Dangers of Using Opiates with Potentiators

3 min read · 6 sections

Opioids are common forms of drugs. They are used for pain relief and often prescribed by doctors. Some include oxycodone, hydrocodone, and morphine. Heroin is one type of opiate that is illegal but its abuse is still rampant. In 2014, the Centers for Disease Control (CDC) reported 78 Americans died on a daily basis from an overdose of opioids.

Sometimes, potentiators are used to intensify the effects of opiates. A potentiator is a chemical, herb, or other drug that is used to increase the effects of a substance.

How Opiates Are Combined with Potentiators

The use of potentiators is exacerbating the issue of opiate abuse. For thousands of years, people have been combining substances in an effort to achieve a greater “high.” According to Pain Community Centre, as far back as the 1600s, morphine was sometimes combined with alcohol and cocaine in an effort to intensify morphine’s opiate effects.

Today, many people try to combine opiate-based substances with other substances to maximize the euphoric effects.

Combining opiate drugs with any other medications or substances comes with many risks, as potential interactions may occur.

Even with seemingly harmless everyday substances, unintended consequences may arise at any time, and combining substances increases the potential for overdose.

Many unintended overdoses have occurred due to opiates across the United States. The Washington State Department of Health reported a 370 percent increase in unintentional poisoning deaths from 1990 to 2010, and many of these were due to opiates.

Orange and Grapefruit Juice

The Nordic Pharmacology Society reported grapefruit juice can increase exposure to oral oxycodone. Through biochemical processes, the juice can actually increase the concentration of oxycodone in the body and enhance its effects. In many cases, the interaction can be harmful. More of the drug can actually pass from the digestive system into the bloodstream, leading to respiratory failure, bleeding, and death. Grapefruit juice can be ingested hours after a pill, and the impact can still be dangerous.

Certain oranges can have a similar effect to grapefruit juice. People who eat limes or have marmalade with oranges can be at risk as well. Those who take a prescription painkiller or even cardiovascular medications should also ask their physician whether they can consume grapefruit.

Other Potentiators

Antihistamine Aficionado Magazine has indicated many other ways opioids could be potentiated with other substances. Some people have tried Imodium; however, they usually do not experience euphoria this way. Not enough of the loperamide crosses the blood-brain barrier, but doses that are 150-300 percent higher than recommended may produce a buzz.Antihistamines and opiates are dangerous to combine. These can increase respiratory depression and thicken bronchial secretions. Phenyltoloxamine citrate can be obtained over the counter. It has been combined with hydrocodone, codeine, or dihydrocodeine.

Doxylamine succinate, the active ingredient in NyQuil, and some sleeping pills have been combined with opiates as well. Dimetapp is known to increase the high felt when taken with opioid medications and illicit drugs. Dramamine II can reduce nausea for those who take opiates. At the same time, it can enhance the desired effects. Valerian has been used to manage insomnia after taking an opiate-based drug, while St. John’s wort boosts the stimulating properties of opiates, which differs from one person to another. Tylenol, aspirin, or ibuprofen mixed with codeine and cyclobenzaprine can boost euphoric effects if the person hasn’t eaten.


Additional substances used to potentiate the effects of opiates are:

  • Alcohol
  • Ophenadrine citrate
  • Cyclobenzaprine
  • Diazepam
  • Barbiturates
  • Alkaloids
  • Benadryl
  • Dimetapp
  • Chlorpheniramine and codeine

Drinking alcohol can cause respiratory depression to such a degree that the combination can be fatal.

Methods of Combining Opiates with Potentiators

Alternative methods of taking opiates can enhance the effects. For example, Antihistamine Aficionado states that when codeine, hydrocodone, oxycodone, or dihydrocodeine are ingested rectally, the effects can be increased by 10 percent. Heating hydrocodone and codeine cough syrups can boil off alcohol and decompose the drug. The opiate elements can be extracted with cold water and ingested with a syringe or medicine dropper. Adding oatmeal, cornstarch, or baking soda to liquid opiates creates a solid that can be ingested as well.

