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  • BDD Moderators: Keif’ Richards

Hydrocodone Weirdness

O

Opie8

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Joined
Nov 21, 2010
Messages
7
I've been taking prescribed generic Norco a few years for chronic pain, and I have noticed a phenomenon … but I'm not sure how common it is.

Here's the thing. The medication only works for me about 40% of the time.

For instance, one day I will take 10mg of hydrocodone, and I will receive a good amount of relief. I will also get a very slight "buzz". It is not intoxicating in the slightest … I just seem to be a little more content and talkative. I'm sure many of you know what I am talking about.

On these day when the meds work, my pain is minimized, and I can take 10-15mg of hydro every 4-5 hours and be very productive. I end up getting quite a bit done and I sleep well also.

Other days, however, the tablets don't work at all.

AT ALL.

I can take 10mg. 20mg. 30mg … doesn't matter. I might as well be taking Tic Tacs or M&M's. Actually, if I try to increase the dose, I might get lightheaded or nauseous but I experience no pain relief or any "buzz" so to speak.

Of course, most people will assume that I am experiencing tolerance, and this is what I assumed as well.

However, the next day, the day after I receive no relief with 20mg … I can take a single 10mg Norco and it will completely knock me for a loop. It will completely relieve my pain, and on some days, it will even have me slightly nodding.

I've tried every variety of tablet. Watson, Qualitest, Malliwhatever, and it's exactly the same. Very hit and miss. I've tried empty stomach, full stomach, fatty meals, fasting … no difference.

It's the strangest thing. Some days hydrocodone works very well, and sometimes it does not work at all. Since the days in which it works are completely random, and increasing the dose has absolutely no effect, it's clearly not tolerance.

There are simply days (about 60% of the days) in which my body does not process hydrocodone in any quantity. It just goes through my system with no effect.

The other 40% of the time, it is extraordinarily effective. This has been going on for years.

Now my question:

On what planet does this make any sense?

Has anyone else experienced this random on/off effect from acetaminophen/hydrocodone?

Is there any way to increase the days when it actually works?

Can anyone explain this in a rational manner?

Thanks for listening.
 
I find that with hyrdocodone, redosing does not increase the effect, or make it last longer. Instead, I take a larger dose once in the morning. Also, the opiate "buzz" definitely makes the pain less severe because if you feel good, then even if you have pain you won't care about it.

I don't know why this is happening to you, but I would say that if your normal dose does not take away the pain, then don't redose as it does not seem effecient IME.
 
Get scripted something else? 5-10mg oxycodone perhaps?

Talk it over with your doctor, and see how well a different opioid works is all i can say.

I have no idea why this would happen, so sorry i can give any advice there. I can only say what i would do in the situation. Maybe your doc can shed some light?

You have been on norcos for a few years, might be time for a bump to something stronger anyway? I may be a strange tolerance pattern due to taking a different dose everyday for years, rather than taking the prescibed, set dose.
 
Thanks.

I thought about the re-dosing issue as well, and have tried to take more in the morning, but on those days when it doesn't work ... even the first dose is ineffective.

I've got an appointment in 5 weeks. I'll discuss it with him then, but the war on CII drugs makes even the pain specialists here stateside squeamish.
 
Could be an enzyme deficiency. That is indeed very strange. Maybe a topic to discuss with your doctor? To be honest, I'm not sure they would have much insight, but they might, and it would probably be a good idea to do so either way.

Most of us, myself included, would be skeptical towards the hypothesis that there must be some certain physiological factor responsible for the inconsistency of the subjectively perceived effects. For example, on the days you take two, three, or four tablets and feel that you're not getting adequate relief or the expected (or hoped for) effects, you may have a predisposition or preconceived notion towards thinking that either the Norco's aren't going to work today, in which case they probably won't since you've already decided they won't- Or you think that they will work, so they do. On the days when one tablet gives the the relief you need, and gives you desired effects, it could be that you simply have [little or] no expectations, and therefore are not focused on getting high or achieving some idealized superior level of pain relief by increasing your dose.

