Opioids Taking a break – Pointless? Or an effective way to reduce opiate tolerance?

I am an opiate addict on MMT. I take 60mg methadone/day. I find slow tapering to be incredibly disruptive to my schedule and have always preferred the idea of cold turkey to gradual reduction.

I want to get on the waiting list for an in-patient detox in a hospital setting. I need to be on 40mg methadone/day or less to qualify for this.

I don’t have the time, space or financial resources to take 2 weeks out of my life to do a cold turkey on my own terms at the moment. Methadone withdrawal for me lasts at least 10 days for the initial hell to subside.

I would however be able to take a hotel on the outskirts of the city for a few nights and stock up on valium, loperamide and other essential medicines and spend 3 or 4 days of withdrawal in a hot bath, watching films and playing xbox to distract myself. This would not be my first time experiencing withdrawals.
I would hope on the morning of the 4th day that my tolerance would be sufficiently lowered that (by titrating a dose upwards from 10mg) I would feel comfortable again at around the 30mg mark, maybe even less.

Does anyone have experience reducing tolerance like this? Is it viable or am I indulging in wishful thinking? Between the price of the hotel and medicine required, not to mention the pain I will be putting myself through I’d hate to do all this only to discover I’d reduced my tolerance by just a few mg.

Opinions much appreciated, thanks.

I think expecting anything in 3/4 days is hoping a bit too much. But i'm sure someone experienced will be able to answer better.

I agree with madog, 3/4 days is not enough to really put a dent in your methadone tolerance. However, it will certainly help a little to lower your w/d.

This is what I'd do: stop taking your done, and wait, living your normal life, until you're almost in full blown w/d (1.5-3 days). Then, once you're already in acute w/d, check yourself into the motel and do your thing. after 3 or 4 days, then you'd have about a week off the done. this is certainly enough to significantly lower your tolerance. but really, even then, done's half life is so long it isn't necessarily going to be such a huge reduction in tolerance.

do you ever use potentiators? using something like promethazine/hydrazine (however you spell it)/benadryl and tagamet on top of 4-7 days off your done will allow you to get significantly higher/more out of your opioids than your might expect.

If I was to do a week off the methadone I think I'd just stick it out until my withdrawals had subsided. Another few days and the worst would be over. Another week and I'd be home free more or less.

I often use promethazine to potentiate opiates, but as far as tolerance goes IME the body will just recognise 30mg methadone + X amount of promethazine as a higher dose of methadone; perhaps 50-60mg.
As far as I can remember if I was to use 60mg methadone + 50mg promethazine each day for 2 weeks and then stop taking promethazine my body would still experience withdrawals even though I would be taking 60mg methadone.

Do you find it works differently for you?

Have you ever detoxed from methadone OP? It's going to take A LOT longer than just a week. Like, a week in, you'll probably be about half way through it, maybe a little bit more.

How long have you been on maintenance? I was on 100mg for about a year, was tapered down in a detox to 40mg, then sent to an inpatient where I had to cold turkey it (you can't really taper someone in one week from 100mg-40). I hate to say it, but the acute withdrawal will likely last at least two weeks, probably peaking around day 7-8. When I kicked it the biggest problem more than anything was the hellish anxiety, RLS and insomnia. Once the acute phase was over I went through PAWS for about six months, and after that, one day I just felt normal again.

It can be done, you just got to give it patience.

you have a good plan it sounds like, but i can't say you'll experience a ton of difference. Do you smoke weed at all? I always found that helps when w/d's hit and you can use slightly smaller and smaller doses depending on. Do you have a friend to help when you start to get really sick? that might be a good idea if at all possible.

I think it's a bad idea. But I get where your comming from. Cold turkey used to be the way I would go with suboxone when I was sick of that crap and just wanted to quit. I was taking 8mg's a day then did a faster taper to 4mg's a day and quit. It was fucking hell for 3 weeks.

When I wanted to quit benzodiazapines I did a much slower taper and switched to valium. Thanks to that slow taper I have been able to stay free from them and never went on.

So you might want to take some time to at least try and taper. Here's some good advice, dont rush. I often always felt like I was in a hurry to get off that shit. But it's like what for, if you do it right then you can get off of it for good. If you hurry to much you will do it wrong and be right back on it in no time.

So taper as low as you can if you decide to do a fast taper. 40mg's is such a dumb dose to stop at. When you could just go lower. The lower you go the better your chances are going to be of staying clean. But like I said cold turkey is possible it's just going to be rough on your body and make it much harder to stay clean.

Can you get kratom? It will help, you wont get high from it but should get some relief and a little bit of energy. It works on other receptors besides the MU and delta so even with a massive tolerance can bring you relief.

I never used valium for withdrawal from opiates and always thought the shorter acting potent ones worked better for that. But none the less i'm sure it will help.

Get alot of valium, lopermide, kratom, and whatever else you can think of to help the pain your going to be in. I would plan on being miserable for longer then 2 weeks. The intensity will probably go down by the third week or month. With improvements hopefully in the second week.

Do it right and you will only have to do it once. It took me a couple of times to quit subs before I had success. So if your not able to do it I would recommend doing a real taper. But either way get some kratom and go on that for 2 weeks. It will absorb some of the withdrawal and wont prolong it because it's really weak.

Why can't you detox at home? It would be cheaper and you could try it out.

I think with any other opiate, this would work, but I doubt it will with methadone. Maybe 5 to 10mg off your tolerance.

