Opioids How do you deal with opioid constipation?

[thizzlemonster86]

I was in a very similar situation a few years back. Was so constipated I could barely walk normal. On second day was becoming unbearable so resign myself to check in at nearest ER in the middle of the night. Doc argued with me saying it sounded more to him like herniated disc or other back pain factor but to make sure x-ray was required, and I should stay overnight because x-ray room was short-staffed at that hour. Got stripped, put on hospital gown and off to bed and wired to machines. Sorta dozed off for an hour waiting for x-ray people to thaw. Finally a nurse appears and injects something in my IV drip. Thinking it's constipation med I say nothing but within a few seconds a weak but telltale sensation invades my body. I ring nurse and asked what she just injected me with. "morphine 5mg you can have it every 3 hours" she replies. WTF?! morphine for a constipation case of biblical proportion? I started to laugh uncontrollably, what else could I do.

Morphine for constipation? That makes no sense whatsoever. I guess maybe if you were complaining of pain.

 

[Kilfer]

Morphine for constipation? That makes no sense whatsoever. I guess maybe if you were complaining of pain.

Obviously the morphine was not intended to treat my constipation lol, but to keep me quiet. Not that I was making any noise, but I have since learned that many hospitals routinely inject ER patients with low doses of morphine at night to keep them calm (I suspect it was also to prevent potentially incontinent patients from defecating in bed). Patients who are really in pain get more than 5mg obviously. But still, it's pretty idiotic to give opiates to constipated patients, she should have read my chart before injecting me with any drug. Anyway in the early morning they asked if I needed the morphine and I half yelded HELL NO! probably loud enough for the whole ER to hear. Good thing I wasn't still asleep. To be honest, the megaconstipation was causing some pain and the PK shot provided relief from it but as they say, the untoward effects overruled the benefit.

 

[Jabberwocky]

the safest way to clear out constipation for me personally was to take a daily dose of doccusate sodium and dulcolax before i went to bed. i'd take 4 caps of the doccusate and 2 of the dulcolax. now this is a terrible, terrible way of managing opiate induced constipation, however i kept on forgetting to stock up on lactulose (which comes in later in this) and had to do this several times.

when things got really dire (aka when i'd run out of laxatives, which happens from time to time), i'd use a fleet enema. they are weird fuckers i'll give you that, as i never really knew when they'd start working, but they would flush me out real good eventually. word of warning though - DON'T HOLD THEM IN FOR LONGER THAN AN HOUR - if they are the ones which contain phosphate i believe, as that can start causing electrolyte imbalances which is essentially another problem added to heap of shit you're trying to clear already. i had a splitting headache for the next couple of days after holding one in for about two hours. if an hour has passed and nothing, it's time to try and expel as much of that fleet enema that you can and get to a doctor. (i don't condone this, but personally if an hour had passed i would fill up the enema bottle with filtered water and squeeze it up there again and again). shove a glycerin suppository up there too, as your rectum could quite literally need that extra push which the fleet enema unfortunately doesn't give and get ready for the crap of a lifetime. - note this was when i had been backed up for about 10 days. i actually usually found that at this point the thing giving me real issues was that my sphincter muscles just would not relax (a bit graphic here - but i could feel how tense it was, so, lubed up a finger and hey presto was hellish. i'd usually take a warm epsom salt bath adding more and more salt to around my anus area until i felt the urge to go, and go i did eventually) yes, i've had to do the manual evacuation several times before and let me tell you it's highly unpleasant. i must have suffered from multiple bowel obstructions during my opiate abuse times as i tried to pass stool the size of footballs several times that i had to break up piece by piece, and let me tell you manually disimpacting them is fucking ego shattering, not to mention horrifically painful despite being doped up, slow and humiliating. not to mention the horrific haemorrhoids and anal fissures you suffer with on a daily basis too.

you really need to take care of your bowels when you're on opiates for a long period of time because the constipation is no fun whatsoever. it also starts to ruin the high of the opiates as you're constantly worried about your colon exploding. my best advice to you is that if you're going to be using opiates for a long term period start taking lactulose now, and never ever run out. it was my best friend, it doesn't stop being effective (apart from when you've forgotten to take it cause you're in an opiate and benzo induced stupor 24/7) and isn't harmful unlike so many of the other laxatives out there that are. 10mL at each meal should suffice, but when i was blocked up hardcore i'd swig it down - lots of discomfort, cramping etc for the next day or so, but it would clear me out sharpish even when taking opiates ontop. how safe that was i have no idea, but it worked miracles. keep up a healthy diet (i know it's really fucking difficult) but honestly, if you do, you'll be so grateful in the long run. the constipation was what eventually ruined opiates for me - but also scared the hell out of me. fuck the respiratory depression due to taking copious amounts of oxycodone and xanax, the constipation was the scariest in the end. i just can't imagine exploding inside out.

now this i don't recommend whatsoever, but it helped enormously for a short lived while: 40mg of d-amphetamine, 100mg of tetrazepam, 2 strong double espressos, a pint of water, and a cigarette. KABOOM. - that only helped for a little while though, became practically useless after a while and just will divulge you into an amphetamine and benzo addiction ontop of what you're already suffering - you don't need that whatsoever. (if i didn't use the tetrazepam it would be like shitting rocks, it's quite a potent muscle relaxant for the sphincter!).

