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Core Topics => Drugs => Opiates & Opioids => Topic started by: mickeyaye6989 on October 21, 2016, 02:22:32 AM

Title: Switching from one opioid to another - does your body prefer a specific drug?
Post by: mickeyaye6989 on October 21, 2016, 02:22:32 AM
I'm currently on a vacation and didn't want to fly with a bunch of H, so I got a bunch of 50mg Kadians to keep me going while I'm away from home. Generally I pretty much stick strictly to heroin, but I generally keep a few MS Contins around in case my dealer doesn't pick up when I need to cop. I've never had a problem before, but this time I'm noticing that the morphine doesn't seem to make me feel quite as perfect as the H, regardless of dose. I can shoot enough to get slight pins and needles, but it still leaves me with that uncomfortable scratchy feeling where even a small scrape hurts like a knife. I'm totally fine otherwise - no yawns or runny nose/eyes, haven't shit in 2 days, and otherwise feel totally well, but the morph just doesn't seem to cut it like the H did. I'm wondering if my body somehow has a preference for heroin, or if the morph just doesn't hit my receptors in an equivalent manner (I mean I know it's a different drug, but generally opioids all keep me well, no matter what type). It seems that even if I do much more than enough to get me high, I still can't shake this scratchy feeling.

Has anyone else noticed that switching from one opiate to another leaves them with reduced/increased efficacy, even if you know the amount is equivalent with regards to strength/dose?
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Dopeless Hopefiend on October 21, 2016, 08:16:34 AM
For me H was always in a league by itself. When I had a habit none of the pharmaceutical opis were fully satisfying. I can remember being in the hospital & getting 2 of the 8mg hydromorphone pills every three hours. Even if I cooked them up & shot them into my picc line it wasn't the same.
I think the closest thing for me was the OG oxycontins. Those were pretty great. Still not as good as H though. The only one I've never tried is oxymorphone, but I've done just about everything else.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Chip on October 21, 2016, 11:08:02 AM
I'd quite often use M when I wanted a break from Methadone. The ER version always took an hour to even start working (oral) but I always felt better (normal) on it.

Occasionally I would use Heroin (feeling the best !) but it just pushed my tolerance up and then I'd suffer feeling lousy and this would linger until I got my dose put up and then I'd suffer again with the increase of side-effects from the 'done.

That's the shirty part, not knowing where I am with my dose plus my tolerance ended up climbing rapidly - a symptom of being too long in the game.

I need to feel stability, that's why I'm desperate to be back to opiate free.

I'd still prefer oral morphine over Methadone but it was never an option.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Anti-hero on October 21, 2016, 02:51:40 PM
Heroin is definitely my DOC
I can switch between
Most opiates
Just to keep from being sick
But nothing beats
Good old fashioned
HEROIN
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: mickeyaye6989 on October 21, 2016, 04:25:33 PM
Totally agree that H is my DOC by far, but does anyone else seem to experience WD's when switching drugs even if you know your dose is equivalent to your typical H dose? I think some of my problem is that I didn't realize how much dope I was doing, but I still don't feel totally peachy like I would with a small shot of H. Gotta love the double edged sword of addiction....
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Z on October 21, 2016, 09:00:04 PM
I find that the first shot of an opiate that I haven't done in a while is usually stronger then it should be compared to my tolerance.  It's almost like something new just hits differently, or it shakes things up enough that it has a more pronounced effect.  Maybe it's just that I'm so used to the subtle differences that having a new type of high feels so different and strong. 


What usually happens is that after more then a day I start to feel like it isn't usually hitting the spot all the way.  Maybe it's psychological, or maybe there is truly something missing.  It's very pronounced with my methadone.  I have gone off it for a week before, and I feel progressively worse as the time goes on until I hop back onto my normal dose.  The best way I've found is to take a small dose of methadone and combine it with whatever the other drug that I have is.  Luckily I manage my medication much better than I used to, and I don't find myself in the position of having to make up for a week's worth of take homes that I no longer have since I sold them or took them.  It is a long time that I haven't found myself in that position, and I definitely don't want to go back to it.


