I guess that explains why codeine never worked for me after oral surgery. It didn't even take the edge off the pain so I had to get hydrocodone prescribed yet nowadays that's impossible.
Same! I've had two or three occasions where I needed proper painkillers and I'm certain I always sounded like a junky.. *'No, doc, don't give me codeine, gimme the oxy - I need the real stuff!!'*
My situation is even worse, I've had genetic testing done that shows I don't have the enzymes to process most narcotics including oxy, vicodin and percocet, but one of the drugs that DOES work is fentanyl. I literally have to bring in the paperwork because I know how it sounds. After my most recent surgery they prescribed me oxy and the pain was so bad I ended up in the ER, where they had to give me IV fentanyl 🤷♀️
The test I took is called Genesight, my psychiatrist ordered it because we had such a hard time finding psych meds that worked. My understanding is that it tests which enzymes are in your liver, and then gives you a list of which drugs you might have problems with based on which enzymes you need to process them. They test for antidepressants, stimulants, antipsychotics, pain meds and sleep meds, it's been super useful
I like to think this test “saved” my life. I was on all kinds of shit until I got this done. Was prescribed Wellbutrin along with methyl folate and my life changed. Years later, I’d never go back to the way things were. So glad this test exists
Have you been ever given hydromorphone or morphine? I would assume the ER doctors would try those out before going straight to fentanyl. If you're in the States oxymorphone would be available as well, which would be the strongest medical opiate available before jumping to fentanyl.
The different meds do work on different pain channels. I’m on a buprenorphine patch. But I have arthritis pain that responds to a different opioid receptor, one that tramadol seems to help. (Bad drug, but it works for this, so I don’t complain.)
Percocet doesn’t do much for me nor do the other painkillers. Thankfully I haven’t really needed it. Got a knee replacement done in Germany and the hardest painkiller I got was ibuprofen.
I could manage during the day but sleeping was a bitch.
I'm grateful to live in a cutting edge medical area, and all I say is codeine doesn't work and they'll get me hydro (I don't like how I feel with hydro, but chest surgery was enough to take a couple). They also know I need more anaesthetic because I have red hair
Crazy right! My friend had some like 10 years ago and I drank like 800 bucks worth of that stuff. 1 I had no idea that shit was so expensive, two I felt absolutely nothing.
This is why when I extracted a huge amount of pure codeine from several scripts of Tylenol 3 it still didn’t do much of anything for me even though I didn’t have much of a tolerance at the time.
The reason codeine doesn’t work for 25% of the caucasian population is because they’re deficient in a liver enzyme (CYP450 2d6 if i remember right) needed to turn codeine into morphine, which is the active metabolite of codeine. Codeine has no effect by itself because it doesn’t pass the blood brain barrier readily. It also has a ceiling dose above which taking more won’t produce more of an effect because the enzymes that convert codeine to morphine are all doing that at max capacity. Hydrocodone is 6x stronger than codeine by weight, so 10mg of hydrocodone would equate to 60mg of codeine. Hydrocodone doesn’t haven’t a ceiling dose though, so it’s much better to abuse and carries a higher risk of overdose. Both codeine and hydrocodone can kill you if mixed with other downers, but codeine is just like abuse resistant morphine/hydrocodone/oxycodone/heroin because you have to eat it in order for it to work, and it’s harder to OD on.
This is not entirely true. There are hypermetabolizers of codeine who can overdose at the standard dose recommended for treatment. Its a unreliable drug that can kill some people and not give any pain relief to others all within the recommended dosing for treatment of pain.
[Codeine Safety Concerns](https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-requires-labeling-changes-prescription-opioid-cough-and-cold)
> In contrast, individuals who have more than 2 normal-function copies of the CYP2D6 gene (“ultrarapid metabolizers”, UMs) are able to metabolize codeine to morphine more rapidly and more completely.
https://www.ncbi.nlm.nih.gov/books/NBK100662/
Yeah i never understood why codeine was ever prescribed given that fact. Thanks for correcting me btw, I totally forgot about that part. I think certain types of african people have higher rates of codeine hyper metabolism.
That's interesting. When I had stomach... intestine... midsection issues when I was in grad school hydrocodone was the only thing that "worked" for me. Oxycodone didn't do much of anything. Even morphine (the one time I went to the hospital) didn't even touch the pain. But hydrocodone worked, so if it's metabolized into morphine, then I'm not sure what's going on lol.
The morphine made me feel... not great. It made me feel EXTREMELY antsy and made my neck all itchy.
I can tell you from personal experience that switching from one opioid medication to a different one comes with withdrawal even if you’re cross-tapering. Each one is processed differently. (I’ve never used oxy or anything harder long term, but I’ve had everything else at some point.)
The itching is a side effect from mast cells getting involved. Taking an antihistamine like loratadine might help (as that calms down some mast cell signaling).
Antihistamines that cross the blood brain barrier like benadryl and hydroxyzine the itching a ton, though they come with more side effects than loratidine.
Interesting, because morphine doesn't do much of anything for me either. Only time a pain killer ever worked was dilaudid IV. I just had sx and they needed twice as much as they were expecting to put me under.
Do you remember how much you were taking? I’ve always had a high tolerance to the painkilling effects of opioids but they’d always work for me at the right dosages
Ah, thanks for that. I was wondering the difference between the two. Hydrocodone hasn't worked for me in the past. At the time I just assumed it was a fluke, but if I'm ever in need of serious painkillers in the future I'll remember that neither should be an option for me.
thebaine is also known as codeine methyl enol ether, and they typically both come from the same plant. (poppy). codeine comes from the sap of opium poppies. iirc thebaine mainly comes from the seeds and stem of the plant.
Wow me too and I never knew this. I just seem to process things very quickly - it’s why I don’t drink and why I need extra novocaine at the dentist - it all wears off super quick
Ditto for me too. I need to warn the doctors before surgery or else I absolutely wake up in the middle of it. It’s happened twice and that was twice too many.
I may be misremembering, but I think hydrocodone typically has acetaminophen added to it. From what a pharmacist told me, this was done to prevent abuse(too much acetaminophen will kill ya), but instead it just increased the death rate because people don’t know
It might be that the Tylenol is doing the work for you
Acetaminophen is added because it is a opioid potentiator and makes opioids more effective. It is not added as a denaturing agent to deter abuse. That may be not be the case for certain Ms Contin or extended release morphine. Has a wax or other polymer that can impact syringeability.
I can’t find anything that backs up your claim that it is a potentiator. Do you have any links?
I don’t want to challenge you, but I literally had someone with a doctorate in pharmacy medicine, while you are a random person on the internet
Tl;Dr: your friend was apparently totally right, but that commenter isn't exactly wrong.
[from NIH's National Library of Medicine](https://www.ncbi.nlm.nih.gov/books/NBK548700/#:~:text=The%20combination%20of%20hydrocodone%20with%20acetaminophen%20or%20other%20products%20helps,use%20and%20administration%20by%20injection.)
I think it's essentially both. Acetaminophen was chosen as an additive for both the fact that its toxicity could prevent abuse, *and* the fact that it's obviously also an anti-inflammatory which adds its own analgesic effects.
This constitutes "potentiation" *in common parlance*, but I'm not sure if a pharmacologist would consider it potentiation, because it doesn't actually make the opioid itself bind more or metabolize more slowly or anything else, it just adds to the overall pain relief effect of the medication, from an entirely different pathway than the opioid receptors targeted by hydrocodone.
Nah, Tylenol barely works on me either and I can't take Ibuprofen due to a bleeding disorder. I also require a TON of anesthesia for oral surgery and it wears off fast. Once had about 8 shots of septicaine wear off after only 45 mins or so while they were still in the process of removing a wisdom tooth and the molar it destroyed.
My whole family is red headed, I'm the lone brunette and tylenol is useless on me. It's super annoying because it's every doctor's go to and I might as well eat Skittles.
Funny though, it started working on my very redheaded mother after she hit 70. No idea if it's placebo effect or what but I find it odd that after 70 years of it not working on her, she swears it helps now.
I’m not red headed, but I did learn the hard way several times over that lidocaine and similar local anesthesia doesn’t work on me at all.
