# Why combo of clonazepam and oxycodone was so effective?



## Kon (Oct 21, 2010)

Trying to figure why this combo was so effective. Any ideas/theories of why this particular profile was so effective for me?


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## Canadian4Life (Sep 27, 2010)

Well clonazepam is a benzo and is a VERY potent one for anxiety and social phobia. Oxycodone is also potently anti-anxiety and has antidepressant features. Combined they work well for alot of people. It's no cure though and a very poor solution..using a benzo and an opiate for anxiety


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## Kon (Oct 21, 2010)

The thing is, it seems that the particular NT profile was almost perfect for me minus the GI and sedation side-effects. Equipotent doses of other benzos (lorazepam, diazepam) and other narcotics (fentanyl, dilaudid, morphine, codeine) were not nearly as effective. And the narcotics alone actually increased my anxiety, slightly. They made me feel anxious in a numb/detached way. I've never had any depression.


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## Canadian4Life (Sep 27, 2010)

Kon said:


> The thing is, it seems that the particular NT profile was almost perfect for me minus the GI and sedation side-effects. Equipotent doses of other benzos (lorazepam, diazepam) and other narcotics (fentanyl, dilaudid, morphine, codeine) were not nearly as effective. And the narcotics alone actually increased my anxiety, slightly. They made me feel anxious in a numb/detached way. I've never had any depression.


I know what you mean. Valium and ativan cause me anxiety but clonazepam doesn't. And oxycodone causes me panic attacks and restlessness. Only morphine and dilaudid help me relax. Just tuned differently.


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## Kon (Oct 21, 2010)

Canadian4Life said:


> I know what you mean. Valium and ativan cause me anxiety but clonazepam doesn't. And oxycodone causes me panic attacks and restlessness. Only morphine and dilaudid help me relax. Just tuned differently.


Damn. That is interesting. It's like we're opposites. Curious what are all you diagnoses or suspected one. Here's mine:

1. Severe Performance anxiety.
2. Mild Generalised SAD
3. Misophonia
4. Mild GAD
5. Mild BDD
6. Mild Asperger's

Officially I've only been diagnosed with Performance Anxiety and GAD. I know I have Misophonia, even though it's not yet in the DSM. I'm guessing it will be in the distant future. No depression whatsoever.


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## Under17 (May 4, 2010)

Opiates help with social anhedonia and not much else really for me in terms of social anxiety, but this alone is enough to overcome AvPD since it gives me a reason to talk to people (luckily other meds besides opiates should help with this). I'll still get nervous around people and exhibit physical symptoms, and I'd guess adding a benzo might help with this although benzos don't work that well for me. Its pretty common from what I've read to not respond well to some opiates and respond amazingly to others, as to why that is I have no idea. A lot of people in general seem to dislike morphine and fentanyl (whereas they love oxycodone). I remember when my sister was in the hospital she couldn't stand the morphine drop and made them stop it, hahaha.


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## Canadian4Life (Sep 27, 2010)

ADHD-Hyperactive Impulsive
Social Anxiety
Major depression
Bipolar (was dropped though but once was dx it)


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## crayzyMed (Nov 2, 2006)

Kon said:


> Trying to figure why this combo was so effective. Any ideas/theories of why this particular profile was so effective for me?


How good do they both individually work for you?


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## Kon (Oct 21, 2010)

The narcotic alone is not very useful. I still get anxious but I kinda feel like it numbs my emotional pain of feeking anxious.The clonazepam worked pretty good on its own but not as good as the combo.


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## metamorphosis (Dec 18, 2008)

Kon said:


> Trying to figure why this combo was so effective. Any ideas/theories of why this particular profile was so effective for me?


Because Klon hits GABAa and opiates bind to the pleasure enhancing opiate receptors. Flooding dopamine into the brain. They both kick ***. And they both produce tolerance and addiction.


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## Kon (Oct 21, 2010)

metamorphosis said:


> Because Klon hits GABAa and opiates bind to the pleasure enhancing opiate receptors. Flooding dopamine into the brain. They both kick ***. And they both produce tolerance and addiction.


