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#945877 - 10/18/09 06:46 PM Tolerance/Dose Question
mjh84 Offline
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Registered: 10/26/07
Posts: 31
I have a fairly high tolerance to opiates, i usually take between 60-120mg of methadone for pain relief, 100mg of Tramadol every 6 hours. I am trying to find a substitute for the methadone and got some 90mg dihydrocodeine time release tabs. What kind of a dose would I need of these to get the same kind of relief? Anyone know? Thanks in advance!

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#945886 - 10/18/09 07:09 PM Re: Tolerance/Dose Question [Re: mjh84]
DeeRock Offline
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Registered: 07/11/06
Posts: 857
Loc: St. Louis
well, from what I understand dihydrocodeine is inbetween codeine and hydrocodone in terms of strength, right?

well, I looked up how much codeine would be equivalent to 60mg of methadone and it told me 1500mg (thats 1.5 grams!!) so it would at least probably be around that ballpark. but honestly I don't think you'll get as much relief. methadone is a very strong drug.
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#945902 - 10/18/09 07:47 PM Re: Tolerance/Dose Question [Re: DeeRock]
mjh84 Offline
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Registered: 10/26/07
Posts: 31
Good god, I'd have to take 1500mgs of DHC to get the same relief!!!??? Wow...that seems a bit excessive, lol. UGH

So, lets say...I crush up, oh...6 pills taken orally, thats 540mg...is that even safe!?


Edited by mjh84 (10/18/09 07:48 PM)

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#945939 - 10/18/09 08:54 PM Re: Tolerance/Dose Question [Re: mjh84]
DeeRock Offline
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Registered: 07/11/06
Posts: 857
Loc: St. Louis
I think someone else that knows more than me needs to come in here and say something. I've only had DHC once, I had one of the 30mg instant release ones.

if the only thing in them is dihydrocodeine and you can accept that much of it without overdosing I don't see why you couldn't.

search google and see if there are ceiling doses for this particular drug.
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All I ever wanted was to pick apart the day,
put the pieces back together my way.

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#945953 - 10/18/09 09:19 PM Re: Tolerance/Dose Question [Re: mjh84]
nephro Offline
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Registered: 09/04/06
Posts: 10289
Loc: NOT 40!
Originally Posted By: mjh84
Good god, I'd have to take 1500mgs of DHC to get the same relief!!!??? Wow...that seems a bit excessive, lol. UGH

So, lets say...I crush up, oh...6 pills taken orally, thats 540mg...is that even safe!?


No it's not safe. Methadone will still be in your system and you could overdose on opioids generally.

It would be best to taper the methadone without using a substitute if you can. Switching from one opioid to methadone is done because it is safe. The other way round isn't, because of the long-acting nature of methadone.

Nobody has a clue what 500+mg of DHC does. If you really can't get off the last few mg of methadone, at least get it into a range where you can use clinical doses of DHC or codeine.

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#945957 - 10/18/09 09:24 PM Re: Tolerance/Dose Question [Re: nephro]
mjh84 Offline
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Registered: 10/26/07
Posts: 31
I have been off the methadone for 8 days now, I know of the extremely long half life of the chemical. But I still will have quite a tolerance. But don't worry, I won't be taking a 500+mg dose...that just seems crazy. :-)

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#945962 - 10/18/09 09:36 PM Re: Tolerance/Dose Question [Re: mjh84]
nephro Offline
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Registered: 09/04/06
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Loc: NOT 40!
It's impossible to gauge what tolerance you do have now, which is why just using one drug is often advantageous.

It's great that you've stopped the methadone, but on the other hand it's made things rather complicated.