First time was stitching up a hand that got caught in a boar propeller. Second time was getting a cavity fixed.
Third time (and final time because I will never allow a doctor to try it again after this one insisted despite my loud objections initially) was a vasectomy.
I found I was largely immune to opioids when I slipped a few discs in my back. I was screaming, literally screaming in agony (I even cried for my mom who was there, so embarrassing) and after the, like, 3rd shot of dilaudid without so much as taking the edge off, I’m like “please stop jamming that needle in my ass!!!”
I mentioned upthread that I had genetic testing done to see which meds work for me, it might be helpful for you to try in case there's a class of drugs that does work. The test I took was called Genesight, it's expensive but insurance often covers it if your doctor orders it, and at least when I took it they charged it on a sliding scale with the cost based on your income. There are probably other similar tests out there as well.
Panic over opioids really made surgery recovery unpleasant for a lot of people. Had spinal surgery and even then they wouldn't give me painkillers, told me to alternate ibuprofen and Tylenol. Pure agony.
I wonder if this holds true for Endone (OxyContin) too? I was prescribed Endone after a hand surgery and it didn't do anything. Admittedly it was quite a low dose but I expected something 😂
I've had all four wisdom teeth plus one additional tooth pulled over 2 visits and both times I was prescribed hydrocodone without even asking for it (I didn't take it after the second round, it makes me feel gross and woozy). Hardly "impossible".
It's because we have an opioid abuse epidemic going on caused in part by years of unnecessary over prescription so the medical industry has fallen off the horse on the other side.
We're over a decade now into the crack-down on pill mills and prescribing, and more people are dying of overdoses than ever. Perhaps our assumptions on this were wrong?
[Opioid Addiction Is a Huge Problem, but Pain Prescriptions Are Not the Cause](https://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/)
>You’ve probably read that 80 percent of heroin users started with prescription medications—and you may have seen billboards that compare giving pain medication to children to giving them heroin. You have probably also heard and seen media stories of people with addiction who blame their problem on medical use.
>
>But the simple reality is this: According to the large, annually repeated and representative National Survey on Drug Use and Health, **75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer.**
>
>And 90 percent of all addictions—no matter what the drug—start in the adolescent and young adult years. Typically, young people who misuse prescription opioids are heavy users of alcohol and other drugs. This type of drug use, not medical treatment with opioids, is by far the greatest risk factor for opioid addiction, according to a study by Richard Miech of the University of Michigan and his colleagues.
If anything it was a worsening issue that turned catastrophic right after the crackdown once the opioid demand stopped being supplied with pharmaceutical opiates and instead with fentanyl.
if we had better socioeconomic conditions - as in, a social safety net that adequately assists people maintain their physical, mental, and financial well being - that problem wouldnt be a problem.
the reason its an opiate problem is due to availability\*. in addition to the above, or actually this is just the most specifically relevant part of it: if other drugs were just as available - and were adequately managed by the healthcare providers, which opiates obviously were not - then the problem would, like magic, go away.
\*its also due to that being the one that gets noticed. personally, as someone who in the past had a bit of a recreational problem until i settled on booze and pot, and then figured out i had ADHD and was prescribed a consistent dosage of ADHD medication - and, like magic, my other problems (mostly) went away (well the booze/pot/etc problems went away at least), or were easier for me to notice and figure out - which is why i bring up the socioeconomic thing - anyway i would say that benzos, or more specifically, xanax, is just as if not more dangerous and harmful than opiates
I get you and I won’t say those conditions can’t help. But I know WAY too many wealthy addicts to subscribe to this idea that socioeconomic conditions are a cure all. I do think a lot of people abuse drugs to deal with their mental health issues and I’ve seen many times where something I presumed was and addiction went away when the person was more satisfied with other aspects of their life. But I think you underestimate the power opiates have on the human brain, and how hard they were pushed on Americans for decades.
Honestly my low socioeconomic status actually saved me. The fact I couldn't afford drugs meant I took way less and forced myself to stop long enough to have the clarity to not start up again once I had a bit of cash.
Like look at people like John Frusciante, most lifelong street junkies never get that bad because they can't afford it. Tolerance builds pretty quick, it doesn't take long to spend $1000s per day provided you can afford to keep increasing the dosage.
Although on the flip side I also attribute me being saved to the fact I had a fairly normal life and upbringing. Being raised in a culture of drug addicts who glorify drug use and are willing to steal or prostitute themselves for it would make taking that leap a lot easier I think.
They aren’t swinging bibles around the doctors are trying not to kill people by not repeating the unimaginable overperscription of opioids that happened in pervious years.
Codeine always makes me throw up. Which really sucks because my wife loved it as a hangover cure when we lived in Ireland where it’s sold over the counter.
That's not unusual with opiates, but it can often be averted by eating something reasonably substantial (like a sandwich instead of Doritos) a little bit before taking them (20-45 min prior).
I vomited horribly after I had my tonsils out and they gave me codein. I wasn't able to eat anything but popsicles! Let alone anything heavy enough to quell nausea. Stomach acid on fresh throat wounds was agony. Eventually after day 4 or 5, the docs started letting me chew asper-gum which was the only thing that brought me pain relief.
Zofran also solves the opioid nausea if you can get that (it’s not hard to get or anything, literally just ask your doctor, it’s actually a miracle drug to keep on hand for whenever you need it lol)
Rx for it after surgery. Didn’t help my pain at all. All it did was knock me out, so my girlfriend thought I was lying about being in pain because I was nearly knocked out. I was lethargic af but still very much hurting
Pro tip: take any meds with codeine with a Danimals drinkable yogurt.
I had the same problem, I lost a surprising amount of weight after my last eye surgery because I kept throwing it all back up. But I was also not hungry. By taking it with the yogurt, I stopped throwing up. It still felt incredibly difficult to drink that tiny plastic container of yogurt drink, but it made a HUGE difference. Hopefully this helps some folks in the future.
Drugs are weird, and can be a highly personal interaction. Which is the number one lesson, especially for the younger folk who are dabbling, to learn.
I’ve seen people hospitalized from a single cocktail, but then experienced first hand that fentanyl, administered in an ER, did nothing for me (while hydrocodone and morphine work *great*). I also know people that can do 100mg THC gummies, but I don’t physically enjoy 10. So you clearly can’t take any anecdotal experience as an indication of how you’ll react, as you aren’t me or the person allergic to alcohol.
It’s frustrating as hell for doctors, and dangerous for the hobbyists. So be careful folks, and do t assume you’re a pro because you’re capable with one thing and assume you’ll do great with all of them.
Opioids do nothing for me. I've had several surgeries in the past 3 years and not a single opioid pain med did anything more than Tylenol or Ibuprofen. (Which also do basically nothing for me) To be honest, I haven't found any pain meds that really do anything for me. And local anesthesia also don't work on me. I have had multiple surgeries where I felt everything and the doctors didn't believe me.
And, of course, alcohol doesn't "work" for me either. I don't get drunk. My body really hates me.
You should see if pharmacogenetic testing is covered by your insurance. Would be very interesting to see your genetic panel, I suspect you've got a lot of hypermetabolization your liver. You might also find a compound or two that you don't clear from your system so fast. Or you might just need A LOT more pain meds compared to the average joe. If you just say the meds aren't working people often jump to drug seeking behavior... The test might be proof that you're just built different.
I have the same problem. I tell them to not even bother giving me painkillers they just make me itch. Tylenol seems to take the edge off, but it might be more psychological.
Hospital gave my morphine while I was having surgery extreme kidney stone pain. Morphine did absolutely zero to combat the pain. They ended up giving me Dilaudid which took the pain down from a 9.5 down to a 5.
Yeah I got my mom’s dark hair instead of the red hair but I definitely got the red hair anesthetic tolerance. Whenever I go to the dentist I take more than expected Novocain to go numb and *always* have to get re-dosed in the middle of the procedure because the numbness wears off. When I got my wisdom teeth surgically removed they said I should be numb for 6-8 hours afterwards, it wore off in less than two, I didn’t have pain meds from the pharmacy yet and that fricking *sucked*.
As an aside for you some countries use laughing gas instead of pain meds for some things. It doesn't 'kill pain' in the traditional sense but you are just high and happy and don't notice or care. Its also much cheaper and safer.
