codeine, oxys and methadone.

[misk]

just curious as to what this combination would bring about once the codeine has been broken down.

i understand that whatever morphine has been converted will be blocked when the methadone is in the system, but as a curiosity, what would the outcome be?
ie. i understand it will effect the amount of morphine that will work, but will it interact with any of the other metabolites that give say some of the slight stimulation, jitteriness and what not that comes when having 400mg codeine just before 50mg of methadone just before the methadone his hit its peak.

i'm also curious about the effects of combining 50mg oxycodone with 50mg methadone.

now, dose size regardless, are their any opiates that can be combined with methadone without the standard properties of the drug being effected at all, or very little?


PLEASE note, i am not after a high, this is genuinely just a curiosity of mine.
the figures i have mentioned is because that is just what i have on separate occasions - DO NOT read this thinking that theses drugs together are ok at these doses without reading the responses posted below from users with the relevant knowledge; i understand combing obiates must not be taken lightly and don't want the wrong message being sent...

 

[Mr Blonde]

Depends on tolerance, and the methadone 'blockade' effect doesn't kick in until around 80mg or higher if I remember correctly. As methadone and oxycodone are both stronger opioids, I imagine they will overpower the morphine/codeine high.

 

[misk]

shit sorry, didn't make myself too clear lol, fuzzy screen was winning vs typing.

i never really understoodthe process but i guess its a bit of stronger meds vs stronger meds on the same receptors?

i had 50mgmethadone 1.5hours ago and will have 5mg oxys. the 50mg methadone feels like what the last 30mg dose did (i've had one 50mg dose since then), but i've only ever had 2x 20mg oxy XR.

so im unsure on how much oxy will be safe, but was thinking 10 -15mg on its own.
or should i have the 400mg codeine and less oxys, remembering that codeine does sweet fuck all to me, but maybe have a positive effect on this combo?

 

[Mr Blonde]

^ I'd leave out the codeine seeing as it doesn't affect you, and stay with what you know works. The methadone and oxycodone will be competing for some of the same receptors, which will lead to slightly different effects but the methadone definitely will last longer then the oxycodone will.

Adding 10-15mg of oxycodone should be fine, it's not that great a dose. It's when you add CNS depressants that work through different methods, e.g. alcohol, benzodiazepines, etc... that you can run into trouble easily.

 

[pisspotnrock]

TBH, I would chill out on the opiates and just take one at a time in a semi large dose if you have a tolerance but thats just me and I rarely touch opiates...

fuck I'm sorry I missed that last paragraph.. still, curiosity kills the cat

 

[misk]

hmm
well i think i had the done around 3-4pm and just had the oxyal
took 5 (25mg) cause the done probly wasn't a biig enough dose for me anyway, coul have had around 80mg i reckon.
guess ill see what happens and just have a few more if need be.

never had an instant release oxy before. whats the average length onset>

 

[misk]

TBH, I would chill out on the opiates and just take one at a time in a semi large dose if you have a tolerance but thats just me and I rarely touch opiates...

fuck I'm sorry I missed that last paragraph.. still, curiosity kills the cat

i don't have opiates often, but i build tolerances to some meds realllly quick.
surely my random 200-400mg of codeine use isn't enough to for kill all opiates for me
i've only had methadone 4 times including today
15mg, 25mg, 50mg and 50mg today, but spread out over once ..

 

[pisspotnrock]

hmm
well i think i had the done around 3-4pm and just had the oxyal
took 5 (25mg) cause the done probly wasn't a biig enough dose for me anyway, coul have had around 80mg i reckon.
guess ill see what happens and just have a few more if need be.

never had an instant release oxy before. whats the average length onset>

cant remember, I was drunk and nodded off last time I had the endones haha

 

[misk]

so snorted 4 more last night after have 2mg xanax and 30mg oxazeapam and 16 nurofen plus.
didnt feel much for around half an hour, the climbed into bed, then woke in the back of an ambulance
had a naloxone shot or two apparently and spent some of he day in the hospital

i owe my life to my girlfriend who called 000 when my lips went blue. the paramedics and hospital where very good about it all also.

i thought i left ample time between the oxy doss, but maybe not
regardless, anyone thinking of attempting any of these combos, take care and take things slowly. i had no forewarning at all and ended up in serious situation.

thankfully i was lucky

 

[Mr Blonde]

^ I'm glad to hear you are OK brother! Hopefully your post will help others out in choosing how to use their opioids in the future.

