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Opioids Gauging the fallout from the new Opana ER

T

timetohunt

Bluelighter
Joined
Oct 23, 2007
Messages
334
Would really like to hear some educated opinions here. This information is for the benefit of a group of friends, almost a small community.
I myself have thankfully been unchained from opiates since the end of 2011, save for one or two screwups that lasted about 3 days each.
What I am targeting is the fallout (impending dope sickness) that could be caused by the new Opana ER. While abused, all of these folks have legit scripts, they are all snorters, no needles (Yet ! , but most seem sworn to never go that route). Most of them are still working off of the last old formula scripts, and some are starting to deal with the new TRF as it begins to surface at pharmacies and be distributed. Even with their old formula habits, nearly all run out of them before the end of the month. And almost all are on high doses, 40mg ERs seems to be for about 80%, and some get 20s and 30s but no less. We're talkin way over 100+mg Opana a day. These scripts are usually supplemented with some form of IR, mostly roxi 30s. But those never last either, and those Opanas are their mainstay. I can tell you they are in deep. Pathetically deep. A few of these folks I really don't care about. But one married couple are nearly my best friends. I say 'nearly' because if they were clean they likely would be my best friends. Its just now that I am clean....well you know how it is, but I still love them.

Since we mostly know that the new Opana ERs are crap for snorting..... I tried to tell them that they better start preparing for next month (christ, or even this month), because I think they are doomed (super sick in my estimation). I tried to portray this bit of math based on a 40mg ER Opana, Here goes: Nasal Bio-availability, 30%, thats 12mg, but still some portion of the drug will be locked up even in old formula time matrix even thru the nose. So on estimate, lets say they get 8-10mg in a full blow, and a few mg dispersed over time. With the new stuff, a 40mg might act as fallows: 10% Oral Bio-availability, 4mg, but even if chewed (the new wax jobs), I think your only going to just get fractions of 1mg over long periods. Now after my warnings, my friend keeps telling me "Oh, I'll be fine as long as I don't get sick, I'll get used to not having the fast onset". If my math is sound, I see no way anyone is going to keep from getting sick if they were nasal users. What I can see is a sudden panic, and anywhere from 4 or more 40s will be chewed at one time by these folks to stay well. My estimates say you would really have to chew about 6 at once just stay well. That means entire supplies would be consumed in a week to 12 days. Leaving a looooong time before that next script. Ok, so the roxis will still be there, but mind you, those are total candy to them and keeps them well for like an hour. I said they were bad. I am trying to warn them to do something, like Taper NOW, or find a suboxone source, or get help. The couple I am speaking of just started a 5-week long job class that is 8 hours a day. I tried to tell them that was in Jeopardy. But as addicts they seem to want to celebrate the fact that this is their last run of old formula opana, and a snorting they go. Am I wrong here, maybe over looking something? Or is this the absolute disaster that I think its going to be? And even with their super high script numbers, they even run out now by about 5 days every month of their old formula. With this new Opana ER TRF it just looks like an opiate doomsday to me (for them). I'm trying to get them to listen and prepare. Maybe if I can get some of you experts to corroborate my intents, maybe they will listen further. And then again, have I miscalculated? I don't think so, but want to hear from you. I can see H and needles on this rise further driving them into deeper addiction. Thanks.
 
Yea they are screwed. I would snort them too in their shoes though. I'm sure this switch will be worse than the OC switch and put tons of people on the needle/H. Maybe the mexicans can use this opportunity to bring some powder to the west coast. What area are you from btw?
 
I am one of those people who are screwed. Pain patient who snorts his Opana ER, and has trouble getting decent pain relief any other way.

What I am doing is working on having my doctor switch me to Dilaudid. I also have many friends, family members, and like you said, I'm part of a small community of fellow chronic pain patients who got screwed with OxyContin, and are about to be screwed again with Opana ER. Most are switching like I am, to dilaudid. The others, to fentanyl. Neither of these are ideal, oxymorphone was a blessing and a godsend to those of us with severe pain, but time is running out for us. The new Opana ER are even worse than the reformulated OxyContin, I've heard many reports from friends already on the new Opana ER that it does NOTHING for pain, and the pill comes out intact in their feces.