Different opiates do fit into our receptors differently, and some of them have other components then just the opiate.  Methadone is a good example of that.  There is a lot of NMDA activity with methadone, and it binds to other receptors then what are the traditional opiate receptors.  There is evidence to show that this could attenuate the medication to an extent, have an impact on tolerance, and likely becomes another thing that our bodies need to function.  Different opiates might have different effects, and it might even be in ways that we don't even understand with our modern medicine.


Does anyone else find that as time goes on a drug change becomes less satisfying?  Methadone has a long half life, so with heroin the scale would be shortened a lot.  Instead of a week it might be a day for a relative example.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Wildcat on October 22, 2016, 07:11:47 PM
Your genetic make up may not contain the necessary enzymes to metabolize some drugs;

I cannot take methadone because the gene I carry doesn't have the correct enzyme to metabolize it normally; this is true for everybody for a whole bunch of medications not just opiates.  SO it would be dangerous for me to take methadone; because I don't get the relief, I would want to take more, and more, and die of an od as a result.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Lolleedee on October 24, 2016, 02:32:50 AM
@Wildcat Could you explain a little bit more about why you can't metabolize methadone? What exactly is your body missing? How did you find out that you had this issue with methadone?

I'm sorry if that's too personal a question, but I'm very interested in the medical side of how we metabolize things.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Z on October 24, 2016, 04:04:56 AM
I know that some people have two recessive copies of the cyp2d6 gene that is responsible for metabolising many drugs like codeine.  I know that it has an impact on the rate of metabolism of methadone, but I didnt realize that it lead to some people not being able to metabolize methadone at all.   When you drink white grapefruit juice to potentiate codeine or methadone you are effecting the cyp2d6 gene. 

Im interested now.  Does methadone have no effect at all or is it just a reduced effect? That really sucks.  Methadone has been a real lifesaver for me, and not having that option would make it so much more difficult. 
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Dog Food on October 24, 2016, 04:25:17 AM
When i was in detox last there was a guy there that had an allergy wristband on for codeine/morphine, but was there for iv heroin.  I didnt think that really made much sense as h is metabolized into those and im sure street dope has morphine still in it too.   
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: mickeyaye6989 on October 24, 2016, 07:19:43 AM
Codiene allergies are actually quite common, and definitely do not mean that all opiates/opioids will affect you similarly. Codine allergies are codeine specific, so people with them can generally take oxyocodne or hydrocodone, or some similar opioid and be totally fine. Moreover, I actually make it a point to mention to all of my doctors that I have a codeine allergy so that they won't give me weak ass T3's or some similar bulltshit. Example: recently broke a bone in my foot and went to see my doc. He was about to write a me a script for T3's but I said I had an allergy to codeine. I then mentioned that because of my Irritable Bowel Syndrome (IBS), I can't take paracetamol or ibuprofen. He was about to write a script for Percs, but as those have paracetamol, that wouldn't work either. I figured he'd just script me plain 5mg oxy's, but to my surprise, he handed me a script for 50x 1mg hydromorphone. SCORE!

tldr: codeine allergies are codeine specific, and have no bearing on other opioids. also, claiming a codeine allergy is often a good strategy for getting scripted stronger alternatives!

Edit: I remember hearing something about codeine being the most common allergy-enducing opiate because it causes an unusually large histamine response relative to other opioids. Hence the fact that you can't IV it as it will cause such a massive response that your body goes into shock and you might die. Not sure this is 100% accurate, but I do remember reading that somewhere.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Chip on October 24, 2016, 04:21:16 PM
my friend uses Heroin and has been recently plagued with differing degrees of allergies from it, as it varies from batch to batch.

i told her to get some anti-histamines (she uses PhenergenWiki) and this does the trick but i wonder if she's developing a progressive allergy as it seems to be happening more often ?
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: mickeyaye6989 on October 25, 2016, 01:41:47 AM
Interesting - are they getting it from multiple sources or just one? Could be a gross new cut that doesn't go over well. Haven't heard of someone developing an allergy slowly over time to dope but the body is a crazy thing so you never know.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Chip on October 25, 2016, 01:53:38 AM
i'm not sure about her sources but the gear definitely varies.

another friend who used to use Heroin about 30 years ago developed and EXTREME skin-peeling response to Codeine since then and unbeknownst to her !
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: LadyKalma on November 12, 2016, 10:26:57 AM
It depends on the opiates in question for me. For example, I was addicted to oxy a long time ago and when i got some h it for sure made me feel great, it wasn't like cause I was used to the oxy that I would prefer it. However, my husband did prefer the oxy, still would if it was available. Also, I have always been able to be ok with a small amount of methadone, and despite us having similar sized habits, my husband is still sick seeming with twice as much methadone. Dilaudids seem to work just fine too even though they are something ive gotten rarely so not "used" to them either.

