Safe Doses for Long Term Dihydrocodeine Prescription (Not recreational doses)

[7ca5p]

Hi all, long time since I've posted, not sure which forum to post in to get the best answer here.

First and foremost, I am a 21 year old male who has regular prescriptions for Dihydrocodeine - I do not ever use it recreationally.

My doctor has misdiagnosed several of my health issues over the last year, leading to potentially life saving emergency surgeries, so I don't trust his judgment on this matter either. I was wondering if someone with a bit more knowledge on the matter than my doctor could inform me of the safe usage of long term opiate usage.

Due to various health issues, I have to take up to two 30mg tablets a day, but I am very concerned about potential addiction. I regularly have days where I deliberately do not take any, in an attempt to give my opiate receptors a rest, as well as attempting to alleviate the gastrointestinal effects it seems to cause.

I am wondering if some one could please let me know how I can safely regulate my doses so I can take it regularly over the next few years until my health either improves or kills me. I have already noticed a very slight decline in the potency of the effect it has on me over the last two months.

Thanks for any advice.

 

[morphonorconic]

The decline in potency you've been experiencing is a result of your tolerance building to the drug. Continued use will lead to a continual decline in effects, and ultimately in the level of pain relief. That is why the dose of an opioid is generally increased [gradually] over time when treating pain in the long term.

If you're asking whether or not you can maintain a consistent daily dose, say 30mg 2x daily, for several years, the answer is yes. However, the therapeutic/analgesic effects will diminish and that dose will become less and less effective over time at managing your pain.

 

[pally pete]

Hi all, long time since I've posted, not sure which forum to post in to get the best answer here.

First and foremost, I am a 21 year old male who has regular prescriptions for Dihydrocodeine - I do not ever use it recreationally.

My doctor has misdiagnosed several of my health issues over the last year, leading to potentially life saving emergency surgeries, so I don't trust his judgment on this matter either. I was wondering if someone with a bit more knowledge on the matter than my doctor could inform me of the safe usage of long term opiate usage.

Due to various health issues, I have to take up to two 30mg tablets a day, but I am very concerned about potential addiction. I regularly have days where I deliberately do not take any, in an attempt to give my opiate receptors a rest, as well as attempting to alleviate the gastrointestinal effects it seems to cause.

I am wondering if some one could please let me know how I can safely regulate my doses so I can take it regularly over the next few years until my health either improves or kills me. I have already noticed a very slight decline in the potency of the effect it has on me over the last two months.

Thanks for any advice.

Careful with DHC )Or any Opiates for that matter) as the addiction and dose increase creaps up on you, so beware, although i can only talk fro my own personal experiences as i have a very addictive nature and very little willpower.

Right now in time it would take me over **** mg of Dihydrocodeine to get any half decent recreational effects, this is a situation you dont wan't to end up in!

Btw does anybody know if it's safe to use Ritalin and Dihydrocodeine? Together? or spaced apart at different times in the same day, for example 20mg Ritalin at around 12pm midday and then x amount of DHC around 6pm.

Is it wise to take them together? do they potentiate or synergise in anyway? Or ar they just plain dangerous used together?

Thanks for any help.

 

[7ca5p]

Thank you both for your replies.

The decline in potency you've been experiencing is a result of your tolerance building to the drug. Continued use will lead to a continual decline in effects, and ultimately in the level of pain relief. That is why the dose of an opioid is generally increased [gradually] over time when treating pain in the long term.

If you're asking whether or not you can maintain a consistent daily dose, say 30mg 2x daily, for several years, the answer is yes. However, the therapeutic/analgesic effects will diminish and that dose will become less and less effective over time at managing your pain.

Thank you. Is there any tips or practises that can be put in place to combat tolerance? Will missing a day of doses every few days help?

Careful with DHC )Or any Opiates for that matter) as the addiction and dose increase creaps up on you, so beware, although i can only talk fro my own personal experiences as i have a very addictive nature and very little willpower.

Right now in time it would take me over **** mg of Dihydrocodeine to get any half decent recreational effects, this is a situation you dont wan't to end up in!

