Talk:Dihydrocodeine

Potency compared to codeine

How potent is DF-118 when compared to codeine? Codeine article says about 10% of codeine is converted to morphine and this says that DF-118 is 30% potency of morphine. Does that mean that DF-118 is 3x as strong as codeine? —Preceding unsigned comment added by 139.30.17.38 (talk • contribs) 20:49, November 18, 2005

DHC is a more effective anlgesic than codeine for several reasons. From personal experience, it is more euphoric than codeine. Opioid analgesics work in part from their anxiolytic and reality detaching effects,(the psychic component of opioid analgesia). It has a much wider range of use in this respect, as its effective range from mild analgesic to euphoriant, is much wider. It is difficult to put into words, it just has a certain 'zing' to it codeine lacks (analgesically, and euphorically). Also having ~3x > bioavailability (S.C,I.M,I.V) than codeine, it is even far more effective than codeine by injection, w/w. It creates a strong dependency, but is a relatively functional opiate, even in large doses, cf.bupreorphine, morphine. It is not exceptionally sedating, in fact it can have a paradoxical stimulating effect. I estimate it to be 1.5x stronger orally, and 3-4x by injection. Though you could not take inceased levels of codeine to acheive the same effect.Profmad (talk) 11:53, 21 November 2008 (UTC)Professor Mad

In reply to the above, my understanding is that DHC is about 1.5 to 2 times more potent than codeine. According to the British National Formulary however, codeine and dihydrocodeine are more or less equipotent. There is much controversy about how strong DHC really is. —Preceding unsigned comment added by 84.12.30.34 (talk • contribs) 11:35, November 22, 2005 The BNF indeed does state this, though it is widely accepted by Doctors to be a more potent analgesic. Profmad (talk) 11:58, 21 November 2008 (UTC)ProfMad

stronger

The reason DHC is considered a stronger drug is because it crosses the blood-brain barrier much easier than codeine. —Preceding unsigned comment added by Blonde2max (talk • contribs) 15:51, April 3, 2006

stronger yet again / comparison to hydrocodone

Another consideration (in the states) is that commerical combination products use higher strengths (i.e. DHC/APAP) for an overall higher analgesic impact. This contrasts with some of the clinicals done in the UK during the 1990s that only compared a 1mg or 2mg preparation of DHC and concluded that DNC was merely equal to ibuprophen. A 2001 Study in US found equal efficiacy between 32mg of DHC/ 712mg APAP/ caffeine and Lortab 10/650 (Hydrocodone/APAP). —The preceding unsigned comment was added by Binkerzip85 (talk • contribs) 05:45, 8 March 2007 (UTC).

21:23, 9 May 2011 (UTC)ProfMad21:23, 9 May 2011 (UTC)

Please note: Dihydrocodeine is not Hydrocodeine. Refer to structure:- the latter is reduced by one more hydrogen atom, on the first benzene ring. It does appear to be a slightly more potent analgesic than DHC. Vicodin, made famous by 'Dr.House', is Hydrocodone/Paracetamol. It is not prescibed, other than as an admixture (with acetominophen/aspirin), in the U.S.A. It is not in the UK Phamacopeia

21:23, 9 May 2011 (UTC)ProfMad21:23, 9 May 2011 (UTC) —Preceding unsigned comment added by Profmad (talk • contribs)

Ive been addicted to Dihydrocodiene for over 4yrs.ive been taking between 300mg to 600mg a day.ive been trying to dettox off dihydrocodiene for over 2yrs now but find it VERY hard. The withdrawls are horific,insomnia,sever Depresion and flu like symptoms.ive seen my doctor sbout this and at first wanted to put me on methadone.i wasnt keen to go on methadone so she has put me on 120mg of DHC continus a day,i still suffer sever withdrawls but im sure its better taking the dihydrocodiene than the methadone.if anyone has suffered with dihydrocodien addiction and has succsefully detoxed off them i would like to hear if you have any advice.DFDen —Preceding comment was added at 17:38, March 19, 2007

