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O-DSMT is an interesting opioid with dual action at the mu-opioid receptor and as a norepinephrine receptor inhibitor. As a tramadol metabolite, it differs in the lack of serotonergic effects, which could theoretically result in fewer side effects.

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IC-26, also known as methiodone, is an investigational opioid structurally related to methadone. It acts as an agonist at the μ-opioid receptors and has similar analgesic and sedative effects.