Some, not others.
Skipped the cyclizine, buscopan, haven't applied a fresh transdermal scopolamine (hyoscine, its the same drug, also the same as in the oral drug buscopan, used for people with IBS mainly, but also for other sources of stomach cramps, both are hyoscine/scopolamine, the main difference being a much higher dose in the oral tablets, but its in the form of a butylbromide quaternary ammonium salt, so the molecule bears a permanent positive charge, and is unable to cross from the periphery into the CNS, never makes it through the blood-brain barrier, which allows higher doses to be used than if it wasn't a quat; Because its thusly, incapable, or the very very least, has a massively reduced potential to cause central antimuscarinic toxicity. Delirium, psychotic reactions, nightmare-trip nightshade poisoning type hallucinations, seizures etc.
Didn't take any ondansetron, macrogol (an inert polymer bulk-forming laxative I take on an as-felt-like-it basis because of the need to take regular and sizeable doses of opioids, they constipate given half a chance, so I drink a lot of fluid (beer, ideally, nice, cold, frosty, tasty ale is just the thing:D) and get the macrogol sachets added to my prescription, although I actually throw out far more than I ever use them, but if I've had to take heavy levels of analgesics, or alternatively, either chosen to take more than usual of my morphine/oxy, have been working on anything a bit more unusual, or when the season is right to make harvest of the annual poppy pods-and-straw crop and have some propionylated, de-codeine-ified* pantopon** (codeine can cause possibly fatal pulmonary oedema if its given by the intravenous route, so it MUST be stripped from any, all, and every injectable product that has as its origin, the opium poppy plant)
**Basically, this is opium, after having been subjected to the extractions and crystallizations requisite to remove all plant matter, gums, waxes, chlorophyll and what have you, and refined to a white, crystalline powder. It is usually simply the natural ratio of alkaloids present within the plant, only purified and refined. The codeine removal however, thats not standard, but it is necessary to render the preparation suitable for intravenous dosing. There isn't a very high demand at all these days though, and pantopon is very seldom used in medicine now. Although some military morphine syrettes contain something similar, omnopon, a stripped-down version of pantopon (morphine mostly, around a quarter codeine, and some papaverine, for the most part, probably the trace stuff too, but I don't know for sure)
So once the codeine is stripped out, and then the product is reacted with a combination of either propionyl chloride and an organic amine base to suck up the hydrogen chloride that is emitted upon reaction of the acyl halide, doesn't particularly matter what base, it needs removing afterwards. Or, much easier, especially for anybody unskilled in o-chem, is the acylation reaction performed using propionic anhydride, that just needs cooking up, and any excess distilling off. Its the exact same procedure as for making heroin, the only difference being that acetic anhydride or acetyl chloride/base is used. Preferable to employ the anhydrides IMHO, because its a lot simpler, easier, the rxn rate is not quite so fast as using an acyl halide but theres no need to mop up HCl fumes, or clean out the amine base used as an acid-scrubber. As well as requiring fewer steps and less work to work up the final product into something sterile and suitable for actually taking a belt.
Dipropionylmorphine on its own I've tasted too, and I like it. Very pleasant, smooth and quite a lot longer acting than heroin, as well as being several times as potent, and its MUCH more potent than
morphine sulfate. Faster acting too due to the increased lipophilicity of the propionyl diester compared to (di)acetyl.
Pod tea, just a simple infusion made with hot water, and chopped poppy pods, stewed on the stove for a bit, perhaps with a squirt of lemon juice, a pinch of citric acid or any other suitable, biologically safe mild acid, vitamin C works well too (ascorbic acid, although some supplements are as ascorbate salts, and a few as ascorbate esters, these are no use for encouraging the plant tissue to solubilize and liberate the alkaloids into the tea.) lasts a lot longer too, oddly, than morphine/codeine or mixtures of the two, by mouth. Quite different too, being stimulatory, in a lovely perky kind of way, without actually overloading the CNS with adrenergic type stimulant effects, because the compound responsible, thebaine, is an antagonist at strychnine-sensitive glycine receptors, in large doses its a convulsant poison, just like strychnine. But smaller, nontoxic doses (there isn't a huge amount in Papaver somniferum, so pod tea doesn't just poison its drinkers, but it does very significantly change the character of the experience, and for the better IMO)
The main downside to the tea, is the smell. And the taste. Both are WAY beyond godawful. Truly, truly disgusting. Bitter, but that can be overcome, but the taste goes way beyond bitterness thanks to the hideous STENCH that it gives off. Jesus, it really is terrible. I prefer to wear my gas mask while brewing pod tea, not because its harmful, but just so the organic vapor filter cartridge currently in the mask can eliminate perception of that unholy putrescent reek. Smells like a..well theres nothing quite like it, but if someone were to visit the river Styx, go fishing, and pull up a sunken shopping trolley full of rotting hades-spawned fish corpses and the anoxic, rotten organic muck of a few thousand centuries........no, it wouldn't smell like that. The former could be used as air freshener, if suspended in a big cup of cold cat sick and stale, fermented piss.
So to say the least, its adviseable to dump in enough sugar while its still steaming and too hot to drink to create a supersaturated sugar solution, then tip it back from a bowl or other wide shallow vessel in one go, hold your nose, and have a sweet-sour tangy type drink ready, sitting right next to you, to grab when putting down the empty bowl of tea, and down, saving some to swill round the mouth, and gob back out again BEFORE you release the death-grip on your schnozzle
Vile, but the effects are worth it. And last almost all day. Not a day and night from morning to morning, thats expecting a bit much from one single dose of pod brew. But certainly from morning to maybe 10-11pm.
