Synergy Cocktail to Manage Pain
Hydrocodone, Metaxalone, Tramadol, Alprazolam & Ketamine
Citation:   RxDrugLord. "Synergy Cocktail to Manage Pain: An Experience with Hydrocodone, Metaxalone, Tramadol, Alprazolam & Ketamine (exp97892)". Jul 13, 2018.

30 mg oral Hydrocodone (pill / tablet)
  975 mg oral Acetaminophen (pill / tablet)
  100 mg oral Pharms - Tramadol (pill / tablet)
  1600 mg oral Metaxalone (pill / tablet)
  1 mg oral Pharms - Alprazolam (pill / tablet)
    insufflated Ketamine (powder / crystals)
I'm currently a patient at a pain center and usually struggle with basic daily functions due to my condition. I'm in the initial stages of managing it, so I'm stuck with only a few medications, with norco being the staple opioid. My background of substance use includes most recreational drugs with the exception of LSD and E. I am also a health care professional, so I understand the pharmacology and toxicology of these medications.

Last night I came home from work in agony and just wanted to ice, sit on the couch, and watch football while on my meds. Usually, the regular meds do just enough to make me comfortable, so I thought about adding adjuvant agents to enhance the efficacy of my cocktail. So along with the Skelaxin (metaxalone) and Norco, I just so happened to have some pure ketamine powder laying around and an older prescription of xanax. Any time medications that have risks for CNS depression are taken together, caution should always be exercised, and alcohol should best be avoided.

So here is the experience starting at around 9:00pm. Setting: comfortable living room environment with ambient lighting and an energetic young puppy.

I break 3 norco tablets in half and wash them down with 2 full glass of water along with two 50mg tramadol tabs. It is important to fully dissolve medication in your gut in order to get max absorption. This holds true for most drugs taken in capsule or tablet form.

Next, I took two 800mg Skelaxin tablets and two 0.5mg alprazolam tablets.

[Erowid Note: Two samples of powder (even of the same chemical) with equivalent volumes won't necessarily weigh the same. For this reason, eyeballing is an inaccurate and potentially dangerous method of measuring, particularly for substances that are active in very small amounts. See this article on The Importance of Measured Doses.]
I don't have a balance to weigh out powder, so I eyeballed two small piles of about 5mg each of the ketamine powder and bumped both. The remanence can be applied sublingually which will absorb nicely. With all the cocktail taken at once, I went to take a warm shower to further relax and wait for the onset.

The ketamine is the first thing to hit (obviously). While in the shower, the warm water washing over me takes on a character of its own, its thousands of massaging beads of water dancing on my skin. The typical bodily effects of what ketamine brings. With 1.6 grams of Skelaxin awaiting absorption into my bloodstream, I expect full augmentation of the warm bodily effects of the combo.

Now clean and fresh, I got comfortable on the lux sofa in my living room and turned on football. I thought that hard-hitting NFL might not be the best programming considering the experience about to take place, so I turned on netflix and played breaking bad. The hydrocodone is starting to come on strong, as this is a medium-high dose for me. Usually the xanax will take about 45 minutes to set in. I'm sinking comfortably into my couch and feeling my chronic pain slowly fade to background noise as breaking bad starts.

By the time the first episode is over, my eye lids have slightly slid downward, pupils constricted, and body feeling relaxed and sinking into the couch. Euphoria is growing and the show is getting more and more interesting. Can't help but have a smile on my face as I feel the characters of each agent vying to take over. At this time, the ketamine is still the most noticeable, and it feels as if the pure bumps slightly blunted the effects of the norcos.

By an hour into it, the effects of the xanax have come through and I can feel the body high growing into a warm, dizzying spell of euphoria and relaxation. I had to get up to pee, and as I stood up I nearly lost balance as I felt incredibly heavy, yet as if I was floating around. It wasn't a sensation I was familiar with and it took a minute to regain my balance and coordination as I made my way to the bathroom. I had to squint my eyes to focus on the things around me and try very hard not to wobble or stumble. The lights in the bathroom felt brighter than usual and changed the character of my high. I suddenly felt the ketamine very strongly and the other agents hardly at all. I was shocked at what was happening because at that dose of norco, I can feel it pretty strongly. I'm not sure why the ketamine was over powering everything. As I glided back to the couch with the same smile on my face. I assessed my pain, which had delightfully been dulled down to a very manageable level. On a typical pain scale of 1-10, I would rate this as a 3. This is the lowest I've ever had my pain. However, the intoxicating cocktail also rendered me pretty much ineffective at anything but watching TV while lying down with a drunkard-looking smile on my face. Mentally, I felt pretty motivated when I thought about business related topics, but the haze and intoxication of the cocktail probably would not allow for much progress to be made-only drive creativity.

The effects lasted fairly strongly for about 2 hours and slowly faded away before I fell asleep. The other meds I took felt as if they were hardly present during the experience, but the ketamine felt much more different than usual. As a pain cocktail, it was effective for the type of pain I have, but realistically it is quite taxing mentally and extremely sedating. The dosages of the meds can be adjusted to achieve different results or rid side effects related to one particular drug. All in all, it was a good medical and recreational experiment. One note about the types of drugs used has to be made however: the combination of muscle relaxers, opioids and benzodiazepines taken together has resulted in respiratory depression overdoses.

Exp Year: 2012ExpID: 97892
Gender: Male 
Age at time of experience: 28
Published: Jul 13, 2018Views: 7,791
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Ketamine (31), Pharms - Alprazolam (98), Pharms - Tramadol (149), Metaxalone (653), Hydrocodone (111) : Therapeutic Intent or Outcome (49), Medical Use (47), Combinations (3), Alone (16)

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