Bupe My Fellow Opiate Professionals - let’s talk detox protocols

[OpiateKiller]

Hello all. I currently am in a kind of medical high tech detox facility.

the goal is to bridge me from 110 mg of methadone to 0 in 10 to 12 days.

My last methadone use was 90 hours ago and it was 50 mg IV.

Tomorrow I am supposed to induct my subutex taper and they start me on 20 mg over 24 hours.

this will consist of a 6 day taper in which they drop me down to 2 mg as my last dose.

they are currently giving me gabapentin, clonidine, Valium, ibuprofen, IV Fluids, Micro doses of Iv diluadid (last night I got 2 mg over 2 hours)...

I am honestly considering telling them fuck the subutex taper. Keep me on the comfort meds and let’s rock and roll this shit out for the next 7 days.

I’m honestly not suffering nearly as bad as I thought I would be. The meds they are giving me are even allowing me to get 6-7 hours of sleep.

The doctors and nurses here think it’s a really bad idea to not use subutex, they have developed kind of a magic detox protocol. But in my eyes the more opiates the longer the detox the more I suffer.

what are your guys thoughts? If I decline the subutex it’s not like there gonna load me
Up on diluadid that’s not gonna happen

 

[fakebuttcheekz]

That's quite the cocktail for a detox center, enjoy it while it lasts. I've never been on methdone myself, but I've only heard bad things about the extremely long detox from it. How long have you been on it? And yes, I agree, fuck the subutex, it just prolongs the inevitable.

 

[OpiateKiller]

That's quite the cocktail for a detox center, enjoy it while it lasts. I've never been on methdone myself, but I've only heard bad things about the extremely long detox from it. How long have you been on it? And yes, I agree, fuck the subutex, it just prolongs the inevitable.

its the best detox I’ve ever attended. I’ve sat j jail and been laughed at by COs, I’ve been in state run facilities where if you weren’t dying you didn’t get Suboxone, and forget about a benzo LOL even the alcoholics were lucky to get a Librium.

 

[Deru]

I am honestly considering telling them fuck the subutex taper.

Good idea. At the very least, don't start at 20 mg.

 

[negrogesic]

I'd go for the buprenorphine if i were you.

It won't end quick like withdrawal from other opioids. Methadone withdrawal only begins to peak at day 10. Go with the buprenorphine. It sounds like they know what they are doing.

 

[OpiateKiller]

Good idea. At the very least, don't start at 20 mg.

They're gonna micro dose me with a 1 mg IV to see how it goes but for whatever reason the protocol is 20 mg in 24 hours so my head nurse said once we start I need 20 mg in me by 24 hours from the start. Which I kind of find absurd but I'm no medical professional

 

[OpiateKiller]

I'd go for the buprenorphine if i were you.

It won't end quick like withdrawal from other opioids. Methadone withdrawal only begins to peak at day 10. Go with the buprenorphine. It sounds like they know what they are doing.

I think I'm gonna. As much as I want to "cold turkey / fight" this. I'm not sure I can. I'm not even full blown withdrawaling and I'm 96 hours in... that's saying something.

I also am going to a non medical wilderness program for 2-3 months after this so if I leave this detox and get hit with a wave of severe withdrawal my options are basically, I'm fucked.

I'm gonna trust this Dr. He told me he's been running this detox for 10 years and this isn't his first rodeo.

He also told me he's gotten 2 patients off 200+ mg of methadone in 12 days leaving the center with mostly high hopes and minimal symptoms walking out the door. Now that's some serious magic.

 

[negrogesic]

20mg sounds right to me. Higher doses avoid precipitating opioid withdrawal.

Buprenorphine is a high affinity, low efficacy MOR agonist (making it a "partial" agonist). This means low doses kick everything else out and almost guarantee withdrawal, whereas higher doses bind with high affinity but start to activate the receptor more strongly. It works out on paper so ill be curious to see how it goes for you. It seems as though they've handled this situation before so I wouldn't try to second guess it. Sounds like you got lucky in fact.

At 110mg/day you do not want to wait to see what day 10 of no methadone is like. My bones ache thinking about it.

 

[OpiateKiller]

20mg sounds right to me. Higher doses avoid precipitating opioid withdrawal.

Buprenorphine is a high affinity, low efficacy MOR agonist (making it a "partial" agonist). This means low doses kick everything else out and almost guarantee withdrawal, whereas higher doses bind with high affinity but start to activate the receptor more strongly. It works out on paper so ill be curious to see how it goes for you. It seems as though they've handled this situation before so I wouldn't try to second guess it. Sounds like you got lucky in fact.

At 110mg/day you do not want to wait to see what day 10 of no methadone is like. My bones ache thinking about it.

You're right my friend. I will keep this thread updated for the sole purpose of education and harm reduction. But I will follow through their protocols.

I've been trying to run the show so long and my methods get me fucked every time. Let's listen to the pros.

They turned a guy from a 20 mg Xanax habit back to his home in 15 days, completely sober. This place knows how to detox someone. and fast.

 

[fakebuttcheekz]

I'd go for the buprenorphine if i were you.

