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Opioids Levorphanol for pain management

Pembroke

Bluelighter
Joined
Nov 17, 2016
Messages
301
Hello, hello!


I have searched the threads and I'm finding very, very little information on the long-acting opioid Levorphanol. I believe this to be the most suitable location for this query, as it is a somewhat uncommon drug. I'm basically looking for anyone who has used it, even recreationally, who can share some information on how it impacts chronic pain. I'm an RSD/CRPS patient, amputee, and long-time methadone patient. I live in a state wherein methadone has recently been banned for the treatment for chronic pain, so after five years of effective treatment they're now filling meds in with oxycodone and IM Dilaudid while we work out a replacement. I just received notification that the drug company will be providing me the medication free of charge for as long as I'm on it. I'm trying to be hopeful, but methadone has been the ONLY thing that has been effective at managing my pain, and I certainly want to be off IM meds and back on oral before this shit gets out of hand.


So. I know most people live with some level of physical pain - none of us live at a zero - so I'm hoping some of y'all who have used it, even recreationally, would have had some noticeable impact on how your body feels after oral ingestion. Looking forward to responses.


Xoxo Pembroke Louise
 
It's a very strong opioid with good bioavailibility, so on paper it's a good choice for pain control. In practice though, I don't think anyone makes it any more! (It is, after all, totally synthetic, made in the same process that would yield DXM, actually...)

I've heard of people getting prescriptions for it and being unable to fill it from its absence on pharmacy shelves. Something to do with abuse liability, and the fact that oxycodone sort of overshadowed all the other strong opiates for a while there...
 
Thank you for that information. I was just informed that the single company who produces it, Sentynl, will be giving it to me. I initially turned it down because my worst nightmare scenario would be getting it, finding it effective, and then losing access to it. I usually feel like I'm literally on fire and has a large vascular graft that causes me pain, and I'd rather not find a miracle drug only to have it taken away! They came back at me with a trial that will last two years and that will provide me with the drug indefinitely, so long as I participate in the observation program, have a valid monthly prescription, and remain under the care of an anesthesiologist in good standing. I'm really hoping it's the wonder drug I've been lead to believe. While my nightmare scenario is finding something that works and losing it again, my dream scenario is going back on oral meds with good BA and no longer relying on injection drugs every 4-6 hours for life. It's embarrassing and I know people judge me, even through it's prescribed medication.

Thank you again for the info! I'm reading all I can about Levorphanol, but nothing beats talking to someone who has experience with taking the meds. :)
 
I actually had a 200 2 mg bottle scripted for pain once. It can be useful, but it doesn't really have any sedative opiate effects in my opinion and even feels slightly like DXM at an extremely low dose and probably gets nowhere close to a low plateau dose just the spacey feeling. I took it twice a day and usually used only 2mg as I noticed no difference in taking a higher dose. The withdrawals after the month though ended up being my first and the most excruciating one I've ever been through with extreme hot cold feeling. It worked well at first, but in the end I just didn't feel it was stable and as useful as oxycodone and oxymorphone, which I ended up getting scripted after only after having to go a week about without it. I honestly think you should try it as it may do wonders for your pain due to it supposedly lacking cross tolerance. I didn't inject at the time, so I can't say myself, but hear IV with it is amazing were nasal I didn't care much about it when I tried it.

I hope you find a solution good luck. Personally I found oxycodone er 3x a day and oxymorphone 4x-6x for breakthrough pain the best although I used the oxymorphone as Iv only.
 
Thank you, Tacodude. That does help. I'm prescribed 4mg PO TID, but I haven't receive it yet. I think I will try 2mg to start based on that feedback. I was briefly on Oxymorphone and girl. Omg. It did not relieve my pain at all, but had me so damn high I had zero f's to give. It was so bad! Honestly, the methadone with oxycodone and hydromorphone for breakthrough pain was the. Eat thing for me, but the methadone is no longer allowed to be used for the management of chronic pain, and after months of being of injectible Dilaudid, oxycodone does nothing. Not orally, not IM, not IV. It's truly become useless. Even the Dilaudid, taken orally, does nothing anymore, and my greatest hope with the Levorphanol is that it helps me get back on oral medication, because sticking myself 4-6x daily is so damn old.

