Help Does opioid rectal or transdermal absorption (i.e. DMSO) cause nausea/vomiting?

[Mayonaise]

I'm planning to go with oral DDMA (Diazepam, Digoxin, Morphine, Amitriptyline) and I have a few questions regarding opioids, please.
I can't get Morphine (15g would be required) but I may be able to source other opioids. I'd like to avoid oral administration because of the nausea-inducing effects and I'm wondering if other ROAs are less prone to induce nausea/vomiting.

My questions are:

- Would oral administration induce nausea/vomiting in an opioid naive person? How bad would that be? I would be taking Metoclopramide + Ondansetron.
- Is transdermal or rectal absorption less likely to cause nausea/vomiting? Is DMSO absorption as reliable as other members reported?

Since I have no experience with opioids, every bit of advice is extremely useful and appreciated. Thank you

 

[Talvikki]

Perhaps you will find this useful:

According to the Academy of Aid-in-Dying Medicine

The standard pre-medications with ondansetron and
metoclopramide have made significant vomiting of aid-in-dying medications
rare.

The doses of aid-in-dying medications are intentionally over-calculated, as a fail-safe method in case of partial ingestions and/or vomiting. Academy data has shown multiple reports of patients who vomited 50% of their meds and still died quickly.

Courses and Information | Academy of Aid-in-Dying Medicine

www.aadm.org

https://www.aadm.org/wp-content/uploads/2025/02/Morphine-allergy-or-vomiting.pdf

 

[Mayonaise]

Thank you very much. I read most of the official MAiD papers but missed this one, it sure is interesting.
I see you've researched D-DMA too so I value your opinion: do you think a simplified protocol (Diazepam or another long-acting benzo + 100mg Digoxin 30 minutes before the Amitriptyline + a minimum of 8g Amitriptyline) could do the job within 12 hours? I'm basically skipping the opiate component so I would rely solely on the cardiotoxic drugs. I'm in my 40s, no serious heart conditions AFAIK.
I researched this method quite extensively but I always value other opinions. Thank you