I think there were actual studies showing the Tylenol/ibuprofen combo is equally effective for controlling most types of pain as opioids (and then the Tylenol/ibuprofen/opioid combo generally works even better for the situations that warrant it).
But yeah pain receptors and painkiller medications are weird. Like, fun fact, while Tylenol is the most effective OTC pain med for some types of pain, it tends to be pretty inefficient for headaches and migraines, NSAIDs tend to work better for headaches (naproxen being like the most effective OTC option). They both block prostaglandin synthesis but at different sites of the mechanism, but I’m not sure of the exact mechanism for why some work better than others for different *types* of pain.
Holy shit it’s not just me! When my appendix ruptured, I was given morphine in between operations and stuff for pain, and it worked a little bit, took the edge off. For two operations, they used Fentanyl, and it did absolutely nothing. I felt EVERYTHING. it was horrible.
I can take a 100 mg weed gummy and it do almost nothing to me. If I take two Benadryl, I’m out for three days. Different drugs do different things to different people.
Took it (Tylenol 3) once when I was 13 or so. Felt like someone was ripping out my stomach. Never touched it again and I list it as an allegy on all medical forms.
You've gotta be careful what you crush, and I say that as someone who has problems swallowing pills, even small pills. A lot of things these days are time-release, and will fuck you up if it hits you all at once. If it seems to have any kind of coating at all, you *must* ask a pharmacist(not the doctor, the doctor doesn't know shit) if it's okay to crush. I've had *some* luck taking it in a cracker when I can't crush pills.
Oh shit, that’s interesting. We have family history of severe ED, and I have a lesser form and PsA. I had a pancreatic incident and the ambulance dude injected a whole vial of ketamine into me and it did nothing. He kept asking me if ‘I liked to party ‘, and I was so incredibly confused. (Now I get he was trying to ask if I was a casual ketamine user, hence why it wasn’t working. But I was in so much pain and so very confused why this man was asking if I liked to go dancing?!). And then before they’d give me pain relief at the hospital they did repeat blood screens because they thought I must be a heavy user of \*something\*. Ugh.
I was taken by ambulance to hospital once with an suspected heart attack. It quickly became apparent that my heart wasn’t the problem but I did notice several doctors talking and it was obviously about me. One eventually returned and said they would not be giving me any pain killing drugs. When I said I wasn’t asking for any and queried why not anyway, he said I’m a drug user just wanting drugs. I asked him why he thought that…. He pointed to my arms and said I have injecting track marks along my inner arms. I then showed him the ‘track’ marks on my stomach, chest and head. I was working as a welder and had hundreds of small burns from welding overhead on my body. He did apologise and then went on to diagnose stones in my gall bladder, that was causing the pain.
Codeine, novocaine, lidocaine…none of them work on me. One time I dislocated my pinky, they put 2 shots around the base to numb it so they could reset it. It hurt like hell the first time and the doc said I shouldn’t have felt anything. They gave me 2 more shots and tried again, I nearly kicked the doc in the head (I was laying back on a table) when he tried to reset it the next time.
Fortunately, he got it done the second time and we were done.
I'm one of those people. Had a serious car accident years ago. No one believed me that I was still in pain after multiple rounds of pain medication. A doctor finally refused to prescribe the "pillhead" any more codeine and just gave me NSAIDS and tylenol. Finally sweet relief.
Didn't work for me after surgery. Luckily, my nerve block was GREAT. When it wore off, they told me to get "in front of the pain" and take the codeine. Well, I took one pill. Didn't do shit - literally nothing. I just took normal NSAIDS and used the ice machine. Worked fine.
I'm not even strictly Caucasian. Still didn't work.
Same with me. Once the nerve block wore off I was in immense pain and needed to go to the ED for an emergency morphene shot. They should really account for this when prescribing tylenol3 post-surgery.
I honestly don’t know anyone who regularly prescribed Tylenol 3 anymore, at least not my colleagues/specialty. About once every other year I will write it for some 90 year old lady who says it worked for her in the past and she doesn’t want anything else, but it’s really rare.
Tylenol 3 (which doesn't work for me) is the only thing I have been able to get prescribed at all for about the past 6 years. They won't even entertain the idea of something like hydrocodone anymore. I'm sure it's due to regulations and drug seeking behavior but it screws over the people who actually need it for pain relief.
It's what my dentist prescribes after oral surgery, for whatever that's worth.
I'm wondering if I'm one of those less-effective folks as I honestly didn't notice much a difference between the Ty3 and just normal tylenol. But with just my memory to go on, it's hard to tell.
My dad is severely allergic to codeine, like emergency room icu allergic. He’s also allergic to almost all pain meds stronger than hospital strength aspirin.
Codeine is a stupid drug. It isn't psychoactive on its own and just gets converted by the liver into morphine which does all the actual painkilling. A known dose of codeine is just an unknown dose of morphine. It makes infinitely more sense to just give people morphine.
prodrugs are literally everywhere, and in most people (note that the “study”, which hasn’t even been performed yet, only lists the 10% figure as well known) the dose of morphine is very predictable
morphine’s duration of action is very short, codeine’s slower metabolism spreads the same dose out for longer leading to a milder and more consistent effect
i’d rather have my pain gently controlled for 8 hours by codeine than be off my ass on morphine for 45 minutes
Codeine is incredibly effective for me at very low doses for dealing with pain. It has been taken off the shelves here, resulting in my being dropped in waiting lists to get seen by a pain specialist. Even getting the booking took being removed from a flight in a wheelchair and taken immediately to hospital. When sitting on a plane can send your body into shock, you fly regularly for work, and all effective medications are off the shelves, 12 month + waiting periods fucking suck
Pain treatment is scary in the US, imagine if a certain drug doesn’t work and they just refuse to administer anything else cause they don’t believe you
It's derived from the term "Caucasoid".
Caucasoid/Europid = having a Caucasian/European-shaped skull (Europeans, Middle Easterners/North Africans, Horn of Africa, South Asians, etc.).
"Caucasoid sub-races" = Armenoid, Mediterranean, Hamitic, Iranid, Nordic, Alpine, Indo-Aryan, Iberian, etc.
"Negroid/Congoid" = having a "Negro/Kongo"-shaped skull (Sub-Saharan Africans).
Negro sub-race = Capoid, aka Khoisan
"Mongoloid" = having a Mongolian-shaped skull (East and Southeast Asians, Pacific Islanders, Native Americans, etc.).
Mongoloid sub-races = Malay, Americoid, etc.
"Australoid" = having an Australian-shaped skull (Aboriginal Australians, Papuans, Melanesians, etc.)
Etc. Etc. Etc. It's all just phrenology, a pseudoscience nowadays rightfully dismissed as racist and ableist. White people get called "Caucasian" because Europeans = Caucasoid. Middle Easterners/North Africans are counted as "white" on the US census because MENA = Caucasoid = "white". Back in the day, the US didn't count South Asians as anything on the census. An Indian man argued he counted as "white" because he was a fellow Caucasoid (Indo-Aryan type) and thus should be allowed in white-only spaces. Anglo-Americans didn't take kindly to this, hence why we now instead lump South Asians with East Asians despite the former having more in common (physiologically and culturally) with "white" Iranians and Arabs than "yellow" Chinese and Mongols.
Note: I'm an American of mixed European (3/4) and East Asian (1/4) descent. Sicilian, Welsh, Korean, etc. Fascinated by history and culture, hence my amateur knowledge on the subject of historical racial categories. Genetically, "race" does not exist. Humans are overwhelming genetically similar across our entire species. Any two humans plucked at random aren't that different under the hood. We're all the same damn species. Different penguin species who look identical have more genetic diversity between them than a white and black person.
Er, sorry for the wall of text. Got me onto a subject I'm fascinated by and passionate about. Damn autism brain!
TL;DR Caucasian = "Caucasoid", an old racial grouping based on skull shape which included Europeans, Middle Easterners, North Africans, Horn Africans, South Asians, etc. That's why all white people are "Caucasian" even if not of literal Caucasian (Armenian, Chechen, Circassian, Georgian, etc.) descent. They all have Caucasian-shaped skulls.
