• 🇬🇧󠁿 🇸🇪 🇿🇦 🇮🇪 🇬🇭 🇩🇪 🇪🇺
    European & African
    Drug Discussion

    Welcome Guest!
    Posting Rules Bluelight Rules
  • EADD Moderators: Pissed_and_messed | Shinji Ikari

When doctors would rather prescribe you something you have an allergy to than treat your pain adequately..

ChemicallyEnhanced

ChemicallyEnhanced

Bluelighter
Joined
Apr 29, 2018
Messages
10,410
Location
UK
So in the UK we have a lot less opioid options than in the US (we don't have any form of hydrocodone, oxymorphone, hydromorphone, or oxycodone in the form of percocet) and a year ago we lost Dihydrocodeine [opioid 2-2.5 x stronger than codeine and roughly 1/5-1/4 the strength of morphine] as it was randomly decided only patients in hospital could be prescribed it.
I was on it for years along with a tiny morphine dose (10mg twice a day) and when it was stopped I was bumped down to codeine. Not only does that mean I was on a drug less than half the potency of what I needed, but I am also mildly allergic to it*.
I told them so and asked if instead I would just have my morphine dose increased so that it equalled an equi-dose of the DHC I was no longer getting. They said no.

So now I have to take pills I am allergic to every day, plus anti-histamines every day to try and counter the allergic reaction I get.

Medicine is so fucked up when it comes to pain.


*But, weirdly, none of the codeine-BASED opioids like Dihydrocodeine or Oxycodone
 
The UK has oxycodone and hydromorphone, codeine, Dihydrocodeine IR & SR formulations of 60,90 & 120mg that last for 12 are also available. We also have tramadol, tapentadol, pethidine, buprenorphine, fentanyl and meptazinol. Oh, and methadone is also used to treat pain,

UK Doctors have a wider number of options than a US doctor. The difference is that a US doctor gives opioids for pain but to quote the BNF 'opioids are used to treat unacceptable suffering' which is a VERY strange mandate if you ask me.

But the truth is that 95% of them have NEVER prescribed anything except tramadol and codeine. If you are in long-term intractable visceral pain then you need to get an appointment at a pain clinic. Even then, they will try to avoid opioids wherever possible.

I was in an accident and my right-hip was destroyed. The replacement is dislocated so in effect I'm walking on a dislocated hip and it STILL took 20 years to get codeine which was upped to oxyContin and codeine for breakthrough pain and then the codeine was dropped and the oxyContin increased - the doctor told me it's because codeine is more addictive....

If you can see the logic of that, you are doing better than me,
 
DeathIndustrial88 said:
Doesn't the UK also have heroin? Not that they're likely to give it to you ever but at least they acknowledge it has medicinal potential unlike the US which has it as a schedule I
Click to expand...

Indeed - it's called 'diamorphine' and it's very rarely used. Generally end-of-life care (less volume to inject if the patient is emaciated) or prompt analgesia is required.

Their used to be a Manchester-based ambulance that had a 5.6l Rolls Royce engine in the front and 2 heart specialists in the back nicknamed 'Whiskey 1'.

A friend of mine had a heart attack at the railway station and the W1 doctors decided the distress could trigger further heart attacks so gave him diamorphine... and he said it was a lot (I'm guessing actually 30mg) but he marvelled that he was in so much agony he was screaming... and 10 seconds later he was.... well not OK but able to communicate his medical history to him.

He died in the 90s. I still miss him. Brian was a really nice bloke.
 
Are you actually allergic to codeine (massive facial swelling, airway constriction, EpiPen time) or is it just a histamine response (itching, flushing)? The latter is quite normal and is not a true "allergy" at all. (Also, taking an antihistamine with codeine is a known way of potentiating it, c.f. "lean")

It is unlikely you are truly allergic (i.e. have an inappropriate antibody linked immune response) to codeine if you can tolerate DHC and morphine.
 
sekio said:
Are you actually allergic to codeine (massive facial swelling, airway constriction, EpiPen time) or is it just a histamine response (itching, flushing)? The latter is quite normal and is not a true "allergy" at all. (Also, taking an antihistamine with codeine is a known way of potentiating it, c.f. "lean")

It is unlikely you are truly allergic (i.e. have an inappropriate antibody linked immune response) to codeine if you can tolerate DHC and morphine.
Click to expand...
This. Just reads as someone whining because they didn’t get what they wanted.
 
