Thursday, September 18, 2008 Daley Aker, Community Member, asks

Q: Crushing Opioids

I am under prescription for Dilaudid, and take 4-6 mg. as needed.

I've been taking this medication for several years, taking occasional "drug holidays" to prevent dependency. I find that it now takes up to one hour before I get any relief from my chronic (fibromyalgia) pain. Is it safe, beneficial, or dangerous to try and crush the pills for faster effect? I have NO side effects from this medication and would be happy to reduce the dosage to 2-4 mg as needed, if crushing the pills would help.

Also, are there any other medications that would help to increase the sensitivity of the opioid receptors (safely, of course!)?

 

Many thanks

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Answers (3)
Cort, Health Guide
9/19/08 8:24pm

I really don't know about crushing the tablets. Crushing is usually associated with drug abuse -which is obviously not your problem - but since it is I couldn't find any references to crushing the tablet to increase the speed with which it works in non-abusers. Crushing it will speed its activity for sure - whether its safe or not I don't know. 

 

You may know that several drugs have been approved by the FDA for FM recently; Lyrica and cymbalta. Neither work on the opiod receptors but this also means they are not habit forming. Cymbalta is an 'anti-anxiety' drug - the tag they've given it - but it also turns down the pain response apparently. These drugs work for some people and not for others and they have their own set of side effects for worry about but have you thought about giving them a try? 

 

http://www.healthcentral.com/chronic-pain/find-drug-68370-73.html

 

http://www.healthcentral.com/anxiety/find-drug-25164-25.html

 

 

 

 

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mermaidme, Community Member
9/18/08 2:35pm

I'm not sure if you have been told this before but I was told, and found it does help, that if you have a cup of coffe with the pain meds it does help to get the opioids to work faster. I do remember back when I served food that they had tylnol with caffeen in the same pill and wondered why. Now I know. There has got to be something to it. I hope this helpsSmile

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Karen Lee Richards, Health Guide
9/21/08 9:10pm

Crushing opioids is never a good idea.  It's particularly dangerous for extended release opioids because medication intended to be released over several hours is released all at once.  But even with immediate release opioids, crushing them can cause the medication to be released too quickly.  Opioids depress respiration.  When you get too much at one time, there is the danger you will stop breathing.  That is how people die from accidental overdoses.  Tablets are designed to allow medications to be released at the time and location in your body that is safest and most effective.  Trying to side step the purpose of that design can be extremely dangerous and even fatal. 

 

I agree with Cort's suggestion that you consider talking with your doctor about one of the new medications approved for fibromyalgia.  Research has shown that opioids may not be the best medication for fibromyalgia because our mu-opioid receptors have a reduced ability to bind with the opioid medications.  You can read more about this research here:  Why Painkillers Don't Work on Fibromyalgia

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By Daley Aker, Community Member— Last Modified: 06/06/12, First Published: 09/18/08