Opioids Dilaudid Nucynta or Morphine?

[Walter1252]

First post. Direct me to any rules I violate
I’ve 2mg dilaudids, some 15mg morphine Er, 50mg nucynta and even some belbuca 75mcg. My back is raging today. Seems as if my tolerance is wrecked after decades of on and off again use. Been doing roughly 3mg dilaudid per day. No effect. I’d like to work around the house but could use advice on what would work best while conserving pills, while not constipating myself (recent bowel issues). I’ve also a strong indica.
Looking to achieve pain relief and euphoria.
Not opposed to insuffulation.
also have gabapentin

 

[Walter1252]

I’ve spent this time reading prior posts.
seems the consensus is to go with the hydromorphones. Just unclear on the ROA and dose. There’s something about my recent 7 months with opiates now. It’s as if I don’t take a boatload, I can’t cover 7/10 pain. I can maintain and not go into withdrawals with minimal (1mg twice a day of dilaudid) but to cut the pain, I need ten times that? My endogenous System is FUBARed. Should I combine a lower dose with DXM? They put me on ketamine in the hospital and I loathed it to the point I had them take me off it.
Is 10mg dilaudid reasonable (intranasal but how do you space that out)? With 600mg gabapentin on board.
I’d weaned down and nearly off these from a very high dose. Yay. But also wtf pain. I want to celebrate the win of coming off these but the pain reminds me it may be a necessary evil.
sorry if I’m all over the place. Da pain messes my thinking. It’s as if I’m looking for validation it’s okay to take these. Help?

 

[Coffeeshroom]

When it comes to Dilaudid's its called Jurnista in S.A. but they are ER/SR tablets and come with a strength range of 4mg, 8mg, 16mg strength. So Hydromorphone i have found that a twice a day dosage of 8mg works wonders if its pain only you want to take away and be more functional us a human being.

As for Nycynta i have bever heard of it and its not available here but sounds to be very similar to tramadol. And if using that for pain only then a dosage of 400mg spread out should help but not as much as above mentioned.

Then for the Morphine ER i have no exp so no input there

So for pure pain management and being able to work and function with a semi feeling of euphoria, i would go with a low to reasanble dose of opiates and just potentiate them with gabapentinoids But this is from my own personal exp and trail and error. Are you doing this yourself or with the help of a doctor?

 

[Walter1252]

Thanks for responding. All meds are from same doc. I’d just weaned down to a few mgs hydromorphone a day but it’s not covering my pain anymore. Plenty left in the bottle but I don’t see him for several more weeks. They never respond between apts. I even requested LESS dilaudid at my last apt
it’s fine so long as I don’t move / do anything during the day but my back pain kicks off if I’m active at all. And I gotta be active. The depression and boredom are almost as bad as the pain.
I’ll leave the nucynta and belbuca and morphine Er in the box for now. Unless those could be combined with the hydromorphone but from what I’ve read, that’d likely be a waste

 

[Kara Kava]

I would choose the nucynta for daytime. I don't find it as drowsy. The hydromorph would be better for evening or night. The hydromorph last longer if you sniff it

 

[Coffeeshroom]

With that and from what i can understand (and this is my own personal insight, im no doctor) but maybe there is a pinched nerve or muscle spasm or something in that line that acts up when you get physical. If so then maybe using a gabapentinoid or a muscle relaxer or maybe even Xycam as i have found that to help me a lot too with pain and functionality. I suffer from lower back and hip pain from an old injury.

 

[MsDiz]

Tapentadol (Nucynta) is definitely what I’d recommend. Ask the dr for a SR tablet, say 150mg for day time and a few 50mg Instant release for breakthrough pain and then maybe a 100mg SR for night. You can’t go over 500mg a day with tapentadol but less really is more with it. It won’t get you high but it really will help the pain. I wouldn’t combine it with any other med for the start and see how you get on. It really is a great medication.

Other things for your pain rather than meds is good oldfashioned stretching, using a roller and massaging the area, sauna or a cryospa whatever you have in your area. You can even create your own cold water immersion in your bath. 10 mins in really cold water really does do wonders.

edit to add: tapentadol is an opioid so be careful if you’re combining with other opioids obviously. I would really not bother and give it a chance to work on its own anyway.

 

[Walter1252]

Great info. Thanks all. I went with the hydromorphone yesterday , 6mg sniffed over ten min. Def worked but was also pretty out of it. I followed it up with a strong indica a few hrs later. I do seek the euphoria which seems to be best with the hydromorphone but hard to achieve after decades of on again off again use. also had 900mg gabapentin on board.
I do the stretches, hot baths massages physical therapy etc. sadly only the meds seem to help. Hot bath help the leg aches when those happen.
it’s been awhile since trying the tapentadol. Would like to give it a shot today. The comedown from the hydromorphone sucks (even at just 6-8mg).
cold water sounds brutal but I’m down to try that.
ofc I’m sore as hell today from cleaning while on hydromorphone yesterday.
the tapentadol is 50mg pills.
Unclear root cause of my back pain. Removal of the l4-l5 hardware didn’t resolve it.
Thanks again everyone. Wish I’d joined here yrs ago. Way more helpful than the docs.
I’ll search the forums but any advice on how much tapentadol to take and how would be great. And I really do seek the euphoria if I’m taking any of this stuff. Dunno if that’s possible with the nucynta.

