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  • BDD Moderators: Keif’ Richards | negrogesic

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

@negrogesic buddy please chime in I respect your input because I know you've been in my shoes

They're trying to taper me from 20 mg subutex to like 2 or 4 mg in 7 days.

I want to speed it up or essentialy just stop the subutex all together.

I just want to get through to the other side.

What would you do?
 
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..

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..

At this point, the best way forward is to trust in the process, and then reassess with the doctor when you reach 12 mg. As long as the doctor is willing to communicate with you and listen and address your concerns, that's a good sign, in my opinion.
 
Sounds like an interesting protocol, especially the hydromorphone. 20 mg seems like a lot to start, but what @negrogesic said makes sense about flooding receptors. It sounds like they know what they’re doing so, like others have already stated, trust the process. Extreme addictions require extreme solutions and it sounds like maybe you’ve finally hit your stride. I know with buprenorphine you can drop pretty quickly down to about 4-6 mg before you really start feeling it due to the ceiling effect, so that’s probably where the medical staff is coming from. Either way dropping from that high a Methadone dose to 0 that fast is pretty impressive. Good luck!

And can we please stop spelling “taper” with 2 P’s? I don’t think it was in this thread, but I see it all the time and it drives me nuts. WTF is tappering? Do I need special metal-tipped shoes for it?

Also, it kind of sounded like you were gonna jump from 2 mg buprenorphine at the end. Is that correct? I hope they are able to bring you down lower than that. Definitely better than 110 mg of methadone, but IME it is still pretty unpleasant coming off 2 mg instead of like .5 or .25 if for nothing else other than how long it lasts. I find that I can jump off .5 or lower pretty comfortably and still be able to sleep, eat, etc. Anything more and I’ll be pretty antsy for a week.
 
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I'd stay on the buprenorphine for a bit if i were you. You might think you are fine but methadone is a different animal when compared to other opioids. Full blown acute withdrawal is still prevalent even 20 days after stopping. If it were any other opioid you might consider stopping the bupe.

If you were get to off of it then transfer to the other facility you might be in a world of hurt. You might not have the option to get back on it again. You can always stop but you might not be able to start it up if you find out you needed it. The safest bet would be to stay on it. I'd stay on the buprenorphine, I have a feeling you'll need it. It takes 10 days for the opioid receptors to start fully screaming after quitting methadone.
 
I'd stay on the buprenorphine for a bit if i were you. You might think you are fine but methadone is a different animal when compared to other opioids. Full blown acute withdrawal is still prevalent even 20 days after stopping. If it were any other opioid you might consider stopping the bupe.

If you were get to off of it then transfer to the other facility you might be in a world of hurt. You might not have the option to get back on it again. You can always stop but you might not be able to start it up if you find out you needed it. The safest bet would be to stay on it. I'd stay on the buprenorphine, I have a feeling you'll need it. It takes 10 days for the opioid receptors to start fully screaming after quitting methadone.

Thank you. Greatly. You're a great mod and addition to this site, as others such as @Deru @Serotonin101 @Genetic Freak I'm sure i'm missing some but I've spent most of my time in the Steroids and BDD forums.

oh and good @JessFR :giggle: as long as we don't talk politics LOL

Remembered a few more @Keif' Richards @madness00

Sounds like an interesting protocol, especially the hydromorphone. 20 mg seems like a lot to start, but what @negrogesic said makes sense about flooding receptors. It sounds like they know what they’re doing so, like others have already stated, trust the process. Extreme addictions require extreme solutions and it sounds like maybe you’ve finally hit your stride. I know with buprenorphine you can drop pretty quickly down to about 4-6 mg before you really start feeling it due to the ceiling effect, so that’s probably where the medical staff is coming from. Either way dropping from that high a Methadone dose to 0 that fast is pretty impressive. Good luck!

And can we please stop spelling “taper” with 2 P’s? I don’t think it was in this thread, but I see it all the time and it drives me nuts. WTF is tappering? Do I need special metal-tipped shoes for it?

Also, it kind of sounded like you were gonna jump from 2 mg buprenorphine at the end. Is that correct? I hope they are able to bring you down lower than that. Definitely better than 110 mg of methadone, but IME it is still pretty unpleasant coming off 2 mg instead of like .5 or .25 if for nothing else other than how long it lasts. I find that I can jump off .5 or lower pretty comfortably and still be able to sleep, eat, etc. Anything more and I’ll be pretty antsy for a week.

