Alertness--RLS vs. pain dosages?

[wantok]

This is probably a no-brainer, but if codeine causes alertness at dosages for RLS, it will likely cause alertness for pain level dosages?

[Rustsmith]

It is my understanding that alerting is more of an individual specific situation than one of dose and that those of us with severe RLS are more likely to experience alerting (which is why doctors all seem to think that opioids are sedating). Therefore, if you are experiencing alerting with low dosage codeine, it seems likely that you would also experience it with a higher dose for pain.

[QyX]

It is my understanding that alerting is more of an individual specific situation than one of dose and that those of us with severe RLS are more likely to experience alerting (which is why doctors all seem to think that opioids are sedating). Therefore, if you are experiencing alerting with low dosage codeine, it seems likely that you would also experience it with a higher dose for pain.

Indeed. Alertness from opioids is simply a general side effect. It is unclear if RLS patients are more likely to experience this compared to your average chronic pain patient but even if this would be the case, it might be difficult to determine between RLS related insomnia and insomnia caused by opioids.

However I also made the experience that some opioids, especially Oxycodone in my case, can cause major alertness. This ultimately made me stop Oxycodone and switch to Hydromorphone. But this all happened in the first few years of opioid therapy. The alertness disappeared for me after 3 years. It also seemed that Hydromorphone was only causing slight activation for and Morphine none at all. But of course that can be very different for another person.