Still high after narcan?

Maybe you are in this boat, maybe not, but I've noticed that a lot of folks have a misunderstanding about how drugs actually work in your system.

The misconception is that the drug, like heroin, finds a receptor and binds to it, and just stays there. That's actually not what happens, it's moving around and hits the receptor for maybe a couple milliseconds max and then moves along.

So when you take an antagonist, what it is doing is actually blocking other things from binding to those receptors, without itself triggering the receptor itself.

So a good way to think of it is in percentages. Like, when you're high, imagine that maybe at any point in time 60% of your mu opiate receptors are being triggered. If you have an antagonist present, consider it as blocking.. so you may have X amount of an antagonist which at any point in time is blocking binding at 50% of receptor sites.

Precipitated withdrawal happens when there's > 100% potential of agonist + antagonist, to where antagonists (which have a higher binding affinity than the agonist, such as naloxone vs heroin) are actually at that point pulling an agonist off the receptor, and that agonist cannot re-bind later on. Since your body is always moving towards homeostasis, you basically "adapt" to having X % of your receptors being hit. So when there's antagonist action which is reducing the % of receptors being hit (versus just both being present), you feel the sickness whilst your body has to take time to adapt to the new levels.

I hope that made sense the way I described it. <3

/r/opiates Thread