Opioids Combination Potentiation of SPECIFICALLY Dihydrocodeine

[kitsunedemon]

I have a moderate tolerance to Dihydrocodeine and also have Gastrointestinal Problems (GI Problems), I am prone to severe Nausea on Opioids (especially when smoking cigarettes - i'm a heavy smoker - and I know all about this being due to the MAO factors of nicotine increasing the rush/high).

I'm not a habitual Dihydrocodeine user, probably once every 1-2 weeks at the moment, but my tolerance seems to be sticking and I'm not getting the buzz I first did off 240mgs rectally...

I am also a habitual user of Valium, 40mgs nightly, today I have taken 20mgs in the morning however.

I want to have a Dihydrocodeine session later this evening, and would like to here other users opinions on my methods, dosages, and when to dose.

Plan for Session:

Firstly I have more recently been taking the Dihydrocodeine orally, in fear that rectal administration would only make GI Problems worse. However, I have taken Dihydrocodeine rectally twice before, and actually found the Nausea to be a lot less severe taken rectally than with my bouts of taking orally, so am going to mix things up and probably take the majority rectally, and a couple orally. The last dose I took was 240mgs of Dihydrocodeine orally with 0.5mg Xanax and 20mg Valium and wasn't quite as high as I wanted. Dosage ideas?

Potentiation:

Valium - I know in essence there is a lot of disagreement whether Benzos poteniate the opiate nod, or this is just the effect of the Benzos working simultaneously. Regardless, this is added CNS Depression and will still be in my system when I take the Dihydrocodeine, which is a factor to take into account.

DXM - I have some pure-ish (99 percent) Dextromethorphan Hydrobromide and some gel-caps at my disposal, I would quite like to use this to lower my tolerance, and have heard it can slightly enhance the high. My question is should I be dosing the DXM after the Dihydrocodeine or before (a few sources I've seen have said an hour afterwards and an hour before, so I'm slightly confused :/), and what dosage?

Promethazine (Phenergen) - I usually tend to use 25mg for several reasons, to poteniate the high/nod, as it is an Antiemetic it helps with my GI problems and Nausea, and as a 1st Gen Antihistamine helps with the intolerable Dihydrocodeine/Codeine itch. However Promethazine is a CNS Depressant in itself (or increases the CNS Depression of Opioids - I can't remember which) and as a rule of thumb I don't like taking 3 CNS Depressants all in one go due to the dangers of Respitatory Failure and other nasty and potentially fatal issues. If I was to take the Promethazine - at what dosage would people recommend (my Phenergen pills are 25mgs) and again their seems to be disputes online as to whether to take before the session, but some people have recommended 1hr after dosing the Dihydrocodeine as it elongates the high, so best time to dose?

Hangover:

I have work tomorrow at 12pm-8/9pm and I have to be relatively on the ball (though puking doesnt bother me) and I still have to take my 20mg Valium before I go to bed tonight. Any idea's for helping with this? I've seen Tomato Juice/Tomato's help with constipation if eaten/drank before the session and plan to have some Tomato soup.

I could really use some advice as I plan on starting the session around 10pm (GMT+0 - London) and before anyone asks I have read http://opioids.com/opiates/index.html.

Any advice would be heaviliy appreciated

 

[Znegative]

I would stick with the promethazine, as it actually does effect the metabolism of opiates, and therefore should increase the high. If you dont take the Phergen regularly, than take the minimal recomended dose. DXM like other NDMA antagonists can help with withdrawal, tolerance and potentiation but I personally find that it gives me a dirty feeling even at threshold dosages.

 

[effie]

As you have an opioid and benzo tolerance, adding promethazine into the mix should be fine in terms of CNS depression. You don't really want to take more than 50-75mgs however as at higher doses it can cause delirium and other anticholinergic side effects, which can be extremely unpleasant - as zneg said, it's wise to start low though, so 25mgs. I would make sure you don't take another CNS depressant alongside your combination, however, as this could potentially be dangerous.

If your dose of DHC/diazepam is not high enough for you currently, try it with the promethazine first before you increase the doses - as zneg said, promethazine directly affects DHC's metabolism by inhibiting a liver enzyme which breaks DHC down. This is one of the cytchrome P450 enzymes (which metabolise a lot of drugs) known as CYP-2D6. Another CYP-2D6 inhibitor is cimetidine (Tagamet).

In terms of being groggy, I don't sleep well on opioids (awake now for this reason haha) and diazepam has a long half life, so both can leave you feeling a little sluggish. Promethazine can do as well but not as commonly.

 

[kitsunedemon]

Thanks for the replies.

I have used Promethazine during 3-4 of my Dihydrocodeine sessions before (25mg Promethazine with varying doses of Dihydrocodeine 200-340mg orally, I tend to find orally 300mgs gets me where I want to be with slight nausea even with Promethazine's Antiemetic effects) however I have never used Promethazine while dosing Dihydrocodeine rectally, which has a much higher BA than oral.

I postponed my Opioid session due to a friend coming over last night, and plan on doing it tonight. I have not taken any Benzos today (though due to Valium's half life will still have some in my system) but will probably have to take 10mg before the Dihydrocodeine session due (I will try not to if I don't have to, as I know it can kill the high and increase the nod and of course CNS Depression) and plan on taking the rest of the Valium when I am coming down from the Dihydrocodeine.

Due to the the BA of rectal dosing, I'm going to play it safe and probably dose at 160mg-200mgs, and take 40mgs orally to boost the duration of the high, and see how I feel after and hour or so of that. In regards to the Promethazine (I will be dosing 25mg), for optimum potentiation should I be dosing it before the Dihydrocodeine or afterwards and in what time duration?

Opinions on my dosages and optimum time to take the Promethazine would be much appreciated.

 

[effie]

I'd take it half an hour before so it has time to kick in - rectal dosing can hit you fast. 25mg should be okay, and you could take another if you wanted but I wouldn't go above 50mgs really. 75mgs absolute maximum. What dose have you taken previously?

Diazepam shouldn't kill your high as such, unless it overpowers the DHC, but you are right that combining opioids and benzos puts you at a higher risk of CNS depression, so definitely go steady

 

[kitsunedemon]

Thanks for the quick response Effie!

The max I've ever taken of Phenergen is 25mg, and I've never gone below that dosage. If I'm not feeling as high I'd like about and hour or so in, I'll take another 12.5mg, and see how that treats me.

I will do! Thanks for the advice

 

[effie]

If 25mg has always worked in the past then hopefully it will do the trick this time too sounds like you've got a good plan!

No problem