Thabk you you for your input. I've read through the Levorphanol threads on here, including the one about the 2decade old bottle, and I'm gaining much more information about it than what I was finding through regular google searches. There's just not much info Nation out there, so I totally appreciate the folks here who have shared their experiences. Best site on the web, hands down.
 
Funny I found methadone by accident to be the best med fort pancreatitis and that's including heroin. Gotta go to the clinic everyday and can't tell them it's for pain but so far it works great except when I get flare ups I could really use a breakthrough med but the way the system is here in Massachusetts that'll never happen so I guess I'll just keep going up on the methadone as a maintanence drug that I'm using for pain control. Us pain patients sure do get treated horribly when all we want is relief and will do anything to get it. Maybe trump will change that, lmfaoooooo! Yeah right!
 
Hello, hello!


I have searched the threads and I'm finding very, very little information on the long-acting opioid Levorphanol. I believe this to be the most suitable location for this query, as it is a somewhat uncommon drug. I'm basically looking for anyone who has used it, even recreationally, who can share some information on how it impacts chronic pain. I'm an RSD/CRPS patient, amputee, and long-time methadone patient. I live in a state wherein methadone has recently been banned for the treatment for chronic pain, so after five years of effective treatment they're now filling meds in with oxycodone and IM Dilaudid while we work out a replacement. I just received notification that the drug company will be providing me the medication free of charge for as long as I'm on it. I'm trying to be hopeful, but methadone has been the ONLY thing that has been effective at managing my pain, and I certainly want to be off IM meds and back on oral before this shit gets out of hand.


So. I know most people live with some level of physical pain - none of us live at a zero - so I'm hoping some of y'all who have used it, even recreationally, would have had some noticeable impact on how your body feels after oral ingestion. Looking forward to responses.


Xoxo Pembroke Louise
Hey Pem, so Washington state banned methadone for pain?? Seems silly. Sorry to hear that. I use methadone for arthritic neck hell, and it has been fuckin rad! I hope this Levwathamacallit works out for ya!
 
Hey Pem, so Washington state banned methadone for pain?? Seems silly. Sorry to hear that. I use methadone for arthritic neck hell, and it has been fuckin rad! I hope this Levwathamacallit works out for ya!

it hasn't happened 100% yet, but it's coming so swiftly that most clinics are dropping it now. It's thanks to Jay Inslee (our governor) and Dr. Frank Li. You can google him, but he basically was running a bunch of pain clinics that were truly pill mills. It's unfortunate because whenever a doctor does his, it delegitimizes pain clinics and pain patients, and he had so many clinics that he left over 25,000 patients without care - including both pain patients and the addicts he was supplying who were sent abruptly into withdrawal with no support. Rather than consider this as the actions of one doctor, the response from our governor was "oh noes, methadone must be super dangerous for pain management, and we're going to start shutting down all the clinics that use it! That should prevent deaths!" while meanwhile a bunch of pain patients have ended up going to more dangerous drugs for lack of care. And I'm sure there were some addicts who acquired methadone in this way to keep "rehab" off of their medical records who are now in a really bad place, too. It's a frustrating and sad situation that didn't have to happen like this.
 
Funny I found methadone by accident to be the best med fort pancreatitis and that's including heroin. Gotta go to the clinic everyday and can't tell them it's for pain but so far it works great except when I get flare ups I could really use a breakthrough med but the way the system is here in Massachusetts that'll never happen so I guess I'll just keep going up on the methadone as a maintanence drug that I'm using for pain control. Us pain patients sure do get treated horribly when all we want is relief and will do anything to get it. Maybe trump will change that, lmfaoooooo! Yeah right!

