Opioids Oxycodone hydrochloride

[KurtAurelius]

To quote Ricky Ricardo" you have some splaining to do",

4DQ will explain better than I but..

I believe I recall them explain due to high oral bioavailability and the strength of oxymorphone,

any conversion via whatever CYP enzyme will cause a overall greater level of opioids versus even IV Oxy at the same dose

but I could be wrong..

 

[4DQSAR]

It's oxycodone that is actually more active when consumed orally. For decades the parroted wisdom was that although around 10% of any oral dose of oxycodone was converted to oxymorphone by liver enzymes, it was stated that the oxymorphone took no part in the subjective effects of oxycodone.

But in the last decade, studies using knock-out mice showed not only that the oxymorphone metabolite WAS part of the subjective effects of oral oxycodone, it was in fact responsible for around half of all the subjective effects of oral oxycodone.

I suggest that it was this reasoning that led researchers to wrongly conclude that oxycodone would not end up feeding the needle or even just have pills of it crushed up and snorted. The recieved wisdom was that it would make no sense to use anything but oral administration.

Of course they never told anyone and so it appears that oxycodone indeed has been abused and commonly that abuse took the form of parentheral administration.

Hence my not trusting Wikipedia even an inch. Someone wrote that page over decade ago but since nobody gets paid, nobody ever bothered to check if new studies showed totally different results. Who wants to argue with total stranger that science is a process, not a set of axioms?

 

[KurtAurelius]

Realised I wasn’t being clear lol that I was referring to oral use of oxy but loads of great info as always^

 

[Jnowhere]

4DQ will explain better than I but..

I believe I recall them explain due to high oral bioavailability and the strength of oxymorphone,

any conversion via whatever CYP enzyme will cause a overall greater level of opioids versus even IV Oxy at the same dose

but I could be wrong..

I mean Oxy orally or sublingual as compared to someone shooting it, is there really any difference between the "rush" or fast strong onset?

Not comparing IV Dilauded( hydromorphone), that is a very thing. Orally it kind of sucks like the boiavailability low of morphine. Maybe it is due to person's personal basic body chemistry( or whatever, I was good at chemistry, but hated all the tedious stuff). No, Patience when it comes to that type of lab stuff.

But comparing IV Dilaudid and Oxycodone is huge strength difference but Oxy, if you take a high ( no pun intended) doses is much more euphoric than oral Dilaudid apparently but IV Dilaudid wears off in 2 1/2 hours to maybe just under 3 hours. But comparing the two IV isn't a fair comparison, besides all the Canadian junkies on huge daily Dilaudid scripts 28 , 8 mg aday? I guess fentanyl is really super strong if a tolerance is that absurdly high( I have only had it in the hospital, many times, Dilaudid) great while it lasts. However when your feeling "relaxed" time flies and when your waiting time stands still.

Dilauded is even harder to get than Oxycodone for a legit problem. Also like morphine it varies so much from person to person.

Besides, I don't want to be an addict. There is a difference between addiction and dependence.

I forget my meds till, Oh I gotta shit, I guess I didn't take my pill(s) and was feeling bad,( aka eating and other pains). Forgetting and hating your meds isn't addiction, lol.

I need a cigarette,lol.

 

[Dr. John Thackery]

I guess we have different priorities. I am concerned only with my legally prescribed meds taken properly. Opiods are a tool for managing pain or at least lessening it enough to not be miserable from pain.

At least in my case. And they are great without shooting them, or years ago were. Now it wouldn't give, me or someone on long term chronic pain management a rush. Even smaller doses produce high tolerance while being able to control pain some.
--‐----‐----
In the past I was only interested in the ritual of opening the bottle or I suppose cans of beer and pouring them into a big plastic cup,lol.

I am not an IV drug user, so I don't understand the ritual. The ritual of trying to find a vein, and going through the whole mixing of it with water and heating the spoon and injecting seems almost masochistic and much more dangerous.

I would not even be able to come close to being able to shoot a large enough of a dose of Oxy to get a rush. Too much mass with fillers and binding shit.

Besides ruining veins seems horrible, not that I am afraid of needles. I suppose that getting high off it; and being able to eat without a lot of pain, are two different issues.

