Opioids Advice on humanely detoxing from fentanyl pills...

[RobT1981]

I have tried multiple times to get off these pressed fentanyl pills (smoker) but the sickness is unbearable CT and I haven't found a way to using suboxone w/out awful PW. Anyone have success doing this? Would love to hear your thoughts...

 

[CaptnRon]

You may wanna consider a quick taper methadone program.

Otherwise, you’ll likely need to wait 148-160 hours or so for the fent to clear your system before you can safely induct on subs.

I used to wait like a 100 hours and take maybe 2mg of sub and be thrown into the worst precipitated withdrawal.

I refused to take another long acting opiate to replace my illicit heroin/fent (fent for the past 5-6 years after it inundated my local open air drug markets) like methadone.

I cold turkey’d with no comfort meds. The only thing I used was a little bit of cannabis for relief. It was hell for about 2 weeks, and lingering withdrawal effects lasted for about a month total (phantom pain, running nose, watery eyes, goosebumps etc)

Take this info and do what you will with it, I do understand that the majority of addicts can’t or won’t cold turkey out, but it worked for me. The pain of that awful withdrawal is a strong motivator to keep myself from making bad decisions on the daily.
People are resilient creatures. You can take many more times the pain and suffering than you think you can.

Anyhow I hope you find the peace and life you’re seeking.
Always, fair winds and following seas

 

[LoveTractor]

I’ve had success with the Bernese method. It needs to be done very carefully - exactly as directed.

I used this guide and it worked well but I started with 1/2 of the recommended dosage for two days before going onto the schedule in the document linked.

https://medschool.cuanschutz.edu/docs/librariesprovider294/default-document-library/bupe-microdosing-january-20-2021.pptx?sfvrsn=7aea66ba_0

It can work well, but you do need to mind your doses - use a milligram scale if you’re using tablets or measure strips very accurately and precisely to get the doses you need for each step. You can be off fent in ten days. If you search here for fent + Bernese method you will find a lot of horror stories mostly b/c people misapplied the guidelines or messed up their doses, this is why I started at 1/2 the dose for two days before carrying on with the schedule in the document above, so you’d do 0.25-mg eq. sublingual rather than 0.50-mg for two days b/f going to 0.50-mg sublingual.

Those are sublingual doses(!) - for better results I suggest starting for two days with half the dose listed and snort tablets or waterline strips. So I started with 0.125-mg from a tablet weighed with a milligram scale and snorted it. Intranasal (IN) is very close to 2x sublingual as it was used in studies that proved the Berneses method works . This is b/c bupe is more evenly absorbed by IN. I suspect a lot of failed inductions used sublingual dosing, I’ve read a lot of successes with snorting (IN).

People will reply that this deosn’t work for fent. It can and does for a lot of people, especially those who do it in a clinical setting where the doses are prep’d by pharmacists / medical personnel with experience. You can do this if you can get 30-mg of bupe you can get off fent, but then of course you’ll need more to taper the bupe as quickly as you can tolerate. That you’ll need to figure out, you can ask here for advice.

Methadone as mentioned above is your other option and that you can start w/o worrying about PWDs but also you’ll not be well with the first dose it may take a week or weeks to get to a comfortable dose of methadone. Bupe by Bernese method can get you there with very minimal to no pain. Very minimal.

EDIT: I needed to correct the numbers in this post. All good now, I underestimated so nobody would have been harmed. The full calcs are in a post I made below. Always check yur math a few times to be sure its correct. Bad math = PWDs at worst, wasted time and material at best.

 

[RobT1981]

Wow. Thank you both for your detailed replies. This is exactly the type of engagement I was hoping for; better than 100 responses devoid of firsthand experience. I have heard of Bernese working but was concerned about myself actually doing sublingual accurately in such small doses. Despite being in this opioid cycle for 15 years or so I have no experience w/ intranasal bupe, and for sure im curious about a better method; will definitely explore all this advice thoroughly, thanks again guys.

 

[RobT1981]

I’ve had success with the Bernese method. It needs to be done very carefully - exactly as directed.

