What are TIQ's and how do they affect addiction and pain ?

[Brighty]

I recently asked this question and it was removed from the board unanswered. 2 other questions that others sent regarding chemical dependency and use of massage in recovery were also removed unanswered. Other questions were answered though !!! I attended an informational lecture at a treatment center, ( drug rehab) and the presenter mentioned something about a chemical I believe called TIQ ( short for a longer name) that is present when there is pain. I did not fully understand the topic but got the idea that narcotics are less addictive if they attach to TIQ's. As I said I did not understand this and the presenter did not linger on this topic. I believe this question is important to those who are addicts and need narcotics either chronically or simply for a surgery. I do not know if the information I heard was correct or theoretic. Will the doctor kindly answer this question? Will the webmaster also tell us why current and appropriate questions to this forum are removed with no explanation. I have come here for many months and have never seen this happen before. However, at one time months ago there was discussion on the board about buprenorphine and it mysteriously disappeared. It did not age out since older topics remained. There was nothing in those discussions that would have violated any forum rules. Nor did the questions removed yesterday morning violate any forum rules. I believe we deserve an explanation. Thanks. Brighty

[Brighty to Sam]

Thanks Sam ! Well it looks like this lack of information may be the reason my question was removed from the board. I plan to do a net search on this topic but never seem to get around to it. When I find some more info I will share it here under this heading. I appreciate your information. Seems like the info I originally got was not the same as yours or even more likely I did not fully understand it. Thanks for sharing this with me.

[Sam]

I noticed that your question regarding TIQs did not seem to receive much informative response.  I do not claim to be an expert, by any means, in the field of biochemistry.  However, I am a licensed chemical dependency counselor and have some woking knowledge of TIQs or more accurately called THIQs (tetrahydroisoquinlines) at least in regard to addiction.  THIQs are an opiate like chemical which acts on opiate recptor sites in the brain.  No one, as far I have researched, knows exactly what produces them or why, but they have been found to be present within the brain chemistry of alcoholics and heroin or opioid addicts.  They basically fit in the same receptor sites as the neurotransmitter - enkephalin, thus acting as an agonist and imitating the pain relieving qualities of opiates and alcohol.  This is pretty much what I understand about TIQs in a nutshell.  I hope it was of some use.  Sam

[Sam]

I noticed that your question regarding TIQs did not seem to receive much informative response.  I do not claim to be an expert, by any means, in the field of biochemistry.  However, I am a licensed chemical dependency counselor and have some woking knowledge of TIQs or more accurately called THIQs (tetrahydroisoquinlines) at least in regard to addiction.  THIQs are an opiate like chemical which acts on opiate recptor sites in the brain.  No one, as far I have researched, knows exactly what produces them or why, but they have been found to be present within the brain chemistry of alcoholics and heroin or opioid addicts.  They basically fit in the same receptor sites as the neurotransmitter - enkephalin, thus acting as an agonist and imitating the pain relieving qualities of opiates and alcohol.  This is pretty much what I understand about TIQs in a nutshell.  I hope it was of some use.  Sam

[Brian to Sick and Scared]

Glad I was helpful, and yes, I plan to stay.  I figure this is one way of "atonement" for some of the things I am not proud of having done (or not done) during my active addiction.

[Brighty]

Thank you for a very specific reply which is what I was looking for. I am particularly pleased to understand more about the buprenorphine. I am also glad you were forthright with me about the issue of injecting it and what may possibly occur. These are the things that I need to understand and I suppose that maybe recovering addicts need to know also, so not to be caught unaware. The therapist figured since the wisdom teeth need to come out that doing it now while in a therapeutic environment would be the way to go. Thanks for giving replies that are supportive and accurate since this is a busy forum and sometimes it's hard for everyone to get the types of replies they were hoping for. Hope you plan to stay on :-)) Brighty

[Brighty]

Brian,
Another thing... if buprenorphine clings to the opiate receptors then would that mean it could "awaken the beast" for an opiate addict? If it does then I wonder how it could be considered better.  That really was the purpose of asking about alternatives to narcotic pain killers.. the possibility of relapse.  I hope you see why I have had so much interest in this TIQ... because my understanding was that the presence of TIQ had a cancelling effect, so to speak, with the narcotic hitting the pleasure center. I wonder if this could be the same for the buprenorphine. Maybe I am just chasing rainbows.. but I want to find the safest situation possible for my daughter to minimize her possibility of relapse. I realize that in any case the fellowhip of NA is the best backup she can have. Thanks again, Brighty

[Brian to Brighty]