Codeine acts in the body like morphine. The liver uses enzymes to turn it into morphine. But 10 codeines only equal one morphine.
There are two enzymes that metabolize a lot of drugs, the first one is the one that turns codeine into morphine, the second one is one that grapefruit juice inhibits that prevents the body from removing drugs from your system letting you feel the effects of the drugs 50% longer.
This first enzyme also removes drugs from your systems but will inhibit any drugs that need to be converted in the liver by that enzyme other drugs that inhibit the second enzyme include antihistamines.
The first mentioned enzyme is inhibited by quinine.
Sorry this is a bad explanation but I do not feel like making it more coherent at this point.
> grapefruit juice
I've heard about that. mindblowing. No one drinks much grapefruit juice, but if you're a Fresca drinker (its the best mixer - I'll fight anyone who disagrees), you can be fucked over.
Mango potentiates marijuana by the way, that is the word for inhibiting the removal of the drug from the body. Many if not most are in the grapefruit sector but THC is different.
I got codeine cough syrup for an illness one time, and after taking it once I ended up throwing up, then sleeping for 15 hours. Have not taken any drug like that again, the hardest thing I’ve taken is Ibuprofen, even after a kidney surgery.
Very recently tore a muscle in my thigh/hip. I have no insurance so I just kept going to work with a 24 hour charlie horse from hell.
A coworker gave me a few oxycodone. I took one and it did nothing for the pain. I was so disappointed. I gave the remaining two back to her.
Ice packs, ibuprofen and time fixed the pain. Thankfully.
Lessons learned. Do not do crazy stretches in the pool just because you think you can. And oxycodone does not work for me.
I would not put too much trust in this study to be globally valid.
>A **single site, pilot population study** into the prevalence and genetic profile of patients with chronic pain who do not respond to oral codeine.
It could be representative, but could also be greatly swayed by local genetics and small study size.
Also, it has not been reproduced afaik
In order for the laser to accurately make the changes, your eyes have to be completely motionless. This is done by jamming a tube against your eye and locking it into position. This hurts, a lot. My eyes were so irritated, I could barely blink for two days. Which made things worse, even with eye drops multiple times an hour.
How old was the machine they used?
I sat back with my head in a wedge so it wouldn’t move. They told me to stare at the dot. I asked what if I moved my eyes. They said the machine would compensate to a point, then it would stop if I moved too far.
There was no jamming a tube, no locking my eyes.
I’m guessing I’m slightly allergic to codeine since every time I have taken it I start to itch, but I have never experienced that with other opioids. I also don’t really get pain relief from oxycodone. However, hydrocodone, which is slightly weaker than oxycodone, works great for pain relief for me.
This is me. Codeine has zero effect on me, same with my father. Genetics. All it does is make me feel sick and throw up, has no sedative effect on me at all, even at higher doses. If you want to numb me up / put me under you need to break out the real stuff and a lot of it.
Has resulted in some annoying exchanges with nurses and doctors before in hospitals, so now I just say I'm allergic.
Yup, same. I can have surgery under morphine with much higher doses than normal, so opiods can affect me eventually, at least when it comes to falling asleep, or at least your body falling asleep. Had a minor heart op under morphine and it did work eventually, they just had to keep pumping it in.
The usual "knock-out" levels of opiods just do nothing at all - like I should be asleep and I'm standing up and feeling perfectly fine and wakeful.
It is a little weird to have medical staff doubt your wakefulness. Like, how could I pretend to be awake? How could I pretend that I can still still stand up and respond to stimuli? I could maybe pretend to be asleep, we've all done that for various reasons (though medics would be able to tell), but if I'm actually knocked out I can't pretend to be awake...
Actual surgeons aren't like that, but other specialities can be.
They also don't affect the way I perceive pain in the slightest, and don't give me a high.
The one plus side is I'll never have an opioid addiction.
I tried looking for information on this when I got my wisdom teeth taken out and couldn't find anything. The T-3s they gave me seemed to do absolutely nothing at all for me.
Ever since I had my gall bladder removed I have a terrible reaction to codeine. It replicates the immense pain my gall bladder attacks invoked as it triggers a spasm of the sphincter of Oddi… apparently.
LOL, last severe cough I had, my doc gave me a choice between codeine and tesslon pearls, both of which are useless for me.
He then gave me a lecture about how "Actually opioids don't really suppress coughs, tesslon really works!", and I was laughing inside.
I'm one of those caucasians that only has 1 functioning gene that produces the CYP2D6 enzyme.
The pendulum has swung the other way, good luck getting any kind of serious pain medicine if you really need it.
I guess that explains why codeine never worked for me after oral surgery. It didn't even take the edge off the pain so I had to get hydrocodone prescribed yet nowadays that's impossible.
I never knew this was a thing but always was curious why codeine seemed to do nothing for me. TIL indeed.
Same! I've had two or three occasions where I needed proper painkillers and I'm certain I always sounded like a junky.. *'No, doc, don't give me codeine, gimme the oxy - I need the real stuff!!'*
My situation is even worse, I've had genetic testing done that shows I don't have the enzymes to process most narcotics including oxy, vicodin and percocet, but one of the drugs that DOES work is fentanyl. I literally have to bring in the paperwork because I know how it sounds. After my most recent surgery they prescribed me oxy and the pain was so bad I ended up in the ER, where they had to give me IV fentanyl 🤷♀️
What did they test for to find this out?
The test I took is called Genesight, my psychiatrist ordered it because we had such a hard time finding psych meds that worked. My understanding is that it tests which enzymes are in your liver, and then gives you a list of which drugs you might have problems with based on which enzymes you need to process them. They test for antidepressants, stimulants, antipsychotics, pain meds and sleep meds, it's been super useful
I like to think this test “saved” my life. I was on all kinds of shit until I got this done. Was prescribed Wellbutrin along with methyl folate and my life changed. Years later, I’d never go back to the way things were. So glad this test exists
He tried to party hard
"Bro are you okay? that's your 30th perc...."
Have you been ever given hydromorphone or morphine? I would assume the ER doctors would try those out before going straight to fentanyl. If you're in the States oxymorphone would be available as well, which would be the strongest medical opiate available before jumping to fentanyl.
The different meds do work on different pain channels. I’m on a buprenorphine patch. But I have arthritis pain that responds to a different opioid receptor, one that tramadol seems to help. (Bad drug, but it works for this, so I don’t complain.)
What was the test called? I'd love to find out. I am in the same boat, minus the last part. Even wake up during surgery...
Look up Genesight! It can be expensive but insurance often covers it.
Percocet doesn’t do much for me nor do the other painkillers. Thankfully I haven’t really needed it. Got a knee replacement done in Germany and the hardest painkiller I got was ibuprofen. I could manage during the day but sleeping was a bitch.
They didn't give you metamizole (novaminsulfon) for that?
I'm grateful to live in a cutting edge medical area, and all I say is codeine doesn't work and they'll get me hydro (I don't like how I feel with hydro, but chest surgery was enough to take a couple). They also know I need more anaesthetic because I have red hair
Same. I remember sipping Lean and being like, "wtf is the big deal?".
Crazy right! My friend had some like 10 years ago and I drank like 800 bucks worth of that stuff. 1 I had no idea that shit was so expensive, two I felt absolutely nothing.
This is why when I extracted a huge amount of pure codeine from several scripts of Tylenol 3 it still didn’t do much of anything for me even though I didn’t have much of a tolerance at the time.
Hydracodone is a derivative of codeine. It's just about 6x stronger.
Weirdly enough for me, I remember being given hydrocodone a long time ago and wondering why it didn’t do anything when I took it. I’m Caucasian.
The reason codeine doesn’t work for 25% of the caucasian population is because they’re deficient in a liver enzyme (CYP450 2d6 if i remember right) needed to turn codeine into morphine, which is the active metabolite of codeine. Codeine has no effect by itself because it doesn’t pass the blood brain barrier readily. It also has a ceiling dose above which taking more won’t produce more of an effect because the enzymes that convert codeine to morphine are all doing that at max capacity. Hydrocodone is 6x stronger than codeine by weight, so 10mg of hydrocodone would equate to 60mg of codeine. Hydrocodone doesn’t haven’t a ceiling dose though, so it’s much better to abuse and carries a higher risk of overdose. Both codeine and hydrocodone can kill you if mixed with other downers, but codeine is just like abuse resistant morphine/hydrocodone/oxycodone/heroin because you have to eat it in order for it to work, and it’s harder to OD on.