I used this guide and it worked well but I started with 1/2 of the recommended dosage for two days before going onto the schedule in the document linked.

https://medschool.cuanschutz.edu/docs/librariesprovider294/default-document-library/bupe-microdosing-january-20-2021.pptx?sfvrsn=7aea66ba_0

It can work well, but you do need to mind your doses - use a milligram scale if you’re using tablets or measure strips very accurately and precisely to get the doses you need for each step. You can be off fent in ten days. If you search here for fent + Bernese method you will find a lot of horror stories mostly b/c people misapplied the guidelines or messed up their doses, this is why I started at 1/2 the dose for two days before carrying on with the schedule in the document above, so you’d do 0.125-mg eq. sublingual rather than 0.25-mg for two days b/f going to 0.25-mg.

Those are sublingual doses(!) - for better results I suggest halving the dose listed and snort tablets or waterline strips. So I started with 0.0625-mg from a tablet weighed with a milligram scale and snorted it. Intranasal (IN) is very close to 2x sublingual as it was used in studies that proved the Berneses method works . This is b/c bupe is more evenly absorbed by IN. I suspect a lot of failed inductions used sublingual dosing, I’ve read a lot of successes with snorting (IN).

People will reply that this deosn’t work for fent. It can and does for a lot of people, especially those who do it in a clinical setting where the doses are prep’d by pharmacists / medical personnel with experience. You can do this if you can get 30-mg of bupe you can get off fent, but then of course you’ll need more to taper the bupe as quickly as you can tolerate. That you’ll need to figure out, you can ask here for advice.

Methadone as mentioned above is your other option and that you can start w/o worrying about PWDs but also you’ll not be well with the first dose it may take a week or weeks to get to a comfortable dose of methadone. Bupe by Bernese method can get you there with very minimal to no pain. Very minimal.

I think I'm going to give burnese a shot since I have plenty of bup., I studied the taper sched. etc. and wanted to know if you followed the big jump toward the end from like 4 mg to 12 mg 2x daily, just seemed like a lot, especially after such small/steady increases....

 

[LoveTractor]

@RobT1981 - Yes I did the big jump up at the end where it says:

• Day 6: 4 mg twice a day
• Day 7: 12 mg twice a day and stop all other opioids <- This is important you might fuck yourself and bupe won't hold you if you continue or add any other opioids at Day 7 or beyond. Drop it all!

On Days 2 -7 the doses were taken exactly 12 hours apart.

I want to be extremely clear about the difference b/w sublingual and intranasal dosing:

This is the SUBLINGUAL schedule:

• Day 1: 0.5 mg once a day
• Day 2: 0.5 mg twice a day
• Day 3: 1 mg twice a day
• Day 4: 2 mg twice a day
• Day 5: 3 mg twice a day
• Day 6: 4 mg twice a day
• Day 7: 12 mg twice a day and stop all other opioids
• DONE!

This is the INTRANASAL schedule:

• Day 1: 0.25 mg once a day IN
• Day 2: 0.25 mg twice a day IN
• Day 3: 0.5 mg twice a day IN
• Day 4: 1 mg twice a day IN
• Day 5: 1.5 mg twice a day IN
• Day 6: 2 mg twice a day IN
• Day 7: 6 mg twice a day IN and stop all other opioids
• DONE!

The only deviations from the guide I did was the two day prep period at 0.125 mg IN / once a day (see my first post) before Day 1 and I needed a bit more on Day 7 and for two days after (day 8 & 9) so I used and extra 2-mg IN late Day 7 and the same total of 8-mg IN on day 8 and 9 both days in one dose, yeah after Day 7 I was good to take all my dose once a day.

I then began to taper on Day 10 every day going: 7, 6, 5, then 4-mg IN / day. If I have counted right that is 14 days from start until I was down to 4-mg IN / day on Day 14.

I got my refill on Day 15 and went directly back to 100 microgram per hour fentanyl patch, stopped the bupe with day 14’s 4-mg IN dose and put the patch on the next day at noon, it takes 12 - 36 hours to reach max effectiveness, the overlap was seamless for me.

Best wishes everyone, please ask ?s or leave comment here I do not check my inbox nor log in often, but I get notified of replies to this thread and I will come back ASAP. I’ve been here since late 2003 (diff username). I abused an opioid (heroin, oxy, fent. dilaudid, methadone, bupe for short periods, etc.…) everyday for 20+ years

If I can do it anyone with the tools and patience can do it. What’s 10 days of your life where you aren’t even uncomfortable. I worked full days all through this. No issue! This was more comfortable than my last few periods.

Mods - If you’d like this in a better edited format to put somewhere I do think this is as complete a guide in one place as we have here. Or just promote the document I linked in my first post. Anything I can do to help others I want to.