A bit of psychology for you; placebo is a very powerful thing. If you are convinced something isn't going to work, it won't work. If you're sure something will work, there is a very high likelyhood it will work. Another example: Lets say you were in serious pain, lets even say w/d too, and you went out on the street and found some suspicious looking pills that didn't look like any Norco you've ever seen, from a shady looking dealer who swears they are real Hydrocodone pills. You buy them and immediately take two or three. An hour later you are cursing the guy who ripped you off, only to find out shortly thereafter via a pill ID that the pills you bought are in fact Hydrocodone. You had made your mind up that they were fake, and that they weren't going to work based on the circumstances.

Inversely, lets say you are in the same situation and go to the hospital or doctor seeking relief. The physician hands you and familiar looking yellow ovular scored tablet with numbers/imprints that appear more or less consistent with the pills you are accustomed to. You take the pill, wait ten minutes, and when asked whether or not you feel better, you are surprised, and realize, "Yes, I do feel some relief. Thank you." The doctor then proceeds to tell you that what you have just taken was in fact nothing more than a sugar pill- a placebo. You would probably be furious if this happened, and this is purely hypothetical just to make a point. However, similar occurences happen all the time, especially in blind studies and the like. Sometimes even the placebo/sugar pill out-performs the drug which is being tested. It's really pretty amazing when you think about it. Wouldn't you wonder afterwards how you could have felt that Opioid relief without actually taking any Hydrocodone?

I've learned through experience, with all Opioids, that this sort of thing can happen. I am prescribed Norco 10/325 q.i.d. (4x daily). Sometimes I take them as prescribed if my wrist/knee is really bothering me, but more often I cut back during the schoolweek and indulge on the weekends. It seems so unlikely, but I think many of us experience a phenomenon similar to that of your own, and perhaps more so with Hydrocodone than the next Opiate, I don't know. But regardless... I can cut way back during the week, and take one here and there and get excellent pain relief and actually feel pretty good on a weeknight or whatever. Then the weekend rolls around and I've got big plans to "feel really good" on Friday night. I might even break out the potentiators and stashed Benzos etc, and take pretty much as many Norcos as I feel like taking (almost never more than 5-6 in a day/evening) with a very reasonable expectation of "feeling really good," reasoned by the logic that, "If one is good, two will be better." A number of the times I've done this- had big plans to catch this extraordinary buzz- I've ended up dissatisfied with results. I sometimes take an extra to try to kick things into gear, but like you mentioned, it only seems to compound the not so desirable side effects.

You can tie it into many different theories: The less is more theory. Tolerance, metabolism, placebo, attitude, diet, etc. I personally think that expectation can be a killer in all aspects of life; when you expect something to turn out in a way which is ideal for you and for suiting your needs, you will almost always be let down in one way or another. Just my experience.
 
It's entirely possible that you are right, and I have tried to be reasonable about the potential causes.

I've explored the psychosomatic possibilities, and I have no doubt that this has something to do with it, but there are other things like pupillary constriction and mild constipation that happen when the drugs "work" that don't happen when they "don't" (for lack of better terms).

I suppose these effects could be 100% psychological too, but I'll be damned if I even know how to constrict my own pupils.

Nevertheless, I think your theory is probably responsible for some of the phenomenon, or even most of it, but after 1+ years of trial and error, it really does feel like there is some kind of bioavailabilty issue that is also coming into play.

My guess is that I will never truly know what it is, and since pain is such a subjective thing, I don't imagine that it could be quantified enough to be studied.

I can't really point to it and say "see, doctor, look, it's not working!"

Some things can't be explained, but I will see if my Dr. can at least try me on something else in January.

I just hope the same thing doesn't repeat.

It's like I go through days of complete malabsortion from the GI tract, or my liver doesn't convert the codone to morphone on certain days.

I wish I knew.
 
