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    A guide to opioid addiction treatments and other medications used for withdrawal 
    #1
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    I thought this would be helpful to all of you trying to get clean. I spent the last hour revising it, and editing it. Feel free to pass this along.

    A Guide to Opiate Withdrawal by cashtothemoney
    (w/ help from our over-the-counter friends)

    DISCLAIMER: I'm not a doctor, but I have been reading about this sort of thing extensively for a very long time. This is not medical advice, but rather my own experience which you can take from what you want. In order to be in line with my own morals (and the LAW!), I have to say that it would be best to review this with a doctor before making any decisions. All drugs listed, with the exception of one, can be bought over-the-counter, but this does not mean that it is automatically "safe".

    Introduction

    Expect the worst in withdrawal. It might not be "crazy", but it sure as hell won't be comfortable. At the same time, for some of you, it will be the hardest experience of your life. Lack of energy, muscle/bone aches, diarrhea, insomnia, depression, anxiety. It can be hell, but you can ease all of these withdrawal symptoms with over-the-counter drugs. I've survived it a few times, and as long as you keep yourself busy it can be made a bit easier. The physical part is somewhat similar to having the flu, but magnified depending on the dose/frequency of use/duration of use; however, I think I can speak for most people when I say, the mental struggle that follows the physical withdrawal is MUCH worse. This is given as a possible alternative to therapies such as methadone, buprenorphine, etc. Good luck to all of those attempting to rid themselves of addiction.

    The intensity and length of opiate withdrawal will depend on a few factors. The larger the dose, the more intense the withdrawal. The longer you have been using, the longer and more intense the withdrawal will be. If you did it once a day, it might take a few days for the withdrawal to kick in. If you took opiates shortly before bed, insomnia might be the biggest problem. If you took opiates when you woke up, you might not feel like getting out of bed without them. All of this could be wrong, or it could all be right on the money. The point is opiate withdrawal will differ for everyone; however, it will universally suck.

    The Essentials
    • Positive mindset
    • A multivitamin
    • Courage
    • Determination
    • An understanding that this is not forever.


    Diarrhea

    • Immodium A.D. - 4-6mg loperamide per 50-60mg of oxycodone/hydrocodone. (May vary!)
    • Try not to take this too often as it can make you REALLY constipated, but it can get rid of (in my experience as well as others) the majority of the physical withdrawal symptoms. Just remember that loperamide is an opiate, so it's better to only take if NEEDED. Laxatives can counter the constipation or try the natural route, fruit or olive oil.
    • Note: It is very important that you keep in mind that loperamide is an opiate, so you must also taper yourself off of loperamide, which can be done over the period of a few weeks to a month. This will let you start dealing with any mental dependency issues almost right away, which will be the hardest part of coming off opiates.


    Insomnia

    • Benzodiazepines: Exercise EXTREME caution if you plan on using any sort of benzodiazepines to ease the insomnia. Examples of benzos include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin/Rivotril). For myself alprazolam and clonazepam work the best, although I will not recommend obtaining these illegally. Working your way up from 0.5mg (assuming you have no tolerance) until you find your dose may be helpful. ONLY take these if you absolutely need them. I can't stress that enough. Benzodiazepines are, in my humble opinion, more addicting than opiates, and it is a fact that they are more dangerous. They are one of the few classes of drugs that can include DEATH in the withdrawal. Another positive aspect of using benzos would be the fact that it can really take the edge off if/when you are feeling stressed out and anxious. Research them extensively before you use them, as you do *NOT* want to trade addictions. If you are taking buprenorphine as an aid during withdrawal, do not take any benzodiazepines, as this combination has resulted in death.
    • Diphenhydramine: This is an antihistamine which includes drowsiness as one of the side effects which makes it a great candidate for a sleep aid. It works wonders for many opiate addicts and I think this would be better to use than any benzos.


