Harm Reduction ⫸DANGEROUS Drug Combos⫷

[KremKrocInc]

This is such a great idea! It’s always upset me how little scientific research information of this stuff is available to the public. I personally have always had a rule for myself to avoid combining 2 or more uppers / 2 or more downers at once. Looking forward to reading the info this thread will produce!!!

 

[RandomClean3]

I'm new to this but was wondering how bad taking 1mg of Ativan in the morning then drinking a pint of vodka at night. Any advice

Say the vodka gives you 5 of sedation and the lorazepam gives you 2. You'd expect a 7 from combining both, but in reality you get somewhere between 9 and 15 (All numbers are made up, just explainint synergistic vs additive)
Is it enough to knock you out? I don't know, depends on your tolerance. Is it a riskier than taking more alcohol or more benzos on their own? Yes, in my experience benzos and alcohol were particularly good at giving me blackouts.

 

[harmer]

CYP2D6
Cytochrome P450 2D6 is an enzyme that in humans is encoded by the CYP2D6 gene and a member of the cytochrome P450 mixed-function oxidase system.It's one of the most important enzymes involved in the metabolism of xenobiotics in the body. In particular, CYP2D6 is responsible for the metabolism and elimination of approximately 25% of clinically used drugs, in a process referred to as O-demethylation.

CYP2D6 shows the largest phenotypical variability among the CYPs, largely due to genetic polymorphism.
There are 4 types:

poor metabolizer – little or no CYP2D6 function (those people won't feel much from codeine, as codeine is a prodrug and needs to be metabolized into morphine)
intermediate metabolizers – metabolize drugs at a rate somewhere between the poor and extensive metabolizers
extensive metabolizer – normal CYP2D6 function
ultrarapid metabolizer – multiple copies of the CYP2D6 gene are expressed, and therefore greater-than-normal CYP2D6 function

Warnings:
poor metabolizer -> Don't take Dextromethorphan, as even normal therapeutical doses can make you trip for hours or even days, because you don't metabolize DXM well. This could potentially be lethal
ultrarapid metabolizer -> Don't take codeine, as you will metabolise codeine rapidly into morphine, thus increasing the risk of an overdose


Drugs that are metabilized by CYP2D6:

All tricyclic antidepressants, e.g.
imipramine, amitriptyline
Most SSRIs , e.g.
fluoxetine, paroxetine, fluvoxamine
venlafaxine
duloxetine
mianserin
mirtazapine
opioids
codeine
tramadol
O-desmethyltramadol
N-desmethyltramadol
oxycodone
hydrocodone
tapentadol
antipsychotics, e.g.
haloperidol
risperidone
perphenazine
thioridazine
zuclopenthixol
iloperidone
aripiprazole
chlorpromazine
levomepromazine
remoxipride
minaprine
tamoxifen
beta-blockers
metoprolol
timolol
alprenolol
carvedilol
bufuralol
nebivolol
propranolol
debrisoquine
Class I antiarrhythmics
flecainide
propafenone
encainide
mexiletine
lidocaine
sparteine
ondansetron
donepezil
phenformin
tropisetron
stimulants
amphetamine
methoxyamphetamine
dextromethamphetamine
atomoxetine
chlorphenamine
dexfenfluramine
dextromethorphan
metoclopramide
perhexiline
phenacetin
promethazine


Drugs that inhibit CYP2D6 (this will result in higher and longer blood concentration of the drugs mentioned above, this could lead to increased side effects and could even be lethal or to no effects at all):
White grapefruit juice
Strong
Certain SSRIs
fluoxetine
paroxetine
bupropion
quinidine
cinacalcet
ritonavir

Moderate
sertraline
duloxetine
terbinafine

Weak
amiodarone
buprenorphine
cimetidine
citalopram
escitalopram

Unspecified potency

antipsychotics
haloperidol
perphenazine
thioridazine
zuclopenthixol
risperidone
chlorpromazine
hyperforin (St. Johns Wort)
antihistamines
promethazine
chlorphenamine
diphenhydramine
hydroxyzine
tripelennamine
clemastine
celecoxib
clomipramine
cocaine
doxorubicin
metoclopramide
methadone
moclobemide
doxepin
halofantrine
levomepromazine
mibefradil
midodrine
ticlopidine
cannabidiol