I think morph offers the best exposition so far. A psychological explanation over a physical one seems more likely to me.

This isn't exactly OD material so I'll toss it over to BDD



--->BDD


EDIT:

I think speculating that its not absorbed in the GI tract is silly. You have no reason to think that one day you absorb perfectly and one day you don't. Also, only a VERY small part of the hydrocodone is metabolized into hydrmorphone. Nearly all of the effects are from the hydrocodone itself.
 
Morph is right. The human body and mind is a crazy thing. Look at all the studies done on pharmaceuticals where the placebo group reports similar effects as the drug itself. Just as much as your body can tell your mind your feeling the effects it can work the other way around...
 
I am in total disagreement with Morphs opinion of the cause of erstwhile effect/ineffectiveness of the pills. hes assuming that subjective thinking is somehow metaphysically powerful enough to override the objective effects of a powerful narcotic. in other words no matter how muc i believe before i shoot my Dilaudid that its not an opiate, that im just about to shoot water, im still gonna get profundly euphoric when i inject it, no matter what i believe is in the syringe. When you are talking about something as potent as 4 or 5 pure opiate agonist pills, the subjective mind does not stand much of chance when it comes to erase the objectivity of the effects, no matter how strong the belief that no effects will be felt. I would say that it probably is something to do with enzymes, or perhaps your brain is short on the amino acids needed to produce serotonin and dopamine, which are the chemicals that CNS drugs like opiates and cocaine manipulation to cause a high. remember it is not the hydrocodone that gets you high, it is the effect of the drug on your dopamine ( and other brain chemicals). If you are lacking in dopamine, serontonin, norepinerphrine etc., then the Norco will not have any of the chemicals on hand to manipulate to produce a high. i know the power of the mind is very great, but the hit or miss effectiveness of the pills tells me that it is not purely mental, although your attitude may have a secondary less profound effect. try taking some amino acid supplements, especially L-tyrosine, L- Taurine, and in moderation, L- Phenylalanine. These aminos are the building blocks of proteins that your entire being is made up of, and if your brain does not have them on hand it will not synthesize the brain chemicals that the opiates need to manufacture a high. I also find for people without your problem that these simple aminos are a great potentiator. If this fails i would see about getting switch from 10MG hydrocodone to maybe 15mg oxycodone. it is a step up in both MG, and oxycodone is slighty more potent, as well as in mine and many others opinion, more euphoric. it gives more of that warm opiate bath feeling, while Norco is kind of speedy and different from that true, perfect, blissful opiate hit. Maybe also try crushing the pills and preparing a solution in an oral syringe and squirting it in your mouth. It will hit you much faster. Hope some of this helps more than just being told its all in your head( no offense Morph, your thesis could just as easily be true as mine).
 
^its funny that you deride a psychological explanation that is supported by decades of research into placebos, nocebos and the power of the mind and what do you offer in place? Pure, baseless speculation.

None of the amino acids you listed affect endorphin production.
 
I was simply stating the facts thats its unlikely for the philosophical ( and uproven ) subjectivism of Morph is unlikely to have an effect on something as powerful and profound as a full opiate agonist at a medium dose such as 4 hydrocodone pills. I could just as easily argue epiphenomalism as he can subjectivism, which is the belief that mental states have no effect on physical states. in my opinion simple subjectivism cannot explain away why a full opiate agonist simply isnt working. the OP obviously has bias toward thinking the pills wont work anyway, or he wouldnt be into taking them.

Im not sure where you got your info about the aminos i listed, but L-phenylalanine is THE precursor of dopamine, norepinephrine, and epinephrine. Its synthesizes into tyrosine in the body, which in turn converts to brain chemicals listed above. you can either take phenylalanine itself, or you can take tyrosine and go one step further down the conversion chain. Taurine does the same thing for serontonin. look it up anywhere on the internet. i first read it in book last year and check it against many websites. thats why these aminos are used to treat depression, as well as used in energy workout supplements and drinks. So perhaps instead of just discounting what i say because you believe in some Buddhist version of mind-is-everything, and just dismissing offhand what i say about brain chemical precursors, you should do a bit of reading. There are other philosophies out there other than just your brain makes the world , some of us actually believe in objective world where rational relationships of cause and effect exist, and mind doesnt have the powerful to override everything just by thinking the opposite. And you just spewing falsehoods when it comes to the aminos look up what i said anywhere.

