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Tex Murdock DDS
09-26-2010, 11:18 AM
Hey guys. A friend of mine just picked up 8 Morphine sulfate pills. These ones to be specific:

http://www.healthsquare.com/common/images/e/ETX03130_79614_5.JPG

He has a pretty decent tolerance, takes about 100mg of Oxycontin to get him right. Would these 8 pills be enough to get him feeling it? What's the best method for taking these? Crush & Snort, parachute, IV, or taken as-is? Any info would be greatly appreciated.

mainline
09-26-2010, 11:22 AM
IV. you probably won't feel a thing otherwise

Tex Murdock DDS
09-26-2010, 12:02 PM
Cool, thanks. Awesome Av/Post combo by the way :p

E: Also, any tips on prepping these for IV? I've been reading the sticky but I don't know which one to follow with these. Any suggestions?

MethadonBoblow
09-26-2010, 02:49 PM
With my experience with Morphine Sulfate pills it's better to take them like you would suboxone. Put them under your tongue and let them dissolve there. Snorting or just eating them doesn't do anything.
About 60mg would get me a decent hum done like I said above. I've never tried to IV them so I don't know what that does. But snorting them will just make them gel up in your nose and then pretty much notta. I use to hate those things until a friend of mine's mother who is a nurse told use to put them under the tongue and let it dissolve. Then I loved it. Especially mixed with some methadone. Best feeling ever in my opinion.

Thanat0s
09-26-2010, 02:52 PM
UTMFSEMF.


crush, cold water, big cotton,
filter AGAIN,
inject.

no more than 60mg/mL

Morphine
09-26-2010, 03:41 PM
But snorting them will just make them gel up in your nose and then pretty much notta.

I think the ones the OP has are instant release. instant release morphine does not gel up.

thanat0s is exactly correct. cold/room temp water, DO NOT heat pills, especially morphine, as it degrades pretty easily (I think 180°F, which isn't really that hot and can be acheived with a lighter rather quickly).

its water soluble, so almost as soon as it hits water, it goes into that, heating it will just degrade it and put the fillers and other stuff in water.

I always double filter my pills. I use a luer lock without the needle to do the first filter. then put into another clean spoon with another clean filter and then suck it up using one of my regular orange cap insulin syringes to suck it up and shoot it.

and I'm glad that thanat0s also added that you cannot fit more than 60mg/ml. I"m tired of reading posts of people saying they're putting 100mg into a 1cc rig, you're wasting SO MUCH of it that it hurts me to think of it. unless you're keeping the washes for later use, then I guess you could get a better wash than what I get with mine.

I get the roxane brand 30mg instant release, and I also get the watson (abg) 30mg SR's.

all the IR's are prepped pretty much the same, as thanat0s said, but there are different prep methods for the SR, but I'm pretty sure there are ways posted on here for all generics.

Mercury
10-18-2010, 06:50 PM
I have some Morphinr Sulphate Zomorph 60mg slow release caps. UK based.

I crushed up the little balls and added water and heated alittle but I got a wax surface appear and I found it almost impossible to draw anything up. The filter became blocked.

I shot what little bit I did get into the syringe but I felt little and I was gutted.
The first time I have ever managed to get my hands on any morphine and I couldnt get any into my veins!
Never tried again since.

What can I do to better this situation?

simply put more caps in the mix? use more filters?

Will any of this wax shit do me any harm?

Swellin
10-18-2010, 08:31 PM
The ones i use have beads in them also, but from what ive read mine are unlike like the US based morphine ERs, the beads in my pills are extremely tiny and there are hundreds if not thousands and after filtering i get 99% of the morphine. Can you describe how large the beads are in your pills, also look of the Kaiden info and see if thats what they are like. More info before we can help

Morphine
10-18-2010, 09:15 PM
I have some Morphinr Sulphate Zomorph 60mg slow release caps. UK based.

I crushed up the little balls and added water and heated alittle but I got a wax surface appear and I found it almost impossible to draw anything up. The filter became blocked.

I shot what little bit I did get into the syringe but I felt little and I was gutted.
The first time I have ever managed to get my hands on any morphine and I couldnt get any into my veins!
Never tried again since.

What can I do to better this situation?

simply put more caps in the mix? use more filters?

Will any of this wax shit do me any harm?

was there gel before you added heat? you're not supposed to heat pills, its not necessary. next time try without heat. since its water soluble, as soon as the the morphine touches water it transfers to the water. so just crush beads, add water, stir, throw in big cotton, or micron filter is best if you have those. if not, always use the whole end of a q-tip, and then squirt into another spoon, throw in a regular sized cotton, and draw up. btw, its easier if you use a needle-less rig for the first filtration.

