Opioids Why is there such a Dilaudid discrepancy via "standard" IV and "home-use" IV

[Whistle Blower]

Why is there such a Dilaudid discrepancy via "standard" IV and "home-use" IV

When I make it to the hospital for any reason, I am put on IV Dilaudid (last time was 1mg every two hours + PRN)...

When I'd get that shot, I'd have an immediate rush of euphoria, although it didn't stay long or anything -- especially not even the help with pain, for what it was prescribed... (I had been up to 64mgs daily up until late last year.. but I digress...)

Why is it that when SWIM tries to inject pills...say even 12 or 16mgs of Dilaudid, that w/he doesn't get the same "to be expected" results of that which a much smaller dose is capable of?

Dilaudid has great water solubiity, so I just don't understand.

Any comments/suggestions would be appreciated, so I can get much more use out of my Rx.

 

[Znegative]

You probably aren't filtering it properly. You should invest in a micron filter if you're going to shoot up pills. Also, so we can
help you better, can you please describe what brand of hydromorphone you are using?

Also we don't use swim here. It doesn't protect you in any way, plus we all know you're talking about yourself-just a heads up.

 

[Whistle Blower]

I absolutely use micron filters, first of all.. Am as safe as possible when "doctoring" myself, new needles, sterile environment, etcetera. But I really appreciate your caution in the name of harm reduction!

The manufacturer of the pills is Mallinckrodt, 4mg tabs.

Again, I'm just curious as to why 1mg IV in the hospital provides an immediate feeling of having been injected, while "home-use" in no way corresponds to 1-to-1 dosing. In fact, it's not really worth the hassle, except that if IV doesn't provide the relief necessary, you can imagine that oral dosing is a total waste of time (or I wouldn't have ever decided on trying an alternate route of administration in the first place).

I know that opioid tolerance builds quickly to begin with -- and I used to be prescribed 120mg of methadone for pain (3-40mg methadose), and I took them because they were prescribed, but never really knew that they helped.. All I remember for certain that getting off that dose took forever to titrate off. (in fact, the first time I ever suffered withdrawals was during this timeframe, when I "forgot" to take the methadone for a couple of days and ended up in the ER trying to explain the symptoms I was having.. For some reason -- intuition?? -- on the way there, I took a dose, so by the time -- 4 hours or so -- the doctor finally "got back to me," the sensations were subisiding, but it wasn't until weeks later that I pieced two and two together to realize what it was I had experienced.)

I also used to be prescribed 150mcg Fentanyl patches, of which I'd sometimes wear 3 at a time, and still couldn't ever "tell" for certain whether they were actually helping or not.. Chronic pain sucks big time, especially when given meds that should work that don't...

So.. long story short.. except for the PAWS which are to be expected, if I can't get the Dilaudid to be more effective/efficient, I guess it's time to quit trying to get them to "work," and then I don't have to deal with potential harm that comes with the territory.

What.. time to move onto smack for a "home remedy"?

 

[Captain.Heroin]

I think it's important to realize slowly plunging liquid, versus quickly plunging liquid, will yield a difference.

When you are self administering IV opiates, you know what to expect.

When someone else administers it, you may not be expecting it.

Also, factor in environmental tolerance.

 

[comatoserct]

are you sure you were receiving 1mg? I was under the impression that liquid hydromorphone for injection is at least 10mg/ml. so either you were only receiving 10 units of the solution or were in fact getting shots of 10mg.

I used to shoot the 16mg palladone capsules (a true pain in the ass to break up) and those got me as high as I've ever been. Unless you are mistaken in some way, your results are quite strange

 

[racoonx]

I think your tolerance is the answer. 120mg daily methadone is a lot, once your body is used to that, there is not much you will feel.

I was on 150mg for a bit. As a result, I can't feel K4's, or couldn't feel 6 of them either, several years ago, which is last time I bothered. Heroin isn't the answer, your tolerance is too high, unless you have lots and lots of money, or lots and lots of heroin. I think you have about hit the ceiling for tolerance, you have a thin thread between I might feel this, and death.

