Opioids Oxycodone Dosing Advice

[TheTraveler101]

Hi there.

I have been on Clonazepam for several years now to manage (though not well) my constant anxiety.
I have also dealt with severe suicidal depression that has not responded to any treatment medications etc, even though I have spent many years trying different antidepressants.

I have also been dealing with progressively more severe chronic pain for more than 20 years. A couple months ago my doctor put me on Oxycodone to assist with pain control, and to both of our surprise, my anxiety is gone (I’m almost completely off Clonazepam, down to 2mg/day from over 5mg/day), my depression has disappeared completely, and I am much more affectionate and caring towards my wife and daughter.

As a result of these unforeseen beneficial psychological results, my doctor has suggested that I take my Oxycodone IR closer together and see if that helps even more (keeps the psychological benefits more consistent).

What I have found is that when I take the Oxycodone, I get pain control about an hour after ingestion, and prior to that a wonderful feeling of euphoria. The euphoria fades usually within an hour however and naturally I’m left wishing it stuck around.

My questions are these:
- is there a reset time when it comes to the dopamine euphoria? I.E. if I were to to take my Oxycodone more often, (say every two hours) would I still feel euphoria and the general psychological benefits, or does the dopamagernic system need time to reset?
- what would you advice when it comes to not only consistent pain control, but also more consistent mood stability (I would trade the intensity of the euphoria for less intensity but longer duration).
- lastly, how much is the Clonazepam inhibiting either the euphoria of the Oxycodone, or the analgesia?

 

[PharmSauce]

Euphoria will reduce over time. Likely, as time progresses, you will desire a higher dosage of oxycodone. That's just the nature of the effects of the drug if you are taking it for the positive psychiatric effects, and even regardless of those effects. It works like no other for me as an antidepressant. It actually gives me a sense of motivation and energy which is what I have always been desperately looking for, after not having felt it for so long. I love oxycodone, and it's a great antidepressant. However, I believe it to be too addictive for me to maintain it regularly on a scheduled dosing regimen, without wanting to increase the dosage after some time. This concept is true with many drugs, but especially instant release, short-acting opioids. This may be good for your life in the near-term and possibly even long-term. However, as doctors tighten up on this overall as a community, it may be hard to get a prescription eventually. If your doctor moves or retires, you might be screwed. Most doctors will not understand the reasoning for your usage of oxycodone. I wish that my doctor believed that oxycodone was the answer for my brain situation. That would be awesome. Like im saying, its not common to be in your situation. I would love to be in it, but you might run into some problems in the future with addiction/dependence, doctor access.

 

[Shortec Stublue!!]

Hey TT1 thanks for being thorough, makes it much easier to respond constructively.

Firstly what is your Oxy dose, and is it only IR you are prescribed? The initial obliteration of any anxiety and depression is a common occurance, this is due more to the neurotransmitter endorphin and enkephalin release more than dopamine agonism or transporter fluctuation.

Obviously the closer together you dose the more continuous positive effects for both your pain, and your psychological issues. The problem across the board for us all, is that this both fades and is so “beautiful” when it’s in full flow that it WILL!! become ever more relied upon and escalating, if you let it run away with itself.

Your Clonaz should synergise with it nicely, but PLEASE BE AWARE, that both are depressants of respiration, don’t take together without reducing doses to at least 50% less to begin with. Anything else just ask happy to help!!

 

[Zonxx]

Fuck addiction.
Thats one. Your anxiety etc is gone because oxy makes you feel ... great and i take IR crushed. They are wonderful as long as not taken at night as theyre more of an upper in the opiate field...you can take the oxy as prescribed HOWEVER. And take my advice... you'll run into tolerance. Please do not take extra just to achieve the inital feelings and effects, oxy isnt too long lasting so i firmly believe in spreading your doses further apart. My own use on days when its not bad aside from my morphine etc etc, i'll take oxy when i wake up with hydromorphone, an hour after follows my morphine.. then around noon-3 if you can make it till 3 great but 12 if fine i suppose but the way youre using oxy, you WILL become severely dependent on it 'addicted" its not really an addiction if you need it to function like a normal person so keep that in mind


But yes. You will ALWAYS feel euphoric. The thing that may happen is youll get used to it and only notice half of if but itll still sork

Clonazepam is great for anxiety.. but not so much for during the day or to be taken with oxy unless your tolerant, 2-4mg of clonaze send me into nod land with my morphine so try not to chase the high...itll fade over time while u get used to it and then take a break but physical addiction is a biiiitch.