I have never wanted to shoot anything and I do understand that rush, kind of. Severe alcohol wd/s and the rush of pharmaceutical Dilaudid IV and Ativan( Lorazepam), was kind of a rush; especially when you are in horrible shape from countless severe alcohol wd/s and that warm feeling of relief from pain and all the other misery associated with having to deal with past alcohol wd/s is, very very pleasant.

But Oxy ir, today if it can be obtained might cause a rush if you haven't been on it it everyday several times a day for so many years.

But sublingually taken works guick and even just regular oral kicks in fast, 20 minutes or so, maybe longer for others.

Besides the ease of taking it( legally in my case because of a chronic condition) seems to the whole point. Besides recreationally tolerance builds fast and is very expensive from what I have read on here.

I suppose that people into the old school original Oxycontin, back ~20 years ago or longer were just taking a large conentrated dose and being able to shoot large amounts with less shit to add size to the IR ones( the no Tylenol ones of course) of today.

But, snorting it is a waste, up the butt, Hell No!! Shooting seems pointless( no pun intended,lol) with it working so well orally.

i don’t recommended it i just understand why ppl do it. the rush rationale is really only worthile for dilauded - any other opioid it’s not worth any risk.

i used to use IV for 7 years straight. now it’s bee about 12 years since i’ve injected. it’s just not sustain able and i already have permanent bladder and lung damage from drugs so yea….i don’t take any drugs other than orally and only weed for a long time.

the only thing id ever inject again and thats worth injecting instead of just eating is dilauded.

if i ever acquired dilaided again i would inject it. “just one time so i dont get addicted tho”

i’m opioid dependent anyways on 10 mg of methadone. hope to taper off completely but chronic pain issues have made that not happen yet.

 

[Them Witches]

was prescribed low dose amitriptyline to help with neuropathic pain (and it worked) but when, after just two decades of constant pain, a consultant finally prescribes Oxylan (generic Oxycontin) BUT told me to stop taking the amitriptyline as both modulate eatracellular monoamine levels i.e. have the potential to cause serotonin syndrome.

I am an odd case. But I take amitriptyline 150mg for fun with daily Zoloft 100mg, Busbar 30mg, Oxycodone IR 210mg, Methadone 40mg, Clonidine 0.9mg, Lunesta 3mg, Cyclobenzaprine 10mg, Valium 15mg and I have no issues with serotonin syndrome. I like amitriptyline during the day time cause it helps keep me calm taking 5 out of 7 days each week

 

[Them Witches]

I mean Oxy orally or sublingual as compared to someone shooting it, is there really any difference between the "rush" or fast strong onset?

Oxy has no rush shooting it. I have even used 20mL PICC line rigs with 120-150mg with a fast push. It was a scary "pins and needles" "sweating" "grab a wall oh shit 15 seconds of am I going to die feeling"

Oral is a 20-25 min onset with energy feeling. Crushing or dissolving a Mallinckrodt whole pill under the tongue is a 10-15 min onset has a heavier feeling/sedative and lasts longer. put 90-120mg under your tongue and it is very sedative and most should expect a nap.

 

[4DQSAR]

red tops good to know -- if you dont mind me inquiring how many mg's a guy who gets shot and likely is dying get in one of them red tops?

Ive always kinda wondered that -- we goin 10mg (traditional) or like 100 in that situation

10mg i.e. one red top. But I do know of a single case where a second dose was given. I thought I had covered this. If not, I can only apologize for the oversight.

@Dextro .45 - FYI in the UK we still get what I can only assume to be the original modified release formulation. The difference is that oxycodone is only rarely prescribed and as far as I can work out, a UK clinician is likely to prescibe roughly half the amount a UK clinician would prescribe.

@Skorpio pointed out that new 'abuse resistant' formulations actually use osmotic pressure to release the active. Sure, it's ALWAYS possible to overcome any form of modified release, but it seems that for once sense has prevailed so that although you can indeed still produce an IR solution, you can't easily produce a solid. At some point it becomes more trouble than it's worth.

Putting pills into salt water and leaving them on top of a radiator will always work, but you then end up with a salty drink which you still have to swallow.

