New to opiate withdrawal + convulsions

[Foreigner]

First let me say, I am not under the direct care of a doctor. My health care team lets me be very self-directed with treating my auto-immune disease, since there's not much more they can do for me. When I ask for something, they give it to me. When I need their advice, they are a phone call away.

My pain relief regimen has been 2mg hydromorphone + 2 x 5mg morphine sulfate every 4 hours like clockwork, for the past 3-4 months. This is for the bowel ulcers I'm dealing with.

Well, my ulcers have healed and now I am just dealing with scarred, raw bowel tissue. It still hurts like hell, but it's almost bearable.

A couple of nights ago I fell asleep around 9pm without taking my opiates, and surprisingly slept right through the night. I woke up around 9am not feeling much pain, so I thought... "Maybe now's a good time to stop taking the opiates." They mess with my mind and my mood and I'd rather not keep taking them.

As the day went on I became very physically weak, tired, difficulty speaking, VERY depressed, and just over all listless. Hot flashes, feeling hot then cold (thermometer showed normal body temp). I started smoking a bit of pot to help offset it a bit.

It was very difficult, but I was doing it.

And then... something unexpected happened. Around 1am the next night, as I was falling asleep, I started having convulsions in my upper body along with weird brain zaps. Non stop arm, hand and head twitches. Violent ones, my arms would go flying. I could feel the nerve potential build and then fire off, almost like when you get a tickle in the back of your throat that forces you to cough. I could feel the nerves charging up in my neck and shoulders and there was nothing I could do. It was making it impossible to sleep. The convulsions just kept getting worse and worse, but only stayed upper body. My mom kept rubbing my shoulders and back to see if it would distract things, but it didn't work.

I took a zopiclone and two sub-lingual lorazepams, which for me is over kill. I also gave myself an IM injection of 300mg magnesium sulfate. After a half hour, the convulsions were slightly better, but then they picked up again an hour later.

I ended up having to cave and take a dose of morphine. I didn't know what else to do. The convulsions stopped within 45 minutes, and I was able to sleep through the night.

Now it's a new day... and I still have opiate in my system. Do I just stop taking it again, but maybe take one dose around bedtime to prevent the convulsions?

I've taken opiates for years for IBD pain but NEVER had this effect coming off of it.

Because my schedule was 2 hydromorphone and 2 morphine sulfate, maybe I could downgrade to 1 and 1 as the next step.

TIA for any help offered.

 

[Mafioso]

A taper would definitely help. You might need to do a bit more subtle of a taper, like cutting by 10-25% every 1-2 weeks, depending on how your body handles it. Anything to ease your body into the transition rather than the shock going cold turkey can cause your body. Personally what I have the most success with is a somewhat quick taper(1-3 weeks, depending on dose coming off) followed by a handful of "emergency doses" which is usually 1/4-1/2 of whatever pill I was taking- just enough to pull me out of withdrawal, not enough to induce euphoria.

Normally with opiates, I would say that it's best to cut your dose as much as you can and as quickly as you can, however, reading the withdrawal symptoms you describe is a bit concerning. Mainly the convulsions and brain zaps, which almost sound like a borderline or possibly a type of mild seizure. It's definitely something I would bring up and discuss with your medical team.

Most withdrawal symptoms can just be "toughed out", but when/if there is risk of seizure, things need to be taken a little more seriously. Given your health history, consulting with your doctor on this might be a very wise thing to do. Hopefully your team will be on board with your decision, and even provide with some meds to help this step.

 

[Foreigner]

My doctor gave me clonidine and cyclobenzaprine. I am nervous to take either, but I don't know what else to do. The convulsions and brain zaps are intense at night, and I don't want to have to take hydromorphone twice a day just to stay stable.

 

[Meth novice 79]

Only upper body?
Are you sure? Perhaps you weren’t aware of your lower half.

This is really really strange, the brain doesn’t work like that. You’ll seize either left, or right or whole body.
I wonder was it not a brain zap at all and more to do with your CNS or something?
Yeah I’m not a doctor, I’ll stop there. It’s just really weird.

I hope you’ve decided no more cold turkey?
That shit’ll kill ya.
Hell. It does frequently.

 

[Foreigner]

It's called myoclonus and is a common side effect of opiate withdrawal. I'm pretty devastated that this is happening.

The clonidine and cyclo are not helping. Had more myoclonus tonight as I was falling asleep. It was constant and intolerable. Had to take morphine to stop it.

I'm fine during the day. I'm depressed and low energy from no morphine. It's just when I try to go to sleep, the myoclonus starts and I can't sleep. If I could just stop this one fucking symptom I could get off these opiates.

 

[Mafioso]

Have you tried taking any of the medications your doctor gave you?

Sorry to hear you are still struggling with this, does it seem to be subsiding at all?

 

[nuttynutskin]

It's called myoclonus and is a common side effect of opiate withdrawal. I'm pretty devastated that this is happening.

The clonidine and cyclo are not helping. Had more myoclonus tonight as I was falling asleep. It was constant and intolerable. Had to take morphine to stop it.

I'm fine during the day. I'm depressed and low energy from no morphine. It's just when I try to go to sleep, the myoclonus starts and I can't sleep. If I could just stop this one fucking symptom I could get off these opiates.

Is there a reason you can't taper down?