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  • BDD Moderators: Keif’ Richards | negrogesic

Tolerance question - taken crazy high doses oxycodone with no effect

Nooby

Nooby

Greenlighter
Joined
Sep 24, 2013
Messages
18
Hey, I’m a chronic pain patient who’s been on opiates purely for pain relief (not judging) for about 15 years.

My tolerance has got crazy high and at its peak I was on 250mcg fentanyl patch, with 180mg oxy three times a day, 300mg codeine and as much oramorph as I needed for breakthrough pain. I took myself off fentanyl completely by tapering slowly over a year. Weirdly the fent never helped my pain but increased my opiate tolerance hugely and knocked me out with side effects but no relief. I lost three years of my life to that nasty stuff. Oxy has always worked really well for me but I wanted to reduce my dose as much as possible so that it’s as effective as it can be when I have a flare up. I got off fent completely, dropped to 120mg oxy three times a day, came off codeine completely and reduced my gabapentin dose by 2/3. So far so good, then I have a bad flare up of my condition, and pain was totally out of control. I lost my mind and had a bit of a breakdown and I overdosed. I started popping my oxy 20’s like they were sweeties and one night I took at least 56 of them, drank about 100ml of oramorph - I didn’t expect to wake up. I was kind of counting on not waking up, but I did. So over the following week I consistently took 2 or 3 times my usual doses, every night assuming I’d get to a point where I just wouldn’t wake up.

That hasn’t happened (and I’m not asking for help committing suicide, I want to be clear about that, but I am now really curious) so what would it actually take to kill me? I know if I drank or mixed benzos in then it’s much more likely but I always thought a straight massive dose of opioid would do it too. Am I at the mythical top end of opioids where there is no top dose?

I should say I’ve had most of my intestines removed so OIC isn’t a problem, I know that’s what stops most people taking more. I didn’t nod, didn’t have a lovely warm sleep, I literally felt no different to normal. Maybe a tiny bit woozy when I stood up. My BP was 90/48 and my HR was 110 bpm (I was in hospital at the time - i hadn’t handed over my medicines kit so I had all my own meds as well as what they gave me in hospital, I figured it would be less distressing for my family if I just died in the night at hospital, nobody who loved me would need to find me etc etc. So I didn’t have enough on board for any medical staff to notice anything unusual. That just feels really weird after such a high dose - I took 1300mg oxy, 200mg morphine and nothing happened.

Is there no cumulative damage? I can’t find anything online, type in oxy overdose and you get a million articles about America’s epidemic what a total disaster it is but no actual info. I asked a friend who works in pharma to look it up for me and she came back saying that no, by itself it’s not especially dangerous, it’s only mixing it with alcohol or benzos or taking your normal dose when you’ve had a day or two off. Nothing about a high dose of just oxycodone

TLDR - is there really no top end to opiate intake if your tolerance has grown slowly over years?
 
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OP, let me start by asking you to please break up large bodies of text into paragraphs based upon individual ideas and questions. It makes it much easier for us to read, understand and hopefully, answer your question quickly. There are a lot of folks (including myself when I'm feeling lazy) that look at one big wall of text and just move on because it's too difficult to read. For your own good in the future my friend! :)

I'm just going to say, this topic is a little bit more esoteric than what we would typically deal with and it doesn't really have a definitive answer that I feel would be particularly helpful to the community or even you, the person asking it. It would appear, that it's disproportionately more difficult for someone dependent upon Opioids to die from lethal respiratory depression, but it's not impossible. If anything, I would say that your case, in terms of you not dying from massive dosages, is probably closer to the norm than to being a statistical outlier.

For instance and don't try this at home please, when I was prescribed 120mg of Methadone per day, I once, stupidly, consumed all 6 of my take-home doses for that week in one go because I had some kind of vague deathwish, like yourself. I woke up the next morning feeling fine, but a little groggy. To be clear, that's 840mg Methadone. Also, I would routinely take 4 times my daily dose for a total of 480mg Methadone. You would be surprised what the human body can handle, but as I said, it's disproportionate in a lot of ways, as you've experienced yourself. It's harder for us to kill ourselves when we already have a dependency working.

Now, if you were to supplement this sort of behavior with other CNS depressants like Benzodiazepines, Barbiturates and/or Alcohol, you would be far more likely to die. Even if we're talking about a minuscule amount of sedative, it could be the straw that breaks the camel's back.

About long-lasting damage to your body from the practice: Opioids are not really harmful to the body in any way, so long as you don't die from respiratory depression, the only major things you need to worry about are your bowels. You can definitely die from bowel obstruction/constipation, but it's just really unlikely that that would ever happen to someone in the developed world. Typically, you can just administer laxatives, but if it's really bad, they'll just go in and fix it surgically. There's no reason why anyone should die from this.
 