I'll try to answer your queries in the order set forth.  Methadone is a long acting narcotic and is often used not only for addiction but to treat chronic pain.  It can be used as a detox drug for narcotic addicts by replacing their narcotic and then gradually tapering.  For detox, as opposed to maintainence, the main drugs being used are methadone, buprenorphine or non-narcotic drugs such as clonidine (catapres).  Naltrexone (Revia) is used to block the euphoria associated with narcotic use, and often is used after detox to help keep the addict clean.  It is not appropriate for detox because it will cause immediate and severe withdrawal.  As for buprenorphine, it acts as a partial agonist (meaning it will stimulate the opiate receptors), but it is also a potent antagonist (meaning it can be used to reverse an opiate agonist).  It's agonist properties make it a potent painkiller, while it's antagonist properties make it much safer because of the minimal risk of respiratory depression. A pure antagonist such as Naloxone (Narcan) is used to reverse a narcotic overdose.  Buprenorphine is a narcotic.  It is chemically derived from Thebaine, which is a constituent of opium.  Buprenorphine may "awaken" the narcotic cravings despite its very limited "high."  It really doesn't have anything to do with its propensity to cling to the opiate receptor.  Since your daughter was injecting, the combination of the buprenorphine and the needles used may well trigger cravings.  However, with proper supervision and support, addicts can and do get treated with narcotics for very short term pain.  Although there is a risk, the alternative may be too cruel (suffering in severe pain).  Finally, although I don't want to get too specific here because of my fear of licensing authorities in my State, you are getting warm as far as my profession.  The drugs I speak of I have first hand knowledge about (either by my taking them or my prescribing them).  Best to you and your family.  Brian

[Brian to Brighty]

I'll try to answer your queries in the order set forth.  Methadone is a long acting narcotic and is often used not only for addiction but to treat chronic pain.  It can be used as a detox drug for narcotic addicts by replacing their narcotic and then gradually tapering.  For detox, as opposed to maintainence, the main drugs being used are methadone, buprenorphine or non-narcotic drugs such as clonidine (catapres).  Naltrexone (Revia) is used to block the euphoria associated with narcotic use, and often is used after detox to help keep the addict clean.  It is not appropriate for detox because it will cause immediate and severe withdrawal.  As for buprenorphine, it acts as a partial agonist (meaning it will stimulate the opiate receptors), but it is also a potent antagonist (meaning it can be used to reverse an opiate agonist).  It's agonist properties make it a potent painkiller, while it's antagonist properties make it much safer because of the minimal risk of respiratory depression. A pure antagonist such as Naloxone (Narcan) is used to reverse a narcotic overdose.  Buprenorphine is a narcotic.  It is chemically derived from Thebaine, which is a constituent of opium.  Buprenorphine may "awaken" the narcotic cravings despite its very limited "high."  It really doesn't have anything to do with its propensity to cling to the opiate receptor.  Since your daughter was injecting, the combination of the buprenorphine and the needles used may well trigger cravings.  However, with proper supervision and support, addicts can and do get treated with narcotics for very short term pain.  Although there is a risk, the alternative may be too cruel (suffering in severe pain).  Finally, although I don't want to get too specific here because of my fear of licensing authorities in my State, you are getting warm as far as my profession.  The drugs I speak of I have first hand knowledge about (either by my taking them or my prescribing them).  Best to you and your family.  Brian

[Brighty]

Since all the information you provided on Buprenorphine has aged out and has scrolled off the board I can't remember all of it's potential uses. I mainly recall it's use in opiate detox. If a recovering addict needed an oral surgery could buprenorphine be used for the short term pain rather than narcotics ? I think you said it is only available in injectible form so far in the US. Do you know if that is limited to detox facilities or do other doctors have access to it? Do you know of any non-narcotic substitutes that could be requested of an oral surgeon ? This would be a surgery for removal of impacted wisdom teeth and would not require but a day or 2 of pain med before going on to something like tylenol. Thanks for your help.

