Using loperamide to kick Heroin

[SuperPsych]

My recommendation - sorry if I repeat myself - is memantine and pregabalin, granted the memantine needs to be megadosed too but it's a very safe medicine. Problem might be to get it though, doctors are still ignorant about it but these two agents helped me kick 600mg/d morphine with little discomfort.

How much memantine did you dose and how often? I am currently working on a suboxone taper. I'm still on 10mg so still a ways to go, trying to speed up my taper because I'm sick of being on this medication. I do have some memantine though. I've never thought about using it for opioid WD. I also have a few gabapentin and clonidine.

 

[Keif' Richards]

This is a difficult subject. It's beyond doubt that Loperamide (Immodium) in large quantities can cause very serious and potentially deadly effects to the cardiovascular system, but this is typically seen in chronic users, often using in the 100's of milligrams per day. In my opinion this is a matter of using your practical reason as a human being. We take risks every day with our health anyway, don't we? Every cigarette we smoke, every Big Mac we eat, we know these things are unhealthy, yet we do them and time keeps moving on.

If you were to say to me, by using Loperamide for 3-5 days, even at an excessive dosage, I can quit Heroin for the rest of my life and be healthy, happy and loved? I'd say the benefits far outweigh the risks, especially given the fact that we are specifically discussing acute usage here in this thread.

We are a Harm Reduction community, but the goal of Harm Reduction is to make people's lives better, ultimately. We understand that there are risks and rewards and we do our best to act and advise accordingly.

So, case in point, I'd say you proceed at your own risk, but if it were me and you asked me such a question point-blank, I would definitely be taking the Loperamide to quit Heroin. This is just my opinion based upon my knowledge and experience.

 

[ChemicallyEnhanced]

Ok everyone I could really use ur opinions and advoceI’m going to do my best to taper down the H and start my loperamide 2 days before I quit using H….minimize my H usage on those 2 days…that way I can build up the loperamide in my system so when I stop using H, I won’t have to wait and go thru w/d while waiting for the loperamide to kick in??? I just cannot afford to not be able to tend to my family duties and responsibilities…. So what would my taper look like? Day 1: still using small amounts of H, before bed dose with 80mg of loperamide
Day 2: still using small amounts of H, take 60mg of loperamide.. Day 3: NO heroin, 80mg of loperamide oh and 600mg of tagamet. Day 4: 40mg of loperamide and 600mg of tagamet
Day 5: Hopefully cut that dose into 20mg of loperamide and 600mg of tagamet Day 6: 10mg of loperamide 400mg of tagamet Day 7: 5mg of loperamide 400mg of tagamet. ???? Does that sound somewhat freezable

If you do, you then need to taper off the lope!
I used lope for a couple weeks from 16-28mg/day and then stopped. I had the most extreme diarrhea of my life and the accompanying cramps were so painful I scream-cried like Sarah Paulson in any given American Horror Story episode.
I lost 12lbs in a week from the extreme diarrhea and because I was too scared to eat anything (I had many a bowl of soup or half a slice of toast a day).

 

[escapingwonderland]

Kratom is the way to go for opiate withdrawals. Red vein will help with withdrawal symptoms, white vein gives energy. In a pinch I've picked some up at the local smoke shop. Best quality and price I've gotten from website kats botanical. Really more cost effective that way. Also it's way more effective to mix it with juice or water and chug it over capsule form. Helped me get away from prescription opiates very easily with minimal discomfort. Very much a lifesaver.

 

[plumbus-nine]

How much memantine did you dose and how often? I am currently working on a suboxone taper. I'm still on 10mg so still a ways to go, trying to speed up my taper because I'm sick of being on this medication. I do have some memantine though. I've never thought about using it for opioid WD. I also have a few gabapentin and clonidine.

How's it going for you? Sorry for the late answer.

I did 60mg memantine upwards, it's what they used in papers and was well tolerated. The drug has an incredible safety, usually prescribed are 20mg/d for Alzheimers and they start with 5mg but people tolerate multiple 100mg's where it becomes a full dissociative. Highest I've done were 200mg within 24h, was quite wasted but not as strong as ketamine or DXM would have hit.