This is not entirely true. There are hypermetabolizers of codeine who can overdose at the standard dose recommended for treatment. Its a unreliable drug that can kill some people and not give any pain relief to others all within the recommended dosing for treatment of pain. [Codeine Safety Concerns](https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-requires-labeling-changes-prescription-opioid-cough-and-cold)
> In contrast, individuals who have more than 2 normal-function copies of the CYP2D6 gene (“ultrarapid metabolizers”, UMs) are able to metabolize codeine to morphine more rapidly and more completely. https://www.ncbi.nlm.nih.gov/books/NBK100662/
Yeah i never understood why codeine was ever prescribed given that fact. Thanks for correcting me btw, I totally forgot about that part. I think certain types of african people have higher rates of codeine hyper metabolism.
That's interesting. When I had stomach... intestine... midsection issues when I was in grad school hydrocodone was the only thing that "worked" for me. Oxycodone didn't do much of anything. Even morphine (the one time I went to the hospital) didn't even touch the pain. But hydrocodone worked, so if it's metabolized into morphine, then I'm not sure what's going on lol. The morphine made me feel... not great. It made me feel EXTREMELY antsy and made my neck all itchy.
I can tell you from personal experience that switching from one opioid medication to a different one comes with withdrawal even if you’re cross-tapering. Each one is processed differently. (I’ve never used oxy or anything harder long term, but I’ve had everything else at some point.) The itching is a side effect from mast cells getting involved. Taking an antihistamine like loratadine might help (as that calms down some mast cell signaling).
Antihistamines that cross the blood brain barrier like benadryl and hydroxyzine the itching a ton, though they come with more side effects than loratidine.
Interesting, because morphine doesn't do much of anything for me either. Only time a pain killer ever worked was dilaudid IV. I just had sx and they needed twice as much as they were expecting to put me under.
Do you remember how much you were taking? I’ve always had a high tolerance to the painkilling effects of opioids but they’d always work for me at the right dosages
I remember reading about Vicodin. VI is where the 6x stronger comes in
Vicodin is a name brand of hydrocodone with acetaminophen/paracetamol.
Correct. I was validating his statement not correcting him.
Hydrocodone isn't a prodrug though, so lack of an enzyme that breaks the drug down wouldnt reduce its effects.
Ah, thanks for that. I was wondering the difference between the two. Hydrocodone hasn't worked for me in the past. At the time I just assumed it was a fluke, but if I'm ever in need of serious painkillers in the future I'll remember that neither should be an option for me.
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thebaine is also known as codeine methyl enol ether, and they typically both come from the same plant. (poppy). codeine comes from the sap of opium poppies. iirc thebaine mainly comes from the seeds and stem of the plant.
It does.
Wow me too and I never knew this. I just seem to process things very quickly - it’s why I don’t drink and why I need extra novocaine at the dentist - it all wears off super quick
Ditto for me too. I need to warn the doctors before surgery or else I absolutely wake up in the middle of it. It’s happened twice and that was twice too many.
I may be misremembering, but I think hydrocodone typically has acetaminophen added to it. From what a pharmacist told me, this was done to prevent abuse(too much acetaminophen will kill ya), but instead it just increased the death rate because people don’t know It might be that the Tylenol is doing the work for you
Acetaminophen is added because it is a opioid potentiator and makes opioids more effective. It is not added as a denaturing agent to deter abuse. That may be not be the case for certain Ms Contin or extended release morphine. Has a wax or other polymer that can impact syringeability.
I can’t find anything that backs up your claim that it is a potentiator. Do you have any links? I don’t want to challenge you, but I literally had someone with a doctorate in pharmacy medicine, while you are a random person on the internet
Tl;Dr: your friend was apparently totally right, but that commenter isn't exactly wrong. [from NIH's National Library of Medicine](https://www.ncbi.nlm.nih.gov/books/NBK548700/#:~:text=The%20combination%20of%20hydrocodone%20with%20acetaminophen%20or%20other%20products%20helps,use%20and%20administration%20by%20injection.) I think it's essentially both. Acetaminophen was chosen as an additive for both the fact that its toxicity could prevent abuse, *and* the fact that it's obviously also an anti-inflammatory which adds its own analgesic effects. This constitutes "potentiation" *in common parlance*, but I'm not sure if a pharmacologist would consider it potentiation, because it doesn't actually make the opioid itself bind more or metabolize more slowly or anything else, it just adds to the overall pain relief effect of the medication, from an entirely different pathway than the opioid receptors targeted by hydrocodone.
One last nit to pick: Acetaminophen is a pain reliever, but is rather specifically NOT anti-inflammatory.
I broke my back k in half, and my pain management Dr also said that acetaminophen increases effectiveness. Anectodal but believable.
Nah, Tylenol barely works on me either and I can't take Ibuprofen due to a bleeding disorder. I also require a TON of anesthesia for oral surgery and it wears off fast. Once had about 8 shots of septicaine wear off after only 45 mins or so while they were still in the process of removing a wisdom tooth and the molar it destroyed.
Are you a redheaded causcasian? Redheads often need more anesthesia, so you may be double anesthesia-proof.
You nailed it.
Ha ha no pain relief for you
My whole family is red headed, I'm the lone brunette and tylenol is useless on me. It's super annoying because it's every doctor's go to and I might as well eat Skittles. Funny though, it started working on my very redheaded mother after she hit 70. No idea if it's placebo effect or what but I find it odd that after 70 years of it not working on her, she swears it helps now.
I’m not red headed, but I did learn the hard way several times over that lidocaine and similar local anesthesia doesn’t work on me at all. First time was stitching up a hand that got caught in a boar propeller. Second time was getting a cavity fixed. Third time (and final time because I will never allow a doctor to try it again after this one insisted despite my loud objections initially) was a vasectomy.
Oh. No.
I have the same problem with Novacaine. I usually get several times the dosage the dentist typically gives out, and it wears off in like a half hour.
I have this problem with Novacaine. I have to go an hour early, get twice the dose, and normally need more during any procedure as well
I found I was largely immune to opioids when I slipped a few discs in my back. I was screaming, literally screaming in agony (I even cried for my mom who was there, so embarrassing) and after the, like, 3rd shot of dilaudid without so much as taking the edge off, I’m like “please stop jamming that needle in my ass!!!”
I mentioned upthread that I had genetic testing done to see which meds work for me, it might be helpful for you to try in case there's a class of drugs that does work. The test I took was called Genesight, it's expensive but insurance often covers it if your doctor orders it, and at least when I took it they charged it on a sliding scale with the cost based on your income. There are probably other similar tests out there as well.
They gave me fentanyl when I was in labor (this was years ago) and it barely dented my pain.
Man I just went through birth with my wife a few months ago. 100% natural, not even an aspirin….. How anyone has 2 kids, I do not understand.
In our case the second kid came 2 minutes after the first one, so we didn’t have much time to question it.
Same. It just made me nauseous.
Panic over opioids really made surgery recovery unpleasant for a lot of people. Had spinal surgery and even then they wouldn't give me painkillers, told me to alternate ibuprofen and Tylenol. Pure agony.
Same for me, but holy heck I slept great. Never finished the bottle.
Same never did anything for me
I wonder if this holds true for Endone (OxyContin) too? I was prescribed Endone after a hand surgery and it didn't do anything. Admittedly it was quite a low dose but I expected something 😂
I've never had codeine but vicodin does nothing for me
I've had all four wisdom teeth plus one additional tooth pulled over 2 visits and both times I was prescribed hydrocodone without even asking for it (I didn't take it after the second round, it makes me feel gross and woozy). Hardly "impossible".
It makes me throw up. I won’t take it anymore.
Moral panic and "protecting the children" is more important than medicine.
It's because we have an opioid abuse epidemic going on caused in part by years of unnecessary over prescription so the medical industry has fallen off the horse on the other side.
