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  • BDD Moderators: Keif’ Richards

Opioids Opioid stacking

4DQSAR said:
When you mixe stuff, you are always increasing the risk over and above a simple addative mix.

Tapentadol is an odd one. I looked into it and while it'a MOR affinity is low, it appears to act as a SUPERaconist i.e. it activates the site more then the body's endogenous opioids.

It appears the nitazenes are both potent AND are superagonists so I foresee a major problem for anyone who becomes physically dependent i.e. there is no dose of methadone or buprenorphine that will fully substitute. I hate to say it but to me, nitazenes seem like a one way street. I mean, FANTASTIC for the dealers but very bad for the consumers.

But with nitazenes and fentanyl analogues on the market, nobody could compete on price. Someone COULD produce an alternative that was much better subjectively (and there are still some examples that are quite potent i.e. x80 M) but we are seeing Grisham's law played out in the most tragic manner.

Take care ofr yourself, man!
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I’ve read some really gnarly posts on Dread about people who are using crazy high doses of nitazenes (so high I’m surprised they’re alive; they clearly worked up a mega tolerance over time) and searching for ever stronger ones because nothing else cuts it just like you. These are people who claim to actually prefer them and see them out though, so I don’t really pity them. But still - alarming. And the withdrawals are far worse than from any other type of opioid. I’ve had a taste of that myself from what’s in European h.
 
To answer the OP, I have rarely combined opiates/opioids because I try not to combine drugs in general and especially not downers. The withdrawal is always worse from multiple opioid compounds than just a single one. This is part of why poppy pod tea has such brutal withdrawals. I do not use for fun but for pain so I can’t report on any recreational effects, but I have not found any synergistic increase in pain relief from combining opiates. Just more side-effects. I’d avoid just stick to oxy, and consider other ways to lower your dose/tolerance. I find ketamine as an NMDA antagonist quite useful in this regard, and cimetidine also has notable potentiation. But be careful with cimetidine because the withdrawal from it can be unpleasant if you’re also withdrawing from an opiate (severe stomach pain); wait until you’re off the opiate before withdrawing from it.
 
Everything within my personal experience with these drugs and what I've read tells me that this effect is not "synergy", it's just taking more Opioids. There isn't any mechanism in Codeine that should increase the potency of Oxycodone or vice versa. It doesn't work that way. If you're just trying to get a more potent effect, just take them both at the same time, as there is no advantage to this split-dosing you're describing.
 
Me and my frenz wanted to share some purple drank but only had 2 lines between the 6 of us. We decided to make a legendary drink and we've stuck to this recipe time and time again. it goes as follows:
2 shots of Jagermeister
2 lines of codeine cough syrup
75 mgs promethazine
60 mgs percocet (we get perc 10s with 325 mgs tylenol and throw 6 of those in)
60 mgs 7 oh
12 mgs tizanidine muscle relaxer
4 mgs to 8 mgs xanax depending how much we have (4 is canon though)
a splash of nyquil

We would crush the pills and mix them with a very small amount of nyquil in a cup and we'd pour in the Jager and prescription cough syrup while mixing it as well. We then would pour it all into a 44 oz cup with some ginger ale. I named it, "Niggajizz Potent" and that shit is so fucking fun. It would last like 6 hours and it had a very nice wavy come up. The xans would hit first of course which just made us fiend for more so it's hard to sip on. But you'll black out if you don't sip on it slow enough. We never got respiratory depression that was too bad. It's way better than just lean imo. If you're already into opioids I'd say try it out. Just make sure you call it Niggajizz Potent. I'd love for that to be an actual drink that takes off.
 
The best combo for chronic pain syndrome (opioid tolerant over 300MME) is Roxicodone & Methadone. The high bioavailablity in PO (oral) of Roxicodone and Methadone's full-life.
If a patient was on Roxicodone 30mg every 4hrs, taking Methadone 10mg every 6-8hrs keeps the Roxicodone from dropping below a working baseline. The last Methadone dose of the day helps keep physical withdrawals at bay giving the patient better sleep and helps them make it through needing a dose 4hrs into the sleep cycle. Without the Methadone at bed, typical long-term opioid treatment patients will wake in the middle of the night from withdrawals starting. Again the Methadone will allow the patient to not waste a Roxicodone dose in the middle of night.
 