sekio said:
Are you actually allergic to codeine (massive facial swelling, airway constriction, EpiPen time) or is it just a histamine response (itching, flushing)? The latter is quite normal and is not a true "allergy" at all. (Also, taking an antihistamine with codeine is a known way of potentiating it, c.f. "lean")

It is unlikely you are truly allergic (i.e. have an inappropriate antibody linked immune response) to codeine if you can tolerate DHC and morphine.
Click to expand...
THe 'flushing' can be alarming though. I once took too much codeine too quickly, thinking it might be OK as a relatively low dose, but I still turned betroot red which gradually spread from my head downwards and covered my whole body IIRC. It was an uncomfortable and prickly heat, and even if not strictly speaking dangerous, I was so glad that I had some anti-histamines in the house.

I never get such bad reactions with DHC either. Never did with poppy tea either, back in the days when it was possible to get pods rich in those good alkaloids, supposedly including codeine.

I gather these are all fairly typical reactions to codeine and DHC.
 
LoginNotSecure said:
This. Just reads as someone whining because they didn’t get what they wanted.
Click to expand...
well, the side effects are anyway shitty, huh?
And anyway any adult should get any drug they want in the first place. Or at least in very wide range.
Not necessarily prescribed by doctor always tho (but in this case yes, prescribed by doctor, for it is medicinal use)
 
Has anyone ever been on clonazepam and when given UA's it never shows up???????????

This keeps happening to me at every clinic I've been to that uses those dumb 10 panel drug tests.
I literally take my klonopin the night before & the day of my appointments & when I'll pee, they'll say it didn't show up.
This makes me wonder how many people out there have had their meds taken away or some shit because these bunk tests said they weren't taking it when they really were.

Idk why it keeps happening either but those little 10 panel tests should never stand in a court of law if they're this stupid.
I've even had one come back negative for buprenorphine when I've literally taken buprenorphine every day for the past 6-7 years. Every single day without fail.
Even if i had skipped a day or even two, there's no way it would be gone out of my system or that low that it wouldn't register.

Sorry, thread derailing topic.
 
Pissed_and_messed said:
well, the side effects are anyway shitty, huh?
And anyway any adult should get any drug they want in the first place. Or at least in very wide range.
Not necessarily prescribed by doctor always tho (but in this case yes, prescribed by doctor, for it is medicinal use)
Click to expand...

Very true, i believe and adult should be able to take what they need. It's our bodies after all. Who's a government to tell me i can't trip on lsd in my 40's. Canada has crazked down on family doctors giving scripts easy but you could go to a clinic and get subs methadone morphine or hydromorph... makes little sense eh?.. send grandma to the meth clinic because her doc said no.

But thankfully we have that option. I can't take codeine, not allergic just get itchy. We can buy codine otc but i don't know many that do
 
DeathIndustrial88 said:
Has anyone ever been on clonazepam and when given UA's it never shows up???????????

This keeps happening to me at every clinic I've been to that uses those dumb 10 panel drug tests.
I literally take my klonopin the night before & the day of my appointments & when I'll pee, they'll say it didn't show up.
This makes me wonder how many people out there have had their meds taken away or some shit because these bunk tests said they weren't taking it when they really were.

Idk why it keeps happening either but those little 10 panel tests should never stand in a court of law if they're this stupid.
I've even had one come back negative for buprenorphine when I've literally taken buprenorphine every day for the past 6-7 years. Every single day without fail.
Even if i had skipped a day or even two, there's no way it would be gone out of my system or that low that it wouldn't register.

Sorry, thread derailing topic.
Click to expand...

At my clinic they have a 14 panel i think(?). I take clonzepam and it shows up. It test for benzo's. If you get a dirty test they sent it to the lab for a mass spec test because false positives happen
 
DeathIndustrial88 said:
Has anyone ever been on clonazepam and when given UA's it never shows up???????????

This keeps happening to me at every clinic I've been to that uses those dumb 10 panel drug tests.
I literally take my klonopin the night before & the day of my appointments & when I'll pee, they'll say it didn't show up.
This makes me wonder how many people out there have had their meds taken away or some shit because these bunk tests said they weren't taking it when they really were.

Idk why it keeps happening either but those little 10 panel tests should never stand in a court of law if they're this stupid.
I've even had one come back negative for buprenorphine when I've literally taken buprenorphine every day for the past 6-7 years. Every single day without fail.
Even if i had skipped a day or even two, there's no way it would be gone out of my system or that low that it wouldn't register.