Yes, Donald "I've never done a drug or drank a sip of alcohol in my life!" is going to help us. Lol. Honestly though, anyone who has never lived with chronic pain just doesn't get it. I look back sometimes to when I was a working clinician, and I can't help but wonder if there were patients I let down. Until you've lived it, you just don't get it - and we're taught to eye with suspicion anyone who is constantly looking for opiates or opioids. It's difficult to know who is drug seeking for genuine pain vs. who is drug seeking for fun. I'm somewhat fortunate in that there is a clear record of what happened to me, so I don't get questioned on the validity of my condition. There's no denying the extreme physical trauma I endured, and I have laboratory-measurable indicators of inflammation and nerve death. I really feel awful for people who have nothing to point to for what caused their pain.
 
it hasn't happened 100% yet, but it's coming so swiftly that most clinics are dropping it now. It's thanks to Jay Inslee (our governor) and Dr. Frank Li. You can google him, but he basically was running a bunch of pain clinics that were truly pill mills. It's unfortunate because whenever a doctor does his, it delegitimizes pain clinics and pain patients, and he had so many clinics that he left over 25,000 patients without care - including both pain patients and the addicts he was supplying who were sent abruptly into withdrawal with no support. Rather than consider this as the actions of one doctor, the response from our governor was "oh noes, methadone must be super dangerous for pain management, and we're going to start shutting down all the clinics that use it! That should prevent deaths!" while meanwhile a bunch of pain patients have ended up going to more dangerous drugs for lack of care. And I'm sure there were some addicts who acquired methadone in this way to keep "rehab" off of their medical records who are now in a really bad place, too. It's a frustrating and sad situation that didn't have to happen like this.
That sucks! Gonna google this mess now. Sounds like a nightmare.
 

Yep, it truly is a nightmare. I consider myself lucky in that I went to one of his clinics when my original anesthesiologist developed ALS and had to retire. At that time, I had been stable on a regiment of methadone, oxycodone, citalopram, and Ritalin for about four years. I met Dr. Li once, and he wanted to put me on a fentanyl patch, raise my methadone, keep the oxycodone;and add trazadone, oxymorphone, and something like temazepam for sleep. I was horrified. I am always super honest with my doctors because I have a lengthy family history of addiction and drug deaths, so it's important for me to make sure we're always sure I'm taking the right amount of the right drug for the right reason. I was sure that guy was going to end up killing me, and I scheduled to get a consult with a different area pain clinic. Now, I've had major issues with the head doctor at my clinic - no place is perfect - but they are absolutely responsible when it comes to holding us accountable and looking at non-Opioid options for pain management. In the two years I've been with them I went off oxycodone, did a trial of opana, and ended up on Dilaudid for breakthrough pain; but every time we've done a new med trial I've gone to bimonthly appointments for assessment and we generally start at lower doses of things. Honestly, I think the only reason the doctor went with the higher starting dose of Levorphanol is because we know I have to replace that methadone. Staying on the amount of injection dilaudid I'm on simply isn't sustainable, and it needs to be addressed before it becomes more
of a problem than it already is!

And all bthe cause of Frank Li deciding to try and kill us all. -_-
 
Yep, it truly is a nightmare. I consider myself lucky in that I went to one of his clinics when my original anesthesiologist developed ALS and had to retire. At that time, I had been stable on a regiment of methadone, oxycodone, citalopram, and Ritalin for about four years. I met Dr. Li once, and he wanted to put me on a fentanyl patch, raise my methadone, keep the oxycodone;and add trazadone, oxymorphone, and something like temazepam for sleep. I was horrified. I am always super honest with my doctors because I have a lengthy family history of addiction and drug deaths, so it's important for me to make sure we're always sure I'm taking the right amount of the right drug for the right reason. I was sure that guy was going to end up killing me, and I scheduled to get a consult with a different area pain clinic. Now, I've had major issues with the head doctor at my clinic - no place is perfect - but they are absolutely responsible when it comes to holding us accountable and looking at non-Opioid options for pain management. In the two years I've been with them I went off oxycodone, did a trial of opana, and ended up on Dilaudid for breakthrough pain; but every time we've done a new med trial I've gone to bimonthly appointments for assessment and we generally start at lower doses of things. Honestly, I think the only reason the doctor went with the higher starting dose of Levorphanol is because we know I have to replace that methadone. Staying on the amount of injection dilaudid I'm on simply isn't sustainable, and it needs to be addressed before it becomes more
of a problem than it already is!