Here's some advice to the above from someone who has first been addicted to DHC, then to Heroin, then to Methadone. Heroin & DHC withdrawel were similar for me. Methadone was not as bad physically, but the depression was much worse. I found and still find that giving up opiates has not lifted my depression so you always have the feeling that you either want to become addicted again or top yourself (between a rock & a hard place, so to speak). I feel for you and the many thousands of people like you in the UK at least; maybe for you the answer is to stay addicted, but I am certainly not a physician, I'm an opiate addict. As an aside Subutex (buprenorphine) seems popular as a detox here (UK). JSM —Preceding :unsigned comment added by 212.57.241.227 (talk) 09:44, 17 April 2008 (UTC)

GABAergics (benzodiazepines ie diazepam, GHB) can releive the symptoms of withdrawal, taper the dose down to nothing while taking the GABAergic, then taper down the GABAergic. If you have an underlieing medical condition resulting in you self-medicating with opiates eg depression/anxiety/pain then that needs to be treated as well. There is also the "rapid detox" method whereby they administer you with an opioid antagonist and knock you out with sedatives, this is however not a good idea considering that acute opiate withdrawal is neurotoxic - I'll get a reference if you want on that - afaik GABAergics inhibit the neurotoxicity of opiate withdrawal. —Preceding unsigned comment added by Blahfooblahfooblah356 (talk • contribs) 13:06, November 19, 2007

To the poster wishing to get off DHC... It's tough, but if you find the right time in your life to do it (i.e. You've got good reason to be off it, like a new girlfriend, or maybe you've just had enough etc..) then it can be done. It takes about 5 days in total for me. They are not pleasant days but if you're committed, you can do it. Diazepam and a lesser opiate also work wonders, but you need to take them frequently to really stave off the w/d symptoms. I have also gone through the subutex/bupe detox, and in my opinion it is three months of hell on earth and I wouldn't wish it on my worst enemy. Stay away from buprenorphine, just get some benzos, a little codeine and some soothing music, strap yourself in and know that it'll be over in 5 days or less, and when it's over you'll be free! Don't go through extended withdrawals, just get off it and be done with it. That's my honest opinion, hope it helps. —Preceding unsigned comment added by 121.216.122.55 (talk) 06:41, 15 August 2008 (UTC)

There are as many opioid users around the world as alcohol, this might be hard to beleive, but its true. Most for medicinal, the less for recreational. Be strong and taper down. Write out a schedule, and stick to it. Its easy as that... Continus and slow release formulations are really bad, go back to 300/400mg a day of the Normal DHC preparation, taper down 60mg a week, 30mg the first 3 days, and the other 30mg the next 4 days. Every 3 days gone past every taper, give yourself a single reward dose higher than the current tapered dose. It works really well. One important thing is not to confuse normal life strains and fatigue with that of an opioid withdrawal. 30% of opioid withdrawals are in your head. Opioids have kept you warm and going for so long, that when you taper or give up, real life may seem part of the withdrawals. Opioids have a huge motivating effect, allowing you to want to get on with things while your on it.. in real life, you have to push your self to do work etc. Realize this is real life, things don't happen by themselves, they happen by your will. Some people actually have a better quality of life habitually using things such as DHC than that with real life... these people normally suffer from a less than normal endorphin system, which is why some feel they are back to being normal after using DHC. If you are one of those types, perhaps you should consider tapering down, and maintaining a low dose for until you feel you can cope with life without opioids. Tolerance can easily be avoided by taking each dose the minute withdrawals set in. Many people dose early, in other words, before any withdrawals show, they take the next dose to avoid the slightest tinge of withdrawal, this is why tolerance builds up rapidly. Wait until you get a runny nose, start feeling fatigued, then take the next dose, not earlier unless you want a slow increasing tolerance. Opioids are not evil, they are just as bad as alcohol, they are addictive, but if you know the ins and outs of opioids, you may well use it as a positive thing for a long time. Part of the stigma is also the media etc, they keep telling people about how addictive and dangerous opioids are that people mentally trap themselves in that area... I heard of a guy who said he suffered withdrawals after 2 doses of DHC, in scientific terms, this is bullsh*t, but it just shows you how much the stigma associated with opioids can make ones mind create illusionary withdrawals when infact, they are not there.

