Common Opioid Potentiators and How They Affect Opioids

Whether you consume opioids for recreation or to relieve pain, certain over-the-counter medications, foods, and other not-so-psychoactive substances can substantially improve your experience with opioids. While, in theory, it’d be best just to take a higher dose of opioids — as opposed to combining two or more drugs together, which greatly increases your chance of overdose or death — these drugs are hard to come by.

If you buy them from the black market, they’re too expensive for all but the wealthiest folks, and if you’re prescribed opioids for pain management, you’re probably not given enough to satisfactorily relieve your pain. That leaves many opioid consumers in a tough situation — one that greatly benefits from the use of opioid potentiators.

First Off — Please Take These Safety Precautions

If you’re reading this guide, you’re probably interested in getting more from prescription opioids—pain pills, in other words. Whether a doctor prescribes them to you or not, I don’t care.

The Age of Practically Perfect Fake Pills

Now that people have been pressing fake opioid tablets for the better half of a decade now, fake roxies, Xanax bars, and other pills look more real than ever before. Don’t just assume your pills are real. It doesn’t matter how legit you think your source is—or how legit they actually are.

People can start pressing pills with a thousand dollars or less. It’s possible to buy parts of pill presses on the clearnet. If not, there are undoubtedly pill press hardware vendors on the darknet. While many pressed pills don’t look 100% right, please don’t trust your ability to judge fakes to keep yourself safe.

The Fentanyl Poisoning Crisis

Here in rural West Tennessee, I noticed that heroin disappeared from the entire market—not just for Bobby Jo or Joey Bob or your mom’s boyfriend—but for everyone back in March 2021. While heroin resurfaced intermittently, straight fentanyl remained on the market. Today, many people think they’re using heroin—but they’re actually not. It’s just fentanyl.

Why is heroin cut with fentanyl? Learn more here.

It’s crazy — my syringe exchange’s participants have asked me more than once, “My meth showed up positive for fentanyl. Why is meth cut with fentanyl?” Meth even has fentanyl in it sometimes—though not often, admittedly.

The rash of overdose deaths in the U.S., which continue to climb year after year, are mainly caused by inadvertent fentanyl consumption. Or, if people know they’re consuming fentanyl, they inadvertently—a.k.a. “accidentally”—use too much.

Fortunately, We Have Safe Drug Use Protocols to Share With You

Whether you have a low tolerance and only occasionally use opioids or you take them everyday, please follow these tips. By continuing to read this article, you agree to (#1.) read the following tips and (#2.) follow them as closely as humanly possible. Please.

I’m almost done with this disclaimer, I swear! Without further ado, here are my proven opioid safety tips:

#1. Get Naloxone

Naloxone, also called NARCAN®, saves people’s lives by reversing opioid overdose. Here’s a resource for finding free Narcan kits in Tennessee.

If you’re already knowledgeable about naloxone and just need to find it, here’s a list of Tennessee harm reduction programs and syringe exchanges in Tennessee.

Not in Tennessee? Ask Next Distro for help. It’s free. They mail it to your doorstep.

#2. Learn How to Use Naloxone

You can’t use naloxone on yourself. Don’t even try. The hallmark of opioid overdose is being unconscious. By the time you overdose, you’ll be unconscious. You can’t save your life while you’re asleep.

Here’s a short, easy-to-understand guide on how to use naloxone.

#3. Always Use Around Someone Else

Always use opioids around someone else who isn’t using the same drugs at the same time as you. Make sure they know where your naloxone is. Make sure they know how to use naloxone. Make sure they know the signs of opioid overdose. Make sure they’re willing to spend at least an hour beside you after you dose so you won’t die.

#4. Use Fentanyl Test Strips

Fentanyl test strips are very easy to use. They require very little substance, are 95%+ accurate, and give you results within 30 seconds.

That’s it for the opioid safety stuff. Happy potentiating!

What Is an Opioid Potentiator?

To potentiate something is to make it better. Certain drugs synergize well with other drugs.

For example, some opioid users claim that benzodiazepines — which are a very dangerous combination (I’ve overdosed on the combination once before) — feel good with opioids. In other words, they synergize well with one another.