I can't give you exact advice as everybody reacts differently and I have had tolerance to dissociatives (which, once acquired, seems to last for ages) but as said in papers they used 60mg acutely without tapering and it reduced tolerance to morphine slightly. So you'll need some time and/or high dosages which will interfere with your daily schedules. But maybe more relevant than the amount is the duration, for me it correlated with how long withdrawal would have lasted without memantine, dosed for a week or 10 days and then most was over so I could continue with kratom.

 

[Boxofjuice]

How's it going for you? Sorry for the late answer.

I did 60mg memantine upwards, it's what they used in papers and was well tolerated. The drug has an incredible safety, usually prescribed are 20mg/d for Alzheimers and they start with 5mg but people tolerate multiple 100mg's where it becomes a full dissociative. Highest I've done were 200mg within 24h, was quite wasted but not as strong as ketamine or DXM would have hit.

I can't give you exact advice as everybody reacts differently and I have had tolerance to dissociatives (which, once acquired, seems to last for ages) but as said in papers they used 60mg acutely without tapering and it reduced tolerance to morphine slightly. So you'll need some time and/or high dosages which will interfere with your daily schedules. But maybe more relevant than the amount is the duration, for me it correlated with how long withdrawal would have lasted without memantine, dosed for a week or 10 days and then most was over so I could continue with kratom.

ketamine reduces my tolerance to subs taken the same day of use I mean after the ketamine it works but less sedating/or just different ...but the next day my tolo is way down

 

[Boxofjuice]

Kratom is the way to go for opiate withdrawals. Red vein will help with withdrawal symptoms, white vein gives energy. In a pinch I've picked some up at the local smoke shop. Best quality and price I've gotten from website kats botanical. Really more cost effective that way. Also it's way more effective to mix it with juice or water and chug it over capsule form. Helped me get away from prescription opiates very easily with minimal discomfort. Very much a lifesaver.

but imo I have to wait days of no bup and then only get very light effects and mostly just the sides...id imagine id have to be in full wd or at least some for it to work with subs
wd from subs must take forever t start ..at least for me its a very long half life drug

 

[plumbus-nine]

ketamine reduces my tolerance to subs taken the same day of use I mean after the ketamine it works but less sedating/or just different ...but the next day my tolo is way down

Ketamine is too short acting, and yeah when continuing usw tolerance will come to the same level again very fast even with 60mg memantine they had just a few percent reduction of methadone in papers but when switching or cross tapering it works almost like magic, at least for me it did. Key is to stay on the dissociative for at least as long as the acute withdrawal would usually last (so roughly a week minimum for solid habits, possibly longer - this is also why I recommend memantine, besides it's long hald life it's not so trippy like others).

 

[Boxofjuice]

Ketamine is too short acting, and yeah when continuing usw tolerance will come to the same level again very fast even with 60mg memantine they had just a few percent reduction of methadone in papers but when switching or cross tapering it works almost like magic, at least for me it did. Key is to stay on the dissociative for at least as long as the acute withdrawal would usually last (so roughly a week minimum for solid habits, possibly longer - this is also why I recommend memantine, besides it's long hald life it's not so trippy like others).

ya just saying plus the ketamine for me is extremely healing feel like i can feel the brain damage repairing itself ... raises BDNF heals damage cause by depression and lights up networks to city that's lost it power grid for a while soo to speak.. remarkable drug imo.. theoretically it can be dosed in small doses throughout the day ..but what do I know I'm not a dr. just a psychonaut drug nerd. ntm the BDNF and neuroplasticity continue long after the drug is out of your system.

 

[cdin]

ketamine does not cure opioid damage or wd. if it did, i would be fixed lol.

 

[Stassi202]

Only use enough immodium to take care of the symptoms of withdrawal that it is designed for (gi symptoms)

Since you have to function I would go to a smoke shop and get kratom
that will take away the withdrawal symptoms and you can function that way and then slowly taper kratom and have minimal if any withdrawals
I switch back and forth from oxy to kratom with no problem all the time


or you if you can get 5 days worth of suboxone you can do a rapid taper using the subs and have no withdrawal symptoms that way taking the largest dose on the first day and then cutting down until you take the last sliver and stepping off with no problem this I have not done but know someone who has and if I have to withdraw again will use this method

if you had a week I would have some other pieces of advice how to make life bearable out but since you need to function that limits your options

Omg I needed to see this so badly. I’m smoking the shit out of a ton of dope (heroin in my section of the woods) …was on subs consistently for 3 years up until about a year ago. I was selling my subs because I was getting more than I needed.
I miscalculated and sold too many, and when I realized I wouldn’t have any for almost a week, I picked up ONE bag of heroin. What I was thinking was I wasn’t able to fool myself for the one thousandth time. Well, I haven’t stopped buying heroin since then. I want to get back on subs, I have a consultation set up, but every time I try to start subs, the worst thing to ever happen to me happens…PRECIPITATED WITHDRAWAL.

