We don't get Hydrocodone in the UK but I believe it's somewhat comparable to an opioid we do get - Dihydrocodeine - in as much as they are both used to treat moderate to severe pain. I don't know how the 'strength' of each opiod compares.
I have previously taken kratom and Dihydrocodeine together and found that any effects from the DHC were totally killed.
At that time I was quite new to resuming kratom, maybe only a week or 2 into occasional dosing.
Now I am about 6 months in to more regular kratom use, although with some breaks, maybe 2-3 days off per week, and one 4 day stretch off a few weeks ago. To prove to myself I'm not getting addicted.
My tolerance has risen slightly. Increasing my average doses from 4.5 g to 5.2g twice a day. It is meant to be quite strong kratom, and taking 10g doses, as I was with previous kratom supplies, is very unpleasant.
I have seen a lot of posts on that other message board which does seem to have some good info (as does bluelight of course), and some of them are saying that you should wait at least 6-10 hours, but most saying saying 24 hours, several saying to wait several days after taking kratom to dose any opiate.
One has said that 'this is because the active compound in kratom has such a high binding affinity to the mu opiate receptors and will not be dislodged by most opiates (even heroin users complain that kratom ruins their buzz/euphoria if taken too close together). So there is a waiting time between your kratom wearing off and leaving the receptors and you being able to get high off your opiate of choice.'
I don't know to what extent this is true. I recall one person I knew on this forum saying that he'd taken 10g of great quality red borneo kratom on top of injecting heroin, and the combo was fantastic for him. There's probably a lot more examples to be found of people successfully combining kratom and opiates. But there's probably also a lot of examples of such combos failing to work for others, as in my own personal case. So who actually knows for sure about this?
Another is saying 'Kratom is a strong inhibitor of the liver enzyme CYP2D6 and will stop any conversion of DHC to DHM. It take a good 4 or 5 days for it to replenish in my experience, and if you do take it, you won't feel the full effect. 450mg (DHC) is a decent amount so you might feel something but nowhere near the potential if you gave it a few days.'
Again, myth or true I don't know.
Another is saying:
There's three major possibilities to consider:
- Antagonist in kratom is sufficient to blunt agonist effects, unlikely because the antagonist is just 1% of the alkaloid content and does not have a higher affinity than mitragynine.
- Tolerance. Nearly every known opioid agonist produces tolerance by desensitizing mechanisms activated by cellular messengers. Technically, it is true opioids can differ in their recruitment of cellular messengers, but it is still not negligible in kratom. As a result, an obvious difficulty for users exists in figuring an equipotent dose, unless you happen to know the precise alkaloid content of your kratom and your individual pharmacokinetics for kratom (though you could assume a ~4 hour half-life with 3% bioavailability as has been shown in rats.) And to state the obvious, unless you dose your desired opioid agonist in excess of the equipotent dosage, you're going to fall victim to the tolerance trap. That's drug tolerance 101 (same amount = less effects after repeat administration).
- Research emerging in the last decade suggests mitragynine may actually be a partial agonist. This has been demonstrated again in a study published this month, May 2016, with HEK 293 cells that are more or less 'human' in nature. Partial agonists (e.g., buprenorphine) attenuate the effects of full agonists, because there is a finite number of receptor sites and inevitably some will be occupied by partial rather than full agonists. This is perhaps the strongest argument, and I'm not surprised that some of the pharmacologically naive users in this sub failed to mention it. Partial agonism together with tolerance reconciles virtually every phenomena people have described subjectively, including the ceiling effect, diminished effects upon co-administration of kratom and other opioids, and diminished effects of other opioids following extensive kratom use. In addition, although not likely due to its affinity and abundance, the antagonist corynantheidine in combination with partial agonist mitragynine could in theory further decrease the effects of a full agonist à la Suboxone. I'm sure you've heard of desperate junkies fearing they will waste precious drugs by not waiting out the half-life of subs; this is somewhat a consequence of that principle, though in that case the naltrexone is certainly contributing whereas corynantheidine's impact is not as clear.
W/e is true, it seems to be complicated, an no one seems to know for sure?
Most people seem to be saying they are fine after 24 hours, but some longer. I've decided to have a day off kratom today and I'll probably try some DHC tomorrow, at a time which will probably be about 40 hours after my last kratom dose.
I will report back as to what happens.