I had to switch off the OP branded OxyContin when they reformulated that because it was much less effective and caused me stomach aches, pains, and cramps. Something you don't expect from a strong painkiller.
I would imagine yet again, I will be forced onto a less effective painkiller. I really do not want to go on the fentanyl patch for personal reasons, so it looks like I will have to make the switch to dilaudid, hydromorphone at high doses. If this doesn't work, they're going to have to put me on very high dose morphine, insane triple digit dosing.

Once again, chronic pain patients are screwed over by big pharma and their "anti-abuse" products. Just know that your chronic pain patients are not alone, and that they should talk to their prescribing physicians about their concerns, just like I am.
 
My writing ??

toothpastedog said:
Could you break your post up into more legible paragraphs or sections op so I can read it? Thanks
Click to expand...

From the OP: Granted my post is not split into perfect paragraphs, but most folks say I write pretty well. Did others find this hard
to digest or illegible or cumbersome. My feelings are hurt. Just kidding, but was the post really that ponderous?

Also, c'mon ye Opana blowers. I would like to hear more takes on this. I'm just imagining this awful impending nationwide misery for Opana users.
I would like to ask at least this one specific question. Lets say your normal dose is 40mg intranasal (per dose, not per day), how many of these
new 40s do you think you would have to chew at a sitting to stay well?
 
Good luck chewing them. But I would imagine (going by the bioavailability nasally being ~40% and oral ~10% I would say you'd almost need four times what you would usually snort.
 
toothpastedog said:
^yup
Click to expand...

Thats what I suspected. Given a dose of say 40mg nasal of old formula = 4 to 6 of new formula chewed.
I'm hearing that even folks who did not abuse the old formula and took it orally are raising fits. Endo should have
done some dry run studies rather than just dump this on the public in bulk fashion. Shame. With any luck the FDA
will allow the new companies to produce the old formula when production rights are assumed in September (and then
in January of 2013)
 
Ideally they would have started to switch to the oral ROA before getting the new formulation. The only thing that will slightly work in their favor is that if they are already running out early, then the lower dose that they will receive from taking the new formulation orally will be better than nothing. It's better than going from getting 40% of the drug daily (intranasal BA) to 10% of it daily (oral BA) since they will have a window of time with 0% of the drug for when they run out early, but when they start back up on it I think it will likely act as more of a maintenance drug than a pain relief drug when they resume consumption of the drug via the oral ROA since it will be the new forumulation.

All in all it will be a lot worse for people taking it daily via the nasal ROA and not running out compared to the people taking it nasally but running out and withdrawing for a week. Either way, a 30% decrease in BA is not going to be fun for anybody, but it will be easier for people that have already kicked.

Opana (oxymorphone) is probably the worst drug to be made into an abuse-proof formula due to the large gap in BA between ROAs, and the fact that the oral BA is so much lower than the others. Considering the high percentage of people that switched to heroin after OxyContin was reformulated (when the oral BA was even higher than nasal for that drug) I can only imagine the number of Opana users that are going to make the switch. The only guarantee that I have from going to my heroin dealer is that he will never say to me one day that his product will gel up when it becomes moist, and that the only way to take it is orally.

I really can't think of any positives that will come from this new formulation. People are going to inject an even worse form of it once they discover a method to do so (matter of if, not when), people that are taking it intranasally for pain will no longer get the same pain relief, and people that are sick of the first two things will end up using heroin. It's not that hard of a concept to grasp, and these things were all seen when OxyContin was reformulated, so there is no excuse for thinking that this will yield any better results.
 
Another scary update

Yea, another scary update on the new Opana fallout. I have one friend who gets an opana script, yet oddly enough is not dependant, and only uses it when severe pain sets in. Uses only a few times a month. This person has such a small tolerance that one half of a 5mg IR can often
get results for her. Occasionally she will do more. Granted, she goes nasally which speaks of abuse, but definitely not addicted and one of the most responsible users I know. Just recently she tested one of the new TRF 20mg ERs, starting out with a nibble and finally consuming the whole thing after about an hour or so (all oral of course). Nothing. Nothing she says. No pain relief, no opiate buzz, nothing. Folks, that is just plain scary. If she were to blow an old 20mg Opana, she would be passed out, maybe even riding close to an OD. If someone with this low of a tolerance is getting nothing than what is going to happen to the rest of us? Wow, how in the heck is the Opana population going to cope with this, no matter what ROA. And by gosh, the snorters are going to be laid out flat. In our little community, I am hearing similar. Corroborated from many corners.
 