If you haven’t experienced it, you are the luckiest person I know. IT IS WORSE THAN BENZO WITHDRAWAL PEOPLE…do not fuck with it.

What do I do how do I make sure this never happens again???

 

[Jabberwocky]

Omg I needed to see this so badly. I’m smoking the shit out of a ton of dope (heroin in my section of the woods) …was on subs consistently for 3 years up until about a year ago. I was selling my subs because I was getting more than I needed.
I miscalculated and sold too many, and when I realized I wouldn’t have any for almost a week, I picked up ONE bag of heroin. What I was thinking was I wasn’t able to fool myself for the one thousandth time. Well, I haven’t stopped buying heroin since then. I want to get back on subs, I have a consultation set up, but every time I try to start subs, the worst thing to ever happen to me happens…PRECIPITATED WITHDRAWAL.

If you haven’t experienced it, you are the luckiest person I know. IT IS WORSE THAN BENZO WITHDRAWAL PEOPLE…do not fuck with it.

What do I do how do I make sure this never happens again???

You have to wait until you are at a 5 in the clinical opiate withdrawal scale before you take Suboxone
use benzos, gabapentin, lyrica, Imodium, nitrous oxide, zzquil, whatever you have on hand to make it through at least a day? Someone know the right amount of time? I’m not sure the amount of time Ive heard 48hrs but it could be less if you are in full blown symptomatic withdrawal
but you can’t take kratom because that is an opiate and taking that and then taking a sub will put you in p.w.

Here is the clinical opiate withdrawal scale (cows). Nida.nhs.gov has the test where you can self score but it will not left me link it

The 11 Withdrawal Symptoms on the Scale​

The 11 withdrawal symptoms measured as part of COWS are:

1. Resting pulse rate: 80 or below, 81-100, 101-120, or greater than 120 beats per minute
2. Gastrointestinal upset: based on symptoms from the past 30 minutes and rated as no symptoms, stomach cramps, nausea or loose stool, vomiting or diarrhea, and multiple episodes of vomiting or diarrhea
3. Sweating: not taking physical activity or room temperature into account and measured over the past 30 minutes; scale includes no chills or flushing, some self-reported chills and flushing, flushed face with observable sweat, beads of sweat on brow or face, and sweat streaming off of face
4. Tremor: based on the clinician’s observation of the patient’s outstretched hands; measures no tremor, felt but not observed, slight observable tremor, or gross tremor or muscle twitching
5. Restlessness: measurable through observation, like tremor, and described with able to sit still, difficulty sitting still, frequent shifting of legs or arms, unable to sit still
6. Yawning: measured as none, once or twice during assessment, three or more times during assessment, and several times per minute
7. Pupil size: measured based on visual exam, through descriptions pinned or normal size for light, larger than normal for light in room, moderately dilated, and extremely dilated
8. Anxiety and irritability: predominantly self-reported by the patient, but can be a very useful measure of how the individual experiences withdrawal symptoms; scale rates as none, increasing irritability/anxiousness, obvious irritability/anxiousness, and participation in assessment is difficult due to irritability/anxiety
9. Bone or joint aches: only related to sensations attributable to opiate withdrawal; measures as none, mild and diffuse discomfort, patient-reported severe aches, and patient visibly rubbing sore joints or muscles during assessment
10. Goosebumps: measured with descriptions skin is smooth, piloerection (hairs standing up) can be felt but not seen, and piloerection is prominent
11. Runny nose and watering eyes: measurement only for withdrawal-related symptoms; descriptions for measurement: none present, nasal stuffiness and unusually moist eyes, and nose constantly running with tears streaming down the cheeks

In some clinics, COWS also includes the introduction of buprenorphine during the assessment: whether none was given, or when it was supplied during the assessment and how often.

Each description in the 11-symptom scale has a numerical value, which is tallied to help the clinician understand the severity of withdrawal. Scores of 5-12, for example, indicate mild withdrawal, while a score of 36 or more indicates severe withdrawal.