What's weird for me is I have virtually no desire to take benzos. I have some and I haven't taken any since last spring. In fact, I kinda don't like taking them because they make me feel tired and sleepy. The oxycodone is a different story. It is highly addictive. When I was working the benzo worked on my anxiety and the oxycodone allowed me to bare my boring, crappy job. I could be filing or putting medications in a blister pac and I'd enjoy it because of stimulating my pleasure centre. I even enjoyed cleaning the sink.


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## orbit55 (Apr 23, 2008)

Kon said:


> Trying to figure why this combo was so effective. Any ideas/theories of why this particular profile was so effective for me?


Are you really asking this question? I mean you might as well ask why is 1L of vodka so effective or why do I feel so good after 5 lines of booger sugar?

Have you tried any MAOI's? They are usually the last line of defense...


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## 49erJT (Oct 18, 2010)

I think they used to prescribe opiates for anxiety back in the day.


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## orbit55 (Apr 23, 2008)

49erJT said:


> I think they used to prescribe opiates for anxiety back in the day. I've only taken lortab 5-500 for pain from surgery. Is oxyccodone a lot more potent? I've heard the wd from opiates is a cake walk compared to benzos.


Ummm... Did you know Heroin was an opiate? You think coming off that is easier than a benzo?


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## Kon (Oct 21, 2010)

49erJT said:


> I think they used to prescribe opiates for anxiety back in the day. I've only taken lortab 5-500 for pain from surgery. Is oxyccodone a lot more potent? I've heard the wd from opiates is a cake walk compared to benzos.


5 mg of oxycodone is equivalent to about 7.5 mg of hydrocodone (lortab). But I was taking way more than this due to tolerance. I found withdrawal pretty mild/moderate for both clonazepam and oxycodone. I used clonazepam for ~ 8 years and oxycodone/narcotics for ~ 4 years.


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## Recipe For Disaster (Jun 8, 2010)

orbit55 said:


> Ummm... Did you know Heroin was an opiate? You think coming off that is easier than a benzo?


heroin withdrawal is a cakewalk compared to benzo. it doesn't last for years and it can't even kill you, unlike benzo withdrawal.


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## 49erJT (Oct 18, 2010)

orbit55 said:


> Ummm... Did you know Heroin was an opiate? You think coming off that is easier than a benzo?


Yes and I cant say because I've never used heroin. I don't think I'd like to withdrawal from either one though.


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## 49erJT (Oct 18, 2010)

Someone was telling me recently that Dilaudid was one of the most powerful opiates. I've never had pain issues but it's nice to know that there are some strong meds out there if I ever need them....I wish the docs had more to offer in the anti-anxiety department.


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## Canadian4Life (Sep 27, 2010)

49erJT said:


> Someone was telling me recently that Dilaudid was one of the most powerful opiates. I've never had pain issues but it's nice to know that there are some strong meds out there if I ever need them....I wish the docs had more to offer in the anti-anxiety department.


Dilaudid is the most potent anti-anxiety drug i've ever taken. Far more anxiety relieving than any other opiate. a mg or two of clonazepam and 8mg of dilaudid and i'm 100% cured. For a few hours mind you..


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## orbit55 (Apr 23, 2008)

Recipe For Disaster said:


> heroin withdrawal is a cakewalk compared to benzo. it doesn't last for years and it can't even kill you, unlike benzo withdrawal.


I guess I'll have a better idea once I start my benzo taper but the medical professionals I've spoken with all say if done "correctly", benzo tapers can be very mild.

I'm really skeptical that going off heroin cold turkey could not kill you. If you have ever taken Vicodin for more than a week, the label says something like do not abruptly stop taking this medication...


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## Kon (Oct 21, 2010)

Canadian4Life said:


> Dilaudid is the most potent anti-anxiety drug i've ever taken. Far more anxiety relieving than any other opiate. a mg or two of clonazepam and 8mg of dilaudid and i'm 100% cured. For a few hours mind you..


Me too except oxycodone works much better than dilaudid even though dialudid is a stronger opioid. Maybe it's because you have ADHD and I have kinda the opposite of ADHD. I wonder if that's why dilaudid works so well for you and oxycodone for me. Maybe it's hitting different endorphine receptor sub-types? That's why I started this thread.


