Whether or not taking opioid painkillers while on LDN is acceptable is a current debate.

If you are currently dependent on opioids

If your body is physically dependent on opioids or opioid agonists (narcotics or narcotic medications) due to long-term use, it would be prudent to wait at least a week after stopping taking any such medication, before beginning to take LDN. Taking LDN any sooner could theoretically cause the opioids to be released from their receptors, causing withdrawal effects immediately.

If you are NOT currently dependent on opioids

If you are the type of person who errs on the side of safety, than heed the following advice: It is generally not recommended to take any opioid medications while taking LDN. If your own doctor or pharmacist disagrees, than it’s your personal choice whether to heed their advice our the more conservative advice of this paragraph.
Having said that, many LDN patients do indeed continue to take opioid pain medications, no sooner than 6 hours after taking LDN and no later than several hours prior to taking LDN. There are several reasons this use seems to be non-problematic in some users:
  • LDN, unlike full-dose Naltrexone, has only a minor effect on opioid receptors.
  • LDN only blocks opioid receptors for three or four hours.
  • There are current clinical trials which actually pair opioid pain medications with naltrexone, in the hopes of achieving greater pain relief with less dependance and fewer withdrawal effects.