Opiate and opioid withdrawal: Coping strategies and medication

[Tinker55]

Oh wait,where's the nuts? I thought red methadone was that nasty wild cherry flavoring.

 

[mydrugbuddy]

After reading this thread I've decided to try loperamide and Kratom tomorrow for day 1 kicking H.

Anyone have any suggestions on dosing? I am doing about .5 g a day.....

Tbh it's a matter of guess work and fine tuning what your body is comfortable with. I'm not sure if Kratom is quite as mild as everyone makes out, something gave me a very heavy h tolerance, and my money is on the kratom. Though it could also have been the Mirtazapine fucking up the h high.

Personally I'd start off with ten Lopes, remembering they can take as long as 4 or 5 hours to kick in, and in the meantime you'll have to experiiment with the kratom and see if a 'normal' dose range of 2-6g holds you for at least an hour or 2. It probably wont last longer than that. At all costs i would avoid consuming huge amounts of kratom, like i read about one person taking 22g for each dose several times a day. And i thought that my 10g 3, or 4 times a day, if i was being indulgent was bad.

Clonidine is also immensly useful.

Good luck. If you do go ahead with this quite unusual, but potentially workable quit method, let us know how you get on.

 

[BigG]

I see you've found that with lope too MDB.....

The times I tried it i would take it in the morning and feel nothing until tea time. This can fool you into thinking it's not working and encourage you to take more....which is obviously dangerous.

I tried lope a few times when i was coming of my fentanyl then methadone scripts but found that I needed stupid amounts even with pgp & cyp450 inhibitors....like 60+ at once which given lopes notorious propensity for causing extended QT syndrome at those doses seemed a but unwise....

Incidentally what pgp inhibitors are you using with your lope?

 

[mydrugbuddy]

None mate. im not worried about the BBB thing, as long as it keeps my guts intact and keeps me feeling at least a little better than The Walking Dead, it's still significantly easier than quitting kratom cold turkey.

 

[BigG]

At 5 pills a day with no pgp inhibitors I think it's safe to say that zero is making it past the BBB and staying there as the only was you can do that without inhibitors is with HUGE doses that overpower pgp.

This is significant because it means all the lope your taking is only having peripheral gut actions and no CNS action.....this means that there isnt really a need to taper it....

Hope that makes sense mate....

 

[MMT]

Oh wait,where's the nuts? I thought red methadone was that nasty wild cherry flavoring.

Plenty o nuts standing in line,take your pick.

 

[Mrsjuice]

It does make sense. And without the pgp inhibitors it still helps wth withdrawals right!? I could care less about feeling a high from any of this ( the lope or Kratom ) I just want to be clean and be able to function some during the process.

I have four kids and a husband that works a terrible shift. Cold turkey is not an option for me. I have no family or friends in the area as we haven't lived here long, so no help. Lope and Kratom are going to be my saving grace I hope. We shall see tomorrow. I will start a thread tonight to be able to check in all week and hopefully get some support from wonderful people like yourselves.

 

[mydrugbuddy]

At 5 pills a day with no pgp inhibitors I think it's safe to say that zero is making it past the BBB and staying there as the only was you can do that without inhibitors is with HUGE doses that overpower pgp.

This is significant because it means all the lope your taking is only having peripheral gut actions and no CNS action.....this means that there isnt really a need to taper it....

Hope that makes sense mate....

Yeah it does make sense, cheers.

In fact it works to my advantage (once again much more by luck than design) as it will make the eventual quit off Lope a whole lot easier and i can also do it much quicker too, like within a week i should think, since it is only having peripheral, but still very important effects imo on my gut.

I didnt bother with the inhibitors simply because i didnt have the energy to get them, but my energy level has improved markedly by today, all together non sensically after having a stim allnighter on Sun but getting a cracking nights sleep last night. I know stim sessions etc are a terrible idea during recovery, i think it may be an issue i need to go back to DS for help with, as i dont seem to have the mental 'tool set' (if you'll forgive the horrible expression / euphemism) to resist them just yet.

But im gonna try leaving out the Clonidine today, expect for at bedtime (the side effect that it makes you very tired and sleepy is very helpful at bedtime but im not gonna abuse it for that reason for too much longer) as the hot/cold/feverish thing along with the non existent energy seem to have gone. I wont speak to soon, but things are looking good atm. :D

So, just to confirm i understand correctly, the Lope wont be helping any with any other opi w/d symptoms without passing the BBB, only gut action?

