Hey
@BackInTheFire88 
I regret not seeing this earlier. I see you've got a lot of bullshit to deal with. It's all good though. It's all possible, I can tell you from experience. Opioid withdrawal really can make everything so difficult. It robs you of a lot of your executive function. It's a very good idea to find someone you like here and put your trust into them so they can support you through this. You need support. You also need some blunt advice so you don't end up wasting time and energy.
You have a lot of extra stuff going on in your life. I get that. However, it's a good idea to do some serious self-evaluation here. You need to decide about your level of openness and honesty with your wife. I know you want this trip to work out. It might just be too complicated for you to pull of successfully. The only way I can picture this vacation going any kind of "good" would be for you not to attempt anything until after you get back.
I was an English teacher in my 20's and I was always addicted to Heroin for 90% of this time. I have gotten on airplanes before hoping for the best only for my problems to become infinitely more fucked up after leaving the comfort of my home and people. If you get there and shit pops off with your withdrawal, you could easily end up in the hospital in a strange area with your wife freaking the fuck out. She is going to be 10x more pissed off at you if you reveal this problem after flying to the most remote location in the entire world. I'm sure they have plenty of Fentanyl in Hawaii, but then you run the further risk of getting arrested/robbed/killed by the wrong person in the process. I imagine this would also piss your wife off.
I would highly advise against this idea of going to Hawaii while dealing with a $300/day Fent habit. This is your desperation and lack of control telling you to just keep going with the flow. You need to get right out in front of this. Either cancel the trip, tell your wife what's going on or better yet, do both.
Now let's look at the nitty gritty.
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I would advise against using any Opioids other than your Kratom at this point. Methadone is contraindicated for your specific situation. It will only get you involved with a substance that works much differently than what you're familiar with. Fentanyl is quite short-acting while Methadone is of the longest-lasting Opioids used in medicine. It's highly effective for maintenane for these reasons.
I'm not sure what your usage is like for other substances. You are going to need to rely heavily on medications that will help relieve symptoms of withdrawal while also allowing you to progress through the stages of withdrawal. I'm going to tell you what I've done with success and hopefully we can find a way to tailor it to your needs.
Benzodiazepines - rather self-explanatory. These are powerful sedatives that act upon similar channels to Alcohol or Barbiturates. They are useful for relieving psyhoIogical symptoms like anxiety, depression and cravings. Very important is the fact that these will hopefully enable you to sleep. Fentanyl is short-acting, but extremely potent. This means that your real battle is going to be the first 72 hours. This means 72 hours completely without Opioids with no cheating.
Assuming you're able to stay at home and rest through this process, I would recommend dosages of Benzodiazepines that might seem very high. They are. The goal is to get yourself sedated enough that you're able to get at least 3-4 hours of sleep per night. It doesn't have to be great sleep, just some. Even minute amounts of sleep pay dividends in keeping you on track through the process.
I would advise up to 4mg Alprazolam in a sitting (preferably less) up to 3 times per day. This is only to get you through the harshness of the first 72 hours. This will basically make you into a half-awake zombie for the duration, but that's fine. At this stage, we're just trying t make time pass with as little trauma as possible. You need to figure out how much you need to get where you need to be. These are very high dosages so you need to make sure you're not driving or otherwise responsible for anyone other than yourself.
Gabapentin (Neurontin) of Pregabalin (Lyrica) - these are the secret weapons for many an Opioid user. They have a tremendous ability to relieve some of the more severe symptoms of withdrawal. The end effect of taking them in the proper quantities will mean relief from anxiety, insomnia and most importantly, Restless Legs Syndrome/Akathisia. The latter is often stated as the most crippling symptoms of withdrawal; the uncontrollable urge to move the limbs that prevents us from resting for even a moment. The above stated drugs are magic for withdrawal.
Gabapentin would be best taken at 300mg 3x per day to start. This could easily be escalated to 6x per day. It will depend upon how the medication works for you. Pregabalin works in much the same way as Gabapentin. It's more potent, with 600mg Gabapentin = 100mg Pregabalin. The end result will be essentially the same.
Both Gabapentin and Pregabalin are available on the street, but for someone with a trusted physician in their lives, obtaining a month's worth of Gabapentin is as easy as complaining of neuropathy. Gabapentin must be taken in separate dosages of only 300mg at a time. If the dosage needs to be increased you only increase the frequency and not the per-dosage unit. Pregabalin does not work in this way; it works essentially like any other medication.
Clonidine (Catapres) this is a blood pressure medication that is quite handy, but is of less general importance than the previous two listed. Essnetially, if you have all three of these, they work very well in tandem. By utilizing all three of these together, getting through the 3 days of Fentanyl withdrawal can seem much more doable.
Cannabis - Appetite, insomnia, anxiety. Pretty self-explanatory if you know Cannabis.
This information is a good place to start. If you need extra assistance, you can send me a PM or talk to me here in the thread. This is just my method of doing things, but I do swear by it, as do many others who have had success with it.
I'm not a genius. I do know a lot about drugs and Opioid addiction. Together we can figure this all out man. Just keep the faith going and keep talking to us. We won't let you fall, I promise.
Well done and great to hear. Enjoy Hawaii........I'm jealous.
