Opioids Low pulse oximetry when nodding on opiates

[pussilanimus_possum]

So after doing various opiates on and off for years now via various ROA's, I have finally gotten around to shooting them. Not the best of habits to acquire obviously but tolerance has become quite an issue despite what I would consider to be quite restrained use. (using 1-2 times a month) I have to plug around 60-80mg of hydrocodone or 40mg of heroin just to get a nice buzz.

Anyway my question/concern is that lately I have been noticing quite severe respiratory depression at these levels. I have this pulse oximetry thing I put on sometimes when I notice I am not breathing as much and I have seen some pretty startling values displayed on it as of late. This morning I decided to shoot a 8mg hydromorphone pill and it was quite pleasant, however 30 minutes later I started nodding quite heavily and decided to check what the pulse ox device said. I sat there with it on as I was nodding in and out and to my horror when I came to for a moment and looked at it my pulse had dropped to 48bpm and 68% oxygen saturation. This gave me quite a startle and I quickly stood up and started forcing some deep breaths in and managed to get it up to my normal values. (70bpm and 98% sat.)

So quite obviously I am pushing the limits here... Are there any EMT's medical professionals here that can tell me how bad these values actually are or if they are accurate? Could I have died from this if I hadn't have recognized they were so low and roused myself?
I admit that I went a bit too far this time, I usually don't ever try to take enough to nod, only enough to get a nice buzz. However lately I have noticed that even on a moderate dose where I am just enjoying a decent high and not nodding that my O2 saturation goes down to 80% or so if I don't consciously try to take deeper breaths.

It is my understanding that tolerance to the respiratory effects of opiates decreases faster than the tolerance to the high, could it be that my relatively infrequent use is actually causing a more pronounced reaction like this? Is there anything I can do to mitigate this effect?

 

[Deru]

I sat there with it on as I was nodding in and out and to my horror when I came to for a moment and looked at it my pulse had dropped to 48bpm and 68% oxygen saturation

A peripheral oxygen saturation of less than 75 percent typically means loss of consciousness, also central cyanosis occurs around here (tongue and mucous membranes start to turn blue) and cyanosis starts to occur around 67 percent.

Anything below 90 percent is considered low and requires supplemental oxygen, anything below 95 percent is abnormal.

Was this a temporary dip to 68%?

What device are you using to measure?

 

[negrogesic]

These $50 finger mounted units are not very accurate...

 

[Deru]

These $50 finger mounted units are not very accurate

Exactly, does your device show the plethysmograph? The cheaper devices have a difficult time sometimes maintaining accuracy due to a variety of variables. The graph is a good way to indicate how reliable the reading is (although not a perfect indicator.)

If you were truly below 90 percent, you would know it. On that note, CoVID-19 causes some insanely low spo2 readings with the patients having no complaints of shortness of breath.

So, there's always exceptions. And then exceptions to those exceptions when it comes to human beings.

 

[pussilanimus_possum]

Anything below 90 percent is considered low and requires supplemental oxygen, anything below 95 percent is abnormal.

Was this a temporary dip to 68%?

What device are you using to measure?

This is what has me confused, I am not sure how I am still alive to be honest if it was actually that low. In answer to your questions they are just a couple cheap units from the pharmacy, they do not display anything besides pulse and O2. Both units usually display something around 80% when I notice my breathing getting shallow during a normal high. The last time when it dipped to 68% I'm pretty sure I had only dozed off for less than a minute.

 

[Deru]

It's more than likely having a hard time producing an accurate reading. Some of them require near perfect stillness and consistent breathing.

Try to take your reading 3x in a row. That will eliminate inaccurate readings.

 

[negrogesic]

This is what has me confused, I am not sure how I am still alive to be honest if it was actually that low. In answer to your questions they are just a couple cheap units from the pharmacy, they do not display anything besides pulse and O2. Both units usually display something around 80% when I notice my breathing getting shallow during a normal high. The last time when it dipped to 68% I'm pretty sure I had only dozed off for less than a minute.

Those are terribly inaccurate. Not sure why they even sell those, they can cause great alarm.

Maybe look into a used masimo radical-7 unit on ebay if you are seriously concerned, its hard to say otherwise.

Perhaps there are consumer devices that are accurate, this would require research and still probably a few hundred dollars.

 

[Deru]

I can give a recommendation:

For a good consumer one, get one with the plethysmograph. These can be purchased for under $150, check on Amazon, but you more than likely won't be able to get it for a couple of months due to demand.

 

[pussilanimus_possum]

Those are terribly inaccurate. Not sure why they even sell those, they can cause great alarm.

Indeed it did cause quite the alarm! Anyway thank you both for the info. I will definitely look into getting a more accurate device to see if there is actually any extraordinary effect going on here, as I definitely do still "feel" alot of respiratory depression...

 

[Deru]

@pussilanimus_possum It's more about the device lacks the sensitivity needed to compensate for people's movements.

If you try to be very still and breathe consistently, take the readings 3 times in a row, I think you'll find much better accuracy.