Opioids Breaking Free of 2 Years of Tramadol/Loperamide Addiction

[Psychonautico]

Hi everyone, I am writing this in the hopes of getting some tips and even just support for this predicament I blindly fell into. Let me give a little history. I am 24 now, I started using drugs around 16. I’ve tried just about everything excluding meth. I was addicted to Adderall for a few years and had my own script. I was able to kick that finally about 2 years ago, and around that same time I first tried Tramadol. Other opioids always seemed too expensive and didn’t get me very high even though the same doses got others high. For some reason, Tramadol really clicked. It wasn’t long before I was taking it daily, occasionally running out, going through 3-4 days of w/d’s, and then being mostly drug-free (besides weed & alc) getting more within a few weeks. Around this time I graduated and started my career in web development.

Eventually, I was at a point where I had ran out of Tramadol and I knew withdrawals were coming, so I looked online for ways to help make it less painful. Today I regret this discovery, but I stumbled upon some forums mentioning loperamide was an opioid that crosses the bbb only at high doses. I went to the store and bought 20 pills of loperamide, which cut the withdrawals in half. I went back the next day for a 48-pill bottle and downed the whole thing. Bam, I felt warm and fuzzy, even better than Tramadol. One of those every other day became a habit. Then 2 a day a few months later. Then 3 48-packs a day for a while. The last month and a half I tapered back down to 2 a day reducing 3 pills a day. I tried quitting cold-turkey over a vacation (terrible idea) where I had no access to loperamide. I had constant sweats, diarrhea, my joints felt like a 70-year-old’s, my nose was a waterfall, and I would constantly cycle between feeling overly hot to very cold. These maybe got slightly better 5 days in, but only slightly. On day 6 I started back up again, and here we are a few months later.

I got some Subutex today thinking “this is just a simple switch-over to something that won’t be as cardiotoxic and cruel to my GI tract as lope”. But I was wrong there too. I took 8 mg earlier tonight expecting to feel a nice buzz, but started to feel like I was further from my last dose of lope. I took another 4mg an hour after, and it got even worse. Low and behold there’s this thing called precipitated withdrawal! Research should have been conducted.

Anyways, I am wondering if there are any pointers, tips or words of encouragement anyone from the community could provide. I’m happy to answer questions about this roller coaster of an addiction that wasn’t supposed to be, too.

 

[Quere]

Yeah you need to wait until you're fully in withdrawal from whatever regular full agonist opioid you're taking before taking a partial agonist like buprenorphine.

Good decision on quitting the lope, that shit is far worse on your body/heart than pretty much all other commonly used opioids.

 

[Nicomorphinist]

If you are able to obtain alternative opioids, you may want to get one which has a shorter duration of action than loperamide, which can have well over 24 hours of action and does not reach peak plasma levels until five hours after dosing, and one with a rather simple and well-known pharmacology, and preferably a weaker full agonist, such as codeine, and stabilise on that and taper it off. Buprenorphine is a mess as you have just stated to discover. High dose use for well over two years may actually lead to the duration of action of the loperamide being closer to 72 hours per large dose depending on the size.

Buprenorphine in the United States has a political advantage compared to methadone of being CSA Schedule III and able to be used by general practitioners to maintain or detox their patients, although there are special regulations such as how many patients they can carry on this and so forth. What would actually allow addicts and habitués to be treated by their doctor for their habits, and to be treated with their drug of choice or any other narcotic as is the case in most other countries. Morphine, for example, is a narcotic of very low toxicity and is well tolerated. I have personally known of pain patients and others who were on morphine, including one who started with smack when it was available, before 1924, who have been on morphine for 63 and 102 years until dying of old age, and there are many cases of people on morphine, opium, hydromorphone, codeine, dihydromorphine, smack, and so on for many decades.

Switching the loperamide to a long-acting opioid and then maintaining or detoxing with which can be done with poppy pod tea in particular and poppy seed tea works as well/ If available, tianeptine and kratom in very conservative doses may make some things easier. In the United States, ignorant organisations and people beholden to gangsters who run rehab clinics want to make it is as hard as possible for people to help themselves so they try to eliminate these tools and even try to put pressure on Canada to not sell codeine to its citizens thinking it leaks south of the border to people who are needing it.

Have you noticed any evidence of cardiotoxicity so far? The other toxicity with loperamide and related drugs would be the accumulation of neurotoxic metabolites, in a manner quite like pethidine as loperamide is a 4-phenylpiperidine synthetic opioid, and may also have some un-natural and marginally toxic metabolites related to its derivation from normethadone as well as norpethidine as the major precursors. The structural similarities to alphaprodine and MPPP mean there is a low level of a neurotoxic metabolite which is present in a dose dependent amount and does not accumulate to a huge extent. The structural similarities of loperamide and especially its relatives diphenoxylate and difenoxin to piritramide are not the cause of significant toxicity, and if you can get either Lomotil and/or Motofen, those are workable stop gaps as well in this taper.

Directly countering the withdrawal symtoms can be done with clonidine, paracetamol, sleeping agents of a number of types nd others.

 

[KS78]

maintaining or detoxing with which can be done with poppy pod tea in particular

Great advice. As far as I know, it became very hard to obtain dried pods. When I was living in NYC, I could get both dried and fresh pods from a couple florists. They used to keep it at the front of the store, they weren't keeping it a secret at all. This was from 2001 to 2008 though. Shame that one can't get it now. It's a great plant to use for opiate withdrawal or tapering down.
I'm on opium these days and It's very good quality but eating pods are still different from opium. It definitely has a longer half life than opium, probably because of all the other Alkoloids in the raw plant.

