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Providing straightforward information pertaining to drugs, drug use & drug policy. The Grey Pages promotes drug-related literacy and advocates a system of viable and tolerant drug policies. This is my personal collection of commentaries, essays, tid-bits, and other such writings on everything ranging from drug use, drug policy and drug-myths, to drug-science, addiction, human behavior, and the workings of the human brain. I started this blog with a particular focus on opioids, and over the past year have found my interest gravitate toward the intriguing, ever-changing world of designer intoxicants (i.e. "research chemicals" or "designer drugs").

Saturday, October 23, 2010

Oxymorphone (Hydromorphone's Sibling Brother): The Holy Grail



Oxymorphone (or OM): Oxymorphone is related to morphine in the same fashion that oxycodone is to codeine. It is about 10 times stronger than morphine; 1mg by intravenous injection is equianalgesic to about 10mg of IV morphine. It is currently available in the US as an instant release tablet form as the brand name Opana or generic, and Opana ER; an extended release tablet form of the drug which is designed to release a steady dose over 12 hours, similar to the Oxy/MS-Contin series by Purdue. Opana ER is now available to a limited extent as a generic product marketed by Teva Pharmaceuticals.

Its high potency allows for its use in the hospital setting as a substitute for morphine; as an analgesic during minor procedures, alongside benzodiazepines or other sedatives, and as a potent, fast acting analgesic in the trauma-emergency setting. Oxymorphone is very effective for the most severe states of pain, and is generally best suited for those with a tolerance to strong opioids or an extended history of prior narcotic use. This drug generally produces desired effects with fewer adverse reactions than morphine.

Oxymorphone is relatively longer acting than similar opiates when given orally, with an elimination half life of 1 to 10 hours, and a duration of effects lasting generally no less than 6 hours. A dosing regimen of traditional oral oxymorphone may very well resemble that of agents like methadone and levorphanol more so than that of morphine and hydromorphone.


Opana ER is a long acting oxymorphone medication

Oxymorphone is slightly stronger than its sibling brother hydromorphone (Dilaudid) and when injected, gives an intense rush and high that is similar to hydromorphone or heroin; Some prefer its rush to either. Both oxymorphone and hydromorphone are highly regarded in the narcotic world for their heavy hitting effect when injected, and might be considered the "Holy Grail" of injected opioids in pharmaceutical form. Users afraid of needles often crush the tablets into a powder to snort, and some compare the effects to oxycodone, but cleaner or more refined. Like hydromorphone, oxymorphone may produce much less sedation or clouding than morphine. Effects are typical of an opioid agonist; possible sedation, anxiolysis, analgesia, increase in motivation or energy, positive mood change, sociability & empathy, a strong feeling of contentment and intense euphoria. These effects are pronounced when injected and remarkably subtle by other routes, with the exception of intranasal which many claim is quite intense.

Along with buprenorphine, oxymorphone has been specifically mentioned as a possible symptomatic treatment with severe depression which has not responded well to SSRI's SNRI's or stimulants. Opioids had been historically used for this purpose and are highly effective in attenuating severe depressive symptoms, much more so than today's aggressively prescribed & toxic monoaminergic antidepressants, which may be little more effective than placebo. Opioids exhibit direct action on mesolimbic dopamine transmission and profoundly alter the brain's emotional interpretation of suffering. Interestingly, research is continuously discovering connections between serotonergic transmission and the triggering of endogenous opioid transmission. Regardless of science however, the mere symptomatic treatment of mood disorders with opioids is not accepted by todays establishments, as after all, the motive behind prohibition is based heavily on social control and morality, far more than it is science. Our government is greatly concerned with protecting us from ourselves and maintaining control over individual brain chemistry and behavior, and is not open to reason.

13 comments:

  1. Opana in both the ER & IR formulation have given me back the opportunity to live a much more comfortable life. I don't want to get into all the serious medical problems I suffer from but IMO, This wonder drug has given hope in an otherwise miserable painful life that I had been living. I am not a drug addict and so resent these "high" seeking scum. So selfish, don't you understand what you are doing to your fellow man that need these and other prescription medications? We as chronic pain patients need these meds to help us live a better life. All you seekers are making it harder and harder for us CPP's to have access to them and our doctors scared to prescribe them, for fear of the DEA coming down on them. Why cant you keep to your Heroin, Meth, etc... and leave our prescription medications alone? I beg of you...