 

[xtcgrrrl]

What I do is have coffee and then smoke a cigarette in the bathroom while I'm trying to go. The combo works well for me. Oh, and fiber.

 

[Reddo_]

Hey, I had serious constipation issues after the doctor upped my methadone script, (no longer on meth, thank god). I bought some Senokot over the counter and I was suprised that is was quite effective. Looked up the ingredient's and it's made from Senna plant. 'senna is derived from Cassia acutifolia or Cassia angustifolia – the senna plant.' This type of medication is no long term solution but I was chuffed with the relief if things got painul.

 

[JackiePeyton]

Linzess is a great prescription for constipation. Especially if your on maintenance. I use that and miralax everyday. I tend to shit at least once every 48 hours which is a huge improvement for me.nif things get backed up I use a enema.

Supposed to be for IBS~C but I imagine it could be used as a lax. I thought the trouble would be over after quitting subs - guess what- nope. Doc put me on this. It can be horribly dehydrating - to where I cannot stand in one spot for long. And alcohol- forget it. Cannot do it while on this med.

 

[GetOnGoing]

The most overlooked factor imo is exercise. Stay hydrated, eat plenty of fruit and veg, keep active. This will help more than anything else. I've tried everything, movicol, senna, lactulose. Actually lactulose will completely stimulate the shit out of your gut but it's deeply unpleasant and isn't sustainable.

....100% true i went within 20 mins...lots lots of water then cycle or tread machine

 

[electric moon]

Shove my finger up there and pull the turds out. Plus, BONUS, you have an excuse to shove your finger up your ass!!!

 

[Crashing]

You just wait until you've got a monster energy can sized turd in there, then sit down on the toilet while in withdrawal, bang a few oxies and the rush will allow it to seep out.

 

[Eveleivibe]

Just be as healthy as possible. Eat fibre, fruit vegetables, drink plenty of water. Don't over do it with foods like bananas and milk. Maybe try decreasing the amount of opiates taken daily.

Don't strain on the toilet it can cause further problems and if it happens frequently see the doctor about it.

Evey

 

[CoastTwoCoast]

I've had some really bad times where I literally couldn't go. Get some magnesium citrate laxative from the store and drink a bottle of that with water. You will be going like crazy. Non of that ex lax crap that takes forever. Drink a bottle of magnesium citrate and you are GUARANTEED to shit your brains out.

 

[nightclubgal]

Prunes with hot tea or water is the best for you because they are natural. Also there is Smooth Move, a fiber tea that you can buy anywhere laxatives are sold or in a Health Store. You just boil the water, make the tea and cover it with a saucer or something that is going to hold all the "power" of it in for 20 minutes. When you take the Tea bag out, make sure you squeeze it over the cup. It tastes nasty, but if you've gotten to the point of needing this, you won't care!

 

[Kel44]

I didn't read this whole thread, but this is how I managed constipation when I was on Oxycodone 24x7 post surgeries (only for maybe 3 weeks at a time):

Colace twice a day (safe to take this indefinitely, I hear)
Drink LOTS of water
Eat prunes daily (actually pretty yummy. I bought them individually wrapped)
If you are able, get up and walk around a couple times a day
Try to avoid eating things that bind you up, like cheese

I only use laxatives if I'm totally desperate. Too harsh for me.

 

[opiatekrzy]

Dulcolax (bisacodyl) will work great if all other methods failed, or magnesium citrate drink. You will be cleared out for sure

 

[losangeles1993]

eat a lot of fiber 1 bars ...they helped me a lot when i was smoking/slamming heroin

 

[tacodude]

I don't know if it's been said, but mirlax is probably the best choice to use regularly as it doesn't irritate to cause relief, but instead causes water to absorb more. It works really well.... You'll literally not feel forced, but you will have lots of loud explosive farts.

Edit : also make sure to use lots of probiotics. They will help you digest your food.

 

[BeachBum4u]

Personally I'm on pretty high daily doses of opiates and I will usually have to go whenever I can push my next dose an extra hour or two. I have never taken anything to go and this routine works for me every time. I know it's nothing complicated but it works for what and when I take my meds.

 

[Keif' Richards]

Personally, I found Miralax to be the most effective laxative out there. To each his own though. Whatever happens, I would advise against using powerful stimulant laxatives on a regular basis.