Good day,

-Lady Tractor.

Edited to fix my first dose weight it was 0.125 mg as bupe not 0.0625 mg bupe.

 

[RobT1981]

@RobT1981 - Yes I did the big jump up at the end where it says:

• Day 6: 4 mg twice a day
• Day 7: 12 mg twice a day and stop all other opioids <- This is important you might fuck yourself and bupe won't hold you if you continue or add any other opioids at Day 7 or beyond. Drop it all!

On Days 2 -7 the doses were taken exactly 12 hours apart.

I want to be extremely clear about the difference b/w sublingual and intranasal dosing:

This is the SUBLINGUAL schedule:

• Day 1: 0.5 mg once a day
• Day 2: 0.5 mg twice a day
• Day 3: 1 mg twice a day
• Day 4: 2 mg twice a day
• Day 5: 3 mg twice a day
• Day 6: 4 mg twice a day
• Day 7: 12 mg twice a day and stop all other opioids
• DONE!

This is the INTRANASAL schedule:

• Day 1: 0.25 mg once a day IN
• Day 2: 0.25 mg twice a day IN
• Day 3: 0.5 mg twice a day IN
• Day 4: 1 mg twice a day IN
• Day 5: 1.5 mg twice a day IN
• Day 6: 2 mg twice a day IN
• Day 7: 6 mg twice a day IN and stop all other opioids
• DONE!

The only deviations from the guide I did was the two day prep period at 0.0625-mg IN / once a day (see my first post) before Day 1 and I needed a bit more on Day 7 and for two days after (day 8 & 9) so I used and extra 2-mg IN late Day 7 and the same total of 8-mg IN on day 8 and 9 both days in one dose, yeah after Day 7 I was good to take all my dose once a day.

I then began to taper on Day 10 every day going: 7, 6, 5, then 4-mg IN / day. If I have counted right that is 14 days from start until I was down to 4-mg IN / day on Day 14.

I got my refill on Day 15 and went directly back to 100 microgram per hour fentanyl patch, stopped the bupe with day 14’s 4-mg IN dose and put the patch on the next day at noon, it takes 12 - 36 hours to reach max effectiveness, the overlap was seamless for me.

Best wishes everyone, please ask ?s or leave comment here I do not check my inbox nor log in often, but I get notified of replies to this thread and I will come back ASAP. I’ve been here since late 2003 (diff username). I abused an opioid (heroin, oxy, fent. dilaudid, methadone, bupe for short periods, etc.…) everyday for 20+ years

If I can do it anyone with the tools and patience can do it. What’s 10 days of your life where you aren’t even uncomfortable. I worked full days all through this. No issue! This was more comfortable than my last few periods.

Mods - If you’d like this in a better edited format to put somewhere I do think this is as complete a guide in one place as we have here. Or just promote the document I linked in my first post. Anything I can do to help others I want to.

Good day,

-Lady Tractor.

Thanks again, I really appreciate all the info. I'll give an update on here at the end of my taper attempt..

 

[LoveTractor]

The math: Check my math! And don’t use my value for tablet weight! Weight yours, I used 8-mg Subutex tablets.

If you have access to 2-mg tablets the amount to weigh out will be greater per mg of tablet weight for equal weight tablets at 2- and 8-mg. A lot of 2-mg tablets are 1/4 the weight of 8s so those would offer no advantage.

Example for the two pre-schedule days I did at 1/2 the scheduled day 1 dose by intranasal (IN):

The sublingual starting dose is 0.5 mg so intranasal would be 0.25 mg half of which is 0.125 mg - that’s where I started (if i haven’t made that clear )

Again 1/2 scheduled dose IN dose = 0.125-mg buprenorphine how do I get that from an 8-mg tablet?

I had 8-mg tablets that weighed exactly 400-mg. I needed 0.125 mg bupe crushed finely, evenly and well mixed to snort.

Material to weight out calc: (0.125 mg / 8 mg / tablet) * 400 = 6.25 milligrams of tablet, this is difficult with a milligram scale but it worked for me. You could do piles of higher weights and divide by eye but this how people get into PWDs. So underestimate or weigh out 50 mg of the crushed tablet and remove 6.25 mg - it’ll be more accurate. And even if you blow it by +100% you’re still starting at the recommended dose.

