Hydromorphone (nasal or rectal) vs Oxymorphone (nasal)

[Oxymorph]

We have an understanding my friend.

I realize that an opiate-virgin is not guaranteed (or even likely) to experience ill effects from stopping an opiate binge. In the case that this DOES happen, I am open to the idea that ill effects after stopping opiate use CAN result from chemical and other changes OTHER THAN receptor down-regulation (adaptation).

However, while giving credit and respect for the knowledge you have presented, it is still my intuition that tells me that if the ill effects include any level of depression, anxiety, chills, lethargy, or other 'classic' withdrawal symptoms, then the down-regulation of receptors (mu and/or others) and the lack of a drug to which the brain has adapted is MORE TO BLAME than any other mechanism(s).

[Dilauday]

A couple of other factors that could be at play for such a situation to happen with an "opiate-virgin" is perhaps that person has some psychological problems, ie. prone to depression, anxiety etc. For those type of people any disturbance in their brain chemistry can cause severe issues to arise. Something that would need to be taken into consideration anyway, if such a thing happened. Though most likely they wouldn't experience chills and aches etc, but it's not impossible.

Something else that comes to mind is that some people are very sensative to substances to begin with. I've known a number of people that a small amount of opiates, amounts that even to an opiate-virgin would do next to nothing, knocks these people on their ass so to speak. Small amounts of other psychoactive substances cause intense experiences and other effects. I am not saying these people would be more prone to rapid opiod dependency, but some people could indeed either build rapid tolerences to opiods, or perhaps their brains could actually begin to experience an opiod type dependency from only a few days use. This I think would be very, very rare and unlikely to happen for the most part, but anything is possible. If someone did, for example, experience all the symptoms of classic withdrawal from only a few days use (if they were an opiate-virgin) I think the above could be the case with them specifically. However, again, this I have never seen and would think very rare if at all possible, meaning that this usually would not happen (not saying impossible) and in general for the masses it takes repeated use for the brain to slow down or reduce its own production of endegenous opiods as this happens over time.
As well to answer a previous question of yours, I do not think there is a point in which someone suddenly becomes opiod dependent, their is varying levels of dependency, thus varying tolerences. However in my own experience, there was, a type of point that I knew I would now experience withdrawal from ceasation, where as before that point I could indeed stop for a few days without much discomfort, it can happen very quickly, AFTER, a fair while of use.


With all that out of the way, I would like to get back to the point of this thread, in which you are thinking of having your doctor switch you to hydromorphone. As I stated previously, it is possible for a patient to be happily pain free and sustainable on hydromorphone alone, but that is not the case for everyone. Some people, if they are only perscribed hydromorphone, will burn through them quite quickly and cannot seem to space them out to remain pain free. Your tolerence does go up rather quickly as it is a short-acting and powerful opiate, but if you are supplied with enough (and enough compeltely depends on what you eventually need) and you do posses some ability of control, you can be happy with hydromorphone alone.

I might suggest you keep some oxycodone, or have a form of extended-release perscribed alongside, morphine ER or even opana ER if you can swing both. Since in the US oxy ER is now pretty much useless unfortunately.

I have also been thinking about Opana and how people's tolerences build so quickly. Take for a moment hydromorphone, the same can happen if someone where to have access to a large amount. I always found it a bit odd how they make 2, 4 and 8mg tablets where they make 5, 10, 20mg etc tablets of other substances. Though being such a powerful substance there can be a big difference between taking 24mg or 30mg if it is everyday, multiple times a day, day after day, or even 32mg compared to 40mg etc. I am not totally sure about the comparative nature to oxymorphone to hydromorphone. It seems that Opana has a higher BA intranasal compared to hydromorphone, orally maybe it is about the same, but I think oxymorphone may indeed more potent mg per mg than hydromorphone is. Meaning that since Opana is made in higher mg doses, and may actually be more potent on a mg/mg basis, SOME or the reasons people find Opana withdrawal is worse is because they may actually be taking much more than they were previously with whatever the other opiate they were taking was. If one were to suddenly double the dose of hydromorphone they were regularly taking, they would get much more sedated etc and their tolerence would go up really quickly as well. When people get switched to Opana this may actually be what is happening. Some people say they get 40mg ER compared to 80mg ER oxycontin, when I think 40mg ER may be more comparable to 120-160mg of OC ER.

This is just something I've been thinking about lately.

[Dr. McKay]

The generic 10mg IR opana is fine for a snorter.

