Monday, May 12, 2008

Sparky's Opioid Issues

I'm increasingly exasperated with my effort to keep Sparky properly dosed up with his drug of choice, Torbutrol.

Torbutrol can be used as a cough suppressant, and the pressure of Sparky's enlarged heart on his trachea, plus poor circulation, have caused him to have a permanent cough. He has a second cough suppressant, Theo Dur, but as far as I can tell, only the Torbutrol is really effective.

The veterinarian prescribes only small amounts of Torbutrol - about ten pills at a time - and cites trouble with obtaining adequate amounts of the drug, because human abuse has led the Drug Enforcement Administration to watch it's administration like a hawk. The stuff is expensive too: $1.25 per tablet. I'm supposed to give 2 to 4 tablets a day, but I'm giving just one a day, in order to stretch it out. And that just means Sparky coughs all the more.

When I obtain the drug, the folks at the vet ask, "Age?" I say "Well, Sparky is about 15 years old," and they say "Not Sparky, you!" I guess the DEA is monitoring who gets the stuff, to short-circuit the underground market. I wouldn't mind finding out more about the underground market in Torbutrol, to keep Sparky dosed up, but reading a bit more, it looks like Sparky might also be suffering weird drug-related mental effects, like crazy dreams and dysphoria - the opposite of euphoria. He certainly sleeps a lot these days, more than I would expect because of his age. Maybe he shouldn't be taking this stuff anyway. But the cough, the cough....

Here's some information regarding Torbutrol:
Brand Name: Stadol, Torbutrol, Torbugesic

Available in 1 mg, 5 mg and 10 mg tablets

Background

The opiate class of medication is complicated to describe. There are several types of receptors in the nervous system that respond to opiates. These receptors are designated by different Greek letters (“mu,” “kappa,” and “sigma”). Opiates work by binding and stimulating some receptors (such opiates are said to be “agonists” of the receptors they stimulate) or they may bind and block receptors (in which case they are “antagonizing” the receptor). What the effects of a given opiate are (euphoria, cough suppression, pain relief, hallucination, addiction etc.) depend on which receptors are stimulated and which are blocked. Some opiates only stimulate receptors. These are called “pure agonists.” Some opiates, like butorphanol, stimulate some receptors and block others. This makes butorphanol what is called an “agonist/antagonist.” It seems to stimulate the kappa and sigma receptors and antagonize mu receptors.

Butorphanol is a controlled substance, which means there are special legal requirements for prescribing and stocking it.

How this Medication Is Used

Regardless of which receptors are stimulated and which antagonized, butorphanol ultimately is a cough suppressant as well as a short-acting analgesic. It also has some sedating properties. Many people are familiar with codeine, which has nearly identical uses and is also in the opiate family (though it is not an agonist/antagonist like butorphanol). It may be helpful to think of butorphanol as being similar to codeine: lower doses can be used to suppress cough, higher doses for pain relief.

Most opiates can be used to suppress cough but, unlike other opiates, butorphanol does not suppress the respiratory center in the brain (and does not slow respiration nor make breathing more shallow).

Butorphanol is also sometimes used as a pre-anesthetic tranquilizer though it is very mild in this regard. It may also be used for pain relief following a surgical procedure (it acts rapidly but only for a short time so usually a longer acting pain reliever is used in combination).

Butorphanol has some anti-nausea properties and is commonly used in this way prior to the administration of cisplatin in cancer chemotherapy.

Side Effects

The chief side effect is sedation. Occasionally, it can cause diarrhea or appetite loss. Butorphanol is able to slow the heart rate though this is rarely of meaningful significance to normal patients.
A human experience with Torbutrol:
Okay, this experience happened roughly a week and a half ago, and my memory is a little shaky. I have a good amount of experience with opiates, particularly oxycontin. My tolerance, however, was at an all time low after a four-month abstinence.

I obtained a bottle of Torbutrol from a veterinarian for administration to my cat. The pills came in 1.25mg pieces (5mg whole). I browsed the web to see what I could dig up on these pills. To my surprise, I found that they are an opiate synthesized from thebaine. I further looked into it, and found that there was a form called 'Stadol' which was an aqueous solution designed for insufflation. I immediately grew anxious to give it a try.

I started by snorting 1/4 of a pill. The burn was bearly noticable, but the drip tasted putrid- about two or three times worse than oxycontin.

I waited a couple of minutes and felt nothing. I then went ahead and bumped the other three quarters.

I proceeded into my room to play Amped, a snowboarding game, on my X-Box. Within a couple of minutes I noticed a warm sensation beginning in my stomach and radiating out into my legs and arms. Soon, I found myself somehow scoring higher than I ever had before, even though I was barely paying attention to what I was doing.

After about ten minutes of X-box, I decided to lay down. That's when it hit me like a ton of bricks. The room was spinning, and I had an awesome warm, jello sensation througout my entire body. It was pretty incredible, for a veterinary medicine.

I was soon walking around socializing, growing a little antsy. I could tell the effects were winding down.

I proceeded to my room and bumped another pill. This time it hit me extremely hard. I light up a bowl and laid on my bed.

I was completely disoriented, and what started out nicely turned dreadful. I had read of the dysphoria associated with high doses, and stupidly I ignored the advise.

I soon was feeling terrible feelings of panic and fear, potentiated by the pot. I had the feeling that everything was out of control. Within thirty minutes I passed out entirely.
At the least, it looks like Sparky shouldn't be operating heavy machinery. I guess that means I'll have to get the car keys back from him. Sorry, Sparky....

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