Opioids Need Advice. Can I use subs only through the first part of w/d and stop?

[limegreen_421]

I'm very close to w/ds from fentanyl. I've been physically addicted for approximately a year. Don't know my dosage as the stuff I've been getting isn't pharma fent, but clandestine lab fent. I know, I'm an idiot. I've been in a weird semi-w/d (tapering the last of my supply basically) and its hell. I'm so depressed and have zero energy. I know this is largely because I went from doing a gram of what was billed as china white (not here to argue terminolgy or anything like that. I know what I was getting wasn't real heroin #4 as it was purely some analogue of fent). I've been totally out of that since Sunday am, but had tapered very quickly for about a week prior from a gram a day (snorted) down to less than 1/4 of a gram a day. I'd only been using that powder since March. Prior to that I had a nasal spray. I've been back on the nasal spray since the powder has run out and its been hell. I was weirdly doing so much better on a tapered dose of the powder than I am back on the nasal spray. Yes, I'm not in full wds by any means, but I'm certainly not comfortable and certainly not getting high. I've wanted off for a long time and when the powder supply dried up and I got ripped off for nearly $600, I took those as major signs that it was time to take my life back. I'll try to link to a couple of other threads I've started to give more background info and not make this an extra-long post/hi-jack the thread in any way. Basically I'm being a total baby about this whole process and I really need some support. I'm really scared of the wds and have only ever been through the first 36 hrs before I was able to get more, so I don't even know the worst of it. Plus my tolerance is way higher than what it was when I did that 36 hrs. I know this is going to be a temporary condition and I WILL get and feel so much better once its over (aside from dealing with any PAWS issues), but I am a nervous person as it is and am trying so hard not to panic, I just don't have anyone at all to talk to about this.

Finally to my question about using suboxone through the w/d process. I've never used it before (I'm honestly quite drug-naive, i had no business getting involved with this shit as I had an extremely low tolerence to vicodin when I started. Literally 3.75 mgs would make me feel awesome). I've done my research and am aware that I need to be in full wds before I were to ever consider using it. I only want to be able to get through the worst of the w/ds, I do not want to trade addictions. Is it possible to just use it for the first 4-6 days of wds without any real consequences? Or will it just stave off my actual wds until I stop taking it? Really need help on that question! I'll add my links to my prior threads below if anyone wants any further background info. If this post needs to be moved someplace more appropriate please do so. I am fairly new here and am still learning the ropes. I'm 30, but have never been a huge forum person so I'm not great at it yet.

link: (There should be another one that explains why I even started messing around with this stuff, but I cannot find it right now and its irrelevant since I am where I am now)
http://www.bluelight.org/vb/threads/825766-Need-Support-While-I-Kick-Fent-Please-Help!

 

[keeping]

it's totally possible to use subs to get off any opiate without trading addictions. this is actually the smartest way to use subs, they shouldn't be just maintained for years and years as the wd from subs takes a really long time. so yeah, just wait til you're in full wd's and then take however much you need to stop feeling bad, but not feel high - just maintain - from here on stabilize for a few days and then begin to reduce. this is known as The Rapid Sub Detox, here's a basic (and kinda fast) detox schedulee, as an example i would recommend lengthening it a bit more, like a week/week and a half and you should be good.

maybe stock up on some non-opiate detox meds for when you make the jump off of the subs, things like: clonidine for the sweats, ibuprofen for aches, Imodium for the shits, valium and/or xanax for anxiety and insomnia and gabapentin or pregablin for everything else.

best of luck mate

 

[limegreen_421]