But maybe i should take up the mind over matter philosophies like Buddhism, Subjectivism, Advaita etc. I can fly over mountains with wings of wax just by thinking it, and no matter how many Dillies i slam ill be ok as long as i just believe it.....yea.....right
 
Hi guys,

Thanks for the feedback. I think there is validity in both hypothesis.

The thing is, as much as it is tempting to say that it is 100% mental, this can only be explained to a point.

For instance, it is possible to overdose on actual opiates, but not possible to overdose on the placebo (unless the placebo is rat poison or something).

There is, clearly, a point at which a dose of opiates will stop the breathing of even the most staunch non-believer. If you give 100mg of IV morphine to someone while telling them that it's saline, they are still going to have very dramatic effects from the drug.

Now, the question is, does 40mg of hydro rise to the level of mind-over-matter?

Well, since my usual dosage is 10mg, and I have only taken 40mg once (on a day when the drug didn't work), I can tell you that it's a pretty whopping dose for me.

On days when the drug works, 20mg is usually too much. Pinned pupils, my bowels don't move. some nausea at times, a bit too fogged for work ... yes, I am a lightweight but it is what it is.

Because of this, I typically don't go above 15mg at a time. On days when it works, more than this in 3 hours is simply too much.

Now, on days that it doesn't work, I can more or less take as much as I want and it will have no effect. None whatsoever. It's completely on/off like a light switch, all or nothing.

I've grappled with this a bit, and I've tried lowering expectations and such, but when I have taken the drug ... I have always expected that it would work, so placebo should certainly be in my favor. I expected that the drug will work, because it has worked before. My expectations do not change from day to day, yet the effects change a HUGE amount.

Keep in mind that there are many people who swear that hydro doesn't work if they eat too much beforehand, etc, so there has to be some factors that put bioavailability to issue besides just randomly swallowing the pills. Something happens with me whereby a dose which would put my into OD territory (subjectively) has the same overall effect as a tic-tac.

At 10mg, this could probably be explained by placebo. Maybe 20mg as well. 30-40, however, for a person who is reasonably naive to that dose, and I think something is going on.

One other thing I have noticed is, on the days that it doesn't work, I tend to have a very dry mouth. Before taking anything, I wake up with an extremely dry mouth and it stays that way throughout the day. On the days when it does work, I tend to have normal moisture in my piehole.

I doubt that this has anything to do with anything, but you never know.
 
30 should get you a nice buzz with no tolerance.

If not then its just not for you.

hydrocodone used to work wonders for me but barely gives me a buzz on 50 anymore, so dont feel bad.
 
I was simply stating the facts thats its unlikely for the philosophical ( and uproven ) subjectivism of Morph is unlikely to have an effect on something as powerful and profound as a full opiate agonist at a medium dose such as 4 hydrocodone pills. I could just as easily argue epiphenomalism as he can subjectivism, which is the belief that mental states have no effect on physical states. in my opinion simple subjectivism cannot explain away why a full opiate agonist simply isnt working. the OP obviously has bias toward thinking the pills wont work anyway, or he wouldnt be into taking them.