Morphine seems the least preferable to me anyway, way to much histamine reaction. So for me personally I think it dosent seem to work as well cause i can't tolerate doing very much in one setting, face turns super red and everything too. But dosen't h get converted into morphine soon in the body anyway? So maybe it dosen't work as well to make you feel great cause its missing part that happens before its converted? Idk
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Snout on November 12, 2016, 02:18:32 PM
Wait! You mean other people like heroin also?!?! I thought I was weird.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Wildcat on November 13, 2016, 07:46:58 AM
@Wildcat Could you explain a little bit more about why you can't metabolize methadone? What exactly is your body missing? How did you find out that you had this issue with methadone?

I'm sorry if that's too personal a question, but I'm very interested in the medical side of how we metabolize things.
@Lolleedee - No, I don't mind ; )-

I had genetic testing to determine which medications I respond normally or best to, and which ones I don't.  For example;
For Methadone, the enzymes that bind to the gene I carry are unknown-so I am sensitive to it, and it is recommended not to take it.

I am prescribed Oxycodone, however the enzymes(CYP2D6) that bind to that gene I carry do not metabolize this drug normally-I have an altered response, meaning  need more of this drug than a normal metabolizer or it's recommended that I be rx'd a drug not metabolized by CYP2D6=like morphine, oxymorphone, fentanyl

I am also rx'd Fentanyl(Duragesic is the one I use 100mcg) - I have above normal response because I carry the gene/enzyme combination that targets at least 3 opioid receptors- so it's a very good drug for me!

The report I have is very valuable and contains this type of info for all sorts of medications(heart, seizure,anti-depressants, muscle relaxers, etc)

If your ins will pay for this-you should have it done-especially if you have a lot of medical problems and take multiple medications.  It could save your life.

I can't take Naltrexone either(not that I'd want to, lol)for the same reasons. But if I were to OD I'd be in deep shit because I don't respond to it.

From now on, I make sure any doc I see and wants to Rx me anything, I have this report for her/him.

Be well!  ; )

wildcat
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: mickeyaye6989 on November 14, 2016, 12:13:28 PM
That's interesting that our genes affect the enzymes that metabolize these drugs in such a dramatic way. Had no idea that some people who lack a certain enzyme may get almost no effect from a certain drug - seems that our body chemistry is still quite a mystery to us all! I always figured that if I had not had a drug before, it would be more effective as my body wouldn't have encountered it and this wouldn't quite know how to metabolize it right away (given what I've read now, this seems like it's probably bs) but it would be really cool to have the enzyme testing done.

Where/how exactly did you get set up with the lab/doc who did the testing for you? Was it ordered by a pain doc, or done on your own initiative?
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Dopeless Hopefiend on November 14, 2016, 12:29:54 PM
@Wildcat Could you explain a little bit more about why you can't metabolize methadone? What exactly is your body missing? How did you find out that you had this issue with methadone?

I'm sorry if that's too personal a question, but I'm very interested in the medical side of how we metabolize things.
@Lolleedee - No, I don't mind ; )-

I had genetic testing to determine which medications I respond normally or best to, and which ones I don't.  For example;
For Methadone, the enzymes that bind to the gene I carry are unknown-so I am sensitive to it, and it is recommended not to take it.

I am prescribed Oxycodone, however the enzymes(CYP2D6) that bind to that gene I carry do not metabolize this drug normally-I have an altered response, meaning  need more of this drug than a normal metabolizer or it's recommended that I be rx'd a drug not metabolized by CYP2D6=like morphine, oxymorphone, fentanyl

I am also rx'd Fentanyl(Duragesic is the one I use 100mcg) - I have above normal response because I carry the gene/enzyme combination that targets at least 3 opioid receptors- so it's a very good drug for me!

The report I have is very valuable and contains this type of info for all sorts of medications(heart, seizure,anti-depressants, muscle relaxers, etc)

If your ins will pay for this-you should have it done-especially if you have a lot of medical problems and take multiple medications.  It could save your life.