    Bone/Muscle Aches (with a little bit of advice for the mental part as well)
    • Ibuprofen, Naproxen (Recommended dose/as needed)
    • ABSOLUTELY NO OPIATES! The only way one can use opiates is if they are tapering. There are hardly any people with the willpower, and self-discipline to actually complete a successful taper. The road to becoming clean must be taken one day at a time, maybe even one hour or one minute at a time. Tell yourself to get through the next minute or hour. Reward yourself for getting through that period of time. If you start thinking about the next week, month, or year, you WILL overwhelm yourself.


    Lack of Energy/Depression
    1. EXERCISE! This is, by far, the number one way of combating the physical and mental part of withdrawal, including depression. You may not want to do anything, which could even include getting out of bed, but if you can motivate yourself to exercise, you will notice a dramatic increase in your energy levels and your mindset. This is what has made a dramatic difference each time I've gone through withdrawals. It is THE wonder drug, not to mention you can obtain the infamous “runner's high” after running for a certain amount of time.
    2. L-Tyrosine: (Available at GNC) Studies show l-tyrosine will help with depression, energy levels, and other mood disorders. It is a precursor to dopamine (the Almighty), norepinephrine, epinephrine, and L-dopa. Epinephrine and norepinephrine are two of the body’s stress-related hormones, and l-tyrosine’s role in their creation can help ease the negative effects of stress. Starting at 2000mg per day, and adjusting is one way to begin. Vitamin B6 is essential in the creation of the neurotransmitters, so be sure to take the it along with the l-tyrosine.
    3. Vitamin B6: Vitamin B6 helps in the creation of serotonin (the “happy” neurotransmitter), dopamine, norepinephrine, and GABA (the mechanism in which benzodiazepines work through; reduces stress levels; induces relaxation). So one can easily see why B6 is beneficial. It also provides energy, and as said before, is essential in the conversion of l-tyrosine to the various neurotransmitters.
    4. FIND SOMEONE YOU CAN TALK TO! We all need to vent. Find a friend, someone on this forum, a psychologist, etc. It is essential if you want to succeed.
    5. Think about all of the things that can be done now. Money in the bank, be around for family/friends, not worry about your next fix, not be sick all the time, etc.


    Other supplements that could help: Kava (anxiety), valerian root (anxiety/insomnia).

    Closing Notes

    The worst of the physical withdrawal will most likely be over after the 4th day. It typically lasts 3-5 days and fades off after that, but can last as long as a week (longer with opiates with a long half-life, such as methadone). I've found the fourth day to be the worst, and once you are over that hump you start to feel physically better. Then, it is time to deal with the mental problems that result.

    If you have friends that do drugs, you have to separate yourself from them. Unless you are superman, or have an abnormal sense of self-discipline, you will have to do this as the temptation is too great for most. Getting away for a week can really make all the difference in the world. Staying clean is a lifelong journey, and if that is what you are after, YOU CAN DO IT! Don’t give up if you have a bad day or are feeling a bit down. Keep yourself busy. It can make all the difference in the world. Start a new hobby, continue an old one, spend time with the family, go hiking, go for a walk, talk to a stranger, have a cup of coffee (avoid it in the beginning as this can worsen anxiety), etc.

    As addicts, we might have started doing opiates for fun, or maybe to cover up problems. It might have only been a weekend romance, but that changed into a daily obsession. We might be broke, losing friends, and at rock bottom. Sometimes there are problems that we try to cover up, and a lot of emotions come out as the drug leaves our body. We have to get used to living a “normal” life, and dealing with “normal” problems. It is important to get to the root of the problems, and face them head on. There is no more hiding. After all, the REAL you is coming out from hiding as well. You mine as well make the most of it.

    Best of luck to all of you in your endeavors. Godspeed.