Im not sure where you got your info about the aminos i listed, but L-phenylalanine is THE precursor of dopamine, norepinephrine, and epinephrine. Its synthesizes into tyrosine in the body, which in turn converts to brain chemicals listed above. you can either take phenylalanine itself, or you can take tyrosine and go one step further down the conversion chain. Taurine does the same thing for serontonin. look it up anywhere on the internet. i first read it in book last year and check it against many websites. thats why these aminos are used to treat depression, as well as used in energy workout supplements and drinks. So perhaps instead of just discounting what i say because you believe in some Buddhist version of mind-is-everything, and just dismissing offhand what i say about brain chemical precursors, you should do a bit of reading. There are other philosophies out there other than just your brain makes the world , some of us actually believe in objective world where rational relationships of cause and effect exist, and mind doesnt have the powerful to override everything just by thinking the opposite. And you just spewing falsehoods when it comes to the aminos look up what i said anywhere..
 
OxyDillyKing said:
I was simply stating the facts thats its unlikely for the philosophical ( and uproven ) subjectivism of Morph is unlikely to have an effect on something as powerful and profound as a full opiate agonist at a medium dose such as 4 hydrocodone pills. I could just as easily argue epiphenomalism as he can subjectivism, which is the belief that mental states have no effect on physical states. in my opinion simple subjectivism cannot explain away why a full opiate agonist simply isnt working. the OP obviously has bias toward thinking the pills wont work anyway, or he wouldnt be into taking them.
Click to expand...

Unproven? Have you read about the placebo and nocebo effects before? MANY factors can influence how strongly a drug affects someone and how enjoyable it is. Look at Timothy Leary's famous phrase 'set and setting'... obviously it is more applicable to psychedelics but it certainly plays a role in all recreational use.

OxyDillyKing said:
Im not sure where you got your info about the aminos i listed, but L-phenylalanine is THE precursor of dopamine, norepinephrine, and epinephrine. Its synthesizes into tyrosine in the body, which in turn converts to brain chemicals listed above. you can either take phenylalanine itself, or you can take tyrosine and go one step further down the conversion chain. Taurine does the same thing for serontonin. look it up anywhere on the internet. i first read it in book last year and check it against many websites. thats why these aminos are used to treat depression, as well as used in energy workout supplements and drinks. So perhaps instead of just discounting what i say because you believe in some Buddhist version of mind-is-everything, and just dismissing offhand what i say about brain chemical precursors, you should do a bit of reading. There are other philosophies out there other than just your brain makes the world , some of us actually believe in objective world where rational relationships of cause and effect exist, and mind doesnt have the powerful to override everything just by thinking the opposite. And you just spewing falsehoods when it comes to the aminos look up what i said anywhere.
Click to expand...

Opioids work primarily on ENDORPHINS, not dopamine which they only indirectly act on unlike drugs like amphetamines and cocaine that work directly on and deplete the aforementioned neurotransmitter and thus, THOSE users would benefit from supplementing those amino acids, not opioids users.

OxyDillyKing said:
But maybe i should take up the mind over matter philosophies like Buddhism, Subjectivism, Advaita etc. I can fly over mountains with wings of wax just by thinking it, and no matter how many Dillies i slam ill be ok as long as i just believe it.....yea.....right
Click to expand...

Straw man much? No one is claiming ANYTHING REMOTELY resembling that bullshit. Just that "set and setting" affect drug use. Psychology undeniably impacts how a drug affects a person TO AN EXTENT. Obviously you can't will or will away an overdose, but expectations and other biases certainly can turn the effects up or down a little as the placebo effect clearly demonstrates.

To be clear, do you think there are no hypochondriacs who actually manifest physical symptoms? Somatoform disorders don't exist and the entire psychiatric community is just gullible? No one with anxiety gets hypertension or sweats? Hysterical pregnancies where women believe they are pregnant and actually exhibits signs (not symptoms which are just self-reported, but actual PHYSICAL SIGNS) are some kind of conspiracy? These are very well-documented phenomena so to say they simply don't exist seem a little naive.
 
Nope, another straw man. Kudos on ignoring literally everything in my response. I said they don't deplete dopamine like amps or coke do so supplementation after opioid use is unnecessary.

I clearly said opioids have an indirect effect on dopamine and primarily work on endorphins, how do you equate that to saying 'no effect on dopamine'?