Thank you, I really appreciate you taking the time to respond. I don’t have any problem with constipation because I don’t have any large intestine and am missing quite a lot of my small one. So I think that’s probably why I’ve got to such a high regular dose without effect. Thanks for replying.
 
No problem Nooby, we're all here to help you with your various problems, because a lot of us have been where you are now or have been there and gotten out of it. Some of us are better at answering questions related directly to the acute use of drugs and some of us are more geared toward helping addicted members get well again, but I think you'll find that the majority of us will take the time to help you out if you really need it, be it with pseudo-medical or emotional support. I can see you're new, so I just wanted to run down a few basic things with you.

First of all, if you interact with someone that you feel you want to talk to more or that you feel could help you, you can send and receive private messages once you've made 50 posts which is not too difficult and can be done in an afternoon.

Also, in addition to the forums we have dedicated to active drug use, we also have forums dedicated to things like recovery. This can mean recovery from drug use, mental illness or both. Being an addict, as I'm sure you're aware, can be a very socially stigmatizing existence. It can be very hard to find people to talk to, but there are always people to talk with openly here. So, I encourage you to check out The Dark Side if these are ideas that you feel might be meaningful to you.

Just let myself or anyone else know if you have any questions about how to use the site or the best places to get your information heard.

Welcome!
 
Due to some kind of kindling your tolerance never really goes to 0 after you taken such high doses of opiates. I would say it was probably the high doses of fent your body was used to processing that saved you.

That's not to say you should underestimate your tolerance but if you've taken very high doses before i think it's more likely you'll tolerate high doses.
 
Thank you, that makes sense. I’m really keen to get my dose down to the space where I can function but am not taking any more than I need. I’m looking into a couple of things that have been suggested in other forums for helping me regain tolerance (as much as I possibly can). And I’m interested in any other ideas about managing long term pain.
 
It may not be a tolerance issue but an absorption one. The majority of drugs are absorbed in the small intestine and shortened ones tend to cause poor absorption of many drugs.
 
That’s a very good point - I had to swap contraceptives because I couldn’t absorb the pill. My pain team have said they don’t think it should affect my pain meds but who knows? I will talk with them about it (but not mention my freakout because then they'll take me off of everything and not trust me to control my own doses etc).
 
Good point KC. It's definitely one that I hadn't fully considered. OP, what is your experience in using other routes of administration? (Rectal, Insufflation, Intravenous etc.)
 
My oxy are the immediate release ones, I was on Fentanyl for slow release pain control and when I came off that I didn’t replace it with anything else. I’ve had slow release oxy and MST in the past.

I have no experience at all with other ROA’s for opiates other than having IM and IV in hospital. Rectal not an option as my bum has been sewn up from the inside (told you I’d had a lot of surgery!) I have an permanent ileostomy.
 
Nooby my first thought upon reading your story was the same as kitty said : you can't possibly be absorbing thru the gut so..... a whole lotta oxy may be hitting your liver. This can kill ya if they have APAP (?) I've never taken oxys

I wonder in your specialized case If doc would consider those morphine drops on the tongue?
They can be prescribed outpatient; just please if you reach a point where you're actually feeling suicidal, Reach Out for help. I've known some folks with tremendous physical challenges leading very happy n productive lives.

Strength and Peace to you; I hope you get this pain situation under control so life will have some Good Times ahead!
 
Thank you, I really appreciate your kind thoughts. My oxy is free of APAP or any additions so it seems I’m unlikely to have buggered my organs, but I will get bloods done soon to check. My pain specialists seem pretty confident that I have enough gut left for my receptors to work, as do my gastro team but I can’t find a definitive answer (that I can understand!) online regarding exactly where in the guts the receptors are. I do also have liquid morphine which I take for breakthrough pain relief and I’m very tolerant to that too. The difficulty now is that while I’m now determined to fight this bad patch head on, I can’t tell my pain docs, or my GP, about having been suicidal as they’ll then freak out and want to take my opiates away in case I’m a suicide risk. And while my pain isn’t well controlled right now I cannot begin to explain the fear of trying to cope with my daily pain without any. What a mess!
 
Keif Please could you pm me so I can message you back with a question? I’ve not had time to get up to 50 posts!
 
I understand. Yeah you do NOT wanna burn that bridge to what pain relief you're able to procure from the docs.
As to "reaching out if feeling suicidal again" I meant tell your partner your family a trusted friend perhaps. Call an anonymous support line , talk thru it etc etc.

I didn't mean to say Run to your providers and confess all. No
 
Thank you, I quite agree, I’m lucky enough to have an amazing husband who I don’t deserve and some very supportive friends.
 
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