 

[Jabberwocky]

Ask about pregabalin if you're scared about opiates/opioids.
It's kind of stronger version of gababentin. Helps with nerve pain.

 

[Walter1252]

Ask about pregabalin if you're scared about opiates/opioids.
It's kind of stronger version of gababentin. Helps with nerve pain.

Thanks. I’ll ask. I’d tried lyrica long time back for depression I think. Worth another go. I’d like to only take the opes as needed

 

[Keif' Richards]

Hey Walter! Congratulations on your first post. You will remember and cherish this day forever.

As you're well aware by now, pain is a complex and sometimes aggravating process. We can do our best to help guide you, but it will be nearly impossible for us to ascertain the best and most effective course of pain treatment for you.

As far as the bowel issue goes, I often recommend something like Miralax to folks who are on chronic Opioid treatment just as a prophylactic against constipation. I really have found it to be the most effective without potentially painful stimulant laxatives like Bisacodyl for instance.

I want to comment about the use of Gabapentin (Neurontin) in conjunction with Opioid analgesics. Here is a nifty article to check out.

https://www.google.com/url?sa=t&sou...FjABegQICxAI&usg=AOvVaw2Tx2Y-hV030mqOMQ2LR7GO

[/URL]

It is regarding the use of Pregabalin (Lyrica) after surgery and how it seems to quite effectively reduce the need for Opioid analgesics when administered after surgery. Pregabalin and Gabapentin are very similar and I've found through personal experience as well that co-administration can really help.

As far as which Opioid to use, I think you have to go through some trial and error. Tapentadol (Nucynta) has some qualities that differentiate it from standard Opuoid agonists which might also work better for your pain.

If you need advice upon when and how to incorporate the Gabapentin into your regimen just let us know. If you find success with it, you may be able to lean on it a little bit while you attempt to use less Opioids. It's a complicated situation but we will figure it out

Let us know if you have any questions!

 

[Walter1252]

Hey Walter! Congratulations on your first post. You will remember and cherish this day forever.

As you're well aware by now, pain is a complex and sometimes aggravating process. We can do our best to help guide you, but it will be nearly impossible for us to ascertain the best and most effective course of pain treatment for you.

As far as the bowel issue goes, I often recommend something like Miralax to folks who are on chronic Opioid treatment just as a prophylactic against constipation. I really have found it to be the most effective without potentially painful stimulant laxatives like Bisacodyl for instance.

I want to comment about the use of Gabapentin (Neurontin) in conjunction with Opioid analgesics. Here is a nifty article to check out.

https://www.google.com/url?sa=t&sou...FjABegQICxAI&usg=AOvVaw2Tx2Y-hV030mqOMQ2LR7GO

[/URL]

It is regarding the use of Pregabalin (Lyrica) after surgery and how it seems to quite effectively reduce the need for Opioid analgesics when administered after surgery. Pregabalin and Gabapentin are very similar and I've found through personal experience as well that co-administration can really help.

As far as which Opioid to use, I think you have to go through some trial and error. Tapentadol (Nucynta) has some qualities that differentiate it from standard Opuoid agonists which might also work better for your pain.

If you need advice upon when and how to incorporate the Gabapentin into your regimen just let us know. If you find success with it, you may be able to lean on it a little bit while you attempt to use less Opioids. It's a complicated situation but we will figure it out

Let us know if you have any questions!

Thanks very much all. I’ll dig deeper into the pregab as it looks promising!
I went on a mini dilaudid binge the past two days. 6-8mg at a time - not huge binge but Enough to cover the pain and achieve euphoria. Trying not to turn that into an every day thing. Today would be good time to retry the tapentadol.
I’ve done plenty of trial and error but have lost track of the results, ironically as a result of the trail and error. Should be keeping a pain journal.
thanks again. I plan on sticking around.
Will search again for info on tapentadol dosing here today. I’m not ope naive. Not sure where to start.
Ya. Been doing the miralax along with senna and even a script for IBS to help. Gets things out but it’s a balance between the cramping from too much laxatives or bloating from not enough.
thx again. Nice community here.

 

[Walter1252]

Well. I just went with the dilaudids. I knew they’d give me a bit of a buzz too. I don’t like this as a long term solution tho. I did about 8mg with 900mg gabapentin. The high is nice and it does get rid of my back pain but I get a pretty bad hangover. I try and stay very hydrated and took some APAP but the headache sucks. And this makes my colon pain worse. Ugh.

 

[Walter1252]

Well. I just went with the dilaudids. I knew they’d give me a bit of a buzz too. I don’t like this as a long term solution tho. I did about 8mg with 900mg gabapentin. The high is nice and it does get rid of my back pain but I get a pretty bad hangover. I try and stay very hydrated and took some APAP but the headache sucks. And this makes my colon pain worse. Ugh.

Just to add on...
Tomorrow I will try the tapentadol. It takes 8mg for the dilaudid. Will check the charts for equivalent dose. If anyone knows best way to get most out of tapentadol lmk. Dose spacing (similar to tramadol) etc. ?

 

[Walter1252]

FWIW. Some dxm and a little indica is helping with the comedown from dilaudid.