Btw doesnt it show how much of this stuff can have a placebo effect cos i swear i felt a wave of wellbeing sweep across me every day about 4 hours after taking the Lope, (although the Pregabalin might have been partly helping, although that normally acts far quicker and i didnt really feel much off it, i deliberatley kept my doeses v low, due to fear of another GABA substance addiction) the placebo effect wasnt strong enough to improve the no energy issue, but that would have just been too miraculous and outrageosuly lucky wouldn't it?.

 

[BigG]

Yeah well the thing is with lope, there are two ways of keeping it brain side of the BBB which are

a) the use of PGP inhibitors or

b) the use of very high doses to simply overpower PGP

Since you have done neither of these I can't see how the small doses of lope you've been taking could have had any significant CNS effects. Of course it's impossible to say that it's been having zero CNS action but given the above circumstances I doubt out had been having much. I would still taper off it but wouldn't worry too much about it.

You're spot on regarding the power of placebo effect during withdrawl. The fact that it's enabled you to get through this can't be understated regardless of mechanism of action.

You must be near the end now as you've been off the kratom for quite a while. I think a short taper off the loperamide and the pregabalin & clonidine and you're there...

Well done by the way. I'm dead proud of how well you've done. I know it's been a difficult battle with using the kratom to come off subs and now having to come of that but you've done so well. Now comes the (arguabley) hardest part of staying clean in the long run...

Again though I can't commend you enough for how well you've done mate

 

[mydrugbuddy]

Thanks once again [MENTION=284118]BigG[/MENTION] Tbh the honest the hardest thing was getting started on the quit, but once it was under way it made sense to stick to it, and i found something somwehere (probably all those comfort meds lol) that made sticking to it quite easy.

You're right about the staying off. But that's an issue for later.

 

[Mrsjuice]

Mydrugbuddy,

Did you start all the comfort mess before you actually felt sick? Today is day 1 for me, woohoo, I plan on popping my immodium and Tagament and Kratom here in s couple hours. Any advice would be great!

Rachel

 

[mydrugbuddy]

Yeah, ive learnt that Lope will only help prevent your guts liquifuing and wont help with any other wd symptoms unless you take things like grapefruit juice first, maybe tagamet will help, BigG will know better than me, though i think that will only potentiate the lope, it wont help it cross the BBB and have any effect on the CNS and other WD symptoms. You may need to lean very heavily on the kratom, if you dont get the Lope to cross the BBB, its not about getting high off it, its about enabling it to act as taperable opi on the whole CNS.

Tbh although i think kratom will help at least a little bit, i think you're first few days might be difficult unless you get the BBB thing sorted. Scroll back through the thread, BigG lists a number of ways of getting Lope to cross and stay crossed the BBB.

I felt sick immediately i stopped kratom, as i always woke up in wd and needed some immediately, so i started the comfort meds immediately i stopped kratom.

 

[breakcorefiend]

Its weird you get anything from kratom, When i was in heroin withdrawals I ate 40grams of kratom and didn't so much as feel the slightest bit of relief, that only came when i made some poppy pod tea, Maybe it was just shit kratom though

As for lope, it will take care of the majority of w/d symptoms, any opiate receptors outside of the brain will feel relief from lope, your guts being the main thing to benefit from it

MrsJuice, I read you have been using .5g a day of heroin, what route have you been using? what potency would you estimate your heroin as?

I feel that if you have been injecting say, and you have been using strong heroin, kratom wont do much to help ease your suffering, are you in the uk? if you are in desperate need of relief then a cold water extraction on some cocodamols will help like crazy

 

[the_gay_blade]

Its weird you get anything from kratom, When i was in heroin withdrawals I ate 40grams of kratom and didn't so much as feel the slightest bit of relief, that only came when i made some poppy pod tea, Maybe it was just shit kratom though

No, same here. I never even got enough to consider it an opioid. Even 300mg of codeine blew the stuff out of the water, and that's after trying several strains. It does make you feel a bit relaxed, but beyond that I can't really see the appeal.

