Codeine & CWE Megathread: Version II - [insert witty title]

[Sustanon]

There is definitely a ceiling dose although it may be much higher than the 400mg that a lot of people suggest although everyone is different. Dont forget that with codeine there are other actives such as Codeine-6-glucuronide. So if one feels higher off 700mg opposed to say 500mg you may be getting more Codeine-6-glucuronide but still same amount of codeine converted to morphine. Was just an example like I mentioned everyone is different, so bottom line is when you have a higher dose and pass that "ceiling dose" which is impossible to predict as its completely different from person to person then you are getting basically the same amount of morphine but higher amounts Codeine-6-glucuronide. So yes there is a ceiling dose but its not exactly 400mg. My dosages range from 500mg-700mg and believe me it feels way stronger than 400mg.


AminoAcid: Ur taking subs because your addicted to Codeine? Good luck tapering off / quitting subs. Subs and methadone are just as hard if not harder to kick than heroin. If one were to quit itd be betetr to go cold turkey off Codeine (wth tapering dosages) and may also use some things to counter act the Codeine WD effects.

 

[tentram]

can you find a source saying there's a definitive "ceiling dose" sustanon.

c-6-g is prominent as an analgesic, not to the high and euphoria the morphine gives when codeine is metabolised so your theory is flawed.

 

[bustabraincell]

For HR purposes, this was recently on the TGA website...
22 August 2012

The Editor of MSU has become aware of an error in this article published in the August 2012 issue of MSU (vol 3; no 4, 2012). The article incorrectly stated 'In a study of 662 patients with severe paracetamol-induced hepatotoxicity, 48% had not exceeded the recommended maximum daily dose of 4g'. The reference which accompanied this statement was also incorrect. The TGA has referred back to the original source cited in the Lubel et al article in the 2007 MJA.

The text should read 'In a study of 662 patients with acute liver failure, 275 were cases of severe paracetamol-induced hepatotoxicity. 131 (48%) of these 275 cases were the result of an unintentional overdose and 19 (7%) of the 275 patients had not exceeded the recommended maximum daily dose of 4g'. The correct reference is:

Larson AM, Polson J, Fontana RF, Davern TJ, Lalani E, Hynan LS, et al. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology 2005;42:1364-72.

However this error does not change the underlying reason for the original article, which was to raise awareness among health professionals that in certain situations, paracetamol-induced hepatotoxicity can occur at normal therapeutic doses and, in fact, was the documented cause of death for a 45 year old Australian woman. Risk factors for paracetamol-induced hepatotoxicity include fasting, regular excessive alcohol use, and concomitant use of drugs that induce cytochrome P450 (CYP) 2E1 (e.g. ethanol).

In addition, there is a risk that consumers may take paracetamol-containing products such as those for the relief of cold and flu symptoms in addition to regular paracetamol for chronic conditions such as osteo-arthritis and therefore unintentionally overdose. Both consumers and providers should ensure that the total amount of paracetamol from any source does not exceed the maximum daily dose of 4 grams.

The author and the editor of MSU regret this error.

http://www.tga.gov.au/newsroom/media-2012-msu-erratum-120822.htm

 

[Captain Brewster]

People should be really careful with this method of codeine extraction, it can be very addictive, especially if you're going through a rough period. I'm actually on Suboxone right now due to abuse of it, and trust me you don't want to be on it. It pretty much puts your whole life on standstill.

Yeah, it's addictive.

How much where you on before you decided to see a subs doc?

 

[pinkanga]

.... but a 45 year old woman actually died from liver failure which was attributed to paracetamol use.... and she was taking less than or equal to 4g a day?

There must be other variables in there. I should probably read the paper I guess.

 

[Captain Brewster]

^ what would you give for a device that reads the amount of paracetamol in liquid.

 

[pinkanga]

Would be handy eh?

 

[junkie skumbag]

Is codeine effective in dosages exceeding 400mg (the classic supposed ceiling dose), I have heard this called bullshit by a lot of people. Does anyone have much experienced with doses > 400mg? And if so, is there any basis to this ceiling dose claim? Personally I have yet to exceed what I yield from a 30 count box of ibuprofen/codeine phosphate (just under 400mg).

