Opioids What would you ask for? Dillies, Percocets, Oxy's?

[AbsolutDoc]

Hello,

I'm a new participator and I posted a thread called my stint of dilaudid IV. A warning and a Question moving fwd...
I invite you to read it for a background on me, but for the sake of brevity ( I have a pain management doc appointment on Thursday) I've shortened my post to these facts and questions:

- I suffer from legit pain from a mesh implant due to multiple hernia surgeries. However, opioids has given me an added benefit as that I don't crave a drink anymore and I'm significantly more upbeat and less depressed.

-I like to snort them as well as take them orally.

-I've been on Percocet 5/325mg #90 but he has switched me this past month to a "safer" Dilaudid 4 mg #90. My doctor is pretty open on finding the right pain med for me.

-He'll want to know what I want to continue with on Thursday... would you stay with the percocets? Go with Dilaudid? or maybe see if I can get back to OxyContin 2x/day 10 mg with oxy 5mg IR for Breakthrough?

I love the energy and pain relief I get orally from percocet, but I love the relaxing, warmness I get from snorting Dillies. Plus, I have to stop sniffing Percocet it's completely dumb and destroying my nose.

All feedback is definitely appreciated!
~Doc
(not a real doctor, just a nickname)

 

[AbsolutDoc]

also, I've mentioned to him that during my time in hospital (4 months) they gave me percocet during the day, because they kept me up, and dilaudid at night, because they made me sleepy -- which wasn't exactly true. He responded "yeah maybe in a controlled environment that's ok, but they aren't usually prescribed together" which was his way of saying "there's no fucking way I'm writing you scripts for both at once." lol

 

[Speed King]

Which would benefit you more without the abuse?
I agree to have a pain medication that helps with pain and makes you feel good at the same time.
Honestly, I'd stick w/ Dilaudid.

 

[legaluser]

Dilaudid id go with.

 

[BeachBum4u]

Is there any chance you could get Dilaudid ER (I think someone on you other thread mentioned it's called Exalgo or basically Dilaudid ER). Hopefully he would add and IR drug for BT, of which I'd choose Oxycodone IR for whatever mg he's willing to prescribe. I believe that would be the best PM cocktail to get the job done. It should provide the PM aspect you need with the IR med for the bad times or whatever purpose you'd use it for. Hopefully the Exalgo would provide a solid baseline of PM that you may be able to use the Oxy IR for pleasure. I think I read somewhere you'd like to have something available for this purpose. Good Luck at your appointment tomorrow (oddly enough I have my monthly PM appointment tomorrow too).

 

[legaluser]

if your just taking them orally Dialudid wont get you as "high" its a much more clear headed high, Oxy would be much more recreational if thats what you want, now if you IV ive heard Dialudid is pretty good, but so is oxy after filtering of course.

So id choose Dialudid if you want pain releif with a more clear head or oxy if you plan on feeling more "fucked up". Thats not to say that Dailudid doesnt feel good, it is quite enjoyable just not the best oral.

 

[Kittycat5]

Oxy without question.

 

[Epiper888]

Oxycodone, preferably Percocet. Dialudid has low BA. I know you like snorting but your taking this for pain not recreational effects and you Probally wouldnt have enough all around coverage. Plus the added acetaminophen in Percocet really helps with pain.

Im guessing you would get perk 10s. You still want lowest amount of acetaminophen to oxycodone ratio

 

[sekio]

Everyone will respond differently to different opioids, find one that works and stick to it...

oxycodone is a good general purpose opioid for oral usage, there's a reason it's so popular. especially if you use it in concert with NSAIDs/other painkillers.

 

[AbsolutDoc]

Thanks everyone for your input. He put me on Morphine Sulfate 30 mg ER generic MS Contin. I told him I've taken an Extended Release before, I played dumb as to what the exact drug was and that they gave me something for "Break Through" pain and I'm pretty sure it didn't have tylenol in it. He cut me off and was just yeah but that's not the best to have in an uncontrolled environment. Despite the lack of IR's I was pretty excited when I saw MS Contin because of what I remember reading in these forums. Until the next day I was in pain and nauseous, and started reading forums. And the consensus was that Morphine ER sucks! And I completely agree. I tried snorting it. I sucked off the coating, and completely powderized the pill. I sifted out the heavy particles that weren't able to break down to powder. (Same thing I used to do with Tramadol) and I found there was no difference. I did very little and haven't tried it nasally again because I haven't found the time to set aside in case I get really fucked up and nod out and can't function.

