Hydrocodone vs Hydromorphone

[IsaiahBisGod]

I have used both hydrocodone, and hydromorphone on several occasions (orally). In my experience they feel quite different. From what I understand hydrocodone is inactive by itself, but converts to hydromorphone in the liver when ingested. So theoretically they are the same drug. But I can't get over how different they feel to me. Vicodin feels more euphoric to me, kind of similar to oxycodone. Where Dilaudid feels more like oral morphine, it is fun to do, but it just makes me nauseated and doesn't really get me where I want to be. Does anyone else notice the difference, and if so what do you think causes it? The way it crosses the BBB? Maybe the oral bioavailability of the two being different, maybe a different ROA would make a difference.

 

[sekio]

Hydrocodone is active as an opioid receptor agonist, that's why. It's not totally inactive until conversion to hydromorphone.

 

[Nagelfar]

I have used both hydrocodone, and hydromorphone on several occasions (orally). In my experience they feel quite different. From what I understand hydrocodone is inactive by itself, but converts to hydromorphone in the liver when ingested. So theoretically they are the same drug. But I can't get over how different they feel to me. Vicodin feels more euphoric to me, kind of similar to oxycodone. Where Dilaudid feels more like oral morphine, it is fun to do, but it just makes me nauseated and doesn't really get me where I want to be. Does anyone else notice the difference, and if so what do you think causes it? The way it crosses the BBB? Maybe the oral bioavailability of the two being different, maybe a different ROA would make a difference.

Typical response of, no offense intended, the opioid naïf (naive- in terms of tolerance, and by consequence, naive in what is liked about the differing drugs). The nausea is due, I find most often, to *technically* (but not seriously) overdosing; not in a way for which your body cannot retort; even if while holding it down without succumbing to emesis (regurgitating / emergent stomach evac), your body can adjust but we have 'safe rather than sorry' automatic reactions if our body doesn't have it pinned or know exactly what the potency is for the speed of onset with the same route; taking many differing sub-varieties of opioids in the beginning can do this:

Now Dilaudid is many times stronger than morphine, but like morphine, has poor oral bioavailability (unlike oxycodone which has great oral/ingested route blood -absorption; i.e. doesn't get broken down into inactive metabolites by stomach acid &/or first-pass metabolism prior to reaching a saturation point into the blood stream as regular ol' feen does.)

Vicodin is, widely, considered one that does *nothing* for a highly opioid dependent (for years on end; sorry Doctor House, but your plot is too thin to hold water to real opiophiles, esp. one w/ a PhD.). I have heard others say they like oxycodone but not heroin; just makes them itchy, etc., all the *negatives* (too potent for their tolerance) but once they up the ante, the others don't do much for them. H-morphone has no legs for me, and I don't even feel it unless injected, but when injected, it's rush is one of the most intense, euphoric of the opioids configured for a fast onset route.

 

[IsaiahBisGod]

Typical response of, no offense intended, the opioid naïf (naive- in terms of tolerance, and by consequence, naive in what is liked about the differing drugs). The nausea is due, I find most often, to *technically* (but not seriously) overdosing; not in a way for which your body cannot retort; even if while holding it down without succumbing to emesis (regurgitating / emergent stomach evac), your body can adjust but we have 'safe rather than sorry' automatic reactions if our body doesn't have it pinned or know exactly what the potency is for the speed of onset with the same route; taking many differing sub-varieties of opioids in the beginning can do this:

Now Dilaudid is many times stronger than morphine, but like morphine, has poor oral bioavailability (unlike oxycodone which has great oral/ingested route blood -absorption; i.e. doesn't get broken down into inactive metabolites by stomach acid &/or first-pass metabolism prior to reaching a saturation point into the blood stream as regular ol' feen does.)

Vicodin is, widely, considered one that does *nothing* for a highly opioid dependent (for years on end; sorry Doctor House, but your plot is too thin to hold water to real opiophiles, esp. one w/ a PhD.). I have heard others say they like oxycodone but not heroin; just makes them itchy, etc., all the *negatives* (too potent for their tolerance) but once they up the ante, the others don't do much for them. H-morphone has no legs for me, and I don't even feel it unless injected, but when injected, it's rush is one of the most intense, euphoric of the opioids configured for a fast onset route.

