Misc Opioids and Beta Blockers?

[ChemicallyEnhanced]

I've read online that taking a betabocker along with your usual opioid dose can reduce feelings of pain that reoccur when you start to become tolerant to the analgesic effects of said opioid and can also overall lower the dosage of opioid required.

I'm currently on the max. dose of Dihydrocodeine (8 x 30mg pills per day) BUT I've been on this dose for a couple of years and I have problem number 1) my pain is increasing, partly because ,my body is SO used to the same dose of the same med and problem number B) I've found I now need to take a minimum of 11 x 30mg pills of the DHC a day JUST to not be in withdrawal.
I'm gonna speak with my doctor next week, but the next step up on the opioid ladder is oral morphine and my doctor has said in the past that he will NEVER prescribe me morphine (or anything equal to - or stronger than - morphine) ever again because of history of dependence/abuse (actually NOT of morphine but because of Oxycodone and Fentanyl which I was originally legit prescribed for very severe pain)

I was thinking about bringing up this Beta Blocker research with my doctor?

Has anyone heard about this or is taking/has taken both drugs at the same time?

 

[supersonic89]

I have never taken a beta-blocker but it's true that it helps reduce opioid use. You should tell your doctor.

Beta-Blockers Decrease Opioid Rx in Comorbid OA, HTN - Rheumatology Advisor

Beta-blocker use was associated with less joint pain and lower use of opioids in patients with symptomatic, large joint radiographic OA.

www.rheumatologyadvisor.com

 

[GetMeOutOfThisCRAP]

Beta blockers help people for things like stage fright or hardcore anxiety inducing situations. I see no point to use them regularly for anxiety--although anxiety is not a singular treatment plan by no means.

I see no correlation between beta blockers and opioids. I bet some other posters could objectify the correlation.. but beta blockers don't seem to be potentiated by much as far as I know. Beta blockers inevitably work best for irregular situations. I bet people take them daily as they really don't have negative side effects prevalent enough to cast hate on beta blockers--but I'm not sure how stimulant use on them would effect the heart. Either way.. I don't see how beta blockers have anything to do with opioids lol.

 

[DKs]

I'm currently on the max. dose of Dihydrocodeine (8 x 30mg pills per day) (...) my doctor has said in the past that he will NEVER prescribe me morphine (or anything equal to - or stronger than - morphine) ever again because of history of dependence/abuse (actually NOT of morphine but because of Oxycodone and Fentanyl which I was originally legit prescribed for very severe pain)

Ist his a pain specialist or a GP? - He's not really competent regarding pain and opioids, really. Get advise from a specialist. There are enough opioid-type substances a specialist might give you regardless, and if it is buprenorphine or methadone. Or more DHC. The max daily dose of dihydrocodeine for pain is more around 1000 mg, if needed.
You could mention your betablocker idea to a specialist, why not. But see a(nother) specialist first. I wouldn't go back to your old doc if I was you.

Beta blockers help people for things like stage fright or hardcore anxiety inducing situations.

Well, they don't really work. They just suppress some physical symptoms of anxiety like sickness and tremor., but they won't help you with anxiety or panic (attacks) at all. Didn't help me at all.

 

[Skippwiggins]

Beta blockers are odd.

They help with pain slightly. Even clonidine helps more though.

They don't do shit for mental anxiety and some like metropolol even made my anxiety worse because they made my head feel so disgusting. They will help with the physical symptoms though.

They make me tired af so I guess that could potentiate opioids.

They help with withdrawal a little bit.

This all just my own personal experience. Id honestly prefer clonidine over beta blockers for any and every situation.

AFAIK it hasn't been proven but beta blockers and hair thinning/baldness seem to be hand in hand. Found a lot of anecdotal reports of this.

 

[ChemicallyEnhanced]

Ist his a pain specialist or a GP? - He's not really competent regarding pain and opioids, really. Get advise from a specialist. There are enough opioid-type substances a specialist might give you regardless, and if it is buprenorphine or methadone. Or more DHC. The max daily dose of dihydrocodeine for pain is more around 1000 mg, if needed.
You could mention your betablocker idea to a specialist, why not. But see a(nother) specialist first. I wouldn't go back to your old doc if I was you.


