Opioids Visible Damage or Powder in Nose

[chronicpain47]

Though I read the rules, I'm not entirely sure if this is the best place for this question but since I'm asking about more than one drug though, I hope it is. My apologies in advance if it is not.

I snort ER opiates and an ambien every day. I've been snorting the opiate for maybe 10 months and the ambien for 2 months, maybe a little longer.

Though I am an addict, I actually started not to get high but to simply better treat my pain and insomnia. As you might've guessed from my username, I suffer from chronic pain and it is very severe. My pain management doctor didn't like how long I'd been on an IR opiate, so he switched me from a very effective IR opiate to an ER opiate that gave me no noticeable pain relief. I had read that snorting it was more effective, and that other pain patients had turned to that. I did not want to do this but I was once again in so much pain that I could not function, so I was desperate.

It does not hurt at all to snort and doesn't seem to be causing me any problems yet.

As for the ambien, I was prescribed this to combat the severe insomnia side effect of a high dose of steroid that I take for another illness. Everyone who's ever taken ambien will know that it can have bad side effects if it kicks in while you're not in bed, and that the onset time is so sporadic that either you take it at bed and risk it not kicking in for up to 4 hours(in my experience, though usually the longest is closer to 2 hours) or you take it early and then risk the aforementioned side effects.

So, one night I was heading to bed closely after eating, so I knew that it definitely would take a long time to take effect. That's when I first tried snorting it, and it worked so well that I've been doing it ever since.

That one DOES hurt, but only for about 45-60 seconds, and I still do not have any problems with pain in my nose. Not even dry nose.

I understand these are bad things to do. At this point in time, I am just trying to get by until I have a better game plan regarding my health issues so I am not interested in torturing myself trying to stop yet.

So, with all that being said, I have two questions regarding a checkup I have coming up. I know the doctor will want to look in my nose, so what I want to know is first, if there is damage that I somehow don't feel yet, will she be able to know it's from snorting drugs? And secondly, how much time do I need in between snorting and the appointment so that all the powder will be out of my nose so that she will not see it?

Let me just reiterate that I do understand that this is not healthy. I do understand that I am an addict. But I'm also in a semi-unique position that I am both addicted to these medications, and also actually still need them for legitimate medical reasons. Before these medications, I would be horribly depressed and often suicidal over how miserable I was all the time. I was in such severe pain, and getting about 3 hours sleep per night, punctuated every few nights by a "good" night's sleep - which was still only about 6 hours.

That's why it is so incredibly important that I not be caught at this time. I know the focus here is harm reduction, so you may be inclined to think that getting caught would reduce harm because they would no longer prescribe these things to me, but it would only increase harm to myself through making me suicidal again.

Thanks

 

[Lorne???]

...

Your ok, if you know how to actually snort a pill

8(

 

[Scrofula]

Howdy, welcome to bluelight.

It would help to know which opiate it is you're snorting, since they don't all work well up your nose and some might damage it more than others. And how much you're actually using.

If you're, presumably, just smashing up pills (how else would OP do it Lorne?) I'm sure the various fillers have different lingering times before oozing down the back of your throat, so I have no idea what to say about your doctor. If she's a pain management doctor, I imagine she's trained to look for signs we don't even know about.

If you do have damage, it's good for her to know, right? She's not going to call police if she thinks you're snorting pills. She would cut you off, but look at it as a way to get into treatment. You'd need to quit if you had obvious damage anyway.

And now, consider Ambien/zolpidem. It does work to insufflate, unlike the similar benzodiazepenes. But reports say that doesn't accomplish much. You don't gain anything over just swallowing your pill. If that's the one that hurts to snort, my medical advice is to stop snorting it, and just swallow it before bed.

You left out a lot of details, so I can't say much. It sounds like chronic pain isn't your problem, or you'd prefer the extended release. If you aren't already, you're gonna start buying pills off the street, which are not covered by insurance. You'll worry less about your nose and more about where your money went.

So, step back and reassess your situation, try to just give up on getting high for a little while and adjust to the ER pills by mouth. If you can't do that, you need some addiction treatment while it's still early.

 

[Lorne???]