Best to cut your loses, if you are withdrawl free, celebrate and run , don't walk, to something else, non-opiated.

 

[upriser7]

I need some help with this subject too. I IVed 8mg of dilaudid , 4 2mg (M2) pills and did not get ANY rush. I has a high tolerance with oxy and Norco ie, needs about 15-20 oral oxy to feel good, but didn't think that was a high enough tolerance to not feel any rush from the dillies. Perhaps I'm doing something wrong. Would someone please give me the step-by-step process for shooting M2 dilaudids. thanks a lot.

 

[Swimmingdancer]

If you normally get high off 15-20mg of oral oxycodone you should NOT be injecting 8mg of hydromorphone at once! That's dangerous! With your tolerance you should be able to get high off 1 or 2mg of IV Dilaudid. In fact it's really not the best idea to switch from oral oxycodone and hydrocodone to IV hydromorphone. Did you feel anything at all when you injected the 8mg of hydromorphone?

I do not recommend you do this, but if you're going to do it regardless, the safest process for preparing an injection of Dilaudid would be (and I would recommend starting with 1mg or less per injection) the standard process for injecting pills using a micron filter. *Mods can you please post a link? I'm having trouble finding the micron filter/injecting pills instructions*

-Yes, -Tricomb

If you don't have a micron filter and are unwilling or unable to get one, then use a Sterifilt or similar filter.

If you don't have a micron filter or Sterifilt etc and are unwilling or unable to get one, you can do the following:

1. Get supplies: at least 3 new syringes, ideally a 1ml (1cc) or 3ml (3cc) but 1/2ml (1/2cc) is ok if that's all you have; a cotton ball or cotton from Q-tips/cotton swabs; a paperclip; and a clean spoon or mixing cap (sterilize with alcohol/alcohol swab first, let dry)
2. Wash hands thoroughly.
3. Take the cotton and cut some strips that can be doubled up and inserted into the barrel of the syringe with the paper clip. Pack the cotton down firmly with the plunger of the syringe to about the 30-40 unit line.
4. Crush the pills (make sure you are using clean implements to crush them, you can crush them between 2 clean spoons or crush them inside a piece of clean paper).
5. Mix the crushed pills with some water - ideally sterile water - in the spoon or cap (make sure you don't use more water than your syringe can hold).
6. Using a fresh syringe, draw up the solution in the spoon/cap.
7. With the plunger still removed from the first syringe (that has the cotton in it), squirt the liquid into the barrel. Put the plunger back in carefully without squirting out any of the liquid.
8. Remove the plunger from another fresh syringe and "back-load" it with the solution from the cotton-filled syringe. The solution will be pushed through the layers of cotton and getting filtered as you depress the syringe. Carefully replace the plunger on the new syringe, making sure not to squirt out the liquid. This syringe will contain your filtered solution. You can back-load a portion of it into another new syringe for injection if you are not going to be injection all the solution at once. For example, if you used 8mgs of pills and you want to inject 1mg, then divide the number of units of liquid by 8. So if you have 80 units of liquid, squirt 10 units of it into the new syringe that you will be injecting with.
9. Follow the usual procedure for injection.

If you're unwilling to go to that much work or you only have one syringe on hand, then the next best thing I can think of would be the following, however it is not as safe, and nothing is as safe as a proper micron filter:

1. Get supplies: at least 1 new syringe; a cotton ball, cotton from Q-tip/cotton swab or a clean cigarette filter; and a clean spoon or mixing cap (sterilize with alcohol/alcohol swab first, let dry)
2. Wash hands thoroughly.
3. Take the cotton or filter and cut a small piece. Pack the cotton firmly into a ball.
4. For 1mg, break a 2mg pill in half and then crush the pill (as above, make sure you are using clean implements to crush it).
5. Mix the crushed pill with some water in the spoon or cap (see the notes about the water above).
6. Place the cotton/filter into the solution.
7. Using a fresh syringe, draw up the solution through the cotton/filter.
8. Follow the usual procedure for injection.

