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Opioids Methadone

L

Ladybuggs

Greenlighter
Joined
Jul 9, 2017
Messages
6
Ok so my boyfriend started doing heroin, not sure how much but he was doing it everyday for about a month then he wanted to get clean so he went to the clinic and they put him on a 21 day detox they started him off at about 40mg I think and tapered him down in 21 days he was fine the whole time didn't feel WDs or anything the whole time so we were optimistic then he had his last dose, for 2 days he was fine and I think around the 3rd day he started going through WDs right now he is currently on day 8 and it's bad his whole body aches bad and the anxiety is killing him he doesn't want to relapse so I gave him 2 norcos they are 10mg and that seemed to help him for right now, my question is how long will the WDs last? Because he wasn't on that much for that long.. and also can he just take a couple norcos here and there would that help him get through the WDs? Or should we go back to the clinic and get him back on methadone (he really doesn't want to be on methadone) he really just wants to be done with all this it's just getting through the WDs. I just feel so helpless :( it's very hard to watch someone you love go through this I just need to know options thank you all
 
If he really feels he can't stop and wants the lowest methadone dose to stay stable many do that as a maintenance dose until they are ready to make the jump off. He has made it far through the withdrawals and while they might return probably not as severe they will end with a phase of post acute withdrawals I recommend you look up. Also be aware due to methadone long half life the withdrawal is longer than usual, and it's why the withdrawal kicked in slow at first. He is really mostly through it though another week at the worst.

This is a hard time and he's lucky to have your support through it. If you have more questions feel free to ask.
 
I have thought about trying to have him go back on a low dose of the methadone like maybe 2 or 3mg and taper down for another 21 days till he gets to 0 but he really doesn't want to get back on the methadone do you think taking some norcos would help get through the WDs?? But not taking enough to get high..
 
Yea it will definitely lessen the severity of the withdrawal, but likely prolong it. Maybe 2-3 days with it at most although even one dose will set him back, which becomes exponentially more so every dose after. That said Norco w/d is probably easier than methadone. Just make sure you manage his dose and don't let him take more. Make sure he knows if he seeks it on his own he risks ruining things with you as it did he claim if your trust after putting your faith into him.

As far as the Norco try to only give him half every 6 hours. It won't make him well, but it should take the edge off slightly. If you can tell they are uncomfortable increase the dose by half a pill until they find it acceptable or you can tell they are at least functional. Again only for 3 days at most. Reduce by half a pill every other dose if you can or as often as possible...

You can't escape withdrawals only reduce the severity at the cost of strengthening the power of the withdrawals. He's going to have to get through feeling shitty. I find smoking good weed every 4-6 hours works, but unless the strain of bud is changed often I find it loses effectiveness fast and even then still some. Other meds can help and some swear by gabapentin/pregabalin, but I hate them. Benzos like xanax, Ativan, Valium, and klonopin can all help, but have a high risk of becoming their own dangerous dependency as well as having high death risks when combining with alcohol and/or opiates. Finally herbal stuff, a good meal, physical activity, and just regular showers and laundry to clean all that excessive sweat will help...

Not trying to tell you to clean his clothes due to your gender as he needs to learn to do the laundry too especially if you are ever to hold a child although that's thinking too far ahead, but definitely right now cook him food, clean his clothes, help him dress, and even bathe although without hurting his pride just expressing empathy towards the difficulty to even get out of bed now. It's going to be a long road for him and having you there can be the difference between him succeeding and failing.

Also some other opiate alternatives that have helped people ween at their own pace are Kratom and poppy seed tea. The first is probably the better choice as it's not a traditional opiod acting in a more stimulant matter while still being narcotic, but is harder to abuse as making tea from the leaves seems to be the best way do use. Poppy seed tea on the other hand is essentially opium tea, which is why if this route is followed there needs to be great care and practice put into place to test and measure the seeds potency by finding the estimated active mg dosage content of a quarter lb of seeds and measuring each dose accurately as well as dosing about every 12 hours or 8 hours at most as the natural variety of compounds that exist in the opium lead to a much longer lasting effect and can lead to horrible excruciating long lasting withdrawal.

I'll conclude with the last official ort being buprenorphine usually combined with narcan as bs abuse deterrent as another possibility, but without insurance and a developed medical community in regards to suboxone treatment then you'll likely be paying a lot of money and honestly it sounds like he just wants off while suboxone is a very nasty dependency just as bad as methadone if not worse. It is useful to block opiates from working even if he slips up and uses although in case of emergency he can stop using it so he can benefit from opiate pain management unlike a vivitalrol shot, which can't be reversed and may help some people, but in my opinion it's straight evil.

Anyways good luck if you have more questions again feel free to ask
 
This is a good example of a situation where a short course of methadone is not ideal (40mg to 0mg is a very fast taper after all, one that simply isn't enough for a lot of people). I always tend to suggest folks try the six month extended detox rather than the 21 day detox (which was, after all, designed for more inpatient settings like a hospital detox unit). It give much more time to more gentle adjust to life without opioid use. If he ends up relapsing hard or struggling again with opioids, I'd highly suggest he try integrating this longer six month extended detox into his plans.