 

[notsmokeymcpot42088]

I think you did respond once as I kinda thought "Damn 10 mg if I get shot --- not great!" and I think I said I somethin like I was hopin 100mgs - maybe more even, kind of a "Quarter syringe for pain, half for shock level pain, all for mercy kill" type situation

I think you said everyone gets two -- which is better than one, somethin about em being called "coffin kits" (Shit I accidentally deleted your first line in the quote, apologies and let the record reflect such)

I certainly understanding not wanting to deal with "Half syringe/quarter syringe" on the battlefield -- but than again...

o

@Dextro .45 - FYI in the UK we still get what I can only assume to be the original modified release formulation. The difference is that oxycodone is only rarely prescribed and as far as I can work out, a UK clinician is likely to prescibe roughly half the amount a UK clinician would prescribe.

@Skorpio pointed out that new 'abuse resistant' formulations actually use osmotic pressure to release the active. Sure, it's ALWAYS possible to overcome any form of modified release, but it seems that for once sense has prevailed so that although you can indeed still produce an IR solution, you can't easily produce a solid. At some point it becomes more trouble than it's worth.

Putting pills into salt water and leaving them on top of a radiator will always work, but you then end up with a salty drink which you still have to swallow.

 

[notsmokeymcpot42088]

the rush and the ritual.

The rush kinda sucks compared to most opiates though? (Or do you subjectively not agree) You have tried IV morphine and Hydromorphone?

For me the oxy rush was pretty negligible but I certainly seen ppl throw they lives away shooting them -- heard of ppl throwing they lives away 'smoking' them which I dont care to discuss as it has been ad nauseum ad infinum times already

I like the dilaudid high more than oxy -- but I can see that being highly subjective one being thebaine derived. Both are pretty short lived snorted or IV'd --- oxy may be a bit warmer and more stimulating....

Dilaudid is better at just calming the brain and just feels cleaner to me --- ok the rush has a huge part of it. Can't beat it IMO/E.

I hear meth gives it a run for its money but no thanks on that

 

[4DQSAR]

Well, if you have just been shot, fragged, crushed or blown up, no dose of an opioid will be 'euphoric'. It's simply used because it reduces the pain sufficiently for casevac. Medivac for preference, but that's not always available. The goal is to get the injured to appropriate clinicians as fast as possible. Battlefield medicine is nothing more than MARCH PAWS (TCCC). In fact, A is not really addressed. If a casualty has a lump of flesh sticking out and copious blood loss in the result, tape it back. They will die from blood loss long before infection becomes an issue. Sure, clean water is available, clean the wound, but every step is a dilemma. The goal can only ever to make the best decisions based on current information.

Yes, you will see people die. Yes, it's a terribe blow no matter how familiar you become with the process. But with battlefield medicine, triage will sometimes include deciding that a person cannot be saved.

 

[Them Witches]

Last month I was in the ICU hospital, they turned me on to a new favorite PRECEDEX (dexmedetomidine) is an intravenous sedative used for, and often preferred in, ICU, intubated, or procedural settings due to its ability to keep patients calm and cooperative without significant respiratory depression. It provides sedation, analgesia, and reduces anxiety by acting as an alpha-2 adrenergic agonist. They did a 400mcg/100mL constant infusion (72hrs) with Diluadid 8mg IV : 4hrs with my daily PO Roxi 210mg, Methadone 40mg, Clonidine 0.9mg, Ativan 2mg, Lunesta 3mg, Vistaril PAM 100mg. I only slept 3-5hrs over 4 days. I was having a great time regardless of the circumstances.

In the US, the only give Precedex in the ICU. Damn shame I say. It is 8 times stronger than Duraclon IV (Clonidine HCl).

 

[Them Witches]

Dilaudid is better at just calming the brain and just feels cleaner to me --- ok the rush has a huge part of it. Can't beat it IMO/E.

Only the cool nurses push it fast. The slow push leaves more to be desired. Diluadid IV every 4hrs builds up and gets noddy.

BTW, I like the Valium more than Ativan. Valium is safer with opioids and I can remember things.

 

[notsmokeymcpot42088]

Yea soldiers don't get the most humane treatment. Who woulda thought the gov wouldnt take care of everything and be generous.

If I am forced to see someone die and be there I would prefer if they had the option to go quickly through morphine. ( I am going to guess that is not an uncommon sentiment ).
Also tactically bad to be pinned down with a guy you know is dying and cant stop screaming and giving your position away --- a gunshot is loud and pretty harsh. Morphine, quiet and relatively peaceful.