They were gonna give me 0.5 mg 36 hours after discharge to take but the next rehab won't allow it. The nurse said she would consider sneaking it to me. She's a saint.
 
I have made the decision I am ending my taper today.

I'll continue with the comfort meds and benzos but not one more drip of that shit bupe will enter my system so long as i live on this earth.

IDK if my body is allergic, idk if I just hate it with everything in me, but tomorrow I tell the Dr. sorry bud, no more taper. Fuck that shit.

I don't care how bad I suffer, I deserve it.

We'll see if he tries to change my mind.

I'm fucking done with opiates they've destroyed everything I love in this life.

Today I got to listen to my girlfriend tell me she cries everyday on the way to work since I left. How bad she misses me. How she just wants me with her and safe and healthy.

I'm so fucking sick of disappointing the people who love me. For once I just want someone in my fucking life to be proud of me. To not be the fucking fuck up of the century. JUST ONCE. Fuck me
 
I reckon you have already received heaps of good replies here and I agree with most of what has been said.

Just thought as someone who has been on methadone for over 20 years and has had a go at coming of using bup I would add my opinion.

I always thought that if I could do it anyway I wanted, my method would be to transition from the methadone onto an equivalent dose of an opioid with a short half life, I would stay on whatever opioid that may be for a period of time long enough for the methadone to totally leave my body, probably 2 months, then I would use suboxone for 5-7 days to make the final jump.

What you are doing essentially sounds like a condensed version of what I would do.

I would be skeptical when they make claims of getting someone off 20mg of alprazolam in 15 days without pain and obviously if they are making money out of the whole thing that just makes me more skeptical, however that doesn't mean that they don't know what they're doing, infact it sounds like they do know what they're on about.

Obviously their idea is to get as much of the methadone out of your body/off your receptors as painlessly and quickly as possible.

Then the plan is to finish the job with buprenorphine.

When I did it, I was in a government run hospital detox ward so no frills but they had a lot of experience at doing what they did.

So being no frills I didn't get the extras like hydramorphone, man I would have loved that...ha ha.
I had a bed booked for the Monday so I had my last dose of methadone on Saturday morning, I had tapered down to 17.5mg over a period of years, so by the time I got to the hospital it had been over 48hrs since my last dose and I wasn't feeling to good, they still made me wait until Tuesday morning before giving me my first dose of suboxone, I got through Monday night with lots of diazepam and clonidine and even though they gave me much more of that than I thought they would Monday night was still hell.

Tuesday morning and 6mg of suboxone had me feeling a lot better and I was tapered down to 2mg over the next 5 days.

So now it's Saturday morning and it's been 7 days since my last dose of methadone and I am feeling pretty good, not great but not bad, I talked to the doctor and his opinion was that because I had tapered down over a long time to a low dose there just wasn't that much methadone to clear out.

Their theory is that bup has such a high binding affinity it knocks everything off the receptors and basically works as a form of rapid detox, one of the earlier posters made the point that buprenorphine just doesn't perform in the real world the way it looks on paper.

I am not sure whether it's the bup that doesn't work exactly as they theorized or if it is the super long half life of the methadone or whether it builds up in the bodies cells or whatever.

This is what I do know, the reason I was feeling ok on day 8 was because the bup was still holding me.

From the time I got home my symptoms got worse progressively until I gave in at day 16 and scored, a week or so of using smack and I was back on the program which I am still on.

I don't want to discourage you in any way man so I am sorry if this sounds like one of the horror stories you read so frequently on the net about methadone, I just want you to be prepared for some residual withdrawl that, in my opinion, will come when the buprenorphine leaves your receptors.

Perhaps the high dose of bup will rid your body of the methadone, the problem I see though, is that while this will likely completely rid your receptors of the methadone, I think that methadone builds up in your bodies cells and this takes much longer to get rid of.

I have no medical qualifications to back this theory up so it may be complete garbage, I just think, both from my own personal experience and from anecdotal evidence that the only way to completely clear methadone that has accumulated over a long time is, unfortunately more time.

I would definitly stay on the bup for as long as you can get it and I'd go for the extra sneaky dose if you can also.

Off topic but interesting that you spent a lot of your time in the steroid forum, I didn't think there would be many of our type around, by that I mean people serious enough about lifting to use aas but also be as you so eloquently put it, opiate professionals...haha.
Anyway mate wishing you all the best going forward from here and I would be very greatfull for any updates you can make in the future.
 