Thank you so much for the reply and the link! I'm terrible at math and have seen some of the other sub taper schedules (but not this one, so I can't thank you enough!). I read some of the other posts on that thread and I'm definitely like OP in that I want the subs in and out of me as soon as possible. I absolutely recognize the benefits, but I'm not willing to do the maintenence meds thing. I do have access to xanax and klonopin 1mg pretty unlimited as I have a prescription and stockpile since I never abused them. I am somewhat confused about OP's induction time...it seemed like she inducted 11 hrs after her last dose. I have access to the cows chart and some practical medical training, so I should be able to judge myself correctly when the time comes, but is 11 hours a normal timeframe? most of what I've seen in my research its 12-36hrs (the longer end being for methadone and bupe). For me this stuff seems to have a really short half life (the fent, that is). I can find myself in minor wds within a few hrs or less depending on my activity level. I guess what I'm asking is what to expect in terms of how long to wait in order to be able to induce without precipitating wds? I know everyone is different, but is 11-12 hours realistic with what I've been taking basically 24 hrs a day?

 

[limegreen_421]

Oh, I've also got the clonodine, immodium, some dxm cough meds (have occasionally successfully used for sleep in the past, unlikely to use if I'm using the subs), and lots of supplements and vitamins to take. What do you suggest in terms of dosing for the clonodine? That's not something I've been able to find lots of info on in terms of a schedule and i obviously don't want to take too much due to the low blood pressure facet of things and this drug interaction checker I used says there's a major risk using the clonodine, bupe, and benzos together...which doesn't make a ton of sense since it is a fairly common detox method even in hospitals and such. Obviously there is a major risk if used improperly, so I want to make sure I'm using those meds properly. I did pick up some unisom, though I may try to call my dr. tomorrow to have her call a script for trazodone in (I recently went in to have my anxiety meds refilled and said I had trouble sleeping. Hopefully won't be hard to get, but she doesn't know about the addiction and I'd likely lose my anxiety meds if I did admit it, so not an option). I have not been able to get my hands on any gabapentin or pregablin and won't be able to, so that sucks. I really need help in terms of a schedule on how to manage the subs with the 'helper' meds since my brain is not working right currently. I can't focus or concentrate on anything.

 

[keeping]

Thank you so much for the reply and the link! [...] I am somewhat confused about OP's induction time...it seemed like she inducted 11 hrs after her last dose. I have access to the cows chart and some practical medical training, so I should be able to judge myself correctly when the time comes, but is 11 hours a normal timeframe? most of what I've seen in my research its 12-36hrs (the longer end being for methadone and bupe). For me this stuff seems to have a really short half life (the fent, that is). I can find myself in minor wds within a few hrs or less depending on my activity level. I guess what I'm asking is what to expect in terms of how long to wait in order to be able to induce without precipitating wds? I know everyone is different, but is 11-12 hours realistic with what I've been taking basically 24 hrs a day?

you're welcome mate
the easiest answer to that one is everyone is different, i personally find that i can take my subs even earlier than that and avoid precipitated withdrawals,
where some people om this site have waited 26 hours and still experienced pws; we're all different; everyone's mileage may vary; best find out your own subjective timeframe - sorry i couldn't be more help there:D
although now i think about it they might have been using methadone? in all honesty i;m not sure, but lets play it safe and say like 14 hours?

Oh, I've also got the clonodine, immodium, some dxm cough meds (have occasionally successfully used for sleep in the past, unlikely to use if I'm using the subs), and lots of supplements and vitamins to take. What do you suggest in terms of dosing for the clonodine? That's not something I've been able to find lots of info on in terms of a schedule and i obviously don't want to take too much due to the low blood pressure facet of things and this drug interaction checker I used says there's a major risk using the clonodine, bupe, and benzos together...which doesn't make a ton of sense since it is a fairly common detox method even in hospitals and such. Obviously there is a major risk if used improperly, so I want to make sure I'm using those meds properly.

i think you're pretty well covered when it comes to comfort meds.
they can indeed be dangerous but only if taken in excess - you may wish to consult a doctor regarding the appropriate doses, i wouldn't feel comfortable going into much more detaill there pal.
CNS depression is totally a risk hence why you should speak to a doctor who knows your medical history;

 

[barada]

I did a cold kick of Fentanyl once. Oddly, I don't recall sweating or vomiting. Essentially, I had the most horrid RLS (restless leg syndrome) and diarrhea. And of course, insomnia. I'd fall asleep fine, but would wake at 4 or 5am and no falling back asleep. I did not use detox comfort meds.