Opana from ENDO has a very good patient assistance program. all you do is fill out some paper work and send in a copy of your tax return and drivers liscence along with your script.
As long as you make under a certain amount and do not have any insuance than you will get them for free.
I get about $1600 worth of Opana for free every month from ENDO.
Its actually cheaper now to get them this way and just paying cash for my office visit compared to the co-pay for the office visit plus the copay on the opana.
I was paying about $200 a month in co-pays for the opana . It does suck not having health insurance right now, but at least there are programs out there that provide free meds for people like me that really need them.

'

[PoppyLlama]

I have only used oxymorphone nasally, and it was the most amazing opiate experience I have ever had, and also only costed .50 cents per mg!! Unfortunately I was poor and could only buy 12 mgs. But that experience was rivaled only by a high dose of morphine through an IV in the hospital.

Hydromorphone I have also only used nasally, and it was okay, but really dissapointing, I snorted 12 mgs, it only lasted like an hour and was really weak. costed me a shit ton too. I was an idiot at the time.
I would almost surably prefer rectal hydromorphone to nasal.

I am also surprised that oxymorphone has a lower BA rectally, I wonder why this is, and if there are any other sources that say otherwise? I had never been able to find a source of information on rectal oxymorphone.

[Oxymorph]

^^ I found this weird also, and ever since have been trying to crack the logic behind it. Seriously my observation is the trend seems to be that the opiates whose oral BA is higher than nasal BA also have a rectal BA higher than nasal. For example, oral morphine beats nasal, and so does rectal. On the flip side, nasal Opana beats oral, and beats rectal too.

So since oral and rectal usually/always have the same RELATIVE standing compared to nasal, this is leading me to believe that a similar or identical common process is occurring between oral and rectal.

A reputable moderator from another forum once told me that the efficacy of plugging is often over-estimated; That despite popular belief, [at least /about] (can't remember which) 40% of a rectal dose will undergo the first pass effect. My best guess is that first pass metabolism is the common link between the 2 causing a similar figure for oral and rectal BAs.

The action of Oxymorphone in particular is impeded very much by first pass metabolism, so this is the main reason that nasal is so much more efficient than oral and rectal. Now, on the flip side, Oxycodone inherently has to it very little a first-pass effect, and this is the main reason why Oxycodone is so much better oral or rectal than nasal.

AFAIU the efficacy of an opiate is moderated by 2 factors, or 2 'stages'.

Stage 1: External Absorption: How well does the chemical get into the blood from outside of the body? Oral and Rectal have the advantage over nasal, b/c they have such a larger surface area of mucous membrane than your tiny nose does.

Stage 2: Internal Processing: Completely separate from absorption, how much and how does the organs' processing (metabolism) of the drug -- effect it's efficacy?

So for some opiates there is a tug of war happening between ROAs. It all depends on the extent of each and whether the pros/cons of stage 1 TRUMP the pros/cons of stage 2. Again, Oxymorphone seems to act decently when taken nasally and poorly with oral and rectal. Since the stomach and anus have much more membrane surface area, we can rule out Stage 1 as a possible problem for oral/rectal. So just by simple elimination, it's most likely Stage 2, which is that [nasal avoids the first-pass effect], which is so influential that the first pass MORE THAN cancels out the advantage of [more membrane in the stomach/anus].

BTW: I am not professing the above statements as truth. They are just my educated speculations/theories on the matter of BA comparison. Sorry for the length. GOD DAMN OPANA MAKES ME RRRRRAAAAAMMBLE.

[Dr. McKay]

What is wierd is that my doc will not persribe any oxy product to his patients saying that it is too abusable. So he would rather Rx Opana Er and IR.
Not too smart being that Opana is twice as strong, but I am not complaining !

[reddragon3668]

I am trying out an old-school text based brower via linux, so I didn't have the patience to read all this. As I've already seen mentioned, D is useless unless you are going to spike it. Literally (and I've been doing this a LONG time), I'd rather rail a BC powder than HM, any day. OxyM is a totally different story when railed. Great pain reliever, if you rail the ER's, it keeps allot of its extended release properties entact, i.e., legs... and is just a great med for both recreation and pain relief. Hard to controll, but spiking dillies isn't a walk in the park either. Having to constantly stick something up my ass to get high/pain relief is just an option I'd rather leave alone, but that is me.

