Meh. I take all such comparative studies with a huuuuuge shaker of salt. Pain is so damn subjective, difficult to characterize, quantify, assess for its intensity much less its relief. While some studies looking at very narrow parameters for pain assessment proclaim tylenol more effective than codeine, studies of severe post-trauma pain and post-operative pain still show opioids are the gold standard for relieving suffering, if not pain.
I do hope we find better pain relief. We are not there yet
DXM is an NMDA antagonist, which is different than an opiate. NMDA antagonists are used as analgesics and anaesthetics though.
What they do is they take a different drug that blocks the pump that kicks imodium out of the brain, so it can cross the blood brain barrier. Still doesn’t sound too appealing, supposedly even when you do that you need 20+ pills just to equal the feeling of one vicodin. Sounds like a lot of side effects just for that.
in high doses, DXM is also weakly active at the opioid receptors. Its mirror image, Levomethorphan, is a very potent opioid analgesic. DXM abusers take it in large amounts to get both the opioid and dissociative effect, which is pretty harsh actually.
But for an addict, dysphoria is better than no phoria at all. I speak from experience, tho clean now after 28+ years of abstinence from opioids.
I honestly don’t know. I believe current processes for synthesizing drugs now can yield fewer such impurities, if the manufacturer decides to do so. But I’ve no idea what’s actually being done in the industry.
Actually, they do, and there are some drugs that might as well be a cancer cure because they really do work that well, although only for specific types of cancer. I’m thinking specifically of Herceptin for certain types of breast and stomach cancer, or methotrexate and 6-mercaptopurine for ALL, and there are some others, used in combination therapy. Too many laypeople don’t realize that cancer is not a single disease; diabetes, another disease I would personally love to see cured, or better yet prevented, isn’t either.
As for antibiotics, some infectious disease specialists are going back to older drugs that have fallen out of widespread use, because newer drugs don’t work any more but these do. We do periodically hear about some new “Godzillacillin” but those are almost always used for people with multiple risk factors, and usually in an ICU.
I suppose it would be possible, but after all these years, chemists have almost certainly figured out how to make dextromethorphan, and the dextro isomer only.
I’ve been taking hydrocodone since 91 starting at 5/500 then 5/325 now 7.5/325. I always got relief but a few months ago I’m not. That was when I noticed the change as I kept the empty bottles in a bag.
They used to be Watson and Actavis. Now a few months ago I was getting Mallinkrodt and by changing pharmacy I got Lupin this month and it was worse.
I will find out soon because I just ordered some opiate test strips.
Yeah, opioids are not good for chronic pain. You end up with a person who’s habituated to huuuuuuge doses of opioids who’s also in just as much pain as he was before starting to take them for the chronic pain.
Of course NSAIDs and APAP aren’t much better in this situation either.
The answer appears to be yes. The following are: an explanatory note relating to a change in the USP monograph for Dextromethorphan; and the revised monograph.
…This is a major safety concern, because recently, levomethorphan was found at toxic levels in the drug formulation and resulted in deaths globally. The purpose of this revision is to introduce a procedure to quantitatively monitor levomethorphan in Dextromethorphan.
Acceptance criteria: NMT 0.10%
You would not introduce a limit if the impurity was not produced in the synthesis. The level set is pretty standard for an impurity, which suggests it isn’t astonishingly toxic (or, I guess, particularly abusable at that level).
That’s a relative contra-indication, since morphine is metabolized more thru the liver. For most folks, doses can just be adjusted down to avoid problems. Or use oxycodone, which is more metabolized by the kidneys, IIRC.