I would also warn about using benzodiazepines for easing opioid withdrawals. They are addictive, and a benzodiazepine addiction is by far an addiction that has many worse consequences than an opioid addiction. Here is a quote of someone from erowid "Give me a heroin withdrawal anyday, but just don't give me a valium withdrawal. Kicking the valium is the hardest thing I could do." Benzodiazepines such as Valium/Diazepam can help with opioid withdrawals, but if you don't take them as scheduled, you could be replacing 1 addiction for another one that is worse, or hit the bottom and leave with 2 addictions. Many opioid users do not have a clue that they are better of than many Alcoholics or Diazepam users who are trying to quit their addiction. Diazepam can even kill you if you go into withdrawals after being on a high enough dose. Hallucinations, Cold Sweats, Seizures, Shakes, Nausea, Dizziness, and extreme depression are often some of the side effects of quiting benzodiazepines. Just try to taper down your DHC use, diazepam is another sly drug, that seems innocent at first, but can leave you addicted at levels far worse than with opioids. --78.86.159.199 (talk) 19:46, 31 August 2008 (UTC)

22:20, 30 November 2010 (UTC)ProfMad22:20, 30 November 2010 (UTC)00:44, 1 December 2010 (UTC)ProfMad00:44, 1 December 2010 (UTC) The main concern in this section appears to be DHC's ability to create dependence. Indeed, DHC will produce a dependency of equal magnitude to morphine, its withdrawal not greatly disimilar to that which occurs from morphine, {in relationship to relative dosage i.e. 480 -720mg/day DHC (roughly equivalent to 50 -75mg of morphine(oral), & is a very unpleasant experience. DHC tends to produce > diarrhoea, but < classical 'cold-turkey, kick-it type symptoms' A great depression can ensue (this may, or may not be due, to any 'XTC-type euphoria' not inherent to morphine.

It is less the dosage, but length of dependency that is most critical in determining a person's dependence level ( & thus in planning any opiate de-tox). The above figures are approximates of say. two years dependency. It takes the body 6 month's for all physical symptoms to disappear, after this length of dependency. Don't get fooled by 5 days of flu, and that's it. Low body-core temperature, insomnia, cravings, & depression with mood-swings all occur. The mistake all opiate dependant persons make is that it will be quick. If you make it, think month's even a couple of years. Be gentle on yourself, it isn't like giving up smoking. Having said that, if you get prescribed DHC, suffer with pain (psychic included!), it is almost certainly less harmful than 20 'Woodbine's' a day. Somethings we can't change, have the courage to accept them.

Regarding hydrocodone or DHC/ACAP preparations, (hydrocodone is ~4x more potent (w/w)than DHC). Whatever some 'looney backwood' scientists found, in so much that ibuprofen being found to be equal or superior to these opiates, proves scientists too, make poor experiments & judgements in life, too. This group, when presented with their son with a broken leg, will reach for the Nurofen 99 breaks out in a 100. Complete twaddle.

Point 2, I reiterate, and support the 'opiate-dependent' persons advice. Methadone is a sadistic alternative, Buprenorphine, at present more fashionable, is almost/as bad. 120mg m/r (continuus) can be legally doubled by all Doctors (i.e 240mg/day). There are 60, 90,& 120mg formulations, of DHC Continuus. The Continuus form, particularly if dependent on DHC, is the superior formulation. It acts like Methadobne or Buprenorphine, to an extent, pharmacokinetically, in so much that blood levels are more stable, and it tends to taper a little slower from the system. (Requiring only one or two daily doses).