Have also kicked heroin using subs. I crack up at the TV show "Mr. Robot", I think that show has shown a multitude of inexperienced users how to come off opiates with a small supply of Suboxone.
Short term suboxone is the best way to use them. If you can, do a 12 day taper, but it sounds like you don't have enough. A small supply can ward off the super hard acute symptoms like vomiting, sweating, body aches, and unrelenting RLS.

I was on subs for nearly 4 months. I tapered from 6mg all the way down to .25mg. The WD are not as bad as most people claim, but Sub WD can vary from person to person. I think most people that claim it's so horrendous don't have the experience of kicking all the different opiates. I only had RLS, the shits, and insomnia from the Fentanyl kick. And nowhere near as bad as heroin or Fentanyl detox.

Comfort meds are your BEST friend to come off Suboxone. All the meds Keeping just mentioned above.
Clonodine is a GOD SEND. Before I moved to subs, I went 5 days cold from Heroin using only Clonodine to aid. It staved off RLS, the sweats, and the body aches. I still did not sleep and was dizzy. The few hours after a clonodine, miraculously I felt normal. I could function. That was how I lasted 5 days. I would have seen it through, however a rehab facility started pumping me with Suboxone and I did not argue because I wanted to sleep. (I was hallucinating from lack of sleep.)
Gabapentin will ease your anxiety and nerves.
Benzodiazepines will aid in sleep and the shit mood you find yourself in.

I'd suggest Immodium, but that was always counter intuitive for me as something about the shits, and when they end let's me know the acute phase is wrapping up. As if the rest of my body doesn't tell me so. Get Immodium, the person using the restroom after you will be thankful.

Don't underrate the value of Vitamin supplements and EXERCISE when moving out of the acute stage. AND energy drinks can benefit the "I can't lift my fucking head up" phase of the acute/post-acute symptoms.

Best of luck my friend!

EDIT - DO NOT use the benzos and Subs together. Staggering high rate of fatalities with that combo. If you intend to use them, I would wait a few days after the last sub. Subs have a half like around 3 days. Keep that in mind.
I was a poly-opiate user and used Xanax simultaneously for years without incident. Clinics will not administer Subs if you test for benzos. I was on a combo of Subs and Klonopin and I now understand why they do this... this combo was eerily sedating.
I can't tell you how much clonodine to dose, however I am currently prescribed .1mg. It suffices, and .2mg will knock me clean on my ass.

 

[limegreen_421]

I have a plethora of anxiety conditions that I have thankfully been able to get under control (after years of much higher doses) with 1mg clonazepam in am & pm. I also have xanax 1mg if I need it, which I rarely do. Are you saying I cannot continue my normal meds if I want to do the sub taper? I'm really confused. It sounds as though some benzo is given in detoxes with the sub (clonazepam, librium, valium, ativan, one or the other) I've never taken sub before and this year long fent addiction is my only experience with opiates and now the wd process aside from a 36 hr period when I was at a much lower tolerance of fent. When I have experienced wd symptoms, the sweats and anxiety are my worst symptoms but I didn't get far enough into the process for rls to hit. I realize you're not a doctor, but I'm asking are you seriously saying that I shouldn't even consider taking my anxiety meds if I plan to do the sub taper? I have 10 8mg strips. I could probably get more, but really do not want to. I was wanting to be able to use the sub to make to through the detox from the fent and then just stop taking the sub. As I said in an earlier post, my brain isn't working right so if someone would make up a schedule for a week-long or I'd even consider going as far as two weeks, but again I really just wanted it for the shortest amount of time to assist with the fent detox. I have no access to gabapentin, btw.