    Additional Reading:
    L-tyrosine - http://www.mothernature.com/Library/...cfm/Id/2919008
    Vitamin B6 - http://lpi.oregonstate.edu/infocente...ins/vitaminB6/
    Last edited by cashtothemoney; 05-03-2006 at 06:26. Reason: Minor graphical/grammatical errors.
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    #2
    Bluelighter Blind Melon's Avatar
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    Thank's, that was pretty helpful. I had completely forgotten about Kava, I should go get some tomorrow.
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    #3
    That was very well done, although I am a little concerned about recomending Benzos. You did very clearly state that you should not cross-addict yourself and that you should not obtain them illegally when trying to kick opiates. The parts about how if you took opiates in the morning when you woke up were dead on. Same thing goes with if you took them to go to sleep. I personally take Buprenorphine and trazadone to help myself kick. Buprenorphine helps me get through the day without opiates and Trazadone helps me get to sleep at night but is widely considered a non-habit forming drug. It is one of 2 sleep aids my doctor would prescribe an addict. He says the rest are all habit-forming.

    Anyways very good job. You might not be a doctor but it was very well done anyways. You don't have to be a doctor to be intelligent enough to do the research on why you are feeling the way you are feeling. I hope this helps many people kick the most incredibly addictive drugs out there, opiates.

    Good Luck and Enjoy Life, to everyone.
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    #4
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    Feel free to make suggestions... I'd be happy to edit it and give credit where it is due! I think this could be very beneficial for everyone. Thanks for the compliment nexigram.

    -hollywood
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    #5
    phreex had a opiate withdrawal guide as well somewhere and it seemed quite good.
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    #6
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    Perhaps they could be combined...
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    #7
    Thanks for the info, I unfortunately am a long time opiate user whos managed to quit and relapse many times. I used methadone for maintance for about 9 months and just realized i was just as addicted maybe even worse. The withdrawl from methadone was horrible, worse then heroin by far. I managed to come off of 120 cutting back 5mgs every 3 days and then at 30 all toghther i was sick for a good month, and still felt syntoms for a few months. i then relapsed on heroin about 3 months ago, and Im trying over and over to kick the habit with out cuasing any other habits. I always get to about 24 hours and it just becomes to much and i start back up. I wish I could quit and want to more then anything, but i find myself still using and making it even worse. I am week and just wish for the strength to just quit. My yearning to quit makes me so depressed, but some how when i put it down and start withdrawl i feel as though that is all I want. then im high and want to quit and keep saying this is my last bundle and really at the time feel it is, until i feel the pain mentally and physically and just forget about everything that matters and just want to get high. its a never ending bad cycle. Any suggestions on kicking would be great.
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    #8
    Bluelighter Spucky's Avatar
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    Also Clonodin is very effektiv for the Pain and it's calm you!
    Attention, can be very dangerous- get the rigt info. before!!!
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    #9
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    very well done. however, if this is an OTC guide to w/ding - why are benzos included since they are obviously not OTC drugs?

    besides this you included everything I could think of.
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    #10
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    I put them in there because they are practically OTC for some folks! (Though that is very dangerous thinking.) Maybe I should create another section of the guide and put it there... what do you think?
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    #11
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    I think it is perfect the way it is. it was just a misnomer of sorts because the title was misleading. maybe you could just change the title or something... ? I don't know, it's your call. I have to say this guide is up there with phreex's opiate w/d guide - which is saying more than I can express
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    #12
    Bluelighter staypuft's Avatar
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    great work on the guide...

    just to add some hearsay: eating lots of cheese helps with the w/d

    oh...and since benzos were included in the guide and they're not exactly OTC i can probably also add that Ketamine completely stops (postpones...?) all the physical and mental withdrawl from opiates...