Of course if there is a chance of survival you don't do that and I could see it being a problem if every soldier that option..... I digress. I run no army and pretend to be no expert on running a platoon or w/e

 

[notsmokeymcpot42088]

Only the cool nurses push it fast. The slow push leaves more to be desired. Diluadid IV every 4hrs builds up and gets noddy.

BTW, I like the Valium more than Ativan. Valium is safer with opioids and I can remember things.

Lol I use to get a bit of shite from that as they were expensive "Man you slip out you gunna lose like 40 bucks! take your time" --- what are you my dope shooting coach... much more worried about my vein and turny timing.
(Thank god thats done - not that I dont miss it)

I remember going to the sauna (If you never looked at your veins in a sauna check em one time they get like hose sized) and because of that banging a bunch of dilaudid than being able to outlast like everyone in the sauna. "Well I feel no pain and breathe much less than you" --- Room quietly clears

ps at equipotent doses -- yea valium over ativan all day long. Idk why hospitals default to lorazepam (Must be cheap?). Valium lasts longer, has some muscle effects -- ativan is what they use to write ppl that they didnt wanna give benzos before ambien and they were so "off limits" so to speak

 

[Them Witches]

Yea soldiers don't get the most humane treatment. Who woulda thought the gov wouldnt take care of everything and be generous.

If I am forced to see someone die and be there I would prefer if they had the option to go quickly through morphine. ( I am going to guess that is not an uncommon sentiment ).
Also tactically bad to be pinned down with a guy you know is dying and cant stop screaming and giving your position away --- a gunshot is loud and pretty harsh. Morphine, quiet and relatively peaceful.

Of course if there is a chance of survival you don't do that and I could see it being a problem if every soldier that option..... I digress. I run no army and pretend to be no expert on running a platoon or w/e

The Delta Force guys and Navy Seal guys bring there own med bags full of everything. I was listening to a Delta tell a story while undercover deep OP's where the Afgans were trying to dope him up on poppy tea, he drank it, then took his speed out of his med bag and played asleep.

 

[4DQSAR]

Well, that second red top in the 'morphine coffin' IS most likely to provide symtomatic relief. In fact, you hear stories of soldiers handing over red tops so at least those who will die do so without pain. But obviously, the official line is always that 'during administration of moprhine, my second autoinjector of morphine was lost due to incoming fire'. That will get the soldier put on a charge, but I've never heard of a single case where an actual formal military trial resulted.

Drumhead court-martials only seem to remain within the Russian military.

 

[notsmokeymcpot42088]

That makes sense -- I know they were bringing mad heroin / poppy back when we first went into afghanistan. (My personal silver lining of that war the H quality went up a TON)

I think they had a quick battlefield method where they could make a rough heroin synth out of poppy heads right there in the battle field. (I read some report on it, the prevalence citations and methodology I admittedly did not look much at)

In the air force (I believe) they get "Stop and Go" pills everday --- the "Go" pills are dextroamphetamine the "Stop" pills are Temazepam. (looks like they use modafinil and zoldipem sometimes now, that sucks)

 

[notsmokeymcpot42088]

Well, that second red top in the 'morphine coffin' IS most likely to provide symtomatic relief. In fact, you hear stories of soldiers handing over red tops so at least those who will die do so without pain. But obviously, the official line is always that 'during administration of moprhine, my second autoinjector of morphine was lost due to incoming fire'. That will get the soldier put on a charge, but I've never heard of a single case where an actual formal military trial resulted.

Drumhead court-martials only seem to remain within the Russian military.

That is good to hear -- god bless soldiers having a way of looking out for eachother

 

[Them Witches]

ps at equipotent doses -- yea valium over ativan all day long. Idk why hospitals default to lorazepam (Must be cheap?). Valium lasts longer, has some muscle effects -- ativan is what they use to write ppl that they didnt wanna give benzos before ambien and they were so "off limits" so to speak

Ativan is not much of a party drug while taking opioids. Couple extra mg's and I Wake up and everyone is mad at me because I spray painted all over their 2021 Toyota Supra and left the house door open and all the pets ran out in the middle of the night. Oh and filled the coffee maker with motor oil.

Valium is enjoyable and if I take too many I just get tired and fall asleep safely. No harms and no party fouls.