Sorry, thread derailing topic.
Click to expand...
As far as I know the only relatively popular or widely used benzo type drug that doesn't show up on those drug tests is Etizolam, due to it being a thieno-diazepine and not strictly speaking a benzo, although it feels just like one, and the anti-anxiety properties are said to be 6 times more effective than diazepam.

Could be handy to know that in various circumstances.

Not sure why Clonazepam wouldn't show up in some tests. Are you sure they are genuine pills?
 
When given parenterally, maybe. I always found it to be about 1.2-1.5x codeine at best. Also. [ref]

I do think that DHC has either no ceiling effect, or a greater one than codeine, as I could also take much higher doses,

In principle it would not be difficult to turn codeine into dihydrocodeine vie a simple hydrogenation reaction (I did that many times because DHC is a precursor to dihydroheroin if reacted with HBr in acetic acid). It's probably out of the scope of what the average person can do though.
 
Bleaney said:
As far as I know the only relatively popular or widely used benzo type drug that doesn't show up on those drug tests is Etizolam, due to it being a thieno-diazepine and not strictly speaking a benzo, although it feels just like one, and the anti-anxiety properties are said to be 6 times more effective than diazepam.

Could be handy to know that in various circumstances.

Not sure why Clonazepam wouldn't show up in some tests. Are you sure they are genuine pills?
Click to expand...

Modern tests are based on antibody response so if it binds to the benzodiazepine PAM site, it should give a positive. I suspect etizolam is often missed because metabolism is so fast and all of these tests have a cut-off point. It's T1/2 is 3.5 hours and I don't know if the metabolite is active - the alpha hydroxylation may well remove all or almost all affinity.

sekio - it was discovered that unlike codeine, DHC is an active opioid in it's own right. That is why the UK has 12-hour SR formulations (60,90 and 120mg).

I was interested to discover that while codeine-6-sulfate is toxic, dihydrocodeine-6-sulfate is an active opioid with a significantly higher affinity than the parent compound (although I have not computer LogP, pKa or such.

That whole class interests me because most people see an image of the molecule and believe that the A & C rings are more or less planer when in fact they are at almost 90 degrees to each other. Things like that make the discovery of lefetamine interesting. Did they KNOW the conformation of morphine or given how old it is, did they just try it out.

As I mentioned elsewhere, their appears to be 3 aromatics involved in the binding of opioids. Sometimes a fragment is enough/better (e.g. allylprodine) but sometimes all 3 are in there R-4066 & Norbezitramide make the beginnings of a training-set.

I showed you that mod of U4 but I don't currently have the software to test the theory but in example 13 of the patent covering U4, a 2-(2-thienyl) was shown to be active but if you add an entire aromatic ring in that case, it's LogP is so high, one wonders how it was tested. Once again, not long ago I would have simply been able to ask Dan. Sadly Dan isn't with us any more.

He once let me figure out a problem (why is the p-Br or p-Me required) and I DID work it out but too late. I like to think it's because he thought I should be able to work it out but I will never know,
 
AlsoTapered said:
The UK has oxycodone and hydromorphone, codeine, Dihydrocodeine IR & SR formulations of 60,90 & 120mg that last for 12 are also available. We also have tramadol, tapentadol, pethidine, buprenorphine, fentanyl and meptazinol. Oh, and methadone is also used to treat pain,

UK Doctors have a wider number of options than a US doctor. The difference is that a US doctor gives opioids for pain but to quote the BNF 'opioids are used to treat unacceptable suffering' which is a VERY strange mandate if you ask me.

But the truth is that 95% of them have NEVER prescribed anything except tramadol and codeine. If you are in long-term intractable visceral pain then you need to get an appointment at a pain clinic. Even then, they will try to avoid opioids wherever possible.

I was in an accident and my right-hip was destroyed. The replacement is dislocated so in effect I'm walking on a dislocated hip and it STILL took 20 years to get codeine which was upped to oxyContin and codeine for breakthrough pain and then the codeine was dropped and the oxyContin increased - the doctor told me it's because codeine is more addictive....

If you can see the logic of that, you are doing better than me,
Click to expand...

I know, I was prescribed Oxy..I meant (for the one) we don't have it available in a low dose with acetaminophen like Percocet.
 
You must log in or register to reply here.
Top