 

[barada]

Gabapentin is very commonly prescribed. Go see a doctor and tell them you are quitting benzos and they're likely to write a script. Or tell them you have paresthesia... the sensation of pins and needles/burning under your skin. It's basically nerve pain. I have it. It's a fucking joy. They gave me Gabapentin and Clonodine for it. On a side note, my doc is an addictionolgist, and they tend to be script happy.

Honestly, the best way to do this is be truthful with a doctor. Purely my opinion... you are taking Fentanyl and benzos now... I had no problem with opiates and benzos before the subs... but that's me. And like i said - subs/benzos was an eerily sedating combo. It kinda scared the shit out of me. I was detoxing opiates and benzos simultaneously, and I rushed the benzo detox because I was afraid of not waking up one morning. It would be wise to consult a doctor before mixing the subs and benzo. They will err on the cautious side most likely. Clinics refuse this straight away.. they don't want to be liable. Addictionalogists however, they will mix them after they diagnosis the patient. A good lot of them work for rehab clinics.
When you've completely come off the subs, I don't see why you can't take benzos then. You already take them as is. But ON the subs and benzos... take some consideration there.

As far as the sub taper... you have a decent amount of subs... You should refer to the COWS chart for induction and taper. Just google it.
There are also a ton of threads here that someone has listed the details of their 12 day taper down to the details of each day and each mg.

 

[Jabberwocky]

I have a plethora of anxiety conditions that I have thankfully been able to get under control (after years of much higher doses) with 1mg clonazepam in am & pm. I also have xanax 1mg if I need it, which I rarely do. Are you saying I cannot continue my normal meds if I want to do the sub taper? I'm really confused. It sounds as though some benzo is given in detoxes with the sub (clonazepam, librium, valium, ativan, one or the other) I've never taken sub before and this year long fent addiction is my only experience with opiates and now the wd process aside from a 36 hr period when I was at a much lower tolerance of fent. When I have experienced wd symptoms, the sweats and anxiety are my worst symptoms but I didn't get far enough into the process for rls to hit. I realize you're not a doctor, but I'm asking are you seriously saying that I shouldn't even consider taking my anxiety meds if I plan to do the sub taper? I have 10 8mg strips. I could probably get more, but really do not want to. I was wanting to be able to use the sub to make to through the detox from the fent and then just stop taking the sub. As I said in an earlier post, my brain isn't working right so if someone would make up a schedule for a week-long or I'd even consider going as far as two weeks, but again I really just wanted it for the shortest amount of time to assist with the fent detox. I have no access to gabapentin, btw.

If you've been taking benzos and are planning to taper off Suboxone, you actually want to continue using the benzos normally. If you want to deal with stopping those, I suggest you deal with it after you come off the Suboxone and have some time away from opioids under your belt.

 

[limegreen_421]

@toothpastedog, that's what was thinking. It seemed off to encourage the rapid and immediate cessation of longterm benzo use for theraputic purposes. I would like to reiterate that I have never abused the benzos, but am a long term user and to some extent am definitely dependent on them. There was a time during my addiction when I stopped taking them for long enough to have likely been clear of them, but it likely resulted in severe depression (which I didn't realize until after the fact) and so I started taking them again regularly (1 mg 2x/day...nothing crazy at all) approx. 1 month ago. So I maybe could get away with stopping them. Maybe. But I don't think I'm going to risk throwing a wrench in something that I'm willing to proceed cautiously with. Shockingly I was able to to get a full script for 30 300mg gabapentin and 60 50mg trazodones. Since I wasn't counting on these meds I may adapt my initial action plan. I am still not yet in full wd as I ended up diluting my nasal spray with 15 ml of saline this morning, which in hindsight was dumb since I now have a headache from shooting so much water into my sinuses, but I'm not getting any effect at all. My joints are starting to hurt. I'd say my last good dose was at 8am, but i won't start the countdown in terms of induction until my absolute last dose. No way I want to risk PWDs. How often do you all dose with the gaba? The trazondone I will take at night and have taken it maybe 15 years ago+ and all I really remember is that its good for sedation. Thank you all for your replies!