 

[KS78]

If you can stand the pain and want to get the same mental effects from Oxy, I would advise using it less often. Just knowing that this medicine will solve those issues once you take it, puts you in a much better mental state. Good luck.

 

[Quere]

Hi there.

I have been on Clonazepam for several years now to manage (though not well) my constant anxiety.
I have also dealt with severe suicidal depression that has not responded to any treatment medications etc, even though I have spent many years trying different antidepressants.

I have also been dealing with progressively more severe chronic pain for more than 20 years. A couple months ago my doctor put me on Oxycodone to assist with pain control, and to both of our surprise, my anxiety is gone (I’m almost completely off Clonazepam, down to 2mg/day from over 5mg/day), my depression has disappeared completely, and I am much more affectionate and caring towards my wife and daughter.

As a result of these unforeseen beneficial psychological results, my doctor has suggested that I take my Oxycodone IR closer together and see if that helps even more (keeps the psychological benefits more consistent).

What I have found is that when I take the Oxycodone, I get pain control about an hour after ingestion, and prior to that a wonderful feeling of euphoria. The euphoria fades usually within an hour however and naturally I’m left wishing it stuck around.

My questions are these:
- is there a reset time when it comes to the dopamine euphoria? I.E. if I were to to take my Oxycodone more often, (say every two hours) would I still feel euphoria and the general psychological benefits, or does the dopamagernic system need time to reset?
- what would you advice when it comes to not only consistent pain control, but also more consistent mood stability (I would trade the intensity of the euphoria for less intensity but longer duration).
- lastly, how much is the Clonazepam inhibiting either the euphoria of the Oxycodone, or the analgesia?

I have similar mental health issues to you and have the same response to opioids in terms of massive reduction on anxiety/depression not touched (well some provided mild benefit) by the numerous other meds I've tried.

Unfortunately I don't know how well it will work long term using a short acting opioid like Oxycodone.

Also ime the euphoria is not what's reducing my anxiety/depression as I do get a consistent reduction in anxiety/depression despite not feeling euphoric all the time (from my methadone). So chasing euphoria would be a bad idea. I don't think it's even possible to experience opioid euphoria constantly over the long term.

 

[TheTraveler101]

Hey TT1 thanks for being thorough, makes it much easier to respond constructively.

Firstly what is your Oxy dose, and is it only IR you are prescribed? The initial obliteration of any anxiety and depression is a common occurance, this is due more to the neurotransmitter endorphin and enkephalin release more than dopamine agonism or transporter fluctuation.

Obviously the closer together you dose the more continuous positive effects for both your pain, and your psychological issues. The problem across the board for us all, is that this both fades and is so “beautiful” when it’s in full flow that it WILL!! become ever more relied upon and escalating, if you let it run away with itself.

Your Clonaz should synergise with it nicely, but PLEASE BE AWARE, that both are depressants of respiration, don’t take together without reducing doses to at least 50% less to begin with. Anything else just ask happy to help!!

Thank you for

Euphoria will reduce over time. Likely, as time progresses, you will desire a higher dosage of oxycodone. That's just the nature of the effects of the drug if you are taking it for the positive psychiatric effects, and even regardless of those effects. It works like no other for me as an antidepressant. It actually gives me a sense of motivation and energy which is what I have always been desperately looking for, after not having felt it for so long. I love oxycodone, and it's a great antidepressant. However, I believe it to be too addictive for me to maintain it regularly on a scheduled dosing regimen, without wanting to increase the dosage after some time. This concept is true with many drugs, but especially instant release, short-acting opioids. This may be good for your life in the near-term and possibly even long-term. However, as doctors tighten up on this overall as a community, it may be hard to get a prescription eventually. If your doctor moves or retires, you might be screwed. Most doctors will not understand the reasoning for your usage of oxycodone. I wish that my doctor believed that oxycodone was the answer for my brain situation. That would be awesome. Like im saying, its not common to be in your situation. I would love to be in it, but you might run into some problems in the future with addiction/dependence, doctor access.