If he is struggling with withdrawal following methadone, comfort meds like a short course of buprenorphine and clonidine, and perhaps a month of gabapentin and a non-habit forum sleeping med like trazodone.

If long term abstinence is the goal, he may find the stability of a longer course of ORT is preferable to trying to white knuckle it through early recovery when coming off an opioid habit.

That all said, what does you significant other want OP? Have you discussed his goals and how he might work to achieve them? It very rarely just takes detoxing to get established in recovery from harmful patterns of drug use, so I'd suggest you work with him to formulate a recovery strategy with him (and, for that matter, one that deals with your needs as well, as you are also a part of this thing).

On another note, a week or tramadol is also a pretty effective way to detox from a shorter methadone habit like this. Something to consider if ORT or a short course of buprenorphine isn't part of what he wants his equation to be at this time.
 
I was on methadone for years 50mg a day I use to take 100ml every other day 100ml would hold me 2 days then one day I was ill and didn't pick up for 3 days so they cancelled my script it was pure he'll but I was to ill to score for 2 weeks I was in hell then when I recover from my illness I was sill rattling for methadone so I scored dope smoked it on the foil and was instantly better after smoking half a bag on the foil I have read that methadone withdrawal is worse than heroin and can last up to a month.
 
No, the withdrawal isn't worse than with heroin, not in any objective sense at least. Subjectively the more protracted character of methadone withdrawal compared to short acting opioids like heroin might make it seemcworse, but that is more a product of not using methadone properly (regardless of the reason, whether user error or being prevented to by restrictive clinic policy).

You c/t'd 50mg/day after using it for years, which is why you experienced horrible withdrawal (I know they have their regulations, but no pharmacy should do this to someone - it is beyond unethical, but no one gives a shit about junkies, so it's okay for them to mistreat their patients like this...).

Anyways, if you'd been taking a high dose of heroin for years and stopped c/t, it probably would have been just as horrible. The withdrawal might not have been as protracted or drawn out, but it would also be much more intense.

Nothing wrong with warning people against improperly using medications, but the situation you've described bares little to no resemblance to what the OP is currently dealing with. His experience of methadone or opioid withdrawal in this instance will be next to nothing like what you described struggling with.
 
I believe we are fine in agreeing to disagree on that.

I have used methadone for years (almost 8 years) at the end - after almost 1 year tapering - I finally made the jump from 3 mg of methadone. 1 year, being attended in a specialized clinic and being an in-and-out patient including 3+ months after that year. I was on therapy and being treated by other doctors too. I also worked during this period to keep my mind busy.

Still, for me it was the most horrific experience I have ever felt in my life. It took me one month to stand up and be physically okay, but I was feeling really bad, suffering from depression. I'm sober for 2.5 years but I still remember how difficult it was to go through this period of my life.

Heroin detox was hell, but it only took me 7-8 days to detox, after the 4th day I was fine, stable - regardless of all the cravings. Fentanyl was a bit trickier as I have had a medical condition that demanded opiates after a complicated surgery.

Methadone was a life saver and I lived well for many years until I decided to quit it gently like you said. 6 months to reach 3 mg. Then 6 more months to make the jump and up to this day it was hardest feeling I have gone through in my whole life. Don't underestimate Methadone I say.

I have always been pretty strong in life, maybe methadone is my weak spot. But I am not the only one. Even in here in BL I have met quite a number of people who have also reached the 3 mg mark and still didn't make it after a couple of months because it's difficult.

This is not what OP is experiencing right now, but the decision one has to take is either use methadone to taper for a limited period of time or use it indefinitely in the lowest possible dose so that you don't use anything else. With time methadone can be a 'fine' replacement if you are on the streets risking your life everyday.
 
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I forget, were you prescribed any of the many appropriate medications for treating methadone withdrawal (buprenorphine, DHC, tramadol, diazepam, clonazepam, gabapentin, ropinirole, ondansetron, loperamide, clonidine, etc) in the months following your jumping off methadone Erik? Doctors are finally pulling theirs heads out of asses, slowly, here and now recommending people transition to buprenorphine following really long periods of time on methadone, following an appropriate taper on the methadone I mean.

And I had forgotten you only used a year to taper off seven years of methadone (I'm assuming the eight years you mentioned included the year taper). I mean, it's a great taper, but from that many years of use I normally hear people suggest an even more protracted taper (at least 20-30% of time spend on maintenance should be devoted to tapering for those on longer term MMT).

Don't you imagine it would have been perhaps nearly as difficult if you'd have been using an equivalent dose of heroin (or X potent opioid) for the same amount of time you used methadone, and then came off that? Of course it would have a different flavor depending on the particular opioid used, and it would be more drawn out with longer acting opioids. But I have seem many a person scoff at methadone withdrawal and just end up trying to deal with the "shorter" withdrawal of heroin instead of dealing with a proper methadone taper, only to end up crashing and burning thanks to the withdrawal from potent shorter acting opioids being more intense than methadone, albeit not as drawn out.