And all bthe cause of Frank Li deciding to try and kill us all. -_-
Yeah, that doctor Li sounds like he was literally insane, a mix of mania and dementia ;)
 
Levo-Dromoran (levorphanol) was around for a long time although not used much in the US and Canada. It's still in the US? It's likely one of the best pain meds out there, just eating a couple 2mg pills, my older friend who remembers them said it was a good 12 hours+ of nodding. Might be useful in a mix with ketamine for burn wards.
 
Yup, I know, which really annoys me, Canada didn't ban it, nobody bothers making it anymore. Like Oxymorphone or Zaleplon. All things a compound pharmacy can make for you if you got the script for, I know of one in Toronto who said they could make Oxymorphone and Zaleplon tablets. Unfortunately it's all XR Opana like pills, but yeah, better than nothing, I guess a 40 XR Opana eaten does something to most medium tolerance people or chippers.

Yeah it's got this kind of dissociative effect in large doses, like Talwin and Demerol do. Demerol makes you a silly raisin, I don't know if any of you have experience with pcp, I'd take 3-4 snorts of lines (cut obviously), it's how it is here, the Liquid is controlled at the highest levels of the chain and nobody is allowed to buy them like that, you know what I mean, the most people can get is what is used to make the powder, which is about 20% pure...some kind of putty. Anyway, the few times I've eaten 100mg Demerol and slammed 100mg 30 minutes when it started to take effect orally when still just a chipper (I had SteriFilt filters, so I was good, otherwise, don't do that..or if you got microns) and it reminded me of snorting 3-4 lines of pcp and having a joint or some weed aftewards. The silly idiotic contentment one would get from that, Demerol and especially Talwin provided it when I had short scripts for it. Fortunately Talwin comes without Naloxone here, there never was a craze about injecting it with that trippelllenamine which was never available in Canada. Almost all good old sedative antihistamines were removed by Health Canada, cyclizine, meclizine(sic), but we do have over the counter 50mg Histantil promethazine pills mostly sold for migraine nausea and the best of all, Atarax (hydroxyzine). I don't know how Vistaril compares, but the doses of the pamoate in that go higher than 50mg so I assume it's weaker. There's also Pheniramine which is really sedative, but only in that powder you gotta boil water and drink that's ugh...pretty bad, powder APAP, powder DXM, powder pheniramine and I think I forget another ingredient. Comes in 2 flavours, but even the strong lemon one cannot make me not taste the horrible APAP at the bottom of the cup no matter how well stirred.

Pharmacies here are obliged to order from the manufacturer a script you want from them and it's the only pharmacy in town or even if it's not, they can always get them. Like how they don't stock a lot of generic oxycontin, but if you bring a script,they'll order them, they normally don't stock those over 15mg, while Oxy IR/Supeudols get sold without question and get to 20mg and are ALWAYS in stock, a lot of patients on Oxycontin had to start using OxyIR 20mg, which to me is okay, they didn't think of it correctly.

Anyway I've read how levorphanol could be used for ORT, because of the NMDA antagonism similar to methadone. I wish. But Canada made Diamorphine ampoules legal again after a minister with no knowledge of pharmacology at all was placed ministry of health in a cabinet shuffling by the previous Tardy Harperites, and when she realized people were scripted a shot at the pharmacy and another ampoule to bring home for later in the day....although it's an annoying programme, you never get takehomes, except for that later in the day ampoule. Plus, you gotta prove your addiction is Heroin, maybe a morphine addict could trump (I hate typing this word now) a bloodtest, I don't think 4-MAM hangs around a little, people who slam 200mg M-Eslons are not much different than Heroin IV users anyway.