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    1. hello anon I totally agree with you as a CPPS WE go through hellfor every milisecond WE are existing its hard to really live free if ther be such a thing for us. like you i jhave had so many surgeries/complications. you are right those of who really need that team appraoch to our pain.WE ARE MET WITH LABELS AND HOSTILITY. Hey you inconsiderate selfish ass. keep your false fake med issues away so we can get the true treatment we need just to get through the day

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  2. Wow... Some comment are truly just exhausting to read. You sound like every one of the other whining embiciles looking for someone to point the finger at... Aside from that, a generic post (meaning an unintelligent comment which I've heard dozens of times), deserves a generic answer...

    While it's true that "recreational" use of opioids can be one of the most risky and potentially hazardous form of use, and the media uproar is a resut of those sometimes deadly consequences.. In addition, media will exploit any opportunity for a scare story, and when someone OD's, they are given that opportunity, further feeding their blood-sucking agenda.

    Pointing fingers can go on all day, and usually will, but as far as the correct/rational solution I believe in a genuinely 'free' society - would not be expecting humans who use drugs to change their behavior (unlikely to happen), but simply accepting the fact that dumb decisions (such as careless, uninformed use) will have dumb consequences - overdose, death, addiction, dependence, etc.. And rather than projecting the responsibility of avoiding those consequences onto the government/law or the pain market, a rational society should simply accept that lack of education and poor decisions is liable to lead to death... Tightening of the noose on pain doctors and drug companies is an inevitable result of the growing mentality of a "Nanny State";

    Additionally, many times the grim consequences such as death and addiction result not from recreational use, but lack of education and careless pain patients; south florida is not only an example of death by recreational use, but many pain patients who just don't know what the hell they're doing... Perhaps with the failure to inform on the part of physicians.
    Not even recreational users should be judged on their lifestyle choices; and should in fact be free to ingest whatever they please; ALONG WITH the acceptance of full responsibility on the part of the user, 100% with no exceptions - which in the case of being prescribed the drugs, will include full disclosure of risks.

    Perhaps you are right that careless recreational users and addicts are a MAJOR cause of this; however it is an irrationally twisted climate of prohibition and society in general, that underlies the regression in pain management as an effect of foolish people.

    "Dummy Proofing" our pain medications will offer a solution to some elements of the issue, but only temporarily. With the progression of technology and evolving of drug use, the pain industry will eventually be producing micro-robotic pain pills with self-implosion devises and GPS tracking in 20 years simply to 'prevent misuse; there is a much more rational solution - SELF RESPONSIBILITY and FREEDOM

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    1. I agree completely. I regret that I have to hide my medication because some of the younger twenty-something people in my family have stolen pain medication, as well as money, jewelry and electronics, from me in the past. Unbeknownst to these thieves, they could easily quit breathing on Opana. Yet to warn and educate them would probably entice them to do it!

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  3. Whew, these CPP'ers are just too much dirty scum. NOT ME! No, I am just an addict trying to get well, but these dirty scum CPP'ers are making it much harder for me to get my illness off!! Why cant u whiners just take tylenol or advil instead, and stfu, and leave us addicts in peace.

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    1. Leave you addicts in peace? You truly are an idiot who is making it harder for me to have access to medication that I need to make my life endurable. You obviously have no understanding of what illnesses and ailments are out there to cause human beings REAL pain. Some of us need relief to be productive human beings. You just need to snort something. You make me sick.

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    2. absolutely correct. drug seekers killed it for genuinely sick patients who need their meds to live good lives.

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  4. Reality is just a crutch for those who can't handle drugs! - Forgot who said it first, maybe Lilly Thomlin or somethig like that.

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  5. What about those of us who are both? I was a junkie long before I became a CPP. And no I wasn't high when I broke my back. But I've tried to stay high since that day in order to mask the severe pain. So I think I'll snort an Opana 40 and then tell myself to stfu and take an advil! Yea that's the ticket!

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    1. I love it! Go for the gold!

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    2. you people have died just trying to get the meds that you just need to get high not to live oh let guess you don't give a shit even going through those nasty withdrawls would make the sun eventually shine on you and if not then WE The Real Chronic Pain Sufferers will just have to fight harder against you and try to rally everyone who is true to our cause a Good Life As Best As can Be Provided. Strength/ Love/ Hope and Gods Glory may these sustain us unite us all together for our livesor just a better today Tommorrow

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  6. well i took my first 10mg for pain, i use to take 30mg's of oxycottin to releive pain in my lower back,,,, any positive feedback appreciated!!!

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  7. What does "stfu" mean? I was prescribed Opana ER six months ago due to side effects of MSContin. My doctor tooks me off 10 mg Oxycodone, 3 pills 4 x a day. I notice Opana does not have the morphine side effects for me, but I seem to start detoxing after 8 hrs, four hours before my next dose, which scares me. As for taking Opana ER any way besides orally, I have read there is a new lung disease from people snorting them, and a new blood disease from people injecting them.

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