Regarding the next post which rambles on, and says use normal formulation DHC, and on the 3rd. day, when you nose runs, and your arse itches etc. Ignore. He is trying very hard to kick 'it' right now, I wish him well, but his advice sucks. It actually gets worse, when he brings the Benzo's into the picture. Smoking, is easy, opiates near impossible, Benzo's - if you are still addicted, - tough titty. Have some fitted in your coffin, these are the mother of all addictive substances. Actually, I apologise. He becomes cleare towards the end. If de-tox were easy, you wouldn't have clinics costing 10 years average salary, only to white-wash over the 'problem'. Opiates are here to stay, live with it. Most of the 'hype' is propoganda, and if you don't OD, they have a relatively low-toxicity.

If you invent drugs, you are socially high-brow, prescribe them, higher still, dispense them, you are still a fine fellow, take them, and you will be taken into the gutter of society, given half a chance, particularly by the former three groups. Thus, the intelligentsia, make & distribute, for the healing of humanity (the masses). In conclusion, if it is late, you are in 'pain', and for whatever reason life sucks, take the DHC kindly prescribed, go to bed, and when that warm feeling soothes a tired body into relaxation & sleep, 'the thought police dismisseth us'.

'Wishing I could soothe you like a bottle of DHC, I bid you goodnight, and sweet dreams' 00:44, 1 December 2010 (UTC)ProfMad00:44, 1 December 2010 (UTC)

—Preceding unsigned comment added by Profmad (talk • contribs) 22:20, 30 November 2010 (UTC)

IBS

"Irritable Bowel Syndrome (IBS) in its diarrhoeal and cyclical forms as well as other conditions causing hypermotility and/or intestinal cramping. The gut itself contains its own opioid receptors, which also allows opioids which do not enter the CNS at all or in appreciable quantites following oral administration such as the pethidine-related drugs loperamide, diphenoxylate, and difenoxin to work in the same fashion in a significant percentage of the population. These drugs also have direct anticholinergic effects which contribute to their action. The loperamide-like drugs, however, can exacerbate cyclical IBS and have little or no effect on the cramps associated with all major forms of IBS and exacerbate the constipation-predominant manifestation of this condition. As a result, the most effective opioids for this spectrum of GI complaints would be whole-opium preparations such as paregoric, laudanum, Dover's Powder, granulated opium, opium in pill form etc., with codeine and dihydrocodeine working very well also, especially on diarrhoeal and cyclical IBS. Whole opium contains not only morphine and codeine and other narcotic alkaloids but also the alkaloid papaverine, a smooth-muscle relaxant, and other alkaloids, oils, resins and waxes which can help with cramping and other symptoms. Preparations containing both paregoric and extract of belladonna were once available that were probably the strongest and most efficaceous of GI drugs."

I dont know who added these comments, but they are unreferenced and seem to be mostly factually incorrect as far as I can see. I have major cyclical extremely painful IBS which I have to take dihydrocodeine for on a daily basis which relieves the symptoms and the pain. Loperamide ALSO helps with the symptoms of CYCLICAL IBS for me which DO NOT INCLUDE CRAMPING. Oral poppy tea with those alkaloids does help the pain but it makes the symptoms worse and causes me bloating. Antimuscarinic drugs (including belladonna) cause all manner of side effects, do not help the pain, make everything worse and I hate them. Unless someone would like to add a reference for the comments on all drugs relating to IBS - I am going to delete/correct them. —Preceding unsigned comment added by Blahfooblahfooblah356 (talk • contribs) 13:13, November 19, 2007

Recreational Use

The end of this article sounds like it was copy-pasted from Erowid or something. Somebody fix it. —Preceding unsigned comment added by 72.69.86.183 (talk) 18:53, 20 March 2008 (UTC)

