[artgal]

Is Propoxyphene HC 65 (Darvon) considered an opioid? The reason for my question is that I've been addicted to prescription pain killers for 25 years and have been researching detoxing with Suboxone. I've used a variety of pain killers, including most recently Fentanyl 75 patches (which I know is an opioid). I stopped using the patch over a week ago and have substituted the Darvon to stay out of withdrawal. Next I will need to get off the Darvon. The Suboxone website doesn't provide a comprehensive list of drugs that qualify for treatment - only that it's intended for opioid dependancy. Does anyone know if Darvon dependancy is treatable with Suboxone?
TIA for any replies.

[Cats Meow]

That depends on who you talk to, I believe Darvocet is an opioid, it meets the definition, it does target the same receptors in the brain that the true opiates such as morphine, and the true opioids such as hydrocodone do. It is extremely weak in comparison to all the other opioids, but as you know, it is addictive, which meets the other part of the definition of an opioid. Using Suboxone to treat propoxyphene addiction is extreme overkill, it's like killing a fly with a 18lb sledge hammer, look at it this way, propoxyphene is 1/40 the strength of morphine, Buprenorphine (SubO) is 40 times stronger then morphine, that's what 80 times stronger? You see, it's far too strong, and even if you switched you would still have to w/d from the Sub, so it makes no sense. Propoxyphene w/d is very mild, Sub is not, so just taper down and quit.
Cats

[methadonfriendly826]

I would say fentanyl patches are probably more addictive than darvocet. You might need suboxone for fentanyl but not for darvon. I dont think suboxone is quit that strong, but it is stronger than darvon.

[Asashi]

Fentanyl patches are more addictive? Can we please just call a drug a drug? The fact is that Darvon IS an opiod, it IS addictive. You've been dependant on opiods for 25 years. I think at this point, Darvon is not okay to take, and really, you're only taking it you say to stay out of withdrawals. I'd 100% say Suboxone is a great choice for you. Stick to a low dose (unless of course, it's not enough to keep you out of withdrawal.)

I work in a clinic designed for people with opiate addictions. I'd also give a vote for a low dose of Methadone, but that's because in my area in Canada, we tend to not see too many people on Suboxone. Here, it's pretty expensive and is not covered by most major drug plans.

Good luck to you!

[Asashi]

I don't mean to double post, but I didn't want to include this in my post from last night until I confirmed it. I spoke with both a Clinical Case Manager who specializes in patients with opiate addictions, and a methadone doctor. Where have you got this information that buprenorphine is 40 times stronger than morphine? Granted that it's a manmade opiate, it is a longlasting one. The point to it is finding a dose that keeps you out of withdrawls so it spans for 24 hours until your next dosage. I don't think your analogy fits at all. Sorry to nitpick at your post! I'm just interested in your source.

Originally Posted by Cats Meow

That depends on who you talk to, I believe Darvocet is an opioid, it meets the definition, it does target the same receptors in the brain that the true opiates such as morphine, and the true opioids such as hydrocodone do. It is extremely weak in comparison to all the other opioids, but as you know, it is addictive, which meets the other part of the definition of an opioid. Using Suboxone to treat propoxyphene addiction is extreme overkill, it's like killing a fly with a 18lb sledge hammer, look at it this way, propoxyphene is 1/40 the strength of morphine, Buprenorphine (SubO) is 40 times stronger then morphine, that's what 80 times stronger? You see, it's far too strong, and even if you switched you would still have to w/d from the Sub, so it makes no sense. Propoxyphene w/d is very mild, Sub is not, so just taper down and quit.
Cats

[Cats Meow]

Double posting is fine, and my facts are correct, as is my analogy, and I know what I'm talking about. Here you go.
http://www.pharmer.org/forum/discuss...oid-comparison

[FrumiousFalafel]

Originally Posted by Cats Meow

Double posting is fine, and my facts are correct, as is my analogy, and I know what I'm talking about. Here you go.
http://www.pharmer.org/forum/discuss...oid-comparison

Hi Cats. I'm in no way saying "your table is wrong." However there exists in fact many such tables in different medical books on the subject(s) of Opiate dependence and Palliative Care (among other books) for example.

In fact one of the best books I have ever read was a book on Palliative care (last year as my Mother was dying of bone cancer, I was the primary care-giver / suggester of dosages / drugs to her doctors) from a older doctor in the UK who taught other doctors about Palliative care. It was an excellent book and he made the point as well that he found these comparative lists as something he would perhaps start with if her were unsure of a general relationship between two opiates, but in no way would he rely only on a particular "opiate-comparison chart" to be the final determinant in how he dosed his patients. And then he also went on to make the point, which I noted above, that there exists many such charts and in no way do they all say the same thing. Certainly they will say Methadone is more "powerful" than Codeine -- I grant you that, but assigning actual numbers to that relationship is a tricky game.

There are always studies going on which attempt to create a "latest-greatest" chart as a result of either a coalescing of previous studies or results from their own experiments. Naturally the results of different researchers studies don't always come out the same, nor do the individual researcher's methodology in determining these relative numbers.

[Cats Meow]

Thanks for posting, and I agree with you for the most part, it is tricky, I've seen narcotic calculators too that vary to some degree with facts in the published table, but usually the calculator is very generous, and what's also tricky is factoring in cross tolerance, and whether or not if the drug is administered p.o, p.r, IM, or IV. A doctor does have to rely on an Ope comparison chart of some kind, even if said "chart" is in his own head, these drugs are very quantitative in relation to each other, but I guess that's why they call it "practicing medicine", for whatever reason, some drugs just work better for some patients. For the most part the chart is very accurate.