Phenobarbital to Potentiate Hydrocodone and Codeine

[iwilliam]

Okay, I'll preface by saying I know that I'm talking about a risky sort of combination, which includes one of the most notoriously over-dosable drugs out there -- Phenobarbital. However, this is kind of my reason for asking. I have been reading, and it seems that to best potentiate codeine type drugs (which in the body will be converted to morphine type drugs) one would want to INDUCE CYP2d6 and INHIBIT CYP3A4. So far as CYP3A4 goes, there are plenty of inhibitors to choose from. However, the list of inducers of CYP2d6 is very, very short. The only one I can get my hands on is phenobarbital. And so comes my question: Exactly how risky do you think it would be for an OPIATE TOLERANT person to take say, 15-30 mg of phenobarbital along with 10mg hydrocodone and 100-200mg codeine? (cyp3a4 inhibitors will be present, and legion)


Any advice or info is welcome. Mind you, I'm not looking for, or asking dosage advice... just maybe some opinions about the kind of combo I mention above.

Thanks.

 

[jackie jones]

It is a bad idea. OD via respiratory depression, as you likely know. Also, I find phenobarbital to be one of the dirtier feeling barbiturates. It has a tendency to make one quite sleepy.

 

[iwilliam]

I do understand that this is one of the biggest risks with this combo. (Sorry for poorly formulated questions) I think what I'm trying to ask, is exactly how big of a risk do you think that kind of thing is. Better way to ask it maybe:

How much would a very small dose of phenobarbital increase the liklihood of serious respiratory depression in that kind of combo / dose-range? My initial thoughts about a "small dose" were 15-32... but I guess could go as small as 7mg-ish. I'd just have to 1/4 the tablet.

Keep in mind, I am pretty opiate tolerant. I'm in my first week detoxing from suboxone on a codeine taper. I'm nearly out of codeine and my kratom may not be here until Friday... hence my desire to boost what I have, as best I can.


***I would also be using albuteral inhalation (I have both metered inhaler, as well as a nebulizer) to counter some of the respiratory depression.

 

[iwilliam]

Okay, the consensus (here and elsewhere) seems to be that this is a bad idea, so I won't use the phenobarbital. Thanks for the advice.

 

[muie]

^^Bad idea or not why has no one answered the OP inital question, does phenobarbital or other barbies potentate opioids that are metabolized via cyp 2d6?

 

[lowerthanlow]

I got another angle on it today. I was interested in the same thing, but for amphetamine (metabolized by CYP2D6 as well). I washed some amphetamine sulfate(aq) with DCM for myself. This is the cleanest amphetamine you can get outside of the lab. Chloroform works as well. I advise to warm the biphasic solution to further separate DCM from water phase because higher temperatures decrease their miscibility IIRC.

Anyway, I was writing that for you to believe me that it's true amph that works pretty well for 12 hours, all day, and it's easy to see when something speeds up its clearance, like ascorbic acid/cranberries for faster excretion in more acidic urine. What phen did today was unbelievable - I've taken of it 3x 100 mgs during the course of the day, all converted with KOH to form potassium phenobarbital, which is a more water-soluble form used in injections (sodium salt actually), and what I've felt seems to confirm that it would come up much faster - about 30 min instead of 2 h like the generic nonpolar version, which peaks after 8 effin hrs in blood god hahah.

Anyway, I was on the amph the whole night, went to buy phen today, and after all that, when I took that same amph, the main high lasted for about 1-2 hrs instead of 3-6 like before. I took the last dose at about 6PM and I am pretty sure that most of it is out of my system.

I know it's hard to assess since phen would cancel most of amph's side effects like tension. BUT since we're on that, the combo is marvellous. Phenobarbital blocks or somehow reduces AMPA glutamate receptors activity which is crucial for reduced anxiety on stims IMO - also for the risk of psychosis. Ibuprofen kinda does a similar thing too, maybe another mechanism, dunno, I'm getting flakey hahah. Peace.

PS
I don't do opioids, but the combo will be tested by some friends in no time.

 

[Keif' Richards]

The difference is going to be negligible in subjective terms until you've been taking the Phenobarbital (Luminol) for at least 4-5 days and maybe more. I'd wager you'll start experiencing subjective effects relative to enzyme manipulation starting on day 5 of consistently taking the drug. I'd wager you're not going to get anything approaching "recereational" benefit until you've been taking Phenobarbital for a couple of weeks. The process of inducting onto Phenobarbital like this will leave you in a fairly constant state of lethargy and numbness. It's not enjoyable at all, trust me. After a day of it you're gonna be seriously annoyed by the feeling. There is a reason everyone says not ti use this stuff recreationally.

I firmly believe that if it were available over the counter tomorrow, it wouldn't be a serious problem, at least after people tried it once for themselves.

I have ~300 Phenobarbital tablets in my desk drawer that I got a long time ago for withdrawal from Methadone. Now this is an appropriate application for this shit. When you're rattling with Akathisia, any kind of rest is a godsend. The whole exercise you're describing is just not worth it and I'm putting myself completely in your shoes here based upon what you've discussed here. It is a waste of your time, but I imagine you'll see for yourself.

Note: 3-4 years ago when I was still an active addict, I tried selling my surplus. Nobody was interested, as they didn't know what it was. I talked a few people into trying a few stating they were sedatives like Benzodiazepines and not one of them ever asked for more. They didn't even want them for free at the end of it. I still have a bunch of useless shit in my drawer. I wish I could send it to some poor epileptic kid in the Mumbai slums, but just like sending them my leftover dinner, the logistics just don't make sense.