Opioids Precipitated Withdrawal Theory...

[Gkg434]

Hey Everyone,

First off thank you all for the incredible content. BL has helped me countless times over all these years. I'm hoping to hear from folks that have experienced precipitated withdrawal..

Specifically, has anyone experienced precipitated wd followed immediately by a period of abstinence? If so, could you please share how long you were in wd, and what kind of tolerance you have?

I've mostly used oxy/roxys in my career, along with long stints on suboxone. And I'd say I have a pretty decent tolerance; to get a good effect I need between 300-400mg of oxycodone.

I've been lucky to avoid precipitated wd for the last couple decades, until last week, when I transitioned to subs just a little too soon and I got it for the first time. From all of the research I've done, it sounds like symptoms usually last less than 24-48 hours, and this brings me to my theory... if someone wanted to get off of subs/opiates, I wonder if purposely triggering precipitated wd might be a feasible method of detoxing.

For me personally I've probably detoxed myself (or been detoxed in inpatient treatment) around 10-15 times, and it just seems to get worse/harder every time. I've tried every tapper plan I could find, and they don't seem to help at all, I get just as sick as stopping cold turkey. For me the worst part is the long drawn out process.. I can handle being dopesick for a day or two.. but it typically lasts me 5-6 days and by day 3 I just don't have any fight left in me.

So the next time I'm ready to detox myself, I'm considering purposely triggering precipitated wds with the hopes that it might be possible to make the detox process shorter, even if it is more intense.

Like I said I just went through precipitated wd last week, and in hindsight I'm wishing that I hadn't kept taking suboxone, because I'm really curious what would have happened if I had just taken that one initial 4mg dose of suboxone that triggered the pwd. Maybe I would have had 24 hours of intense pwd, followed by 1-2 days of recovery, and be opiate free?

Thank you anyone that has any input/experience. And I apologize if this was discussed elsewhere, I searched but didn't find it.

 

[negrogesic]

It would sort of resemble ultra-rapid detox that is performed under general anesthesia, except minus the anesthetia part.

This is not particularly effective since it only deals with the acute withdrawal phase, but doesn't address the post-acute phase, which is where the relapses occur.

The efficacy of ultra-rapid detox isnt great: https://jamanetwork.com/journals/jama/fullarticle/201451

 

[Jen X]

I did it last week. Did some hydromorph and chewed up a suboxone pill thinking it was tylanol. I wanted to die, worst withdrawl i've ever experienced and i've wd from most
everything.
Within 15 minutes it felt like every cell in my body was trying to jump out. Took a day for that and the puking rls to stop then a couple days and drugs to feel better.
I wouldn't do it willingly again that's fure sure.
No easy way out but that just sounds crazy

 

[Jen X]

I mentioned it once(rapid detox inpatient) to my old methadone doctor and it's not here in Canada because people die

 

[Gkg434]

It would sort of resemble ultra-rapid detox that is performed under general anesthesia, except minus the anesthetia part.

This is not particularly effective since it only deals with the acute withdrawal phase, but doesn't address the post-acute phase, which is where the relapses occur.

The efficacy of ultra-rapid detox isnt great: https://jamanetwork.com/journals/jama/fullarticle/201451

Good point. But that's interesting; it sounds like you agree with my theory - that it might be possible to do a more intense but shorter term rapid detox by intentionally initiating precipitated wd?

I think we have to assume that regardless which method someone were to detox, treating PAWS and building a foundation for long term recovery are necessary if we wish to achieve long term abstinence. I think for the sake of this discussion, we should assume that the person will be receiving treatment for PAWS.

From my personal perspective, I've detoxed 4 times at different inpatient treatment centers, where I had a medically supervised and treated detox, followed by long term inpatient as well as outpatient treatment. Then I've also detoxed maybe 5-8 times on my own, at home with no treatment at all, but done my own work on my recovery after detoxing. I actually had longer periods of recovery following the home detoxes, where my only PAWS treatment afterwards was 12 step meetings and the like. However, there's obviously a ton of variables to consider.. most of those experiences were shortly after doing an inpatient detox and then relapsing, for example.

Anyway, back to the theory here... let's assume that someone were going to be going to be having the same longer term treatment (for PAWS) just for the sake of this discussion.

We know that precip wd is essentially due to the BUP kicking the other opiates off of your receptors, right? This makes me think that if you did not take any more BUP or opiates once you initiated precip wd, then you would be very sick for a short period (likely around 24 hours, maybe a little more or less) in full blown withdrawals, but then it would start to ease and would be over much faster.

