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Swim is prescribed percocet for facet arthritis and a herniated disc by their pm doctor. Swim take anywhere from 60-75 mg per day on average between the Percocet and some other oxy. Swim has the chance to acquire some Hydromorphone 4 mg and is curious about a couple things.
1. If swim takes 25ish mg oxy oral/ins to feel good(initially, then more throughout the day), how much Hydromorphone would be needed to equal that dosage?
2. Swim is tested at their pm doc about every 3rd visit. What does the HM show up as on a test, and how long would it be in swims system?
Any other general experience info with HM would be appreciated.
There are several different opiate conversion calculators available, you can UTFSE for more info on that. The problem is that what you are asking for is a subjective feeling. What I mean by that is the feeling that you get from a certain dosage will not be the same feeling that I get, so it is hard to say for certain exactly what X number of milligrams of drug Y will make you feel like. Personally, I would not feel a thing from 25 mg. of oxy, and I would not feel very much from 60-75 mg. And that is all at once, not spread throughout the day! When I was still taking Hydromorphone, I was at 32 to 40 mg at a time, 3 to 4 times a day. That would kill a normal person.
Hydromorphone is considerably stronger than percocet, so proceed with extreme caution! Standard rules apply when trying out a new or unfamiliar drug, especially an opiate-start very small and work your way up. I would highly suggest that you only try 1/2 of the hydromorphone at first, with no other drugs in your system. It is a short-acting drug as well. After you have judged the effects of the small dosage, you can then proceed with increasing as you see fit. It might also be advisable to have someone you know or trust to sit with you for the first few hours, just to make sure that everyone remains safe. Also, remember that the effects of opiates are exponential, not additive. especially when you are mixing them! What this means is that 1 + 1 does not necessarily = 3. It could equal 1 or just as easily equal 11! Perhaps a better word would be synergistic.
In any event, be extremely cautious when you are trying out a new drug for the first time. Start small, have a sitter, and don't mix different opiates together until you are absolutely certain that you are familiar with the effects of each one separately.
As far as the drug test goes, again, it depends on what kind they are using. Your standard "front-line" test will show a positive for opiates for certain. Depending on the quality of the test, that posite result may then be broken down further, i.e. heroin, oxycodone, etc. The normal procedure on a positive hit is to then send the sample out for a confirmation test, which is done via GC/MS. This test is considered the gold standard and will show each and every individual drug-percs, oxys, dillies, etc. as well as the amount in your system. It takes anywhere from 3 to 5 days for your system to clean itself out, assuming no additional drugs were taken during that time.
I think toxinreleased covered most of the bases, but I'd like to add a few things.
When you say "feel good," do you mean you still achieve some amount of euphoria from the oxycodone, or do you just feel good from being out of pain? The problem with hydromorphone for some people is it's oral biovailability is not very good, only around 30%. Oxycodone's is close to 90%. That being said, hydromorphone is still a very potent pain reliever, but the low oral BA makes it difficult to achieve any euphoria if you have any tolerance when taking it orally if that's what you were referring to and if that's your goal. Definitely NOT impossible, but not easy.
I'm not necessarily recommending either of these things and certainly not recommending you abuse your medication, but with hydromorphone you're probably better off considering intranasal use or plugging (anal administration). Not only will this be better for pain relief, but may actually give you a bit of a high which... let's face it, is nice for the general suck of things when living with any chronic pain condition. I'm not recommending these things sort of with a wink and a nod because either of these routes have a much higher BA and will take far less mgs.
HOWEVER, if you do consider this, you must excise extreme caution because to the best of my knowledge plugging has a very high BA and therefore you really need to dose small. You can always add. I haven't been on ER opiates in a long time so don't remember the dosage exactly, but it was a lot... I believe 120mg of Oxycontin/day (40mg 3x). I was also on 15mg 4x a day for B/T, but then switched to hydromorphone 4mg 4x a day. The hydromorphone did nothing when taking by mouth, but even on all that oxy, 4mg was about all I needed when plugged... sometimes 6. Point is, dose low and be careful if you were to consider it.
Otherwise, best advice I have for you is to carefully read toxin's post because it's full of good information. I don't think I need to tell you to be really careful when fooling around while under contract with a PM doctor, because if you're caught you're screwed.
Typically, looking at the charts by the sellers of Jurnista (hydromorphone extended release), 4mg hydromorphone is somewhat equivalent to 10mg oxycodone.
However, cross-tolerance can vary, so the last official thing I read suggested starting on 33% of the equivalent dose and titrating upwards (fairly quickly/or downwards) as needed, when going either way. So 4mg could be 3.33mg or less, while it could equally be 30mg or more "equivalent".
I think opioid-naivety would come into play to prevent 'silly' cross-tolerance effects (eg. 4mg jurnista should be safe for someone on your dosage), but 'safe' isn't a word you can ever apply to opiates, even prescribed under a physician's care. they're always dangerous - I know if I left my pills out even one could kill a baby or my beautiful little tiger cat.