fentanyl, diamorphine (Heroin) and substitution therapy

[tajfeaster]

Do users of either believe they'd be interested, were the possibility of take-home prescribed opioids to be on the table?

fentanyl, methadone, buprenorphine, morphine, hydromorphone, oxycodone, codeine, laudanum et cetera are coming to mind.

I fail to see the allure of fentanyl. It seems like it makes you nod-off for a short period of time, after a short alleviation of craving symptoms.

Can someone correct me?

 

[Fertile]

Well, in the UK we have HAT (heroin assisted treatment) but I know more people who get ampoules of morphine... but it's not many.

If you look at the costs, methadone & morphine are the cheapest by some margin. I mean, I'm presuming people would have to pay?

 

[tajfeaster]

Yea, or else have their insurance cover it. Demographics mean out of pocket is likely for many. All hypothetical of course. Ampoules legally or illicitly?

 

[nervepain]

I would as long as it’s not bupe or methadone. Those are soooo much worse in my experience. The bupe helped me get clean when I was doing 1-2 gs a day. I had to mix subs and h to get off the subs/bupe. The withdrawals where ungodly and lasted forever. I found the substitution meds they gave were far harder to kick.

 

[plumbus-nine]

Methadone isn't that bad. I found it to be more euphoric than morphine for some reason, at least as a pharmaball (opioid + stimulant). Switching to morphine for to quit is easy. Quitting it turkey isn't.

 

[AlsoTapered]

Yea, or else have their insurance cover it. Demographics mean out of pocket is likely for many. All hypothetical of course. Ampoules legally or illicitly?

Legally prescribed. They also add about 20% caffeine by weight to allow dependent users to smoke the diamorphine hydrochloride.

Now fentanyl binds to an extra site within the mu receptor which means methadone, morphine and diamorphine will not halt withdrawal. That was not likely a consideration when people started to produce fentanyl in bulk BUT their was a drug used for substitution therapy in The Netherland that DOES stop withdrawal from fentanyl, but I very much doubt that the US would introduce it, however many lives it would save.

I suppose the 'ultimate' substitution is the acetyl ester of R-4066 which is x212 morphine in potency and it's duration is so long that it can be given on alternate days.

I think the US is going to wait for thienorphine to be introduced (which WILL help fentanyl detoxification).