Opioids Taking more than the daily dose (codeine)

[Inc3pti0n]

Update here guys -

im hoping my doc offers me something better more effective this time around, i do take ibuprgel daily on the effected areas but the tramadol and codeien are to take the pain away but it lasts not long at all with codeine having a short half life. If i took say 10-20mg diazepam as im precribed but rarely take them now, which ive had plenty of times would that increase the effects of codeine or tramadol even, more over codeine id like the answer to ?

Hello guys, I'm not new when it comes to opiates. However recently I have reduced on my tramadol and turned to using more codeine than prescribed in a day.

I get more than enough codeine to last me a few weeks but I'm taking the full daily dosage in one go at the moment then using more when it wears off.

In order to not be causing myself harm how would I go about getting the best out of codeine for moderate pain relief ? I use to get a real good relief when I first started using

 

[kleinerkiffer]

That's a tough question, to get the most out of the codeine you'd need an enzyme-inducer (codeine is metabolized into morphine via CYP2D6, so you'd want more of this enzyme to get more morphine and via UGT2B7 into codeine-6-glucuronide which too has opioid activity) or you'd need to inhibit the metabolism into norcodeine via CYP3A4 but both ways aren't really viable and it'd still increase your tolerance.
The only thing to really combat tolerance would be a tolerance break. Would it be possible for you to take less for a few days and maybe take a nsaid like ibuprofen or apap?
Depending on the cause of the pain massages etc could be helpfull too.
How many mg is your full daily dosage? And is it pure codeine or codeine with apap? If it's with apap you need to do a cold water extraxtion to prevent liver-failure if you're consuming more than 3g apap a day

One thing to consider when taking pain medication is that that pain perception is tied to circadian rhythm, pain is usually lowest during mid-afternoon and highest during nighttime-morning so maybe splitting the dosage may help for example 50% or your daily dosage right after waking up 20-30% during the day and the rest to help you get some sleep

 

[sekio]

Codeine alone is actually a crap pain killer, it should be combined with at the very least APAP (Safe dosages mind you) or more preferably a NSAID like naproxen or ibuprofen.

According to the League Table of Analgesic Efficacy (cool tool) 60mg of codeine is literally the worst painkiller possible. It also says, counter-intuitively, many people will experience more pain relief with just a high dose of ibuprofen than even morphine or Percocets.

 

[Inc3pti0n]

That's a tough question, to get the most out of the codeine you'd need an enzyme-inducer (codeine is metabolized into morphine via CYP2D6, so you'd want more of this enzyme to get more morphine and via UGT2B7 into codeine-6-glucuronide which too has opioid activity) or you'd need to inhibit the metabolism into norcodeine via CYP3A4 but both ways aren't really viable and it'd still increase your tolerance.
The only thing to really combat tolerance would be a tolerance break. Would it be possible for you to take less for a few days and maybe take a nsaid like ibuprofen or apap?
Depending on the cause of the pain massages etc could be helpfull too.
How many mg is your full daily dosage? And is it pure codeine or codeine with apap? If it's with apap you need to do a cold water extraxtion to prevent liver-failure if you're consuming more than 3g apap a day

One thing to consider when taking pain medication is that that pain perception is tied to circadian rhythm, pain is usually lowest during mid-afternoon and highest during nighttime-morning so maybe splitting the dosage may help for example 50% or your daily dosage right after waking up 20-30% during the day and the rest to help you get some sleep

I only use the pure codeine phosphate 30mg tablets I use around 240-360mg per day currently also using tramadol 200mg

So in basic terms how would I get more of the enzyme your referring to

 

[Inc3pti0n]

Codeine alone is actually a crap pain killer, it should be combined with at the very least APAP (Safe dosages mind you) or more preferably a NSAID like naproxen or ibuprofen.

According to the League Table of Analgesic Efficacy (cool tool) 60mg of codeine is literally the worst painkiller possible. It also says, counter-intuitively, many people will experience more pain relief with just a high dose of ibuprofen than even morphine or Percocets.

Hard to get these types of drugs for moderate pain relief here in the UK, the best I can get is tramadol but my tolerance is very high with that too

 

[adder]

Can't get paracetamol or ibuprofen in the UK? You don't need a prescription for them, I luckily never needed a prescription for a pain medication when I was there but I heard from many people APAP is considered a cure-all in the UK and thus very popular among GP's.

 

[Speed King]

Hello guys, I'm not new when it comes to opiates. However recently I have reduced on my tramadol and turned to using more codeine than prescribed in a day.

I get more than enough codeine to last me a few weeks but I'm taking the full daily dosage in one go at the moment then using more when it wears off.