As suggested, Endo has a wonderful patient assistance program. So, maybe your doctor can write your regular script until you get accepted on the program and then you are home free. I really would suggest trying that long before you fuck with the dillies and figure out from personal experience that they aint worth a fuck (for most people--I concede, there are exceptions above) outside of a rig. Good luck and do let us know how it goes.

BTW, text based browsers are great for research and reading articles and such, but suck balls for forums like this.. just saying. Aren't you glad you know that now?

[Oxymorph]

Okay, it seems nasal HM is pointless.

However, I would like to read some info from someone who has much experience in both PLUGGING HYDROMORPHONE, AND SNORTING OXYMORPHONE

New title: Rectal HM vs. Nasal OM.

[HandMeSomeOpiates]

Old thread I know but I was wondering why I snorted HM for a week straight and never really got that high. It seems worthless other than shooting. I didn't experience one symptom of withdrawl after snorting 32mg a day for a week. Weak shit for sure. I got higher on norcos. HM is lame, unless shot. I was stoked when I got a boat-load but after a week was extremely dis-appointed. I would have been better off snorting advil. Why didn't I get any w/d's? Is a week not long enough to get w/d from HM or was it because I snorted it and barely got any of the drug in my blood? Moral of the story: If you're not a spiker, fuck HM.

[digby]

Old thread I know but I was wondering why I snorted HM for a week straight and never really got that high. It seems worthless other than shooting. I didn't experience one symptom of withdrawl after snorting 32mg a day for a week. Weak shit for sure. I got higher on norcos. HM is lame, unless shot. I was stoked when I got a boat-load but after a week was extremely dis-appointed. I would have been better off snorting advil. Why didn't I get any w/d's? Is a week not long enough to get w/d from HM or was it because I snorted it and barely got any of the drug in my blood? Moral of the story: If you're not a spiker, fuck HM.

HM is not weak shit or lame. Either you got some stuff that someone left out in the sun for a year and destroyed the potency or your first pass metabolism consumed most of the HM. I don't know what your tolerance is, but your post didn't make any sense. I have taken HM for years without a spike with good results, as have countless others. 32 mg a day is not a lot of dilaudid, especially without spiking it. I've had to take that much in a single dose to feel anything special, and I don't have a monster tolerance.

[HandMeSomeOpiates]

HM is not weak shit or lame. Either you got some stuff that someone left out in the sun for a year and destroyed the potency or your first pass metabolism consumed most of the HM. I don't know what your tolerance is, but your post didn't make any sense. I have taken HM for years without a spike with good results, as have countless others. 32 mg a day is not a lot of dilaudid, especially without spiking it. I've had to take that much in a single dose to feel anything special, and I don't have a monster tolerance.

Yeah, I guess just not doing enough. My post was totally legit though, fresh from the pharmacy, no habit for 2 weeks. HM for a week with very disappointing results, but like u said maye I need to do 32mg in one dose(I was doing half that for a dose).

[Oxymorph]

^^ I would really like for you to try plugging that same dose, and see what happens. HM has a terrible nasal BA (20% or less), but something tells me rectal has high potential for HM.

[Nagelfar]

HM is not weak shit or lame. Either you got some stuff that someone left out in the sun for a year and destroyed the potency or your first pass metabolism consumed most of the HM. I don't know what your tolerance is, but your post didn't make any sense. I have taken HM for years without a spike with good results, as have countless others. 32 mg a day is not a lot of dilaudid, especially without spiking it. I've had to take that much in a single dose to feel anything special, and I don't have a monster tolerance.

Hydromorphone is the cocaine of opioids. Once you've mainlined it, because of the 'rush', going back to any other RoA is like night & day. So I see where HMSO is coming from.

[Pharma]

Dilauday-- well-reasoned and thoughtful post above ^^^. Some of my own experience with HM (in a variety of ROA's) mirrors your own description. Especially calling notice to the "subtle nature" of hydromorphone...that's accurate IMO also. I get the 8s prescribed as part of a two-drug therapy for CP; have also had OM in the 10 mg IR formulation. I had to go off those due to poor insurance; OM is wildly expensive at the retail level in my area. Also just about any "ER" form is pretty expensive too of any pain med. There is a difference between makers of the various HM's- I have been trying (w/o success) to get the Lanett's. But the old school Mally white triangle 8's are what a lot of us end up with, that is, those of us lucky enough to get HM scripts at all! There is still a bit of "stigma" hanging on to this old school painkiller in the minds of some docs...but it doesn't get splashed on the front pages like OC does...

