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Successful quick heroin detox using Suboxone and other "comfort" meds....

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Dancer57

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Joined
Apr 18, 2017
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Hello, I am a 59 year old male who has been putting off detoxing from a year long IV & Nasal heroin addiction. About 1 month ago I completed a 5 day detox for heroin addiction. When I got home from detox it took me all of two days to pick up again because I felt so bad a couple​ of days later. I guess that I took detox for granted. Anyway, I enrolled in a Suboxone maintenance program before realizing that I did not want to be dependent on subs, heroin or any other drug. So, basically I have been on a year long run of a 3 bag a day mostly nasal, but for the last month​ IV heroin binge. I have about 10 2mg Suboxone tablets and 1 8/2 sublingual film and would like to get some suggestions on a quick taper that starts low dose and ends with the least painful/uncomfortable jump off. My mental health Dr. wrote prescriptions for Gabapentin, Seroquel, Clonidine and Remeron to help me, hopefully, with PAWS that is the hardest phase of detox for me. I am really kinda desperate to stop this Merry Go Round. I ain't getting any younger and I am slowly but surely wrecking what's left of my life. I recently have had long periods of abstinence ( 9 years and also 13 months so) so I know that I can do it. So, this is a cry for help with this detox attempt and how the comfort meds are used for the frackin' almost unbearable PAWS phase. Will be grateful for any suggestions.

Dancer57,
 
Welcome to the site, I will move your post over to our 'Sober Living' section where you will get a more replies and help.

Good luck
 
Hey, Dancer. Luckily, it sounds like your doc is pretty compassionate...you've got a good-sounding kit of comfort meds (though I always need to have some Imodium/loperamide on hand, too. But that's OTC at least in the US, so it's easy to get.)

Could you maybe clarify one issue a bit, though? The meds you've listed (and in some sense, what we tend to call comfort meds in general) tend to be most effective during acute withdrawal. But in your post you've specifically asked about PAWS. Could you help us understand a bit more clearly whether you're asking about how to use your meds to get through acute WD, or whether you're looking for help on handling PAWS?

It is worth noting that the remeron and seroquel may well serve you on a long-term basis, depending on whether you have certain kinds of co-occurring psychiatric issues.
 
Good luck man! im just a little younger than you and i totally agree and said it many times (im getting too old for this shit!). You have all the right comfort meds ready, if you already have high blood pressure keep an eye on it during acute stage. PAWS was the worse part for me the insomnia etc but little by little it gets better after a couple months its all worth it!!, take it one day at a time. Best of luck!!!
 
Thanks for reply, I would like suggestions for both. But the part of detox that makes me want to say F it and use is the jumpy nerves that usually occur when trying to go to bed.The insomnia also drives me crazy.The doctor "Psych" that wrote the prescriptions for me, also treats me for anxiety, depression and panic attacks. By the way, I have a couple of boxes of 12 Imodium tablets. Basically just seeking some guidance on the whole procedure starting with the taper and ending with surviving the electric twitching and sleeplessness.. thanks again...
 
What they do professionally is to set a standardized dosing schedule than slowly weens you off your medication. The most effective tapers are not rigidly followed come hell or high water, but flexible as well as stable (after all, the point is maintaining stability...). The particulars of this aren't necessarily as important as regimenting yourself to taking the medication at the same time, in the same way, in the appropriate dose for each day. They matter, but effective tapers always end up emphasizing stability (come to think of it, an effective taper is essentially returning to a state of stability).

We can help you with these too though. However, you know your body better than anyone else (you inhabit it, after all). Though they may be on fire when you're in withdrawal, you're senses are your best friend for determining how to deal with your buprenorphine taper. I'm not suggesting you go in half cocked or something, it is essentially to have a strategic plan in terms of how you are going to deal with symptoms of withdrawal and whatnot during the taper.

Look into "sleep hygiene" in the SL Directory. Tiger Balm (or something similar) and a hot bath/shower should help with the electric twitching you describe.
 
TPD is right i tapered slowly for months and more aggresively during the last 1 1/2 months. Its very important to cut then normalize for a week or so you dont wanna beat yourself up. Each time i lowered i always felt this would be the dose where i wont normalize but i always did. It really is surprising how little mgs you need to get by compared to the doses i was taking months earlier. At the very end it did get difficult but at that point i was doing less than 40mgs oxy a day, when i jumped wds really were easy for me because of the ween. There are alot of threads here for anywhere from 3 days to 2 week sub tapers i had one 8 mgs strip all cut up in little pieces down to 1/4 mg. I ended up not touching the subs i was able to get by on weed brownies, lyrica, and clonidine, i would save your gabapentin for wds tolerance is built fast on it so you want it to be effective during wds. Im not sure on the dosing gabapentin for wds i had pregabapentin which is alot stronger i dosed 450mgs the first day lyrica was a godsend for wds that along with my other comfort meds did the job. btw ive read more than once that Seroquel can cause rls.
 
On the other hand, if you taper too slowly with subs, you'll get addicted to it - and it has a nasty WD.

