Opioids Precipitated withdrawal from injecting 16 mg hydromorphone.

[Bomb319]

No, I didn't think that would be physically possible. No, it was not psychological. I am on 200 mg methadone daily. I've been doing very well on it, having abstained from opiate use and having very few cravings for the past several months. However I did get paid today, had a drug dream last night, and got curious again. I injected two 8 mg dilaudids (definitely real - distinctive pills I've used hundreds of times). I fully expected to feel little or possibly nothing since when I tried using smaller amounts of H before, I felt almost nothing despite others saying how good it was.

What I didn't expect was to start sweating, have a few chills, and have my pupils dilate to my entire eyeball. I didn't think this could happen from using a strong agonist. I know that I could have experienced some withdrawal from the methadone a bit sooner than usual due to the tiny bit of increased tolerance, but for this to occur, I imagine that the hydromorphone molecule has a lower binding affinity to the opiate receptors than methadone does. Would that not be the only way this could happen?\

Anyone else experience this or know about it?

 

[adder]

Methadone has a higher efficacy at MOP receptors than morphine and morphine derivatives like hydromorphone, so what might have happened is hydromorphone kicking some methadone off your opioid receptors activating them to a lesser extent. Perhaps also methadone at such a high dose changed the conformation of your opioid receptors, so when hydromorphone got bound, it couldn't properly activate them? As a matter of fact hydromorphone binds very strongly to MOP receptors - 0.28 nM (vs. [3H]-DAMGO, source). I don't have methadone's binding affinity at hand, but it's lower.

 

[Bomb319]

That would make sense then. If the hydo kicked off some (but not all) 'done, but can't ACTIVATE as well. I immediately had strong pupil enlargement and sweats, yet not bad enough to really feel sick or even yawn. After the approximate hydo half life of 7 hours, I felt better and even some euphoria from the 'done.

 

[purplehaze147]

When I was on 80mg of methadone heroin I.V. still got me high. Hydromorphone is stronger than heroin. I think it should have a higher efficacy and affinity but I'm not sure. Maybe you got bunk pills that had buprenorphine in them that's the only thing I can think of.

 

[killshot]

Why are you taking such a ridiculously high dose of methadone? That is so unnecessary if you are on it for maintenence purposes. Youre gonna have a hell of a time comin off that shit if you ever decide to. Dont get locked up bro lol

 

[rhun]

Hmm. 200mg Methadone should be too high of a dose for any opioid to have any effect, other than buprenorphine which I believe has a higher binding affinity.

How long have you been on that dose if methadone? I guess it's possible that the hydromorphone was strong enough that both opioids were competing for your receptors... But I don't think you went into full blown precipitated withdrawal, what you described sounds like withdrawal only, precipitated withdrawal is hell and 100x worse. At the same time though, at your dose, it would take at least a couple days to even going through regular withdrawal.

I have the flu and my brain is a little foggy, but my guess is there was some competition for your receptors with the methadone winning. True precipitated WD would have meant that the methadone was knocked off your receptors and neither of them would have been able to attach, leaving you stuck in precipitated WD hell for a long time.

Does that make sense? I feel like shit. Also, I agree with previous posters, there's no reason why you should be at 200mg. It will make coming off methadone impossible later on and even if you stay on MMT you'll end up higher and higher to accommodate tolerance and those levels of methadone are terrible for your body. I've had to watch my dad's health deteriorate over the last 10 years being on 300mg, it fucked up his testosterone, blood sugar and cholesterol, and all this other unexplained shit.

If you're still having cravings, you need to address that with counseling, meetings, and active recovery.