I have detoxed from methadone and heroin before.

When I detoxed from methadone before I was taking 30mg/day but switched back to heroin for about 2 weeks to give my body a chance to get rid of most of the methadone. I did take one final 30mg dose of methadone the day before I started my detox but I'm sure what I experienced was a mixture of methadone & H WDs as opposed to true methadone withdrawals.
That time I'd say I didnt sleep for a week and I was in constant pain for those 7 days but as far as I remember I was able to sleep a few hours a night at around the 8th day, and by day 14 I was feeling almost like my old self.

This time I have been taking 40-60mg for almost a year with no breaks apart from the odd heroin run where I would do H and not bother taking my methadone for a few days.

I have been thinking about kratom. I tried it before but I was already opiate dependent at the time and it didnt seen to have any effect on me. Also I doubt I'd manage to keep that shit down during WDs, I'd have to try to make an extract or at the very least capsule the shit beforehand. Thanks for the advice though.

toothpastedog & Znegative do you think I should switch to heroin for a couple of weeks like I did before? I imagine this would reduce the amount of time I spend in acute WDs as it did for me before.

I am in Dublin. I can get on a 4 week Subutex reduction in London, UK but it is expensive, not including the money I will spend on traveling expenses. I just don't think it is worth $500+ for a slight reduction in physical discomfort.

I think a taper to 40, then switch to suboxone for a fast taper. It is so much easier to taper off subs imo.

If you can find Lyrica (Pregabalin), it is absolutely fantastic at controlling the cravings and withdrawal pain. 150mg 2-4x a day is what got me off of a yearlong 80-100mg/day oxy addiction.

muvolution said:

Why can't you detox at home? It would be cheaper and you could try it out.

I think with any other opiate, this would work, but I doubt it will with methadone. Maybe 5 to 10mg off your tolerance.

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I am basically homeless. I sleep on a couch in my friends house. The only shower I have access to is at the gym where I train.
My relationship with my parents is strained. I can stay a few days in their house every now and then and leave my possessions there but their attitude towards drug use is seriously draconian so it is not possible to detox there either.

Do you really think it is worth spending the little money I have on the 4 week subutex reduction? I have no income besides social assistance and I am hoping to be able to put my savings (not even the cost of the treatment & travel) towards renting a room of my own because I really feel like I'm over staying my welcome on this couch.

Tryptamite said:

toothpastedog & Znegative do you think I should switch to heroin for a couple of weeks like I did before? I imagine this would reduce the amount of time I spend in acute WDs as it did for me before.

I am in Dublin. I can get on a 4 week Subutex reduction in London, UK but it is expensive, not including the money I will spend on traveling expenses. I just don't think it is worth $500+ for a slight reduction in physical discomfort.

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If you have the money to burn, the bupe would prob get you the best chance of success statistically speaking. However, if you've detoxed from the done before, you'll be able to get by. How'd you do it before? Personally i never recommend switching to a shorter acting opioid, although i understand the desire to get it over with asap. The thing is that you're still going to have to get from the done to the dope. So just cut out the extra step imo.

Again though, how'd you get off it before?

Yea, if i were you I'd spend whatever money you can muster on w/d meds, get as low as you can on the done as you can then jump off. Just make sure you have something, even if its just clonidine and gaba, which would actually be ideal, to keep some of the wd pain at bay.

toothpastedog said:

how'd you get off it before?

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I was on a relatively low dose 30mg methadone/day and I did a cold turkey in my parents house. I had very little in the way of comfort meds. A few small doses of librium (really weak benzo) and 1 7.5mg zopiclone tablet/night for sleep.
Also my parents insisted that since it was their house they would keep my medicine and give it to me as they saw fit.

They have told me that I will never be allowed to detox in their home again. Not that it's something I would be willing to do either. The pain from withdrawals was bearable. Their attempts to "help" me were not.
Also I have younger brothers and it must be frightening for them to see their older brother retching and spitting and hurling, destroyed by the madness of withdrawals. I would feel too guilty about this. They too know very little about drug use. We are a sheltered family, myself included (up until the last 4 or 5 years since I moved away from home).

Do you think you can get those detox meds mentioned and be able to go ct wherever you are located now? Trust me I've been on the street before but frankly i don't think I'd be able to imagine dealing with what you have to go through atm. But as long as you can stick out the first 4 to 7 days on the street then get into a hotel for the worst of it, and you're able to get said meds, I think you could very well be successful.

And i take it that staying on methadone until you get sorted in terms of lodgings and whatnot isn't an option?

toothpastedog said:

Do you think you can get those detox meds mentioned and be able to go ct wherever you are located now? Trust me I've been on the street before but frankly i don't think I'd be able to imagine dealing with what you have to go through atm. But as long as you can stick out the first 4 to 7 days on the street then get into a hotel for the worst of it, and you're able to get said meds, I think you could very well be successful.

And i take it that staying on methadone until you get sorted in terms of lodgings and whatnot isn't an option?

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Yes I could get my hands on the detox meds easily enough (except for clonidine). I also have a few codeine/paracetemol(APAP) 30/500mg and some medicine containing a low dose of carisoprodol as well as paracetemol, aspirin and caffeine stashed away for when the time comes.

Might be able to get some pregabalin from my father if he agrees.

I suppose the best thing to do in light of new information would be to taper down a bit and wait to do the actual detox until I've sorted somewhere of my own to stay.