Inducers of CYP2D6:
Strong

glutethimide

Unspecified potency

dexamethasone
rifampicin




From Wikipedia

Done some 3-mmc , friday till sunday, this is my normal weekendroutine for me in 2021.
- aprox. 2-2.5 grams, not an insane ammount for me (125kg) + the habutation from continous weekly use.
Also tried aprox. 0.4gr. 3-cmc ;never did this cathinone before and will not do it again since it was almost unnoticable.
Saturdaynight 1mg etizolam and a beer to get a few hours sleep.
Sunday, when the 3-mmc bag was empty in the afternoon, I ate a big, healthy meal and took some etizolam so i dont feel the anxiety from the cathinone craving.
Also eat during my Cath-binge sessions; mostly fruits, berry's , mueslibars, banana's, soup, yogurt..., and take my daily omega's and antioxidants ,and magnesium.
Before i went to bed another 0.5mg eti and 125ug Flunitrazolam , gave my nose a good flush with my Rhino Horn and salt water, and a normal dose (1x pump per nostril) nasal spray and whent to bed.
Monday the usual mild hangover, (mostly from not enough sleep and too mutch cathinone) my usual clogged nose (ROA is 75% oral and 25% nasal, but sometimes more nasal than oral) cold feet that whent away after taking some L-arginin/citrullin.
Took 0.5mg eti , some L-Tyrosine hoping this helps with the dopamine depletion, some Taurine,curcuma and other suplements that help the liverfunction, some N.A.C. and did my job kinda okay-ish , sometimes hiding from my co-workers because of the stealty silent, but very noticable N.A.C. farts.
Just before I went to work applied 2x2 nasal sprays (double the maximum daily dose , because of the exessive nasal ROA this weekend) 'dexametasone nasal spray' (UNSPECIFIED POTENCY as an inductor of CYP2D6 says the list)
That night before bedtime, took some L-trypthofan and also 1mg eti. (tuesday till at least saturday normally no more benzo for me) and again, took some dexametasone nasal spray. and a puff from my RELVAR 92/22mcg fluticasone furoate/vilanterol inhaler (I don't use the inhaler when on cathinones/stims)
Tuesday morning felt like shit when i woke up...very weak, shivers, hot/ cold, anxiety, depersonalisation (never had that before!) took another double dose nasal spray (so I don't sound like a chronic cocaine user / 3-mmc snorter when I talk to co-workers) and had my weekdays puff from the inhaler and felt worse and worse.... massive panic attack. what is happening !! sweating, stiff muscles...felt sooo uncomfortable, reminded me of my once but never again little heroin adventure, 20 years ago...
Need to work at 15.00 , Took some eti, with no effect , and some more, and more... (5-6/7 half 1mg pellets within a few hours) and finally 2.5mg diclazepam because it felt like i was going trough a bad state of withdrawal.
First time I had this ! And I need to go to my job. can't call in sick. Felt like shit for the most part of my 8 hour work day, but the eti and diclazepam helped me get trough, but it was a struggle. Back home still shivers. hot / cold etc. again 1mg eti (normally no benzo's after monday) no effect, another one, and another one, this time with a beer glass full of wodka. finally that helped. no I am feeling okay-ish...

In retrospect, could it be that I had a mild case of serotonin syndrome? Maybe the added 3-cmc was the tipping point and my - more than usual - nasal ROA this weekend, which indirectly led to the overkill-use dexamethasone spray ?

 

[MiamiMami]

Meth + Afrin nasal spray (oxymetazoline hydrochloride) almost gave me a heart attack.

I snort so I always used to keep a bottle of saline nasal spray around to keep my nasal passages clean. This time, I made the mistake of getting Afrin, a decongestant. I was coming down off my meth high and getting ready for bed so I decided to use the spray. In less than a minute, my heart started pounding and racing. I just felt my body getting tense and had shooting pains up and down my arms. My legs felt weak. I could barely breath. I truly felt like I was gonna die. Luckily I had some Xanax on me and I was able to get through it but I was terrified. I woke up the next morning soaked in sweat.

