Help How many mgs of Dihydrocodeine would it take to kill someone

[gingerplum]

Does anyone else think that 3600 mg of dihydrocodeine might be too little? I see @gingerplum citation, but it's 1/10 the strength of morphine.
@allgood says that 100x30mg may be obtained by online scrip in UK.

https://sanctioned-suicide.net/threads/buying-painkillers-online.19767/#post-372011

Therapeutic substitution for heroin addicts is up to 2500 daily.

Pharmacokinetics of dihydrocodeine and its active metabolite after single and multiple oral dosing

The pharmacokinetics of dihydrocodeine (DHC) and its active metabolite dihydromorphine (DHM) were assessed after a single oral dose of DHC and after increasing doses of DHC at steady-state.Twelve healthy male volunteers (18–45 years, CYP2D6 extensive ...

www.ncbi.nlm.nih.gov

In US as much as 240x60 mg can be written in a single scrip.
As to amitriptyline, right-to-die
organizations and PPH say 7 g + lots of benzodiazpines. Our dear former members @Rocksandsand and @Funkygibbon failed with it, Roxy with 7 g and funky in 2 attempts, one of 3 g

https://sanctioned-suicide.net/threads/amitriptyline-cocktail-advice.16570/

Failed on 7 gms? That is a tremendous amount; I wonder if that's accurate. Other factors would include individual tolerance and whether or not there was vomiting. This source says to give activated charcoal in the event of an overdose, or what they consider to be > 350 mg.

Consider activated charcoal if an adult presents within one hour of ingestion of more than 350mg.

Codeine Phosphate Tablets 30mg - Summary of Product Characteristics (SmPC) - (emc)

Codeine Phosphate Tablets 30mg - Summary of Product Characteristics (SmPC) by Accord-UK Ltd

www.medicines.org.uk

Another source references the lethal dose at 0.5--1.0 gm.

The acutely lethal dose of codeine for an adult has been estimated at 0.5-1.0 g. The lowest reported lethal dose was reported to be 12 mg/kg. Doses of this magnitude may cause unconsciousness and convulsions; and death from respiratory failure may result in 2-4 hours.

https://www.google.com/url?sa=t&sou...FjAIegQIARAB&usg=AOvVaw3XrpK-_96zxPFJUd9ngxDh

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(Sorry, this was a PDF I had to open with Adobe Acrobat, and I can't get it to link)

This was my initial reaction:

I'm inclined to think no, this won't work, because codeine is so much weaker than morphine.

However, since multiple sources disputed that, I changed my mind. I think that if the lowest lethal dose of morphine is 200 mg, then 2000 mg should be the adjusted amount for 1/10th of that strength, and surely 3600 mg would be enough.

No guarantees, but this is the best information I could find. Alcohol will potentiate the strength and effects of the codeine, so I'd knock it back with some hard alcohol if I wanted an insurance policy.

Now, the good news for @howard is that I can't find any cases or examples of codeine related to hepatotoxicity, that is, liver failure. If it was bitartrate (codiene + acetaminophen) I'd be a lot more worried about a potential failure, but as it is, if this results in a failed attempt, there's nothing I can find to indicate concern about potential liver damage or failure.

I would also figure out the mg per kilo to see how that dose at your weight compares with the 12 mg/kg cited... if you don't know how to do this, PM me your weight and I'll calculate it.

I failed with both.

Hey Rachel! What were the doses you failed on? Thanks in advance, gorgeous girl .

Edit: @Rocksandsand was found pretty quickly and even at 7 g it can take some time. I'd recommend researching here before getting or using ami.

Thanks for the edit, @Neville. Do you know if they induced vomiting and/or used Narcan (Naloxone) to reverse it when they found her? It must have been pretty quick, because I'm thinking it would have all been systemically absorbed in about 30 min.