I'm done with finals in a week, and after that I plan on deleting this whole section and fixing it. I understand someone's good intentions in providing info on safety with recreational use, but a lot of this information is guesswork, inaccurate, or just totally fabricated. The starting dose of hydrocodone in an opioid naive patient is between 5-10 mg, for moderate-severe pain. From my own experience, one Vicodin ES knocked me on my ass the first time I took it for wisdom tooth surgery pain. Another time, I took 17.5 mg of hydrocodone recreationally, and was so obliterated I couldn't type anymore. Another person may not even be affected by these doses. So suggesting doses for recreational use is not appropriate for WP, because recreational use of drugs is an inherently subjective thing, which shouldn't be brought into an objective environment. I'll be back.Ohnoitsthefuzz (talk) 07:28, 5 May 2008 (UTC)

Come on, we all know DHC is the bomb man. It even beats morphine, which just makes you sleepy and retarded. They should put DHC in drink form, and serve them in pubs, everybody would be hugging each other. The recreational sections sounds v. true... unfortunately, the government aren't going to publish are report saying DHC actually makes you feel good.... so no source could back that up except original research. If you want just tidy it up. --93.97.181.187 (talk) 17:20, 26 April 2009 (UTC)

00:56, 20 October 2012 (UTC)~PROFMAD00:56, 20 October 2012 (UTC)~ DHC that mild/moderate pain-killing opiate, slightly stronger than codeine, and 1/10 the potency of morphine, as an analgesic. Actually, fairly accurate, from the physicians point of view. This is my reason for never submitting a mixed bubonic, as an opiate comparison chart. A rough guide to analgesia, found in any MIMS, gives as a ball-park guide to an opiate analgesic activity Then their requires the comparative guide to 'recreationally used opiates'. Regarding DHC, the British form of Hydrocodone ( USA) is DHC. They are two different drugs.

Hydrocodone (Vicodin) appears 4 times the potency of DHC, for pain.(16mg vs. 60 mg respectively) Recreationally, Hydrocodone, may be of a higher potency to DHC, also/ DHC is a very recreational opiate, (and I suspect Vicodin is?) DHC may well be more preferable to morphine, at times? MIMS under praises DHC. Physicians know this.

An anti-depressant and also a mood-elevator! Opiate analgesic for moderate pain I.M. & I.V, (you quote DHC to have a 20% bio-availability (orally)), which though possibly low, still vindicates my stating it to be 2-3 times more effect (recreationally), & certainly half-as -strong again, as an analgesic. Increased confidence & communication , A 'warmth', Anxiolytic Constipating. Anti-tussive Even its own specialist reduction Kit for opiate withdrawal! That you may injure yourself more so, on DHC (lowered pain threshold), appears to me, reasonable. 00:56, 20 October 2012 (UTC)ProfMad31.54.13.161 (talk) 00:56, 20 October 2012 (UTC)

MDMA & Heroin

The comparison made between DHC/Opioids and MDMA in this article is unfounded. Although most opioids do create a feeling contentment, well being and empathy, their method of action is totally different than MDMA, and comparing the empathy and euphoria of DHC to Heroin is another general statement that has little scientific background. I can see where the author is coming from, but he is basing his conclusions on personal experience, and lacks a knowledge on neurology, endorphins, dopamine and the serotonin system. I will try to fix this article in good time. --78.86.159.199 (talk) 23:20, 31 August 2008 (UTC)

There's no reference to MDMA in the recreational use section anymore, but it still sounds like its a description of MDMA, not like any typical description of opioid intoxication. I won't argue that I haven't felt those effects from opioids plenty of times, but those effects should be at the bottom of the list, not the top five. (Nor do I suggest that it read like a med textbook, I think euphoria, drowsiness/nodding w/ high dose, a sense of being comfortable are the key points) PS. Comfortable as in reduced sensitivity to hot, cold, pain, no desire to move around, is there a name for this? Besides analgesia and CNS depression? 68.113.151.211 (talk) 04:58, 13 April 2009 (UTC)