    i managed to not get dopesick for a couple of days by doing an IM every hour or so a while back...but i would NOT recommend this to anyone
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    #13
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    -bump-
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    #14
    I can't belive that you have to taper from Immodium, are you sure?
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    #15
    Bluelighter hazejunk's Avatar
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    we schould make this a sticky
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    #16
    Weed
    This is a great help but I go with good old Pepto Bismol. The mental part is a MFer and tapering is real hard when I know I have more available to do.
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    #17
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    Quote Originally Posted by PIC
    I can't belive that you have to taper from Immodium, are you sure?
    Positive.
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    #18
    Im normally a pretty energetic guy and excercise all that mumbo jumbo, but when withdrawing I just lock myself up in a room curl up and spend the next 3 days sweating and going mentally insane.
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    #19
    Bluelighter 'medicine cabinet''s Avatar
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    great guide...i just recently kicked myself. i had 2 8mg suboxones about 10 1mg xanax 5 10mg valium, 6 .2 mg clonidines and weed and booze...in the peak of the WD the clonidine really helps with the "shock" feeling, although too much xanax/valium and clonidine you will fall out of bed and bump your head...i know i did....i got outta bed and had an insane headrush and str8 fell over in blackout mode for a hot second haha..but thats what i did this time to kick, done it dozens of times....no easy way to do it, the way that works the best imo is straight cold turkey

    ^^its what tokey said, locked in a room fetal position going bonkers for 3 days. its the most cathartic experience i think ive ever felt...getting so sick you are almost immobilized because it feels like your skin is melting and it hurts so bad to move. i always seemed to stay cleaner longer when i did it that way...relapses are part of the "road to recovery" but they still suck...
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    #20
    depending on where u are. GBL will stop most of the cluck. although-hardly-otc-in-america-and-some-evidence-it-acts-on-opiod-receptors-but-no-withdrawal-from-it-after-3-4-days-which-should-cover-the-rattle
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    #21
    Loperamide IS NOT an opiate...
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    #22
    I'm sorry but I really don't think that you have to taper with Immodium, do you have any scientific literature to back that up? On the other side, I remember reading somewhere that it is an opiate which has a quite similar chemical structure to fentanyl.
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    #23
    OK look fuckers, loperamide is a piperidine, its not related to phenathrenes like moprhine or oxycodone, but then again neither is fentanyl, so whats your definition of opiate?

    You can discount what i say all you want, but i have plenty of credibility here both on this board and from real life experience and education, and i know for absolute certain that loperamide IS ACTIVE, it WILL stop withdrawl, not just symptoms, withdrawal itself. I've theorized as to the route of its action numerous times, one of the following is true.

    A) it does make it into the brain in amounts far less than huge doses with enzymatic inhibition

    B) a metabolite of it makes it into the brain in normal doses with enzymatic inhibition, if you stop metabolism of the primary route, secondary routes then become active in larger percentage.

    C) loperamide or a metabolite bind to opiate receptors peripherally, and cause CNS activity that way.

    Every single one of those routes is both possible and likely, so dont post crap about drugs having to get into the CNS for activity, and yes loperamide likely DOES get into the brain in only slightly higher than normal doses if you use an enzyme inhibitor like cimetidine, i have 3 years experience screwing with it every way possible.

    And yes, if i had stopped taking it by itself there would have been withdrawl from it alone, so by implied logic you therefor have to taper it if youve taken enough for a period of time.

    6mg isnt going to do shit though, in a tollerant person 6mg isnt even going to be capable of putting a dent in withdrawal, your not going to get to the point of needing to taper if you only take 6mg.

    48mg, yes, that point you would need to taper it back down, because 48mg is active.
    Last edited by TheTripDoctor; 25-06-2006 at 03:01.
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    #24
    "i have plenty of credibility here both on this board and from real life experience and education"

    Yeah, whatever man, do you have scientific literature to back it up? I just want to see where it says that one can withdrawal from Immodium. Forget your credibility, that is quite subjective.
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    #25
    TripDoctor,

    What dose of loperamide would you recomend someone start out if they were taking around 60mg of hydrocodone/daily, but quit taking it and is in w/ds? I've used loperamide to help stop up my liquid G.I. tract, but have never noticed it helping with anything else. Just keeps you from shitting the bed when you are in withdrawal, basically.
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