 

[misk]

yeah was fine after the naloxone, but not really sure how i got in such a bad state.
id have to hazard a guess and say the methadone was in the background enough to fuck with things

 

[madmick19]

hey misk and everyone here on BL, this is a good lesson to be learnt about mixing substances especially when your not sure of your tolerances. always have another person with you if your playing with opioids, and have a plan with your friends in case someone drops - eg call the ambo, put into recovery position, maintain airway ect.

the blockade effect of methadone is not just due to reaching a specific dosage but is also related to increasing a persons tolerance from day to day administration of a medication in increasing quantities= eg the reason it have a blockage effect is because of the repeated administration of the drug and tolerance (synaptic changes/ down regulation of the Mu opioid receptor from memory) if will not have a blockade effect on one dose- due to the high potency and long half life methadone can very very fatal reaching LD50 exceedingly quickly in opioid naiive users. the reason why there are not more fatalities is due to the fact it is mainly used in areas where people have already high tolerances. **** that is also why people are started on low doses say 30 stabilized on that for a week and then increased every third day to account for the long half life and need to build tolerance to make the treatment effective*** people have died on less misk.... you are lucky that your girlfriend reacted the way she did and call the ambulance.

if your going to mix opioids there are some rough equivalence guides available- do some research if your going to paly round with the unholy trinity (benzo-opioids and alcohol) this combo always makes doctors and people trained in AOD nervous about a persons saftey.

and the potentiating effects of benzos and alcohol should also be considered- yes while you may become more stuporours and high this also problematically increases the potential for you to have adverse effects from use as heard above- respiratory depression (stopping breathing). so you gotta weigh up getting mre high with increased odds of doing yourself harm. btw what was the ambulance response time?

 

[misk]

i've had enough experience with all that i took except the oxys.
after the first 25mg whilst the methdone was still felt to be active (around 7 or more hours after methadone dose), the 25mg did barely anything, just a very subtle change in what i felt.
my partner had the same doses of both drugs with me and she was fine also - she didn't have the second combo as i was in a bad state by the time she came back from a smoke outside.

so gave it another couple of hours, by then over 24 hours since taking the methadone and snorted 20mg oxy, and had the 2mg xanax and 30mg oxazepam.
i was doing reading and research the entire time both before and whilst on the substances, so please don't think i was having random combos for kicks, i was confident it wasn't going to be harmful, but obviously the combo didn't agree with me.

my partner and I have both had first aid training in the past and she had me in the recovery position but my jaw was clenched tight to check my airway; she called 000 at this time.

i think the downfall was adding the benzos and nurofen plus.
benzos have little effect on me alone and have had experience with them on methadone before, but it was maybe just the wrong combo for me.

for the record, i always research anything i'm taking as much as i can and still err on the side of caution and would never attempt anything like this on my own or without whoever is with me knowing the potential effects of the drugs, length of time they will be present and what to do when things go bad.
its not excuse for what happened, but we always discuss drugs and the reasons behind certain 'highs' so there is less guessing involved if anything goes wrong.

there was no alcohol present as i am aware of the issues that can bring about when mixed with some drugs and would definitely not have attempted mixing it with benzos and opiates at the same time.

 

[pisspotnrock]

.......... and 16 nurofen plus.

hahhaahhahahahahahhahhhhhhhhhhhhhahahhahahahahah

sorry, this is a very serious subject but mixin all those opiates is hectic enough and then you added the whole 'and 16 nurofen plus' which was the icing on the cake haha just made me crack up..