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## Canadian4Life (Sep 27, 2010)

Kon said:


> Me too except oxycodone works much better than dilaudid even though dialudid is a stronger opioid. Maybe it's because you have ADHD and I have kinda the opposite of ADHD. I wonder if that's why dilaudid works so well for you and oxycodone for me. Maybe it's hitting different endorphine receptor sub-types? That's why I started this thread.


Yeah I think dilaudid hits mu-receptors and oxycodone hits kappa receptors. But I can take 8mg of dilaudid Without the clonazepam and it still works awesome. f I don't take clonazepam with oxycodone I get anxiety attacks, the shakes and insane restlessness. Very strange differences


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## metamorphosis (Dec 18, 2008)

Kon said:


> What's weird for me is I have virtually no desire to take benzos. I have some and I haven't taken any since last spring. In fact, I kinda don't like taking them because they make me feel tired and sleepy. The oxycodone is a different story. It is highly addictive. When I was working the benzo worked on my anxiety and the oxycodone allowed me to bare my boring, crappy job. I could be filing or putting medications in a blister pac and I'd enjoy it because of stimulating my pleasure centre. I even enjoyed cleaning the sink.


 See I like both and of course they both can be addictive. I do like klons. Sometimes when you start taking them they can make you tired. especially if Once your body adjusts it should just mellow you at> just be careful with tolerance and addiction if you take it on a regular basis.

I really like opiates but I only use them when they happen to be around.
You obviously like the dopamine release from the opiates. That's SAD for you. The dopamine being the key along with GABA.


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## Noca (Jun 24, 2005)

I have tried every opioid available here and none of them helped my SA one bit, Oxy tho helped with my depression. The rest just kill pain.


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## Recipe For Disaster (Jun 8, 2010)

orbit55 said:


> I guess I'll have a better idea once I start my benzo taper but the medical professionals I've spoken with all say if done "correctly", benzo tapers can be very mild.


and what makes you think opiate tapers done correctly couldn't also be very mild?



> I'm really skeptical that going off heroin cold turkey could not kill you. If you have ever taken Vicodin for more than a week, the label says something like do not abruptly stop taking this medication...


so because the label says that it means you'll die if you don't listen? just google it, benzo withdrawal can easily kill you by causing seizures and status epileptus. opiate withdrawal is almost never fatal unless the person is already seriously ill from something else.


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## Kon (Oct 21, 2010)

The worst part of narcotic withdrawal is diarrhea. Make sure you get some imodium (Loperamide)!


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## Noca (Jun 24, 2005)

Kon said:


> The worst part of narcotic withdrawal is diarrhea. Make sure you get some imodium (Loperamide)!


I think nausea/vomiting is far worse and harder to treat than diarrhea.


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## 49erJT (Oct 18, 2010)

Recipe For Disaster said:


> benzo withdrawal can easily kill you by causing seizures and status epileptus.


Are seizures and death only associated with cold turkey wd or can they also occur with a slow taper?


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## Recipe For Disaster (Jun 8, 2010)

they are only associated with a cold turkey or very rapid withdrawal.


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## crayzyMed (Nov 2, 2006)

Kon said:


> The narcotic alone is not very useful. I still get anxious but I kinda feel like it numbs my emotional pain of feeking anxious.The clonazepam worked pretty good on its own but not as good as the combo.


Seems like the narcotic increased your reward response in the brain from social activity, however there was still anxiety causing unease and with the benzo you calmed that down so you could take advantage of the prosocial effects of oxycodone.

Let me ask you a few questions about your habit:

- Did the drugs give you euphoria and were you also chasing the euphoria, or were the effects limited to feeling normal
- How long did you take the combo and did you take them everyday?
- How fast did tolerance go up?
- When you quit did you have bad withdrawals?

It appears that benzo's slow down opiate tolerance:


> Inhibition of morphine tolerance and dependence by diazepam and its relation to mu-opioid receptors in the rat brain and spinal cord
> by
> Tejwani GA, Sheu MJ, Sribanditmongkol P, Satyapriya A.
> Department of Pharmacology,
> ...


I personally also have a suspicion benzo's inhibit amphetamine tolerance tough, explaining ultrashy's lack of tolerance, but on the other hand i also think that opiates speed up tolerance to amphetamine, i'm looking into it.