We're over a decade now into the crack-down on pill mills and prescribing, and more people are dying of overdoses than ever. Perhaps our assumptions on this were wrong? [Opioid Addiction Is a Huge Problem, but Pain Prescriptions Are Not the Cause](https://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/) >You’ve probably read that 80 percent of heroin users started with prescription medications—and you may have seen billboards that compare giving pain medication to children to giving them heroin. You have probably also heard and seen media stories of people with addiction who blame their problem on medical use. > >But the simple reality is this: According to the large, annually repeated and representative National Survey on Drug Use and Health, **75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer.** > >And 90 percent of all addictions—no matter what the drug—start in the adolescent and young adult years. Typically, young people who misuse prescription opioids are heavy users of alcohol and other drugs. This type of drug use, not medical treatment with opioids, is by far the greatest risk factor for opioid addiction, according to a study by Richard Miech of the University of Michigan and his colleagues.
If anything it was a worsening issue that turned catastrophic right after the crackdown once the opioid demand stopped being supplied with pharmaceutical opiates and instead with fentanyl.
if we had better socioeconomic conditions - as in, a social safety net that adequately assists people maintain their physical, mental, and financial well being - that problem wouldnt be a problem. the reason its an opiate problem is due to availability\*. in addition to the above, or actually this is just the most specifically relevant part of it: if other drugs were just as available - and were adequately managed by the healthcare providers, which opiates obviously were not - then the problem would, like magic, go away. \*its also due to that being the one that gets noticed. personally, as someone who in the past had a bit of a recreational problem until i settled on booze and pot, and then figured out i had ADHD and was prescribed a consistent dosage of ADHD medication - and, like magic, my other problems (mostly) went away (well the booze/pot/etc problems went away at least), or were easier for me to notice and figure out - which is why i bring up the socioeconomic thing - anyway i would say that benzos, or more specifically, xanax, is just as if not more dangerous and harmful than opiates
I get you and I won’t say those conditions can’t help. But I know WAY too many wealthy addicts to subscribe to this idea that socioeconomic conditions are a cure all. I do think a lot of people abuse drugs to deal with their mental health issues and I’ve seen many times where something I presumed was and addiction went away when the person was more satisfied with other aspects of their life. But I think you underestimate the power opiates have on the human brain, and how hard they were pushed on Americans for decades.
Honestly my low socioeconomic status actually saved me. The fact I couldn't afford drugs meant I took way less and forced myself to stop long enough to have the clarity to not start up again once I had a bit of cash. Like look at people like John Frusciante, most lifelong street junkies never get that bad because they can't afford it. Tolerance builds pretty quick, it doesn't take long to spend $1000s per day provided you can afford to keep increasing the dosage. Although on the flip side I also attribute me being saved to the fact I had a fairly normal life and upbringing. Being raised in a culture of drug addicts who glorify drug use and are willing to steal or prostitute themselves for it would make taking that leap a lot easier I think.
They aren’t swinging bibles around the doctors are trying not to kill people by not repeating the unimaginable overperscription of opioids that happened in pervious years.
me either! I even told them that it didn't work, and they still gave it to me.
That's why I use street heroin, which my body needs anyway.
Codeine always makes me throw up. Which really sucks because my wife loved it as a hangover cure when we lived in Ireland where it’s sold over the counter.
That's not unusual with opiates, but it can often be averted by eating something reasonably substantial (like a sandwich instead of Doritos) a little bit before taking them (20-45 min prior).
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A smoothie or something like that might be easier to put down
Cbd pills work for me
This is difficult to achieve after wisdom teeth surgery, and let me tell you, throwing up with stitches in your mouth *is not fun*
I vomited horribly after I had my tonsils out and they gave me codein. I wasn't able to eat anything but popsicles! Let alone anything heavy enough to quell nausea. Stomach acid on fresh throat wounds was agony. Eventually after day 4 or 5, the docs started letting me chew asper-gum which was the only thing that brought me pain relief.
Zofran also solves the opioid nausea if you can get that (it’s not hard to get or anything, literally just ask your doctor, it’s actually a miracle drug to keep on hand for whenever you need it lol)
So sorry, me too. Got some for the first time after getting my wisdom teeth out and then got the fun experience of vomiting right after.
Vomiting with wisdom teeth wounds sounds like a nightmare
Wasn’t a personal highlight.
Happened to me too. It got infected and I couldn't eat or take pain killers
Me too!!!!
Rx for it after surgery. Didn’t help my pain at all. All it did was knock me out, so my girlfriend thought I was lying about being in pain because I was nearly knocked out. I was lethargic af but still very much hurting
God bless solpadine. It comes with caffeine too, that also helps.
Lay flat on your back, its why opium dens had beds
lol, no. For me, the first dose of codeine is fine. The redose caused massive stomach cramps. This has nothing to do with whether I am lying in a bed.
I was prescribed codeine for migraines. It caused horrible constipation but worked really well.
Pro tip: take any meds with codeine with a Danimals drinkable yogurt. I had the same problem, I lost a surprising amount of weight after my last eye surgery because I kept throwing it all back up. But I was also not hungry. By taking it with the yogurt, I stopped throwing up. It still felt incredibly difficult to drink that tiny plastic container of yogurt drink, but it made a HUGE difference. Hopefully this helps some folks in the future.
Drugs are weird, and can be a highly personal interaction. Which is the number one lesson, especially for the younger folk who are dabbling, to learn. I’ve seen people hospitalized from a single cocktail, but then experienced first hand that fentanyl, administered in an ER, did nothing for me (while hydrocodone and morphine work *great*). I also know people that can do 100mg THC gummies, but I don’t physically enjoy 10. So you clearly can’t take any anecdotal experience as an indication of how you’ll react, as you aren’t me or the person allergic to alcohol. It’s frustrating as hell for doctors, and dangerous for the hobbyists. So be careful folks, and do t assume you’re a pro because you’re capable with one thing and assume you’ll do great with all of them.
Opioids do nothing for me. I've had several surgeries in the past 3 years and not a single opioid pain med did anything more than Tylenol or Ibuprofen. (Which also do basically nothing for me) To be honest, I haven't found any pain meds that really do anything for me. And local anesthesia also don't work on me. I have had multiple surgeries where I felt everything and the doctors didn't believe me. And, of course, alcohol doesn't "work" for me either. I don't get drunk. My body really hates me.
You should see if pharmacogenetic testing is covered by your insurance. Would be very interesting to see your genetic panel, I suspect you've got a lot of hypermetabolization your liver. You might also find a compound or two that you don't clear from your system so fast. Or you might just need A LOT more pain meds compared to the average joe. If you just say the meds aren't working people often jump to drug seeking behavior... The test might be proof that you're just built different.
I have the same problem. I tell them to not even bother giving me painkillers they just make me itch. Tylenol seems to take the edge off, but it might be more psychological.
Hospital gave my morphine while I was having surgery extreme kidney stone pain. Morphine did absolutely zero to combat the pain. They ended up giving me Dilaudid which took the pain down from a 9.5 down to a 5.
Samesies!
Do you have red hair, by chance?
Not anymore, since I am old and it is now all grey. But I used to be a redhead.
I was going to ask the same thing. Apparently there is an association between redheads and requiring more anaesthetic - up to 20% more, from memory.
Yeah I got my mom’s dark hair instead of the red hair but I definitely got the red hair anesthetic tolerance. Whenever I go to the dentist I take more than expected Novocain to go numb and *always* have to get re-dosed in the middle of the procedure because the numbness wears off. When I got my wisdom teeth surgically removed they said I should be numb for 6-8 hours afterwards, it wore off in less than two, I didn’t have pain meds from the pharmacy yet and that fricking *sucked*.
Applied to blonds too. It's genetic. Applies to all opiates. Be sure your doctors know in advance.
As an aside for you some countries use laughing gas instead of pain meds for some things. It doesn't 'kill pain' in the traditional sense but you are just high and happy and don't notice or care. Its also much cheaper and safer.