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I would imagine Endo loses a lot of money when people come to their senses and switch to another pain killer. Shame, oxymorphone ER was perfect in the octagons....
 
Yeah. No one is going to buy full price tamper resistant Opanas. Everybody's just gonna switch to generic morphine ER. (as Im sure most have already). That's about the only good high dose chronic pain (ER) pill left in the US. (http://1.usa.gov/Hx0dU8)

Watson and Impax were supposed to start w/ their own gneric high dose ERs in Sept. and Jan., but that's probably not happening with the patent transfer now. Roxanne IR generics are out til end of April and Endo IR's are even longer.
Anyone know if the Actavis 7.5 and 15mg ERs or the Teva IRs are still available? They're not listed on the FDA drug shortages or removal list.

edit
Activis and Impax ERs are still listed as valid on FDA site, and neither are sceduled for removal yet. Watson ER's not mentioned anywhere.

http://www.accessdata.fda.gov/scrip...h.Overview&DrugName=OXYMORPHONE HYDROCHLORIDE
 
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Its confusing.
The 7.5 + 15mg ER from Activis were approved and on the market last year w/ no abuse deterrent. I can't find anywhere on FDA site about them being discontinued. They were only there to fill in since Endo decided it didn't want to make that dose anymore, so they might have been phased out when Opana was reformulated.

The Impax and Watson ERs (up to 40mg) are licensed but weren't scheduled to arrive til 2013. But Watson got approval last year to bring to market as earrly as Sept. of this year.
 
Yes, there is much that is confusing regarding the future here. I have to wonder if endo just screwed this up so badly that maybe in september 2012 and January 2013, the other companies will be allowed to make the old formula. I say 'allowed' because the FDA required all of the oxycontin to be new formula. I have no idea if its a done deal for Opana though. Does anyone know? This seems to be a worse situation than oxycontin, for at least 2 reasons. One, the BA tween ROAs is huge and two, this new formula just seems to be terrible. Even oral users are raising fits. Almost a dead medicine now except for the IRs. Also, why such the massive shortage reported for IRs now? I don't get that. In addition, maybe when the FDA sees the use of H skyrocket over the summer, they will rethink some of this. I guess my biggest question would be : When watson goes into production in september, must this be the new formula, or is there still a chance at them being able to make the old form?

Also, I would really like to hear some honest statements on this: Are these new Opanas really passing almost whole into users stool? Or is this just the first line dopers are using to get their doctors to consider scripting other meds? I mean if this is true, for god sake Endo! Did you really do any research?
 
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I have aggressive Relapsing/Remitting MS (mostly in my spine) and am on Opana ER 40mg tid after jumping ship from the OC's. Yes, I insufflated them, but the care and feeding of my nerve endings should be left up to me, not the FDA. I had my last two stop-sign shaped Opanas yesterday, with two of the new round teal 20/E to finish out the daily dose. Now today it is only the new Opanas. They didn't pass the "saliva test" so I know nothing short of a Dremel tool is going to get me in there... I do get 5 30mg oxycodone IR's for breakthrough pain each day, but that is Tylenol compared to what the Opana did. I was, at one point, on oxymorphone IR's too, but decided that I didn't want to burn out that receptor completely. I really liked the Opana as it didn't require the time and effort that properly preparing OC's did (id est shaving them with a hose-clamp), only suck off the coating, a little time under a hot light bulb and Boom! Perfect...

I can definitely testify they are garbage. I'm really starting to get sick... it's going to be hell tomorrow. I, with great difficulty, have been cutting them in half just to create more surface area for my body to work on them.

This was the thing that finally worked for me, and they've mucked it up! It was the magic bullet...
 
tricomb said:
What I am doing is working on having my doctor switch me to Dilaudid.
Click to expand...
That's the best advice to give with this situation, period. I made the switch over a month ago right when the new formulation started popping up. You can switch over quite flawlessly once you figure out your dosage. If they are taking over 100+mg of opana a day they are gonna have to take a bit of dilaudid. Good news for them is you can still insufflate it.
 
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