^ You would be surprised, Scrofula

Ambien has a fast onset PO, it is a fast acting GABA-A agonist(with selectivity) that peaks fast and wears off fast; snorting is pointless; IV is unadvisable, though understandable if you are desperate, because of the BA% increase, and higher plasma levels (probably not a huge difference, just saying)

Anyway, unlesss you snort something 20 minutes before you walk in, you are fine; you could literally just rinse you're sinuses. Unless you snort sufentanly every 15 minutes, you're ok

As for damage, you would want that found, right? Although unless it is severe, you could maybe try an ER doc if you do not want to get cut off

That satisfactory, teacher?

 

[Scrofula]

Gettin can-kickey, there Lorne.

Thought you were making fun of OP's pill-smashing skills.

But it made me think, not every filler in all pills is going to be incredibly soluble, right? Some people have dry-ass noses that aren't gonna instantly dissolve all the talc and FD&C yellow #3 in a typical pill. I can't imagine all pills vanish on nasal contact, even if they all dissolve in your stomach.

And I'm sure not all opiates are equally only barely bad for your nose tissue. There must be some outlier that's awful.

Not to mention boogers, OP. As a regular snorter of crystalline drugs, I can assure you that you should check in the mirror before you go in, because while I'm sure your nasal hygiene is top-notch, those hairs can catch a bundle.

We have a whole thread on that.

 

[Lorne???]

^That is already in running for thread of the years!

 

[Tubbs]

Lol that was a great thread, I will say some opiates definitely have worse effects on your nose than others. Morphine for one burns like hell and dries out your nose, where as hydrocodone doesn't burn all that bad and your nose can stay pretty moist. A good practice is to get an eye dropper, and drop one or two drops in each nostril before snorting, helps to absorb the powder, and keeps it from going down your throat. Also helps keep nasal damage down a bit.

 

[chronicpain47]

Howdy, welcome to bluelight.

Thank you!

It would help to know which opiate it is you're snorting, since they don't all work well up your nose and some might damage it more than others. And how much you're actually using.

I snort oxymorphone twice a day. The pills are tiny and make a very small amount of powder. Though I admit I am very inexperienced and have only snorted four different kinds of drugs total, would I be correct in assuming how much and how long it hurts after snorting, and how many obvious problems - such as dry nose, scabs, nosebleeds, and pain outside of immediately following snorting - would be good indicators of how much damage you're causing?

If you're, presumably, just smashing up pills (how else would OP do it Lorne?) I'm sure the various fillers have different lingering times before oozing down the back of your throat, so I have no idea what to say about your doctor. If she's a pain management doctor, I imagine she's trained to look for signs we don't even know about.

If you do have damage, it's good for her to know, right? She's not going to call police if she thinks you're snorting pills. She would cut you off, but look at it as a way to get into treatment. You'd need to quit if you had obvious damage anyway.

This doctor is not my pain management doctor, she's just my regular GP. She's actually not even an MD, just a PA so I'm hoping that will work in my favor lol

No, it's not good for her to know. I would be willing to stop snorting ambien if necessary, and that's the one I would assume is causing more damage anyway, but I cannot be cut off from my pain medication. I broke my back in multiple places, leaving multiple permanent fractures in my spine. This is in addition to a variety of damage in my body, including arthritis, caused by over a decade of high impact sports. I am in severe pain constantly.

I am currently trying to improve my pain by getting back into shape and strengthening the necessary areas to compensate for the weak points through physical therapy and chiropractic work. Without my pain medication, this would be impossible as I cannot function through the pain, let alone actually exercise.

I am also allergic to every NSAID I've tried, as well as acetaminophen. I know that's often what addicts say to doctors to try to get drugs, and I've had many doctors treat me like shit for saying this - including during a recent stay in the hospital where I was truly very, very ill but all the doctors thought I was simply seeking drugs. This resulted in my unnecessarily prolonged suffering through medical neglect, cutting me off of my pain medication cold turkey and refusing to treat my withdrawals. They then practically insisted on me trying an NSAID that I hadn't had before, even though I told them repeatedly that every kind I'd tried up to that point I had been severely allergic to. They obviously didn't believe it, and I figured the best proof would be to take it and let them see my reaction. Plus, I was receiving no pain relief at all at that time, so I was desperate anyway. They were absolutely shocked when they learned that I wasn't lying after all!