Well, they don't really work. They just suppress some physical symptoms of anxiety like sickness and tremor., but they won't help you with anxiety or panic (attacks) at all. Didn't help me at all.

He's a G.P. but has already notified the pain clinic NOT to prescribe me ANYTHING. And stated that even if I somehow convince them to anyway, he has final say and the power to deny their request that I be prescribed whatever.

Yeah, my mother has a heart condition and HAS to take Beta Blockers (5mg Bisoprolol/day) to live (it's VERY dangerous for her heartbeat to be over 60BPM) and she says she's exhausted a lot, too.

I was prescribed Propranolol (only the 10mg pills but was told I could take like 4 or 5 at a time if needed) to bridge the gap between having to stop Diazepam (you can only be prescribed it for 2 weeks here) and my SSRI starting to work and I remember it doing NOTHING for my psychological anxiety, but it stopped physical stuff so my heart wasn't racing and I wasn't as nauseated or sweaty and it stopped my hands from shaking as much.

I just need something to make my DHC more effective as I'm not getting anything stronger (and I already blag Codeine Phosphate 15's off my mother and Codeine 30's off my grandfather as it is, and also blow the neighbour-boy for his MSContin 60s) so.... :/

No, here in the UK the N.I.C.E. guidelines make it clear, it is illegal for anyone to prescribe you more than 240mg/day.

 

[DKs]

He's a G.P. but has already notified the pain clinic NOT to prescribe me ANYTHING. And stated that even if I somehow convince them to anyway, he has final say and the power to deny their request that I be prescribed whatever.

Well, I'd just be honest. Also you might want to register with another GP. But that's not your only option. I'm UK based, too and I think your GP is telling a lot of bullshit. So your GP might have informed a (pain?) clinic near you. So what? I'd just be honest with them and register with another surgery. But that's just me and I don't really know anything about your background.

I was prescribed Propranolol (only the 10mg pills but was told I could take like 4 or 5 at a time if needed) to bridge the gap between having to stop Diazepam (you can only be prescribed it for 2 weeks here) and my SSRI starting to work and I remember it doing NOTHING for my psychological anxiety, but it stopped physical stuff so my heart wasn't racing and I wasn't as nauseated or sweaty and it stopped my hands from shaking as much.

Yeah, they like to prescribe propranolol plus some SSRI for serious anxiety. I was on the same combo. It made me not throw up because of my anxiety so frequently any more, put I still had my attacks and full blown panic attacks. My GP didn't even refer me to a psychiatrist. Don't know what it is with GPs in UK that they think they can treat anything with their first line methods and know everything better than any specialists anyway...

No, here in the UK the N.I.C.E. guidelines make it clear, it is illegal for anyone to prescribe you more than 240mg/day.

I'm not sure, but I would be very surprised if no exceptions to this rule can be made. I've certainly seen much higher doses. Your doc might have to explain why an exception is necessary (because he doesn't want to give u morphine for reasons, e.g.), but I don't really know to such an extend how NHS prescriptions work.

EDIT: Seems to be kind of advice, a recommendation for best practice. N.I.C.E BNF say 240 mg. If this is not enough, a strong opioid should be used (or some more acetaminophen). UK manufacturers generic 30 mg dihydrocdeine say 1000 mg per day max. Again: I don't know the exact legal situation, but it seems this is just a straw-man. I guess, just like with the anxiety-thing, your GP might become liable to some extend, should something happen. So he plays it safe. More comfortable from him, u know.

I just need something to make my DHC more effective as I'm not getting anything stronger (and I already blag Codeine Phosphate 15's off my mother and Codeine 30's off my grandfather as it is, and also blow the neighbour-boy for his MSContin 60s) so.... :/

A tiny bit of codeine will probably not help you, I'd guess. Did it help you?
Anyway, you could try about 60-100 mg DXM (Robitussin, OTC) to reduce tolerance. Might help. I'm just stating it might help. This is not a recommendation to anyone and I'm not a trained health-care professional.

 

[ChemicallyEnhanced]

Well, I'd just be honest. Also you might want to register with another GP. But that's not your only option. I'm UK based, too and I think your GP is telling a lot of bullshit. So your GP might have informed a (pain?) clinic near you. So what? I'd just be honest with them and register with another surgery. But that's just me and I don't really know anything about your background.