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#945975 - 10/18/09 09:54 PM Re: Tolerance/Dose Question [Re: nephro]
mjh84 Offline
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Registered: 10/26/07
Posts: 31
I am prescribed methadone 25mg-4x a day, Tramadol 100mg 4x a day, diazepam 5mg at beditme, and just recently 600mg gabapentin at bedtime. The DHC's I got from a friend and I was just interested in trying them to see if they would ever be a good alternative to methadone. Since doctors can be wishy-washy and cut you off for no reason, I wouldn't mind having a back up at hand so I don't go through withdrawals for months on end as I've been on opiates for about 2-1/2 years now. I can say with almost 100% certainty that my doc will not cut me off, because I don't abuse my meds, call for early scripts, all that [censored], but you never know. Anyway, thanks for the info smile

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#945977 - 10/18/09 09:56 PM Re: Tolerance/Dose Question [Re: mjh84]
mjh84 Offline
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Registered: 10/26/07
Posts: 31
Originally Posted By: mjh84
I have a fairly high tolerance to opiates, i usually take between 60-120mg of methadone for pain relief, 100mg of tramadol every 6 hours. I am trying to find a substitute for the methadone and got some 90mg dihydrocodeine time release tabs. What kind of a dose would I need of these to get the same kind of relief? Anyone know? Thanks in advance!


Meant to say i take between 60-100mg of methadone for pain relief, not 120, lol.

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#946180 - 10/19/09 12:02 PM Re: Tolerance/Dose Question [Re: mjh84]
martind Offline
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Registered: 05/01/08
Posts: 2730
Are you saying you discontinued a 60-100mg/day dosage of methadone 8 days ago?
How are you feeling?
Why did you stop taking this medication if it was regularly prescribed to you by your doctor?
That is an extraordinarily high daily dose of methadone to discontinue even with continuing Tramadol.
I'm very interested in your experience accomplishing this.

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#946189 - 10/19/09 12:10 PM Re: Tolerance/Dose Question [Re: martind]
TAZLOVER Offline
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Registered: 02/07/09
Posts: 2965
Loc: Gonna take a trip with my budd...
Me too. I am prescribed methadone also and the doctor may decide to cut everybody off. I heard this from people in the waiting room. One person told me that he plans on doing it to everybody. He hasn't done it to me yet, but I get nervous when I have my visits. Keep thinking it will be my time.
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#946304 - 10/19/09 03:34 PM Re: Tolerance/Dose Question [Re: TAZLOVER]
mjh84 Offline
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Registered: 10/26/07
Posts: 31
I never seemed to get that bad of withdrawals from any of the opiates I've ever been prescribed, which is most of the regular ones ( vicodin, percocet, oxy IR, etc... The first 2 or 3 days I just felt like I had a cold, then after that I was fine, minus the wrenching pain in my back. I recontinued the methadone last night after learning that the DHC is not a viable option and not being able to stand the pain anymore. Guess I'm one of the lucky ones? hah...

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#946325 - 10/19/09 04:09 PM Re: Tolerance/Dose Question [Re: mjh84]
martind Offline
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Registered: 05/01/08
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I would say you are one of the very lucky ones.
Still don't understand why you would just discontinue a methadone dose like that abruptly though.

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#946470 - 10/19/09 10:35 PM Re: Tolerance/Dose Question [Re: martind]
mjh84 Offline
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Registered: 10/26/07
Posts: 31
I discontinued because I was going to test the dihydrocodeine as a backup medication, but after finding out that it wasn't potent enough, I went back on the methadone. Yes I was in pain for the days I was off it, which sucked, but if it had worked out, I would have had a backup, but it didn't, lol smile

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#946600 - 10/20/09 10:22 AM Re: Tolerance/Dose Question [Re: mjh84]
nephro Offline
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Registered: 09/04/06
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Loc: NOT 40!
If you find yourself out of methadone but with a more usual opioid, the only safe way to use it as a backup is to wait for withdrawal symptoms to begin, and then take the backup med at 'normal' doses, every 2-6 hours of so (depending on the drug), until you feel the withdrawal being attenuated. Then just try to formulate a regimen based on this, taking as little as possible just to keep you comfortable. A titration upwards, in other words.