Mercury
10-20-2010, 05:06 PM
the full text on the packet says

Zomorph 60mg
Morphine sulphate BP
PL Holder : Ethypharm
BN2021013 exp 10/2012

The Caps are half orange and transparent
The little balls are tiny, 100s. off white, yellow, creamy in colour.

I think the wax appeared once I heated, I will try to desolve them at room temp next time.
I used a cooking pot with no critic acid and the filter suppied from a needle exchange.

If I was to eat these, I would open and desolve under my tongue.
Thinking of doing 2 first just to see. got a stripe of 10 caps.

How many should I be shooting or eating to be safe?
Currently got a 25ml methodone and 1/2 gram H daily habit.

Thanks guys, any help much appreciated.

Swellin
10-20-2010, 07:50 PM
Mercury, those sound exactly like mine, all but the name. Mine are called M-eslon they come in a capsule the cap is orange and the base is transparent like yours, on the transparent base it says M-ESLON 60, and on the orange cap it has a symbol with nPr in a half circle, or something like that. And like you say the beads are a creamy color.

Oh wow i just re-read your post and the Ethypharm stuck out like a neon light. I once went to the hospital and they gave me some of the pills I usually get except this time they were in a blister pack, this was years ago, i have the blister pack right next to me! It says Ethypharm. We are getting the same pills! I can help you much more now.

These pills are SUPER fucking easy to prep for IV, I dont know what a morphine slash h habit would be in comparison so i cant help you there but i can tell you how to prep them. There are two ways to do this both are real fucking easy, here are the steps to prepping them

1. Pour out the beads into a small cup and use a rounded edge of something to crush them just like a mortar and pestle, i use a small candle holder that looks like a shot glass and a butter knife with a rounded edge.

2. Once beads are in powder form add 1 CC of water and mix it, the longer you let it sit the stronger it will become, but really it only needs to sit for a few minutes and i feel you get 90% of the shot, letting it sit for an hour or so does make it stronger tho.

3. Here is where you can do it two different ways, the first way is just mix it up once more and grab your filter ( I use a Q-tip) and just dip it in there and draw it up and boom your done.

Now the other way is to heat the solution slightly don't bring it to a boil as you will destroy some morphine (even if it does boil, the effects are not noticeable) What i do is heat it until i see steam coming from the glass and you should see the powder dissolving quite a bit and coming together into groups, this is the wax. Heating it will make the shot cleaner for sure, but also keep in mind it can dissolve some of the binders as well.

After its heated do the same thing put in a filter and draw it up.

If i add 1 CC of water and do the heat method after all is said and done i will only have about 70 units of water in the rig, be sure to add more water to your cup and suck it up thru the same filter to get the rest of the morphine, i always have 1 CC of water when im done.

Thats it, bang away, using either of these methods and you will have a very potent shot you just need to make sure you use enough morphine. I bang 100mg at a time and every time i get the beautiful pins and needles feeling. 1 more thing, you will hear different opinions on heating pills some say there is no need, others say it will make the shot stronger, try both and see what you like most. Good luck, if you have any questions post back i will try to answer them. Be safe.

Morphine
10-21-2010, 12:47 AM
how many times do I have to say this? DO NOT heat your pills, at all. I'm not saying this because it may kill some of the drugs, I'm saying this because it puts filler into the solution, and filler is bad for you. and as you found out, it also causes it to gel. so NO HEAT, whatsoever.

also, I would double filter the shot, especially if its a pill that has the capabilities to gel up.

and another bit of info for you, you can only fit 60mg into a standard 1cc syringe. thats as far as the solubility of morphine will go 60mg/ml.

Swellin
10-21-2010, 01:50 AM
Not sure who your talking to but the etheypharm pills that i use and the ones that merc uses dont gel, unless the ones in the UK have a different additive. Heating them definitly does not cause these ones to gel. Also Mercury i should add something, whether you choose to heat it or not the solution should be Crystal Clear. I have done both methods and just using a q-tip I can get the solution as clear as water so if its cloudy after you have filtered it i would try a different filter.

doctor diesel
10-21-2010, 07:32 AM
Question: if morphine pills taken orally are jack shit because of shit bioavailability (due to first-pass metabolism?), then why are they prescribed so frequently as oral pills, and why aren't they prescribed sublingually (as MethadonBoblow suggests above) or suppository-wise instead?

I mean, a guy presents in serious pain, which you as an MD, want to address, and you have the choice of giving him hydros, oxys, methadone.... heck, even codeine tabs - all of which are highly orally bioavailable - and instead you conclude that sending him packing with morphine tablets (bioavailabiolity, what, 15%??) is the best possible course of action.

I have never understood this. Does anyone?