HR note, dont do that again..

EDIT: Holy fuck I am so sorry, I just read the first line of your post earlier and replied straight away.. soo glad so here you alright.. as I said earlier "I would just chill out on the opiates n take one at a time"

 

[Christ!]

Glad you're alright dude.

It was good of you to be honest and share your experience, people need to read about things like this. Lesson learnt I hope.

Mixing opiates is a bad idea unless you're really experienced with them. In general, mixing opiates has never appealed to me anyway, as I find them to be much more enjoyable taken one at a time.

Adding benzos to opiates is a bad idea, always. Even multi-decade long opiate addicts drop from this combo. If you are going to try it, be careful and start with super low doses.

It was lucky your girlfriend was around and you did the right thing by trying to research.

Mentioned above but methadone is a sly bastard. Has such long lasting effects and even when you think you're sober it's still there. Methadone is probably one of if not the worst opiates for non-experienced users, adding benzos to the mix (and/or alcohol) is more dangerous than just about any other combination I can think of.

/end rant.

Again, glad you're alright...I read your post last night where "15mg, 25mg, 50mg and 50mg today, but spread out over once .." and was a bit worried.

 

[misk]

i miss typed that bit lol, i meant to say was taken over a long period.
never went any less than 2 weeks between a dose at the shortest period.

i think it was the benzos that bought me undone, even with a high tolerance to them alone it was a silly choice.
i had taken only 50mg of methadone on the day, long before the oxys and was over 12 hours when i took the second set of oxys.

 

[NotAgain!!]

Interactions between your selected drugs
codeine ↔ methadone

Applies to: codeine, methadone

MONITOR: Drugs that are inhibitors of CYP450 2D6 may interfere with the analgesic effect of codeine. The mechanism is decreased in vivo conversion of codeine to morphine, a metabolic reaction mediated by CYP450 2D6.

MANAGEMENT: The possibility of reduced or inadequate pain relief should be considered in patients receiving codeine with drugs that inhibit CYP450 2D6. An increase in the codeine dosage or a different analgesic agent may be necessary in patients requiring therapy with CYP450 2D6 inhibitors.
codeine ↔ oxycodone

Applies to: codeine, oxycodone

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
methadone ↔ oxycodone

Applies to: methadone, oxycodone

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.
Other drugs that your selected drugs interact with

codeine interacts with more than 300 other drugs.
methadone interacts with more than 400 other drugs.
oxycodone interacts with more than 300 other drugs.

Interactions between your selected drugs and food
methadone ↔ food

Applies to: methadone

GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of methadone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. In 8 study subjects stabilized on methadone maintenance treatment, ingestion of regular strength grapefruit juice (200 mL one-half hour before and 200 mL simultaneously with the daily methadone dose) for five days resulted in an approximately 17% mean increase in methadone peak plasma concentration (Cmax) and systemic exposure (AUC) and a 14% mean decrease in apparent clearance for both the R(+) and S(-) enantiomers. Grapefruit juice did not affect the time to peak level (Tmax), terminal half-life, or apparent volume of distribution of methadone. No signs or symptoms of methadone toxicity or changes in intensity of withdrawal symptoms were reported in the study.

MANAGEMENT: Given the interindividual variability in the pharmacokinetics of methadone, a more significant interaction with grapefruit juice in certain patients cannot be ruled out. Patients treated with methadone should preferably avoid or limit the consumption of grapefruit juice, particularly during the induction of maintenance treatment.

 

[misk]

lol thanks mate...
i know the drugs have interactions, but what that website doesn't tell you is safe dosages and when to seek help.

that site is a crock of shit if you are researching with the intent to mix said drugs as it lists interactions to the point that it becomes impossible to actually determine if its safe, and once ingested, what could go wrong and to what degree.

please don't go posting info like this in threads unless people request it. i use google also and actually do research before posting threads.
info like that will clog up threads with useless shit. if you don't know that 3 drugs from the same class will have an interaction with each other you should do alot more reading before ingesting anything.