Of course, I have heard from some long term, heavy heroin users that it took well over a month to begin feeling even remotely normal after kicking, but that is the extreme of course, just as your situation was coming off methadone I feel. Anyways, the above paragraph is kinda besides the point (it's more for folks to read who don't already have your breath of understand when it comes to opioid use).

Anyways, I don't even think we disagree, because ultimately there are soooooo many individual factors as work that play a role in determining the character and severity of acute withdrawal that many of us are bound to have different experiences - and we both try to respect that. This is one of the reasons it's so important to hear from a wide range of individuals, and to get an accurate picture of what they went through (from them, in their own words), so as to gain the wisdom of the diversity of our experiences with this. We might have had different personal experiences, but that's part of what makes us who we are as distinct individuals.

Perhaps there is something that makes it more difficult for some people to come off of methadone (or other super potent opioids) after using them for really long term? I mean, that would make sense.

In terms of what I've seen at clinics, with tapering, using appropriate comfort meds, and various other forms of appropriate treatment, the many folks I've met who have successfully come off <5 years of methadone didn't experience anything even remotely like what you describe going through (and it sounded pretty fucking beyond awful). But I wonder if, like I said particularly for some individuals, there is a point where it just gets harder and harder to come off methadone. For sure, this was part of the reason I tried to not get my dose too high and started tapering shortly after beginning MMT and ended up on it for under three years. Certainly the longer methadone is used, the more one will benefit from a longer taper.

I guess I am just trying to point out how it's problematic to highlighting the more extreme case of of opioid withdrawal that some people do unfortunately experience, as it has relatively little to do with what a totally different person, in a totally different set of circumstances, is going to experience. Particularly, as you mention Erik, that your situation coming off methadone (not to mention mine) as well as thegunman's isn't very indicative of what the OP is likely to experience with his present situation.

And frankly Erikman, I kinda love the little dance we do sometimes with this! We're like yin and yang a little bit, good individually but better when you hear from us together ;) <3

Pls forgive me for this crazy long fuck of a post :)
 
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Update:
this morning my boyfriend woke up feeling really bad so I took him to the ER where the gave him a Ativan for the anxiety and 2 other pills (not sure what they were) and a prescription for buspar.. a hour or so later he took a buspar and then another one about a hour or so later (5mg pill) then about 2 hours after that (still felt really bad) I gave him a 10mg norco (seems to be the o my thing that really helps I may give him one more norcos before bed just to help sleep (7 hour period.. I really don't want him to end up back at square one because of the norco but I have read it won't because he was on heroin and methadone which is way stronger and the norcos are relatively low dose. Tomorrow we are going to see what his primary doctor says I just want to make sure I'm not messing up the recovery process by giving him a norco here and there :/
 
It won't send him back to square one taking low dose of Norco, but taking enough or for long enough without break can. It's just something you need to be aware of. It's a catch 22 right now he needs to get off, but he also needs the help of staying on so it's not so horrible. As you said a small amount of Norco especially at night for bed isn't bad, but just make sure you don't let it become a regular thing unless they find a doctor who is willing to script their own for them and they can keep the habit under control. Opiate use isn't inherently bad, but the misuse of it that is.
 
How much hydrocodone has he taken so far each day, and how often a day do you give them to him? Try not to exceed 20-30mg/day for no more than four to seven days. By day for you should be able to lower the hydrocodone dosage/frequency as his acute withdrawal peaks and begins to fade.
 
I'll usually give him one 10 my pill in the middle of the day when it's really bad and one before bed about 8 hours apart
 
That should be fine. 4-7 days or that and he will be get through acute withdrawal just fine.
 
No lope needs to stop being recommended as the first thing against withdrawal. It's a available for a reason.... It's only good for the shits. I don't care what anyone says the risks outweigh the benefits using it any other way.
 
Kratom wouldn't be a bad idea. And yes, I only really approve of high dose loperamide use to combat opioid withdrawal when it's literally the only option (and it very rarely is).
 
DXM or Dextromethorphan-Hydrobromide or polistirex which is an OTC-over the counter (no prescription needed) cough medicine in things like Robatussin can help as a comfort medicine if your bf isn't using any anti depressants. It's best to find a cough syrup without any other ingredients if possible or maybe just guifensin or acetaminophen as the 2nd ingredient and no more than 1 1/2x the recommended dose or 20mg every 6 hrs.. Loperamide is also good at 12mg or less to settle stomach cramps and diarrhea if that's a symptom.
 
Yes, if the dude can tolerate it (most people hate DXM) and has some time off to devote to kicking, DXM can be a godsend in withdrawal. Frankly I have the sneaking suspicion it would have taken me far longer to move beyond my opioid use disorder had I not discovered it's value, though it took many years of experimentation before I figure out how to use it "properly" (I use quote because admittedly I wasn't exactly using it properly ;)).

I never really encourage anyone to try something like DXM during withdrawal without having experienced it under normal circumstances. I love most of the effects, but many people find them very unpleasant. Now, what's unpleasant when taken from a sober standpoint and unpleasant during withdrawal are two very different things. Even if the DXM is unpleasant, I imagine it could still be more pleasant than bad withdrawal, where it would still be able to have its therapeutic pharmacological effect.
 
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