Doc

Woody Bear
10-21-2010, 08:13 AM
Question: if morphine pills taken orally are jack shit because of shit bioavailability (due to first-pass metabolism?), then why are they prescribed so frequently as oral pills, and why aren't they prescribed sublingually (as MethadonBoblow suggests above) or suppository-wise instead?
Morphines oral bioavailability is around 25%, but it is a much more potent drug than codeine. So instead of prescribing a 60 mg oral codeine dose, you can instead prescribe 10 mg oral morphine. Morphine's sub-lingual bioavailability isn't much better than it's oral bioavailability. Morphine does come in suppository form, but a lot of people don't like sticking things up their arse, so that's why the suppositories aren't prescribed much in the UK.

Also codeine has a dose ceiling, where giving more codeine won't reduce the pain, because codeine is a pro-drug and your body can only convert so much of it. But morphine doesn't have a dose ceiling, so there's no upper limit to the morphine dose you can take. If you are in pain you can keep taking morphine until the pain goes away, but if you were in severe pain then after a certain point, taking more codeine or dihydrocodeine wouldn't give any more pain killing effect, just the side effects.

Morphine is the gold standard, its effective orally as well as by injection, unlike diamorphine, which is broken down so quickly when taken orally, that diamorphine only comes in injectible preparations in the UK.

And morphine is very stable so it doesn't have to be stored in the fridge, so big batches of tablets can be made and stored easily for a long time.

Also it's cheap, and this is particularly important for patients in countries with Socialised Health Care, because the health funding authorities don't want to pay a lot of money for expensive patented drugs, when there are effective and cheaper alternatives.

doctor diesel
10-21-2010, 08:26 AM
Okay Woody, I follow all that, and thanks. But it's clearly inefficient to give oral morphine - 75% inefficient, from what you say. So faced with the choice of 80-90% efficient oxy tablets or morph tabs, would an MD prescribe the latter onlyon cost grounds?


Doc

Import
10-21-2010, 09:52 AM
Doc-Because 25% of the morphine in one of those pills is ample pain relief for your average person. They are formulated to be equivelant to other drugs. For instance, the highest dose morphine pill is 200mg. The biggest oxycontin tab is 80mg.

The pills are dosed to make up for bioavailability differences.

More Feen
10-21-2010, 12:46 PM
Doc,

Say you're my patient, even though you ain't got a tail, and in the horsepittal, 10mg of IM or IV morphine makes you happy (relieves your pain).

If you're stable, I could send you home with a bottle of injectible morphine and some syringes:

"Now inject only 10mg at a time young man. You can take more 4 hours later, no sooner."

Or, more likely, I will Rx you 30mg pills, or 40mg morphine sulphate pills:

" Take 1 pill PRN for pain, q 4h (every 4 hours)"

Pretty much same-same. I'd feel safer giving you pills though (which is why most doctors prescribe & why most medicines are in this oral form).

M F

doctor diesel
10-21-2010, 12:47 PM
Doc,

Say you're my patient, even though you ain't got a tail, and in the horsepittal, 10mg of IM or IV morphine makes you happy (relieves your pain).

If you're stable, I could send you home with a bottle of injectible morphine and some syringes:

"Now inject only 10mg at a time young man. You can take more 4 hours later, no sooner."

Or, more likely, I will Rx you 30mg pills, or 40mg morphine sulphate pills:

" Take 1 pill PRN for pain, q 4h (every 4 hours)"

Pretty much same-same. I'd feel safer giving you pills though (which is why most doctors prescribe & why most medicines are in this oral form).

M F


That's good, I get it. But you would prescribe me morphine pills over more efficient opiate/oid pills because.... what?


Doc

Woody Bear
10-21-2010, 01:14 PM
Okay Woody, I follow all that, and thanks. But it's clearly inefficient to give oral morphine - 75% inefficient, from what you say. So faced with the choice of 80-90% efficient oxy tablets or morph tabs, would an MD prescribe the latter onlyon cost grounds?
You're absolutely correct in that oral morphine is not as efficient as oral oxycodone from a bioavailability point of view.

However for the majority of people taking it, morphine is an effective painkiller when taken orally, and because it's much cheaper than Oxycodone, over here in the UK, doctors would only prescribe Oxycodone if the patient was having a problem with side effects or sub-standard pain relief from taking morphine.

You can go to the NHS Electronic Drug Tarrif, and check out the prices the NHS pays for it's drugs. It says:

56x Oxycodone 10mg capsules cost £22.73
56x Morphine 20mg tablets costs £10.55

The narcotic dose converter here (http://www.globalrph.com/narcotic.cgi) says that 10 mg oral oxycodone = 15 mg oral morphine, so actually the morphine would provide better pain relief, and it costs less than half the price of the oxycodone. That's why in the UK, oxycodone would only be prescribed if someone didn't get effective pain relief from morphine, or else if morphine gave them bad side-effects.