Opioid potentiators, for this article’s purpose, are over-the-counter drugs that give you more bang for your buck. Although there are many opioid potentiators, I’ll be writing about three of my favorites.

Cimetidine (Tagamet)

Cimetidine, also sold under the brand name Tagamet, is marketed as a stomach acid reliever. The drug is a solid opioid potentiator because it inhibits certain liver enzymes that are responsible for breaking down opioids and eliminating them from your body.

Inhibition, if you didn’t know, of such liver enzymes is good in terms of improving your opioid high or your opioid’s analgesic effects — the weaker concentrations of such liver enzymes are, the longer opioids stay in your body, meaning you get high for longer.

In my opioid using career, I’ve found that most opioids last about four hours. Believe it or not, cimetidine can lengthen the duration of an opioid experience by up to two hours.

If you want a longer duration with slower onset of effects, take cimetidine well before your opioids of choice — in my experience, anywhere between 30 and 60 minutes before dosing is sufficient to take full advantage of Tagamet as an opioid potentiator.

To retain your normal onset time but still prolong effects, take cimetidine at the same time you dose your opioids of choice.

Typical doses of cimetidine for this purpose — liver enzyme inhibition, that is — are 600 milligrams, or three 200-milligram tablets. Cimetidine is very affordable and is available practically everywhere.

I’d like to note that I’ve read real-deal academic research regarding a link between the development of gynecomastia in roughly one-fifth of men who took the stomach acid reliever regularly for even just a few months at a time.

Classic Chewable Antacids

Cimetidine is just as much of an antacid as classic chewable tablets bearing the active ingredient of calcium carbonate.

Tums, which is what I’ll be calling antacid chewable tablets with calcium carbonate from hereon out, also potentiate opioids, though not at all in the same way as cimetidine. Rather, calcium carbonate increases the stomach’s pH level, making it more basic — an ideal condition for the human stomach to absorb medications like opioids.

Keep in mind that you can substitute baking soda — that’s right — for Tums. Although baking soda — also known as sodium bicarbonate — doesn’t contain calcium carbonate, it still raises your stomach’s pH level, in turn helping your body absorb any opioids you ingest.

Diphenhydramine, a.k.a. Benadryl or Dormin

Benadryl is a common first-generation antihistamine that is also used as a sleep aid.

Because diphenhydramine acts as a sedative, it can increase the “nod” — the sleep-like state caused by higher doses of opioids — associated with opioid use. It can also increase the risk of overdose and death. Almost all overdoses result from combined drug intoxication; even though Benadryl might sound harmless, it really can increase your risk of overdose.

That said, diphenhydramine can also reduce the itchiness — and even the nausea — associated with opioid use.

If you choose to use diphenhydramine with opioids, never exceed 50 mg — and never drink alcohol or consume other sedatives like benzodiazepines (e.g., Xanax, Valium).

Fatty Foods

To be honest, I don’t know the science behind why increasing fat content in your stomach just before you take opioids by mouth actually improves their bioavailability… but it works. And this isn’t just “bro-science.”

DXM, a.k.a. Dextromethorphan or Coricidin Cough and Cold

This medication is available all across the United States in an over-the-counter fashion. The drug is pharmacologically known as belonging to the drug class of morphinan. Drugs that are part of the morphinan family have three psychoactive properties that other particular drugs almost always don’t all possess at the same time — these three properties are dissociating, sedating, and stimulating, all of which dextromethorphan can possess.

I never took DXM much for opioid potentiation. This was because, once I found out that dextromethorphan, a relatively harmless over-the-counter medication — not to mention a cheap medication, at that —really was a legitimate, reliable means of keeping your opioid tolerance from growing, I was taking medicine that could have caused serotonin syndrome if I took DXM with that medicine. I was taking an SSRI, a common type of antidepressant that doesn’t mix well with DXM due to this serotonin-related health problem.

Taking DXM, again, is something that I don’t have much experience with. However, I understand that most people who utilize the common cough suppressant for opioid potentiation purposes report that consuming the drug— just an aside; I remember in high school when people sometimes hung out with one another after school, all of them sharing a good experience on high-dose dextromethorphan — anywhere from 30 to 60 minutes prior to consuming your opioids.