Yeah, they like to prescribe propranolol plus some SSRI for serious anxiety. I was on the same combo. It made me not throw up because of my anxiety so frequently any more, put I still had my attacks and full blown panic attacks. My GP didn't even refer me to a psychiatrist. Don't know what it is with GPs in UK that they think they can treat anything with their first line methods and know everything better than any specialists anyway...



I'm not sure, but I would be very surprised if no exceptions to this rule can be made. I've certainly seen much higher doses. Your doc might have to explain why an exception is necessary (because he doesn't want to give u morphine for reasons, e.g.), but I don't really know to such an extend how NHS prescriptions work.

EDIT: Seems to be kind of advice, a recommendation for best practice. N.I.C.E BNF say 240 mg. If this is not enough, a strong opioid should be used (or some more acetaminophen). UK manufacturers generic 30 mg dihydrocdeine say 1000 mg per day max. Again: I don't know the exact legal situation, but it seems this is just a straw-man. I guess, just like with the anxiety-thing, your GP might become liable to some extend, should something happen. So he plays it safe. More comfortable from him, u know.



A tiny bit of codeine will probably not help you, I'd guess. Did it help you?
Anyway, you could try about 60-100 mg DXM (Robitussin, OTC) to reduce tolerance. Might help. I'm just stating it might help. This is not a recommendation to anyone and I'm not a trained health-care professional.

I'm extremely reluctant to change GP surgery (no point seeing another GP at the same surgery as my GP happens to also own the whole practice and also be senior (most advanced, not oldest) GP there) as any other GP would have written me off or forced my to leave the practice a hundred times over by now and - when it comes to anything put addictive meds - he's EXTREMELY good to me. He's even called me or came to my house (without me even asking) on evenings and weekends just because he was concerned and wanted to check I was okay etc. And we're sorta friends, like he asks me for movie and restaurant recommendations etc.

I'll just ask him about what I can do and request he look into my options or send me to a pain clinic and at least LISTEN to what they advise him to do.

The codeine's help a little if I take like 12 of them.

I used to use a lot of DXM (like, where I couldn't use stairs lol) but haven't in a couple of years as even a tiny whiff of that syrup makes projectile-vomit all of my internal organs across the room, but I think i WILL get some and try out like 90mg and see how it helps.

Thanks for all your advice

 

[DKs]

I'm extremely reluctant to change GP surgery (no point seeing another GP at the same surgery as my GP happens to also own the whole practice and also be senior (most advanced, not oldest) GP there) as any other GP would have written me off or forced my to leave the practice a hundred times over by now and - when it comes to anything put addictive meds - he's EXTREMELY good to me. He's even called me or came to my house (without me even asking) on evenings and weekends just because he was concerned and wanted to check I was okay etc. And we're sorta friends, like he asks me for movie and restaurant recommendations etc.

Well, if that is how it is the only things that remains might be a script for buprenorphine or methadone. They both work very well for pain, btw. There should be something like turning-point near you. They'll contact your GP, though.
Might be I tries and wants to do well but this upper-dose DHC and and being able to switch you to another pioid is nonsense. Let's assume 240 mg daily is the upper limit, really, for whatever reason: does he think DHC is less addictive than the corresponding equivalent dose of other opioids? - Just not true! And a high dose of DHC is no joke, really. You might not want to inject it in the first place as the histamine release makes this very dangerous practice, but what is a junky not happy to do for his high?

I used to use a lot of DXM (like, where I couldn't use stairs lol) but haven't in a couple of years as even a tiny whiff of that syrup makes projectile-vomit all of my internal organs across the room, but I think i WILL get some and try out like 90mg and see how it helps.

90 mg whould do something for you. Will not increase the euphoria, but rather the damping effects only. But it should work. If you feel really sick, you can use some phenergran (best deal at boots, but can buy at other pharmacies less pills, too). Make sure you get the DXM only cough syrup, as there are different formulations.

EDIT: just to be perfectly honest: when I read you first post in this thread saying you needed already 11 of your 8 pills to be normal, can't talk to you doc, I already thought a script for methadone might be the right thing for you. Just don't make friends with the other clients at the clinic to not end up on heroin, too .

