The package insert even starts with the headline that all people have a right to freedom from pain.
I like that. Just checked mine but this isn't written on the UK version.
Also kinda funny to me that DHC Continus and MST Continus are both made by Purdue. They seem to be the ones behind almost all of the time released opiates.
Actually with all of the antihistamines I take as potentiators and so forth, I imagine I could handle very high doses of Codidol Retard now without problems like itching and the like.
I actually enjoy the itch. What I can't stand is the nausea. DHC Continus already makes me nod the fuck out so I don't use sedating antihistamines (I find using sedative antihistamines to try and boost your nod just makes the whole experience feel "dirty" anyway) just non-sedating ones to stop the nausea. Cetirizine is what I tend to go for. No sedation but just a single 10mg pill stops me feeling sick from high doses of opiates. Perfecto.
If one is needing immediate-release DHC, one can always chew the tablet and wash it down with Coca-Cola, and not much of the extended-release mechanism is defeated even when one does that, it is just front-loading a bit
I've only been using it for a few days so I might end up changing my mind about this but so far I actually prefer time release DHC to instant release. The time release feels a lot stronger and still makes me nod. IR hasn't felt this good in years. No idea how but even at the exact same doses XR just feels better than IR. Actually even at higher doses of IR it feels weaker than XR. I can easily do 300-400mg IR and just get a mild high (and mild pain relief). Whereas one or two tablets of 120mg XR has me proper nodding. I now see why Burroughs compared it to smack. I've always loved my DHC, but now I really fucking love it.
The XR is only a mild improvement for actual pain relief though from what I can tell. It does seem to be eradicate pain for a few hours but it goes back to just taking the edge off like IR DHC does after those initial few hours, which is kind of defeating the purpose of XR. I do actually get even more high after that, but the pain relief is reduced.
Ironically a low dose of XR morphine like MST Continus 20mg would probably give me less euphoria, less side effects, but superior pain relief. However I can't imagine getting that any time soon, my doc is already wary of having me on DHC long-term, doesn't want to get blamed for making me an addict so is hoping my pain just disappears even though it's been there for ages and I have chronic pain in the family. I would have hoped he'd trust me more considering I've got scripts for all sorts of addictive and abusable controlled drugs and have done for years and have never once been a "problem patient."
He does obviously trusts me enough to give me a pretty nice supply of max dose DHC Continus in the first place, but I think this is a paranoia most docs have about treating chronic pain not caused by terminal illness. If the patient will live with the opioid long-term the doc is worried the patient will get hooked and blame the doctor. Not sure what to say to the doc to assure him this won't happen except for... I'm already on multiple addictive controlled drugs which you're happy to script me on repeat and have been on more in the past, I have been on these meds for easily over half a decade and I've had no problem keeping myself in check with those, no massive tolerance increase, no begging for early refills, no trying to blag bigger doses or stronger drugs, etc.
Wish I could get away with being more frank like: look I don't need a doctor to get opiates, I'm coming to you because I want medical oversight, I want to use them sensibly, I don't want to get proper hooked on anything. That's why I want a legitimate prescription from a doctor who can oversee my use. Either way I will use them. I would rather go the safest route. But for that to work I need my doctor to understand it's chronic pain that we're managing here.
one can always chew the tablet and wash it down with Coca-Cola, and not much of the extended-release mechanism is defeated even when one does that, it is just front-loading a bit . . . I am thinking maybe one of the reasons it is finding favour both with patients and doctors
Afaik to fully bypass the time release you use baking soda or something don't ya? I skimmed a few threads here on BL that happened to mention it, but I honestly don't want to bypass it myself so didn't research it to deeply. I have like 100 IR's left anyway. But I prefer XR.
But yes doctors (in the UK) certainly prefer to put patients on XR opioids if they're for long-term use. For post-op pain they use IR but for chronic pain they will pretty much always give you XR. Sometimes with low dose IR for breakthrough.
The way it seems to work is they stick you on IR for 1-2 weeks so you can work out the effective dose then they give you an XR version of that dose or the closest available.
A sensible approach imo. I see what my doc means about XR being less addictive in terms of it not giving you a rapid hit and not having to keep redosing etc... but definitely not less abusable, I am literally taking my scripted dose, actually less than the dose I usually take of IR so not a high dose for me, and nodding the fuuuck out. I am literally nodding and getting fucking CEV's when I close my eyes! Madness, literally feeling as strong as a chewed up OC80! I shit you not (quite literally, I'm rather constipated ?)!
I have heard of some places considering Perduretas, the 50 and 100 mg codeine hydrochloride extended-release tablets as well.
Yeah I've heard they have codeine XR in a few countries but I can't imagine it's much good especially for treatment of chronic pain. DHC XR works because DHC is actually stronger than the medical system seems to think it is (in the UK at least). Codeine is very weak though unless you happen to be a lucky ultrarapid metaboliser. But in that case why not just be on MST Continus instead of a prodrug for the same thing?
