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Opioids Why does Codeine not work for me?

oxyloveUK said:
Codeine is a stupid drug producing an unknown amount of morphine in anyone as everyone has different individual metabolism. 300mg codeine would do nothing for me now whereas oxycodone or morphine 20mg would begin to -they dont need to metabolize to work. Better and safer to prescribe low dose morphine
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is Oxycodone prescribed much in the UK? I thought it was more of a US thing

but I doubt I'd be able to persuede my doctor to prescribe either, so I'm stuck with either Codeine or Dihydrocodeine
 
US and Canada by far use the most but it's becoming alot more common in the UK very quickly as its saving money for the nhs with efficient pain relief and more generic versions being introduced in Britain now like longtec

You should be able to get tramadol (which can be fantastic) from your doctor/GP very easily here and if you have a pain problem like a bad back and give good reasons for oxycodone it wouldnt make sense to say no. 5mg of oxy = 60mg of codeine roughly, just works MUCH better
 
oxyloveUK said:
US and Canada by far use the most but it's becoming alot more common in the UK very quickly as its saving money for the nhs with efficient pain relief and more generic versions being introduced in Britain now like longtec

You should be able to get tramadol (which can be fantastic) from your doctor/GP very easily here and if you have a pain problem like a bad back and give good reasons for oxycodone it wouldnt make sense to say no. 5mg of oxy = 60mg of codeine roughly, just works MUCH better
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it seems I don't metabolise Codeine properly since I have not felt any effects so far, and the same would be true of Tramadol since they use the same enzyme I believe
 
Correct. If Codeine doesn't work because you don't produce the enzyme that metabolizes it into an active chemical, tramadol shouldn't work either. Same enzyme needs to activate both.
 
Tramadol generally gives a far better and longer effect than codeine to people from what ive heard even though they work the same way. its opioid metabolite is alot stronger than morphine!

Codeine and dihydro do nothing for me (I dont metabolize well either) but I find tramadol consistently fantastic and lasts uniquely long, 2nd favorite after oxy and ive tried many things like iv morph, methadone, hydrocodone. Tramadol tops em :) - its because the M1 (O-desmethyltramadol) metabolite is FAR stronger
 
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Also found its very easy to get tramadol both sides of the pond probably because its only been recently controlled in the UK and US and it isnt widely considered a narcotic in the US. And in places like Mexico many pharmacies will sell it cheap without prescription! Had a huge supply thanks to this last summer, gave me some great weeks
 
Forever Changes, first off, I dig your name. "Love" don't get nearly the attention they deserve.

The most likely issue here is that you have an enzyme deficiency that is preventing you from effectively metabolizing the Codeine (3-Methlymorphine) into Morphine in vivo. It's shitty, but I have this issue also. It's not unheard of. I'm not entirely immune to Codeine's effects, but if I'm in a pinch and can obtain a large supply of Codeine, I will take several grams and that will at least make me less sick. Otherwise, Codeine is worthless to me.

There are Opioids that don't require metabolism to active substances. Morphine/Heroin for instance is a great example. Morphine is not metabolized in a significant way by the Cytochrome P450 system. I'm willing to bet that you have a fairly normal reaction to Morphine.
 
^ agreed, its my favourite album!

do you think that Dihyrdrocodeine is worth trying or would that be useless too?
 
Forever Changes said:
^ agreed, its my favourite album!

do you think that Dihyrdrocodeine is worth trying or would that be useless too?
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If Codeine does not work for you, it's almost a certainty that Dihydrocodeine will not work either. They are very similar substances. Dihydrocodeine is metabolized into the active substance, Dihydromorphine, in the same way that Codeine (3-Methylmorphine) is metabolized into Morphine.

It's probably not worth your time. If you truly have an enzyme deficiency, you are going to need to acquire Opioids like the ones I have described that do not require the same metabolic process.
 
^Sorry, that isn't true. Well, it is true that dihydrocodiene has multiple metabolites, and 2D conversion to the potent dihydromorphone takes place; however, it seems to have little effect, presumably because it is produced in such small amounts.

And dihydrocodiene is an active opioid on it's own. Not a potent one, sure, though if poor enzymes are truly responsible, this or Hydrocodone are lower level opioids to, uh, "test" the theory(and have my doubts)

Of course, Hydrocodone is S2 in the states now, and available in pure form, and a classic "Starter", so maybe not go there...
 
isaaccain said:
Some people are just poor metabolisers, but there are other drugs that use CYP2D6 as well. If you've ever taken dexamphetamine or DXM and gotten high then you're not a poor metaboliser, there's something wrong with your method
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Dextroamphetamine is active as it is, CYP2D6 metabolizes it to the much less active 4HA (4 hydroxy-amphetamine).
The less active one's CYP2D6 is, the stronger the effects of dextroamphetamine will be.
 
Earlier in the thread some posts suggested that grapefruit juice would potentiate the effects of codeine.
It is the other way around, one needs CYP2D6 to convert codeine to its active metabolite, and grapefruit is an inhibitor of said enzyme.
 
is poppy seed/pod tea also metabolised by the same enzyme that metabolises codeine?

would that be worth trying?
 
Poppy seed/pod tea contains a while bunch of opioid compounds. Most of which I'm pretty sure are active on their own but I might be wrong about some of them.
 
The pods/seeds have the usual morphine & codeine as the most common alkaloids. Like, swamping the rest.

I think the others were right on the CYP2D6 thing. LOTS of things inhibit that, SSRIs to Benadryl. Someone mentioned the glucuronide being the important one, but I think that's more for analgesia (unless that's what you were actually after, y'know, the purpose of the med). Otherwise it's 2D6 for the morphine conversion.

One test is to start taking haloperidol to induce your liver enzymes, see if that helps; and if you can tell through the Haldol.


Makes me wonder if the UGT enzymes can be multi-copy and shunt the codiene away instead?
 
Noscopine and Thebaine seem to be the other two in opium that are heavily present
 
I do forget ol' thebaine. Cause it sounds like it should be some Eastern European herb that witches use and Latvians ferment into a ultra-strong absinthe.
 
The interesting thing is Jefferson grew red corn poppies in his medical garden.... If they don't grow morphine what are their compounds good for. I've noticed with seed tea there are batches that will kill pain, but nothing else as far as muscle tension relief.... It's like a step before too much with pins and droopy eyes
 
Codeine is a stupid drug that shouldnt be prescribed, unreliable for pain relief, often useless and dangerous if you are a quick metabolizer. produces an unknown amount of morphine in anyone. Why low dose morphine isnt always prescribed instead I do not know
 
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