MUCH easier to take, however once prepared and turned into my little broad-spectrum isolate innovation, and given a spicing up with the same propionic anhydride, or the acyl halide/base procedure.
The result is a complex mixture, never analyzed it to determine precisely what the exact products are, but dipropionylmorphine is the main active, I have no idea how the individual minor alkaloids, papaverine, thebaine, noscapine, oripavine etc. would be/are changed by esterification/amide formation when the acylating agent reacts with the amino groups present throughout the alkaloid profile. If taken in isolation, that is, individually. No point my trying really. The codeineless but otherwise full-spectrum isolate, after one has finished with it works perfectly well as it is, without any further fucking-with.
Meds..otherwise. Not taken my gabapentin, gaviscon, most of the GI meds, only taken cimetidine out of the meds for my gizzards, which I take anyhow, even if I don't have the GI issues playing up then and there, both to stop it coming out to haunt me, and also because cimetidine blocks CYP-P450-3A4 and CYP-P450-2D6 (I LOVE springing that one on doctors, because I actually haven't met one yet, who knew about that little trick, to extend the half-life and boost the efficiency of a given dose of morphine without a corresponding increase of dose for the latter, helping people limit side effects and also gain greater stability of plasma levels, so they aren't up and down too much in the gaps between doses of morph. The most profound effect is exhibited with non-XR formulations, but it still does the same thing, just not quite to the same extent, IMO. Personal opinion there though, from bioassay. Not established gospel truth.)
It does seem that way though.
Lol, my own GP didn't know that trick, until I came into the surgery for an appointment with him whilst still taking the related anti-ulcer/anti-reflux/guts-ache drug ranitidine, which was developed from cimetidine with the intent of eliminating such enzyme inhibition. But I went in and requested that the med be changed, from ranitidine to cimeditine. They are usually thought of as functionally identical, bar some specialist non-GI uses of cimetidine, as its got some kind of immunomodulatory properties, although my oxford handbook of clinical immunology mentions this, and a few individual diseases have it as a possible adjunct treatment listed, it annoyingly doesn't clarify HOW these effects are manifested, either what they are or how they are made to happen.
So he kind of did a bit of a doubletake, asked me basically why on earth I'd even WANT to change from one to the other, because they are more or less the same. Then I told him what I intended to achieve
and explained the mode of action. Surprised him a fair bit, in a 'how the hell did you know that!?' sort of way (although he does know of my...hobbies, and knows that unless I actually request an explanation of how something is meant to work, I don't usually need one, by now. Knows the sorts of interests I have in chem, physics, botany/mycology and biotech, as well as pharmacology/creating interesting/unusual/novel psychoactives). Seemed pleased/grateful enough to be taught the cimetidine/morphine combination trick, and that it can potentially inactivate codeine, as its a pro-drug and inactive itself until metabolized, or nearly completely so if there technically is any MOR agonism at all, and if it doesn't, it will definitely impair the metabolism and slash the efficacy of the drug)
I did walk out with my repeat prescription for the cimetidine though, and have been using it ever since for my GI issues, reaping the additional benefit as a bonus.
Did take a couple of clonidine, and tizanidine (overload-prevention/amelioration and muscle relaxant respectively, although clonidine is most typically a blood pressure lowering drug, used for some heart conditions iirc, as well as sedation, counteracting side effects from stimulants amongst a couple of other uses. Presumably my choosing it to stop myself overloading sensory/adrenal-wise, the former of those uses is somewhat......niche. But it does work wonderfully for me, an absolute godsend its been, it really, really has, same with the similar tizanidine, these days, there are days I'd quite possibly find it very difficult to walk in a way not just due to hip/knee pain, but physically difficult to move the lower leg or stand on it due to my nerve injury, left behind by some unsuccessful surgery. Its functionally speaking, somewhat similar to how cerebral palsy sufferers experience muscle spasms, stiffness etc. Only the damage is at the level of the leg itself not spinal or supra-spinal in origin for me, so I have
not the full-body impairment that cerebral palsy results in.)
Doesn't stop it being difficult, though, a royal pain in the arse, and if unmedicated, agonizing.
I still need to take a dose of erythromycin for a mild, localized skin infection, nothing serious, just a bit of a red welt about a centimeter across, thats mildly sore if pressed and poked or knocked against something, as well as I have not, thus far, taken my morning capsule of chlormethiazole. So I am going to go and do that now, plus grind and start soaking some more of my XR morphine in sterile saline so I can come upstairs and have that later, nice and extracted and ready to rock and roll when I next need it. I don't now. I'm happily medicated, not nodding off or anything, but free of pain anywhere.
Haven't taken my proton pump inhibitor, and this reminds me actually I need to go to the docs surgery some time, because I wasn't given my dopamine agonist (pramipexole) when I filled my script for this week. (for RLS). It was ON the rx chits, but the pharmacy failed to give it to me. I'll give them a ring first, or pop round to the pharmacy and see if I can sort it there, but if not, then I'll go to the surgery itself and try to get a new one. Because I have searched all over, high and fucking low, and it just isn't there.