The potentiation process does not have to be invasive. Hydrocodone and oxycodone, for example, can be evaporated using cold water extraction. The liquid can be put into a nasal sprayer. A concentrated solution can also be added to chewing gum with a liquid center; the liquid with concentrated drug may then be added to antacid tablets or sugar cubes. Liquid forms of some narcotics can be enhanced by mixing with antacids or sodium bicarbonate, which lengthens the high.

Consequences of Abuse

The CDC has reported that opioid overdose deaths have been increasing for 15 years. Its prescription overdose data shows 14,000 people died from opioid overdoses in 2014. The rates are highest in the 25-54 age range, while over 1,000 people are treated in emergency rooms every day for opioid-related issues.

The consequences of abusing opiates include:

  • Dependence: This is how the body adapts to chronic drug exposure, the National Institute on Drug Abuse reports. Whether or not people are addicted, they may experience withdrawal symptoms, such as insomnia, restlessness, muscle or bone pain, diarrhea, vomiting, involuntary movements, and cold flashes.
  • Addiction: Individuals who are addicted to a substance are unable to abstain from it. They have no behavioral control, regularly give in to cravings, and may not recognize their behavior and relationships have been affected. Addiction affects the brain’s reward and motivation system. Even after a period of remission, people may relapse with exposure to the substance in their environment or due to stress.
  • Brain damage: The slowed breathing that results from opioid overdose can have long-term impacts on the brain. A lack of oxygen to the brain, called hypoxia, can trigger psychological and neurological problems. Some individuals may lapse into a coma. Permanent damage is a very real possibility as well.
  • Long-term consequences: If people take opiates for a long time, they may experience symptoms, such as nausea and vomiting, abdominal bloating, and constipation. More serious problems can include liver damage.
  • Personal impact: People might withdraw from society, and their behaviors might change with long-term opiate use. This can have profound negative results on personal relationships, career, and family life. Criminal and legal consequences might occur.

Mixing opiates with potentiators can, at the very least, increase exposure and raise the risk of overdose. Antihistamines may relieve some side effects of opiates, according to American Family Physician, but mixing in higher doses can exacerbate respiratory depression. Combining opiates and potentiators can lead to a bevy of unpredictable or unknown side effects.

Addiction Treatment Options

The more substances people take, and the more they mix them, the higher the health risks. In addition, treating polydrug abuse and addiction can be more complicated than treating addiction to a single substance. Those who abuse opiates with potentiators can be helped with recommended and proven medical treatments.

Common treatment options and approaches include:

  • Intervention: Family members and friends gather to discuss the problem with the person who is abusing opiates. Discussions should continue until the person agrees to seek treatment. Interventionists are professionals who specialize in leading such talks and finding appropriate treatment program for the individual
  • Medical detox: Performed under medical supervision, medical detox is a process that must be completed before moving on a path toward sobriety. Common medications used during opiate detox include buprenorphine and methadone. Administration must be managed carefully to adjust doses according to the person’s reaction, and to ensure the person doesn’t become addiction to the replacement medication.
  • Cognitive Behavioral Therapy (CBT): Detox does not constitute addiction treatment on its own; it must be followed by comprehensive therapy. CBT sessions can help clients recognize the triggers that lead to opiate abuse, so they can manage those triggers in recovery as well as their responses to them. Sessions also focus on the thought processes and habits that contribute to opiate use. The ultimate goal is to address thought patterns, beliefs, and other factors that lead to substance abuse and instill healthier habits in their place.

According to the National Institute on Drug Abuse, about 2.4 million people in the US took prescription drugs for nonmedical reasons in 2010, based on the 2014 National Survey on Drug Use and Health (NSDUH) study. During 2014, 4.3 million people took prescription painkillers nonmedically, and 1.9 million of them met the criteria for a disorder based on this use. The average age for using such medicines for the first time was 21.2.

It is evident that the problem of opiate abuse is not going away. If you, or a loved one, are abusing opiates, with or without potentiators, immediate intervention and treatment are essential. It is possible to manage the cycle of dependence and addiction, and get on the road to living a healthier, drug-free life.

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