Adding something about availability in Australia

Added small note about availibilty in Australia, should I expand on this? Didymal (talk) 10:20, 1 June 2009 (UTC)

Side Effects, potentiation, MDMA etc

" First-generation antihistamines such as tripelennamine (Pyrabenzamine), clemastine (Tavist), hydroxyzine (Atarax), diphenhydramine (Benadryl), cyproheptadine (Periactin), brompheniramine (Dimetapp), chlorphenamine (Chlor-Trimeton), doxylamine (NyQuil) and phenyltoloxamine (Percogesic Original Formula) not only combat the histamine-driven side effects, but are analgesic-sparing (potentiating) in various degrees. The antihistamine promethazine (Phenergan) may also have a positive effect on hepatic metabolism of dihydrocodeine as it does with codeine. Higher doses of promethazine may interfere with most other opioids with the exception of the pethidine family (Demerol and the like) by this and/or other unknown mechanisms.

Other side effects include giddiness and a sense of hyperactivity. Many patients and experts have pointed out that many opiates have the effect of generating empathy and improving interpersonal skills in a manner analogous to, but subjectively different from, MDMA, MDA, and many related amphetamine-variant hallucinogens[citation needed][citation needed]. Dihydrocodeine and hydrocodone seem to have this effect somewhat in excess of their theoretical analgesic potency as compared to other opioids[citation needed][citation needed]. SS Bron and other formulations containg ephedrine or to a lesser extent dihydrocodeine analogues of the Tylenol With Codeine series with caffeine will intensify this effect;[citation needed] of course one can always take pure dihydrocodeine along with those ingredients, or other stimulants. Such mixtures are also superior in relieving many kinds of pain."

Surely this could be condensed to read "Antihistamines prleive the histamine mediated side effects of DHC, some may also potentiate its analgesic activity" and "adding caffeine to analgesics often enhances the pain releif afforded"

The stuff about MDMA and DHC being "more potent than it is" seems like gosip, rumor, suposition rather than proven fact.

Any comments?

It's also worth noting that MDMA is an empathogen, not a hallucinogen. — Preceding unsigned comment added by 67.176.58.81 (talk) 02:26, 28 October 2011 (UTC)

A Personal Perspective in response to user Didymal

It's just my layman's opinion, and I'm uncertain as to whether that kind of opinion is valid on this page, but the relationship between MDMA and DHC does have some similarities, but in other ways are totally, totally different.

When I was studying at university I tried MDMA many times. I've also been stricken with a Dihydrocodeine addiction, which I've recently recovered from. So my experience is just anecdotal, and not backed up by proper research.

I would confirm that both Dihydrocodeine and MDMA are both very empathogenic, but MDMA has a less assertive, less controlled effect on empathy. I felt less able to judge people, or situations on MDMA. Put simply, MDMA made me like everyone, regardless. The empathogenic quality of Dihydrocodeine is more selective and incisive. You don't judge people differently, as one does on MDMA, you are, however, more able to delegate and subjectively better at seeing others point of view when taking DHC. Both MDMA and Dihydrocodeine have a 'warming' sensation - a feeling of softness and comfort, but again, feel quite different. There is a much, much more prevalent element of psychedelia with MDMA, whereas Dihydrocodeine is more clinical.

I personally don't believe Dihydrocodeine to be more or less potent than MDMA, just different. —Preceding unsigned comment added by Fentoradore (talk • contribs) 21:47, 2 November 2009 (UTC)

121.209.49.58 (talk) 07:58, 1 November 2009 (UTC) Jonathan, Adelaide, Australia

Dose Ceiling & style?

Dihydrocodeine certainly DOES have a dose-ceiling mediated by the CYP-2D6 enzymes O-demethylating it to dihydromorphine. The Ki data for DHC is very similar to that of codeine. This article seems to be geared towards the misuse of this material stating many facts without actual reference. — Preceding unsigned comment added by 86.30.243.179 (talk) 14:12, 12 October 2011 (UTC)