Looking for advice on Opiate withdrawl / I have Diazepam 5mg and Co-dydramol 20/500mg

[john EC1]

Hi. I have picked up an Opiate habit using H to come down from freebasing. I have been freebasing for about 25 years but only started using H about a year ago to help me sleep while I was doing a post-grad. I'm sure you all know the rest. I only knew about the habit for sure a month ago (first days off in a year) and immediately decided to go cold turkey. After 4 days I ended up in hospital badly dehydrated and quite sick. It was the build up of Lactic Acid and Potassium in my blood that kept me in, combined with awful blood pressure and heart rate.

I had a bad accident 20 years ago and have had 3 back surgeries to deal with pain and also spasms caused by nerve damage. As a result I get 5mg Diazepam a day and 80mg Dihydrocodeine / 2000mg Paracetamol. This is prescribed by a specialist and is unlikely to change. Right now I have 30 Diazepam and 110 Co-dydramol but I can get more. I only use them as required, I don't automatically take them. I'm hoping this will be my lifeline.

Anyway my question is this: Should I work out a reduction schedule and stick to it or just wait until I feel really bad and then take something? I am a bit of a wimp so quite like the idea of gently weening myself off the H but am concerned that just adding a replacement won't really work.

I will check tomorrow for replies and thank everyone who takes the time to read this or shares their experience in advance.

Many thanks,

John in London EC1

 

[falsifiedhypothesi]

Do you mean 80/200 for the dhc/apap? 2000mg of apap seems pretty extreme and you'll definitely need to do cold water extractions if you plan on using these pills, otherwise the meds you have should be plenty for a decent taper.

 

[Nucynta_80]

Hi. I have picked up an Opiate habit using H to come down from freebasing. I have been freebasing for about 25 years but only started using H about a year ago to help me sleep while I was doing a post-grad. I'm sure you all know the rest. I only knew about the habit for sure a month ago (first days off in a year) and immediately decided to go cold turkey. After 4 days I ended up in hospital badly dehydrated and quite sick. It was the build up of Lactic Acid and Potassium in my blood that kept me in, combined with awful blood pressure and heart rate.

I had a bad accident 20 years ago and have had 3 back surgeries to deal with pain and also spasms caused by nerve damage. As a result I get 5mg Diazepam a day and 80mg Dihydrocodeine / 2000mg Paracetamol. This is prescribed by a specialist and is unlikely to change. Right now I have 30 Diazepam and 110 Co-dydramol but I can get more. I only use them as required, I don't automatically take them. I'm hoping this will be my lifeline.

Anyway my question is this: Should I work out a reduction schedule and stick to it or just wait until I feel really bad and then take something? I am a bit of a wimp so quite like the idea of gently weening myself off the H but am concerned that just adding a replacement won't really work.

I will check tomorrow for replies and thank everyone who takes the time to read this or shares their experience in advance.

Many thanks,

John in London EC1

Hi there. I think the best solution would be to go onto Buprenorphine. Codeine and it’s slightly stronger cousin, Dihydrocodeine (weak full agonists) just aren't going to cut it. Codeine is about 1/20th the strength of heroin (only about 8-12% converts to morphine), not to mention the short half life of half-life of about 4 hours means the relief will wear off quickly.

Buprenorphine is a MUCH better substitute opioid. Although it’s only a partial agonist (30% receptor activation), it’s binding affinity is 40x that of morphine AND it covers more receptors than codeine and dihydrocodeine do, not to mention its long lasting, as it has a long half life of 21+ hours. Even 2mgs doses (x2 a day) that they sometimes start people off on before bumping to 4, 6, or 8 is enough to dampen the withdraw better than codeine can. At 4-8mg doses, it should do a satisfactory job helping with the cravings part. You can also safely be on Bupe long term, or alternatively for just a few weeks. Getting off of Bupe is a little rougher than codeine, no doubt, but the withdrawal is less severe than heroin!

Now, this could impact getting your script, but honestly, I still think hands down that it would be a better option. If you decide to, you could stay on it long term to help with pain too!