I never did it, but even I know that you might put yourself at harm by taking too much DXM with opioids. High doses of DXM are potentially harmful on their own, let alone with interference from heavy painkillers.

Naltrexone Might Help

Naltrexone is what’s known as an opioid antagonist, a drug that has a blocking effect on the brain’s opioid receptors, meaning that, until naltrexone has been eliminated by the body, more common, run-of-the-mill opioid drugs with high recreational values such as Percocet and Norco will not be able to cause euphoria or otherwise make you feel inebriated.

Despite this fact, naltrexone doesn’t manage to block these traditional opioids from having a physical effect on your body; in other words, this means that opioids, even if they don’t feel like they’re doing a number on your body, can very well cause overdose even in the presence of antagonists like naltrexone.

Ultra-low-dose naltrexone, also known as ULDN, is a certain way of using naltrexone so that it will have a substantial positive impact on the utility you’re able to derive from working ULDN into your routine so that it ultimately performs a benefit for you.

Normal doses of naltrexone are 50 milligrams. Low-dose naltrexone, or LDN for short, is anywhere between 0.5 mg and 5 mg. Ultra-low-dose naltrexone, on the other hand, are usually anywhere between 1 and 10 mcg — there are 1,000 micrograms (mcg) in a milligram (mg) and 1,000,000 micrograms in a gram, just so you can get an idea of how much difference there is in dosing for the three different modern dosage routines for naltrexone.

A good thing about naltrexone is that it’s not a controlled substance, meaning that it’s subject to less prescribing and dispensing scrutiny. This also makes the cost of naltrexone lower than their controlled counterparts.

The way that people can consistently make accurate measurements when it comes to dosing such small amounts of naltrexone — remember that ULDN doses are in the micrograms, so don’t lose context — is only possible through the power of volumetric dosing. This practice consists of dissolving naltrexone, for example, in a measured volume of water. With a simple, quick calculation, users can readily dose themselves and others with droppers, pipettes, and other liquid transferring tools.

Lastly, White Grapefruit Juice

I’m not a culinary expert, but I think it’s safe to say that white grapefruit juice isn’t the best tasting fruit juice in the world. However, it’s not that bad — it’s totally worth the opioid potentiating effects that it may offer to some users.

I do not like using white grapefruit juice as a means of improving my experiences with opioids.

The idea behind using white grapefruit juice — which needs to be entirely from concentrate and never mixed with any other fruit juices — comes from its ability to block a certain type of liver enzyme called the CYP450 cytochrome. This enzyme is one of the most important when it comes to processing opioids; as a matter of fact, the same enzyme that’s inhibited by the drug at the top of the list — good ol’ cimetidine.

I don’t like white grapefruit juice as a potentiator because its highly acidic nature ultimately has a direct decrease in the pH of your stomach. The more acidic it is, the lesser proportion of drugs your body will manage to secure for the opioids you put down the hatch.

As such, although you could take Tums or baking soda to lower the pH that was increased by the white grapefruit juice, I think white grapefruit juice is not a worthwhile potentiator that is alleged to effectively increase the duration of opioids’ working lives and even make them more potent. However, every person’s body is constructed differently; as such, how well you perceive white grapefruit juice to work as an opioid potentiator may be much different than mine.

Again, I want to reiterate that you need to purchase 100% white grapefruit juice. Some blends may be branded as “white grapefruit juice” even though they may only contain a dozen or two dozen percent white grapefruit juice.

Bad Opioid Potentiators

Alcohol, stimulants, and benzodiazepines are poor choices of potentiators for opioids, though many drug users across the modern United States routinely engage in mixing two or more of these drugs, which puts users at a serious chance of suffering an overdose and potentially dying.

When opioids and alcohol — or any other sedative, for that matter — are combined, they accentuate the sedative effects of one another, causing a greater risk of overdose or other unwanted adverse effects than by themselves.

Benzodiazepines are anxiolytic, meaning they help reduce anxiety; hypnotic, which means they help people go to sleep; muscle-relaxing; anticonvulsives, which stops things like seizures; and sedative, which helps people achieve calmness.

I’ll give it to you — alcohol and benzodiazepines are two of the single worst substances that people can mix with opioids; in other words, you probably were already aware of the potentially deadly results of mixing opioids with alcohol, benzodiazepines, or both. However, you might not know about the next one: stimulants.

