Welcome to the Opioid Withdrawal Megathread and FAQ!
The purpose of this thread is to facilitate questions and discussion for anyone who is considering, in the midst of, or even just curious about, withdrawing from opiates. Withdrawal is no picnic, however not knowing what to expect and what can be done to help ease the pain makes it that much worse. Remember that no matter how terrible your symptoms may seem they are only temporary. Countless people have been there before and have successfully come out the other side. Armed with their knowledge, support, and experience, we'll help you get through it too.
Some of the questions and topics which belong in this thread include:
- How bad can I expect withdrawal to be from my current habit?
- How long will my withdrawal symptoms last?
- How can I use the opiates I have left to help ease withdrawal?
- What OTC medications and home remedies are useful?
- What can I do to help with certain symptoms of withdrawal?
- I just slipped up and used...how will it effect my withdrawal?
- Should I consider going on suboxone or methadone?
- And any other general advice on your own personal situation and plan to get off.
When taking opiates regularly over a period of time, your body becomes accustomed to them and develops both tolerance (where you need more opiates to achieve the same effects) and dependence (where you need opiates just to feel normal). When a person who is dependent on opiates stops taking them or takes less than they require, they go into withdrawal. The severity and duration of withdrawal depends on how long a person has been dependent, how high/strong the dose is that they are dependent on, and how long the half life of the opiate that they are taking is.
PAWS (post acute withdrawal symptoms) begin after you have finished the physically painful withdrawal process. They can continue to occur for an extended period of time especially in users who have been on opiates for a while. PAWS generally consist of psychological problems like depression, anxiety, etc, which stem from chemical imbalances in your brain. The Dark Side is an excellent resource for those who are looking for information and support on this phenomena.
It is important to note that almost all opioids taken for fun act primarily on the Mu-opioid receptor. This means that there is a cross tolerance between them and taking large amounts of weak opiates can be considered almost the same as taking small amounts of strong opiates.
Methods for Withdrawing
There are three main methods that people use to try to get off of opioids.
Going cold turkey (CT) is when consumption of all opiates is suddenly ceased and the person enters acute and full on withdrawal. The advantage of this method over others is that the withdrawal is completed in the shortest amount of time. The downside is the symptoms will be most severe.
A rapid detox is when powerful antagonist are steadily administered to an opiate tolerant individual resulting in instant and extreme withdrawal. This procedure actually condenses the acute withdrawal period, which usually lasts several days, into a matter of hours. Due to the level of pain this inflicts upon the user however it requires a doctor to supervise and the patient is put under generally anesthesia (i.e. knocked out like for surgery) for the duration of the treatment. These clinics are probably a very tempting option for most people however they are expensive, there are still PAWS to deal with, the chance of relapse is higher (because you never had to experience withdrawal), and there are risks similar to that of minor surgery.
Ibogaine is a psychoactive plant that has potential for addiction treatment. It is usually used to send the user on a long introspective psychedelic trip resulting in reduced cravings, lower tolerance, and abatement of withdrawal symptoms. Like the rapid detox above there are clinics which specialize in ibogaine treatment depending on your location.
Tapering is when progressively smaller amounts of opiates are taken over time in an attempt to slowly wean off the opiates and minimize negative symptoms. This is probably the most common method of attempting to handle withdrawal and it can be performed over a time-span of anywhere from days to months. The more gradual the taper, the more subtle the symptoms of withdrawal, but of course the longer it takes to complete. At the end of the taper the user will eventually have to switch to zero opiates at some point. This is called 'jumping off' and usually will result in some negative symptoms even if the last dose was very low.
Some people will attempt to taper by switching from a strong opioid like oxycodone, fentanyl or heroin, to a weaker opioid like codeine or tramadol. This way they can use the cross tolerance to help reduce the withdrawal symptoms but won't be as tempted to get high with their DOC (drug of choice) if they can even get high at all on the weaker opioids. In some locations these opioids are available without a prescription. Depending on your location these include:
- codeine/DHC - preparations often contain other drugs and need to be extracted if consumed in large amounts (Cold Water Extraction Mega Thread & FAQ v2.0)
- tramadol - has lots of other non-opioid mechanisms of action and can present a seizure danger
- kratom - a plant naturally containing opioids
- lopermide - often just used to treat symptoms of withdrawal as opposed to a proper taper
Maintenance - methadone and buprenorphine (suboxone/subutex)
For some people getting off of opiates is too hard or is not as important as getting out of the drug culture and life style. For them opiate maintenance is an option. Opiate maintenance with methadone or buprenorphine is effectively a taper plan overseen by a doctor with the difference that some people choose not to taper for years, if at all, and just "maintain" themselves on the drugs. Choosing to go on methadone or buprenorphine is difficult decision. Many people find it helps them get off of opiates and many find it is more difficult to get off of their maintenance drug than it is their original drug of choice.
People can choose to use methadone and/or buprenorphine in an at home withdrawal setting as well, however these drugs have very long half lives and other special properties which must be taken into account (which is why they have their own threads as linked below). Buprenorphine has such a high affinity if taken while other opiates are still in your system it will rip them off and cause instant and painful 'precipitated withdrawal'.
Where to Start?
The second post of this thread includes most of what you would want to know about OTC and home remedies as well as other advice on dealing with withdrawal and is a good place to start (after reading this first post of course :)).
Although this thread is designed for general questions, comments, and concerns on opiate withdrawal, before posting please review the following threads and see if your topic is more suited elsewhere. For specific questions on OTC and home remedies check out the next post and the relevant links as well.
For detailed information on tapering plans:
For specific information regarding the opioid containing plant Kratom:
For specific information regarding the maintenance drugs methadone or buprenorphine (suboxone/subutex):
- Suboxone/Buprenorphine Mega Thread and FAQ v12.0
- Methadone Mega Thread and FAQ
- **Methadone VS Suboxone Mega Merged Thread**
For moral support and psychological issues:
- Progress Mega Thread
- The Dark Side
- please review their Forum Guidelines before posting
- A guide to opioid addiction treatments and other medications used for withdrawal
As always please try to keep questions, responses, and discussion relevant and on topic.