Opioids Hydromorphone

[VoyagerFun]

# Hydromorphone Dose
I haven’t really gone deep on high doses cos the sick feeling ruins the high but I found 10-15mg oxycodone is an awesome dose and I read 4mg of Hydromorphone is equivelant to about 13mg of oxycodone. Should I just have 2 oral doses or should I go on the snorting hype train and have 4x 2mg dose? Is snorting a superficial high that gets hyped up or should I listen to the oxy crowd and stick to oral doses?

 

[Dextro .45]

Morphine & Hydromorphone cause nausea more frequently than theBaine derived Oxycodone

Oxycodone has less sedative properties and minimal adverse effects such as nausea…..while having a much higher likelihood of causing euphoria and anxiolytic properties

Hydromorphone (Dilaudid) however is an Amazing opioid analgesic administered IV injection
Oral 7.5mg
IV 1.5mg ….when injected Hydromorphone is VERY potent. Slightly more potent than Diacetylmorphine (Heroin)

Oxycodone however doesn’t need injection as it’s very high 80% oral bioavailability is excellent, and very pleasurable and 1.5X more potent than oral Morphine

Take oral Oxycodone if you can….and use Dilaudid 2/4mg IR tablets for breakthrough pain when needed? Or just all Oxycodone ……if it was long term daily chronic pain, maybe even low dose daily Methadone 5/10mg tablets and use Oxycodone IR 5/10mg for breakthrough pain? ……Or Oxycodone XR daily and Tramadol IR for breakthrough pain

The analgesic combinations are vastly

 

[Yunai]

Heavily depends on if your pills are extended release (ER) or instant release (IR). Intranasal has a better bioavailability for Hydromorphone.. I personally would boof them but I don‘t know the BA for that. I did Hydros only a few times, back then I just removed the extended release and swallow them. With no tolerance: 2mg is a slight to low end of moderate dose. 4mg is moderate. Above 4mg is high. If you already have decent opiate tolerance from Oxy I‘d say take 4mg - 6mg and if it is still too little add the last 2mg to get 8mg. Is just my best guess here but please think about your tolerance and research (eg PsychonautWiki) first and don‘t just take my word and do it. I don‘t want you to get hurt by recommending too much. But yea if you have IR pills snorting is the better option, if you have ER pills remove the ER first, then snort it (swallowing is just slightly worse when it comes to BA but again, snorting is slightly better either way). Rectal I have not found a reliable source but I am pretty sure the BA for rectal, if I am not mistaken here, is even higher than snorting. Don‘t do IV it‘s never worth it.
ps. In the ICU (where I am from… medstudent and had internship there… ) everyone after heart surgery got Dilaudid, 2mg if the pain is slight, 4mg if it‘s stronger but some folks even got 8mg… no one died off that but those were mostly ER pills. So take this with a grain of salt.

If you want to be safe snort 4mg, see how it goes, then you can take the rest if it‘s too little. I am usually not a fan of adding more after the initial dose, if you can have a trustworthy friend with you and Narcan at hand if things go sideways.

Also don‘t mix it with any other drug.

 

[Yunai]

Morphine & Hydromorphone cause nausea more frequently than theBaine derived Oxycodone

Oxycodone has less sedative properties and minimal adverse effects such as nausea…..while having a much higher likelihood of causing euphoria and anxiolytic properties

Hydromorphone (Dilaudid) however is an Amazing opioid analgesic administered IV injection
Oral 7.5mg
IV 1.5mg ….when injected Hydromorphone is VERY potent. Slightly more potent than Diacetylmorphine (Heroin)

Oxycodone however doesn’t need injection as it’s very high 80% oral bioavailability is excellent, and very pleasurable and 1.5X more potent than oral Morphine

Take oral Oxycodone if you can….and use Dilaudid 2/4mg IR tablets for breakthrough pain when needed? Or just all Oxycodone ……if it was long term daily chronic pain, maybe even low dose daily Methadone 5/10mg tablets and use Oxycodone IR 5/10mg for breakthrough pain? ……Or Oxycodone XR daily and Tramadol IR for breakthrough pain

The analgesic combinations are vastly

Agree with most of it. I would never ever ever recommend anyone to start using the needle though.

You are right about the BA.
Only thing I disagree with is Methadone. If you can stick to Oxycodone, Hydromorphone, Morphine, etc etc for pain relief do not switch to Methadone. Everything that‘s not fully synthetic and breaks down to Morphine is so much more superior to the fully synthetic opiates like Fentanyl, for Methadone there are a lot of stories here where people talk about how it sucked being switched off from Oxy/Dilaudid/etc to Methadone (which on a side note rarely can cause cardiac issues which other opiates don‘t) in many regards not only pain relief. I briefly took Methadone but they switched me to Morphine HCL extended release (24h) and the difference was so so so so so much better. At least in my experience, Morphine is the best substitution out there, maybe Diacetylmorphine (Heroin) (if you live in Switzerland they actually do this) is even better. Funnily, studies showed the best substitution therapy success is if patients get Diacetylmorphine from their clinic.