In order to not be causing myself harm how would I go about getting the best out of codeine for moderate pain relief ? I use to get a real good relief when I first started using

Personally real codeine beats tramadol, depending on the reason. I agree with Kleinerkiffer how he is using it. If I remember correctly grapefruit juice works with this medication. Also a light dose of hydroxyzine will help add to the sedation and pain relief. If you add any type of downer medicine to your opiate, do so lightly and watch your dose. CNS depressants are CNS depressants.

 

[F.U.B.A.R.]

Can't get paracetamol or ibuprofen in the UK? You don't need a prescription for them, I luckily never needed a prescription for a pain medication when I was there but I heard from many people APAP is considered a cure-all in the UK and thus very popular among GP's.

Yes, of course we can. Also, you're correct about GPs pushing paracetamol - unless you're dieing, our GPs just tell you to man up and take paracetamol, which is also a fuckin shitty painkiller. Afaic, Ibuprofen is the best OTC painkiller available and 16 x 200mg tablets can be had for 24p...

 

[kleinerkiffer]

Yes, of course we can. Also, you're correct about GPs pushing paracetamol - unless you're dieing, our GPs just tell you to man up and take paracetamol, which is also a fuckin shitty painkiller. Afaic, Ibuprofen is the best OTC painkiller available and 16 x 200mg tablets can be had for 24p...

It all depends on the pain, paracetamol is best for tooth pain and headach but is shit for pain related to inflammation etc. but I still prefere it as it's way better for my stomach than nsaids

 

[F.U.B.A.R.]

It all depends on the pain, paracetamol is best for tooth pain and headach but is shit for pain related to inflammation etc. but I still prefere it as it's way better for my stomach than nsaids

Not wishing to get too far off topic, but I personally find Ibuprofen far superior for toothache and headache than either paracetamol or codeine. In fact, I often found that opiates could exacerbate both types of pain, rather than relieving it.

 

[kleinerkiffer]

Not wishing to get too far off topic, but I personally find Ibuprofen far superior for toothache and headache than either paracetamol or codeine. In fact, I often found that opiates could exacerbate both types of pain, rather than relieving it.

Last post so it doesn't go completely off topic:
interesting, the excaberation might be due to histamine as opioids, especially codeine and morphine can cause it's release

 

[Inc3pti0n]

Update here guys -

im hoping my doc offers me something better more effective this time around, i do take ibuprgel daily on the effected areas but the tramadol and codeien are to take the pain away but it lasts not long at all with codeine having a short half life. If i took say 10-20mg diazepam as im precribed but rarely take them now, which ive had plenty of times would that increase the effects of codeine or tramadol even, more over codeine id like the answer to ?

 

[Inc3pti0n]

Yes, of course we can. Also, you're correct about GPs pushing paracetamol - unless you're dieing, our GPs just tell you to man up and take paracetamol, which is also a fuckin shitty painkiller. Afaic, Ibuprofen is the best OTC painkiller available and 16 x 200mg tablets can be had for 24p...

Hit the nail bang on the head there mate.

 

[Keif' Richards]

The situation with Opioid tolerance is just as simple as we all know it to be, deep down. We want maximum relief, at all times, with no negative consequence. People spend millions (billions?) of dollars in the western world on diet products that will enable us to be perfect models of physical fitness and sex appeal, while never moving a muscle to exercise and eating McDonalds every day. I'm not calling anyone stupid either. I think it's natural to feel this way. It's best to approach these situations with as much an eye for realism as possible.

The chances are, you will not be able to completely mitigate pain around the clock without ever having to address the phenomenon of tolerance. You have to accept that there will be moments where you will not be completely in control of your pain. Tolerance and the runaway train of addiction and compulsive use come when we say "I want to feel this way all the time".

The key to maintaining a realistic and effective means of analgesia through Opioids, is by minimizing their usage as much as possible. You will be the best consultative resource in terms of knowing how much is too much and when you have lost control. It's just really difficult for us to ascertain these things from where we're standing. Does any of this make sense?

 

[Ganjcat]

The key to using opiates is to not want or lust after the "high" which is easier said than done I tried to change my mindset to that and it lasted 2 days just to good of a drug in my opinion.

 

[apocalypse_when]

I found out to my own detriment, that the only way to ever successfully taper from opiates is to forget about the high and keeo taking only the minimum needed to keep you out of withdrawl while you slowly taper off.

Still lusting after and chasing the high while at the same time attempting to do a taper is sure fire way to failure..

 

[Ganjcat]

Well said thats what I've more or less concluded after going through my 2 week script in 3 days for the last 10 times i picked up easy