ETA: spelling error correction

 

[barada]

Right they are.. I didn't consider that you are perhaps dependent on benzos. In that case, hell no, do not discontinue benzos. I been in severe benzo WD twice and you definitely don't want the opiate/benzo combo WD. The second benzo WD I experienced was opiate/benzo combo and resulted in psychosis.
I spent 6 weeks on the sub/benzo combo and I never slept better. Kicked the benzo first, then moved onto kicking subs. Either or is fine, considering you want to kick the benzos at all. I chose to kick benzos because it was the worst addiction I have ever experienced. Worse then heroin.

 

[tacodude]

The last thing you want to try is kicking the two hardest dependencies at once. If the benzos are therapeutic don't try to stop them, but you can always try to reduce your use by splitting a dose in half every once and a while until you are comfortable with half then do the same with another and just keep going at it. Getting off the benzos will take a lot longer than the subs so don't be afraid to go up if you need due to crashing the opiates as long as the end goal is to end the opiates then the benzos. If you do start reducing now then if you need to use more later when the opiate withdrawals get tough if you have reduces you might only have to go back up to the dose you are at now vs if you didn't try to reduce and the situation was the same leading to a higher dose than now.

Anyways all I'm saying is focus on stopping the opiates and don't rush yourself so it right. You can always try to taper the benzo slowly, but don't be afraid of going up again in the dose after reducing while quitting the opiates as if it's a screw up. It's very unwise to quit both as once especially if you do it too fast even if it's not impossible. Just take it one step at a time and you'll free yourself in the end

 

[Jabberwocky]

@toothpastedog, that's what was thinking. It seemed off to encourage the rapid and immediate cessation of longterm benzo use for theraputic purposes. I would like to reiterate that I have never abused the benzos, but am a long term user and to some extent am definitely dependent on them. There was a time during my addiction when I stopped taking them for long enough to have likely been clear of them, but it likely resulted in severe depression (which I didn't realize until after the fact) and so I started taking them again regularly (1 mg 2x/day...nothing crazy at all) approx. 1 month ago. So I maybe could get away with stopping them. Maybe. But I don't think I'm going to risk throwing a wrench in something that I'm willing to proceed cautiously with. Shockingly I was able to to get a full script for 30 300mg gabapentin and 60 50mg trazodones. Since I wasn't counting on these meds I may adapt my initial action plan. I am still not yet in full wd as I ended up diluting my nasal spray with 15 ml of saline this morning, which in hindsight was dumb since I now have a headache from shooting so much water into my sinuses, but I'm not getting any effect at all. My joints are starting to hurt. I'd say my last good dose was at 8am, but i won't start the countdown in terms of induction until my absolute last dose. No way I want to risk PWDs. How often do you all dose with the gaba? The trazondone I will take at night and have taken it maybe 15 years ago+ and all I really remember is that its good for sedation. Thank you all for your replies!

ETA: spelling error correction

Try taking 300mg gabapentin with a little snack of protein/fat/sodium/carbs every four hours. If that isn't enough you can try taking 600mg or 900mg every four to six hours (you may find you need to take it less often though). Hopefully you can get more gabapentin. It would also be good for you to get some clonidine as well. And pick some loperamide from the drug store if you don't already have it.

 

[limegreen_421]

Okay, I was in the worst of it and decided to go 16 hrs from my last (extremely diluted dose) and no precipitated wds (thank gooodness). I inducted with 4mg at 9am and ended up taking another 2mg at 2pm due to severe bone pain in my lower back. I have some compression issues and lack any fat covering my coccyx, so have to use special pillows for long periods of sitting and apparently laying down now, though its extremely possible that the symptoms are exacerbated by the wd from the opiates. Last night was hell. Used gabapentin and clonodine and was able to keep the sweats and anxiety (also used a few mgs of clonazepam) most under control, though did definitely experience many small hot flashes, but nothing like it should have been. Very thankful for that. So far the subs are controlling everything pretty well. I wasn't able to sleep at all last night due to bad rls, but sometime between the sub induction and 12 pm I must have fallen asleep for an hour or so.

