Opioids Chronic pain/ stretching my supply with grapefruit?/ Gabapentin?

[Julianspinefusion]

I'm 32 and I've been on opiates for pain since 2009 due to a t2-t9 spinal fusion from a car accident. Now I'm even worse off since I've got artheritis in my back and my bones are digging into my soft tissue (says my pain dr.) So I'm allotted 6 percs a day from pain management and it's coming to the point where it just doesn't cut it. Especially on gloomy days where it looks like it's going to rain but it doesn't. I get these horrible "back attack" where I'm just laid on the floor in debilitating pain. I didn't have insurance for awhile so had to deal with 4 norco a day from my regular dr and was buying about 4 more a day from my "guy". Well when I got insurance in the begging of the year, pain Dr gave me 4 percs a day which was barely cutting it. Then 3 months later I got to where I am now. He doesn't like "giving me more" but nothing else helps, epidural , trigger point, random nsaid's, and most recently I had a allergic reaction trying out lyrica. He mentioned gabapentin but I've read horror stories all over about this. I'm really sensitive to new meds all around historically (as I have some other medical issues) and a lot of new meds make me horribly sick. So with this being said, should I push for more opiates with my pain dr even though he just raised my dosage a few months ago or might he label me as a "seeker"? I've already been lectured and treated like a drug addict/ kid by other drs and I have a semi good relationship with this one and don't want to screw it up. I feel nervous like I'm going on a damn first date everytime I see him lol. The system is so screwed where this shouldn't even be a worry with someone with nuts,bolts and rods in their back.... Then they wonder why the heroin is flooding the middle class. Anyhow, enough of that... back to my questions ...should I try gabapentin (or is there something else I'm missing here that may be a better option to make my pills "last"?). Btw, my pain is all muscular (muscle relaxers don't do crap but get me sleepy). I can literally reach for my back and grab the muscle the protrudes from my back and causes all this grief. And in the meantime, does grapefruit juice really help intensify the pain releiveing properties or does it just heighten the euphoric effect? TIA

 

[SS373dOH]

^Is this dude selling insurance ? lol

Anyways..

Grapefruit juice is an ok potentiator, I think dxm is superior..

Here's the potentiation mega thread > http://www.bluelight.org/vb/threads/534200-The-Ultimate-Opiate-Potentiation-Thread-v2-0

 

[Bonch]

Gabapentin worked really well for me in pain management. Although my pain is/was not as severe as yours. It is much harder to get off of then opiates. When I stopped after only a month of use I had really bad rebound nerve pain. This is just my experience/opinion. Hope it helps . Good luck with everything!

 

[Lorne???]

Grapefruit juice is an amazing inhibitor, though you must drank a lot, and preferably mix it with another inhibitor (and antacid w/opioids, so cimetidine kinda fills two roles)

I could use insurance..,

We cant(?) really tell you what direction to go with your doctor; can tell you that gabapentin is hit or miss yet can be very useful-however if allergic to pregabilin, perhaps use caution

Grapefruit juice will raise plasma levels and increase BA%, so yes it will help w/ analgesia though with oxy can only do so much
Have you thought about opioid rotation? (And to make clear, you should get 50% increase in potency w/ proper inhibitors/inhibition)

 

[Backfromthebrink]

Grapefruit juice is an amazing inhibitor, though you must drank a lot, and preferably mix it with another inhibitor (and antacid w/opioids, so cimetidine kinda fills two roles)

I could use insurance..,

We cant(?) really tell you what direction to go with your doctor; can tell you that gabapentin is hit or miss yet can be very useful-however if allergic to pregabilin, perhaps use caution

Grapefruit juice will raise plasma levels and increase BA%, so yes it will help w/ analgesia though with oxy can only do so much
Have you thought about opioid rotation? (And to make clear, you should get 50% increase in potency w/ proper inhibitors/inhibition)

Just a side regarding grapefruit juice. I experimented with it quite a bit when trying to potentiate lope years ago and a few things I noted were:

You need the fresh grapefruit juice (not the cheap concentrate) and while there's some debate about it I found white to work the best (although Ruby works also)

Also as you say, you need quite a bit...I found 500ml to be optimal (well more may have worked even better but I mean optimal in the sense that you dont want to have to down pints and pints of the stuff)...

I usually consumed the grapefruit juice about 20-30 minutes before the lope.

Some of the points above there is scientific data to back up and some is just my own trial and error..

Also, mixing 500ml grapefruit juice and 500ml Indian Tonic water (or Schwepps Bitter Lemon...they both contain quinnine) works very well too (cimetadine is prescription only in the UK). Normal calcium carbonate ant-acids (Renees) didn't help at all.

Just my 2 cents worth

 

[Lorne???]

