^ Ya, it is, isn't it?
Anyway, I've been Rx'd 2x Opana ER 20mg a day for chronic pain, and while I mostly insufflate them, they are by far the strongest analgesic I've used. I was switched to this from 4x OxyContin 20mg a day. HUGE jump in potency!
However, in the last 6-7 days, my tolerance has gone from 50mg of oxycodone for a good high (I worked hard at getting my tolerance down! I had been up to 60-70mg IV Opana a day!) to, at least for oxycodone, needing at least 200-250mg to catch a nod. Keep in mind, this is SIX or SEVEN DAYS WITH 40MG OF OPANA PER DAY!!!
This stuff WILL destroy your tolerance to any and all opiates! I lost 50% of the euphoric effects of snorting it within 4 days (I refuse to up my dose; I get the med from a pain doc, and as the analgesia has only gone down 20%, I'm not going to snort it AND escalate my dose constantly!), and will be taking an every-other-day break here soon. I have a bottle of "Norco 10/325mg" that will let me stain pain and w/d free while I go on "no-Opana" mode for a day or two and see what that does.
OF NOTE: I have been taking Hydrocodone as a (non-prescribed) breakthrough pain med, as my doctor won't give me anything for BTP (I can't complain; I'm 20yo and he scripts me Opana. Before you get in a huff, it's for legitimate, debilitating pain) due to the fact that I purposefully chose a clinic that is less medication-focused and more interventional-therapy focused.
So, I have a bottle of Hydrocodone/APAP 5/500 that I'm using for breakthrough pain, that was amazingly left over from a surgery I had 2 years ago. I couldn't BELIEVE there were ANY opiates in my household, other than my current Rx!
Anyway, hydrocodone works FAR better than oxycodone does in this situation, and I'm thinking it's because of the metabolites. Hydrocodone is metabolized partially into hydromorphone, while oxycodone is metabolized partially into oxymorphone. Thus, by taking Oxycodone, I would just be adding more opiates that compete for the same-exact-receptors. With hydrocodone, however, there has to be some incomplete cross tolerance (as all opiates work the receptors SLIGHTLY differently...), because 10mg Hydrocodone is FAR more effective for pain (on top of 20mg Oxymorphone) than is 10mg Oxycodone. This is unusual, as 15mg Hydro = 10mg Oxy, but for me it is now more like 10mg Hydro = 12.5-15mg Oxy.
I know we're not all chemists or anything, but does my above theory sound reasonable?
I tested it in another way: I took my Opana, and for BTP used 100mg Tramadol. Yes, tramadol. Believe it or not, the 100mg broke through the Opana and seemed to have 90% of the effect it would on it's own, additive. Perhaps it's because tramadol isn't a real opiate, but it sure increased the effects notably.