Btw does anybody know if it's safe to use Ritalin and Dihydrocodeine? Together? or spaced apart at different times in the same day, for example 20mg Ritalin at around 12pm midday and then x amount of DHC around 6pm.

Is it wise to take them together? do they potentiate or synergise in anyway? Or ar they just plain dangerous used together?

Thanks for any help.

Woah, when you say "**** mg", do you mean like, four figures? Over 1000mg? And yes this is the very thing I am concerned about. I am so scared that I will end up travelling down that road and end up taking huge opiate doses every day. As I said in my first post, I can already feel that starting to come about, and the effects are not as pronounced as they were a couple of moths ago. It also seems that I have got caught in a horrible cycle so that when I don't dose, my pain seems even worse because I have experienced life without it.

With regards to your question on Ritalin, I knew a friend who used copious (irresponsible) amounts of both and his doctor saw no problem prescribing him with both. I had a quick search on the "Drugs Interactions" website for you and there doesn't seem to be any interaction between the two, however definitely bring it up with your doctor if you can.

 

[bunge]

Im also prescribed DHC 30mg and mine is 60mg every 4-6 hours for pain. I find opiates and in particular DHC is great for my GI problems. I wont go into specifics and make everyone nauseaus but if you want to know more then you can always chuck me a pm. DHC is I find, a real bitch for tolerance raising rapidly. If you want to lower your tolerance properly then an abstinance from DHC and other opiates for a couple of months will be needed im afraid, pretty impossible in a chronic pain situation I know. However missing some days out from week to week will aid you in staving off addiction.

 

[bunge]

Pally pete, theres no obvious interaction between DHC and ritalin or other amp type drugs. Unless of course you hg ave a serious heart problem but if you did then I dont think you would take the ritalin in the 1st place!lol a bit of advice I would give though is to maybe have the ritalin first and use the DHC after to combat the ritalin comedown, which is infamous for being nasty.

 

[Swimmingdancer]

It also seems that I have got caught in a horrible cycle so that when I don't dose, my pain seems even worse because I have experienced life without it.

It's not just because you have experienced life without it, using opioids actually makes changes to your brain and CNS and makes pain worse. At this point it is probably just rebound pain, a return of the original pain except worsened, which for more people shouldn't last too long after only taking it for the period of time you have, but if you take dihydrocodeine for a few years you will not be able to function without it, you will need it just to feel normal, and your pain may be seriously worsened long-term if you stop. I would strongly recommend looking into every other possible alternative to cope with your pain aside from opioids, opioids should be the last resort, not the first choice. Even if you are going to take opioids seriously use other treatments to keep your opioid use as low as possible. Not sure what your specific issues are otherwise I would provide more specific advice.

 

[7ca5p]

It's not just because you have experienced life without it, using opioids actually makes changes to your brain and CNS and makes pain worse. At this point it is probably just rebound pain, a return of the original pain except worsened, which for more people shouldn't last too long after only taking it for the period of time you have, but if you take dihydrocodeine for a few years you will not be able to function without it, you will need it just to feel normal, and your pain may be seriously worsened long-term if you stop. I would strongly recommend looking into every other possible alternative to cope with your pain aside from opioids, opioids should be the last resort, not the first choice. Even if you are going to take opioids seriously use other treatments to keep your opioid use as low as possible. Not sure what your specific issues are otherwise I would provide more specific advice.

Thank you for the reply Swimmingdancer.

Well that's exactly the thing. I can't function without it at the moment anyway. Before I started taking it, even in the low doses that I am, I was completely useless. The pain was just too much. As a result, Couldn't get a job, couldn't study, couldn't move, couldn't make food. I attempted suicide a few months ago. Now, I have found a new lease of life thanks to DHC, but now I am told I shouldn't take it.

So I don't really know what to do.

By the way, my problems are in abundance. I have a brain tumour, severe Gastrointestinal problems that leave me hospitalised, and my spinal column is currently being scanned in many different ways for tumours on my nerves.

Not only does DHC help me with the pain that these cause, but also are more effective than my Antidepressant at curing my Anxiety and Depression (although I never take it with that in mind, it's just a pleasant side effect when I take it for the pain).