Best of luck. Definitely check my math and yours a few times and be careful with weighing or cutting strips to waterline, or try sublingual (SL) w/ 2x the weight of IN doses but in my estimation SL is a lot more likely to cause PWDs.

Edit: nothing of substance all good here.

 

[Jen X]

When i did the burmese method i went up 0.5 every 2 days

 

[paranoid android]

If you could get a longer acting opiate like morphine that would work to. Morphine isnt to bad to taper from especially if it's time release

 

[Keif' Richards]

I believe Methadone is a relevant suggestion here dude. I'm not saying you have to be on it for the rest of your life. The fact is, Buprenorphine (Suboxone) is likely not potent enough to manage someone with a serious Fentanyl habit. It's actually a big problem right now, as we are still using science and protocol that assumes people are using Heroin or similarly potent Opioids. There are people out there 10 times more dependent than a Heroin user would be.

In practice, titrating yourself when you're already thoroughly addicted is not at all realistic. The clinic will take time to get your dose raised to the right level. They can only start you at 30mg. You'll be investing some time and energy into this but by the end of the month, you could be on a dose that holds you. I know other Fentanyl users who have started at the clinic and they end up on 150mg-200mg, which is a lot of Methadone. No matter what anyone says, being dependent upon Methadone is going to be a better life than using Fentanyl.

I talk to folks who are out on the street here in Burlington and the consensus is that Buprenorphine is not used very much anymore, as people are too dependent.

 

[LoveTractor]

I have to respectfully disagree with Keif’ - I stated another Bernese induction today after six weeks of 6 mg / day sublingual pharmaceutical fentanyl with 32 mg /day IN hydromorphone. I started at step one with a full 0.25-mg of bupe IN in five small bumps over 50 minutes using a saline spray as follow-up after each snort.

I’m doing great, I will go to 0.25 mg IN twice a day tomorrow and this will work out fine. If this is done carefully it can handle very large habits - bupe is a hella strong binder and active enough on the receptor to handle this habit. Last time is inducted after two months of 12 mg / day sublingual pharma fentanyl and 24 mg/day hydromorphone so this round should work out just as well if not better.

Those are pretty big habits and with a 20+ year opioid dependency I’ve been in deep for a long time. I’m sure there are street fent habits multiples of mine - many many mulitples but I still think it is worth a try b/f going with methadone. No need to stop the doc at the current dose until induction is done, either you’ll screw up weights and PWD yourself, you’ll try it and after day seven not even 16-mg of bupe IN will hold you (unlikely in my opinion and from the several clinical studies I’ve read failure has happened due to habit size but it is rarer than success) or like me it will work. Aside PWDs that can be avoided why not try? Do it right and you’ll be ok or you’ll only waste a week still comfortable and realize you do need methadone - which you will suffer for many days / weeks until they get you to a holding dose.

 

[LoveTractor]

Update - I completed the IN schedule for the Bernese method I described above earlier today. I stopped my other opioids yesterday w/o and withdrawal over the last 24 hours and I feel great today. Clear headed with more energy. This method is for bigger habits (>= 80-mg oxycodone / day, daily fentanyl / heroin, etc.) where the risk of nasty PWDs is significant. I will be fine from here out but if I find I need more than 12-mg /day (6 mg IN, 2x / day) to hold me over the next few days I’ll come back and edit this post.

This works for big ass habits. There’s no loss in trying except seven days time and 22.75 mg of buprenorphine tablet powder IN'd or cut from strips and water lined. PWDs are very unlikely if this is done with a milligram scale / precision cutting and some care to follow the schedule exactly. 2-mg formulations work better than 8-mg but I’ve done it with 8-mg tablets both times w/o problems.

 

[2Toes209]

OP, I’ve been there. I didn’t touch or even want to do subs or methadone. Couldn’t CT, I used kratom and gabapent and gabalin. You need a script or find someone who has em, I had 300mg capsules, I took about 1500-2100mg a day, it’s a lot but it worked. Used for first 4 days, switched to just kratom day 4-15 than quit it all. Gotta want it, be a savage somewhat, after the physical symptoms go away you see how mental it is too. Drink water, eat if you can. It sucks but this worked for me, I jumped doin 20-22 dirty 30s a day. GABA saved me. Not a doctor, my advice isn’t recommended at all. Good luck

 

[badnewzbear]

Does anyone know if you take the sub first and then dope or other way around?