 

[keeping]

^ sounds good man, now just find your dose proper, stabilize on that for a few days and begin the taper
you'll be good as new in a week or two

 

[limegreen_421]

Thank you! Fuck, this is hard. No cravings really since I didn't do the stuff for that. I mainly used to to just knock myself out for when I wasn't required to be conscious. So, no to very little sleep is gonna be hard. If I only take the subs for 4-6 days, am I just staving off any wds? Only taking the subs through the main detox (since my body and mind can't take it and I'm doing this at home alone), do I really need to taper off of it or can I take 8-4mgs m/day for 4-6 days and just stop without any real wd consequence? Or must I taper the subs?

 

[Jabberwocky]

Try taking more gabapentin if your are having bad RLs preventing you from sleeping. It should pass in a couple days regardless with the buprenorphine though (well, tbh I had to take medication for a few weeks to control the RLS, eventually finding ropinirole to work well).

 

[barada]

Thank you! Fuck, this is hard. No cravings really since I didn't do the stuff for that. I mainly used to to just knock myself out for when I wasn't required to be conscious. So, no to very little sleep is gonna be hard. If I only take the subs for 4-6 days, am I just staving off any wds? Only taking the subs through the main detox (since my body and mind can't take it and I'm doing this at home alone), do I really need to taper off of it or can I take 8-4mgs m/day for 4-6 days and just stop without any real wd consequence? Or must I taper the subs?

It would be wise to rapid taper. The absolute best success stories I know are from rapid tapers. You need to remember, regardless of how miracle people present Suboxone as, you are still trading one opiate for another. There is just something about the design of Suboxone that allows rapid tapering with a percentage of the discomfort of other opiates. Furthermore, you will still feel WD during the period of Suboxone and after. Again, at a percentage.

It took me several days to feel "normal" on Suboxone, and I don't remember the first week. Conversations, whereabouts.. I may as well have been drunk. Albeit, I was on a rather high dose of Klonopin for the week.

And lastly.. the Clonodine, Gabapentin, and Klonopin should aid in all those nasty symptoms like your insomnia... Give it some time. The Suboxone should aid in those RLS as well.

 

[Jabberwocky]

A taper isn't necessary after using buprenorphine for only 7-10 days to detox. If you only are using it for four to six days you'll probably notice a little of the acute withdrawal winding up from the habit your currently detoxing from, but you won't withdrawal from the buprenorphine.

 

[crzydiamond]

You should taper. Even detoxes who use subs for opiate withdrawal (usually for 3-5 days) lessen the dose and spread out the dose from 8 hours apart at first to 12 hours to 24 hours. You don't have to taper to 0.125 mg as if you had a sub dependency, but I wouldn't take 6 or 8 mg as my last dose

Regarding the bone pain--it is extremely likely that it's magnified due to removing the opiates. I always found pain like that to be much worse for the first 2-3 weeks off opiates, almost like your brain is trying everything to get you to take some. I had fractured my tailbone about 4 years prior to the last detox I did (did it in a snowboarding landing--landed right on my tailbone and it jolted my whole spine). It had gotten to the point I didn't have pain any longer. But then during and after detoxing, that pain returned to the point that I had to sit on s pillow in group. It lessened after a few weeks. But either ibuprofen (Advil/Motrin) or naproxen (Aleve) is your friend.

Good luck! I did a cold turkey fentanyl wd years ago. Its definitely a faster wd, but very intense. And yes, symptoms hit quick with fentanyl. But on the bright side, usually after 3-4 days you're good to go