Opioids Going to try kicking my opiate habbit.....once again with subs

[VictorZ06]

(fentanyl is very short acting)

Isn't it very LONG acting? Or am I confusing it with something else?

 

[Jabberwocky]

You're confusing it with something else. Fent is notoriously short acting, much like hydromorphone (fent is just far more potent).

If you're really concerned you can also add a bit of clonidine in for the first 12-24hrs it takes to transition. Clonidine and gabapentin should mask the majority of any symptoms of withdrawal you'd otherwise experience. You just have to keep an eye on your BP taking clonidine.

 

[VictorZ06]

You could probably get away waiting less than 24hrs after your last dose of hydromorphone. I rarely had to wait more than 12hrs switching from heroin. But PWD should be avoided at all cost. Even a day or withdrawal is better than even an hour of that.

Methadone won't be helpful for transitioning to buprenorphine. Tramadol would, but that is because it doesn't interact with buprenorphine like full agonists such as hydromorphone and methadone. Switching to another shorter acting opioid for a few days before inducting on buprenorphine, but that will be of limited use. Tramadol would be the ideal medication to use to switch to buprenorphine in your case though (for someone who is really concerned about withdrawal).

TBH it's just 12-24hrs or opioid withdrawal at worst you will have to deal with. Gabapentin will help a lot. Even the most committed opioid users can deal with that, and I have a feeling you'll be able to handle this better than you might think OP.

Going to start today, well....I just took my last shot of hydromorphone. As for switching to a shorter acting opiate....that's actually what I did this past 6 days. I was using something else, but because I didn't know 100% sure what was it in (could of had some fent in) I stopped it completely and just ran the hydro. But man, I needed a LOT of it to keep me straight. This morning was the last of it....I was taking just over 100mg ED.

Any suggestions on how much gaba to take.....and from my list above, what else can I take to help with my WD while I wait? I know my benzo could effect the COWS number, but I have to take it. I'll try and take much less until I induce. I'm going to keep drinking and drinking as many electolites as possible to avoid dehydration.

Why do some studies say that you don't have to get to a 26 on the COWS and that you just need to feel moderately sick/in WD? As stated in some of the links I provided? I'm still going to wait it out as long as I can though. I know the vomiting will come with a vengeance but have the zofran ready.....hope that does something. I'm not sure about when to take the other sups though....

 

[Jabberwocky]

You really shouldn't reduce your benzo dose - it will just make this more difficult. Other than the loperamide helping with possible GI symptoms, the supplements you mentioned early won't really have a big effect on just a day of withdrawal.

The COWS thing is basically a way to gauge how much in withdrawal you are. Personally I don't like this system, as withdrawal is so variable, and it tends to err on the side of caution (not a bad thing necessarily).

Basically you just need to be in moderate to sever withdrawal (based more on physiological symptoms as opposed to just psychological). Most opioid users have a pretty good idea of when they're truly in withdrawal versus just wanting to get high.

The longer you can wait before inducting on the buprenorphine, however, the more effective the medication will be when you indict. So keep that in mind. Waiting as long as you can is definitely worth it, beyond avoiding PWD I mean.

With the gabapentin, it depends on your weight, but starting with 800mg and seeing how you feel an hour or two later is a good idea. Take it with a little fat/protein/sodium if you can (like some cheese and crackers). Generally I find about 4000mg to do the trick when I'm just using gabapentin alone to treat withdrawal, but without a tolerance to gabapentin this much isn't necessary (800mg four times a day is what is normally prescribed for withdrawal). Your benzo tolerance complicates this a little, but I'd still suggest starting with 800mg and titrating up your dose as necessary.

I would also suggest taking the Zofran proactively. If you know nausea is a problem for you in withdrawal, I'd take it at least every 12hrs until you induct on buprenorphine. With the gabapentin and your normal benzo doses the nausea should be managible.

 

[VictorZ06]

Any suggestion on clonodine dosing? I think I can start using it now? I heard mixing it with passion flower is a big plus....but don't want to risk messing up my induction.