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## Kon (Oct 21, 2010)

crayzyMed said:


> Seems like the narcotic increased your reward response in the brain from social activity, however there was still anxiety causing unease and with the benzo you calmed that down so you could take advantage of the prosocial effects of oxycodone.


I asked my wife to confirm it with me. We both agreed that I was far less sociable when I was on the drugs. The only thing was the combo allowed me to work as a pharmacist in a very busy pharmacy. It's like I was numb to everything around me including social (performing) stuff



crayzyMed said:


> Let me ask you a few questions about your habitid the drugs give you euphoria and were you also chasing the euphoria, or were the effects limited to feeling normal


I get zero euphoria from benzos. I actually don't much like taking them, except to calm me down. They make me feel tired, sleepy and without my usual energy. Even after 8 years of use, they still had sedative properties, for me. The oxycodone gave me back the energy/desire/reward to do my work that I found either really boring and at other time, overwhelming. It kinda numbed me with a warm blanket type of feel. It made me feel no emotional or physical pain due to the stress and boredom of my job. So yes, there was a far more euphoria aspect to the oxycodone versus anything I've ever taken in my life. I didn't feel normal. I felt like I was drugged but happily drugged (at least when the side-effects weren't occurring).



crayzyMed said:


> - How long did you take the combo and did you take them everyday?
> - How fast did tolerance go up?
> - When you quit did you have bad withdrawals?
> It appears that benzo's slow down opiate tolerance:


I took the combo for ~ 4 years and I took it pretty well every day but I decreased doses of both drugs on non-work days and took some drug holidays for a few days about 1 week/year.

Tolerance to clonazepam went up slow from 1-1.5 mg/day to ~4-5 mg over the span of 8 years. Tolerance to narcotics went up faster from 2 tylenol 3s (60 mg codeine) to 240 mg oxycodone (that's equivalent to ~1500-2000mg codeine, probably more). I used far less on non-work days (just enough to control/minimize withdrawal). I still had withdrawal, though (increased muscle pain, GI problems).

When I quit the narcotics cold turkey, I had moderate withdrawal for ~ 1 week. When I quit the benzos by using ~1 month taper, I had only mild withdrawal. I'm not sure about benzos slowing down narcotic tolerance. I don't know how fast it would have occurred if I wasn't on benzos?

So tolerance rate for clonazepam over 8 years: ~4x
So tolerance rate for narcotics over 4 years: ~25-30x (at least)


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## orbit55 (Apr 23, 2008)

Recipe For Disaster said:


> and what makes you think opiate tapers done correctly couldn't also be very mild?
> 
> so because the label says that it means you'll die if you don't listen? just google it, benzo withdrawal can easily kill you by causing seizures and status epileptus. opiate withdrawal is almost never fatal unless the person is already seriously ill from something else.


Dude, whatever. I am not saying benzo's are better than opiates. They are both controlled substances and I am really not a fan of either one.

I will have more to say on the topic once I start my Klonopin taper.


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## crayzyMed (Nov 2, 2006)

Kon said:


> I asked my wife to confirm it with me. We both agreed that I was far less sociable when I was on the drugs. The only thing was the combo allowed me to work as a pharmacist in a very busy pharmacy. It's like I was numb to everything around me including social (performing) stuff
> 
> I get zero euphoria from benzos. I actually don't much like taking them, except to calm me down. They make me feel tired, sleepy and without my usual energy. Even after 8 years of use, they still had sedative properties, for me. The oxycodone gave me back the energy/desire/reward to do my work that I found either really boring and at other time, overwhelming. It kinda numbed me with a warm blanket type of feel. It made me feel no emotional or physical pain due to the stress and boredom of my job. So yes, there was a far more euphoria aspect to the oxycodone versus anything I've ever taken in my life. I didn't feel normal. I felt like I was drugged but happily drugged (at least when the side-effects weren't occurring).
> 
> ...


Looks like you managed to take those drugs for a pretty long time without ending in a super nasty addiction.

I think that if you do the following things:

- Add in memantine at 40mg
- Take a 2 day break every week of the benzo and opiate
- Add in curcumin (500mg).

