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Opioid Combinations


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#1 cactuswren

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Posted 29 February 2008 - 10:53 PM

This thread is intended for those who are useing opioids for chronic pain relief [really the truth]. Opioids are effective pain relieving agents. However, their dependency potential is enormous. If you have experienced opiate withdrawal, you know what I mean. If you haven't, none of this information or any warnings will deter or propel you into experiencing your own truth. The major problems of opioids for pain management are twofold: how to maintain efficacy while reducing dependence potential and [2] how to reduce diversion or use of the drug by others than those for whom the drug was intended. This thread will deal only with problem #1.

For well over a hundred years the medical community has been looking for an effective and non addictive [no euphoria] chemical to use for pain management. Cocaine and heroin were both thought to fit this need until further investigation. Then there came meperidine [Demerol]. Again, the same potential for abuse. Now we have buprenorphine, a partial opioid agonist. This substance has a great potential for withdrawal from pure opioid agonist such as heroin as it is much easier to withdrawal from. Unfortunately, it does not have the efficacy in treating sever pain that the pure opioid agonist do. Methadone is [in my opinion] the closest drug we have at the time for reducing euphoria and dependency while maintaining efficacy in treating severe pain. Despite the info provided by the news after Nicole and her son OD on methadone, it does not produce a heroin like high. It also has a much longer half life which means you only have to take it every 12 hours as opposed to every 4 hours. It is also quite safe [empirical data] in low doses; 10-30mg per day. Back to the topic.

For decades, opiods have been combined with aspirin or acetaminophen in an atempt to use less opioid. Currently, a combination of morphine and dextromethororphan is being evaluated for the treatment of moderate to severe pain. This product is called MorphiDex in the US. DXM is a glutimate NMDA receptor antagonist that enhances the analgesic properties of morphine. It is supplied in an oral preparation with a 50 percent reduction in the dose dose of morphine. The amount of DXM was not listed. There are several reports attesting to the effectiveness of this combination [Caruso, 2000; Weinbroum et al., 2002]. Other morphine sparing regiments include combining opioids with an neuromodulator anticonvulsant such as lamortrigine [Arguelles et al., 2002] or gabapentin [Matthews and Dickenson, 2002].

If you are using opioids in any form [this includes poppy tea] to achieve euphoria on a regular basis [every day for 2 weeks or more] you are probably already addicted. The sooner you stop the easier it is. Opioid withdrawal will not kill you [alcohol and/or benzodiazapine withdrawal can kill] but you will wish you were dead. This is a substance with great potential to heal [literraly to become whole] or to destroy. This is not unlike many of the substances discussed in these forums. As someone somewhere said,m "The truth will set you free." Or maybe enslave you.

Be carefull, be safe, be free. Remember; "That which you seek, you allready are...The Upinishads

#2 Lefty

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Posted 02 March 2008 - 11:16 AM

Oh, I thought you meant "pyramiding" like valuim & viks. Doridan & tylenol 4's was a screaming combo until they screwed up doridan due to abuse potential. Wonder what ever happened to that trashbag nurse I used to get them off of? Recall she drove into her neighbors house back when insurance still paid on dui's. Her narcotics collection was unrivalled, introduced me to doors & fours. Never saw them again. Can almost hear Archie & Edith singing "Those were the days"
Methadone (morphine refluxed in HCL) will "get you high" provided you are not a junkie. It is (not real often) used for pain relief. If you are a junkie one must find a ten stick of xanax to potentiate a high similiar to heroin (useless & drooling).

#3 Hippie3

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Posted 02 March 2008 - 11:24 AM

addiction is the least concern of someone in moderate-to-severe chronic pain.

#4 Lefty

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Posted 02 March 2008 - 01:33 PM

addiction is the least concern of someone in moderate-to-severe chronic pain.


Interesting point. Vioxx is a great nsaid, shame about the heart problems but it did wonders for me. Think bextra is legal. Tramadol caught a bad rap when Old Dirty Bastard took a shitload w/coke & croaked.
My orthopedist gave me all kinds of shit & told me to worry about addiction later. A few months later told me the longer I stay on narcotics the longer the pain lasts. I grudgingly admit he was right but @ the time it hurt like hell & that was my primary concern. My physical addiction really sucked.
Interesting story I remember some of, a few years ago a senator or congressman (forget which) was watching his wife die of cancer (breast I think) in agony. The doctor informed him that she would get no more narcotics because he would lose his ability to practice medicine if he gave her anymore. The politician then sponsored a bill (compassionate something) that I believe passed so the dying need not do it in agony. Rather screwed that thousands of families watched loved ones do just that until someone more important comes along.

#5 cactuswren

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Posted 02 March 2008 - 08:24 PM

Yes, I recall fours and dors; also, T's and blues. Valium, opiates, and alcohol combo always seemed to me the ultimate tool for avoiding life. But no, that wasn't what this was about. I'm not sure about wold wide, but in the US in 2004 Methadone was prescribed more often for chronic [not acute] pain than any other opiate. It works.

Oh, I thought you meant "pyramiding" like valuim & viks. Doridan & tylenol 4's was a screaming combo until they screwed up doridan due to abuse potential. Wonder what ever happened to that trashbag nurse I used to get them off of? Recall she drove into her neighbors house back when insurance still paid on dui's. Her narcotics collection was unrivalled, introduced me to doors & fours. Never saw them again. Can almost hear Archie & Edith singing "Those were the days"
Methadone (morphine refluxed in HCL) will "get you high" provided you are not a junkie. It is (not real often) used for pain relief. If you are a junkie one must find a ten stick of xanax to potentiate a high similiar to heroin (useless & drooling).



#6 Hippie3

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Posted 02 March 2008 - 08:28 PM

it [methadone] also kills alot of people.
i'd rather brew my own pod tea.

#7 cactuswren

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Posted 02 March 2008 - 08:47 PM

I appreciate your statement and I agree with you.
I understand that the pain relief is the only thing the chronic pain patient is concerned with; unless he becomes addicted to the rush. In that case, achieving that feeling, or lack of feeling is more important than anything.
I have worked with chronic pain patients whose doctors decided they were addicted and needed to stop taking opiates; that really pisses me off. The mission statement for pain management specialists in the US states that the chronic pain patient has the right to be relieved of pain using any medication currently legal to prescribe. I believe there is a difference between physical dependency and psychological addiction when it comes to opiates for pain management. Certainly, if you take large amounts of opiates everyday, you will be dependent upon them. However, a patient who has been achieving moderate pain relief, on say 4mg of hydrdomorphine 4xa day, suddenly uses up a month supply in 1 or 2 weeks because it feels good when he crushes up the pills and snorts or slams them, we might be talking about a potential psychological addiction. Which is where drugs like Methadone or maybe morphine patches would be less likely to have the same abuse potential. It is interesting to note that this type of addiction is relatively rare with chronic pain patients. Living and dealing with chronic pain is different than being a junkie; at least from my personal experience.

addiction is the least concern of someone in moderate-to-severe chronic pain.



#8 cactuswren

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Posted 02 March 2008 - 08:53 PM

Amen to that. Congratulations on the new child in your life. I didn't check on the due date; is it soon? Was a name chosen yet?

it [methadone] also kills alot of people.
i'd rather brew my own pod tea.



#9 NewsInfusion

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Posted 11 November 2008 - 04:44 PM

OP: Yes, perhaps for people with real, chronic moderate-to-severe pain, methadone is preferable. However, for people like this guy, the pain was gone a few months after the accident, and then he was just a junkie. In cases like those, getting past withdrawal is the most important thing. (The video and article are sponsored by the NAABT.)




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