Makes sense - both oxycodone and methadone are subject to N-demethylation into far less active metabolites. But does the methadone simply use up the liver enzyme or does it inactivate it?
 
4DQSAR said:
Makes sense - both oxycodone and methadone are subject to N-demethylation into far less active metabolites. But does the methadone simply use up the liver enzyme or does it inactivate it?
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It works perfectly. Adding Methadone to Oxycodone creates good sedative effects on the body with some sedation. Kind of like adding Morphine to Oxycodone. great for spine, nerve pain. Oxy helps the brain not even register pain. Methadone adds some good pain management effects and this has come to light recently more and more from pain management and cancer pain.

It is working so well I did not have to titrate for 13 months until my bad infection where I went up Methadone 10mg from 3qty to 4qty. I have increased that for 14 months

It is also helpful to taper the Oxycodone if needed by adding a small increase in Methadone or even keeping the Methadone the same the patient would not know or feel much of a change.

This is the combo for long-term opioid patients Long-term cancer pain patients. who have a strong physical dependency that needs to be meet. Without the Methadone I would be yawning and sneezing every 3-3.5hrs before the 4hr Oxycodone dose. At night I would wake up at 3-4am sneezing 10times in a row. chronic yawning, and tears pour down from the face (not crying).
 
Survival0200 said:
^It's probably not a good idea for the liver to combine Jagermeister and Tylenol.
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Yes true, good safety info, my bad I forgot to consider that. If you share it among 3 people, you'll only be getting .666 shots of jager and 650 mgs of tylenol. I wouldn't think it to be lethally dangerous or anything
 
@Them Witches - you know, I've been given some pretty potent analgesics but the doses you mention are totally different to my own. I don't know where you are based but I've pointed out Levo-Dromoran (levorphanol) to another pain patient. They hadn't even heard of it. It seems to offer a duration of action even longer than methadone and as I understand it, the N-demethylated metabolite is also active as an analgesic.

Some mention is made of it also having NMDA activity, but I honestly don't know if it's clinically significant. Again, somewhat like methadone. The only opioid that appears to mediate a significant amount if it's analgesic activity is ketobemidone (Ketogan) and even then, only at higher doses. Ketobemidone is an odd one. It seems that the activity at lower doses is similar to morphine but a Danish chart of analgesic activity equated 25mg of ketobemidone with 60mg of morphine.

I've found a couple of other examples where the dose-response curve is steeper than morphine or indeed oxycodone and methadone.

One think I suggest the doses you mention and is something you don't dwell on is just how severe your pain must be. With that in mind I can only extend my thanks for your providing valuable information.

BTW for me at least, the medication doesn't so much reduce the pain but rather alter it's character. Without it's that sharp pain that takes one's breathe away and renders me essentially immobile. With it, it's a constant but less sharp pain. I only mention this for the purposes of comparison. I think we have both worked out that telling people you are in pain does not reduce said pain. Just keeping going is my only goal... along with hopefully ensuring all BL members are informed and can ask for resarch. Time is one thing I have.
 
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4DQSAR said:
I'm pointed out Levo-Dromoran (levorphanol) to another pain patient
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I looked it up/ Mallinckrodt makes the 2mg tablets. Dubbed "the forgotten opioid" and few doctors Rx here and most pharmacies to do not carry it. No insurance provider will cover it either. I want to try it and am built for it for sure. For the Mallinckrodt Oxycodone Hydrocloride 30mg I pay $0.006 US cents per tablet and the Mallinkrodt Methadone 10mg tablets are $0.45 US cent per tablet. I am good at the moment. I keep my MME as steady as possible so there is room to work for acute pain treatment. Like my next 2 ankle surgeries, upcoming dental work, and a 2 months recovery eye surgery.

I am retired and have time. I am almost finished building my race car so I will get some pain relief from redlining my Honda K20a engine to 9,000rpm with a 6spd LSD transmission. Aiming for 160mph with this one. I will get some of this pent up anxiety released. I am going to teach my daughter ow to drive it and putting her in
SCCA/NASA road course racing school. She will be better than 98% of the drivers on the highway, interstates, back country roads, and mountain autocross at 18 years old. The car is built for high speed turning, stable, rigid, and tuned engine management.
 