EDIT2: these doses of DHC, DXM and promethazine might make you sleep, but should not be dangerous if you're not unusually sensitive to you DHC and since you're quite used to it this should be fine. But again, I don't particularly recommend this combination! Don't just mix this stuff in whatever-dose with whatever-tolerance, thinking it'll be great in any case!

O and EDIT3: threadstarter may go as high on DXM as he feels. i.e. as long as it doesn't cause hallucinations. The idea is that nerve cells with mu-opioidreceptors have NMDA-receptors. Now DXM acts as an antagonist at NMDA while the opioid is a mu-agonist. The opioid-effect will be stronger on the cell if there is this antaonism, too. But the dissociative effects of DXM itself might help "splitting" you from your pain, too.

 

[ChemicallyEnhanced]

Well, if that is how it is the only things that remains might be a script for buprenorphine or methadone. They both work very well for pain, btw. There should be something like turning-point near you. They'll contact your GP, though.
Might be I tries and wants to do well but this upper-dose DHC and and being able to switch you to another pioid is nonsense. Let's assume 240 mg daily is the upper limit, really, for whatever reason: does he think DHC is less addictive than the corresponding equivalent dose of other opioids? - Just not true! And a high dose of DHC is no joke, really. You might not want to inject it in the first place as the histamine release makes this very dangerous practice, but what is a junky not happy to do for his high?



90 mg whould do something for you. Will not increase the euphoria, but rather the damping effects only. But it should work. If you feel really sick, you can use some phenergran (best deal at boots, but can buy at other pharmacies less pills, too). Make sure you get the DXM only cough syrup, as there are different formulations.

EDIT: just to be perfectly honest: when I read you first post in this thread saying you needed already 11 of your 8 pills to be normal, can't talk to you doc, I already thought a script for methadone might be the right thing for you. Just don't make friends with the other clients at the clinic to not end up on heroin, too .

EDIT2: these doses of DHC, DXM and promethazine might make you sleep, but should not be dangerous if you're not unusually sensitive to you DHC and since you're quite used to it this should be fine. But again, I don't particularly recommend this combination! Don't just mix this stuff in whatever-dose with whatever-tolerance, thinking it'll be great in any case!

O and EDIT3: threadstarter may go as high on DXM as he feels. i.e. as long as it doesn't cause hallucinations. The idea is that nerve cells with mu-opioidreceptors have NMDA-receptors. Now DXM acts as an antagonist at NMDA while the opioid is a mu-agonist. The opioid-effect will be stronger on the cell if there is this antaonism, too. But the dissociative effects of DXM itself might help "splitting" you from your pain, too.

I have actually been on Methadone before (60mg/day for Oxycodone addiction). I've been on heroin many times, too.
The thing about Methadone is it raises your tolerance really fast.

Honestly, I made one mistake of taking slightly more Oxy than I was prescribed for a couple of months and have to spend the rest of my life paying for it :/.

 

[Rocketman1972]

I have actually been on Methadone before (60mg/day for Oxycodone addiction). I've been on heroin many times, too.
The thing about Methadone is it raises your tolerance really fast.

Honestly, I made one mistake of taking slightly more Oxy than I was prescribed for a couple of months and have to spend the rest of my life paying for it :/.

Hello I can relate to your oxycodone payments. I had oral surgery and was prescribed 7.5 mg Percocet for the pain. I was having bad pain on the second day. I took one and it didn’t do much so I took the second, and we’ll yes. I found heaven on earth. I’ve always been a very nervous person and that was the answer to 50 years of unbridled worry anxiety agitation and... you get it. I take about 45 mg a day. It is expensive. I did get a prescription for it but only 15 mg a day. Anyway, I just wish the tolerance didn’t happen.

 

[ghostfreak]

I take Propranolol 160mg SR every morning for headaches and dabble in Tramadol the odd time but haven’t noticed anything between the two.

 

[Jabberwocky]

Beta blockers lower your blood pressure, and so does opiates, your liable to take your same dose and a propanol and liable to pass out, especially if you exhaust yourself. Look up blended therapy OP. Atarax, and opiates are being studied in conjunction to reduce opiate dosages.