Need a little help here.

Can you become dependent on opiods if you alternate the type of opioid on a daily basis? How would the risk of dependency and tolerance differ from a daily regimen of the same medication such as with using hydrocodone.

This is a purely hypothetical weekly schedule of an opioid alternating regimen:
Mon Oxycodone
Tues hydrocodone
Weds codeine
Thurs fentanyl
Fri codeine
Sat hydrocodone
Sun codeine

Thanks,
Poo

Good Question Poo.
I have only taken hydro but would love to try your experiment and report results.
Just teasing...Again, good question, I'm looking for to see what our "expert residents" here have to say.
Best of luck,
Mojo

I think I am out of touch....I had to look up on Google what the pill was for Wednesday, I didn't know what it was.

Please share with us when you get a response.

ADR

I think you will have the same problems with tolerance and dependency as taking only one. My understanding is they work on the very same receptors in the brain. I am not a biochemist, but I am sure if such a regimen would work to the advantage of the patient, doctors would be using it. JMHO
PB

PB, I agree with you. However, since we are all different I want to share my method for using allergy meds. When I need them, I switch between three different OTC meds. It seems to make them all work better, although they are basically the same. Probably all in my head

pb- i agree! an opiate is an opiate and is made to work on pain in the same way and on the same receptors. blessed be!

Hi all! A progress note is due for you, HOWEVER, I do want to gently remind folks that we are lay people and not doctors, pharmacist, or other medical professionals, I think it is good if we stick to PERSONAL experience, strength, and hope, opiod use is not an "Apples to apples" comparison, not at all, nor is there a "One size fits all"...for folks who come in here and read, I am concerned that they may be getting wrong information or mixed messages, I am especially sensitive to this issue because some years ago, I had a young friend in Az. (32 years old) "Lawney" was a brilliant artist, he was also fraught with a number of mental illness's, not to mention, we were both drinking heavily, I FINALLY got Lawney help at the mental health facility, they put him on a couple of medications, by the end of the month, Lawney totally emerged from his shell of horrors and fears, he started painting again (beautifully) we both attended AA and got sober, in a nutshell, most folks get a "sponsor" in this 12 step program who acts as a support and might "suggest" tools for recovery, Lawneys sponsor was an old timer and highly regarded in the AA group, apparently, (and without my knowledge at that time) Lawneys sponsor told him that his medication taking was merely trading one addiction for another...we found out much later that Lawney stopped taking his med. I came home from work one day, Lawney was pacing the room and talking in some "dialect" for lack of a better term, I said something, Lawney went ballistic, left the house in a rage, 3 days later, I got the call that Lawney's body had been found pinned in rocks in the wilderness area outside of Sedona (Az) there was a broken bottle of Vodka near his body...I found his nearly full med. bottles with his art materials...needless to say I was ready to kill this sponsor, in honesty, I think I would have, I moved shortly thereafter, my point here is a gentle reminder that we are laypeople here, what we say are merely suggestions and the sharing of personal experience, strength, and support...I beleive it is totally untrue that all prescription opiods are pretty much the same. I beleive it is also totally untrue that common OTC analgesic's such as aspirin and tylenol are pretty much the same, they aren't, not by a long shot, again, this is JMHO! and may not be a medical fact. Sorry gang, I just needed to get this off my chest.
Thanks to a Pharmacy Watchers benefactor, (she know who she is) I was able to write a post-dated check for an emergency app't. they had NO openings, it was a miracle, someone "happened" to cancel out yesterday, otherwise, I would have ended-up in full blown detox of a SCHEDULE 2 medication by Christmas time...NOT ALL MEDICATIONS can be an at home detox of a week or so...My Doc. and I sat huddled for a good half hour or so, he wrote out a SLOW and somewhat painless detox schedule, he won't let me cold turkey, I will remain on the Methadone 3 more months but with reduction increments, he was also VERY receptive to the Clonidine medication, he stated that a number of his patients have been struggling with GREAT difficulty in getting off of the two most popular detox meds which require a special (certified) doctor to script...he told me the Clonidine should be every bit as effective and in fact, a couple of his patients ALSO managed to quit smoking as well (we shall see)...I mentioned that I should be able to pay for the meds. in a week or so, (again, due to a PW benefactor) he shook his head, excused himself, when he FINALLY came back, he had my script and the written titrate schedule, he reminded me that we will still have our regular face-to-face in Feb. we shook hands and hugged, "Oh by the way David, if you don't mind, I would prefer if you start using the hospital pharmacy, it will make things easier if you have problems, you can re-sign the designated pharmacy on your way out"...of course I said fine, and left, when I got to the pharmacy the clerk brought out the contract for me to sign, then she said, "Hold on, Dr. "Jones" left you a Christmas package", there were the needed medications!..."You can send us the check for these next week"...I was STUNNED!!! while waiting for the bus to come home, I re-read the titration schedule...at the bottom of the page he had written, "Merry Christmas David"...guy's, most of you know I am not a "Christian", but beleive me, I DO have a "Higher Power" and she is working in my life!
I will let you know how my detox. goes..."The FAT lady ain't sang yit! "
Love to all!
David

Well, first, David congratulations on finding some help.

However, I have to disagree with the first part of your post. First, this discussion has come up before here. Basically it has been asked many times, if one builds up a tolerance to one opioid medication can one then take another type and, thereby, get rid of their tolerance issue. In this thread it is being discussed in a generic sense, not an advocacy sense.