Another added benefit is the drug (HM) seems to go easy on my liver/kidneys; compared to the combo meds like Vikes, Norcos which (due to the APAP) skyrocketed my liver tests into high gear. But I can respect all those who say HM isn't very effective insufflated or oral; I'm just lucky my receptors are sensitive to HM and I do get that beautiful subtle and clean effect from them, without fail. As Dilauday calls it- a state of mind. And I'm 8-plus years in with pain mgmt, and have kept the tolerance demon at bay. I have other tricks to keep the effectiveness up, but that's for another post~
Hope this helps!

euko~~

Euko:

You MIGHT qualify for OPANA 10's IR's as i am and orally the 10ir's both endo or Roxi brand feel just like long lasting oxy with less buzz to it. More morphine like regarding legs/sedated feeling.

From what my source says they only make 5mg's tabs and 20Mg/Ml Lannett's so perhaps that is why your not getting them... Unless you want the oral syrup if so that's good shit... I've had it 8 years ago jr. Yr. in high school, once again, GOOD SHIT

-Pharma



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[Dr. McKay]

[QUOTE=Oxymorph;614005]

1. Opana is extremely expensive. I'm uninsured and paying cash, have already gotten quotes, and even at walgreens (the cheapest pharmacy) both Opana IR and ER are too much to afford. This is probably because of the name-brand monopoly (the only generic--Roxanne--I've read are rock hard and a pain in the ass to abuse). Dilaudids (especially generic) are dirt cheap. Generic 8mg dillies cost only around $2-3 a pop, that's less than even roxi 15s !!

2. As already mentioned, the horrible Opana withdrawal trumps the lovely nods that I'm seeking. It's been established in another thread that dilly withdrawals are virtually non-existent compared to opana, so long as you're not IVing every 2 hours.


I pay cash and get my dilaudid 8mg for $69 for #120 of them.
I wonder why you pay so much for them ?
I just paid that 4 weeks ago at a local mom and pop .

[Oxymorph]

I pay cash and get my dilaudid 8mg for $69 for #120 of them.
I wonder why you pay so much for them ?
I just paid that 4 weeks ago at a local mom and pop .

I wasn't ever on them, this is just the quote I got when I called the pharmacy out of curiosity. The reason it was that high is probably because it's in another place (sunny) that was mentioned in another thread if you catch my drift, where prices have skyrocketed.

[gauchoamigo]

Note: after 'crushed' in relation to HM, add 'and insufflated'.

Hmmm Is it really better snorted than plugged?? Ive never plugged opanas suprisingly but i find that odd, unless it has to do witht he whole gelling up deal for the ER's.

I know this isnt as detailed as you like but lets see. Dilaudid: Snorted Vs Rectal. Snorted feels like nothing, rectal feels pretty damn good as 24- 32 mgs plugged. (dunno about the reports saying its as good snorted as rectal Its not)

Since your choice is both IR Id say go witht he Opanas. Better in so many ways especially if you sniff. Id rather shoot the Opanas as well as they have a great rush, with my tolerance i could split the pill to two shots (prob wouldnt but meh) and they last longer.

also if you do wish to plug the IRs are so easy to abuse,

Good luck to you with your scripting.

So far as I am aware, both oxy and hydro morphones are at highest b/a (apart of course from IV) nasally rather than orally or rectally. The only opie I am 100% certain has best b/a by the plugged route is MS. With an oral bioavailability in the 40% region it really is not a drug to help your doggy's pain; certainly not when you can get scripted oxycodone and dipipanone both with oral availability round the 90% mark. My collie barks that crushed Palladone (not SR) is about twice as strong as swallowed.
Oxymorph is only available in one country so there are not many people able to relate their dog's views on that one. My dog keeps asking how he can ever try it for his arthritis if US OPs will not ship internationally. I hear from afoaf that instant release OM is only available in small dose units like dipipanone, Rx only 10mg.

[Dilauday]

in reply to dr.mckay, from months ago lol, I just wanted to add, damn you americans sure pay a lot for your medication, up here, even without any coverage if one is to purchase their medication and pay 100% cost, 8mg dilaudids are only about 40 cents a piece, not 2-3 dollars, I couldn't image paying that much at the pharmacy. and when i hear you guys paying 10+ dollars per pill! thats just insane, their not triptans, now those fuckers cost an arm and a leg, couldnt image down there, what like 40 bux per dose!

