers. Especially those with a legitimate need and script from their MD. That is the nature of Oxycontin use.

@davidbetterman: ”Especially those with a legitimate need and script from their MD” Especially?!? Why Especially those?

Because they are taking the Oxy’s regularly, possibly daily, and this quickly becomes abuse. They are doing so with their doctor’s permission, so they feel they are justified.
If you haven’t been given a prescription for Oxy’s then you don’t know. If you have, then you either know, or you’re in denial.
Oxycontins are the most addictive pain med prescribed today. The withdrawal is so horrific that Oxy users will do anything to get another prescription.

@davidbetterman: It sounds to me like you have addiction and abuse confused. Addiction is not an error condition.

@malevolentbutticklish Call it whatever you want. I work at an agency that provides, among other things, detox facilities. I have personal interaction with an oxy addicted person and have watched him deteriorate from a normal useful person to a homeless, desperate, individual. All his associates are not much better off. I also have access to some frightening personal stories and lives. This area has seen a spike in the use and abuse of this drug, and law enforcement are at their wit’s end trying to deal with not only the addictions but all the accompanying ramifications. The entire community is adversely affected by this drug. Dismiss it all you want, minimize, diminish, scoff. And pray that you are never impacted in any way by this monster that we’ve created. Just stay out of the way when we finally get all the layers of government together to try to fix this problem. It’s going to take a lot because the affects are so far-reaching. Put your head in the sand and paint a nice, big target on your ass.

@Trillian: Do you also think alcohol should be illegal? I have taken Oxycontin and it is a terrific drug because as I stated it works. “When we finally get all the layers of government together to try to fix this problem” the only solution government could implement would be restrictions on my medical care. We need government out of medical care. It creates problems, not fixes them.

@malevolentbutticklish Are you really ignorant enough to put alcohol and oxycontin into the same category?

@Trillian This guy is ignorant enough to simply argue with anyone about anything, regardless of how wrong he is.
He is just a troll.

@davidbetterman Roger that. I won’t waste any more of my time.

I’m out too

@Trillian: Alcohol and Oxycontin both fit into the category of “abusable drugs”. Do you not place both of them into this category?