Ash.

thats bullshit i've taken wayy over 400mg and gotten way higher.that night i took 1.2 grams i was pushing it tho verrrrrrrrrrrry fucked up tho

 

[Halif]

Bustabraincell: thanks for posting that info from the TGA website. That was interesting.

Ashley: I will add to the consensus being expressed here, and say that IME going over 400mg makes a difference. 700mg is the amount at which I seem to have found my personal 'ceiling' with codeine.

Amino Acid: yes, it's good to remind people that codeine is an opiate, and thus is addictive.

I hold a special place in my heart for opiates because I believe they have literally been lifesavers for me in the past. Years ago I started with codeine, doing CWEs. In the beginning 200mg allowed me to experience a kind of peace which I hadn't previously known. I used codeine on and off for a good couple of years, in increasing amounts, before moving on to 'harder' opiates.

These days even 1,000mg (a gram) of codeine doesn't do anything even remotely close to what those early 200mg CWEs used to, but I still respect it and am thankful for the solace it gave me in times of stress.

Obviously different people like different substances, but it's worth keeping in mind that some substances are higher maintenance than others. Opiates are very special for some people, and if you dip your toes into those bitter waters and find that there's something special there (not just 'oh, that's a nice high', but something almost spiritual in its depth) it may be prudent to stop for a moment and ask yourself if you think this new friend is one worth having with you for the rest of your life.

 

[spacejunk]

Obviously different people like different substances, but it's worth keeping in mind that some substances are higher maintenance than others. Opiates are very special for some people, and if you dip your toes into those bitter waters and find that there's something special there (not just 'oh, that's a nice high', but something almost spiritual in its depth) it may be prudent to stop for a moment and ask yourself if you think this new friend is one worth having with you for the rest of your life.

halif, you've done it again.
simple, true - poetic.
opiates and i have been close for longer than i like to even think about. there's beauty there, but also a stupid amount of upkeep and necessary dishonesty. i enjoy turning people onto drugs like acid, shrooms or dmt...but as much as i like sharing a brew of pod tea or something with a beautiful girl, i always have a fear and a guilt of the drug potentially appealing to that person too much.
opiates can take away your innocence, even if - especially if - it feels so right.
be careful, kids.

 

[pinkanga]

Yeah I like your last paragraph too Halif.

as spacejunk wrote (I would add one more) ... Truth. Simplicity. Poetic. Poignant. Hello my new friend. My life-long friend. Or are you a demon in disguise?

 

[spacejunk]

it's a cruel world, sir.
compromises abound.

 

[Dr Phibes]

Locking this thread would just be masking the symptoms. I like a regular visit here.

As has been mentioned a few posts ago, I find that if I squeeze through cloth and then use a coffee filter, it comes out milky. Whereas if I put it only through a coffee filter it is clear as.

I don't think the milky mixture is any more harmful but I know that the clear one is safe. The coffee-filter-only method takes planning ahead and I would only use the more expensive paracetamol tabs 'cause ibu is heavier and harder to work with, but I a am not getting into methods again lest the thread gets locked.

Anyway hoping for some opinions on the way chemists treat you when buying OTC drugs. I understand that the law requires them to question me when buying codeine based pills but some ask for your name and address. I don't mind this and don't lie, although they never ask for proof, but they are outright lying to me when they say the law requires them to get my details.

I don't think there is a law against them asking for details so I don't question them but today they asked for my Medicare card and swiped it through their Medicare scanner thing. I didn't query them as I thought maybe there is a 1st September new law. Appears not.

Are they going too far into breaching my privacy by wanting to scan my card? Are they going too far with their lies saying the law requires them to do that?

 

[Sonny Jim]

as has been pointed out previously there is a ceiling dose for codeine but it's obviously not 400mg for everyone.

most of you have experienced the physiological effects of breaching the ceiliing dose. These are the extreme codeine histamine reaction that can cause temporary welts, rashes, and hives. There are also cardiovasular flow on effects such as swelling in the lungs and I think mild tachycardia (not sure, this is from memory).

the ceiling dose is simply when you have enough codeine entering your portal/heptaic blood vessels that codeine overflows the liver's detoxing/metabolising enzyme systems and enters on mass into the greater blood stream. Codeine is toxic when it is present in the blood stream in high concentrations but breaching the ceiling dose by a few hundred milligrams via the oral route is unlikely to be fatal due to the gradual absorption from the gut but of course this is not the case with intravenous codeine because of the massive bolus of codeine infused blood travelling through the bloodstream from the injection site which has localised (and systemic) histamine reaction(s) along the way. When this bolus of codeine saturated blood hits the lungs it causes a massive local histamine effect in the lungs, which causes swelling, inflammation in the lung tissue which can become fatal very quickly. I think the cardiovascular effects of codeine overdose are flow on? from the histamine reaction?