Again, for me I would much rather go through a 1-2 day really intense detox. In the past I've always given up around day 3 because it's just such a long, slow, drawn out process and I just feel like I need a break from the rsl, anxiety, back pain, sleeplessness, etc. Experiencing pwd last week sucked, of course. But it was much easier than a full 5-6 day detox. So I can't help but wonder, if I had just stopped taking BUP once the pwd started, could I have been fully detoxed and not be dependent on BUP now...

I'm really hoping to hear from someone that initiated precipitated wd but DID NOT continue taking suboxone or any other opiates immediately afterwards. I'm very curious to hear if anyone has done this, how long were they sick, and what was their experience like?

 

[Jen X]

After the PWD you would still go through the WD from what you started with. So no going into PWD don't shorten the experience, just makes it worse

 

[Jen X]

I didn't take anything when i did it by accident and still went through wd from hydromorph, after 5 days i took more hydromorph

 

[Gkg434]

I didn't take anything when i did it by accident and still went through wd from hydromorph, after 5 days i took more hydromorph

Interesting. Thank you for sharing your experience.

I've always been taught that precip wd happens when you take a dose of bup too soon, and the bup kicks all of the other opiates off of your receptors. That's why I came up with this theory, that if the bup kicked all the opiates off of your receptors, then it should be like kickstarting your wd and dropping right into day 3 of detox, basically eliminating the painfully slow onset and anticipation (when purposely detoxing).

I wonder if others had a similar experience.

 

[ztevoka]

I've given myself precip accidentally twice and both times were BRUTAL. The second time I thought I was doing heroin daily but discovered it was actually straight fentanyl. It took me a full week before I started going through withdrawal but on my third day clean I took a suboxone thinking I would cut off any withdrawal before it started. I got horrible precip that lasted about 12 hours then recovered over the next day and was fine for another few days. Then after about a week clean I started going through withdrawals that were really bad for about a week, then I still felt really weak and sickly for another 2-3 weeks. In my experience giving myself precip did nothing to shorten or ease the actual withdrawal symptoms that hit me a few days later and lasted forever.

 

[Jen X]

Ya no easy way out. If putting yourself in WD worked everyone would be doing it

 

[Northerngyal]

I did it last week. Did some hydromorph and chewed up a suboxone pill thinking it was tylanol. I wanted to die, worst withdrawl i've ever experienced and i've wd from most
everything.
Within 15 minutes it felt like every cell in my body was trying to jump out. Took a day for that and the puking rls to stop then a couple days and drugs to feel better.
I wouldn't do it willingly again that's fure sure.
No easy way out but that just sounds crazy

Same thing happened to me when I first got on suboxone. The first week I didn’t feel like it was doing much so I downed 2 percs 5 mg’s. Bad decision!

I’ve never projectile vomited until that day lol. I wish the dr would have warned me about that.

 

[Jen X]

I never thought that there was a worse feeling then withdrawal, but pwd is like 3 days of normal wd compacted into a few hours.
I think you're Canadian also? Our doctors don't really give us information on the drugs. When I first went to a methadone clinic I didn't know how hard it was to get off it, the long wd. I would have never taken it. I got off it by using other drugs. Suboxone is awful for your teeth. All kinds of side effects but they don't tell us

 

[Gkg434]

Wow thank you everyone for sharing your experiences. I figured that would be too easy lol That's my biggest complaint about opioids... The withdrawals have kept me on them for so many more years, so many different times. Like right now, I've been on non-stop since 2014 (so I have not fully detoxed in 10 years). 99% of that time has been just suboxone, with a few short runs on oxy and maybe a few months on kratom. If it weren't for the withdrawals!

 

[Coffeeshroom]

Yeah this to me is still not a full proof plan as the PAWS you call or post acute withdrawals is still the fuck up.

I have experimented on myself ( not sure if we can say this ) numerous times on ways to deal with opiod/opiate withdrawals from numerous different chemicals forms of them and always use bupe to get clean so to speak or shut under control. Point being I have also dealt with precip wds and yes they a fucking nightmare where I ended up in ER to be sedated and monitored.

But now with all that said and your question even going through the 3 day wd in say 1 day and then dealing mostly with light wd and or PAWS. And this is where the f'up or for me mostly happens. So being able to be mentally strong and some comfort mess excluding all forms of opiods/opiates and also not replacing an addiction with another or "accidently" getting addicted to something else "cough" benzos. Then it could work but I do want to add also very dangerous so I personally advise against it for me personally.

Getting of this one is tricky and dangerous in some cases so if possible professional supervision is key, as I even see a pvt doctor once and get bloods done and so on but that's me. Just want to emphasize to tread on the side of caution.
Awe