 

[bunge]

With your health issues I think opiate dependency is really not something you should trouble yourself with too much at the moment. That you can maintain on just two 30mg a day with the pain you must be experiencing is surprising, really 60mg a day is not a massive dose and you seem to have a sensible head on about dosing anyway. If its not too forward can I ask what other meds you currently take and also what country your based in?

 

[7ca5p]

With your health issues I think opiate dependency is really not something you should trouble yourself with too much at the moment. That you can maintain on just two 30mg a day with the pain you must be experiencing is surprising, really 60mg a day is not a massive dose and you seem to have a sensible head on about dosing anyway. If its not too forward can I ask what other meds you currently take and also what country your based in?

Thank you Bunge.

Yeah sure, I am in the UK Midlands and I am on Venlafaxine (although I am changing this to Sertraline soon because I have had better effects in the past from it). I also occasionally take Cyclizine for my nausea to stop me vomiting but I guess it's only semi regularly that I take it. At night, for pain related insomnia I am prescribed Promethazine. For my Anxiety I also occasionally take Diazepam which I am on a regular script for.

Thank you for your responses, it's really nice to be able to discuss this with someone who also takes DHC. I don't know anyone else who ever has regular prescriptions for opiates so it is safe to say you're the first person to have hands on experience that I have ever spoken/typed to.

 

[pally pete]

Thank you Bunge.

Yeah sure, I am in the UK Midlands and I am on Venlafaxine (although I am changing this to Sertraline soon because I have had better effects in the past from it). I also occasionally take Cyclizine for my nausea to stop me vomiting but I guess it's only semi regularly that I take it. At night, for pain related insomnia I am prescribed Promethazine. For my Anxiety I also occasionally take Diazepam which I am on a regular script for.

Thank you for your responses, it's really nice to be able to discuss this with someone who also takes DHC. I don't know anyone else who ever has regular prescriptions for opiates so it is safe to say you're the first person to have hands on experience that I have ever spoken/typed to.

Hey you must be a neighbor of mine as im from the Midlands too

I too used to be prescribed Venlafaxine (which left me with daily suicidal thoughts) and before that i was on Sertraline and before that Citalopram none of which worked for my Anxiety or Depression, unfortunately the only meds that did help were Opiates (DHC being especially good for the depression and anxiety) I also used to use Diazepam with help for sleep and help with reduction with my anxiety.

Neither the Opiates or Benzos were scripted so i ended up abusing them and leaving myself in an even bigger mess!

I now only ocassionally use but my toloerance is still huge so im better off not touching any DHC, Oxy or Benzos as i have little-no willpower and end up abusing them.

But i must admit the depression and anxiety relief from Dihydrocodeine (DHC) really is a great side effect.

Best of luck to you

 

[bunge]

Ah, im in the east of England, lincolnshire. Funnily enough im from the midlands myself, coventry. Your quite welcome btw, im impressed at how little you have to dose considering your health issues. I tried setraline for GAD at one point , brilliant for anxiety but made me so hypermanic I was hoovering the house at 3oclock in the morning and gardening in the pitch black at 4oclock in the morning. At the time I thought it was great but strangly the doctor didnt agree with me! :-D im more then happy to discuss all this sort of stuff anytime, feel free to pm me. Theres not many of us regularly prescribed opiate and benzo users and even less of us in the uk who are prescribed the dihydros month after month. I think the forum members over in places such as the US dont always realize how strict opiate laws are over here and how little choice there is for opiate and benzo meds. My mother is prescribed cyclizine for migraine induced nausea and I know from her run ins with the pharmacys that its rare to be gave it on repeat prescription. Promethazine is an interesting one for me and ive always meant to give it a go but im taking mirtazepine at the minute and cant mix other antihistamines with it so I take zopiclone as a sleep aid and muscle relaxant. Like I said im usually around on here hg anging around the BDD and ODD or pm me, ill be glad of the company.

 

[bunge]

pally Pete, another midlander! Great stuff!:-D if you found anxiety relief with opiates in the past, have you tried tramadol? It successfully treating my anxiety fir nearly two years and is a novel use if you dont tolerate new generation ADs well.