Afrin causes heart palpitations among a host of other cardiovascular effects. It’s also a vasoconstrictor (like meth). I’m pretty sure I’ve read that somewhere before on here but I just wasn’t thinking at the time. I threw that shit (the Afrin) away ASAP!

 

[jasperkent]

Not sure where to post this warning, but this is a start. I live in the Chattanooga,TN area and a buddy of mine very nearly died a couple days ago because of pressed "Xanax bars" that were actually fentanyl. He knew they were fake but had gotten them before from the same source. The ones before had caused no problems. This time he had been drinking but only took ONE HALF OF ONE BAR and passed out, lips turning blue, etc. Somebody with Narcan happened to find him and saved his life.
This is serious shit, folks.
Watch out.

 

[MiamiMami]

Not sure where to post this warning, but this is a start. I live in the Chattanooga,TN area and a buddy of mine very nearly died a couple days ago because of pressed "Xanax bars" that were actually fentanyl. He knew they were fake but had gotten them before from the same source. The ones before had caused no problems. This time he had been drinking but only took ONE HALF OF ONE BAR and passed out, lips turning blue, etc. Somebody with Narcan happened to find him and saved his life.
This is serious shit, folks.
Watch out.

I grew up and Memphis and spent a lot of time in Nashville too. I’ve been hearing ALOT about people straight up dying from pressed bars in both cities. I guess it’s bad all over TN.

 

[Nas47]

It's about time for a megathread where we can discuss dangerous combos to prevent avoidable deaths, like the passing of the Bluelighter Oxydexmorphetamine, who most likely died due to the combination of DXM and Effexor(SSNRI) leading to Serotonin Syndrom. http://bluelight.org/vb/threads/790985-*WARNING-DEADLY-COMBO*Effexor-600mg-of-DXM-ambien-and-lyrica

Dangerous combos by Banquo from the Dangerous Combos FAQ with a few small changes

Opiates and benzos(especially if you iv opiates.Alcohol and opiates/opioids.Too much booze and benzo.Real hypnotics(barbiturats)with almost everything.Flood dose ibogaine with anything else.SSRI and SNRI with stimulants.Some foods and herbs(Grapefruit juice and St.Johns worth) with a number of drugs .Theres a lot of bad combos

 

[Nas47]

Opiates and benzos(especially if you iv opiates.Alcohol and opiates/opioids.Too much booze and benzo.Real hypnotics(barbiturats)with almost everything.Flood dose ibogaine with anything else.SSRI and SNRI with stimulants.Some foods and herbs(Grapefruit juice and St.Johns worth) with a number of drugs .Theres a lot of bad combos

Oh yeas and MAOI with a lot of drugs

 

[Questionsalways]

How can I spot a fake Xanax bar

 

[MiamiMami]

How can I spot a fake Xanax bar

People claim there’s ways you can look and tell but the best way to be sure is by using a fentanyl test strip. They’re cheap and can be purchased online I believe.

At one point I was into Percocets and one night I was craving one soooo bad that I literally just bought one of a random guy off the street (for $40!) .. and like I said, I had been hearing sooooo many stories about people getting their shit laced with fentanyl but I wanted it sooooooo bad. I took the teeny tiniest little piece and placed it on my tongue and just prayed that I didn’t die alone in that cheap motel room. But after a few mins I was like okay, maybe it’s safe. I WOULD NOT ADVISE THAT. GET THE TEST STRIPS.

 

[SoCalShordie]

It's about time for a megathread where we can discuss dangerous combos to prevent avoidable deaths, like the passing of the Bluelighter Oxydexmorphetamine, who most likely died due to the combination of DXM and Effexor(SSNRI) leading to Serotonin Syndrom. http://bluelight.org/vb/threads/790985-*WARNING-DEADLY-COMBO*Effexor-600mg-of-DXM-ambien-and-lyrica

Dangerous combos by Banquo from the Dangerous Combos FAQ with a few small changes

I was going to say Methadone and Alprazolam (Xanax) or any benzodiazepines really, but especially alp. Easy way to overdose. Also, alprazolam and alcohol. Fentanyl and Xanax too.