 

[Neville1]

Many sources say that people are highly variable in their reaction to opiates. The right-to-die organizations have pretty high recommendations for them.The guide to Self-Chosen and Humane Death says no oral amount morphine reliable but 500 mg morphine by IM injection, less for IV.

https://www.dignifieddying.com/publicaties/EN/2006%20Guide%20to%20Self-Chosen%20and%20Humane%20Death.pdf

Dutch eutanasia group used 1.2 g oxycodone oral plus 120 mg benzodiazpines.

MED — 20 / opiaat | Een Waardig Levenseinde

eenwaardiglevenseinde.nl

Maybe worst case is that @howard has some days sleep.

 

[gingerplum]

Many sources say that people are highly variable in their reaction to opiates. The right-to-die organizations have pretty high recommendations for opiates.The guide to Self-Chosen and Humane Death says no oral amount morphine reliable but 500 mg morphine by IM injection, less for IV.

https://www.dignifieddying.com/publicaties/EN/2006%20Guide%20to%20Self-Chosen%20and%20Humane%20Death.pdf

Dutch eutanasia group used 1.2 oxycodone oral plus 120 mg benzodiazpines.

MED — 20 / opiaat | Een Waardig Levenseinde

eenwaardiglevenseinde.nl

Maybe worst case is that @howard has some days sleep.

I can certainly understand why they're erring on the side of more; with zero margin for error, that kind of dose will get the job done right.

Agree about @howard; worst case he's seriously logy for a few days.

 

[allgood]

Does anyone else think that 3600 mg of dihydrocodeine might be too little? I see @gingerplum citation, but it's 1/10 the strength of morphine.

It's more like 1/5th morphine with DHC, most sources place it anywhere between 1.5x-2x stronger than codeine. It's suspected that it has a lower oral BA than codeine, maybe it would be better to plug it since you can't exactly IV grams of the stuff at one time.

If you live in the UK it's very accessible in the form of Paramol (500mg paracetamol 7.46mg DHC tartrate). One packet would net you about 240mg DHC, with a decent CWE you might retain more than 200mg DHC per pack.

I would imagine it's probably better than codeine for this purpose, as it's not metabolised into morphine and does not rely (completely) on that process as codeine does. I've read that up to 10% of people may suffer from an inactive CYP2D6 enzyme which essentially prevents codeine from metabolising, making it rather useless. To be honest they're both exceptionally weak orally, even now I am off methadone DHC is difficult to feel at below 400-500mg.

 

[howard]

Hi all. I have waited a few weeks and now have 4.2 g of dihydrocodiene. The only antihemitic I could get is the liquid phenergan. I have a few anitrptaline and some pregablin. I only have one shot at this and my situation is very desperate.
Any advice please.

 

[allgood]

Hi all. I have waited a few weeks and now have 4.2 g of dihydrocodiene. The only antihemitic I could get is the liquid phenergan. I have a few anitrptaline and some pregablin. I only have one shot at this and my situation is very desperate.
Any advice please.

I'd probably take the DHC rectally if you've no real antiemetic, plus the bioavailability is probably considerably higher than oral.

 

[howard]

Thanks for advice. What about powdered and mixed in phenergan? I really cant go with rectally!

 

[allgood]

Thanks for advice. What about powdered and mixed in phenergan? I really cant go with rectally!

Orally it's roughly equivalent to 420mg of morphine, but even then it's much riskier. I don't know if you would die, if not found maybe but high opiate doses will make you vomit exceedingly quickly. Phenergan helps a little with lower dosages, as does DPH etc. but it's really no substitute for a proper anti-emetic.

 

[howard]

Thanks. Will try to get the meteo stuff.

 

[no more pain]

I have been trying for a long time to get information about the use of DHC for OD, they are probably not very popular drugs for ctb-ing, but I have no opportunity to get other sources mentioned here,
Has anyone tried DHC + xanax/bromazepam? 3600 mg can be enough as @gingerplum wrote? would this be a good combo for OD? + an antiemetic and/or alcohol?
Will it last longer than 1 night/ 10-12 hours? I don't want to just sleep for a few days
@howard probably used SN in the end,