Opioids Fully Synthetics Cutting Through On MMT - Fentanyl, Demerol, Tramadol, Tapentadol

[muie]

If one is ill or gets injured during MMT (Godforbid), most people are on a blockade dose (70mg-90mg), so if they require any pain medication they need to rely on the NSAIDs but also the fully synthetic opioids!

It is said that when one takes opioids on a blockade dose of methadone, one doesn't feel them or at least not psychologically but the body does indeed get the respiratory depression, cough suppression, constipation, pin point pupils, increased tolerance, increased itching, etc. Not the case in my experience though! I feel that whatever it is I take on top of methadone (180mg/day) is a huge waste, though I've never had IV nor IM in all my years as a veteran user. Recently though I've noticed something....

I've gotten a tolerance where 400mg methadone is okay but 9hrs after dosing I felt like my receptors weren't covered so I smoked some fentanyl and now I am high on fentanyl undeniably so!

This begs me to ask the question:

Why is it that MMT users when in pain are given fully synthetic opioids (fentanyl, Demerol, tramadol, tapentadol)?

It must be that those are the ones which can break trough!? Try snorting Demerol or better yet snort/smoke fentanyl on a very high dose of methadone *if you aren't nodding like usual from it* and then tell me.

 

[nothing87]

If one is ill or gets injured during MMT (Godforbid), most people are on a blockade dose (70mg-90mg), so if they require any pain medication they need to rely on the NSAIDs but also the fully synthetic opioids!

It is said that when one takes opioids on a blockade dose of methadone, one doesn't feel them or at least not psychologically but the body does indeed get the respiratory depression, cough suppression, constipation, pin point pupils, increased tolerance, increased itching, etc. Not the case in my experience though! I feel that whatever it is I take on top of methadone (180mg/day) is a huge waste, though I've never had IV nor IM in all my years as a veteran user. Recently though I've noticed something....

I've gotten a tolerance where 400mg methadone is okay but 9hrs after dosing I felt like my receptors weren't covered so I smoked some fentanyl and now I am high on fentanyl undeniably so!

This begs me to ask the question:

Why is it that MMT users when in pain are given fully synthetic opioids (fentanyl, Demerol, tramadol, tapentadol)?

It must be that those are the ones which can break trough!? Try snorting Demerol or better yet snort/smoke fentanyl on a very high dose of methadone *if you aren't nodding like usual from it* and then tell me.

Fentanyl has an extremely high binding affinity for mu-opioid receptor and can oust methadone that already occupies a receptor site and take its place.

Demerol, tramadol, and tapentadol are not only opioid agonists, but also exert action on norepinephrine, dopamine, and serotonin receptors. Their opioid effects are not very significant when on methadone (to my knowledge they do not have the binding affinities required to remove methadone and then occupy the receptor site). The activity on NE, DA, and SERT provides pain relief through additional mechanisms.

 

[nasir~]

This has nothing to do with “synthetic“, “semi-synthetic“ or natural opioids/opiates.

Just like 'nothing87' said, it's all about binding affinity and also potency to some extent.

IV Morphine was able to “break through“ my maintenance dose of methadone(180mg at that time).

Pharmaceutical grade diacetylmorphine was able to break through(the methadone) with ease.

 

[RandomClean3]

If one is ill or gets injured during MMT (Godforbid), most people are on a blockade dose (70mg-90mg), so if they require any pain medication they need to rely on the NSAIDs but also the fully synthetic opioids!

It is said that when one takes opioids on a blockade dose of methadone, one doesn't feel them or at least not psychologically but the body does indeed get the respiratory depression, cough suppression, constipation, pin point pupils, increased tolerance, increased itching, etc. Not the case in my experience though! I feel that whatever it is I take on top of methadone (180mg/day) is a huge waste, though I've never had IV nor IM in all my years as a veteran user. Recently though I've noticed something....

I've gotten a tolerance where 400mg methadone is okay but 9hrs after dosing I felt like my receptors weren't covered so I smoked some fentanyl and now I am high on fentanyl undeniably so!

This begs me to ask the question:

Why is it that MMT users when in pain are given fully synthetic opioids (fentanyl, Demerol, tramadol, tapentadol)?

It must be that those are the ones which can break trough!? Try snorting Demerol or better yet snort/smoke fentanyl on a very high dose of methadone *if you aren't nodding like usual from it* and then tell me.

If you think of the natural/semi-synthetic opiates they're all pretty much alike. Morphine, codeine, hydrocodone, oxycodone, hydromorphone, oxymorphone, dihydrocodeine, heroin and others, they have differences in potency, prefered method of administration, but they all bind to the opioid receptor essentially the same way. Methadone is used because it somewhat blocks heroin, so you can guess it will block the entire family since they all bind the same way, don't have any other mechanism of action, are metabolized more or less the same and if you set heroin as the standard potency, none of them are particularly potent. Oxymorphone is maybe 4 times as potent, but if you're dealing with blocked receptors then fentanyl is the only thing widely prescribed that can break through. PLEASE don't abuse demerol if you have that kind of tolerance, the amount you'd need for a high would be neurotoxic and possibly lethal.