History of the Clinical Opiate Withdrawal Scale​

As heroin addiction became a greater problem in the US and Europe, the COWS scale was developed to measure the severity of the addiction and withdrawal syndrome. COWS is based on the CIWA-Ar (Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised), used to measure alcohol withdrawal after a person struggles with alcoholism. The opioid scale was developed in the 1930s, and since then, many other scales have been developed for opioid withdrawal and other substances of addiction.

 

[Stassi202]

You have to wait until you are at a 5 in the clinical opiate withdrawal scale before you take Suboxone
use benzos, gabapentin, lyrica, Imodium, nitrous oxide, zzquil, whatever you have on hand to make it through at least a day? Someone know the right amount of time? I’m not sure the amount of time Ive heard 48hrs but it could be less if you are in full blown symptomatic withdrawal
but you can’t take kratom because that is an opiate and taking that and then taking a sub will put you in p.w.

Here is the clinical opiate withdrawal scale (cows). Nida.nhs.gov has the test where you can self score but it will not left me link it

The 11 Withdrawal Symptoms on the Scale​

The 11 withdrawal symptoms measured as part of COWS are:

1. Resting pulse rate: 80 or below, 81-100, 101-120, or greater than 120 beats per minute
2. Gastrointestinal upset: based on symptoms from the past 30 minutes and rated as no symptoms, stomach cramps, nausea or loose stool, vomiting or diarrhea, and multiple episodes of vomiting or diarrhea
3. Sweating: not taking physical activity or room temperature into account and measured over the past 30 minutes; scale includes no chills or flushing, some self-reported chills and flushing, flushed face with observable sweat, beads of sweat on brow or face, and sweat streaming off of face
4. Tremor: based on the clinician’s observation of the patient’s outstretched hands; measures no tremor, felt but not observed, slight observable tremor, or gross tremor or muscle twitching
5. Restlessness: measurable through observation, like tremor, and described with able to sit still, difficulty sitting still, frequent shifting of legs or arms, unable to sit still
6. Yawning: measured as none, once or twice during assessment, three or more times during assessment, and several times per minute
7. Pupil size: measured based on visual exam, through descriptions pinned or normal size for light, larger than normal for light in room, moderately dilated, and extremely dilated
8. Anxiety and irritability: predominantly self-reported by the patient, but can be a very useful measure of how the individual experiences withdrawal symptoms; scale rates as none, increasing irritability/anxiousness, obvious irritability/anxiousness, and participation in assessment is difficult due to irritability/anxiety
9. Bone or joint aches: only related to sensations attributable to opiate withdrawal; measures as none, mild and diffuse discomfort, patient-reported severe aches, and patient visibly rubbing sore joints or muscles during assessment
10. Goosebumps: measured with descriptions skin is smooth, piloerection (hairs standing up) can be felt but not seen, and piloerection is prominent
11. Runny nose and watering eyes: measurement only for withdrawal-related symptoms; descriptions for measurement: none present, nasal stuffiness and unusually moist eyes, and nose constantly running with tears streaming down the cheeks

In some clinics, COWS also includes the introduction of buprenorphine during the assessment: whether none was given, or when it was supplied during the assessment and how often.

Each description in the 11-symptom scale has a numerical value, which is tallied to help the clinician understand the severity of withdrawal. Scores of 5-12, for example, indicate mild withdrawal, while a score of 36 or more indicates severe withdrawal.

History of the Clinical Opiate Withdrawal Scale​

As heroin addiction became a greater problem in the US and Europe, the COWS scale was developed to measure the severity of the addiction and withdrawal syndrome. COWS is based on the CIWA-Ar (Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised), used to measure alcohol withdrawal after a person struggles with alcoholism. The opioid scale was developed in the 1930s, and since then, many other scales have been developed for opioid withdrawal and other substances of addiction.

Thank you so much for providing this information; it has reinforced my decision NOT to attempt the transition from dope to subs. I mean 3 or 4 symptoms are plenty, even 5 or 6 are probably doable. But 11??? I’m sorry, but I just don’t have enough of a desire to get clean and put myself through that. In truth, I just don’t care. Make no mistake, I am not suicidal. I have zero motivation to do much of anything. I’ve done lots of things in my life and I’m good. I’ll leave it at that.