So Levorphanol would be welcome as an ORT product. Suboxone is starting to show it is not the miracle drug it is portrayed to be, more difficult to lower doses after years on it for maintenance. I think the literature about how it should only be used for 3 months detoxes is right on the money. The possible permanent disruption of your mu opiate receptors...I know I could never get a high even if I stopped for 48+ hours when trying to have a suboxone break, only to waste precious Dilaudid 4mg brand name pills, doing doses I never even did because there's no point (the rush has a ceiling, 8mg is tops, the dosage structure makes sense on that one facet). Only got added respiratory depression to the scary area....I never got there ever, when in the honeymoon or just stable using because doc-retired making me a worse addict because the system did not pick a new doctor for me automatically when the one guy retired...anyway, it would be easy to implement but I won't dwell on that. Shooting up to 16 and 20mg Dilaudid. Never felt anything. Only felt good again, and by good I mean really like an opiate, was from a professionally mixed Fu-F nasal spray, 2 shots and I'd get that mood boost I didn't think existed, so the few times I got injured and was prescribed Abstrals (authorized by the ORT clinic), first time in my life I enjoyed Fentanyl, Abstrals are sublingual Fent pills, from 80ug to 800ug...the 200ug the first time, I had to take 2 at once, so I told the doctor and the other time I needed a painkiller, it was so horrible, I'll keep it at that, that an antibiotic were mandatory, the 600ug ones broke through. When on methadone at 40-50mg dosages in the evening I could slam a dilly and feel the rush. It wasn't a blocking dose, bigger dose I got to is 60mg which is what the best doc in there said he wanted his patients not to exceed.

This rant brought to you by the tooth destroying, at least the way it is in Canada, even the generics keep that extremely acidic composition full of lime and lemon extracts natural and artificia, liver-enzymes fucking Suboxone (we get blood drawn for a live enzyme test every 3 months). It's good to prevent injection...they went ahead here Rickett...they released Suboxone very late, after twisting the hand of the previous government in 2005 which was the Liberals to wait and not enforce Subutex, 5 years later Suboxone the canadian pill version comes up and yeah, shooting those pills will destroy your veins, arteries, heart...the solution is so acidic after crushing a single 2mg suboxone in a stericup...the only time I did it, I felt very bad for a week...so yeah, snorting is an option to protect the teeth but then it lasts much less longer and then the acidity of the pills wreck your nose. Why the fuck did methadone have to fuck my hormones and make me gain 100 pounds....

tl;dr Levorphanol please, Health Canada.
 
Holy crap. Thank you, TRO!

Late last year, I was BEGGING to be put on suboxone. My doctor was against it because he was afraid it would put me at high risk for suicide, which devastated me at the time but, based on the accounts I've read since then, it was probably a G-d send that my team wasn't down with it. I was in the midst of dealing with an aggressive outside doctor who was arguing to "streamline" my meds - so while I had been on Ritalin, methadone, oxycodone, and two doses of oral Dilaudid for several years; this new guy switched me to Ritalin, methadone, and Opana. The Opana was a nightmare... I was high all the time and couldn't think critically, but it still managed to have no impact on my pain. So I was in excruciating pain, but so high that I would just randomly try to do stupid shit all the time, because I lacked the executive function to foresee how doing these dumb things were going to make my pain that much worse in short order. So dumb.

Anyway, I had read up on the use of suboxone for pain relief in RSD patients and was convinced that it was going to be a wonder drug and I'd never hurt again. My main doctor was astute in picking up the undertone of "if this doesn't work, then I'm out of options... except the final one." He didn't think it would work, and was afraid of what would happen to me if it didn't. I was devastated when they said I wasn't a good fit for it, but I guess I should ultimately be grateful.

There's good news on the horizon, though. I just spoke to the NJ pharmacy who deals with most of the Levorphanol scripts in the US, and they're finally sending it to me. They even pushed it with Fed Ex to have it to me tomorrow morning so I wouldn't have to wait out the weekend. I'm really really hopeful, but I'm also working at being in a more emotionally healthy place where I'm not so obsessed with the idea of it working. If the last six years has taught me anything, it's that not every "miracle drug" is a miracle for every patient.

Also, being that I don't know how this works in Canada... could you not apply to the Sentynl patient assistance program? Then you wouldn't have to deal with your pharmacy; as long as you have a valid prescription and are under them care of pain management, which it sounds like you are, the manufacturer delivers it to your door. :)
 
So, Tacodude and/or anyone else who has used Levorphanol or knows someone who has... my feelings on it, having received it a few hours ago, would best be expressed after I re-review the language guidelines. I want to throw this bottle across the room, set it on fire, piss on it, and then flush it down the toilet for good measure. What the actual fuck is this? I'm convinced it might actually be a bottle of pressed cornstarch tablets and that it comes with a hidden camera connected back to the pharamcist's home, where he runs a comedy club patronized by people who enjoy watching pain patients curled in the fetal position, sobbing.

