Could I be resistant to all opioid drugs?
December 20, 2012 10:06 AM Subscribe
Biochemistry Filter: I believe I have some kind of resistance/insensitivity to opioid painkillers, although I have not been able to verify that this is a medically known phenomenon. I am due to give birth soon, and I am concerned with the possible efficacy of drugs that may be administered for labor pain. Do you have any experience with this in yourself or others, or can you comment on the chemical plausibility of it?
posted by zadermatermorts to health & fitness (20 answers total) 3 users marked this as a favorite
On a couple of occasions I have been prescribed codeine or hydrocodone for pain relief and/or as cough suppressant. Both times, taking the medicine, even repeatedly and at increased dosage, had no effect on me whatsoever—no relief, no feeling of being loopy or high, no drowsiness. It was like I had simply never taken the medicine at all.
My brother reports the exact same experience with hydrocodone, so I am inclined to believe that this is something genetic and that I am not imagining it. Neither of us has ever used opioid drugs recreationally (or almost any drugs at all), so it is not an issue of having built up a tolerance. I can't find any reliable medical information on people being insensitive to these particular drugs or to the entire class of medications; however, I have found posts on health sites where some people anecdotally report similar experiences.
My concern right now is that I am going to give birth to my first child in about a month. I will be attended by a midwife, and I am interested in trying to have a natural (i.e., unmedicated) birth, but I am also kind of terrified about it. The birth center where I will deliver is in a hospital, so whatever I decide during labor about whether to have or not have medication will be available and honored.
From what I have read, injected narcotics for pain relief pose fewer possible complications and interference with labor than an epidural (this is from a pro–natural birth perspective; I'm not super interested in discussing this point), so if I do choose to have medication, I would prefer this route. However, since the commonly administered drugs seem to be fentanyl, butorphanol, and other opioids, I am worried that they may not work on me, and I assume there's no way to find out in advance.
If you are in the medical field, have you ever heard of a general opioid insensitivity? Is the issue more likely to be one of metabolizing the drug, or a problem with the action of opioid receptors, and would that have any bearing on whether an insensitivity to hydrocodone would extend to the entire class of opioid drugs?
Obviously I will discuss this all with my midwife, but as she is not an MD or a pharmacologist, I'm not sure how much this topic will be in her wheelhouse, so I look to the hive mind for broad experience.