Opioids Why does Codeine not work for me?

[tacodude]

It is.... Just got 15 mg er morph 2x today. Dosed way to low, but just restarting a new program

 

[Backfromthebrink]

Codeine is a stupid drug that shouldnt be prescribed, unreliable for pain relief, often useless and dangerous if you are a quick metabolizer. produces an unknown amount of morphine in anyone. Why low dose morphine isnt always prescribed instead I do not know

It's an acceptable pain killer in certain circumstances...and dont forget it's directed for "mild to moderate" pain only....

Also thought to have pain killing effects above simply its conversion to morphine...it's an effective anti diahorria and anti tissutive medication also...

Plus far less chance of abuse than morphine, which doctors love

 

[oxyloveUK]

Morphine could be used for mild to moderate pain too and wouldnt have the same risks for rapid metabolizers.

Its got to be the abuse thing but if someone likes opioids theyll abuse anything, codeine abuse is massive in the UK

 

[Backfromthebrink]

Its got to be the abuse thing but if someone likes opioids theyll abuse anything, codeine abuse is massive in the UK

Yeah, I'm feom the UK. I work in the medical profession too and i wouldn't say "massive"..

True that people will abuse anything but rhey can get themselves into far less trouble than with say morphine or oxycontin.

And as I say, for people purely with mild to moderate pain who aremt trying to get high, just control their pain, 60mg codeine phisphate snd 1000mg paracetamol is more than adequate.. morphine and oxy are only needed for moderate to severe pain...

The main problem in the UK is the gap between weaker opiates like codeine and tramadol to the strongest ones like morphine, oxy and fentanyl.. there is no middle ground.

 

[tacodude]

Morphine and hydrocodone would probably be middle ground for proper oral use. Heavier use is not, but same could be said about high dose codeine as it would be like morphine at some point especially for a certain few while some might get nothing from it.

I actually had some stomach bug and the 5 mg hc I was using stopped working for a week or two. That really fucked me up. I'm not trying to be on codeine formulations anymore.

 

[oxyloveUK]

Totally agree about high dose codeine^ sorry about your stomach bug

Hydrocodone is great for middle ground, would be great in the NHS

https://www.youtube.com/watch?v=4vK1KuwjPJ8

People might not talk about it but it is here, Ive worked with codeine abusers. Wouldnt call it a major problem tho

 

[Backfromthebrink]

The thing with codeine though is the ceiling dose above which it won't really do anything...

Plus there's no scope for anything other than oral use...

These 2 things alone make it be far less abusable drug than morphine..

Of course it's still abused but there is a reason why morphine is a controlled drug and codeine isn't

 

[Jabberwocky]

I've tried codeine at high doses as well and it has literally done nothing to me. Same with tramadol.

 

[Forever Changes]

The pods/seeds have the usual morphine & codeine as the most common alkaloids. Like, swamping the rest.

so even if I lack the CYP2D6 enzyme, pod tea might still be effective?

 

[Lorne???]

If is rare to be a poor metabolizer; and a zero more rare.

Most are aperranlty intermediate or extensive metabolizers

And Pure Codiene can be injected IM(intramusculary) and, it is 1.5-2 as potent, although pure codiene is rare, and rightfully so; IV administration is dangerous, and possibly lethal
(Nite that IV Tramadol, injected slowly and properly, results in double the amount of the opioid active metabolite, AKA M1 for sake of simplicity although even slowly it Ivan produce effects that are rapid and complete, although Tmax < 2rs IV- for M1 via 2D, more like 3-4hrs for by mouth.

Please do not inject Tramadol in any form;

For intrstructional/informative purposes
Only

 

[oxyloveUK]

so even if I lack the CYP2D6 enzyme, pod tea might still be effective?

Yeah the morphine in them doesnt need enzymes to work

 

[Forever Changes]

does anybody know if lacking the enzyme would affect the effectiveness of kratom, bearing in mind that kratom is not strictly an opiate I think?

 

[Backfromthebrink]

If is rare to be a poor metabolizer; and a zero more rare.

Most are aperranlty intermediate or extensive metabolizers

And Pure Codiene can be injected IM(intramusculary) and, it is 1.5-2 as potent, although pure codiene is rare, and rightfully so; IV administration is dangerous, and possibly lethal
(Nite that IV Tramadol, injected slowly and properly, results in double the amount of the opioid active metabolite, AKA M1 for sake of simplicity although even slowly it Ivan produce effects that are rapid and complete, although Tmax < 2rs IV- for M1 via 2D, more like 3-4hrs for by mouth.

Please do not inject Tramadol in any form;

For intrstructional/informative purposes
Only

On the box of tramadol amps it say "FOR SLOW IV PUSH ONLY".

They used to give paramedics in the UK them at one point....then Nubain. Now finally seen sense and just morphine since the associated headaches with tramadol and nalbuphine just complicate and already complicated situation further

 

[Lorne???]