Thank you for the thorough response.
My doctor has already been raising my dose every two weeks as we find the right dosage for my pain. Due to the risks of addiction etc I have been lowballing her recommendations for dosage increases. She is also willing to raise my dose to accommodate the mental health benefits and I think this next visit I will take her advice instead of feeling like I'm always playing "catch-up" if that makes sense. I am familiar with tolerance etc and am comfortable with the fact that we will have to increase my dose over time.
It's EXACTLY the same for me: Motivation was a key part of my issue with depression and my psychiatrist previously postulated that my depression may not lie in Serotonin or Norepinephrine but rather Dopamine, so this makes sense.
Luckily my doctor is young and open minded. Also I do deal with debilitating chronic pain so I feel even if in the future the psychological benefits of opiates are not recognized or accepted as a reason to prescribe, my pain doesn't look like it will cease any time soon given my physical condition, so hopefully if nothing else, the psychological benefits will be a "side-effect" of the accepted use of these substances: pain control.
I appreciate your input and indeed I agree, I'm lucky to have a doctor that is really willing to consider all angles of quality of life.

 

[TheTraveler101]

Hey TT1 thanks for being thorough, makes it much easier to respond constructively.

Firstly what is your Oxy dose, and is it only IR you are prescribed? The initial obliteration of any anxiety and depression is a common occurance, this is due more to the neurotransmitter endorphin and enkephalin release more than dopamine agonism or transporter fluctuation.

Obviously the closer together you dose the more continuous positive effects for both your pain, and your psychological issues. The problem across the board for us all, is that this both fades and is so “beautiful” when it’s in full flow that it WILL!! become ever more relied upon and escalating, if you let it run away with itself.

Your Clonaz should synergise with it nicely, but PLEASE BE AWARE, that both are depressants of respiration, don’t take together without reducing doses to at least 50% less to begin with. Anything else just ask happy to help!!

My current dose is 40mg taken in 5mg IR pills, 1-2 every four hours as I feel I need it. I am not on any other IR opiates, nor ER. I have definitely found that my tolerance has increased and my doctor is willing to raise my dose as needed. I'm lucky that my lifestyle if nothing else is regulating my use of the pills and knowing the dangers or taking them not as prescribed are ensuring I don't abuse them: I need this medication whether it be for chronic pain control, or psychological benefits, and I absolutely do NOT want to risk not having access to them by abusing them just for a kick.

Thanks for the warning: I am aware of the fact that both are respiratory depressants: another reason why I don't want to mess with the doses I'm prescribed, knowing that my doctor is taking both into consideration.

I do appreciate the knowledge and input.

 

[FutureReference]

Are you on Oxycodone or Percocet? If it is the latter be careful about that acetaminophen. I am on 4MG of Clonazepam daily and 40mg Oxycodone daily. Pain isn't fully managed but if 5mg helps you man stick with that. Tolerance builds rapidly with Oxy and I would stick with what works! Try not to ever exceed your prescribed dose. Some people have the same painkilling effects on the same dose for years! Chasing euphoria will make the tolerance rise exponentially though which is never a good thing. Take what kills the pain and nothing more. Best wishes my friend

 

[Shortec Stublue!!]

@TheTraveler101 Maybe you should consider ER as oppose to keep “topping up” every four hours. I take 30mg Longtec (OxyContin) twice a day, with 10mg Shortec (IR Oxycodone) for breakthrough pain.

I find this works much better than IR alone to spread across the day ?

 

[TheTraveler101]

Fuck addiction.
Thats one. Your anxiety etc is gone because oxy makes you feel ... great and i take IR crushed. They are wonderful as long as not taken at night as theyre more of an upper in the opiate field...you can take the oxy as prescribed HOWEVER. And take my advice... you'll run into tolerance. Please do not take extra just to achieve the inital feelings and effects, oxy isnt too long lasting so i firmly believe in spreading your doses further apart. My own use on days when its not bad aside from my morphine etc etc, i'll take oxy when i wake up with hydromorphone, an hour after follows my morphine.. then around noon-3 if you can make it till 3 great but 12 if fine i suppose but the way youre using oxy, you WILL become severely dependent on it 'addicted" its not really an addiction if you need it to function like a normal person so keep that in mind


But yes. You will ALWAYS feel euphoric. The thing that may happen is youll get used to it and only notice half of if but itll still sork

Clonazepam is great for anxiety.. but not so much for during the day or to be taken with oxy unless your tolerant, 2-4mg of clonaze send me into nod land with my morphine so try not to chase the high...itll fade over time while u get used to it and then take a break but physical addiction is a biiiitch.