[TheTalkingAsshole]

in reply to dr.mckay, from months ago lol, I just wanted to add, damn you americans sure pay a lot for your medication, up here, even without any coverage if one is to purchase their medication and pay 100% cost, 8mg dilaudids are only about 40 cents a piece, not 2-3 dollars, I couldn't image paying that much at the pharmacy. and when i hear you guys paying 10+ dollars per pill! thats just insane, their not triptans, now those fuckers cost an arm and a leg, couldnt image down there, what like 40 bux per dose!

6 syrettes of sumatriptan without insurance is over $1000,
zyprexa(olanzepine), an antipsychotic is $900 for 30 days, $30 pill
without insurance suboxone strips, which seems to be what everyone is getting all the sudden around here, run almost $20/8mg strip
and most people are prescribed 16mgs/day
not much of an alternative to a habit i suppose, if youre spending $40 fucking dollars a day

[Dr. McKay]

6 syrettes of sumatriptan without insurance is over $1000,
zyprexa(olanzepine), an antipsychotic is $900 for 30 days, $30 pill
without insurance suboxone strips, which seems to be what everyone is getting all the sudden around here, run almost $20/8mg strip
and most people are prescribed 16mgs/day
not much of an alternative to a habit i suppose, if youre spending $40 fucking dollars a day

For bupe, try to get your doc to persribe the generi subutex tabs..they only cost around $3 each around here when paying cash compared to over $12 for brand name subutex.

As far as hydromorph, I still get them for about .50 cents each for the 8mg tabs. I have also found a sure way to always get them fillled at the same place every month, whch is great being that they are now so hard to get (in most cases) around here.

It seems that most PM docs have switched most patients onto dilaudid for breakthough since you cant get oxy or opana anymore around here.

[PhoenixRisen]

I liked snorting HM, and it was effective, because before that, I was used to drinking GF juice w/ cimetidine and eating them. Now I prefer plugging because, with each experiment, the quality of this quite short lived opiate improves almost exponentially. Now I enjoyed taking them by mouth, I enjoyed snorting them much much more, but the biggest gap in efficacy is between those and plugging. I actually got the warm and fuzzies AND pain relief. I think most don't really want to try plugging, even though it can make 3 4's feel like 12-15 taken by mouth. I snorted for a long time, and the bioavailability is greatest IV/IM (different rush though), 2nd rectal, 3rd intranasal (and yes I've used nasal sprays too), and 4th Oral.

But, whatever works best. Experiment; this is only my body I'm in. Whatever works, works. I would never underestimate the role of psychology and expectation to alter different experiences in spite of different levels of chemical in their blood/nerve cells.

[Albert King]

Alberts experience with old school Opana's and variety of D's
~~~~~~~~~~~~~
Opana Nasal > Hydromorphone (Nasal)
Opana I.V. legs > Hydromorphone I.V. legs
Opana Rush I.V. rush < Hydromorphone I.V. rush
Opana plugging > Hydromorphone plugging


Opana(old school) just last longer, HydroMorph is like opiate crack, feels amazing, and you imagine the rush from HM would lead to amazingly long legs but it lets you down in that department,it's all rush no legs..

OXYMorph is beautiful, wonderful rush, longest legs ever lovely opiated lady friend indeed. closest most will ever get to pure china white. This stuff is serious, be very careful though, the hang over is harsh, sickness will be harder than anything, makes Diesel sickness look easy...plus its pretty sad that the formula of opanas are changed, lot of people hurt from that no doubt..also once you try opana its hard to go back to anything else, will always be second best if you like morphine based IV opiates...oxyC will never cut it again thats for sure

[Obomber306]

OxyM over HydM all day any day. Way stronger, longer half life, I've never found anything I like better than insufflating OxyM, especially mixed with some crushed up benzos and a couple beers. But that shit can get super dangerous. When I do that I find myself struggling with singing cause of the resulting respiratory depression so I had to stop doing that before going onstage.

[Defense34]

^ new person, ill just beat everyone to it and tell it nicely (others may not be so nice) i know its easter time but no need to be raisng the dead, this thread died long ago, and the fact that you brought it back to basically say that oxyM > hydroM dosent bode well for an understanding audience, just for future reference , f its dead more than a month and you dont have VITAL info to add, leave it dead.

ps welcome to the site, sorry my frst talk with you is me being a dick im normally nice, i pwomise

[zystyl]

Bumping an Albert King response > starting new thread.

Hell, I would have repped if it was the types of heroin thread. Goes good with coffee, you know?