I've successfully detoxed of opiates with a short bupe taper; it's the only way IMO.
Just start as low as you can manage (just enough to relieve the sickness) then taper each day til you can jump off at something like 0.2mg (or less if possible)

Honestly, this way you can effectively negate almost all worhdrawal symptoms - so long as you've never been dependent on bupe
 
spacejunk said:
On the other hand, if you taper too slowly with subs, you'll get addicted to it - and it has a nasty WD.

I've successfully detoxed of opiates with a short bupe taper; it's the only way IMO.
Just start as low as you can manage (just enough to relieve the sickness) then taper each day til you can jump off at something like 0.2mg (or less if possible)

Honestly, this way you can effectively negate almost all worhdrawal symptoms - so long as you've never been dependent on bupe
Click to expand...


yeah thats what i was saying my taper was on oxy. What i was saying whatever opioid you are on ween on that. I didnt even use my subs during wds partly because i didnt need it and partly the fear of being stuck on it.
I also agree with short sub tapers i was not planning on being on subs longer than a week the last thing i needed was being on long acting subs especially after being on oxycontin high dose for so many years for that reason i only used my short acting roxys for the last month and half before jumping. But i do agree with some people that feel hopeless and really are not ready to stop they are better off on subs than other opioids just for the stability but if your mindset is right and your ready to quit short sub tapers are suppose to be golden.
 
Ah yes, my bad - i read that too quickly.
You're right, i totally agree :)
 
With tapers it is also worthwhile to keep in mind practical concerns. Recovery from dependence to long acting opioids does make stability more realistic for many people, but the safer, more accessible and (ideally) purer (and more standardized) the opioid the better!
 
Well, my fear of subs was due to a month and a half taper that I did in 2013 that I did myself without a really well thought out plan. I guess that I jumped off too crazy and went through the worst withdrawal ever. RLS lasted almost 7 days and insomnia lasted a few weeks at the earliest. So far, I am doing ok. I started about 30 hours after my last 2 bags before jumping on with just 1mg of 1 of my 2mg pills. Waited to see if that small dosage would take away my sickness and it did after a while. I couldn't eat much, so I then took a 50 mg visteril capsule that I am prescribed for anxiety and surprisingly I fell asleep. The next day, I took another 1 mg of sub and another visteril dose. This time, when I tried to lay down I started to get some moderate RLS in my right arm. So, I then took 1 300 mg gabapentin and remeron. It took a few hours, but somehow I fell asleep for 4 or 5 hours. I guess the sub was holding me because I woke up feeling ok and with a little bit of an appetite. I waited until I started to feel some yawns and watery eyes and took .5 mg sub dose along with a 300 mg dose of gabapentin and a light snack and tried to watch some tv. I didn't watch tv long before I fell asleep again til about 2 am. At that time, I ate a leftover burger and some Gatorade before taking remeron and trying to go back to sleep. This time RLS in left arm made sleep impossible for about 3 hours until I took another visteril capsule and finally feel back to sleep. I woke up after about 4 or 5 hours feeling suprisingly ok and a little hungry. Later that afternoon, I took another .5 mg sub, ate a little and messed around with my android tablet and watched some news. I also took a 0.1 mg clonidine because I was getting some hot and cold flashes. Before I went to bed I put 1 of my 2 mg suboxone tablets in a tiny plastic resealable bag and crushed it into powder because I had read about snorting small amounts before trying to jump off the subs. So, that's where I am at now and I am gonna take a few pings here and there when I feel the need and then stop the subs and see what happens. But as of right now, I may have dodged a bullet....hopefully! But if not I still have plenty of subs and other meds left to try again. Maybe my fear of suboxone withdrawal made me try at the lowest dose that I needed for my habit that I didn't think was as severe as most that I have been reading about. The next week or so should tell......
 
Nice! Vistaril/hydroxyzine can exacerbate RLS in some individuals, but if you apply something like Tiger Balm to the affected area that can help to lesson RLS effetely.

Insulfating buprenorphine is indeed more effective in terms of bioavailability than sublingual use, just try to keep you use as low and infrequent as possible to minimize the any potential for dependence/tolerance/withdrawal as you continue using it and once you discontinue it.

Glad to hear you are feeling better Dancer!
 
That is very common with opioid detox. Expect that when you discontinue the buprenorphine you will continue to struggle (to some degree) with RLS and insomnia, though not to the severity you would kicking a normal full agonist or simply cold turkey (I assume you will reduce your dose of buprenorphine a bit before you discontinue it).
 
Thanks, I know it's early, but I don't think that this run was too bad. I know that I do not want any parts of maintenance. I can't imagine trying to come off of suboxone after that deal! I'm gonna make this work if I have to somewhat cold turkey the last part of it.....
 
Yes, that's why I crushed a pill into powder. That way I can snort the tiniest amount that I can if I feel the need the next couple of days. I don't wanna take any more sub than I absolutely have to...
 
spacejunk said:
On the other hand, if you taper too slowly with subs, you'll get addicted to it - and it has a nasty WD.

I've successfully detoxed of opiates with a short bupe taper; it's the only way IMO.
Just start as low as you can manage (just enough to relieve the sickness) then taper each day til you can jump off at something like 0.2mg (or less if possible)

Honestly, this way you can effectively negate almost all worhdrawal symptoms - so long as you've never been dependent on bupe
Click to expand...
How long did this take you? I would like more info if possible.
 
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