It won't end quick like withdrawal from other opioids. Methadone withdrawal only begins to peak at day 10. Go with the buprenorphine. It sounds like they know what they are doing.

No it doesn't sound like they know what their doing. A 6 day subutex taper isn't going to do a thing for a long term methadone withdrawal...the only thing to help methadone withdrawal is a slow methadone taper.

 

[fakebuttcheekz]

You're right my friend. I will keep this thread updated for the sole purpose of education and harm reduction. But I will follow through their protocols.

I've been trying to run the show so long and my methods get me fucked every time. Let's listen to the pros.

They turned a guy from a 20 mg Xanax habit back to his home in 15 days, completely sober. This place knows how to detox someone. and fast.

Have to agree...we've all tried to out think our way through every route possible...you should go ahead and do what they say. Maybe they're right, keep us posted.

 

[Deru]

They're gonna micro dose me with a 1 mg IV to see how it goes but for whatever reason the protocol is 20 mg in 24 hours so my head nurse said once we start I need 20 mg in me by 24 hours from the start. Which I kind of find absurd but I'm no medical professional

Interesting, definitely curious to hear how it all works out for you.

It works out on paper

Buprenorphine seems to be one of those drugs that works out on paper, but doesn't quite translate to working out in reality, in my 10+ years experience with it. I'm always slightly amused when I hear what buprenorphine should do, and I'm curious why the current data and reality seem to collide in odd ways.

 

[OpiateKiller]

Interesting, definitely curious to hear how it all works out for you.



Buprenorphine seems to be one of those drugs that works out on paper, but doesn't quite translate to working out in reality, in my 10+ years experience with it.

That's exactly my point lol. I absolutely hate bupe. It's a terrible drug for so many reasons. But I'm just trusting the process.

I have a bad feeling though I'm gonna hit my next rehab which has no medical staff and be sick as fuck for weeks. But what are you gonna do ....

you gotta pay to play my friends. That is one life lesson I have learned the hard way many times

 

[OpiateKiller]

100 hours post methadone and fentanyl use they just IV'd me with 0.5 mg of subutex.

I started to sweat pretty bad but I'm over the hump and feel somewhat relieved.

Also note last night I was given 2 mg of dilaudid and 30 mg of temazepam.

 

[Deru]

I have a bad feeling though I'm gonna hit my next rehab which has no medical staff and be sick as fuck for weeks. But what are you gonna do ....

Stay positive. Focus on the basics, diet, hydration and exercise. It seems almost too simple, but something I personally overlooked for far too long. Once I realized those were key, especially getting those endogenous opioids flowing during exercise, everything finally fell into place for me. The withdrawals and pain, physical and mental, eventually just fades into nothingness, it's a beautiful thing.

 

[OpiateKiller]

104 hours post dose they gave me 2 mg of subutex and I went south quickly sweating shaking i curled up in a ball for an hour. But I’m back. Feeling 5/10 pretty sweaty.

kind of expected going from fentanyl heroin and methadone to subutex.

 

[4meSM]

They turned a guy from a 20 mg Xanax habit back to his home in 15 days, completely sober. This place knows how to detox someone. and fast.

That sounds almost too good to be true. If it was an opioid detox I could believe it... But a long term & high dose benzo addiction to nothing in 15 days? That's almost a miracle, or maybe the guy had only been on benzos for a short amount of time.
Assuming of course that the guy wasn't an anxious mess when he got home.

Anyway, best of luck and keep moving forward!
And please tell us how it works for you(if you can), I'm pretty interested.

 

[OpiateKiller]

Day 6 -

They have got me up to about 16 mg of subutex in my system -

I feel fine besides small sweats I made it over the hump of the induction and switch.

I have slept every night with the help of clonidine and restoril (30mg temazepam which they're stopping soon)

Never in my life have I slept in a detox facility. EVER. not a minute.

I'm about to talk to the doctor who started this place about shorting my taper or potentially just stopping Subutex all together.

I'm really fearful this taper will just prolong the inevitable of pain and suffering when i hit the residential treatment.

 

[Deru]

I'm about to talk to the doctor who started this place about shorting my taper or potentially just stopping Subutex all together.

I'm really fearful this taper will just prolong the inevitable of pain and suffering when i hit the residential treatment.

I'm really curious about this specific aspect, I'd love to hear your doctor's thoughts on this. I think it's great you keep updating us and look forward to reading more.

 

[OpiateKiller]

I'm really curious about this specific aspect, I'd love to hear your doctor's thoughts on this. I think it's great you keep updating us and look forward to reading more.

Thanks man. I'm glad it's helpful.

I just spoke to the Doc. He said it's a really bad idea to change the taper. He said just let me get you 4 days from 18 mg to 12 mg then we can talk about bigger drops.

He said we need your receptors as full as possible right now, he told me not to fight him on this and to trust him so I'm gonna..

I don't think I'll have internet access for 30-90 days after I leave here so I'll have to update my PAWS and withdrawals post detox at a later time but I'll be here at least till Dec 27

The problem morally is these places are driven by money and the longer I'm here the more they make so part of me is wondering his true motives.