More Feen
10-21-2010, 01:20 PM
That's good, I get it. But you would prescribe me morphine pills over more efficient opiate/oid pills because.... what?


Doc

Oh, so its not so much that you're getting an oral form of morphine, it that you'd prefer a different oral opioid?

I think oral oxycodone is ~1.5--2 X the efficiency of oral morphine, so instead of 40mg pills of MS, I could script you 20-25mg pills of oxycodone. Would you prefer that?

Some doctors might make this decision based on costs (morphine is cheap), insurance incentives, patient reaction ("oxy makes me all itchy doc, but morphine doesn't" [or vice-versa]).

We could use oral hydromorphone, which is ~3.5--7.5 X oral morphine, but doesn't last as long, so you'd need more of them. To equal 40mg MS, we'd use 8mg tablets.

Again, the issues are: cost, the doctor, insurance, the patient, the pharmacy, etc....

M F

PS- In UK--replace "insurance" with NHS/formulary

doctor diesel
10-21-2010, 01:39 PM
No it's nothing to do with preferring another type of painkiller. But Woody has just explained it perfectly - it's mostly to do with cost.

Thanks guys.




Doc

Indy
10-21-2010, 11:29 PM
I'm being anal, and I know I say this all the time, but codeine isn't strictly a prodrug. It's active in its own right, so taking more beyond the ceiling dose will have increased effect, but with greatly diminished returns.

doctor diesel
10-22-2010, 07:30 AM
I'm being anal, and I know I say this all the time, but codeine isn't strictly a prodrug. It's active in its own right, so taking more beyond the ceiling dose will have increased effect, but with greatly diminished returns.


I understood that its painkilling effect is due to conversion in the body to morphine. So you're saying it does more than that, Indy?

I don't mind you being anal, come on and explain some more, if you can.


Doc

Woody Bear
10-22-2010, 11:00 AM
I'm being anal, and I know I say this all the time, but codeine isn't strictly a prodrug. It's active in its own right, so taking more beyond the ceiling dose will have increased effect, but with greatly diminished returns.
Codeine's painkilling effects are due to its conversion into both morphine, and codeine-6-glucuronide. If a CYP2D6 inhibitor is taken with the codeine, it will stop it's conversion into morphine, but it will still have some painkilling effect.

And if a glucuronide inhibitor is taken with the codeine, it will stop it's conversion into codeine-6-glucuronide but it will still have some painkilling effect.

So codeine isn't purely a pro-drug for morphine, but from what I've read so far, codeine itself isn't a painkiller, as it relys purely on it's metabolites for it's painkilling effects. So that makes codeine a pro-drug.

---------- Post added at 05:00 PM ---------- Previous post was at 04:42 PM ----------

Check out these studies about codeine's metabolism and pain killing effects:

Codeine and morphine in extensive and poor metabolizers of sparteine: pharmacokinetics, analgesic effect and side effects (http://www.ncbi.nlm.nih.gov/pubmed/9010701)

That study showed that the patients on codeine who were extensive metabolisers of CYP2D6, and so were able to convert a lot of codeine into morphine, had much better pain relief from the codeine, then poor metabolisers. So the more your body is able to convert codeine into morphine, the better pain killing effect you'll get from it.

Codeine analgesia is due to codeine-6-glucuronide, not morphine (http://www.ncbi.nlm.nih.gov/pubmed/11092114)


Poor metabolisers of codeine, those who lack the CYP450 2D6 isoenzyme for the O-demethylation to morphine, experience analgesia from codeine-6-glucuronide. Analgesia of codeine does not depend on the formation of morphine and the metaboliser phenotype.

That study shows that even poor metabolisers of CYP2D6, who can't convert much codeine into morphine, still get pain killing effect from codeine. So obviously codeine's painkilling effect is from both morphine and codeine-6-glucuronide. Although 80% of a dose of codeine gets converted into codeine-6-glucuronide, so it supplies a major portion of codeine's painkilling effect.

More Feen
10-22-2010, 11:47 AM
Great info here folks.

Until 5 minutes ago, I would have sworn that if a person lacked CYP2D6 activity, they wouldn't get ANY effects from codeine.

Woody-B has learned me that, that is not the case.

Grassy Ass Amy Goes!

M F

Indy
10-23-2010, 10:29 PM
I'm gonna concede for now because I can't find a source to say that codeine on its own is an opioid, you win this time captain planet!;)

But I'm not 100% convinced, after all there are limited reports of IV and IM codeine being affective, although dangerous.

But my original point still stands that taking more codeine beyond the ceiling dose is not completely ineffective.