 

[pally pete]

pally Pete, another midlander! Great stuff!:-D if you found anxiety relief with opiates in the past, have you tried tramadol? It successfully treating my anxiety fir nearly two years and is a novel use if you dont tolerate new generation ADs well.

Tried it and although it did help it did'nt really suit me and made me feel not so good in a different kind of way.

 

[bunge]

I see, it seems some people either react great to tramadol or have a negative time with it, no middle ground.lol have you tried some of the older ADs like the tricyclics eg.amitriptyline (also good for nerve pain) or the newer NaSSa's like mirtazepine or even if you want to be a bit of a pioneer the gabaergics like pregabalin? Sorry if im firing to many questions at you, my urge to problem solve sometimes takes over my manners.lol but its always with the best of intentions (i hope!). :-D

 

[Swimmingdancer]

Thank you for the reply Swimmingdancer.

Well that's exactly the thing. I can't function without it at the moment anyway.

What I meant is that once you become seriously dependent on opioids you won't be able to function without them even at the level that you normally would when you take nothing. Not meaning "function" as in be able to have a normal life, like you will feel like you can't live without them at all.

Now, I have found a new lease of life thanks to DHC, but now I am told I shouldn't take it.

Not saying you shouldn't take it, just you said you weren't concerned about addiction and you wanted to know how to take it for a few years, and you simply can't take an opioid regularly for a few years without becoming physically dependent. And I would be shocked if you could just stay on DHC that whole time and not require escalating doses and/or stronger opioids. You have to look at it as something you may potentially have to take for the rest of your life, which can be hard to comprehend when you are 21 and in pain and just wanting anything to make that pain stop. I have been there. Opioids eventually stopped working and I was left with far more severe pain and other issues than I had to begin with. So my personal experience has made me really want to warn people of what they might be getting themselves into and to do everything they can to prevent ending up in my situation.

my problems are in abundance. I have a brain tumour, severe Gastrointestinal problems that leave me hospitalised, and my spinal column is currently being scanned in many different ways for tumours on my nerves.

That sucks . I have a lot of empathy, as someone who also lives with chronic pain. Do you know what type of brain tumour you have?
As bunge said, if your health issues are that severe and if they are likely permanent (?), becoming dependent on opioids may be a worthwhile trade-off for you. I still really think it's important to try everything else possible, and keep your opioid usage at a minimum. When taking opioids it can be so easy to not do anything else for your health, especially non-drug treatments that require time and effort. It's so much easier to take some pills that you know will make things feel better right away, and then while you are feeling better you don't have the motivation to do other things that may help your condition. This makes it very easy to not make any real progress on healing.

 

[bunge]

Great advice from swimmingdancer. Make sure you explore all techniques and methods of dealing with pain.

 

[pillboxskid]

Im also prescribed Dihydrocodeine 3 30 mg tablets 4 times a day.What i have to say will be short and sweet.I think one of the most inportant keys into not developing addictive patterns is your frame of mindset you have.You seem like a logical sensible person and i belive if you take as prescribed which you i would imagine would do then that could be a very usefull tool into delaying the development of addiction. You even say that you deliberatly miss out doses to prevent addiction!! personaly i think if that mind set is continusly applied you will be okay!! Good luck my friend and respect for having the balls and the mind set i am to weak to use in my situation...

 

[pally pete]

I see, it seems some people either react great to tramadol or have a negative time with it, no middle ground.lol have you tried some of the older ADs like the tricyclics eg.amitriptyline (also good for nerve pain) or the newer NaSSa's like mirtazepine or even if you want to be a bit of a pioneer the gabaergics like pregabalin? Sorry if im firing to many questions at you, my urge to problem solve sometimes takes over my manners.lol but its always with the best of intentions (i hope!). :-D

Yeah thanks.

My G.P + Psychiatrist will not prescribe any other types of medication until i completely cut ALL Benzos and Opiates out of my life for at least 3 months or more.

They have both said this to me as they do not want the risk of overdose on there conscience.

 

[tomatalli]

IMO change your doctor if he has misdiagnosed you multiple times leading you to life threatening/saving emergency room visits, he sounds like an awful physician.