 

[jasperkent]

Any benzo+alcohol combo is highly risky.
Also I know from personal experience that barbiturates, especially with alcohol, are extremely dangerous. You don't see much of barbs any more and that is a good thing.
I've lost several days and woke up on a ventilator TWICE because of barbiturates....I'm a slow learner. WIth barbs it's a very fine line between "I feel great" and DEAD.

 

[MiamiMami]

Any benzo+alcohol combo is highly risky.
Also I know from personal experience that barbiturates, especially with alcohol, are extremely dangerous. You don't see much of barbs any more and that is a good thing.
I've lost several days and woke up on a ventilator TWICE because of barbiturates....I'm a slow learner. WIth barbs it's a very fine line between "I feel great" and DEAD.

I don’t think I’ve come across any barbiturates before but I’m a frequent Xanax user.

After another meth binge a couple nights ago, I couldn’t sleep and had ALOT on my mind. I was drinking wine, took a Xanax (which I didn’t think was kicking in), and a 25 mg Seroquel. So then I thought, what the heck..may as well take all of my meds for the day. So along with the alcohol, Xanax, and seroquel, I took my lexapro (20mg) and Wellbutrin (150mg).

The plan was to eat and smoke a blunt but that did NOT happen. I woke up the next day on top of a half eaten smushed cheeseburger. I must’ve literally fallen asleep in the middle of eating. I was like WTF. Mood wise, I felt great. But I should’ve known that was risky.

Back in college, I was on klonopin and I’d go have a couple drinks and end up blacked out somewhere not remembering shit. All fun and games til I woke up in a stranger’s bed, sore between my legs, covered in bruises, in the middle of nowhere, without my cellphone.

Benzos and alcohol feel SO good but it can go wrong SO fast.

 

[Oxymuncher]

My near death experience that landed me in the ICU for 4 weeks was from IV heroin mixed with LOADS of cocaine and crack + alprazolam around 20mg. I thought I was totally fine because the crack was "off setting" the high. But went to sleep at 4am thinking everything had worn off as I didn't feel high or anything anymore. BAM I wake up with arterial lines in me in the ICU etc. I now have a permanent injury to my shoulder/left side of my body constantly hurts and am painkillers for life.

NEVER GO TO SLEEP AFTER INJECTING A LOT OF HEROIN AND MIXING IT WITH COKE/CRACK. YOU MAY THINK YOU ARE FINE. BUT YOU ARE NOT FINE. TRUST ME.

 

[Bigsmoke420]

I’ve seen many case of lean / Xanax overdoses

 

[pkt]

I only did this by mistake but mixing good coke with MDMA or MDA has almost killed me a couple of times….heroin and cocaine is a dangerous combo but if you get the dosis right( I almost always did) its one of the best rushes out there(IV)..the problem is that drugs you buy on the street are often more/less potent than you expect and that’s just one of many good reasons to legalize drugs…

 

[pkt]

I’ve seen many case of lean / Xanax overdoses

I guess all benzo and opiate combos can be dangerous but if you have a high tolerance it’s not really a problem, I’ll drink 500mg of codeine and take 50mg of Xanax and barely get a nod but I’m sure others would drop dead.

 

[RandomClean3]

I guess all benzo and opiate combos can be dangerous but if you have a high tolerance it’s not really a problem, I’ll drink 500mg of codeine and take 50mg of Xanax and barely get a nod but I’m sure others would drop dead.

Isn't 500 mg over the ceiling dose? Since playing with methadone and fent codeine does nothing for me, but I'm pretty sure that over 2-300 you start to get vastly diminished returns.
Sd for the xanax, as someone who had seizures while tapering off benzos, I wish you luck dude, I hope you find you a way to at least drop to relatively normal dosages.

 

[Nas47]

I guess all benzo and opiate combos can be dangerous but if you have a high tolerance it’s not really a problem, I’ll drink 500mg of codeine and take 50mg of Xanax and barely get a nod but I’m sure others would drop dead.

50 mg xanax?Seriously?Or 5mg?

 

[sewerslide.666mg]

I drink on benzos I know it's bad but i only 1 or 2 drinks, I've almost died in the past over indulding alot of ppl have just be safe folks, and 50 mg .xan wow