Originally Posted by award11
SWIM has used opiates
for a long time and has a very high tolerance. He recently came across some Opana 20mg ER and simply chewed them up like he has done oxcontin in the past. After not getting any effect from them, he researched and found that they only have about 10% BA. This bein the case, why are these pills so popular and highly sought after ? How can a pill with such poor BA have such good pain relieving qualities ? I now know now that the preferred route of administration is snorting
but what about all the people out there that take them as prescribed, do they just not get much reief ? Just because a medication has a low BA does that make it "not as good" or not as effective for management of pain ? Any enlightenment would be greatly appreciated.
There are numerous misconceptions about oxymorphone
, and it's also important to distinguish between the ER and IR formulations. One commonly addressed fact in Clinical Pharmacology articles in medical journals is that although 10% oral BA sounds low, other opiates including morphine
have and oral BA of only 12-15% - however, there are many factors that are potentiators BA, it is the strongest IR opiate
prescribed outside of a hospital, and even at a mere 10% oral BA, one gram of oxymorphone taken orally is equivalent or higher than 2 mgs of oxycodone
As you touched on, BA is highest (it increases by 43%) using an intranasal
ROA. It is the only opiate with a higher BA intranasally (oxycodone and hydrocodone
, for example, have a lower intranasal BA. While this ROA provides the strongest and most immediate onset, the half-life
of the drugs
are cut in half, its physiological effects drop from ~4 hours to ~1.5-3 hours. Oxymorphone, however, not only increases in BA intranasally but has a faster onset, longer half-life, greater duration, increased euphoria
, more efficacious analgesic properties, and greater overall potency. From a medical standpoint this ROA is presently one of the most effective and safe ROAs - empirical evidence that has prompted the development of what will be dispensed as a nasal spray.
However, if you prefer oral use there are ways to potentiate the oxymorphone and increase BA via an oral ROA as well. Because oxymorphone is less soluble with lipids, eating a fatty meal with an oral dose can boost BA up by 50% or greater. Additionally, cimetidine (e.g., Tramadol
) potentiate the binding action of the oxymorphone thus increasing both BA and efficacy of analgesic properties.
Finally, I must stress that although alcohol
consumption increases BA, it does so in an unpredictable, highly variable manner with potential to increase BA by over 270% - which is deadly. There are of course more ROAs and methods of increasing BA, but I'll leave it here. Opana is one of the strongest, most potent IR meds around, crosses the blood-brain-barrier more than so than other opiates, and due to a relatively stable state for several hours after it's peak in 30-60 minutes, it lasts the greatest amount of time at its peak strength. It can take a few days to build up in the bloodstream for some and will then be similarly efficacious. It is the most effective IR medication able to provide me any pain relief at this point, so if used correctly it should be similarly effective for anyone else.