Stimulants inherently offset the various effects of opioids. They also cancel the recreational value of one another. To get back to where opioid users want to go, they take more opioids than they normally would fight back against the stimulants. If your stimulant wears off and your increased opioid dose has not worn off, you could experience overdose — at the very least, you’ll be knocked out or unable to string any more than two steps, words, or thoughts together.

With this in mind, make sure not to go too hard on either of these drugs if you do decide to mix them. The best thing to do is not mix them in the first place — none of these three drugs are suitable complements to opioids.

In the Vein of Full Disclosure

I overdosed on alprazolam (Xanax), a benzodiazepine, and oxycodone, an opioid, in May 2014 shortly after arriving at UT Martin.

My roommate had just snitched on me for smoking pot in the dorm room I was in — this was less than a month after I arrived at UT Martin and just four months after getting kicked out of UT Knoxville for the same thing — a couple of hours prior. After getting arrested, booked, and released at the campus’ public safety building, Crisp Hall, I took 4 mg of Xanax.

Just a few months prior, I was used to taking 10 mg of alprazolam at once; at this time, I had fostered this five-bar-at-a-time habit while in junior or senior year of high school (boy, I sure knew how to treat my brain right… ugh) for at least a year at this point — what’s important is that I had a tremendous benzodiazepine tolerance.

I wasn’t big into opioids then, but, in previous escapades, I had taken more oxycodone at once in combination with Xanax before than I had this warm, calm summer night in my first few weeks at UT Martin.

About 60 to 90 minutes after the Xanax, I took 30 mg of oxycodone. My reasoning for taking what would turn out to be a far, far too potent dose was that I had built up a major tolerance over a year, if not even longer; also, I had never been sensitive to opioids.

So, I share this to inform you of the two mistakes I made that night:

  • First, I assumed my tolerance was more stout than it actually was.
  • Second, I was using the combination in response to my emotions, which is generally a bad idea.

I hope you won’t make the same mistake that I did that night.

What Are Opioid Potentiators All About?

Just to make sure you understand the concept of opioid potentiators, it’s time to answer what the purpose of potentiators is.

Opioid users get some kind of utility out of pain pills, heroin, and other opioids, whether it be analgesia, keeping depression at bay, or satisfying their bodies’ dependency for opioids.

You can get more utility by using potentiators. Most people can’t simply use more opioids to derive more utility from them because they may have trouble reliably sourcing black-market opioids; also, even more people don’t have enough money to satisfy their true hunger for opioids.

Rather than going broke or running through your stash too quickly, heading to Walmart or another retail store with twenty bucks to spend is an easy, efficient means of improving the experience you have consuming opioids.

Please don’t experiment with new drugs as “potentiators” without having thoroughly studied them and anecdotal reviews other recreational drug users have left on drug-related Internet forums — a better high isn’t worth risking your life for. Even if you have studied up on or have, in fact, practiced these combinations numerous times in real life before, keep in mind you’re taking a risk.

Although I’m comfortable with taking this risk, that doesn’t mean you should be — again, tread carefully in using opioid potentiators.

My Go-To “Recipe”

Note that I didn’t come up with the idea of opioid potentiators myself. I learned about it close to a decade ago online, particularly on an older drug-related website called The Hip Forums.

A user on this forum named Gdeadhead420 copied and pasted the opioid potentiation guide I learned from myself to this forum in 2008. The only scrap of evidence regarding the original author is that Gdeadhead420’s copied-and-pasted post identified “N0 W4RN1NG” as being responsible for having created the guide that ultimately exposed me to opioid potentiators.

So, my trusted cocktail of opioid potentiators over the years has been 600 mg of cimetidine taken between 0 and 30 minutes before dosing opioids, taking 25 mg of diphenhydramine anywhere from 10 to 30 minutes before dosing, and chewing two Tums or swallowing roughly a tablespoon’s worth of baking soda between 5 and 15 minutes before dosing.

N0 W4RN1NG’s combination includes using five more potentiators than my three-drug-combo above. I recommend trying my simpler trio of potentiators at least once sometime and doing the same for N0 W4RN1NG’s infamous recipe.

Good luck!

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