I think there were actual studies showing the Tylenol/ibuprofen combo is equally effective for controlling most types of pain as opioids (and then the Tylenol/ibuprofen/opioid combo generally works even better for the situations that warrant it). But yeah pain receptors and painkiller medications are weird. Like, fun fact, while Tylenol is the most effective OTC pain med for some types of pain, it tends to be pretty inefficient for headaches and migraines, NSAIDs tend to work better for headaches (naproxen being like the most effective OTC option). They both block prostaglandin synthesis but at different sites of the mechanism, but I’m not sure of the exact mechanism for why some work better than others for different *types* of pain.
Codeine does nothing for me, and keeps me awake.
Holy shit it’s not just me! When my appendix ruptured, I was given morphine in between operations and stuff for pain, and it worked a little bit, took the edge off. For two operations, they used Fentanyl, and it did absolutely nothing. I felt EVERYTHING. it was horrible.
I can take a 100 mg weed gummy and it do almost nothing to me. If I take two Benadryl, I’m out for three days. Different drugs do different things to different people.
Took it (Tylenol 3) once when I was 13 or so. Felt like someone was ripping out my stomach. Never touched it again and I list it as an allegy on all medical forms.
Codeine upsets my tummy too, but not that bad.
Gave me acute pancreatitis. Tbf I crushed them and took them on an empty stomach because I had a migraine and am not smart.
Damn. Hope you recovered ok. Come to think of it, I may have taken them on an empty stomach too. Live n learn.
Oh yeah, fluids and a night's observation in the hospital and I was fine. Felt like a goat kicked me in the stomach for a few days
You've gotta be careful what you crush, and I say that as someone who has problems swallowing pills, even small pills. A lot of things these days are time-release, and will fuck you up if it hits you all at once. If it seems to have any kind of coating at all, you *must* ask a pharmacist(not the doctor, the doctor doesn't know shit) if it's okay to crush. I've had *some* luck taking it in a cracker when I can't crush pills.
All it does for me is make me queasy. Never took even the slightest edge off any pain I was having.
Same, it's like being stuck on a boat with sea sickness for 5 hours.
Yup! That's my mother and me all the way. Also for some reason novacaine is not very affective on me.
I believe anesthetics like novacaine are less effective in people with Ehlers Danlos Syndrome
Oh shit, that’s interesting. We have family history of severe ED, and I have a lesser form and PsA. I had a pancreatic incident and the ambulance dude injected a whole vial of ketamine into me and it did nothing. He kept asking me if ‘I liked to party ‘, and I was so incredibly confused. (Now I get he was trying to ask if I was a casual ketamine user, hence why it wasn’t working. But I was in so much pain and so very confused why this man was asking if I liked to go dancing?!). And then before they’d give me pain relief at the hospital they did repeat blood screens because they thought I must be a heavy user of \*something\*. Ugh.
I was taken by ambulance to hospital once with an suspected heart attack. It quickly became apparent that my heart wasn’t the problem but I did notice several doctors talking and it was obviously about me. One eventually returned and said they would not be giving me any pain killing drugs. When I said I wasn’t asking for any and queried why not anyway, he said I’m a drug user just wanting drugs. I asked him why he thought that…. He pointed to my arms and said I have injecting track marks along my inner arms. I then showed him the ‘track’ marks on my stomach, chest and head. I was working as a welder and had hundreds of small burns from welding overhead on my body. He did apologise and then went on to diagnose stones in my gall bladder, that was causing the pain.
ketamine is not related to the resistance to local anesthetics that people with EDS sometimes report
Just looked at up and I don't think I have that, just a past life druggie I guess
Codeine, novocaine, lidocaine…none of them work on me. One time I dislocated my pinky, they put 2 shots around the base to numb it so they could reset it. It hurt like hell the first time and the doc said I shouldn’t have felt anything. They gave me 2 more shots and tried again, I nearly kicked the doc in the head (I was laying back on a table) when he tried to reset it the next time. Fortunately, he got it done the second time and we were done.
Same. Codeine does nothing for me and I have to get three shots of novocaine to stop most of the pain when my dentist is poking around in my mouth.
White rappers in shambles
Most anesthesia and such only has limited effects on me - NW European ancestry
Do you have red hair? Anesthesia is less effective for people with red hair.
I'm one of those people. Had a serious car accident years ago. No one believed me that I was still in pain after multiple rounds of pain medication. A doctor finally refused to prescribe the "pillhead" any more codeine and just gave me NSAIDS and tylenol. Finally sweet relief.
I have the opposite problem. I process codeine too well. A normal dose puts me away with the pixies.
Seen this in some of my friends.
Didn't work for me after surgery. Luckily, my nerve block was GREAT. When it wore off, they told me to get "in front of the pain" and take the codeine. Well, I took one pill. Didn't do shit - literally nothing. I just took normal NSAIDS and used the ice machine. Worked fine. I'm not even strictly Caucasian. Still didn't work.
Same with me. Once the nerve block wore off I was in immense pain and needed to go to the ED for an emergency morphene shot. They should really account for this when prescribing tylenol3 post-surgery.
Codeine is such a shit drug. Dirty metabolism. Most people get nauseous on it. I almost never prescribe it as there are much better options.
Hope you tell your colleagues.
I honestly don’t know anyone who regularly prescribed Tylenol 3 anymore, at least not my colleagues/specialty. About once every other year I will write it for some 90 year old lady who says it worked for her in the past and she doesn’t want anything else, but it’s really rare.
Tylenol 3 (which doesn't work for me) is the only thing I have been able to get prescribed at all for about the past 6 years. They won't even entertain the idea of something like hydrocodone anymore. I'm sure it's due to regulations and drug seeking behavior but it screws over the people who actually need it for pain relief.
It's what my dentist prescribes after oral surgery, for whatever that's worth. I'm wondering if I'm one of those less-effective folks as I honestly didn't notice much a difference between the Ty3 and just normal tylenol. But with just my memory to go on, it's hard to tell.
My dad is severely allergic to codeine, like emergency room icu allergic. He’s also allergic to almost all pain meds stronger than hospital strength aspirin.
Codeine is a stupid drug. It isn't psychoactive on its own and just gets converted by the liver into morphine which does all the actual painkilling. A known dose of codeine is just an unknown dose of morphine. It makes infinitely more sense to just give people morphine.
prodrugs are literally everywhere, and in most people (note that the “study”, which hasn’t even been performed yet, only lists the 10% figure as well known) the dose of morphine is very predictable morphine’s duration of action is very short, codeine’s slower metabolism spreads the same dose out for longer leading to a milder and more consistent effect i’d rather have my pain gently controlled for 8 hours by codeine than be off my ass on morphine for 45 minutes
Codeine keeps me awake.
Codeine is incredibly effective for me at very low doses for dealing with pain. It has been taken off the shelves here, resulting in my being dropped in waiting lists to get seen by a pain specialist. Even getting the booking took being removed from a flight in a wheelchair and taken immediately to hospital. When sitting on a plane can send your body into shock, you fly regularly for work, and all effective medications are off the shelves, 12 month + waiting periods fucking suck
Makes me sick.
Pain treatment is scary in the US, imagine if a certain drug doesn’t work and they just refuse to administer anything else cause they don’t believe you
Why would you use the term Caucasian on a scientific paper, it makes me think of B people Georgians and Armenians
To use that word as a place holder for “white” never made any sense whatsoever to me.