You can make this work long term and drastically reduce tolerance problems, i'm saying this because youv been able to use those meds 4 years without ending in a severe addiction, you just seemed to have tolerance problems, wich can be minimized with my above suggestions.


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## crayzyMed (Nov 2, 2006)

Regarding curcumin, it slows opiate tolerance due to a differend pathway then memantine and the benzo, togheter those should be quite synergetic:


> Neuroreport. 2009 Jan 7;20(1):63-8.
> Curcumin blocks chronic morphine analgesic tolerance and brain-derived neurotrophic factor upregulation.
> Matsu****a Y, Ueda H.
> 
> ...


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## erikslev (Nov 22, 2010)

I was on a combination of klonopin and various anti-depressants for at least 5 years. I was weened off this past year and didn't have any WD symptoms at all. Very strange, but the good kind of strange.


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## Kon (Oct 21, 2010)

crayzyMed said:


> I think that if you do the following things:
> 
> - Add in memantine at 40mg
> - Take a 2 day break every week of the benzo and opiate
> ...


It's not that easy. When I get back my license (soon) I can't take any drugs except the ones prescribed by my psychiatrist. I have to do random urine tests as part of the stipulations to continue practising and I may have to tell all potential employers of my previous drug abuse. Plus my wife and parents don't ever want me to go back on those type of drugs.


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## crayzyMed (Nov 2, 2006)

Kon said:


> It's not that easy. When I get back my license (soon) I can't take any drugs except the ones prescribed by my psychiatrist. I have to do random urine tests as part of the stipulations to continue practising and I may have to tell all potential employers of my previous drug abuse.


There are tricks to neutralize your urine by adding a certain chemical in it, if your interested in that i can give you.

It sucks they are gonna urine test you man.


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## bben (Oct 24, 2009)

All the non synthetic opiates work best for me. Morphine and its derivitives increases serotonin more than the other opiates which is why non synthetics are better at releiving anxiety. Hydromorphone increases serotonin quite a bit over things like hydrocodone.


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## crayzyMed (Nov 2, 2006)

I dont think non synthetic opiates are better for anxiety, it seems to be mostly user dependent.


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## Kon (Oct 21, 2010)

I found this study interesting because it suggests a reason why a combo of benzos + narcotics might be so effective:

Although several lines of evidence suggest a strong association between endogenous opioid peptides and the GABA/benzodiazepine system in the brain, the specific mechanisms underlying the ability of preproenkephalin expression in amygdala to enhance the anxiolytic effects of diazepam are unclear. Potentiated diazepam actions could be related to upregulation of GABA/BZ receptors, enhanced allosteric GABA/BZ receptor coupling, and/or increased GABA release induced by enkephalin overexpression in amygdala.

GABA and opioid neuropeptides are colocalized in many brain regions, including the central nucleus of amygdala, and diazepam can modulate opioid peptide release in distinct brain regions. Thus, if the anxiolytic actions of benzodiazepines relies on the release of endogenous opioids, this effect might be potentiated by virus-mediated overexpression of preproenkephalin. Additionally, chronic opioid treatment causes an alteration of GABA/benzodiazepine receptor numbers in the brain suggesting potential changes in the GABA/BZ receptor could account for enhanced diazepam effects.

http://www.nature.com/npp/journal/v22/n1/pdf/1395414a.pdf


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## izelatlan (Jan 19, 2011)

One can carefully use clonazepam and oxycodone to together. But be very careful and do it very cautiously. Do not MIX ALCOHOL and be very careful. The clonazepam in small doses will kill off the anxiety and so one won't tend to over-correct with the oxycodone. So 1mg of clonazepam will make one think twice between taking a second does of oxycodone b3 it 5mg or 15 of oxycodone. JUst be AVERY CAREAFUL.


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## cduval04 (Oct 12, 2011)

I know this thread is old but I found it on a google search and have to say that my experience with oxy is identical to . I have tourette's and pretty bad anxiety am on 2mg clonazepam daily and recently had surgery and was given oxy for post op pain. If I take 5 or 10 mg on it's own I get very agitated, restless, sweaty & anxious & my heart rate goes nuts. If I take it w/ 0.5mg or 1mg of clonazepam the combo is extremely relaxing, way more so that if I took the clonazepam by itself. Weird.


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