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All 13 posts   Subject: DXM-opiate combo against chronic pain   Please login to post   Down

06-29-00 11:57
No 22785
User Picture 
      DXM-opiate combo against chronic pain     

A close friend has chronic pain due to several botched surgeries. He was on morphine and currently is on legally prescribed fentanyl patches and other opiates but suffers from the serious side effects. I told him I heard about combining DXM with his opiates to reduce their dosage, and he is very interested in this to show it to his doc.

Does any bee have literature references for this or even practical experiences? How much, how often, how much less opiates? Adverse reactions?

I know there was a discussion about it on the old boards, but can anybody help me out with some links and information?

Yes, UTFSE, but please help your lazy moderator out this time, I even posted a nice find in the serious chemistry forum for all of you wink
06-29-00 12:34
No 22806
      Re: DXM-opiate combo against chronic pain     

Well, as I was the one who posted the info back then, I'll look it up again. Give me a bit of time.
06-29-00 15:15
No 22835
User Picture 
      Re: DXM-opiate combo against chronic pain     

Osmium: More stuff you haven't told me? Heh. Thought you didn't have any friends. Such an enigma you are turning out to bee. Seems as if I learn something new EVERY DAY 'bout you. Hmmm...

07-07-00 05:04
No 25729
      Re: DXM-opiate combo against chronic pain     

Osmium, I have personal experience with using DXM and opiates...I was on methadone for chronic pain (headaches-migraines) for 1.5 years..I was told by my pain doctor to try using Dextromethorphan (DXM) to reduce or maintain my dosage..I took 80mg/day (20mg 4x/day). 

It does make the opiates work better, kinda....they seem to act stronger than they originally were.  I use to get really sleepy when taking DXM with them.  But there seemed to be a down side.  Basically, DXM is a mirror image/optical isomer of Levorphanol.  DXM fits into many of the same opiate receptors in the brain as other narcotics (morphine, dilaudid, methadone).  So basically, some of the receptors have DXM in them while others have the opiate. 
The main problem comes when you have a really bad pain incedent and need to take your "rescue" medication, which for me was Dilaudid (hydromorphone hcl).  It didn't work as well when I was using DXM.  I needed to take more of the rescue medication to have the same benefit as if I wasn't on the DXM...

My only hypothesis for this is that since most of my opiate receptors were already used (full) there wasn't much room left for the rescue medication to fit into.  It had to bump out the DXM molecules and this required more rescue medication than normal.  If you think about it how can filling some of your receptor with a non-pain killing molecule make the other ones work better...Probably, because you are in a way "tricking" your brain into thinking that they are all filled with the pain-killing molecule since that molecule is also compeating for the same receptor.  But, when a different drug is introduced your brain is unsure where to put it until some receptors are free'd...

One side effect of using DXM in conjunction with opiates is that there is an increased mental apathy (harder time thinking), sedation, and little euphoria from he narcs...DXM seems to block a lot of the euphoria associated with kinda just feel numb...

If your friend is having major problems with pain and isn't concerned with the side effects, I would give it a try...The more DXM used the greater the side effects I mentioned.  Start out with 1 teaspoons twice a day...them go to 2 teaspoons twice a day, and up from there if needed...also, use DXM like "Delsym" it is pure DXM extended release for 12 hours..none of the cough syrup crap in it!  It also dosen't taste as bad as the rest of the others, althought it is still bad.. :)  If you run out and need a quick replacement, Robatussin Pediatric maximum relief is also pure DXM although the milligramage is different so you will have to take more..Figure it out ahead of time..Don't worry about what the label say's about not taking more than the recommended amount..You are not using it for a cough and you can take as much as 800mg of DXM without any problems..don't do 800mg unless you want to get DXM "stoned"!

Hope that helps...

(Hive Bee)
11-04-04 00:09
No 539530
      I was wondering approximately how much DXM...     

I was wondering approximately how much DXM potentiated the opiates? Is 2x a safe bet?

I also heard on another forum that it prolongs the effect, and leads to less itch, less nod, and more sedation. Quite frankly (at least with the opioid, DHC, I use right now), I get more sedation and itch than nod/euphoria anyway (I've heard heroin described by 1st time users as making them sick, sluggish, and not exactly euphoric, yet in the days after, they feel a tug to repeat it, which is sort of how DHC was, which is different than hydro/oxycodone, in my experience). I don't really see euphoria as an applicable term to any opiate I've ever done other than oxycodone anyway, to be honest, it's more of a foggy fuzzish... I dunno, there's a feeling, but euphoria isn't the same thing as 'mood-lift' IMO. But I digress.

I'm a bit worried about it prolonging the effect to be honest, since DHC doesn't use CYP2D6 that much, yet nontheless my 2D6-metabolized SSRI seems a bit... strange the day or two after, sort of like it's pulsing in and out, or the dose is either too high or too low. Hell, I'd almost be worried about taking a 30mg dose of DXM alone with my SSRI.

