Opioids Codeine Ceiling and redosing

[AlphaMethylPhenyl]

If you want freedom why not consider ORT?

 

[saadman]

If you want freedom why not consider ORT?

Because I have a son and I don’t want social services or anything to get involved because his parent is a junkie (I’m not thank God I’m a functional addict lol)
Also I lost my license because of heroin a while back did now the DVA are basically watching me like a hawk and I can’t afford to lose my license because my wife doesn’t drive and we live outside of town.

 

[ChemicallyEnhanced]

Bit of background: I used to be heavy IV heroin user on the streets and terribly depressed.

I hit rock bottom and got off the H and stopped IVing. I wouldn’t say I’m depressed anymore (mentally anyway, but I suffer chronic fatigue which sucks)
I am married, a homeowner and have a kid. I drive I nice car and my life is generally pretty nice. So no risk of going back to H. My wife puts up with me CWEing because she knows I have some legit back pain problems but it’s not ideal. It gives me nausea and I usually throw up and barely even really get a buzz anymore. I do it mostly out of habit.

I CWE OTC cocodamol on the daily, at first it was one pack a day, then two, now I take 3 packs at once usually twice a day.
That’s theoretically 768mg a dose, though I’d say probably 500-600mg in reality due to loses in extraction.
It’s a pain in the ass because I literally have to hit every pharmacy in a 10 mile radius so as not to be seen going to any more than once a week.

I wonder is my twice daily dosing taking away from the buzz or is my tolerance just at the point where the dose I can get from codeine isn’t enough. It’s weird though because I don’t really get terrible withdrawals when I don’t use. Nothing like when I was on heroin anyway.

Is there a consensus on long it takes for your liver enzymes to recharge or replenish?

If I got morphine tablets would I take 60mg for an equivalent dose or because the oral bioavailability sucks would I need to take more?

Morphine being 10 x stronger than Codeine is based on the strength of ORAL morphine, so yes it would be 60mg.

 

[Rachrach]

Bit of background: I used to be heavy IV heroin user on the streets and terribly depressed.

I hit rock bottom and got off the H and stopped IVing. I wouldn’t say I’m depressed anymore (mentally anyway, but I suffer chronic fatigue which sucks)
I am married, a homeowner and have a kid. I drive I nice car and my life is generally pretty nice. So no risk of going back to H. My wife puts up with me CWEing because she knows I have some legit back pain problems but it’s not ideal. It gives me nausea and I usually throw up and barely even really get a buzz anymore. I do it mostly out of habit.

I CWE OTC cocodamol on the daily, at first it was one pack a day, then two, now I take 3 packs at once usually twice a day.
That’s theoretically 768mg a dose, though I’d say probably 500-600mg in reality due to loses in extraction.
It’s a pain in the ass because I literally have to hit every pharmacy in a 10 mile radius so as not to be seen going to any more than once a week.

I wonder is my twice daily dosing taking away from the buzz or is my tolerance just at the point where the dose I can get from codeine isn’t enough. It’s weird though because I don’t really get terrible withdrawals when I don’t use. Nothing like when I was on heroin anyway.

Is there a consensus on long it takes for your liver enzymes to recharge or replenish?

If I got morphine tablets would I take 60mg for an equivalent dose or because the oral bioavailability sucks would I need to take more?

Generally speaking, the metabolic celing is 600mg. CWE is effective but, it is not perfect so that unless you do 5+ washes you really cannot accurately predict what your net will be.

Oral bio on morphine does not suck. It is roughly 1/3rd that of IV. There are simple methods to bring it close to IM/SC (not much difference between those last 2 routes so that they can be given as 1 value basically). The worst part of oral morphine is the maddening itch. Get some Promethazine and that is no longer an issue. Diphenahydramine will work fine, in a pinch. Promethazine by the way boosts the O-demethylation of your codeine so you definitely should consider co-ingesting. O-demeth. Is the metabolic process whereby codeine converts to morphine within your body.