DHC could be used, but it's the manner in which it must be used that makes it difficult.

But to try to equal methadone with one dose is not viable.

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#946738 - 10/20/09 03:43 PM Re: Tolerance/Dose Question [Re: nephro]
mjh84 Offline
Newbie

Registered: 10/26/07
Posts: 31
I'm just sticking to my methadone regimen, and will find an alternative if the time ever comes (hopefully it doesn't).

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#981953 - 12/20/09 06:44 PM Re: Tolerance/Dose Question [Re: mjh84]
pnfree Offline
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Registered: 11/04/09
Posts: 374
Loc: midwest
I have been taking the DHC 90mg which is a long acting every 12hrs or so and for break through pain i take either percocet or DHC 40 mg. I have been doing this for about a month and a half. I started having this jerking type movement that shocks the hell out of me this morning. I had about 10 episodes this morning. They do seem long enough to call it a petite seizure. What happens is like jolt of electricity across my body. It seem to make me blink and drop whatever I am holding. When it occurs I think I am blinking because what I am seeing seems to change. This is super weird. My other medications are ambien for sleep which I have not have in over a week and ibuprofen. Nothing else. I have Tramadol but with these other meds I have not taken that forever. Any help would be appreciated. I don't to go to the doctor just encase this is related to meds I bought online.
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#981973 - 12/20/09 07:46 PM Re: Tolerance/Dose Question [Re: mjh84]
maec Offline
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Registered: 08/31/09
Posts: 12
Of course, the best way to pick a pain relief method is by consulting your doctor. By knowing the root of your pain, you get to effectively treat it with different pain relief ways, thereby freeing yourself from pain.
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#982047 - 12/20/09 11:41 PM Re: Tolerance/Dose Question [Re: pnfree]
PNWRain Offline
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Registered: 10/18/07
Posts: 1578
Loc: Eugene, OR
Pnfree - sometimes people don't have much of a choice. But if at all possible, self medicating isn't a good idea. Best to be monitored by a physcian.

Having said that, I DO understand. Obtaining pain relief isn't easy to say the least.

Maybe you are taking too much? Not suggesting at all that it is intentional. Maybe cutting back and seeing what happens would be good. You can always go back up.

Going to your doc and saying "hey, doc, I'm getting these meds online" well I understand the onus with that. But you want to be safe. Not risk your well being.

If it were me (and it's not), I'd try cutting the dose. Can you cut them in half? If so, try cutting one in half. Then taking one less. I bet you'd have better results.

I don't know how your relationship with your doc is, but can you talk to him/her? I wouldn't risk the relationship, but if you can talk heart to heart, you may get reassurance. Maybe even have the doc prescribe.

Good to "talk" with you. I hope that you can obtain relief without the sides.

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#982188 - 12/21/09 12:17 PM Re: Tolerance/Dose Question [Re: TAZLOVER]
PNWRain Offline
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Registered: 10/18/07
Posts: 1578
Loc: Eugene, OR
Tazzie, how stressful! I know docs cut people off, but....

Health Devil, cut it out! To me, it is completely irresponsible to just cut people off. I can't word this more strongly or Admin will cut ME off.

I am worried that the doc will cut me off. After my diagnosis with "fluid" on the brain. I am waiting for his call. Please, Dr Dave - I've got enough.

OK, enough about me. We all suffer so much. It makes me so mad. Tazzie, may you have a good day.

I need to go (really) lol. TMI. So I will.

Your friend, Laurie

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#995350 - 01/22/10 01:26 PM Re: Tolerance/Dose Question [Re: PNWRain]
Shanley Offline
Journeyman

Registered: 01/22/10
Posts: 51
methadone is quite strong. consult with your physician for switching meds inorder to help with your receptors. or there is a new 1 day detox procedure for 20,000$...but i dont know if its worth that for you!
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