 

[Quere]

Great advice. As far as I know, it became very hard to obtain dried pods. When I was living in NYC, I could get both dried and fresh pods from a couple florists. They used to keep it at the front of the store, they weren't keeping it a secret at all. This was from 2001 to 2008 though. Shame that one can't get it now. It's a great plant to use for opiate withdrawal or tapering down.
I'm on opium these days and It's very good quality but eating pods are still different from opium. It definitely has a longer half life than opium, probably because of all the other Alkoloids in the raw plant.

Do you maintain with opium KS78? Orally dosed or smoked? Wish I lived somewhere where opium is easily obtainable

And to the OP, read through Nico's post lots of great info, do you want to come off CT (cold turkey) or do you think you'll switch to another (safer) opioid and taper? I would recommend a taper, and whatever comfort medications you can get ya hands on; gabapentin, pregabalin, sedating antihistamines, anti-inflammatory drugs (ibuprofen, paracetamol, naproxen etc), cannabis (especially edibles/orally dosed can be very helpful while in withdrawal), clonidine, muscle relaxants like orphenadrine and benzodiazepines/ghb/gbl/barbiturates etc can be very useful but must be used sparingly and with caution (ideally for just a couple of days once you jump off the taper)

 

[KS78]

I usually take it orally but sometimes, when I want a rush, I vaporize it. I like the oral route because it's definitely a much heavily sedated high because you ingest much more morphine than smoking. Another benefit is the duration of it is much longer eaten, also you don't use as much as you do via smoking. The negative is that the withdrawal will be tougher.

It's not easily obtainable here in Istanbul either. It's more like a novelty drug; people usually don't even think or talk about it, It's dominantly a #3 heroin market. Pharmaceutical opiates aren't easily available to people like in US, you can only acquire them if you have cancer or another painful disease. It took me years of reminding people that I'm especially looking for opium, finally I found it 3 months ago. Dried poppies are vert easy to get online from craft stores or florists and they are extremely cheap which is a lifesaver for a person with dependency. Many use them when they can't get H or when they decide to stop/ taper down because it's hard to get in the list for Buprenorphine and there's no methadone.

 

[Nicomorphinist]

Great advice. As far as I know, it became very hard to obtain dried pods. When I was living in NYC, I could get both dried and fresh pods from a couple florists. They used to keep it at the front of the store, they weren't keeping it a secret at all. This was from 2001 to 2008 though. Shame that one can't get it now. It's a great plant to use for opiate withdrawal or tapering down.
I'm on opium these days and It's very good quality but eating pods are still different from opium. It definitely has a longer half life than opium, probably because of all the other Alkoloids in the raw plant.

Something I noticed with poppy pod tea was that making it by finely grinding the pods with a spice grinder, adding this powder to warm or hot, somewhat acidified water in a large mixing bowl and straining with a tea strainer, not any kind of cloth, which allows a fine brown powder through which collects in the bottom of the cup. This is in fact a high-alkaloid part of the tea which slowly releases more narcotics and can make the tea into a terminate and stay resident kind of thing where the main effect is 9 to 12 hours, then it starts kicking in again and does the job completely for 21 hours and can be felt for 30 to 36 . . .

There is the matter of the loperamide dose . . . there is in fact a safe loperamide dose which can maintain physical dependence in some cases, and indefinintely in fact, and not tear up the digestive tract. It is not at all necessary to take 100 to 600 tablets at once, which is likely to be a simple opioid agonist overdose and people have died from taking too much loperamide, and huge amounts at once and chronically are cardiotoxic and cumulatively neurotoxic . . .

Since some people actually feel narcotic effects from the recommended loading dose of two tablets (4 mg), and the complete instructions and information doctors have is that since loperamide and similar medications cause tolerance and are significantly cross-tolerant with opioids like morphine and hydrocodone, the dose may need to be indexed in some cases, and the maximum is usually a loading dose of 12 tablets and then up to 6 tablets q6-8h for a maximum of 48 tablets or 96 mg per 24 hours at the very most, but this is a case of long term use with cross-tolerance from high-dose morphine and the like. Usually when it gets to be more than 40 mg or so per 24 hours, doctors prefer to switch to diphenoxylate, which is more scalable, stronger, and has more obvious narcotic effects, and this goes double for difenoxin . . .

When doses have to be indexed like this, it is usually a case of someone on narcotics around the clock who has an organic bowel condition and/or inadvertently eats a food, or takes in a drink or medication with a dye, other component, or something like lactose to which they are allergic, so the diarrhoea starts anyways and is at least partially caused by hypermotility . . . and the idea is to allow the initial loose bowel movement to remove any irritants and possible pathogens or other things then reduce the motility. Whatever the reason one is taking these particular kind of narcotics, omeprazole and cimetidine, usually at the same time, are used to modify the LADME profile of the loperamide (and it does work to an extent for diphenoxylate and difenoxin as well) in such a way as to steepen the dose-response curve, which is also part of the reason that the CNS effects are increased.

The diphenoxylate-loperamide family can be used for this as mentioned, but the preferable way would be to, especially in the case of irritation as mentioned above, and cases of Irritable Bowel Syndrome and chronic organic bowel problems, and various chronic bowel conditions are whole opium products, which can be taken or mixed with an anticholinergic such as belladonna, also codeine, dihydrocodeine, or small doses of morphine IR and or ER, also which can be taken with dicycloverine, scopolamine or the like to help with the cramping, other GI agents, and the helpfulness of a carminative should not be overlooked.