^ Yeah Calciumecarbonate has something about it that makes it less than optimalw

However unless you are taking methadone or maybe morphine, regular antacids won’t make a big difference, unless you are downing a liter of (preferably) white grapefruit juice, in which it will help to balance the ph out

Agree with everything; the messed up part is they have made it hard to find pure white grapefruit juice; Ocean Speay now uses a mixture, while other brands are hard to find, and as you say, avoid the cheap stuff in cans, generally

drinking it like 2 or 3 days in a row, with moderate doses of cimetidine in the states(IDK why cimetidine is RC only in the UK; I mean they have RX only tablets here that are 800mg(which is the most you should take in a single dose for potentiation purposes, which is why taking it 2-3 days in a row/with grapefruit juice is best) yet the 200mg are otc, kind of like Motrin; just goes to show you it can be arbitrary, as would love to be able to purchase and CWE dhc,or at least have the option to) is the best way to go, as it takes time for the CYP enzymes to fulky fully recover, so if you cut 3A4 in half, the next day it may be at 70-70%, so the effect stacks up(those were random numbers though they get the point across(hopefully) since, if not mistaken the enzymes have there own recovery t1/2, lending moderately strong inhibitors a long(er) lasting effect, although peak effects will still be with a couple of hours or so if drinking; I would try and wait maybe 40 minutes, rarely longer unless waiting’s on supply or something (or if dosing gradually)

Note: Be careful with grapefruit juice and lope, lurkers, as it can(most likely) EXPONENTIALLY increase the poor BA% of loperamide, allowing a significant portion into the bloodstream, opening the gates for severe side effects or worse; it can be done, just realize people that it could easily m plasma levels 4x higher without an insane amount, so be cautious-unfortunately oxy BA is already pretty good even by mouth(variable at like 35-90% though typically around 50-70% is probably reasonable, so the effects won’t be as dramatic or dangerous- ok done with me speech, have fun and be safe

 

[Backfromthebrink]

^ Yeah Calciumecarbonate has something about it that makes it less than optimalw

However unless you are taking methadone or maybe morphine, regular antacids won’t make a big difference, unless you are downing a liter of (preferably) white grapefruit juice, in which it will help to balance the ph out

Agree with everything; the messed up part is they have made it hard to find pure white grapefruit juice; Ocean Speay now uses a mixture, while other brands are hard to find, and as you say, avoid the cheap stuff in cans, generally

drinking it like 2 or 3 days in a row, with moderate doses of cimetidine in the states(IDK why cimetidine is RC only in the UK; I mean they have RX only tablets here that are 800mg(which is the most you should take in a single dose for potentiation purposes, which is why taking it 2-3 days in a row/with grapefruit juice is best) yet the 200mg are otc, kind of like Motrin; just goes to show you it can be arbitrary, as would love to be able to purchase and CWE dhc,or at least have the option to) is the best way to go, as it takes time for the CYP enzymes to fulky fully recover, so if you cut 3A4 in half, the next day it may be at 70-70%, so the effect stacks up(those were random numbers though they get the point across(hopefully) since, if not mistaken the enzymes have there own recovery t1/2, lending moderately strong inhibitors a long(er) lasting effect, although peak effects will still be with a couple of hours or so if drinking; I would try and wait maybe 40 minutes, rarely longer unless waiting’s on supply or something (or if dosing gradually)

Note: Be careful with grapefruit juice and lope, lurkers, as it can(most likely) EXPONENTIALLY increase the poor BA% of loperamide, allowing a significant portion into the bloodstream, opening the gates for severe side effects or worse; it can be done, just realize people that it could easily m plasma levels 4x higher without an insane amount, so be cautious-unfortunately oxy BA is already pretty good even by mouth(variable at like 35-90% though typically around 50-70% is probably reasonable, so the effects won’t be as dramatic or dangerous- ok done with me speech, have fun and be safe

Yeah mate, we get the 1 litre cartons of Tropicana Pure White Grapefruit juice which is perfect but quite expensive for what it is ...equivalent of about 3 USD for 1 litre...(and if any one says discussing the price of fruit juice is "price discussion" then they need to have a serious word with themselves lol). I guess drinking around 1000ml as oppose to 500ml would be better but I don't really like the taste much and necking 1ltr of the stuff is too much....and I'd rather mix 500ml with some tonic water instead for the quinine (thoughts on quinine Lorne?)

Also good point, when we talk about mixing things like lope and grapefruit juice please be aware (anyone who isn't already) that this is really dangerous..We often have these technical discussions without thinking that someone might actually go out and just down hundreds of lope and a couple ltrs of grapefruit juice thinking nothing will happen....because that could kill you....seriously. While many of us have experimented on ourselves in the past, we know what we're doing but it would be irresponsible to think that everyone else does too....The increase in effectiveness of lope when grapefruit juice is added is indeed extremely pronounced...

Sorry Lorne...what did you say the oral BA of oxy is again? hahaha

 

[Daygone]

I could be mistaken, but I thought the point of an antacid with potentiation is simply to address the acidic nature of the GF juice, i.e., it doesn't ADD to a high. I've never had a problem w/ the GF juice (cast iron stomach), so I stopped using it years ago.