As for converting 600mg codeine into morphine value wise, 60mg is on the nose. I need to add, when talking about jumping from 1 opiate/opioid to another, the safest way is to take only 30mg morphine orally, wait & see how it flies. I reckon that since you used heroin it is not much of an issue, just leaving out there for others.

 

[Rachrach]

It's your tolerance. Use a lower dose and save weekends for high doses. You'll spend less and feel better

Noooo. Codeine has a metabolic ceiling. At 600mg he is at its limit. For experienced users, versus opiate naive users, that is far as his train will travel. The exception would be long term abstinence & then restarting but even then, one you habituate at the ceiling, codeine is over.

 

[soulwentmia]

60mg oral morphine is the same as 600mg oral codeine.
The standard opioid scale uses specifically oral morphine.

So on the scale where oral morphine is a 1 and something half as strong would be a 0.5 and something twice as strong would be a 2, it's approx:

Codeine 0.1
Tramadol 0.1
Dihydrocodeine 0.2
Oral Morphine 1
Oxycodone 1.5
IV Morphine 3

etc etc

it's not tho
.

say you get that 10% of morphine from 600mg codeine, that's morphine directly acting in your body.

when you ingest 60 of morphine however, you get far less. the bioavailability is low, below 50% iirc

 

[soulwentmia]

Generally speaking, the metabolic celing is 600mg. CWE is effective but, it is not perfect so that unless you do 5+ washes you really cannot accurately predict what your net will be.

Oral bio on morphine does not suck. It is roughly 1/3rd that of IV. There are simple methods to bring it close to IM/SC (not much difference between those last 2 routes so that they can be given as 1 value basically). The worst part of oral morphine is the maddening itch. Get some Promethazine and that is no longer an issue. Diphenahydramine will work fine, in a pinch. Promethazine by the way boosts the O-demethylation of your codeine so you definitely should consider co-ingesting. O-demeth. Is the metabolic process whereby codeine converts to morphine within your body.

As for converting 600mg codeine into morphine value wise, 60mg is on the nose. I need to add, when talking about jumping from 1 opiate/opioid to another, the safest way is to take only 30mg morphine orally, wait & see how it flies. I reckon that since you used heroin it is not much of an issue, just leaving out there for others.

promethazine is a cyp2d6 inhibitor (the enzyme that demethylates codeine). how does turnining that enzyme off so to speak boost demethylation? tried it myself. both 2d6 inhibitors and 3a4 inducers reduce how well codeine works or at least how much morphine you get

 

[soulwentmia]

Noooo. Codeine has a metabolic ceiling. At 600mg he is at its limit. For experienced users, versus opiate naive users, that is far as his train will travel. The exception would be long term abstinence & then restarting but even then, one you habituate at the ceiling, codeine is over.

i beg to differ. a long break and restarting will sure enough make the ceiling fun again. but i haven't been there long enough to bet that it will happen as i say and i'm actually trying to quit. entering and exiting polysubstance wd bimonthly at this point for over a year.

 

[soulwentmia]

It depends on dose, though. And duration.
Someone who has been on a very large dosage of codeine for many years will 100% have a worse withdrawal than someone using moderate doses of heroin for a couple months.
I VERY much doubt OP can cold turkey from that much codeine.

been reading alot about this lately as myself I'm quitting 600mg after being on 300 and 150 before.

150 was childs play in retrospect until day 3-4 where insomnia fucked me

300 shit got real and reminiscent of movie like withdrawals

at 600 rn plus cold turkeying gabapentin i honest to god believe this is at least heroin like, somehow. used for a year and a half. absolutely insane

 

[ChemicallyEnhanced]

it's not tho
.

say you get that 10% of morphine from 600mg codeine, that's morphine directly acting in your body.

when you ingest 60 of morphine however, you get far less. the bioavailability is low, below 50% iirc

Yes and no. It works that taking 600mg Codeine is the same as taking 60mg oral morphine.