HELP me understand WHY NO EFFECT prescribed opiates- tolerance? low bioavailability?

[Harmredux]

Pain patient for about 8-10 years.

Usual prescribed dosage:
60mg oxycontin twice per day
10mg hydrocodone six per day.
opium tincture taken just to get to work without using oxy and ward of WD during workday (probably 30mg of morphine equivalent)

This has been my standard for about 4 years.

I recently tore a tendon in my foot, podiatrist confirm 30% tear through MRI, then 2 days later I missed a stair and came crashing down on the tendon which I'm sure did additional damage so used an extra oxy a day.

I only allow 1 doctor to prescribe any controlled meds, so have 100% honesty with him about what I need and he helps me... gave me additional meds to see if I could find relief- (1) 16mg Exalgo + (4) 10mg Opana IR per day.

These meds are BARELY keeping me from withdrawal, BARELY keeping the pain at away. By evening I am in pain and starting to feel WD.
I tried using the opana intra-nasally due to low bioavailability (I hate doing this), which did NOT seem to matter. I tried eating a scoop of peanut butter before around 30mg oral oxymorphone and did not feel any onset that way either.

Is this just a high tolerance to opiates and that's why I don't feel anything? There is no sort of feeling after taking IR oxymorphone (Opana).

Summary-
tried snorting 20mg oxymorphone at once- nothing
tried taking 30mg oral oxymorphone with some alcohol- nothing.
tried eating some peanut butter (fat) with 30mg oxymorphone PLUS some alcohol-nothing.

I don't know why I feel ZERO effects when taking what seem to be rather high doses of strong medication.

Any opinions on whether this is normal (not feeling any effect from snorting 20mg oxymorphone IR at once) I thought that regardless of tolerance I should feel something from 20mg at once using best method (besides IV which I won't do).

 

[Harmredux]

Any thoughts? I really don't want to waste what I have left and need relief and avoid WD. Should I just use orally? The whole crushing and snorting thing is a pain and doesn't seem to help. My regular scripts fill in a few days, just wait it out and deal with the pain and WD or is there a way to get some mileage out of the 15 or so oxymorphone IR I have left?

 

[Chris42393]

After taking opiates for 10 years, your tolerance has jumped up CONSIDERABLY. If you haven't had an increase in dosage of your medicine, chances are it wont be doing much for you (except holding off all the withdrawals). If you want something to help with pain, you need to increase your dosage (by a decent amount) or get on something MUCH MUCH stronger (just a random example: Fentanyl). Im sorry you're not getting any relief with your medicine, it sucks... I totally understand it (thats why I started treating myself and started to use much stronger stuff).

Maybe you want to try something else? Like marijuana. If you prefer opiates for pain, maybe you could simply use marijuana for a couple of months and then go back to opiates after your tolerance has dropped back down.

Are you a medical marijuana state (or recreational one)?

 

[Harmredux]

yes, I could get MJ medical, but I don't want to get high and ime mj causes panic.
I tried fent patches but didn't help.
What else is there?

lol I certainly wouldn't know how to "cop" for H - is that what you are hinting at?

 

[Chris42393]

You can get marijuana strain that doesn't get you high. Its a high CBD type strain, like a 18:1 ratio. It might give you a "feeling", but you're not going to be "high as hell". Its also good for anxiety. I tried this a long time ago and it literally changed my life. I have horrible back pain because of a work injury and it literally took all of my pain away, that extremely powerful opiates couldnt.

As for this ... "lol I certainly wouldn't know how to "cop" for H - is that what you are hinting at?" Im not sure what that means (sorry lol), if you were talking about that last sentence in my first paragraph, I switched to heroin (something I never thought id be doing), but it completely took all of my pain away...even with a high tolerance (this is before I started taking marijuana).

Obviously, there tons of Opiate medicines that you could take, but tolerance is a factor...since you've been taking them for so long. Im not sure if you ever buy street stuff (or maybe talk to your doctor about it), but "micro-dosing" ketamine works really good for pain as well. The only downside is that it doesn't last that long, so you'd have to take it several times throughout the day.

 

[Stats]

Please see my post on tolerance just recently above yours. The only way to combat this is to do the hardest thing in the world (I almost guarantee it may be the hardest thing for you at the moment); that is, you need to slowly lower your intake across a period of at least 1 week and optimally 1 month.

I am a meth user and my habit was 1g a day only 8 months ago. Now I have a full time gig, my life is in order, I am responsible, and most of all, I am happy. It all started with me making the hardest decision of my life: I weened myself down to 0.05g / day orally.

 

[Automator]

This bit of info many help.

I have a high tolerance to pain meds, have chronic back pain and recently switched from 60mg MS Contin to 6mg Suboxone.

Let me HONESTLY tell you my pain went from an 8-10 to around 4 at its WORST.

Took Suboxone for 10+ years at 2mg per day and it didn’t do anything. My doctor tried to up the dose and I refused (I figured since it’s a partial agonist it wouldn’t touch my pain) and went to a pain clinic where I was put on 60mg MSER a day.

It worked maybe a tad better than the Suboxone - so I thought I was coming along nice. Turns out I was wrong.

My pain doc tried switching me to Levo-Dromoran - I had no desire to start that medication so I left the clinic.

Went back to my other doc who asked me to “just try” 8mg Suboxone. I agreed to 6mg.

It took a few days to get through the adjustment (I’m still not fully stable, but close) but my back pain is NUMB. I’m in total shock on how well it’s working. I’m sitting here right now, an hour after my last dose of the day. I’m relaxed and the pain isn’t a thought in my mind.

If all else fails, I’d encourage you to try it. The drug is relatively safe as well, overdose wise.

 

[Jmths]

Sorry for the blunt question but why do you stil work while taking this cocktail on daily basis?

There have been days where I used 20-30mg Diacetylmorfine and the guy next to me would blow trough 2000mg Diacetylmorfine within a 6 hour timespawn. It has already been mentioned but to provide a concrete example of how riddiculous tolerance to opiates can become.

Doctors often refuse to switch from Tramadol to Oxycodon for painmedication because once they switch the patient to Oxycodon they know it's gonna be an upstream fight. It's basicly saying 'I'm ok with a limited lifespawn'. This isn't gonna be pretty, but u have to try to slowly ween off or keep increasing the cocktail dosage to a point where the pain becomes unbearable and when it does you better have a quick and painless option to end it. That is till a certain extend the impression I'm getting.

Back in the days MXE helped me significantly in quitting Diacetylmorfine plus Butyr-Fentanyl use plus it is ofcourse a very effective counter when it comes to pain. Marijuana/Hasj in combination with Diacetylmorfine/opioids has a very strong sedative synergy tendency ime, I tried it because someone told me I should and all I basicly did was lay down flat that day.

If you think the Suboxone is a decent alternative u can try and expend on that. Fentanyl (nasal spray) is often an option opted when all treatment options are exhausted and tolerance becomes an issue, often applied among terminal cancer patients for example, but once again, only a temporary option. All I can think of that is relevant for now. Tough luck.