Hi all
I just wanted to throw this out there, as I was just looking at SEVERAL of the most used and "presumed legitimate " opioid conversion charts.
Here's a big problem I've noticed, and if someone were to follow the conversions for some of the opioids listed,they would almost certainly end up in the grave, or at least at the hospital if the ambulance got to them quickly enough.
The conversions work fine for lower potency and lower dosage opioids, for example, converting 40mg of oral oxycodone to and equivalent dose of oral, or IV morphine.
However, when you attempt to convert a high potency, high dose, high bioavailability ROA, to a lower potency opioid, the converter gives you absurdly high doses for the conversion to the lower potency opioid.
For example, I checked the conversion for 80mg per day of oxymorphone via IV/IM ROA....now granted for those with no or even moderate opioid tolerances, that would be enough to kill you several times over, however I know of many people with a tolerance that not only take 80mg (or more) of IV oxymorphone per day, but are completely functional and not even noticeably sedated. Again, this is not meant to downplay that amount of oxymorphone used via IV....that is a monstrous habit, but tolerance never ceases to amaze me.
The problem is the conversions to IV morphine (not oral morphine, but IV) registers at 640mg of iv morphine per day....and that is including a generous 20% reduction to account for incomplete cross tolerance, without that reduction it's 800mg of IV morphine per day!!!!
I know as a matter of fact that 800 or even 640 is waaaaaaaaaay to high of a conversion from 80mg iv oxymorphone to iv morphine.
To illustrate this, I guarantee if someone with the tolerance to handle it took 15mg of iv oxymorphone one day, and 60mg of IV morphine the next, he would be far more "opiated" from the 60mg iv morphine. Now granted he may prefer the effects of the iv oxymorphone in terms of euphoria and rush, but in terms of analgesia, respatory depressions, somnolence and plain old nodding out, the 60 of morphine is clearly far ahead.
So let's just assume the 15mg of oxymorphone iv is equivalent to the 60mg of morphine (even though I am beyond certain the 60mg of morphine is considerably more potent in terms of dangerous aspects discussed earlier such as respiratory depression and somnolence),
even with that concession, our original conversion of 80 mg of oxymorphone iv would be equivalent to about 300mg morphine iv....nowhere near the 800mg of morphine they list as equivalent, and even less than half of the 640mg they list when subtracting a generous 20% for incomplete cross tolerance.
I know I belabored a very simple point, but I am truly worried someone would consult one of these "legitimate charts" which are indeed accurate for low dose low potency opioids, but could truly end up dying if they go by the conversions when dealing with the high potency, high dose opioid conversions like I discussed.
I actually believe that if someone who daily takes 80mg IV oxymorphone without incident were to attempt to take 800mg or even 640mg of iv morphine, they would be found dead..that's why I took the time to write this.
Be safe
Regardless of what any chart says, use common sense and start waaaay lower than suggested.
It can't be said enough, u can always take more, but u can't take less once it's in you.
I just wanted to throw this out there, as I was just looking at SEVERAL of the most used and "presumed legitimate " opioid conversion charts.
Here's a big problem I've noticed, and if someone were to follow the conversions for some of the opioids listed,they would almost certainly end up in the grave, or at least at the hospital if the ambulance got to them quickly enough.
The conversions work fine for lower potency and lower dosage opioids, for example, converting 40mg of oral oxycodone to and equivalent dose of oral, or IV morphine.
However, when you attempt to convert a high potency, high dose, high bioavailability ROA, to a lower potency opioid, the converter gives you absurdly high doses for the conversion to the lower potency opioid.
For example, I checked the conversion for 80mg per day of oxymorphone via IV/IM ROA....now granted for those with no or even moderate opioid tolerances, that would be enough to kill you several times over, however I know of many people with a tolerance that not only take 80mg (or more) of IV oxymorphone per day, but are completely functional and not even noticeably sedated. Again, this is not meant to downplay that amount of oxymorphone used via IV....that is a monstrous habit, but tolerance never ceases to amaze me.
The problem is the conversions to IV morphine (not oral morphine, but IV) registers at 640mg of iv morphine per day....and that is including a generous 20% reduction to account for incomplete cross tolerance, without that reduction it's 800mg of IV morphine per day!!!!
I know as a matter of fact that 800 or even 640 is waaaaaaaaaay to high of a conversion from 80mg iv oxymorphone to iv morphine.
To illustrate this, I guarantee if someone with the tolerance to handle it took 15mg of iv oxymorphone one day, and 60mg of IV morphine the next, he would be far more "opiated" from the 60mg iv morphine. Now granted he may prefer the effects of the iv oxymorphone in terms of euphoria and rush, but in terms of analgesia, respatory depressions, somnolence and plain old nodding out, the 60 of morphine is clearly far ahead.
So let's just assume the 15mg of oxymorphone iv is equivalent to the 60mg of morphine (even though I am beyond certain the 60mg of morphine is considerably more potent in terms of dangerous aspects discussed earlier such as respiratory depression and somnolence),
even with that concession, our original conversion of 80 mg of oxymorphone iv would be equivalent to about 300mg morphine iv....nowhere near the 800mg of morphine they list as equivalent, and even less than half of the 640mg they list when subtracting a generous 20% for incomplete cross tolerance.
I know I belabored a very simple point, but I am truly worried someone would consult one of these "legitimate charts" which are indeed accurate for low dose low potency opioids, but could truly end up dying if they go by the conversions when dealing with the high potency, high dose opioid conversions like I discussed.
I actually believe that if someone who daily takes 80mg IV oxymorphone without incident were to attempt to take 800mg or even 640mg of iv morphine, they would be found dead..that's why I took the time to write this.
Be safe
Regardless of what any chart says, use common sense and start waaaay lower than suggested.
It can't be said enough, u can always take more, but u can't take less once it's in you.
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