Hydromorphone Maintenance Treatment

[Voyager]

Greetings people,
I'm writting from Serbia and I'm as you can see an opiate addict. I used my first opiate when I was 14 and that was Tramadol (in Serbia Trodon). Since then I knew that my life will never be the same again. I've been on various drugs, but my favorites were always opioides. I had experiences only with Valoron (Tilidine), Methadone, Tramadol (okay, I know it's not a full clean opiate) and Morphine. That's all Serbia has in it's drugstores, now we are even out of Morphine, so tha clinics have to import it specially for it's patients.
Anyway, now I'm 22, currently going on 23 and I'm on Methadone maintenance for already year and a half.
That is the only opiate option I had, even I don't like Methadone so much. It makes me sleepee and crappy all day, I have no engagements in anything, I'm not interested in anything, etc..
So, Serbia is getting a new baby opiate in a few more days, and that is Jurnista (Hydromorphone), 24 hour OROS release tablets in 8mg and 16mg forms.
So, my doctor and I decided to lower my dose of Methadone to 20mg (I'm currently on 80mg of Methadone) and add slowly 32mg of Hydromorphone (two 16mg Jurnista tablettes), and make it my maintenance treatment for the future.
My doctor will even have to discuss giving me Hydromorphone with the Serbia Narcotic Board because it's imported to be used only for the pain manadgement, and not for the maintenance terapies. And he is an honoured member of Serbia Narcotic Board so he will make sure that he can legally prescribe me Jurnista (I will be the first and the only one in Serbia who will get Hydromorphone). He will have that meeting in 2 weeks and then I will know will I get my new opiate. I beg God to give it to me, because it's my last resort. I tried Hydromorphone in the form of Dilaudid once when a friend from the USA brought it and it was great, it was an opiate that suited me so much.
Now, I want to put Methadone to lowest dose of 10mg or 20mg and add 32mg of Jurnista extended release. If my doctor manage to persude the Narcotic Board to give him the authority to prescribe me Hydromorphone for the maintenance that will be great. I'm hoping so much that he will make it, because Serbia had so much problems and people could not get even Methadone because of various stigmas and the like, but now we are entering Europe and Harm Reduction regimens are employed more and more, Serbia finally accepted it as a succesfull way of controlling the addiction. But we still need so much stuff, we even don't have Buprenorphine yet. We only have Methadone solution in the bottle of 10ml, 10mg/1ml, and that is what I'm taking now.
But now I want to ask any one of you, is any one of you on Hydromorphone maintenance ?
I tried Hydromorphone a lot of years ago and only once, can you tell me it's effects when you are taking it every day ?
I know that it's one of the best and one of the cleanest opioides with the lest of the toxic metabolites and that it has the lower incidence of side effects.
Can you tell me a little bit more about Hydromorphone long term effects anyway ? I know that it has the euphoric effects and reinforcing effects contrary to Methadone which only puts you down.
My plan is to finish my system engineering exams when I get Hydromorphone, because I belive I will be able to do that and that I will have those great reinforcing opiate effects. I cannot finish them on Methadone.
So, people, I'm here and waiting for your thoughts, answers, thinkings and advices.
I today asked my doctor and he did prescribe me Concerta (Methylphenidate) to counteract the Methadone downer cnock out effects. I already used it for 5 months for the same reason and it was excellent in counteracting Methadone downing effects. I used, and will be using 36mg tablets, once a day is just enough, until I get the news from my doctor from the Narcotic Board and until I start with Jurnista in 2 weeks, then I will no longer need Concerta.
Regards !

[Voyager]

Please anyone ?
I need your help with this, I need your thoughts.

[blackdb1]

Swim thinks you mean swim instead of "I", correct? If so Swim is not positive on this but this theory makes sense to him with his kowledge of how opiates affect the humanbody... Methadone is an antagonist opioid that has a VERY long half-life (somewhere between 24-36hrs) enabling swiy to take it once a day and have a steady level of opiates in swiyour bloodstream. That way it keeps a maintenance patient at a steady level as to avoid the ups and downs of opiate addiction.
Now with hydromorphone a full agonist opioid, in an extended release form swim believes that it will like most XR versions of meds release 2 times over 12- maybe 24hrs. So say swiy takes 32mgs, swiy will get 16mgs which the effects will peak within 2-4hrs and decline over the whole 6-12hrs. This will cause ups and downs throughout the day because of the rising and dropping of opiates in the body. This would cause swim to have down points when the effects wear off. Where the methadone keeps at a steady level until the next dose.

Like swim said he's not 100% positive on this but is pretty sure this would be the results using hydromorph-XR. It would be like the US using OxyContin to maintain addicts which swim believes would never happen.
Swim wishes swiy the best of luck in pursuing the right medications for swiyourself!!!

[Voyager]

Methadone is not antagopnist, it is like Hidromorphone full opiate agonist.
No, this is not Hidromorphone XR, this is something special and new in Europe and it is called Jurnista. It is allowing the constant rate of Hidromorphone in the body without ups and downs. After injesting the pill of Jurnistra the peak effects come after round 6 hours and last for the next 24 hours after which the tablet is fully dissolved in the organisam.
Jurnista is just the right medication for the maintenance terapies.

I don't understand this "SWIY" and "SWIM" thing, please explain to me that.

[OhCasey]

Jurnista is more like methadone then a regular controlled release opiate in the way that the levels stay the same in the body from hour 6 to hour 24 after intial dosing. Voyager i think you are correct in your thinking that hydromorphone will give you more energy and upper type effect than methadone, similar to most other opiates. Methadone is known for its non energenic and lethargic type effects. Voyager you seem to have a better understanding than anyone else here will on jurnista as most here know very little of it because of how new and rare it is. I hope you experience good results with it id be concerned with it being alot more euphoric than other maintenance meds and increasing feeling to use.

[Voyager]

That's exacly what I'm talking about.
And you are perfectly right, Hidromorphone will give me more upper effects, I'd be more active on it. Methadone was fine for me in the beginning, but now after a year and a half it only stonds me and gets me down.
I'm waiting for the news from my doctor from the Serbia Narcotics Board and will they give me Jurnista or not, but I strongly hope they will give it to me because that's my last resort, we don't have any more alike opioids that I could use in the maintenance.
I'm and IT and Pharmacoinformatics Professional, I gotta know these things including Jurnista thing.

[BuffaloBoobs]

Swim is a person who is nobody here and nobody that you will ever meet, yet you already know him/her/it.
It's someone who isn't me (or you).
It's in the rules.
It's something you should read.

Swim doesn't have much to else to contribute to this other than that hydromorphone is one of swim's favorite opiates in the world. Very awesome. Best of luck to swiy.