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Thread: Does switching opiates reduce tolerance ?

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    Does switching opiates reduce tolerance ? 
    #1
    Question
    Hi,

    Lets say you have increased tolerance to oxycodone from daily use and you want to reduce your tolerance back down to a lower dose so it is more effective for controlling chronic pain, I was wondering if switching to different type of opiate for example like tramadol, codene or fentanyl for a few months would actually reduce the tolerance down towards oxycodone for when you start back on it?
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    #2
    There is only partial cross-tolerance meaning if you switched from oxycodone to another opioid, you could take a SLIGHTLY lower dose at the beginning but your tolerance to that specific opioid will quickly rise... so if you usually take 20mg of oxycodone and 30mg of hydrocodone is equivalent, you may be able to get the same effect from 25mg of hydrocodone for a brief period, but then would need 30mg pretty quickly.

    In essence no, you are tolerant to OPIOIDS first and foremost and unless you abstain from all of them for a period of time, your tolerance will not go down... and even then, it will rise back up much faster then when you first acquired that tolerance.
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    #3
    Thanks for your response, I see what your saying but I gues I should have been more specific in my question, so here it goes....

    I suffer from a chemical sensitivity to all opiates, sedatives, anelgesics, stimulants and every other drug that acts on my Autonomic system due to a rare neurological illnes that I have, for the past one year Ive been having adverse reactions everyday to the oxycodone, at first the adverse reaction was towards only 2 mg but after 1 year of using I have worked my way up to a measly dose of 10mg which still causes me bad reactions, My neurologist has now agreed to further investigate my adverse reactions and he is willing for me to take a dose of oxycodone whilst he looks and documents my vitals during teh adverse reaction.

    I want my neurologist to see that my adverse reaction even occurs with very small dose like only 2 mg so I want to bring my tolerance back down from 10mg to 2 mg. Also when I'm taking the oxycodone everyday the reaction isnt as bad as what it would be if I were to I take a week off from using and then restarting. I want him to see me at my worst because its the only chance I get to have this investigated and documented, but meanwhile I refrain from oxycodone I still need to manage my pain so I want to reduce tolerance whilst putting up with adverse reactions to some other opiate. But Ive chosen oxycodone to show my neurologist because it is the one that causes me the worst reactions yet its also the most effective on my pain.
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    #4
    Bluelighter QuasiStoned's Avatar
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    ^^^
    Unfortunately the best way to reduce your tolerance is to abstain from opiates period. I'm not sure if you switched to another opiate it would really let your oxycodone tolerance drop.

    Maybe it would be best to just take a short break and do your best to endure the pain so that you can be sure that your neurologist sees your reaction at it's worst.
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    #5
    Ok I understand now, thank you both.
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    #6
    BL Ambassador Captain.Heroin's Avatar
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    Quote Originally Posted by Cane2theLeft View Post
    There is only partial cross-tolerance meaning if you switched from oxycodone to another opioid, you could take a SLIGHTLY lower dose at the beginning but your tolerance to that specific opioid will quickly rise... so if you usually take 20mg of oxycodone and 30mg of hydrocodone is equivalent, you may be able to get the same effect from 25mg of hydrocodone for a brief period, but then would need 30mg pretty quickly.

    In essence no, you are tolerant to OPIOIDS first and foremost and unless you abstain from all of them for a period of time, your tolerance will not go down... and even then, it will rise back up much faster then when you first acquired that tolerance.
    Well put, Cane.
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    #7
    BL Ambassador Captain.Heroin's Avatar
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    Quote Originally Posted by Unlucky View Post
    Ok I understand now, thank you both.
    I'm going to move this to BDD Unlucky. I think your question has been answered well.

    Quote Originally Posted by Unlucky View Post
    Thanks for your response, I see what your saying but I gues I should have been more specific in my question, so here it goes....

    I suffer from a chemical sensitivity to all opiates, sedatives, anelgesics, stimulants and every other drug that acts on my Autonomic system due to a rare neurological illnes that I have, for the past one year Ive been having adverse reactions everyday to the oxycodone, at first the adverse reaction was towards only 2 mg but after 1 year of using I have worked my way up to a measly dose of 10mg which still causes me bad reactions, My neurologist has now agreed to further investigate my adverse reactions and he is willing for me to take a dose of oxycodone whilst he looks and documents my vitals during teh adverse reaction.

    I want my neurologist to see that my adverse reaction even occurs with very small dose like only 2 mg so I want to bring my tolerance back down from 10mg to 2 mg. Also when I'm taking the oxycodone everyday the reaction isnt as bad as what it would be if I were to I take a week off from using and then restarting. I want him to see me at my worst because its the only chance I get to have this investigated and documented, but meanwhile I refrain from oxycodone I still need to manage my pain so I want to reduce tolerance whilst putting up with adverse reactions to some other opiate. But Ive chosen oxycodone to show my neurologist because it is the one that causes me the worst reactions yet its also the most effective on my pain.
    You actually get effective analgesia from 2mg oxycodone? That's simply amazing. Your IV equivalent dose must be a few hundred micrograms...or possibly less. An OC 80 could last you much longer than it would 99.9% other people in BL that's for sure.
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    #8
    One thing I have learnt in the course of my condition is that I am very different, and trust me thats not a good thing.

    I always stay away from slow release meds cause of the potential of an adverse reaction could be much worse, I only use liquid oxycodone, morphene or hydromorphone as I can accurately measure out a suitable dose in increments and adjust accordingly to my tolerance.

    Captain.Heroin unfortuanetly the problem with me is that I get an adverse reaction before I even get to a dose suitable effective for anelgesia, so whilst 2mg does not releive my pain it is what I had to start with to desensitise myself before I could work my way up to 5mg where I achieved some pain relief. Had I gone directly to 5mg the adverse reactions would have been much worse as even at 2mg they were bad enough, so maintaing a constant level of exposure certainly helps but still it is not adequate to eliminate a bad reaction totally. But yes my anelgesia levels are still definetly achieved at far less doses than most people.
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