 

[Boxofjuice]

ya just saying plus the ketamine for me is extremely healing feel like i can feel the brain damage repairing itself ... raises BDNF heals damage cause by depression and lights up networks to city that's lost it power grid for a while soo to speak.. remarkable drug imo.. theoretically it can be dosed in small doses throughout the day ..but what do I know I'm not a dr. just a psychonaut drug nerd

ketamine does not cure opioid damage or wd. if it did, i would be fixed lol.

was not mentioning opiate damage maybe trauma ptsd like damage and who knows maybe a lil from drug use ..imo it certainly helps with cravings and lowering tolerance...strange thing it is. NTM it could be helping damage from drug use. but who knows to what degree it has been used to stop using the drugs... I would need to do more research

 

[cdin]

was not mentioning opiate damage maybe trauma ptsd like damage and who knows maybe a lil from drug use ..imo it certainly helps with cravings and lowering tolerance...strange thing it is. NTM it could be helping damage from drug use. but who knows to what degree it has been used to stop using the drugs... I would need to do more research

have tried for all of the above. was not effective long term, at least for me. It will treat anything in the moment. over time it messed w my brain chemistry and caused it's own problems, and renal/internal ones. If used abusively and chronically it's not a consequence free compound. maybe long term tightly controlled IV treatments will remain effective for people, but I have my doubts. certainly the take home tranche 3x weekly thing is going to cause problems sooner or later. I expect some mania/suicides that end up getting the industry more regulated at some point.

 

[Stassi202]

Thank you so much for providing this information; it has reinforced my decision NOT to attempt the transition from dope to subs. I mean 3 or 4 symptoms are plenty, even 5 or 6 are probably doable. But 11??? I’m sorry, but I just don’t have enough of a desire to get clean and put myself through that. In truth, I just don’t care. Make no mistake, I am not suicidal. I have zero motivation to do much of anything. I’ve done lots of things in my life and I’m good. I’ll leave it at that.

It’s important to remember that everyone is different, and for some people maybe 48 hours is long enough to wait; for others, not so much. I was in rehab with a guy who went into precip TEN DAYS after his last opiate use.

 

[plumbus-nine]

ketamine does not cure opioid damage or wd. if it did, i would be fixed lol.

Damage not but withdrawal including post acute symptoms, at least memantine can do that. Ketamine lasts too short for to do anything here imo. But of course nothing is free and one can get addicted to the dissociatives instead, I'm an example of that.

 

[cdin]

Damage not but withdrawal including post acute symptoms, at least memantine can do that. Ketamine lasts too short for to do anything here imo. But of course nothing is free and one can get addicted to the dissociatives instead, I'm an example of that.

myself as well. IMO the usefulness of dissociatives as a "cure all" is wildly and irresponsibly overstated.

 

[plumbus-nine]

myself as well. IMO the usefulness of dissociatives as a "cure all" is wildly and irresponsibly overstated.

Might be, for sure they aren't a cure all but their ability to cover opioid withdrawal is amazing. Just that they're addictive, unfortunately. Don't know if it only works for part of the population and if then what percentage.

But same for tolerance reduction to stimulants, while I was using DXM alongside 18mg Concerta I was fine with the dosage for 3-4 months (then I had to stop because of cardiovascular issues/ angina pectoris which probably was due to DXMs potent NRI effects) while on its own the same dosage of Concerta lasted a whole 10 days, after which I had to take it to maintain baseline.

 

[Boxofjuice]

have tried for all of the above. was not effective long term, at least for me. It will treat anything in the moment. over time it messed w my brain chemistry and caused it's own problems, and renal/internal ones. If used abusively and chronically it's not a consequence free compound. maybe long term tightly controlled IV treatments will remain effective for people, but I have my doubts. certainly the take home tranche 3x weekly thing is going to cause problems sooner or later. I expect some mania/suicides that end up getting the industry more regulated at some point.

I agree . to a degree but that with any substance well not any but most.. SSRI cause suicide sometimes ... raising BDNF and rewiring the brain and opening up new pathways seems awesome to me.. its been studied to so .. yeah taking too much could be a problem. I think one large dose spaced over a long time would be better than. EVERY FUCKING WEEEK repeated doses lol.

LSD shrooms ie the non toxic/more forgiving ones could be used more often but ...
good thing about ketamine is that its so short acting and rapid antidepressant . it truly does work. perhaps someday they will discover a less toxic analog or something that works the same way without. some of the consequences . I do believe ketamine on occasion can do way more good tan harm though IMO.