[Brighty]

Thank you for a very enlightened reply !! I thought any doctor could treat addiction with narcotics although I have no clue what they would use other than methadone. I am curious if methadone is a narcotic and also what others are used in detox?? I am only familiar with methadone use. And of course I am only familiar with heroin detox. About the bup for the oral surgery...I feel so hopeful to learn this is possible. You not only answered my question but supplied lots of important information that will help many who are seeking detox and narcotic alternatives. It may be helpful if you could explain the business of agonists and antagonists.Is bup a synthetic since it is not from opium ??  I'm not too sure about doing the injections because I have a psychological button that gets pushed when I see a needle, ever since the time I found syringes in my daughter's room and was confronted with the horror of it all. Actually, since she will still  be in a therapeutic environment for this surgery ,hopefully we can arrange for the nurse to do this. Pwhew!! BTW, I think you are a pharmacist by profession or possibly a dentist :-)) Just a speculation and of course no response is necessary or expected :-)
Best wishes, Brighty

[Brian to Sick and Scared]

Buprenorphine was developed as a pain medication.  It has gotten lots of publicity due to its other use as a detox medication and a potential substitute for methadone maintainence. It works well for detox because it is a partial agonist (whereas most narcotics are total agonists) and is also an antagonist.  In addition, it seems to remain on the opiate receptors for an extended period of time, making its effects last longer.  As of now, Buprenex (the brand name) is only available in injection form.  The injections are easy, and can be either IM or subcutaneous (skin popping).  As to prescribing Buprenex, any physician can prescribe it for pain relief.  It works well for moderate to severe pain, while not getting the patient "high."  In most patients previously dependent on other narcotics, the main side effect is lethargy.  I believe it would be an excellent drug to use for oral surgery and if you have a reasonable oral surgeon he/she should have no problem prescribing it if you explain about your daughter's history.  In just a moment the surgeon can show you how to do the injections. Buprenex comes in 0.3mg ampules and the pain relief from each injection should last about 6 hrs.  Accordingly, see if he will prescribe 8-10 ampules.  No non-narcotic pain medications work well for oral surgery, which, due to the vascularity in the region of the mouth, is particularly painful.  BTW, the oral form is working its way through the FDA's process and hopefully will be available soon.  Finally, only physicians certified to use the drug to treat addiction may prescribe it for that method because it is against the law for just any physician to use a narcotic to treat narcotic addiction.  Many docs are getting around this by prescribing it ostensibly for pain, when in fact they are treating their patients' addiction.  There is a move afoot to permit all physicians to prescribe Buprenex for addiction.  If it is successful, we may FINALLY be on our way toward compassionate treatment for addicts in the privacy of their doctor's office.  Lets hope.  Any more questions, just post and I'll be happy to respond.  Yours truly, Brian

[Brighty]

Well, it's a blessing to us who are helped by what you remember. Good idea ! I will make contact with the lecturer. Thanks!

[Brian to Brighty]

Thank you for your kind comment.  The information I have is simply what I recall reading in a journal, I believe the Journal of the American Medical Association.  The article really just mentioned TIQ in a footnote.  I am blessed (or cursed) with pretty much a photographic memory so I can generally recall whatever I have read.  Good luck finding more info.  You may want to contact the lecturer who was speaking about TIQ for more info. and resources.

[Brighty]

Thanks!! I asked because the person who posted many of the discussions on buprenorphine that were removed from the board was Steve also... he was from Italy... and buprenorphine is approved for prescription use there. When you said you had something removed from the board I thought maybe you were that person. :-)) Best wishes.

[steve]

No I'm not Steve from Italy.

[Brighty]

I'm not sure. Some posts have been removed because they were in a thread with some inappropriate remarks.. such as personal attacks or language that was in poor taste.  When this happened the webmaster removed those comments. Unfortunately the whole thread had to be removed even if it contained good information. At that time the webmaster left an explanation on the board. In the case of unanswered questions being removed there has been no explanation. A simple comment that the question was too complicated would have been enough. Actually, even those questions unanswered by Dr. Steve are valuable because they create a good exchange of information among the participants of the forum. By the way, are you the Steve from Italy ????

[Brighty]

I felt sure you had some information !!! Thanks for sharing it. At least now I know the full name of the chemical and can begin my search. The first time I heard of TIQ was on a TV news program in June of 1997. It was a news show on addiction and pain management. At the time the topic was of little interest to me personally. So when it came up again at this informational thing I had to attend I was intrigued. If you have any information on where I can get more information I would greatly appreciate it. Thanks for all you contribute to so many here. :-)

[Brian to Sick and Scared]

I did not respond to your earlier question on this subject because I have very limited knowledge about TIQ.  I was hoping someone might have more info, but it seems unlikely.  So, here's what I know.  TIQ is tetrahydroisoquinoline.  TIQ is being studied for its relationship to dopamine production.  I believe it is considered a dopamine "transporter."  Apparently there are studies being conducted concerning its effect in addiction, as well as with certain diseases such as Parkinson's.  I don't think you're going to find too much info about TIQ, at least at this time.  Brian

[steve]

I don't know anything about TIQ. But I did have one of my post dissapear also. It was just a question about oxy withdrawal. Don't know why some post dissapear. That is a good ?