In non human study clonidine mega dose toleranced after 14 days, so you might not feel fine after that range, I see that the whole process will not painless. Without other non opiates medication added in.

wbat do you mean my friend, taking clonidine that long is bad? Or tolerance will build? I don’t want to have my blood pressure sky rocket when I stop it I’ve already was at 165/110 on my in take
 
I reckon you have already received heaps of good replies here and I agree with most of what has been said.

Just thought as someone who has been on methadone for over 20 years and has had a go at coming of using bup I would add my opinion.

I always thought that if I could do it anyway I wanted, my method would be to transition from the methadone onto an equivalent dose of an opioid with a short half life, I would stay on whatever opioid that may be for a period of time long enough for the methadone to totally leave my body, probably 2 months, then I would use suboxone for 5-7 days to make the final jump.

What you are doing essentially sounds like a condensed version of what I would do.

I would be skeptical when they make claims of getting someone off 20mg of alprazolam in 15 days without pain and obviously if they are making money out of the whole thing that just makes me more skeptical, however that doesn't mean that they don't know what they're doing, infact it sounds like they do know what they're on about.

Obviously their idea is to get as much of the methadone out of your body/off your receptors as painlessly and quickly as possible.

Then the plan is to finish the job with buprenorphine.

When I did it, I was in a government run hospital detox ward so no frills but they had a lot of experience at doing what they did.

So being no frills I didn't get the extras like hydramorphone, man I would have loved that...ha ha.
I had a bed booked for the Monday so I had my last dose of methadone on Saturday morning, I had tapered down to 17.5mg over a period of years, so by the time I got to the hospital it had been over 48hrs since my last dose and I wasn't feeling to good, they still made me wait until Tuesday morning before giving me my first dose of suboxone, I got through Monday night with lots of diazepam and clonidine and even though they gave me much more of that than I thought they would Monday night was still hell.

Tuesday morning and 6mg of suboxone had me feeling a lot better and I was tapered down to 2mg over the next 5 days.

So now it's Saturday morning and it's been 7 days since my last dose of methadone and I am feeling pretty good, not great but not bad, I talked to the doctor and his opinion was that because I had tapered down over a long time to a low dose there just wasn't that much methadone to clear out.

Their theory is that bup has such a high binding affinity it knocks everything off the receptors and basically works as a form of rapid detox, one of the earlier posters made the point that buprenorphine just doesn't perform in the real world the way it looks on paper.

I am not sure whether it's the bup that doesn't work exactly as they theorized or if it is the super long half life of the methadone or whether it builds up in the bodies cells or whatever.

This is what I do know, the reason I was feeling ok on day 8 was because the bup was still holding me.

From the time I got home my symptoms got worse progressively until I gave in at day 16 and scored, a week or so of using smack and I was back on the program which I am still on.

I don't want to discourage you in any way man so I am sorry if this sounds like one of the horror stories you read so frequently on the net about methadone, I just want you to be prepared for some residual withdrawl that, in my opinion, will come when the buprenorphine leaves your receptors.

Perhaps the high dose of bup will rid your body of the methadone, the problem I see though, is that while this will likely completely rid your receptors of the methadone, I think that methadone builds up in your bodies cells and this takes much longer to get rid of.

I have no medical qualifications to back this theory up so it may be complete garbage, I just think, both from my own personal experience and from anecdotal evidence that the only way to completely clear methadone that has accumulated over a long time is, unfortunately more time.

I would definitly stay on the bup for as long as you can get it and I'd go for the extra sneaky dose if you can also.

Off topic but interesting that you spent a lot of your time in the steroid forum, I didn't think there would be many of our type around, by that I mean people serious enough about lifting to use aas but also be as you so eloquently put it, opiate professionals...haha.
Anyway mate wishing you all the best going forward from here and I would be very greatfull for any updates you can make in the future.
They gave me 20 mg of subutex.
I’m not taking a mg more of that shit.

because you are exactly right I’m gonna get sick as fuck when I leave and the point is to be sick as fuck now.

God and Valium will get me thru, or it won’t and I’ll die. It is what it is.

when you’ve destroyed your life with opiates for so long you build a certain hatred for them.

they cost me jobs relationships my family my safety many overdoses 4 months in jail. Charges.
 