 

[Jabberwocky]

Yes you can use some clonidine now. As long as your BP isn't abnormally low, try 0.1mg oral. A little goes a long way. It can also make you tired (although this isn't as pronounced or such a bad thing for those in withdrawal), and you'll want to make sure you are careful standing up from a laying or seated position (light headedness and fainting become a bit of a concern when it comes to how it affects your BP).

 

[VictorZ06]

Yes you can use some clonidine now. As long as your BP isn't abnormally low, try 0.1mg oral. A little goes a long way. It can also make you tired (although this isn't as pronounced or such a bad thing for those in withdrawal), and you'll want to make sure you are careful standing up from a laying or seated position (light headedness and fainting become a bit of a concern when it comes to how it affects your BP).

Got it. Will start with both .1mg clonodine and zofran. I can't find any info as to when/how to dose the passion flower. I have caps and liquid. I was going to put the liquid in my Poweraid drink, and take some caps if I could keep them down. Sorry for all the questions, this is such a vital thing that I get right in my life. I can't afford to fuck this up. After the first dose of clonodine, how long until I should wait for the second? Thanks!

 

[Jabberwocky]

Generally clonidine is not dosed more than twice a day. Avoid going above 0.4mg/day, and be VERY careful about your BP when increasing your dose.

Have you taken any gabapentin yet? That should really be your first line of defense apart from Zofran in this.

For passionflower dosing, check out Erowid to see what other people have taken.

Keep your head up, as you're taking the plunge. Exciting! If you're patient and can put off taking buprenorphine as long as possible (12-24hrs at a minimum), you'll be feeling much better sooner than you might think.

 

[VictorZ06]

Generally clonidine is not dosed more than twice a day. Avoid going above 0.4mg/day, and be VERY careful about your BP when increasing your dose.

Have you taken any gabapentin yet? That should really be your first line of defense apart from Zofran in this.

For passionflower dosing, check out Erowid to see what other people have taken.

Keep your head up, as you're taking the plunge. Exciting! If you're patient and can put off taking buprenorphine as long as possible (12-24hrs at a minimum), you'll be feeling much better sooner than you might think.

Thank you brother....I am keeping a log of what I am taking. Just under an hr ago, I took the following:

.1mg clonodine
900mg gaba
8mg zofran
passion flower 2000mcg
B12 5000mcg

I read an article that said that those that used clonodine WITH Passion Flower had far less WD sides. I just can't find any doses. I'm not sure exciting is the word...I mean, it is because once I pull this off. My bags get packed and my ass moves over to Europe to start a new life. I just need to kick this shit first....so yes, it is exciting. I can't go to Europe until this mess is complete. About a year ago this time I sold a lot of my assets to make the move....and when I failed my detox, most of......well, just about ALL of my savings went to meds. So as soon as I'm better, I'm going to score a few quick jobs....just enough to get me over to Greece.

But I'll be 1000% honest. I'm am scared shitless. I have panic attacks just thinking about the PWD I went through last time. I'm going to hold of on the bupe for as long as humanly possible. I even considered cuffing myself to something just to make sure I don't take it too soon!!

From your mouth to God's ear....thanks for the help. I'll chime in from time to time with updates. Last time, I could not see the screen and kept missing keys so....IT BEGINS....

 

[Jabberwocky]

There is nothing wrong with being scared. This is big deal shit you're dealing with. I like the plan you've developed for yourself, and look forward to hearing how things progress.

Doing anything nice to distract yourself while you're waiting to induct on buprenorphine?

 

[VictorZ06]

There is nothing wrong with being scared. This is big deal shit you're dealing with. I like the plan you've developed for yourself, and look forward to hearing how things progress.

Doing anything nice to distract yourself while you're waiting to induct on buprenorphine?

Just woke up and I'm in a world of hurt. Stomach is upset and my face is all wet and am yawning. I was just going to watch some TV and take a few walks. Thought about going for a drive, but don't think that's a good idea. I think I'm going to take more clonodine and zofran now...

 

[VictorZ06]

There is nothing wrong with being scared. This is big deal shit you're dealing with. I like the plan you've developed for yourself, and look forward to hearing how things progress.

Doing anything nice to distract yourself while you're waiting to induct on buprenorphine?