So, believe me when I say that I understand how suspicious that sounds. I even do occasionally take ibuprofen when I'm having an endometriosis flare, and just deal with the reaction because it's the lesser of the two evils. But on a regular basis, I am unable to take anything that would normally be recommended, especially for inflammation. The reaction would be debilitating. Besides, my pain is so severe that these medications, even prescription strength naproxen, hardly help anyway.

So if cut off from my pain medication, I wouldn't just be left with the weak shit that barely even touches the pain. I would be left with absolutely nothing.

And now, consider Ambien/zolpidem. It does work to insufflate, unlike the similar benzodiazepenes. But reports say that doesn't accomplish much. You don't gain anything over just swallowing your pill. If that's the one that hurts to snort, my medical advice is to stop snorting it, and just swallow it before bed.

As I said, I do gain that it takes effect almost instantly. I do prefer this than the alternative of sometimes taking hours to kick in, but I would be much more willing to stop snorting it if necessary than my pain medication.

You left out a lot of details, so I can't say much. It sounds like chronic pain isn't your problem, or you'd prefer the extended release. If you aren't already, you're gonna start buying pills off the street, which are not covered by insurance. You'll worry less about your nose and more about where your money went.

Hopefully my added details will be helpful.

I would actually prefer the extended release. I mean, are you kidding? I would love to have consistent pain relief throughout the entire day! That sounds heavenly. The problem is that it does not provide nearly enough pain relief. In fact, I'd say it's comparable to the effectiveness, or really lack of, of the NSAIDs I previously mentioned. Taken orally, it did little more than just prevent withdrawals.

Even if I wanted to buy street drugs, I couldn't for four big reasons. First, I would have a very hard time finding them where I live in the first place. Second, even if I could find them, I can't drive due to my disabilities and third, I don't know anybody I could call up and ask, "hey, can you drive me to buy drugs?" either lol. Finally, fourth, I couldn't afford it anyway, since all of my health problems have left me disabled, minimizing the amount of time I'm able to work and leaving me with a shit income and a very tight budget. So don't worry, that's not even remotely close to an option.

So, step back and reassess your situation, try to just give up on getting high for a little while and adjust to the ER pills by mouth. If you can't do that, you need some addiction treatment while it's still early.

I'm not getting high. Even when I first started snorting the ER pills, it didn't make me high. I know I was unclear at first, but hopefully after all this you'll understand just exactly how ineffective this medication is.

Thank you, though, I really do appreciate you taking your time to provide such a thorough answer!

 

[MDPV_Psychosis]

I just wanted to add that plugging is a viable, likely safer, alternative to snorting. There is the possibility of long term consequences from snorting pills that you should be aware of - things like the accumulation of insoluble binders in the lungs (look into talc and pulmonary talcosis. Talc isn't the only one of concern either)

 

[Scrofula]

I snort oxymorphone twice a day. . . . many obvious problems - such as dry nose, scabs, nosebleeds, and pain outside of immediately following snorting - would be good indicators of how much damage . . .

Well, how did I know you weren't US American? Infamous deceased Opana. For apparent reasons. And, an absorbed dose in your nose is 400% higher than you get down your throat. Although that's just the drug per se, if you've got ER tabs it may not be so dramatic. Half-life makes twice a day sound reasonable.

For nose damage, I think your revised statement sounds good. My experience is relative to meth, in which nearly everything else is like snuggling your face in a bunny's tail. You can't assume it's all good if it doesn't hurt either, as cocaine users discover when their septums rot out. Numbing action isn't as nice then. Opiates aren't vasoconstrictors to the extent of stims, and twice a day is low for chronic snorters, so I wouldn't worry for now.

I'd heard Opana got yanked because their abuse-deterrent made snorting impossible, and IV worthwhile. But it wasn't some chemical thing, just a physical barrier you couldn't smash with a hammer. I'm assuming you don't have those.

she's just my regular GP . . . just a PA so I'm hoping that will work in my favor . . . No, it's not good for her to know. I would be willing to stop snorting ambien if necessary

Over here, the GP could be head of Ear Nose and Throat and he wouldn't look in your nose. You'll be fine. But you should stop snorting your Ambien anyway. You don't get anything out of it, at very minor risk to your nasal epithelia.