Zonxx,

Yeah well I guess I didn't mention this before, but I was on Opiates for pain for about 15 years, and in my naïvety and youth I let it dissolve into an addiction which I'm thankful to say Ibogaine got me out of. It had been seven years without Opiates, but progressively larger and larger amounts of Ibuprofen to try and manage my chronic pain. I landed in the ER two months ago vomiting blood because the Ibuprofen burned holes in my stomach, so hence, I'm back on Oxycodone, albeit with a much different respect for the chemical and the knowledge of the dark places addiction can take you. I'm happy to say that so far, so good, but I know it's dangerous and I'm being vigilant.

Luckily I have always preferred Oxycodone to other opiates BECAUSE of the stimulating effects. I haven't noticed any issues sleeping as when I have the combo of Oxycodoen, Clonazepam, and Cannabis at night, I sleep very very well (although I eat every cookie in the house beforehand, lol).
I was previously on 6mg/day of Clonazepam and I'm happy to say the reduction to 2mg/day in the span of a month was due to the lack of anxiety and unwanted sedation I was experiencing with both substances in my system. I plan on reducing the Clonazepam further as I'm a Musician and Academic and have always found Benzos affect my memory and cognitive function too much. Ironically... Opiates do not!

I'm happy I took the step to post on this site and talk to others because I needed someone to remind me of the respect I have to give to these substances.

Question for you: I have been on almost every opiate out there at one time or another in the 15 year journey to find the right one for my pain control with the least side effects (Oxycodone); you are on three from what I can tell: what are the benefits of being prescribed all three? Knowing that chronic severe pain as well as these psychological issues are the reasons I'm back on Opiates, would you recommend I try another from your personal experience, or should I switch to extended release Oxycodone? Right now, having family responsibilities and still teaching when I can, I like the control I have when I dose, and how much, where with Oxycontin (or whatever it's called now), I don't think I would have that same level of control.
Sorry for the essay!

 

[TheTraveler101]

If you can stand the pain and want to get the same mental effects from Oxy, I would advise using it less often. Just knowing that this medicine will solve those issues once you take it, puts you in a much better mental state. Good luck.

Alas while my pain does have worse days/weeks/hours, I need constant control, so while I used to have a "never two days in a row" rule of approach when I was younger and the pain was less, now I definitely can't go a day without some analgesia. I agree with you though: would be nice to not have my tolerance and therefore dose go through the roof!

 

[TheTraveler101]

Are you on Oxycodone or Percocet? If it is the latter be careful about that acetaminophen. I am on 4MG of Clonazepam daily and 40mg Oxycodone daily. Pain isn't fully managed but if 5mg helps you man stick with that. Tolerance builds rapidly with Oxy and I would stick with what works! Try not to ever exceed your prescribed dose. Some people have the same painkilling effects on the same dose for years! Chasing euphoria will make the tolerance rise exponentially though which is never a good thing. Take what kills the pain and nothing more. Best wishes my friend

Years ago I was on Percocet, but my current doctor put me on straight Oxycodone Instant Release without any NSAIDs etc to protect my Liver, Kidneys, Stomach, etc...
When my doctor asked me what dose I was on previously, I lowballed because I didn't want to end up overly sedated etc, but even from the start I found that 5mg wasn't helping the my pain much at all. At this point it's been almost two months and I'm guessing either my pain is getting worse, or I have built a tolerance, or perhaps both, because I need 10mg now for any noticeable relief.
I'm glad you and others have warned me regarding "chasing the euphoria" as I'm going to be much more conscious of that going forward. Having a family now, it's much more important to me to have round the clock pain control and use my pills as prescribed than to have a "good time" and then pay the price by not having coverage, and possibly withdrawal.
Much appreciated my friend.

 

[TheTraveler101]

@TheTraveler101 Maybe you should consider ER as oppose to keep “topping up” every four hours. I take 30mg Longtec (OxyContin) twice a day, with 10mg Shortec (IR Oxycodone) for breakthrough pain.

I find this works much better than IR alone to spread across the day ?

