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Opioids FFS....Codeine vs Tramadol (and a mini-rant)

ChemicallyEnhanced

ChemicallyEnhanced

Bluelighter
Joined
Apr 29, 2018
Messages
10,410
Location
UK
Has the same doctor my entire life - literally, he looked after my mum when she was pregnant with me - and he called me a week ago and told me it was his last day/he was retiring.
I've mentioned on here a few times that he has been ridiculously good to me...gone way above and beyond what any other doctor would.

Anyway, I call on Tuesday for a repeat of my Dihydrocodeine prescription....and I'm told they've changed the rules about prescribing it and now in the UK it can only be prescribed to people who are hospital in-patients.
They give me Codeine instead. Despite DHC being twice as strong as Codeine, they give me the same dose (mg-for-mg, NOT equi-dose) insisting that the two are the same strength (a MASSIVE misconception in the UK)....so I've been feeling like hell for several days as I try and cope with half my usual opioid-dose.

Basically, I have a choice of being given Codeine or Tramadol as my new med. FFS. BOTH are too weak to be much use at all.

What would you guys recommend between the two?
 
In the US anyway they're much more likely to let you hang onto a Tramadol script. I know it's not quite what you're looking for in strength, but it might actually stick.

According to this chart, 100mg Tramadol is roughly equivalent to 60mg Codeine, if that helps at all.
 
You can buy 'Paramol', which is 500mg paracetamol (sometimes referred to as acetaminophen in the USA) and 7.5mg DHC over the counter in the UK. As ingesting large quantities of paracetamol is very, very bad for you (liver failure - a nasty slow death) you should try a careful cold-water extraction to separate the paracetamol from the DHC. Don't keep going to the same chemists for Paramol, they are very aware of its addictive properties and will refuse to sell it if they think you are using it too regularly.
 
Your doc should probably let you know about the SNRI effects of tramadol, namely the inhibition of serotonin and norepinephrine. This essentially makes the substance an antidepressant, making it that much harder to come off of when it's time to withdraw.

But of course, a lot of the doctors I've had experience with try to get you on antidepressants anyway, so hey. God bless the medical industry.
 
I am also prescribed dihydrocodeine and if u don't have problems with CYP2D6, choose tramadol over codeine. Tramadol lasts longer and Is more stimulating but after few hours also more noddy than codeine. But DHC Is still better than tram or codeine...much better
 
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