Ok so they basically interventioned my plans this morning and I took 4 mg subutex.

I told him
That’s probably all I’m taking today.

will update.

Day 6 no methadone, slight sweats, fatigue, etc.

But I’m ok
 
^I think this is probably your best bet. As I’m sure you know, methadone w/d takes FOREVER and it might seem like a good idea right now to stop your taper, but you’re gonna be hating yourself in a week and will continue to hate yourself for another few weeks as you struggle to sleep or sit still. If your concern is being sick at the next spot maybe see if you can take just enough buprenorphine to get you through and just continue to drop down until you’re comfortable jumping off. You know your body better than I do obviously, but from what you say it sounds like your kick is nowhere near its terminus and if you are to be at a wilderness retreat with no medication relatively soon, I think you would still be feeling your methadone w/d pretty acutely and that sounds like a real bummer to me.
 
^I think this is probably your best bet. As I’m sure you know, methadone w/d takes FOREVER and it might seem like a good idea right now to stop your taper, but you’re gonna be hating yourself in a week and will continue to hate yourself for another few weeks as you struggle to sleep or sit still. If your concern is being sick at the next spot maybe see if you can take just enough buprenorphine to get you through and just continue to drop down until you’re comfortable jumping off. You know your body better than I do obviously, but from what you say it sounds like your kick is nowhere near its terminus and if you are to be at a wilderness retreat with no medication relatively soon, I think you would still be feeling your methadone w/d pretty acutely and that sounds like a real bummer to me.

That's exactly what's gonna happen and I have little say in the matter. No narcotics and it's basically a wilderness program. My sub taper ends and off I go to the mountains.

If I fight the plan I lose the support of my family and have to fend for my sobriety, withdrawal and life by myself which I could do but don't really want to.

My only other reasonable option is to disobey my parents and set up a sober house back home to get into post detox.

I'd rather be close to home in a sober house than on a mountain withdrawaling really.
 
I would say consider kicking buprenorphine after a month of post methadone. If you are only on day 6 you have a very long way to go...
 
I would say consider kicking buprenorphine after a month of post methadone. If you are only on day 6 you have a very long way to go...

I have little to no choice, they're gonna have me on bupe for around 8 days then it's off to snow mountain...

unless i can convince my dad otherwise but I don't think he gives a shit if I'm withdrawaling for 3 months hes not happy with me

or I go home with around $5,000 because I blew the rest on drugs and have to get into a sober house, get a job and fend for myself. And they won't give me subs either anyways.

I think im pretty fucked regardless
 
Update - I'm abandoning the wilderness program.

I've gotten into a sober home in my home state. Thankfully I have connections from previous periods of sobriety.

I'll have to face my demons of withdrawals but at least I'll be close to home and my friends and family.
 
DAY 7 - methadone free

Now though they're going 18 mg to 16 to 14 to 10. ( of subutex ) Today is the 10 mg day.

I tried to push for a faster and lower dose taper and the doctors and nurses who have been here years really advised against it. They said once your trying to catch up in severe WD subutex might not you save and they didn't wanna have to IV 4 mg of a diluadid cause then I'm just back tracking.

The Dr. said Day 5 I can make the decision on the drop. He said it's not as important as the first 4 days because we have you basically inducted and entirely saturated. I mean I feel pretty fine honestly I'm not even sick right now.

So the rest of my sub tapers looking like 10 mg to 4-6 mg to 2 mg to 1 mg to 0.5 mg to quit.

I've argued with the Dr I told him look guy, I wanna be fucking sick right here . Not in my next rehab thats not medically staffed or trained.

He told me it it's not gonna be that bad. But if it is that motherfucker can expect a hell of a phone call from me telling him he shoulda let me cut the taper sooner.

In my eyes eventually when the subs are gone I'm gonna be basically full blown WD. but he said it's not gonna happen. So we'll see.
 
In my eyes eventually when the subs are gone I'm gonna be basically full blown WD. but he said it's not gonna happen. So we'll see.

I admire this doctor’s confidence in the program you’re in. I actually think that taper plan, now that you‘ve specified, sounds like an excellent plan, fast and efficient, exactly how it should be. Staying on buprenorphine any longer leads right back to square one, dealing with the inevitable terrible withdrawals from another long half-life opioid when the time comes. You said it spot on originally, we all eventually have to pay to play.
 
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