Yeah, IV Tramadol is overwhelming, and not ina goodnway, and it is not like it!fades.

And more than 100mg? Was never crazy/desperate enough to try that myself!

 

[Backfromthebrink]

Yeah, IV Tramadol is overwhelming, and not ina goodnway, and it is not like it!fades.

And more than 100mg? Was never crazy/desperate enough to try that myself!

IIRC the amps we used to get at work were 100mg/2ml but we would dilute to 100mg/10ml (as we do with morphine) in order to titrate easier and also to ensure a slow push.... It wasnt a great choice of analgesic really, and after a breif dalliance with Nubain, switched to parenteral and oral morphine supplemented with entanox.

And fentanyl/ketamine/midazolan only for use when performing a RSI which requires extra training so not everyone can do that.

Interestingly (for me anyway lol) in Australia, paramedics use intranasal fentanyl (liquid squirted up the nose....There's an interesting story about a one paramedics consuming it themselves and refilling the vial with H20 which is a pretty low thing to do

 

[Lorne???]

^ Wow, what a prick move

Yeah, you would need to dilute that, for many reasons

and codeine has it's place, and being less abusbable makes it otc in many ciuntries(albeit low doses, though that is what CWE is for)

Agree that doctors should be patently aware that its effectiveness shall vary, especially in the states, where it is pretty much RX only now( a couple of states you can still TECHNIY get formulations without a prescription from a pharmacy, good luck though)

 

[Backfromthebrink]

^ Wow, what a prick move

Yeah, you would need to dilute that, for many reasons

and codeine has it's place, and being less abusbable makes it otc in many ciuntries(albeit low doses, though that is what CWE is for)

Agree that doctors should be patently aware that its effectiveness shall vary, especially in the states, where it is pretty much RX only now( a couple of states you can still TECHNIY get formulations without a prescription from a pharmacy, good luck though)

Interestingly Lorne..up until the early 2000s there was no limit on how many co-codamol you could buy in one go and they came in bottles of 100...now you can only buy 1 pack of 32 per chemist shop although this is at the chemists discretion whether they sell you more than 1...but they usually won't give you any more than 1 (people just go to several different chemists)...They sometimes give a stock verbal warning about only taking for 3 days before seeing a doctor and codeine can be addictive etc...but then just give it to you anyway....

The reason for only selling one pack of 32 at a time though is for the paracetamol not the codeine . there was a law brought in to limit the amount of paracetamol per pack to 32 and amount purchased to 1 pack .seemingly to prevent intentional overdose. ...which of course it doesn't.

It seems the government is far more worried about the paracetamol than they are the codeine.

 

[Forever Changes]

^ and yet they put paracetemol in everything!

govt have their priorities all screwed up 8(

 

[Forever Changes]

this is interesting. Apparently there's a drug called Glutethimide which induces the CYP2D6 enzyme. might be worth trying if you lack the enzyme for codeine metabolisation

https://en.wikipedia.org/wiki/Glutethimide

I can't find out if it's OTC or you need a prescription for it though

 

[Scrofula]

Meanwhile, Johnson & Johnson, corporate owners of Tylenol since the fifties, struck twice: not just with the "headache wars" of the 80's (like the Cola Wars, I still get flashes of PTSD). Compared to Aspirin and Motrin (ibuprofen), Tylenol (paracetemol/acetaminophen) was the shortest-lasting, least effective and most toxic (and still is), but what does data matter when you got good commercials? Yes, it would turn out paying off the FDA helps too.

So when there was a tall enough mountain of evidence for liver damage due to Tylenol, the FDA finally had to say, "excuse us, sirs, we need you, uh, to at least put a warning on it that you shouldn't take Tylenol if you drink alcohol." Johnson & Johnson said Fuck That Noise, and wrote a compromise on another check to the FDA, such that some booze is ok, a vague 2-3 drinks per day (a lot of booze) and that ALL painkillers on the market everywhere must ALSO carry the same warning. Not to start that thread again, but you can drink alcohol and use aspirin and ibuprofen without worrying about your liver. (Might be bad for stomach bleeding with Aspirin and Aleve though.)

This story has been going on for over forty years and only recently has the FDA decided to try at least reducing the amount of unnecessary toxic chemical in like all the products in WalGreen's. It's only in there to make it harder to get rid of anyway. Tylenol PM is really just Benadryl people, with half your daily max of Tylenol. For no reason, other than to keep Tylenol that much more insidious in the face of recall. It's probably in the Flint drinking water too.

Apparently there's a drug called Glutethimide which induces the CYP2D6 enzyme.

Yeah, you can stop at "hypnotic sedative." Not OTC. There are hardly any inducers of CYP2D6, and of the ones available, none are worth taking just to get a codeine buzz.