I really would not wish this upon my worst enemy. I've been dropped in the middle of nowhere from a helo knowing I might never come back. I was OK with that....didn't bother me. Like I said, I'd been shot, took a lot of shrapnel to the chest, seen my brothers fall.....yet this shit.....this shit still has me more worried than anything else I have ever endured...thanks again man...

 

[Jabberwocky]

How much gabapentin have you taken? Try taking a larger dose of that and then heading in for a hot shower or bath. I'm sorry to hear you are so uncomfortable, but it's only a matter of hours until you can get some relief. Long hours, but hours nonetheless.

What do you have to distract yourself other than tv? A bike ride, walk or some exercise might be a good idea.

 

[VictorZ06]

How much gabapentin have you taken? Try taking a larger dose of that and then heading in for a hot shower or bath. I'm sorry to hear you are so uncomfortable, but it's only a matter of hours until you can get some relief. Long hours, but hours nonetheless.

What do you have to distract yourself other than tv? A bike ride, walk or some exercise might be a good idea.

I think the clonidine is helping me a great deal....but I was told to take it after I hit 26 on the COWS. It's been 15 hours and I do feel like shit, but will the clonodine prevent me from getting to a 26 on the COWS?

I've taken the gabapentin twice....900mg each time. Also took the following a few hrs ago....

.1mg clonodine
900mg gaba
8mg zofran
passion flower
B12
B12 cap
Mag 250
VD
Immodium 4mg

My vision is blurry and I am off balance. I'm worried about getting out of bed. I went up and down the stairs a few times....but got light headed and dizzy so I went back to bed. My main concern is when to take the sub now. What if 24 hours comes and I'm not a 26 on the COWS? Wait longer?? ARGH!

 

[Jabberwocky]

It wouldn't surprise me if you won't be able to rely on the COWS scale with the comfort meds you are taking. If you are really dizzy and off balance do not take any more clonidine. It could also be the gabapentin, so I would avoid taking more right now.

You're almost there! You can totally do this! At the 24hr mark you should be totally in the clear for the buprenorphine. I would be very surprised if you went into precipitated withdrawal after waiting a full 24hrs or more since your last dose of short acting opioids.

How much hydromorphone were you taking each day again? And what ROA? If you were using like 100mg IV or something you'll want to wait as long as possible before starting buprenorphine, but if you haven't been using it that long regardless of dose or ROA that a day will be enough.

 

[VictorZ06]

It wouldn't surprise me if you won't be able to rely on the COWS scale with the comfort meds you are taking. If you are really dizzy and off balance do not take any more clonidine. It could also be the gabapentin, so I would avoid taking more right now.

You're almost there! You can totally do this! At the 24hr mark you should be totally in the clear for the buprenorphine. I would be very surprised if you went into precipitated withdrawal after waiting a full 24hrs or more since your last dose of short acting opioids.

How much hydromorphone were you taking each day again? And what ROA? If you were using like 100mg IV or something you'll want to wait as long as possible before starting buprenorphine, but if you haven't been using it that long regardless of dose or ROA that a day will be enough.

Well, to be honest my dose of hydro was really high. I was using about 32mg 3-4X a day via IV. So yeah, it was about 100mg via IV like you said. I think I got dizzy going up and down the stairs....I probably would have with or without the comfort meds. I need to take my benzo now....I tapered off a bit but my body is asking for it.....I think. Everything is fuzzy and I can't think straight. I just don't want to take the subs too early and land in PWD. I need to figure out when to drop the subs because I don't think I can depend on the COWS due to my benzo, gabapentin, and clonodine......

 

[Beenbetter]

Hope your alright man.
Praying for u.

 

[VictorZ06]

im 25 hrs in and feel awful but am no 26....guess i waiit longer.....FUCK!!

 

[Jabberwocky]

The good news is, the longer you are able to wait the more relief you'll get from buprenorphine.

You're doing great Vic, keep up the greet work!

 

[VictorZ06]

Waited 30 hrs.....I never touched a 26 on the COWS.

Now, I feel a little better on 12mg of sub.....but I am still vomiting from time to time even with the zofran. Also, extremely emotional. I find myself crying like a little bitch when watching TV.

I went to the ER because I was worried about dehydration. They wanted to send me to inpatient therapy....nope. I took my subs and left. I still feel like total shit and my stomach is on fire.....burns....