Morphine / Naloxone Withdrawal and HCV RNA

[NYgirl]

I don't know if anyone else in here is on either Suboxone (Naloxone) or Methadone or on a lot of morphine based pain pills...

But this is a very interesting article to read regarding the Interferon being interrupted during treatment.

I have wondered if perhaps the basis of Suboxone was whacking out my treatment at all...so I am going to be looking in to this to see if perhaps it is blocking the Interferon at all and that may be why I have a few errant virus's floating around.

http://www.hepatitisneighborhood.com/content/in_the_news/archive_2602.aspx

A short excerpt (I think that is ok to copy and paste) of the subject matter:
These results were observed when morphine was directly withdrawn or indirectly removed by using naloxone, they reported, and even to a greater extent in the latter case.

"Collectively, these new observations in conjunction with our earlier findings support the notion that opioid abuse is a co-factor that promotes HCV replication," wrote Ho and his colleagues.

The researchers point out that the clinical relevance of this study remains to be determined, but the findings suggest that "opioid abuse may contribute to the chronicity of HCV infection and promote HCV disease progression."

[NYgirl]

write that the findings suggest that IV drug abusers or those receiving opioid substitutes like methadone, and who are infected with HCV, may have more difficulty clearing the virus.


Great huh?  All that work to get off my pain pill habit (and there ain't nothing more full of morphine than oxycontin LOL) and the morphine they addicted me to while in the hospital...for nothing?

At week 20 it is just too late right now to detox myself from the suboxone and have it make a difference.  Plus I just don't WANT to have to go through all that withdrawl during this time.

God it just gets more impossible!

[cuteus]

it looks like withdrawal from the morphine is worse for the liver cells than keeping it supplied with it, so I am not sure how they apply the results in their conclusion.
Of course, all of this happened in a petri dish, without all the other variables present, such as interferon from other organs or tissue, as well as other immunological substances produced by the body, that in real life might hinder hcv.  
Something about the "study" just does not sit well, they use the results from their other 'study' that says opioids aid hcv replication and mixed it in with this conclusion after stating that withdrawal is aiding replication by suppressing the production of interferon in the liver cells.
some articles are not too clearly written for us laypersons.

[friole]

This is not what you need right now -- more stressors.  I found that article quite interesting and I can understand your concern.  If I am remembering correctly you are on Naloxone in order to withdraw from a dependence on pain meds from a back (?) injury.  The article has a d.. if you do and d... if you don't approach.  The morphine boosts the Hep C virus growth, but the effect of withdrawal from morphine is the blocking of the interferon.

I think we need to try to find more on this.  It is just research at this point, and I am not even sure the research was done on people - maybe only cells in petrie dishes.  It offers no real help as to what to do when you are on tx.  

Personally, Deb, I am just holding my breath waiting for your next PCR to show that you have dumped those 400 virons.  Then this article is a academic.  You have had a rough week and I know things will be better.
Your friend, Kath

[NYgirl]

I'm not obsessing on it but I started to think...what are the ramifications of all the "other" meds I'm pumping in to my body you know?  We think about herbs and vitamins etc....but what about all the prescribed medications that one doc will put you on compared to another?  I wish to GOD I had gotten off them all before I started...never really thought of it.

Yes...I was in the hospital for two weeks in Critical Care on legal limit morphine every four hours (even when I was sleeping they would come in and give me the shot) for my injuries. Then I got out and had all my lovely prescriptions............and then a wonderful addiction.

Not that I was EVER a Saint by any means before...but that was the kicker. Legal meds are more dangerous sometimes than the illegal when you have unlimited supplies.

[can-do-man]

Just one more reason why i think a hepatolgist is so important in the treatment of hep-c. Good luck going forward.

[NYgirl]

You are SO RIGHT...a good doctor supervising everything and everybody is just CRUCIAL.

It really can save your life!

How are you feeling?

[can-do-man]

Fit as a fiddle today thank you, How you doing? Ever answer that phone and stop that ringing?

[Mister beagle bailey]

Good mornig,

Did I read this right? That pain meds like methadone can prevent the virus from clearing.  I always thought that meds like methadone did not attack the liver.

Hope your feeling better,

   The Beagle,  your twin  :) :)

[NYgirl]

Can do - God I love a good laugh - thank you so MUCh for that.  Still have mild ringing and know why...just trying to ignore it and come in to work anyway!

Beagle - that is what I got out of it there that it interferes with the Intron or something.  Or that withdrawl originally makes things replicate faster too. Sounded like a bunch of stuff. Since I'm on the suboxone (which is like methadone except I get it's the "working man's methadone") I am curious now to learn more.

But as always...I think EVERYTHING is subjective you know?

[dyce]

Hello.I read the article and it seems when withdrawing from opoids hcv replication is enhanced,and when on tx,it lowers svr chances. I've read older post where people on tx were using narcotic pain meds daily but this was at prescribed doses and had good pcr test results.Maybe by using pain meds as prescribed and avoiding withdraw by suddenly stopping it,one could attain undetectable pcs test results.

    
Dyce

[NYgirl]

Then I should be ok in that world...thanks Dyce.

It's all such a big crapshoot all of it - I might as well roll dice and have 7 be ok and 11 no or something ;-)

[Mister beagle bailey]

I just read the article and this is what I came away with:

This research was done in a petri dish, the culture was taken from a piece of liver from a research lab. The HCV liver cells were put in the dish and morphine was added, after awhile they withdrew the morphine showing a surge in HCV, but it was only temporary and 72 hours later the HCV was responding to the interferon-alfa.
They go on to say that this is found in culture and has not been done on humans,and in the culture they compare it with IV abusers who are using and withdrawing,then using and withdrawing and so on.  They only suggest that methadone and other opiate abuses or withdrawal can enhance the viral replication.

This quote ends the article:" The growing implication from these and other studies is that continued opiate abuse leads to enhanced viral replication, liver injury, and...fibrosis.  Futher studies are required to determine wether these effects occur in humans, as well," they wrote

I think you are fine and I believe you have nothing to worry about. So let's march on to SVR. :)

          The Beagle

[antman]

hi NYG. i quit a pill habit myself over the holidays specifically to get ready for treatment. i feel your pain. drug abuse and alcohol are toxins. i can't imagine they are any good for us, on tx or not. plus, norco, my DOC has 325mg of tylenol in each. i was taking 8 a day for 4.5 years and drinking on them as well. oh, and taking xanax at night to sleep ! i told my Dr's nurse, as i was advised here, she said get help. the treatment won't work if i take all that stuff.i looked into suboxone and subutex. suboxone has narcan which is very hard on the liver. narcan is an opiate antagonist. it reacts if you take opiates and cancels it out so you won't get high. in fact in can bring on nasty WD's if you take them together. subutex does not have naloxone and is safe on the liver. hope this helps.
antman