Yes! That's actually something my doctor has been asking me if I want to switch to. I have been on Oxycontin previously a decade ago when my dose was much much higher than it is now, and I did find it provided me with round the clock coverage. Do you mind if I ask how many IRs you usually take in a day for breakthrough pain?

I mentioned in a previous reply to someone else that one of the reasons I have been hesitant to go to a continuous release formulation is that I am a Musician and an Academic, and I find that sometimes I want to wait to take my next Oxycodone IR until after I'm done teaching or whatnot if I find the content advanced enough that I feel cognitively impaired by the Oxycodone. The other reason I have been hesitant to switch is that my pain is quite variable: I need control round the clock every day, but some days I can get out of bed with less need for Oxycodone, where other days the pain is much worse and I need a lot more control.

 

[Shortec Stublue!!]

I see your point with the on hand dosing idea, but you will have a slower increase in tolerance with a 12hrly on paper at least. The withdrawal would also be less irratic than training your brain to be waiting for more every 6 hours or so.

I find rather than take 10mg IR Oxy (Shortec) every 4 hours, taking 30mg MR (Longtec) steadies the ship exponentially. When I have pain breakthrough I have a 10mg IR on hand but need usually only 1 a day, always less so for sure.

 

[TheTraveler101]

I see your point with the on hand dosing idea, but you will have a slower increase in tolerance with a 12hrly on paper at least. The withdrawal would also be less irratic than training your brain to be waiting for more every 6 hours or so.

I find rather than take 10mg IR Oxy (Shortec) every 4 hours, taking 30mg MR (Longtec) steadies the ship exponentially. When I have pain breakthrough I have a 10mg IR on hand but need usually only 1 a day, always less so for sure.

I usually take my doses 3-4 hours apart depending upon how much I have taken in that dose, and how bad the pain is, so luckily I feel the way I am dosing is probably similar to how the Controlled/Extended Release doses I'm assuming; do you know how that 30mg Longtec releases the dose, ie in what increments?

I see my doctor soon and we are going to switch me from the 5mg IR to 10mg IR because the 5mg isn't doing anything for analgesia anymore, and even when I started, it was barely touching it. I think I'll try my current regiment with the new dose for a couple weeks and see how I feel. Then I think I'll make the call to try the OxyContin or whatever it's called now (here in Canada they phased out OxyContin and there is now OxyNEO which is apparently more difficult to abuse, but is also expensive). My pain is so variable day to day. Today for instance, my current dose is barely touching it. Tomorrow, perhaps my current dose will cut it. I would much prefer to not always be maxing out my prescription and still have moderate to severe pain: I would prefer to have enough that I bank the ones I don't need and proudly show them to my doctor, lol. Extended Release would make that more difficult unless we literally split my max dose as half ER, and half IR so I still have that control over dosing.
Sorry, I realize I was just "thinking out loud" here. lol

 

[FutureReference]

With OxyContin it is pretty much half the dose being released upon onset with the other half being slowly released throughout the day. OxyContin 80's were a godsend and I wish I could still get them here.

 

[Shortec Stublue!!]

As you say, your dosing is pretty much as an ER would work. I am not certain but it is 2-3mg an hour trickling into circulation I suspect, but in a way that you do notice analgesia building up.

That is a good idea, half ER half IR giving you the best of both worlds. I have only 30mg max a day in IR, and with the baseline ER in circulation it is a good regime.

You’ll get there don’t worry ?

 

[FutureReference]

As you say, your dosing is pretty much as an ER would work. I am not certain but it is 2-3mg an hour trickling into circulation I suspect, but in a way that you do notice analgesia building up.

That is a good idea, half ER half IR giving you the best of both worlds. I have only 30mg max a day in IR, and with the baseline ER in circulation it is a good regime.

You’ll get there don’t worry ?

I am so glad your pain is properly managed my friend! It truly is crazy how they treat us in the US. This 40MG IR is hell, I'd truly rather have a single 60MG ER. I don't want to sniff them or have a high I just want to stop seeing suicide as righteous

 

[Shortec Stublue!!]

Something will inevitably change on your side of the pond, it’s just a matter of when. Your population is to big not to eventually have an overhaul of pain management common sense.

If Purdue hadn’t been so greedy and irresponsible I suspect you wouldn’t be in such dire straits!!

Any luck finding some DHC online?