My regime is Belbuca 300 micrograms x2 a day, with 5mg oxycodone (up to 3 a day) for when I need more relief. While the formula for that Bucal film is 55% bioavailability (making it more akin to 500 micrograms of Bupe sublingual), you have to consider, 1mg of Bupe in a day drops my pain by 60-70%, so you could probably get by with doing a maint dose of 2mg sublingual x2 a day that would provide better relief than the meds you are currently on.

Just my views

 

[john EC1]

Hi, first of all thank you so much for taking the time to help me. The Co-dydramols are 20/500 and i get 120 per month so 4 a day. Right now I get 10mg Diazepam a day as well. This will be for as long as I want.
I had my 3rd back op about 3 months ago and hope to have a 4th around October. If they can see enough improvement they will look at further surgery options; if there is not sufficient progress I will be written off as disabled. The meds are necessary, i've had a recent opiate review which found I took 18% of the prescribed dose over a 12 month period and I sailed through to the extent that I will only get another review if circumstances change. The meds are on a repeat which I just order online and collect the next day. I take the bare minimum for the simple reason that the less you take the better they work when you need them which I often but not always do. It is not unusual to go a week or more without prescription medication but when I need it I really need it.
I can and have done CWEs many times but am not looking to get high. I am truly fortunate to have these meds available although obviously I wish I had never had the accident. I have read many threads on here from people looking for X or Y to get through a withdrawal they know is coming. I don't have to look for anything but don't know the best way forward.
I made a 14 day schedule of 8,8,7,7 per day etc and easily have enough, plus spares, with Diazepam available as an extra. And medical cannabis which I also get unusually for the UK. As a wimp I like this idea but im not sure it is the best way to go. I'd be taking more medication than normal. The other option is put 2 or 3 DHC and a Vali in my pocket and wait until I feel rough, take them, then wait for the next time hoping to lengthen the time between doses.
I have only tried this once, went cold turkey and ended up hospitalised. Any advice or experiences people have to offer will be read and gratefully received.
Thanks for replying and your help to date,
John

 

[john EC1]

Hi there. I think the best solution would be to go onto Buprenorphine. Codeine and it’s slightly stronger cousin, Dihydrocodeine (weak full agonists) just aren't going to cut it. Codeine is about 1/20th the strength of heroin (only about 8-12% converts to morphine), not to mention the short half life of half-life of about 4 hours means the relief will wear off quickly.

Buprenorphine is a MUCH better substitute opioid. Although it’s only a partial agonist (30% receptor activation), it’s binding affinity is 40x that of morphine AND it covers more receptors than codeine and dihydrocodeine do, not to mention its long lasting, as it has a long half life of 21+ hours. Even 2mgs doses (x2 a day) that they sometimes start people off on before bumping to 4, 6, or 8 is enough to dampen the withdraw better than codeine can. At 4-8mg doses, it should do a satisfactory job helping with the cravings part. You can also safely be on Bupe long term, or alternatively for just a few weeks. Getting off of Bupe is a little rougher than codeine, no doubt, but the withdrawal is less severe than heroin!

Now, this could impact getting your script, but honestly, I still think hands down that it would be a better option. If you decide to, you could stay on it long term to help with pain too!

My regime is Belbuca 300 micrograms x2 a day, with 5mg oxycodone (up to 3 a day) for when I need more relief. While the formula for that Bucal film is 55% bioavailability (making it more akin to 500 micrograms of Bupe sublingual), you have to consider, 1mg of Bupe in a day drops my pain by 60-70%, so you could probably get by with doing a maint dose of 2mg sublingual x2 a day that would provide better relief than the meds you are currently on.

Just my views

Hi, thanks for the great advice. I will read it again in the morning as it is a bit technical and i'm not sure all the names will be the same but THANK YOU for bothering to reply and again for your help.
Cheers,
John

 

[Las Veghost grower]

If you can wait till your in minor wd and only take enough to feel right I say go that route, the longer you can go between doses the better and periodically take less meds

 

[john EC1]

Thanks! That is exactly what I wasn't sure about. It isnt a brutal habit. I never had B on its own, I just started smoking a couple of pipes at the end of the night. The rest as they say ...
Mate, I really cannot thank you enough.
I'll come back in a week or so and let you know how it went.
Cheers,
John