I can't take Naltrexone either(not that I'd want to, lol)for the same reasons. But if I were to OD I'd be in deep shit because I don't respond to it.

From now on, I make sure any doc I see and wants to Rx me anything, I have this report for her/him.

Be well!  ; )

wildcat

Hey Wildcat, this is really interesting. Is there a specific name for the test that I could ask my doctor to order? I would love to have this information for myself. I know that Morphine just doesn't work for me. Like, I get close to no pain relief from it, but I have no idea if this could be related to genes.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: DreamerOnTheRun on November 14, 2016, 05:01:21 PM
Yeah, I was curious about that myself.  Somebody suggested that something very similar may be the cause of my RIDICULOUS tolerance to benzos.  Yes, I've "built" up a tolerance as well but even if I go months without it still takes 10mg of alprazolam to give me the same effect 2mg seems to have on most people. Obviously totally different receptors but you get my point.

For me, when I switch from one to the other it's usually from Dilaudid to Oxycodone (& vice versa)  and the biggest difference from my experience is how much I miss the rush Dilaudid give me, or miss the sedative/nodding properties of the roxicodone.  Also sometimes forget how quickly I seem to start WDing after my Dilly shot versus the Roxi shot.  But when switching the other way I find the rush from the Dilaudid sometimes pleasantly surprises me with its intensity (and I never get the nasty histamine reaction pins & needles from either dillies or roxies, none whatsoever).

I totally feel you on the morphine.  I can't STAND it. The pins & needles, the hives, the itching overwhelm me to the point it drowns out any relief/rush I may have gotten otherwise.  Never made much sense to me because I thought Dilaudid broke down into morphine once in you, unless it's just from contact before it has a chance to be metabolized?  Idk if that makes sense though.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Chip on November 14, 2016, 05:26:44 PM
funny thing, benzo tolerance ... i have never suffered from any benzo withdrawal as i was effectively treated by a Methadone clinic for Diazepam addiction.

BUT i have a perpetual high tolerance to benzos ... maybe not always the first time but straight after.

the benzo tolerance behaves a bit like the opioid mechanism where once you build it up, it remains with you for life.

maybe all tolerances behave like this ... it means less bang for your buck but at least your body is protecting itself.
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: makita on November 14, 2016, 10:42:38 PM
I def experience moderate WDs when switching from one opioid to another even if the doses are supposed to be equipotent.  It's gotten worse over the years with the more I've used.  Part of this is because opioids don't all have the same molecular "shape" so one drug will affect receptors slightly differently than another.  Think of 2 dif puzzle pieces that are close to the same shape, but not identical; what happens if you have a finished puzzle where one piece fits perfectly, and then you decide to take it out and try to replace it with the other (the empty space is the tolerance you built up to a specific opioid).  It might fit 90% of the way, but still be off by 10%, causing your body to react on behalf of that missing 10% the same way it would if there was no replacement piece at all (ie withdrawal)...just only at 10% severity.   The bigger the difference between the two types and how they affect your receptors, the more intense the withdrawal will be even if you take way more of the new med then you would need to.

The most dramatic difference I've seen w this has been when switching from fentanyl to anything else.  To make it painless I have to basically treat myself as if I were in cold turkey withdrawal and take multiple types of supportive meds like clonidine and gabapentin for the first 4-5 days alongside the other opioid (and usually jack up my dose of it as well if possible). 

I've also heard this is common when going from PST or opium (which has multiple types of opioid alkaloids in each dose, some of which you couldn't get anywhere else like thebaine) to a single opioid like morphine or methadone...even heroin. 
Title: Re: Switching from one opioid to another - does your body prefer a specific drug?
Post by: Wildcat on November 16, 2016, 12:38:05 PM
@mickeyaye6989


It was done by a lab called Alpha Genomix; and was ordered by my PM doc-it's now part of a new protocol in his practice before any medications are prescribed-most insurances pay for it.  They take a simple cheek swab.

The results report is really in depth and quite informative.

@Dopeless Hopefiend -  it's Genetic testing for drug sensitivities/effectiveness/side effects.

***It's especially useful when insurances' require prior authorization or step therapy***You have scientific proof of why you must have one medication over another.

wildcat
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