 

[mydrugbuddy]

From what i gather you have both been fairly regularly using stronger opiates on and off for some time until you both quit. It can only be that I hadnt used as many stronger opis as yourselves that i was able to get something out of kratom for several months, for a long time after that though it wasnt actually doing anything except keeping me out of w/ds. I was taking it just to just about feel 'normal'. For me the bizzarest thing is that i got very little off vapeing very high purity h. Even allowing for the fact that i havent got the technique down 100% i should still hace caught something from it. It certainly kept me out of WDs and i felt a little more energy than usual but that was about it, one night i couldnt sleep all night. I was vapeing well enough to inhale and exhale large amounts of vapour, and each time the amount of vapour lost through wastage was steadily reduced.

On the films and TV one hit like that and the person is completely fucked. Is that kind of thing just made up for films and TV?

Yet i am still able to enjoy what is considered a far weaker opi - Odt. It's all very strange. I cannot come to any conclusions about any of it.

 

[the_gay_blade]

Getting very little out of heroin suggests either bad smoking technique or unfamiliarity with the more stimulating aspects of heroin (expecting it to be a heavy sedative experience - the Trainspotting effect). Or a mixture of both. I've certainly seen them happen before, but your account definitely implies the latter.

 

[BigG]

With regard to the lope BCF....it actually does cross the blood brain barrier easily it's just that it is then immediately pumped back out by P-Glycoprotein. CNS effects are achieved by inhibiting PGP using white grapefruit juice, tagamet, quinine etc. The other means of maintaining CNS (as oppose to simply PNS gut) opioid agonist effects is to simply take such large doses that the PGP is overpowered so to speak. This is really dangerous however as loperamide in high doses causes extended QT syndrome (torsaddes de pointes). This is a cardiac condition that describes the depolarisation of the heart muscle represented by two points (Q and T) on an ECG trace. Taking lope in low doses without PGP inhibitors would simply help with diahorria by acting on the peripheral opiate receptors in the gut.

One overlooked downside of using lope for it's CNS effects to mitigate withdrawl is that it has quite severe withdrawls itself mainly due to it's long half life.

BCF is spot on when he says that it's not about getting high off the lope (the lope "buzz" is actually quite unpleasant and feels rather dirty) but about making the withdrawls tollerable. However as with using any opioid to mitigate withdrawls be that lope, kratom, PST or whatever you need to be careful as really you're just switching one opioid for another and so unless you have a sound taper plan in mind it's just a way to get in a real mess (and often with a substance more dangerous than the one you begin with).

I've no personal experience with kratom and it seems to be something that people either have great success with or non at all..

One of the big attractions of loperamide in the US is that it's extremely cheap but not so in the UK where even bargain supermarket brands are many times what is paid in the States (and unlike in the states where they get several hundred count bottles we are limited to 6 or 12 count packs over here.....making high dose lope an expensive proposition for most)

 

[mydrugbuddy]

Getting very little out of heroin suggests either bad smoking technique or unfamiliarity with the more stimulating aspects of heroin (expecting it to be a heavy sedative experience - the Trainspotting effect). Or a mixture of both. I've certainly seen them happen before, but your account definitely implies the latter.

That could well be correct. As soon as i realised that i 'wasn't feeling it' i knew that it must be a 'learnt high'. I guess for some bizzare reason i just never learnt it. Other possibilities are that my previous kratom use fucked my receptors and tolerance or that Mirtazapine somehow prevented the high taking off, like SSRIs and MDMA. It could be any of those reasons, or something else entirely. Anyway I wont be considering sampling any more h for any time soon, so it's all "academic" for the moment.

 

[Mrsjuice]

Well I have both Tagament and white grapefruit juice to use with the lope. It's weird you say it won't take away the majority of the symptoms because I have read some people eased thru withdrawals and basically just had the sweats with lope only. It's weird to hear the different sides. I plan on taking about 30 mg with 600 of Tagament and 12 capsules of Kratom which is about 4 g. Since it's only day one I won't feel super sick but hopefully it will mask some of it.....
Guess I'll find out soon enough

 

[mydrugbuddy]

If you can get Clonidine I found that to be by far the most useful 'comfort med'. It eliminated about 90% of WD symptoms for me, especially the sweats and fevers and hot and cold shivery type stuff. It can be obtained very easily from net pharamacies. The downside of Clonidine is that it will be next to impossible to be functional and appear normal, especially at first, the first 2 days i took low doses too, but i slept 20 hours a day. That was a blessing for me, but no good at all if you need to keep up appearnces.