So, basically what I'm asking is how much it strengthens it, and how it changes the effects. The second, I've heard it called more 'rough' and 'choppy'. Frankly, it's hard to describe a drug's action, so if all you can chip in about is the 1st, that's understandable.


So differently divine...
(Hive Addict)
11-04-04 21:03
No 539704
      Osmium, this maybe a little bit late, but have     

Osmium, this may be a little bit late, but have a look at:

Effects of NMDA receptor antagonists on acute µ-opioid analgesia in the rat.

Pharmacology, Biochemistry & Behavior; Sep2003, Vol. 76 Issue 2, p361, 12p DOI:10.1016/j.pbb.2003.08.009

(Hive Bee)
11-04-04 22:36
No 539726

i wouldn't do more than experiment with dxm and opiods. sounds like a dangerous combination.
if your friend is looking for something to increase the power of his meds and subdue sideeffects, try antihistamines. it is well known that benadryl increases the effect of opiates and helps solve the itching problem. there is also a drug called vistaril/hydroxyzine that is classified as an opiate intensifier as well as a light anti-anxiety med. there are also other uses for the drug. taking vistaril or any other anti-histamine reduces the dosage of narcotics, thereby eleviating some side-effects seen with higher dosages of opiates.

[red]Hydroxyzine Pamoate
Proprietary names. Equipose; Masmoran; Paxistil; Vistaril

Don't you think if I had something intelligent to say, it would bee in my post?
(Hive Addict)
11-05-04 10:55
No 539834
      potentiation has lots of info on this.
Swim has tried this and regretted it-it made him sick.
phenergan or promethazine I think works better.
Vistaril is usually mixed with demerol as a parental potentiator
(Hive Bee)
11-05-04 19:09
No 539874
      I'm sorry, but I couldn't find anything on...     

I'm sorry, but I couldn't find anything on Can't search for 'DXM' on the forums, since it's 3-letters (tried DXM*, ala Bluelight, no luck), no dextromethorphan, and one post when searching potentiate/potentiating, that said it strengthened it, but that's about all it said.

I'll look again on the off chance you meant the site, not the forums...

So differently divine...
(Hive Bee)
11-05-04 20:21
No 539881
      I'm sorry, but I couldn't find anything on...     

I'm sorry, but I couldn't find anything on Can't search for 'DXM' on the forums,

I beelieve hes talking about the information on vistarli and other opiate intensifiers.

Don't you think if I had something intelligent to say, it would bee in my post?
(Hive Bee)
11-05-04 21:47
No 539901
      1 year on this combo     

I just finished up a 1 year regimine of opiate/DXM consumption. DXM mixed with opiates can have some amazing effects. In a heroin forum I remember a person claiming that he was kicking smack with just DXM alone. My experience was interesting, but I find DXM to be addictive in of itself, physically. with major spatial disorientation setting in in the 4 or 5th day of abstinence. DXM can greatly alter the addictive nature of opiates. one major alteration for me was an energy boost with the ability to achieve orgasm and interest in sex.The two together can be major motivational drive enforcer.DXM allowed me to reduce and increase dosage to suit my needs and to reduce tolerance to daily codeine/poppy seed tea consumption. I decided to quit DXM however, and to my suprise when I did, I found the want to quit smoking tobacco and cannabis a few weeks later. what helps ease DXM withdrawl? chocolate. lots of chocolate.

(Hive Bee)
11-05-04 23:54
No 539928
      I was wondering which of DXM and ...     

I was wondering which of DXM and antihistamines increases the 'rewarding effects' of opiates more?

I was also wondering why some antihistamines increase the rewarding effects while others don't, or do less. I know H2 antagonists don't produce the rewarding effect/can even lessen it, but some H1 antagonists don't, or only do a little, while some, such as triepel... do a lot.

I suppose DXM + antihistamine + opiate would be far too stupid. The antihistamine (assuming you find the right one), would look to increase 'rewarding effects' the most, but also need a 2x+ greater dose than if you combined it with DXM instead.

Damn, that's a tricky judgement call.

And yes, I know this started as a pain management thread...


So differently divine...
(Hive Bee)
11-06-04 03:19
No 539962
      ive had luck...     

with plain old benadryl- diphenhydramine.HCL. i find it to bee the most effective antihistamine for this purpose without getting a prescription. there have been fatalities involved in the usage of heroin and benadryl- i remember the majority beeing in texas. i take 75mgs of benadryl bout 45 minutes before i start "doing stuff". i continue to redose every 6 hours with 50% of the original dose. 75 mgs maybee too much to start with, try 25 and go from there. its important to not take the usual dose of PK's as the benadryl does increase the effects. also keep in mind that benadryl can make people tired/sleepy. dont operate heavy machinarywink!
something else to keep in mind: tylenol PM is the same thing as benadryl- diphenhydramine.HCL. tylenol just has, well, tylenol added to the mix. tylenol PM is alot cheaper than benadryl

Don't you think if I had something intelligent to say, it would bee in my post?

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