Opioids What would you ask for? Dillies, Percocets, Oxy's?

[Conspirator]

Thanks for your assistance and advice Conspirator... I have noticed all those side effects with opiates as well but that is an excellent point with the 12 hour vs. the 4 hour urinary retention.I haven't called yet as I was busy doing other shit, but good thing I did because I got some good advice from you.

It's funny - you make me feel like a guy with a winning lottery ticket to a currency of a country I never visit.

I would much rather oxy er and ir's but from your insight - I'm beginning to come over to the (dark) other side.

I might remind him of the 8mg he offered to write me and then suggest that I stick with the 4mg, but just more of them (#120 instead of #90). Does that sound non-seeking. Because I'm comfortable with the 4mg of dilaudid if that's what I'm going to get (I can always take him up on the 8 mg later) rather than oxy's.

Another thing I was wondering is if this new found fondness of Dillies is from the Morphine ER creating a base line for me. so I was thinking maybe I should just suggest that it's not enough with just the ER. I'm afraid If I say anything about the itching or urine retention, he might just take me off of opiates all together and try a synthetic opioid or something I can't even think of.
Thoughts?

The only opiates that create a large histamine release are hydrocodone, codeine and morphine. Hydromorphone, oxymorphone, and oxycodone cause much much much less of a histamine release than the formers. If you're worried that you'll be taken off opiates, just mention that this is a new thing with the morphine... 30mg morphine ER is barely anything, it's roughly equal to 6mg hydromorphone over the course of 12 hours... That's like taking 1mg oxycodone every hour, your blood levels of the morphine will never reach more than 2mg realistically which is equal to 3-4mg oxycodone. 4mg dilaudid oral equals 4mg morphine IV, 16mg morphine oral and 8mg oxycodone IV or oral. 4mg nasally equals 8mg morphine IV and 32mg morphine oral and 16mg oxycodone IV or oral... Dilaudid's duration of action is about the same as oxycodone plus or minus 20 minutes...

4mg oral dilaudid taken 4 times daily assuming you sleep 4-6 hours without dosing, would mean that to get the same releif from er oxycodone, you would need at least 30mg oxycodone ER, if taken nasally, that would be 60mg oxycodone ER.. if you get the 8mg dilaudid pills, that's 60mg oxycodone ER and if taken nasally that's 120 oxycodone ER. If he's prescribing 30mg morphine ER, I wouldn't expect him to give anything over 20-30mg oxycodone ER, and certainly not 60 or 120...

Bottom line, if you can get 8mg dilaudid, just take it, you won't get 120 4mg dilaudid IMO as doctors rarely prescribe over 100 of a schedule 2 drug, IDK if they're even allowed to. 90 8mg dilaudid assuming taken orally is equal to about 60mg oxycodone per day assuming 3 taken in one day, 80mg if 4 taken per day, and 90 8mg dilaudid oral is equal to a total of 1800mg oxycodone... basically, 1 8mg dilaudid pill taken orally is like 20mg oxycodone IR.

If he offered the 8mg dilaudid, just take it. If it doesn't work for you, just ask him for something different...

If you were snorting 4mg dilaudid, I doubt that the ms contin had much to do with the buzz... Also, hydromorphone is more lipophilic than oxycodone and morphine and has a higher binding affinity, therefore it kicks in faster and seems to "knock out" the pain rather than suppress it like oxycodone does.