@Them Witches - my goodness, I just checked the BULK price of levorphanol and it's about $260,000/kg!

Now that truly IS insane. It's interesting that if you just glance at the list of suppliers, it seems like their is competition. Then you look more closely and it becomes obvious that Mallinckrodt in fact has a monopoly (they OWN the other suppliers). Given how little is produced, I suspect one batch per year is produced.

I say this based on the fact that the synthetically most similar medicine is butorphanol (which is actually synthetically MORE complex) costs about $50,000/Kg.

I'm so pleased that you have your eyes firmly on making the most of what you have. That's the way to go. The only thing that after 25 years still bothers me is that I cannot ride a bicycle. I miss the freedom. But unfortunately, I also have epilepsy so I can't (legally) operate a powered vehicle. Well, it's unclear what laws apply to E-scooters in the UK but I think I'm a little old to start using one of those ;-) Still, I enjoy the little I have.
 
IWantFentanylInMyShit said:
Me and my frenz wanted to share some purple drank but only had 2 lines between the 6 of us. We decided to make a legendary drink and we've stuck to this recipe time and time again. it goes as follows:
2 shots of Jagermeister
2 lines of codeine cough syrup
75 mgs promethazine
60 mgs percocet (we get perc 10s with 325 mgs tylenol and throw 6 of those in)
60 mgs 7 oh
12 mgs tizanidine muscle relaxer
4 mgs to 8 mgs xanax depending how much we have (4 is canon though)
a splash of nyquil

We would crush the pills and mix them with a very small amount of nyquil in a cup and we'd pour in the Jager and prescription cough syrup while mixing it as well. We then would pour it all into a 44 oz cup with some ginger ale. I named it, "Niggajizz Potent" and that shit is so fucking fun. It would last like 6 hours and it had a very nice wavy come up. The xans would hit first of course which just made us fiend for more so it's hard to sip on. But you'll black out if you don't sip on it slow enough. We never got respiratory depression that was too bad. It's way better than just lean imo. If you're already into opioids I'd say try it out. Just make sure you call it Niggajizz Potent. I'd love for that to be an actual drink that takes off.
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Excuse my ignorance but what are “lines” of codeine cough syrup?
 
4DQSAR said:
@Them Witches - my goodness, I just checked the BULK price of levorphanol and it's about $260,000/kg!

Now that truly IS insane. It's interesting that if you just glance at the list of suppliers, it seems like their is competition. Then you look more closely and it becomes obvious that Mallinckrodt in fact has a monopoly (they OWN the other suppliers). Given how little is produced, I suspect one batch per year is produced.

I say this based on the fact that the synthetically most similar medicine is butorphanol (which is actually synthetically MORE complex) costs about $50,000/Kg.

I'm so pleased that you have your eyes firmly on making the most of what you have. That's the way to go. The only thing that after 25 years still bothers me is that I cannot ride a bicycle. I miss the freedom. But unfortunately, I also have epilepsy so I can't (legally) operate a powered vehicle. Well, it's unclear what laws apply to E-scooters in the UK but I think I'm a little old to start using one of those ;-) Still, I enjoy the little I have.
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The forum is not letting me PM you.
 
@Them Witches - I cannot PM you either.

All I can tell you is that I haven't knowingly prevented PMs between us. Do you get an error as I do?
 
@4DQSAR -- I have some information about India I wanted to share with you. I still cannot complete a PM to you. Is this a forum site technical issue ?

Moderators can you give any insight why certain members cannot PM certain members...?

It's cool if anyone has blocked me. My reputation suits me and life dealt me in spades :violin: :lowrider:
 
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Them Witches said:
@4DQSAR -- I have some information about India I wanted to share with you. I still cannot complete a PM to you. Is this a forum site technical issue ?

Moderators can you give any insight why certain members cannot PM certain members...?

It's cool if anyone has blocked me. My reputation suits me and life dealt me in spades :violin: :lowrider:
Click to expand...
Feel free to pm me if you just want to test whether the system works for other recipients. You don't have to say anything more than "yo dawg" or whatever so that you can know it has nothing to do any content
 
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