 

[footscrazy]

^ Good info, thanks Sonny Jim.

Are they going too far into breaching my privacy by wanting to scan my card? Are they going too far with their lies saying the law requires them to do that?

They're lying when they say they have to, but it's not an uncommon practice for them to take ID or medicare card. A lot of the chemists here ask for a driver's licence. It's upto their discretion.

 

[Dr Phibes]

I agree with the good info Sonny Jim (mostly 'cause I like saying "Sonny Jim") but who IV's codeine?

Footscray, I have no problem showing the chick at the chemist asking to see anything she wants to see but I do not know what or where info goes when they swipe your medicare card. Is it on my permanent record? Whose records? And the lie to get those records. Will my GP know I bought them? I do not know, and that is a problem.

I would show them my license or anything else they may or may not want to see, but I think swiping my Medicare card is going too far. /rant.

 

[Oxyuranus]

I agree with the good info Sonny Jim (mostly 'cause I like saying "Sonny Jim") but who IV's codeine?

Footscray, I have no problem showing the chick at the chemist asking to see anything she wants to see but I do not know what or where info goes when they swipe your medicare card. Is it on my permanent record? Whose records? And the lie to get those records. Will my GP know I bought them? I do not know, and that is a problem.

I would show them my license or anything else they may or may not want to see, but I think swiping my Medicare card is going too far. /rant.

Hey doc,

Not answering your question with certainty, but I am asking my own so thought I'd have a crack... Could they be checking the Dr Shopper list?

I have another question: Is it legal for QLD pharmacies to share s3r purchase details? I have been a cwe junkie in my city for three years now and some chemists have recently begun to share my purchase dates/pack sizes with one another. I am now unable to support my habit reliably. I order online as much as I can but that still leaves half of the month during which I need to purchase from a storefront pharmacy. I'm using 3 x 40 500/15 packs A DAY. Money is no problem for me so am seriously considering a heroin habit. My current codeine habit is $60 a day anyway! (cheaper than what my oxy habit ever was)

Thanks,

B

 

[footscrazy]

^ If you don't want to stop using opiates, I'd recommend switching to poppy seed tea.

 

[pinkanga]

Yeah seeds are really a valid opiate option. I usually do it once or twice a week now. It might not hit you as intensely as codeine or other opiates but it definitely lasts a shit load longer and cna just be really fuckin relaxing. Kinda stating the obvious I guess. Opiates/relaxation etc... and its probably also got something to do with the routine Ive gotten into of late with work and one Friday a fortnight I get off (2-week roster). Ive coined it poppy seed Friday (yeah Im lame ), and Ill usually shake up a kilo of good ol' Hoyts brands (gotta love Coles/Woolworths now and their self-serve check outs, makes it a little easier), anyway a kilo seeds drunk at at around 11 or 12 and basically just max chill podcasts n games all arvo.

Whats the point of this post? Just really digging the seeds of late and thought I'd share! One of the greatest thing about seeds also is the relatively stress-free supermarket purchase to buy them. Compared to fricken hitting a chemist for some sort of codeine product

 

[spacejunk]

seeds are getting harder and harder to source too, i must report.
i used to use codeine daily, but it stopped being worth the cost/hassle for what i got from it. the amount of other people using seeds has risen noticeably in the last year or so, making it harder to find them - and making me worried my supply could be lost if word gets out too much. it's a great little semi-secret but it seems like aus dd is not a good place to advertise it. for the good of all of use that us pst.
my two cents, for what it's worth. but yeah, i agree footscrazy - it's a far better option than so much fucking around for codeine.
even better, grow your own poppies; they're beautiful and easy to grow.