Anyway, He offered to either put me back on Percocets but something funny..

He offered to up my Dilaudids to 8mg!
Should I have just taken that offer?

I miss my percocets. I think they worked best for me. I'm irritable, moody and in pain. I'll ask, as someone suggested, for 10/325 instead of 5/325.

 

[tricomb]

You know that snorting percocet is horribly ineffective right?
And so is snorting morphine sulphate? Morphine does NOT suck. It's incredible at what it does, 30mg is a tiny dose of it for chronic pain patients, I wouldn't expect much from that...

Anyways in re: your breakthrough pain medication, hydromorphone/dilaudid is FAR more potent than oxycodone and is much better for breakthrough pain in my opinion and in my experience as a chronic pain patient. However oxycodone is pretty reliable for a lot of people and if you prefer it, why not ask for Roxicodone 10mg instead of percocet so you don't need to be consuming any acetaminophen that you don't need?

 

[SKR]

^Yes I have to agree with Tricombs comments, morphine is great but you've got a low dose to get good effect from it orally or nasally as you've discovered. You want that oxy imo, I'm a chronic pain sufferer and I have to work and have to run around after a toddler, the stimulation from oxy is incredibly helpful. Ultimately I would like oxy in the morning and an IV/IM or subcut shot of morphine in the evening.....but you can't always get what you want.

 

[SluttyPeach]

You know that snorting percocet is horribly ineffective right?
And so is snorting morphine sulphate? Morphine does NOT suck. It's incredible at what it does, 30mg is a tiny dose of it for chronic pain patients, I wouldn't expect much from that...

Anyways in re: your breakthrough pain medication, hydromorphone/dilaudid is FAR more potent than oxycodone and is much better for breakthrough pain in my opinion and in my experience as a chronic pain patient. However oxycodone is pretty reliable for a lot of people and if you prefer it, why not ask for Roxicodone 10mg instead of percocet so you don't need to be consuming any acetaminophen that you don't need?

Perfect answer. But go with whatever you feel works the best. By the way, snorting Percocet will fuck up your sinuses something fierce.

 

[Kittycat5]

I think AbsolutDoc has discovered that and was talking about sniffing morphine and Dilaudid in his last post. If you like Percocet, try to get that again. As mentioned oxycodone combined with non-opioid analgesics is very beneficial to many. Just dont take too much. You could probably benefit from an ER med, whatever it may be, on top of the Percocet.

 

[Screaming_Skull]

Dillies, if you don't wanna bang em anymore PLUG THEM!!!! It works soooo much better than oral or snorting them. TRUST! I would say Oxy but you are only getting percoets....go with the dillies for a while then say you think you need something that's time-realeased to go with it, like OP 30's, don't say it like that though, just say you think you need something time-released to go with the dillies, what is your opinion on this doctor?? Do you think it would help me to be on something time-released or do you think upping my dillie dosage would be a better option to help with the pain?

 

[Conspirator]

Go with the dilaudid. It's honestly one of the best PM medications out there. If you feel that you may need something ER, you could always crush up some of the pills and extract the dilaudid with water and use the solution orally (25%BA) Nasally (50%BA) Im not sure the plugging BA, but it's easy to find. 8mg oral dilaudid is equivalent to like 20-25mg oxycodone IR, therefore, if need be, you could use a combination of different doses and ROAs in order to get all day pain relief.

Personally, I recommend taking 4mg dilaudid 4x daily for chronic pain and overlap 2-4mg intranasal doses for breakthrough pain. I recommend making a solution for nasal use as it's better for the nose, and very easy to do.