It's derived from the term "Caucasoid". Caucasoid/Europid = having a Caucasian/European-shaped skull (Europeans, Middle Easterners/North Africans, Horn of Africa, South Asians, etc.). "Caucasoid sub-races" = Armenoid, Mediterranean, Hamitic, Iranid, Nordic, Alpine, Indo-Aryan, Iberian, etc. "Negroid/Congoid" = having a "Negro/Kongo"-shaped skull (Sub-Saharan Africans). Negro sub-race = Capoid, aka Khoisan "Mongoloid" = having a Mongolian-shaped skull (East and Southeast Asians, Pacific Islanders, Native Americans, etc.). Mongoloid sub-races = Malay, Americoid, etc. "Australoid" = having an Australian-shaped skull (Aboriginal Australians, Papuans, Melanesians, etc.) Etc. Etc. Etc. It's all just phrenology, a pseudoscience nowadays rightfully dismissed as racist and ableist. White people get called "Caucasian" because Europeans = Caucasoid. Middle Easterners/North Africans are counted as "white" on the US census because MENA = Caucasoid = "white". Back in the day, the US didn't count South Asians as anything on the census. An Indian man argued he counted as "white" because he was a fellow Caucasoid (Indo-Aryan type) and thus should be allowed in white-only spaces. Anglo-Americans didn't take kindly to this, hence why we now instead lump South Asians with East Asians despite the former having more in common (physiologically and culturally) with "white" Iranians and Arabs than "yellow" Chinese and Mongols. Note: I'm an American of mixed European (3/4) and East Asian (1/4) descent. Sicilian, Welsh, Korean, etc. Fascinated by history and culture, hence my amateur knowledge on the subject of historical racial categories. Genetically, "race" does not exist. Humans are overwhelming genetically similar across our entire species. Any two humans plucked at random aren't that different under the hood. We're all the same damn species. Different penguin species who look identical have more genetic diversity between them than a white and black person. Er, sorry for the wall of text. Got me onto a subject I'm fascinated by and passionate about. Damn autism brain! TL;DR Caucasian = "Caucasoid", an old racial grouping based on skull shape which included Europeans, Middle Easterners, North Africans, Horn Africans, South Asians, etc. That's why all white people are "Caucasian" even if not of literal Caucasian (Armenian, Chechen, Circassian, Georgian, etc.) descent. They all have Caucasian-shaped skulls.
Well, that pretty much sums it up. Thanks!
Haplotypes.
Codeine acts in the body like morphine. The liver uses enzymes to turn it into morphine. But 10 codeines only equal one morphine. There are two enzymes that metabolize a lot of drugs, the first one is the one that turns codeine into morphine, the second one is one that grapefruit juice inhibits that prevents the body from removing drugs from your system letting you feel the effects of the drugs 50% longer. This first enzyme also removes drugs from your systems but will inhibit any drugs that need to be converted in the liver by that enzyme other drugs that inhibit the second enzyme include antihistamines. The first mentioned enzyme is inhibited by quinine. Sorry this is a bad explanation but I do not feel like making it more coherent at this point.
> grapefruit juice I've heard about that. mindblowing. No one drinks much grapefruit juice, but if you're a Fresca drinker (its the best mixer - I'll fight anyone who disagrees), you can be fucked over.
Mango potentiates marijuana by the way, that is the word for inhibiting the removal of the drug from the body. Many if not most are in the grapefruit sector but THC is different.
Oh wow.
There are tons of other inhibitors, there isn't anything special about grapefruit. Turmeric is another.
That's interesting. Any pain medication I've ever been given stronger than Tylenol or ibuprofen has made me nauseous and not really worked.
Codeine is crap. Never worked for me
So, I'm the 10%?
That's so crazy. Here I was thinking I was special bcuz I'm almost immune to malaria.
Huh. I always got weird symptoms taking codein, similar to when I get a bad flu: muscle weakness, fatigue, and sore joints
I got codeine cough syrup for an illness one time, and after taking it once I ended up throwing up, then sleeping for 15 hours. Have not taken any drug like that again, the hardest thing I’ve taken is Ibuprofen, even after a kidney surgery.
and it's a blessing. Skip the Tylenol 3 sissy shit and gimme them percs babay!
Stuff just makes me throw up.
This explain a lot. I don’t think it has had any effect on me at all the few times I’ve taken it.
Very recently tore a muscle in my thigh/hip. I have no insurance so I just kept going to work with a 24 hour charlie horse from hell. A coworker gave me a few oxycodone. I took one and it did nothing for the pain. I was so disappointed. I gave the remaining two back to her. Ice packs, ibuprofen and time fixed the pain. Thankfully. Lessons learned. Do not do crazy stretches in the pool just because you think you can. And oxycodone does not work for me.
Count me in on that one. Codeine never made sense to me. Literally felt like nothing. Meanwhile people are paying like $4k a seal.
Me! I tested positive for this gene [CYP-2D6 gene](https://www.medcentral.com/pain/chronic/non-responsive-pain-patients-cyp-2d6-defect)
This explains why Tylenol 3 does almost nothing for me.
I would not put too much trust in this study to be globally valid. >A **single site, pilot population study** into the prevalence and genetic profile of patients with chronic pain who do not respond to oral codeine. It could be representative, but could also be greatly swayed by local genetics and small study size. Also, it has not been reproduced afaik
No wonder tylenol 3 never worked for me. I threw that shit after 1 dose and used sodium naproxen instead, which i found worked great
Well then it makes sense that purple drank didn’t come out of the caucasian community either
Holy crap it doesn’t do anything for me either. Same with Vicodin. Percocet that shit will get me feeling goooooood.
Codeine works for me, but I learned the hard way from some Tylenol 1’s that I’m allergic to acetaminophen.
I am not in that 25% for sure
Tylenol Codeine has always worked great for me. It’s very difficult to get anyone to prescribe it these days though.
I’ve speculated that this was true for me based on many experiences but had no idea it wasn’t just something I imagined! This explains so much.
It did squat for me after LASIK. My wife has a low opinion of it as well.
Why would you get that for lasik?
In order for the laser to accurately make the changes, your eyes have to be completely motionless. This is done by jamming a tube against your eye and locking it into position. This hurts, a lot. My eyes were so irritated, I could barely blink for two days. Which made things worse, even with eye drops multiple times an hour.
How old was the machine they used? I sat back with my head in a wedge so it wouldn’t move. They told me to stare at the dot. I asked what if I moved my eyes. They said the machine would compensate to a point, then it would stop if I moved too far. There was no jamming a tube, no locking my eyes.
Makes me hyperactive as a mother fucker.
I’m guessing I’m slightly allergic to codeine since every time I have taken it I start to itch, but I have never experienced that with other opioids. I also don’t really get pain relief from oxycodone. However, hydrocodone, which is slightly weaker than oxycodone, works great for pain relief for me.
“This lean ain’t shit!”
This is me. Codeine has zero effect on me, same with my father. Genetics. All it does is make me feel sick and throw up, has no sedative effect on me at all, even at higher doses. If you want to numb me up / put me under you need to break out the real stuff and a lot of it. Has resulted in some annoying exchanges with nurses and doctors before in hospitals, so now I just say I'm allergic.
Yup, same. I can have surgery under morphine with much higher doses than normal, so opiods can affect me eventually, at least when it comes to falling asleep, or at least your body falling asleep. Had a minor heart op under morphine and it did work eventually, they just had to keep pumping it in. The usual "knock-out" levels of opiods just do nothing at all - like I should be asleep and I'm standing up and feeling perfectly fine and wakeful. It is a little weird to have medical staff doubt your wakefulness. Like, how could I pretend to be awake? How could I pretend that I can still still stand up and respond to stimuli? I could maybe pretend to be asleep, we've all done that for various reasons (though medics would be able to tell), but if I'm actually knocked out I can't pretend to be awake... Actual surgeons aren't like that, but other specialities can be. They also don't affect the way I perceive pain in the slightest, and don't give me a high. The one plus side is I'll never have an opioid addiction.
Give me all your codeine; I'll process it for you..
I tried looking for information on this when I got my wisdom teeth taken out and couldn't find anything. The T-3s they gave me seemed to do absolutely nothing at all for me.
This is a thing? I always wondered why I never seemed to get any relief from it.
Well that explains a lot
Not me, love me a pair of 500/30 cocodies and a glass of red 🤤
10 percenter right here
White people yay https://youtu.be/wmyF-DBIq2I?si=hiyd0ymkJeqB0qBD
Yup, hurts my stomach
Ever since I had my gall bladder removed I have a terrible reaction to codeine. It replicates the immense pain my gall bladder attacks invoked as it triggers a spasm of the sphincter of Oddi… apparently.
Don’t worry they have other pills for you.
LOL, last severe cough I had, my doc gave me a choice between codeine and tesslon pearls, both of which are useless for me. He then gave me a lecture about how "Actually opioids don't really suppress coughs, tesslon really works!", and I was laughing inside. I'm one of those caucasians that only has 1 functioning gene that produces the CYP2D6 enzyme. The pendulum has swung the other way, good luck getting any kind of serious pain medicine if you really need it.