So, believe me when I say that I understand how suspicious that sounds

This is bluelight. Every member is granted equal suspicion, by me, mostly because of my meth paranoia. And none of them owes me even lip service to strictly therapeutic usage of painkillers. Recreational use of drugs is no vice around here. So it's OK to say you enjoy the rush after a snort, and I do believe you need them to finish therapy.

and third, I don't know anybody I could call up and ask, "hey, can you drive me to buy drugs?"

I'll point out, though, that at a certain stage in the process, that has never held anyone back.

And given the half-life I can see how you might not get "high" with your evening rail. If you did get a rush, though, it'd be ok.

And you're not (my first thought) snorting Vicodin constantly, about to discover transitioning to heroin is cheaper, if the paracetemol didn't kill you first.

I think you'll be fine with your doctor visit if you skip taking Ambien right before, and keep to just snorting what you have. That's famous last words though. And I'm not an opiate guy somehow, yet, but we have more than quite a few around who might have better ideas about pain management, so look around if you'd like.

Good luck, have fun.

 

[Lorne???]

Thank you!


I snort oxymorphone twice a day. The pills are tiny and make a very small amount of powder. Though I admit I am very inexperienced and have only snorted four different kinds of drugs total, would I be correct in assuming how much and how long it hurts after snorting, and how many obvious problems - such as dry nose, scabs, nosebleeds, and pain outside of immediately following snorting - would be good indicators of how much damage you're causing?



This doctor is not my pain management doctor, she's just my regular GP. She's actually not even an MD, just a PA so I'm hoping that will work in my favor lol

No, it's not good for her to know. I would be willing to stop snorting ambien if necessary, and that's the one I would assume is causing more damage anyway, but I cannot be cut off from my pain medication. I broke my back in multiple places, leaving multiple permanent fractures in my spine. This is in addition to a variety of damage in my body, including arthritis, caused by over a decade of high impact sports. I am in severe pain constantly.

I am currently trying to improve my pain by getting back into shape and strengthening the necessary areas to compensate for the weak points through physical therapy and chiropractic work. Without my pain medication, this would be impossible as I cannot function through the pain, let alone actually exercise.

I am also allergic to every NSAID I've tried, as well as acetaminophen. I know that's often what addicts say to doctors to try to get drugs, and I've had many doctors treat me like shit for saying this - including during a recent stay in the hospital where I was truly very, very ill but all the doctors thought I was simply seeking drugs. This resulted in my unnecessarily prolonged suffering through medical neglect, cutting me off of my pain medication cold turkey and refusing to treat my withdrawals. They then practically insisted on me trying an NSAID that I hadn't had before, even though I told them repeatedly that every kind I'd tried up to that point I had been severely allergic to. They obviously didn't believe it, and I figured the best proof would be to take it and let them see my reaction. Plus, I was receiving no pain relief at all at that time, so I was desperate anyway. They were absolutely shocked when they learned that I wasn't lying after all!

So, believe me when I say that I understand how suspicious that sounds. I even do occasionally take ibuprofen when I'm having an endometriosis flare, and just deal with the reaction because it's the lesser of the two evils. But on a regular basis, I am unable to take anything that would normally be recommended, especially for inflammation. The reaction would be debilitating. Besides, my pain is so severe that these medications, even prescription strength naproxen, hardly help anyway.

So if cut off from my pain medication, I wouldn't just be left with the weak shit that barely even touches the pain. I would be left with absolutely nothing.



As I said, I do gain that it takes effect almost instantly. I do prefer this than the alternative of sometimes taking hours to kick in, but I would be much more willing to stop snorting it if necessary than my pain medication.


Hopefully my added details will be helpful.

I would actually prefer the extended release. I mean, are you kidding? I would love to have consistent pain relief throughout the entire day! That sounds heavenly. The problem is that it does not provide nearly enough pain relief. In fact, I'd say it's comparable to the effectiveness, or really lack of, of the NSAIDs I previously mentioned. Taken orally, it did little more than just prevent withdrawals.

