I'm totally gonna be the buzzkill here. I apologize in advance.
Having been in long term recovery in the past and back to using for a couple of years again now there are a number of highlights in your post that stand out to me. Firstly, you've identified that you are a poly-substance abuser and that makes this a little more challenging but here's the good news: Adderall has no major withdrawal concerns. It's like weed, primarily psychological. Taper down and quit. In fact, stopping "cold turkey" is a great idea. Now only you know how much you use. We addicts are great at concealing our ACTUAL intake. We minimize the shit out of our use. That said, only you can safely say that quitting (the amphetamine portion) without supervised detox. Fortunately, you're not dealing with CNS depressants like benzidines, barbiturates or alcohol which REQUIRE supsrvised detox as stopping those can be deadly. In fact, are the deadliest if not closely monitored. Regarding the opiates, you have 2 options: quit, detox on your own at home which (had I know this would've saved myself a shitload of inconvenience and money, but I'll get there in a minute) and go through the "flu" symptoms which I expect you're already familiar with. However, depending on how much you're truly taking, after 4 years, detox can be very dangerous. Therefore, IMHO, you need to seek out a supervised detox treatment center followed up by several weeks of IOP (Intense Outpatient) followed by continuing care perhaps 2-3 times per week of outpatient.
Long story short about me and my proof of knowledge: I began using at 11. Cigarettes to huffing gasoline then butane, on to pot then in to college using everything you can imagine as I ran the gay circuit in central Florida. Ecstacy, GHB, cocaine, crystal, alcohol, weed - you get it. Honey I tore that dance floor up! I'm 37 almost 38 and I can still close my eyes and hear that music, feel those breakbeats and see those lights. I look at my pictures and wonder how exactly I managed to retain my attractive appearance or even live. But I did and here I am. I tapered back after college and did the weed & xanax thing. But ultimately, I discovered opiates around 25 years of age. Began with 10mg percocets, pretty quick to roxycet then combined with xanax and finally to heroin. By the end of 28 almost 29, I knew I was going to die doing it. I needed a change. And so, I went the methadone route. In all honesty, it made my transition off heroin amazingly smoothe. No sickness and minimal body pain. FYI: methadone is a strong pain analgesic that's used for opiate treatment and for others who experience pain that they have trouble controlling (REMEMBER THIS PART). All in all, I spent nearly 9 years taking methadone. Had I been smart, I'd have done it correctly, over a 60-90 day period (which is what state funded provides, if I recall correctly). But I went to a self pay clinic and could do about what I wanted. Up my dose as I wanted, decrease it, just take it as I so chose. Until one day, I said I'm done. I took 2 weeks of vacation from work and on day 1 checked myself into detox. I refused all opiate treatment (which was counter to my goal as I saw it) and accepted only non-opiate pain relief. I was scared going in because my psychiatrist was concerned. He'd detoxed people off street level methadone abuse but not someone as in my case. Nearly 9 years of DAILY straight medicinal oral concentrate. So, as I'd mentioned, methadone is a very strong pain analgesic. It literally deadens everything in your body. Methadone synthesizes opiates for which a UA reads methadone, not opiates. It constipates you. You have a daily morning come down prior to dosing. If you miss a day, the day is ruined by a cloud of depression.
And so I get all checked in. Of course, being OCD, I followed the "allowed items" list and packed a rolling suitcase with some "fun things" to do like coloring books, crayons and puzzles. No joke, I was the queen of the night rolling into that detox unit with my suitcase. Remember, this was my vacation. Some vacation! My anticipated 4-5 days of detox became 14. It was not cute. I'll spare you the gorey details but suffice it to say, when you stop (way too long) long term methadone maintenance, the body and that was deadend begins to come back online. Not pretty! The primary detox medication was phenobarbital. That's what stage 4, terminal cancer patients are prescribed. I was literally put into a daily awake/mobile/up & about coma. No joke. I was being given 400 mgs phenobarbital daily @ 100 mgs each 4 hrs, 1400 mgs robaxin (later decided to have been much too high) to keep my muscles from spasming and coiling up, medication for restless legs at night, 20 mgs Ambien nightly and all the vistiril, antidiarrheal and antinausea I could take, tons of B, C, folic acid, shit tons of other vitamins and of course a constant machine at my side monitoring my heart rate/blood pressure. I was the star of detox. Everbody, nurses, patients and whoever the hell else was constantly checking on me. It was shitty a shifty, painful experience and that's being generous. I never touched my coloring book, crayons or puzzles. I'd wake during the nights disoriented, confused... I'd make my way into the hall and before the nurses could even reach me, my muscles literally buckled under me and once somehow ended up face first with my legs up over me and another time, fell so hard, face first again into the floor I saw stars. The second time I recall crying very intensely because of the impact. I was rushed to have an MRI. Afterwards, I was prescribed Kep-, Kep- something. I cant recall. But it was for seizures. 1200 mgs of that, too. After this fall, I was as if I'd been returned from another planet and realized what happened. It was, needless to say, a horrifying experience. That night, after returning from MRI, I perceived the nurse as having accidentally sloshed water on me. After handing me the water I threw it all on her, verbally destroyed her with some colorful language and scared her right off that unit. Between detox, all the medications and the head falls, I'd become someone completely antithetical to who I am. That nurse was never back on my unit for my duration. I've always felt bad and wanted to apologize to her immensely. But I was coached to understand detox is not glamorous and that it was best I forgave myself. To date, I've never really found that forgiveness to self. Because I was a monster that night to say the very least.
After detox, I was in 2 weeks IOP M-F 8a-330p (intensive outpatient) followed by 12 weeks outpatient Tu-Th 6-9p.
I was required to attend multiple fellowships (NA, AA, SA, CA). I did my 90/90 (90 meetings in 90 days). I believe that worked well for me. It took time to see how the program worked. At first, it seemsd silly. Ultimately, I grew bored of it because on the deep, personal level, I've never connected well with people. Anytime I spoke out loud, I felt fake. And I never understood it. Because I was as real as real got. For me it was always the "connection" thing.
PLEASE REMEMBER MY EXPERIENCE IF YOU CHOOSE THE METHADONE ROUTE. IT CAN HELP BUT DO NOT EXCEED 60-90 DAYSIF YOU DO.
You said you love your husband and child. Put your arms around them, never let go and ignore anyone in this forum that plays a "rescuing" role in how you might explain this or that. Yes, ultimately, you'll need to be forthcoming. Recovery is all about integrity. Truth to self and to others equally. Find treatment, tackle this challenge and reclaim your life! I would challenge you to that. In fact, as I type, I'm re-challenging myself. Because I began smoking crystal about a year ago. And the time to quit is all but here. I wouldn't touch an opiate to save anyone's life after my experience.
In treatment, several things remain with me, most notably: ARE YOU WILLING TO GO TO ANY LENGTH FOR YOUR RECOVERY??? ANY LENGTH.
As addicts, getting into and remaining in sobreity, actively working our program of recovery is in fact the HARDEST thing we'll ever do.
I wish you great luck. And when you are in recovery, if you slip, don't look back. Just don't use and work your program.
RECOVERY, I FOUND TO BE PARADOXICAL: early on, we surrender everything as we cannot control this, that or the other. We're powerless over our addictions. But about 6 months into my recovery, I began to quickly realize that I do, we do in fact have power over our addictions. But it takes work. And diligence and tears and frustration. But it's doable. I know it is! I've done it. And thanks for your post, you've reinvigorated something within me that says, "it's time again".
BEST OF LUCK TO YOU!! IT'S TIME!!