Imma try to gather myself and think rationally about this, so people who have experience or another source of knowledge... is this a drug that normally has to be taken for several days to build up a baseline value in your system? Is it like methadone where the prolonged half life makes it so you don't get as much relief with the first dose as with subsequent doses, which piggyback off of one another? Or is this perhaps something that doesn't work for brain injured patients? Part of the injury that retired me included a somewhat severe anoxic brain injury. I'm mostly recovered, but we continue to have trouble with things like memory, concept of time, and reception of drugs that work off certain areas of the brain / central nervous system. Before I burn this shit to the ground, I want to know if there is any possibility that this just doesn't take after the first dose, which I took 3 hours ago (for clarity/information).

Thanks BLers (but not thanks to the sadistic pharmacist who played this cruel joke on me),
Louise
 
Uhm..no...people here, (in Canada it was a gelcap with powder in it), the 2mg purple ones, loved to inject it, it works instantly and lasts a very long time 12-15 hours that way even.
 
Holy crap. Thank you, TRO!

Late last year, I was BEGGING to be put on suboxone. My doctor was against it because he was afraid it would put me at high risk for suicide, which devastated me at the time but, based on the accounts I've read since then, it was probably a G-d send that my team wasn't down with it. I was in the midst of dealing with an aggressive outside doctor who was arguing to "streamline" my meds - so while I had been on Ritalin, methadone, oxycodone, and two doses of oral Dilaudid for several years; this new guy switched me to Ritalin, methadone, and Opana. The Opana was a nightmare... I was high all the time and couldn't think critically, but it still managed to have no impact on my pain. So I was in excruciating pain, but so high that I would just randomly try to do stupid shit all the time, because I lacked the executive function to foresee how doing these dumb things were going to make my pain that much worse in short order. So dumb.

Anyway, I had read up on the use of suboxone for pain relief in RSD patients and was convinced that it was going to be a wonder drug and I'd never hurt again. My main doctor was astute in picking up the undertone of "if this doesn't work, then I'm out of options... except the final one." He didn't think it would work, and was afraid of what would happen to me if it didn't. I was devastated when they said I wasn't a good fit for it, but I guess I should ultimately be grateful.

There's good news on the horizon, though. I just spoke to the NJ pharmacy who deals with most of the Levorphanol scripts in the US, and they're finally sending it to me. They even pushed it with Fed Ex to have it to me tomorrow morning so I wouldn't have to wait out the weekend. I'm really really hopeful, but I'm also working at being in a more emotionally healthy place where I'm not so obsessed with the idea of it working. If the last six years has taught me anything, it's that not every "miracle drug" is a miracle for every patient.

Also, being that I don't know how this works in Canada... could you not apply to the Sentynl patient assistance program? Then you wouldn't have to deal with your pharmacy; as long as you have a valid prescription and are under them care of pain management, which it sounds like you are, the manufacturer delivers it to your door. :)

American Suboxone is fine, you don't even have pills anymore, those strips which are like blotter paper with 1mg per square do not mess with teeth. I'm not sure about the original Orange coloured pills you had for Suboxone, but if it was vitamin C in it to make it taste like oranges, it wouldn't destroy one's teeth like what we got. Also you have 2 other formulations, Zubsolv which has lower dosages but better bioavailability, same medicinal ingredients and Bunavail which is a kind of nicorette gum you gotta stick to the inside of your cheek. I hear good things about Zubsolv, although no sign it will show up here, not even a sign that we will have the strips anytime soon. It's all in Rickett's control in the end.

I don't think I'm ready to detox the suboxone for a program by a pharma company that doesn't have a presence in Canada but does in the US (common, we got no Mallinkrockt or whatever the spelling here, so no strange white square dilaudid), not much chances I could be part of that study, "most signs points to No", as that classic simpsons magic 8-ball would say.
 
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