I misspoke in that I said they work on endorphins... really exogenous opioids (such as hydrocodone) and endogenous ones (endorphins) both work primarily on mu opioid receptors. I apologize for THAT misinformation.
 
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I hardly think an pseudo scientific acid freak like tim leary is an sort of authority to invoke when it comes to arguing subjective mind vs. objective world. my argument is simply that mind does not change reality, it merely distorts truth. mind is immaterial, it has no effect on the cause and effect structures of the concrete objective world. if mind could override physical cause ond effect relationships, the fabric of reality would be torn apart by 6 billion peoples mind pulling it in different direction to fit their own world view.

when i had poison ivy, it often didnt itch until i saw it. is this because my mind magically produced a histamine like effect after i saw it? absolutely not. its simple the fact that after i saw the phyiscal state of my poison ivy, the mental effect of histamine kicked in. if it itched badly enough before i had seen it, i wouldve eventually looked at it and come to the conclusion " i have poison ivy". some people believe that all physical states are causally determined and that mind doesnt factor in at all. as in the fire creates a mental state of " ive been burned" but mind does not create the fire or it effects. the fire was caused by physical determinism, and it has a one way effect on the mind, mind does not cause any change it physical. now this is an extreme form of objectivism that i do not ascribe to but im only using for the sake of playing devils advocate. according to this view we are really only a spectator viewing an endless chain of causality that we have no control whatsoever over. even our supposed decisions which seem to effect physical objects are really just actions guided be determinism that we falsely ascribe to free conscious decisions just because we view ourselves as a witness to phenomena who is in control of a body.

In the middle we be something like we have a limited ability to influence physical states with our minds ( like moving our limbs, picking things up etc.) and that we can not necessarily warp reality with our minds but we can choose how to percieve things, as in we can align our outlook to what is the Truth or view things in a distorted way, but this camp believes in a concrete objective world that can not be overcome by mind alone, however since all data from it is filtered thru mind, mind does influence the info that comes to its perciever.

the other end is subjectivism which say there is no objective world, all there is is mind. I only wish this were true sometimes.

I subscribe to the middle view.

and the other end of the spectrum
 
Oh goodness. No disrespect taken ODK, and none intended. Cane2theLeft has been kind enough to clearly state many of the points I would like to make.

To reiterate what Cane said just before: No one even mentioned anything about any Eastern Philosophy, Buddhism, philisophical subjectivism and such, so I'm not sure I understand where you're going with that. If you like though, I've read and learned quite enough to lay some of that on you, but I'd prefer not to. Or how about some Existentialism? Shall we begin with Kierkegaard? Or perhaps you'd prefer Nietzsche? Or might we defer toward Metaphysics instead? I'm being a smartass, but I'm only kidding. Honestly? I am a bitterly cynical pragmatist who engages in very fewest aspects of spirituality and/or religion. I practice a cognitive, scientific, and humanistic approach when it comes to matters of life, and of this sort.

As far a placebo is concerned, placebo is not a philisophical ideology, it is a proven concept. I wasn't trying to convey placebo as being some all-powerful force within us which is capable of overcoming anything. However, placebo is a very powerful and very well documented phenomenon, which is backed by numerous valid and reliable tests which support such evidence.

Now, your comparison is simply fascile. Of course if you load a syringe with a Hydromorphone, get ready to inject it, and tell yourself at the last minute "it's only saline," you are going to feel the effects of the drug regardless. If you were in a blind study, and you were given a syringe and told it was saline, when in fact it is a moderate to large dose of Hydromorphone, again you are going to know it is the drug right away. But lets say you are feeling crappy, experiencing w/d symptoms, and you were (back in the study) given a syringe and told it was Hydromorphone. In spite of the contents of the syringe being nothing more than saline, based on years of anecdotal evidence and research, it is almost guaranteed that you would experience "some" level of relief from you w/d symptoms, because you believed you were getting a shot of Hydromorphone, you would in truth be feeling the effects from a flood of your own endogenous Opioids filling receptors.
 
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