I am in no way opiate naive. I've used various pain medications and used heroin daily for years. To me, there is nothing more repugnant and annoying than one of you "drug snobs" that talks down to people because you feel your drug use and abuse makes you some sort of all knowing expert. I was just posting a simple observation I had made about the two drugs. Don't worry, we all know how big and bad your tolerance is now, hopefully one day I can achieve the excellence of sublime drug tolerance like you have, sir.

 

[sekio]

I suspect that the rate of opioid crossing into the brain from the blood is correlated with negative sife f/x like itching, nausea, dysphoria. Drugs with very fast onset like high dose oral oxycodone, hydromorphone IV, morphine IV bolus are notably more complaint inducing than "others".

Maybe there is also involvement from the "other" opioid receptors: delta, kappa, sigma1/2. Some opioids that are "weaker" at mu opiate receptor will still have some affinity for other sites, presumably changing their pharmacology.

 

[Kittycat5]

I am in no way opiate naive. I've used various pain medications and used heroin daily for years. To me, there is nothing more repugnant and annoying than one of you "drug snobs" that talks down to people because you feel your drug use and abuse makes you some sort of all knowing expert. I was just posting a simple observation I had made about the two drugs. Don't worry, we all know how big and bad your tolerance is now, hopefully one day I can achieve the excellence of sublime drug tolerance like you have, sir.

Relax, man. I dont think Nagelfars post was all that offensive and you didnt mention your tolerance, just you used both on several occassions. We good folk here, and this particular forum has some of the sharpest, most highly educated of our community. They are here to help.

 

[serotonin2A]

Maybe there is also involvement from the "other" opioid receptors: delta, kappa, sigma1/2. Some opioids that are "weaker" at mu opiate receptor will still have some affinity for other sites, presumably changing their pharmacology.

One intresting bit of trivia: the natural levo-isomers of morphine and other opiates do not bind to sigma receptors. Only the unnatural dextro-isomers bind to sigma receptors. That is one reason why sigma sites are no longer considered to be a class of opioid receptors.

 

[Mmengel89]

Yea I thought the OP was operating with the assumption that hydrocodone is not an active agonist in its own right and relies on liver mediated demethylation to hydromorphone before feeling any opioid like affects this would be false while the 5%-10%ish of the parent drug that may be metabolized to hydromorphone is a factor in the analgesia & euphoric effects for sure to a degree (people with poor functioning forms of the enzyme required for conversion are well documented as typically getting little to no relief from oxycodone or hydrocodone or codeine) hydrocodone is a active opioid agonist with something like 60% of morphine's agonist capacity but a 90%+ bioavailability give it a 1=1 conversion to oral morphine

 

[cashmunny]

The reason people get excited about Dilaudid is for IV use it's great. Not everyone wants to IV, I don't want to either. But you ought to try crushing it up and snorting it. It's a little more bioavailable. See the link but this is a relevant quote from it:

"Narcotic analgesics such as hydromorphone and morphine have been suggested to undergo an extensive first-pass effect resulting in a low systemic bioavailability following oral administration."

http://www.medscape.com/viewarticle/493398

 

[IsaiahBisGod]

My apologies everybody, I get annoyed about silly shit sometimes. That is my mistake, I thought hydrocodone was completely inactive by itself. Obviously that's not the case.

 

[Bennzy]

So what would the best way to take dilaudid? I'm on 50mc fentanyl patches and still have breakthrough pain. Would snorting be better than just taking orally? Or what about under my tongue? Any thoughts/comments appreciated....

 

[SpunkySkunk347]

hydrocodone is better for me all around. Hydromorphone gets a reputation as being better because of its crazy potency when snorted or injected; a lot of junkies might think that hydrocodone doesn't compare to hydromorphone because hydrocodone can't be injected really, and can only really be taken orally (no one wants 3 grams of tylenol in a line to snort). Hydrocodone is a little bit of a prodrug anyways that needs first pass metabolism for best effect.

 

[sekio]

Hydrocodone is actually not a 100% prodrug: it does have opioid activity on its own prior to any metabolic transformations.

Hydromorphone is definitely more potent, but it is much shorter acting and has crappy bioavailibility by most routes. From what I've gathered, it's effectively the fentanyl of "classical" phenanthrene opioids - fast acting, highly potent, short half life. It kicks your ass with histamine release and raises tolerance super rapidly, doubly so if IV'd.