Procedure for injection:
1. Find a good vein. The best one is usually in the crook of your arm (the "inside" of the elbow). On your left arm it would be around 1/3 of the way in from the left.
2. Swab the area with alcohol.
3. If the vein is not pronounced enough you may apply a tourniquet to your upper arm.
4. Taking the syringe, insert the needle into the vein with the needle pointed at an angle towards your upper arm (ie in the direction of bloodflow towards the heart).
5. Draw back on the plunger to "register" and notice whether blood enters the syringe. If no blood comes in DO NOT INJECT.
6. (if you have used a tourniquet carefully loosen it and repeat step 5). Slowly push down on the plunger to inject the liquid.
7. If you feel any pain or something feels wrong STOP INJECTING.

 

[StartedHydro]

I think it's important to realize slowly plunging liquid, versus quickly plunging liquid, will yield a difference.

When you are self administering IV opiates, you know what to expect.

When someone else administers it, you may not be expecting it.

Really, the speed in which you admin your injection determines a different outcome dpending on said speed? I noticed in reading about Bupe injections admined at a hospital the literature noted to SLOWLY inject the bupe over a 2 min period. It caught my attention but I thought it was due to bupes potancy not so much in absorbtion(lack of a better word).

Also, factor in environmental tolerance.

Really, the speed in which you admin your injection determines a different outcome dpending on said speed? I noticed in reading about Bupe injections admined at a hospital the literature noted to SLOWLY inject the bupe over a 2 min period. It caught my attention but I thought it was due to bupes potancy not so much in absorbtion(lack of a better word).

 

[Swimmingdancer]

Really, the speed in which you admin your injection determines a different outcome dpending on said speed? I noticed in reading about Bupe injections admined at a hospital the literature noted to SLOWLY inject the bupe over a 2 min period. It caught my attention but I thought it was due to bupes potancy not so much in absorbtion(lack of a better word).

It makes a very slight difference in the "rush". I doubt that is the problem in this case. It is safest to inject slowly, but injecting quickly may give a slightly more noticeable rush. If a drug is injected slowly you don't have the drug hitting you all at once, so the high comes on a little more gradually. The main reasons injecting slowly is recommended is because it will be easier to monitor for adverse effects or overdose and stop injecting if need be, and injecting too quickly can burst the vein.

I think if anything someone IVing at home would be more likely to inject the drug faster than a health care professional at the hospital. It does make sense what Captain Heroin said about one's expectations though, but I think it's much more likely that the problem was that the OP was being given more Dialudid at the hospital than he realized (perhaps he was assuming the solution was 1mg/ml when it was actually 10mg/ml), that his tolerance had gone up since then, or that he was not getting all of the hydromorphone out of the pills.

 

[palaika]

You got that right,coonx; that's an enormous amount of Methadone. It is one of the hardest drugs to kick. Even after you have detoxed, you'll still have a high tolerance for any narcotic for quite some time. I've been of off meth for 2 years and still can't get a rush from anything. I can get a slight nod every now and then, but no more 'chasing the dragon'. It's simply a waste of time and money. I guess there simply no high like the first high!

 

[BIGsherm7272]

are you sure you were receiving 1mg? I was under the impression that liquid hydromorphone for injection is at least 10mg/ml. so either you were only receiving 10 units of the solution or were in fact getting shots of 10mg.

I used to shoot the 16mg palladone capsules (a true pain in the ass to break up) and those got me as high as I've ever been. Unless you are mistaken in some way, your results are quite strange

No hydromorphone usually starts at 1mg per injection in hospitals, unless you have a tolerance, and even then the max they would give me was 2mg every 4 hours. And that 2mg felt just as strong if not stronger than banging an 8mg pill. I don't know why this is, I let my pills soak in water for about 15-20 minutes and make sure the powder is very fine and mix it up good. I guess no matter how good you prepare your pills that they just won be the same as a hospital-grade solution for injection.