If you can get 8mg dilaudid IR, take the script and fucking shut up. 8mg dilaudid nasally is equal to like 40-55mg oxycodone oral. If you feel the apap helps, just take a tylenol with it. I also find that oral dilaudid is a more clear headed high than oral oxycodone, and nasal dilaudid is a bit more sedating, but will still give you a bit of energy at first. You can experiment to find the right dose and ROA combo for you. Dilaudid > any other opiate other than pharma grade heroin.

When i was younger, before my tolerance got too high, I used to snort 2-4mg dilaudid solution before any hardcore physical training or martial arts because it made it easier to fight the burn, but it didn't sedate me whatsoever as long as I kept my mind or body active. That's the great thing about dilaudid is that it sort of fits into any situation, if you're mentally or physically active, it doesn't make you sleepy, but if you're trying to relax, it will be more relaxing.

Dilaudid is also more lipophilic and has a higher binding affinity which means that it kicks in faster and hits harder and is more likely to knock out the pain with one swoop rather that dampen it.

the general rule is that if you are ever offerred Dilaudid that isn't ER, just shut up and take the script.

 

[tacodude]

get the oxycotin ER to take one morning dose and half both at lunch and night making 2 doses daily total as maintenance. Then for breakthrough request either the dilaudid, morphine, or oxymorphine IR for breakthrough pain..... You probably would be better sticking with dilaudid.

 

[AbsolutDoc]

Go with the dilaudid. It's honestly one of the best PM medications out there. If you feel that you may need something ER, you could always crush up some of the pills and extract the dilaudid with water and use the solution orally (25%BA) Nasally (50%BA) Im not sure the plugging BA, but it's easy to find. 8mg oral dilaudid is equivalent to like 20-25mg oxycodone IR, therefore, if need be, you could use a combination of different doses and ROAs in order to get all day pain relief.

Personally, I recommend taking 4mg dilaudid 4x daily for chronic pain and overlap 2-4mg intranasal doses for breakthrough pain. I recommend making a solution for nasal use as it's better for the nose, and very easy to do.

If you can get 8mg dilaudid IR, take the script and fucking shut up. 8mg dilaudid nasally is equal to like 40-55mg oxycodone oral. If you feel the apap helps, just take a tylenol with it. I also find that oral dilaudid is a more clear headed high than oral oxycodone, and nasal dilaudid is a bit more sedating, but will still give you a bit of energy at first. You can experiment to find the right dose and ROA combo for you. Dilaudid > any other opiate other than pharma grade heroin.

When i was younger, before my tolerance got too high, I used to snort 2-4mg dilaudid solution before any hardcore physical training or martial arts because it made it easier to fight the burn, but it didn't sedate me whatsoever as long as I kept my mind or body active. That's the great thing about dilaudid is that it sort of fits into any situation, if you're mentally or physically active, it doesn't make you sleepy, but if you're trying to relax, it will be more relaxing.

Dilaudid is also more lipophilic and has a higher binding affinity which means that it kicks in faster and hits harder and is more likely to knock out the pain with one swoop rather that dampen it.

the general rule is that if you are ever offerred Dilaudid that isn't ER, just shut up and take the script.

Thank you Conspirator, I just laughed my ass of at your advice of just shut up and take the fucking script!
But seriously I've noticed over the past for days, I've been on just the morphine ER and 4mg Dilaudid crushed and snorted here and there that I HAVEN't gotten sleepy! I used to use it strictly only when i was taking percocets which gave me social and all around energy or by itself when i wanted to relax and go to sleep.

But since that has been my only drug I've used it before making important phone calls, going out to do yard work. It DOES kick in a lot faster, you're right and it DOES amplify whatever you're doing...

1) physical work - pain free, not achy and not tired...
2) At the end of the day laying down to fall asleep to some TV- perfect to nod off.

WTF? have i found the miracle pain med? I wonder how it will work without the morphine ER because it sounds like he doesn't want to prescribe both at the same time and as I might've mentioned in this thread and to answer someone else's question - my doctor seems like he does NOT want to give me either Oxy IR's or Oxy ER's. If he did, I wouldn't be on here right now.