To that question, recognizing that all opioid medications are not identical, I do believe that switching to another type of opioid medication will not work on your tolerance to them. They do basically work on the same "receptors" in the brain. The major difference is mainly strength, with some differences in side effects. For example, yes, methadone is different than codeine. Mainly because, by weight, say 10 mg of methadone might take the equivalent of 120-200 mg of codeine for the same analgesic effect. That is a ton of codeine that would probably upset even the most iron lined of stomachs. I don't think any "professional" advise was being discussed here. So, for what it is worth, I think this is a topic that can be discussed. It is a question that has been asked. I don't think PooMonk or I were advocating one way or the other. However, as we know, we have several medical professionals on the board. Perhaps they can chime in also.

Again, I am very happy you did get to see a doctor and things are looking good for you. AND, stopped smoking too!!!!! Way to go! You the man.
PB

Just my 2 cents worth. I was on Norco and switched to Oxycodone. Stopped all Norco. No problems. Stopped all Oxycodone and went on Oxtcontin and Norco. No Oxycodone. No problem. Quit Norco, stayed on Oxycontin. No problem (just increased pain). Now back on Norco and Oxycontin. The only thing that changed for me switching these around every month (this is all under supervision/direction on my PM doctor) is just the level of pain relief.

PB, Thanks so much for your nice remarks, it's great to be able to "agree to disagree"...I too have rotated opiods in my own regimen, HOWEVER, not all opiods are the same. I have taken Hydrocodone (an opiod) for years, many folks can switch over for a drug "holiday" and use Tramadol/Ultram (an opiod of a different nature) and have no problems, in fact, I think I recall that you have done this but may be mistaken. If I were to stop Hydrocodone even one day, and take Tramadol it would be a death sentence, my medical record clearly states, "NO TRAMADOL/ULTRAM" If I travel, I have to wear my Tramadol bracelet. I just don't want folks to get the impression that all opiods are the same, someone may want to write a marathon post on the different types/actions of opiods, I myself do not have the expertise. Hope you have FINALLY gotten the new printer!
My best as alway's,
David

Know a place I can orde some Didrex--promise NOT or me. I don't even like Sudafed Thank you. Grits

Gosh, I didn't know I could start such a debate.

Don't worry people, my medication regimen is nothing like the example I gave in the earlier post. I was just curious if anyone knew what alternating opioids would do to a person. We may not know the real answer to that question but there is a could things we do know for sure and correct me if I'm wrote. (If you haven't noticed already I love to list things..haha)

1) if you don't have a history of abuse/dependence or any regular use of an opiod then an occasional pill (say once ever 2 weeks) then you will not become dependent.

2) if you take an opioid that is more potent than necessary and take it on a daily basis for an extended amount of time then (most likely) you will become dependent.

3)if you are dependent on one opioid say oxycodone but that med is not available then taking the next best thing (i.e. hydro) then this will reinforce your opioid dependency.

4)your body and mind becomes habituated to anything that is repeated regularly and at constant levels. This is true for anything such as exercise. If you perform the exact exercise routine at the gym without switching thing up from time to time then your muscles will stop developing at the same rate as they did when you first started a particular rountine. If you take take hydro every 3 days without fail then you will physically and mental expect that medication when the next 3 days rolls around.

5) The same medication can affect different people differently. However, as humans and as animals we all follow the same (yet highly complex) behavioral principles/patterns when it comes to general dependency. The degree to which we become dependent on something is determined by a long list of variables. These factors will influence the degree to which we become dependent on which medication.

If I were to base my opinion (and it's only an assumption) on what we know for sure then I would have to conclude that that hypothetical regimen if carried out exactly the same way for at least 2 month would cause the following coditions.

1) we would definitely become dependent on opioids

2) our tolerance level would rest on the upper end of the hydrocodone potency level. Codeine would feel pretty weak, and fentanyl too strong.

3) if we stopped taking all the meds we would have serious withdrawals. However, if we substituted hydro for oxy and fentanyl we would not experience any withdrawal symptoms

4) Most importantly, the "codeine days" would prevent our tolerance levels from escalating and getting out of control. We would still be dependent but it would keep our dependency in check.

Again this is only my opinion and is entirely speculative. I'm happy if someone would prove me wrong. You learn much more by making mistakes than by doing everything perfectly the first time.

~Poo

well guys-my pm dr. says an opiod or opiate is just that, the difference being the stregth or composition of amount of tylenol or apap that makes the hydro((codeine) work faster, better, or longer. the tylenol being the worst thing for your liver. he says any opiate taken for a long period or abused is dependence/addiction.

he says even if during this period any opiod/opiate is taken you will become dependent/addicted.you may not experience wds. if you switch to an opiate that is stronger. but if you stop cold turkey you will have wds. he says a lot of docs are prescribing Lyrica, esp. for fibromyalgia to get away from the opiates. but the side effects of nausea and severe headaches do not always go away.

i have severe migraines from my brain surgery, which is one of the side effects i do not need. and yes it gave me h/as from h--l. then, i was also informed to dispose of it you have to make sure it can't get in the ground water!
but i can put it in my stomach?????? DUH!!!! DO NOT THINK SO. THIS LEAVES ME WITH MY NORCO. I JUST HAVE TO TAKE AS DIRECTED((3 PER DAY) AND WATCH AND MANAGE MY MEDS.

I DO NOT KNOW IF THIS HELPS BUT IT IS MY DOC'S OPINION. AS DAVE SAID THAT IS JUST ONE DOC. HOW OFTEN DO THEY AGREE? MY PRIVATE OPINION DEPENDS ON THEIR FEE SCHEDULE.
blessed be!

That's so funny Jan that your opinion depends on your PM doctors' fee schedule. Oh how true it is!

...Nah, way too much beard fer me