Even if I wanted to buy street drugs, I couldn't for four big reasons. First, I would have a very hard time finding them where I live in the first place. Second, even if I could find them, I can't drive due to my disabilities and third, I don't know anybody I could call up and ask, "hey, can you drive me to buy drugs?" either lol. Finallyfourth, I couldn't afford it anyway, since all of my health problems have left me disabled, minimizing the amount of time I'm able to work and leaving me with a shit income and a very tight budget. So don't worry, that's not even remotely close to an option.


I'm not getting high. Even when I first started snorting the ER pills, it didn't make me high. I know I was unclear at first, but hopefully after all this you'll understand just exactly how ineffective this medication is.

Thank you, though, I really do appreciate you taking your time to provide such a thorough answer!

Actually, are you snorting Opana ER? This things are NOT nose friendly; they gel up almost immediately after contact w/ moisture
'
Don't get me wrong l, people do snort then anyway, and if you grind it into a fine powder, it is so potent that if half of it absorbs it will work; however mostly it will not be able to dissolve into the membranes of the nose and. e properly absorbed.

This could be root of your problem. Snorting ambien is not helping, it is not very water soluble, and you may be snorting multiple pills

Bad choice for snorting on both counts, really.

And plugging ambient does not really make sense; it may improve BA%, however it isn't really soluble enough to provide a rapid onset(though highly doubt they have studied rectal sleep meds!

And op, ambien kick in pretty quick, surprised it is that much of a difference. Enzyme inhibitors could increase BA%

What dose is the oxymorphone? And if they are the regular non-er kind, then that is different

 

[Scrofula]

I just wanted to add that plugging is a viable, likely safer, alternative to snorting. There is the possibility of long term consequences from snorting pills that you should be aware of - things like the accumulation of insoluble binders in the lungs (look into talc and pulmonary talcosis. Talc isn't the only one of concern either)

Has a point. And as a tiny pill, you'd just shove 'er right up there. I think.

I'm too used to other things, I'd grind it up in warm water and squirt 'er up there.

By other things I mean meth again. And by "up there" I mean your butthole, if you were unfamiliar with the term "plugging". We're serious.

 

[Scrofula]

Lorne, you're right, I only saw it (edit: I mean Ambien/zolpidem) was available as a nasal spray, took that as a sign of solubility (it's not at all benzo structure). It's not very soluble as a salt. So even better reason to not snort, and go with the already fast-acting, potent, by-mouth as-intended method. You may find it works a lot better. Don't put it up your butt.

And I just assumed Eden sold the non-armor coated version overseas. Numorphan has an ER version, but it's in clinical trials or court injunction while Eden sues.

ANd then I found a case report of severe hearing loss associated with oxymorphone insufflation.

 

[IHateColleg]

^that study sounds interesting about the hearing loss, do you have the link?

 

[Scrofula]

Here it is, a case report, which aren't known for their massive sample sizes. Also I didn't read beyond the first column.

I heard that infamous, sinking radio "personality" Rush Limbaugh, who did go near-totally deaf before surgery and implants, did so from a complication of his opioid pill habit. Not because of the hydrocodone or oxycodone or whatever he took (maybe the blood of Afghani children forced to collect opium?) but the APAP in them. But that's 20 year-old secondary reporting, and I'm too lazy to check.

Maybe Percodans? Aspirin is said to cause ringing-in-your-ears in overdose, but I didn't think it was permanent.

 

[IHateColleg]

It says they didnt find any acetaminophen based hearing loss cases. (42-44) that doesnt mean there isnt cases where that it the cause, for NSAIDs are among the list of ototoxic substances. There is a table on the same page as the 42-44 citation that shows the results of studies, and while most are resolved there is two that ended in permanent hearing loss, one from hydrocodone/APAP and another one stemming from heroin. I would have to find more cases because there could have been more variables affecting the hearing loss.

Thank you for including that link!!
:D

 

[Scrofula]

Thanks for reading it for me.

Yeah, when you figure how many Americans routinely eat half the supply of Vicodin their dentist gave them, in a single sitting, any moderate risk of permanent deafness would be pretty well known.

That case report seemed to pop out more for being intranasal-specific. I think even Limbaugh just ground them up over his morning veal.

 

[DayDreamBeliever]

The best remedy for me was using a saline nose spray, like nasonex after snorting a pill. Washed it down, no burn and no powder residue in your nose.