I'm going to call him right now and if I speak to him and/or set an appointment I'll say that this ER situation isn't working, "maybe we should try YOUR idea of the 8mg does of hydromorphone" to remind him it was his idea after all. What are some of the side effects I should mention about ER morphine.. 'it makes me sleepy, hard to concentrate, I like the idea of being able to control when I take pain meds?" shit like that?

 

[Conspirator]

Thank you Conspirator, I just laughed my ass of at your advice of just shut up and take the fucking script!
But seriously I've noticed over the past for days, I've been on just the morphine ER and 4mg Dilaudid crushed and snorted here and there that I HAVEN't gotten sleepy! I used to use it strictly only when i was taking percocets which gave me social and all around energy or by itself when i wanted to relax and go to sleep.

But since that has been my only drug I've used it before making important phone calls, going out to do yard work. It DOES kick in a lot faster, you're right and it DOES amplify whatever you're doing...

1) physical work - pain free, not achy and not tired...
2) At the end of the day laying down to fall asleep to some TV- perfect to nod off.

WTF? have i found the miracle pain med? I wonder how it will work without the morphine ER because as I might've mentioned in this thread and to answer someone else's question - my doctor seems like he does NOT want to give me either Oxy IR's or Oxy ER's. If he did, I wouldn't be on here right now.

I'm going to call him right now and if I speak to him and/or set an appointment I'll say that this ER situation isn't working, "maybe we should try YOUR idea of the 8mg does of hydromorphone" to remind him it was his idea after all. What are some of the side effects I should mention about ER morphine.. 'it makes me sleepy, hard to concentrate, I like the idea of being able to control when I take pain meds?" shit like that?

I'd mention side effects that are more common with morphine than dilaudid first such as moderate itching, itchy eyes... Also, morphine is more sedating than dilaudid based on anecdotal evidence, so also mention drowsiness, You should also mention that due to the itching and itchy eyes, you have to take 50mg benadryl to aid with the itching, but that the benadryl makes you even more tired than you already were. You could even throw in an oddball side effect like that it makes it very very difficult to urinate. Urinary retention is a side effect common to all opioids, but it is uncommon and relatively unknown to most users so it could make your claim sound more genuine.

This is simply what the doctor would rationalize and not what you should tell him, just allow him to come to this conclusion.
The doctor would probably chock urinary retention up to the fact that ER morphine keeps a consistent amount of morphine in your system therefore not peaking and weaning which would cause consistent urinary retention rather than IR drugs which will peek and when they wean, the urinary retention will too... hence allowing you to pee with ease once every 4 hours rather than once every 12 hours.

I forgot to mention that morphine, codeine and hydrocodone seem to cause the largest histamine release compared to others, and if he's against oxycodone, than you just won the dilly lotery. It baffles me how little PM doctors actually know about drug abuse, but they still try to prevent it with their own twisted ideology. Any sound minded junkey would take dilaudid over oxycodone as IV 8mg dilaudid is equal to 80mg oxycodone... Be glad you have the doctor that you have.

 

[AbsolutDoc]

Thanks for your assistance and advice Conspirator... I have noticed all those side effects with opiates as well but that is an excellent point with the 12 hour vs. the 4 hour urinary retention.I haven't called yet as I was busy doing other shit, but good thing I did because I got some good advice from you.

It's funny - you make me feel like a guy with a winning lottery ticket to a currency of a country I never visit.

I would much rather oxy er and ir's but from your insight - I'm beginning to come over to the (dark) other side.

I might remind him of the 8mg he offered to write me and then suggest that I stick with the 4mg, but just more of them (#120 instead of #90). Does that sound non-seeking. Because I'm comfortable with the 4mg of dilaudid if that's what I'm going to get (I can always take him up on the 8 mg later) rather than oxy's.

Another thing I was wondering is if this new found fondness of Dillies is from the Morphine ER creating a base line for me. so I was thinking maybe I should just suggest that it's not enough with just the ER. I'm afraid If I say anything about the itching or urine retention, he might just take me off of opiates all together and try a synthetic opioid or something I can't even think of.
Thoughts?