Opioids The Opioid Withdrawal Megathread and FAQ

[agarttha]

Definitely waiting AT LEAST the 24 hours is the best thing you can do. Don't give in any earlier if you can help it or you may be in a world of pain

It's been 24 hours since I last shot up but I've taken a lot of tramadol in that time. Will sub put you into pwd if you're on tram? It seems kinda like cheating cos I haven't experienced any withdrawal symptoms (unless you count not being really high as a wd symptom, lol).

 

[keeping]

^ tramadol is still an opiod so almost certainly depending on how much you took and what your clearance rate is like

 

[Jabberwocky]

It's been 24 hours since I last shot up but I've taken a lot of tramadol in that time. Will sub put you into pwd if you're on tram? It seems kinda like cheating cos I haven't experienced any withdrawal symptoms (unless you count not being really high as a wd symptom, lol).

^ tramadol is still an opiod so almost certainly depending on how much you took and what your clearance rate is like

No, taking buprenorphine with tramadol in your system shouldn't put you into precipitated withdrawal. Never did whenever I would take them one after the other willy nilly. Same with loperamide. That doesn't mean tramadol (or loperamide) doesn't have its own nasty withdrawal syndrome, but it is a little different from classic opiates (very similar, but less intense on the GI symptoms and for some more intense on the neurological symptoms).

But when taking tramadol and then taking buprenorphine there isn't an issue of precipitated withdrawal such as with morphine or oxycodone (or any opiate/opioid agonist) and then buprenorphine.

 

[KraziKat]

So I'm trying to get clean from opiates, finally and for for good, after about fours years of fairly steady usage. My story begins likes most: chipping with percs, then on to 30 mg blues which I'd divide into quarters, then halves – always just swallowing the pills btw. Fast forward to last month when I was up to between 150 - 200 mgs of oxy (blues) a day.

Over the years, while waiting for pills, I'd use kratom 2 or 3 times a day, then I discovered suboxone, and would use that, maybe 4 mg or 2 mg, while waiting for the blues, but never for more than a week.

On March 31, I decided enough is enough. I ran out of blues, almost out of money, and decided now is the time. On March 31, I swallowed my last pills, procured 2 and a half 8 mg sub strips and began my detox journey. On April one I took 4 mg sub with the mindset to start tapering immediately.

Was using sub every other day and also a fair amount of alcohol and some MJ. A week after my last pill, I was a little high and drunk... I looked at my two kids (4 and 2), and just started sobbing. I then came clean to my wife that I need help.

While tapering down to .5 of sub I was hating the way it made me feel. I was in acute WDs every day and miserable. I decided subs are evil, and can't fathom being on them for YEARS like some people are...so I googled around and stumbled upon a site with someone suggesting using short-acting opiates to "rip the sub off the receptors" and then detox from the blues.

It made sense at the time, and I only bought 15 from the dealer, who said goodbye to forever. I texted my other source for pills as well and told him I'm out of the game. But after 3 days of using the blues and no sub, I'm regretting it. Just so confused.

Here's where I'm at: Today is Friday, I last took 1 mg sub on Sunday. I started on low dosing of blues on Tuesday, but of course ramped up to 90 mgs yesterday. Today I woke up feeling WDs, so have been on blue pieces spaced out throughout the day so far.

I have a total of 2 mg sub broken up into about .5 pieces, eyeballed. I have 4 blues left. I have a fair amount of kratom. I have MJ and booze, of course, and access to anything OTC.

I want to be free of this opiate addiction nightmare and vicsious cycle. How would you advise me going forward based on the above? Any help/advice is greatly appreciated. I'm a 41 year old father of two, btw, and I need to be present and well enough to care for them, and I need to be functional for work. I've decided I am NOT going to buy any more pills or sub strips to get through this. Or Ever again for that matter.

Thank you for reading and thank you in advance for any advice you may have!

 

[agarttha]

No, taking buprenorphine with tramadol in your system shouldn't put you into precipitated withdrawal. Never did whenever I would take them one after the other willy nilly. Same with loperamide. That doesn't mean tramadol (or loperamide) doesn't have its own nasty withdrawal syndrome, but it is a little different from classic opiates (very similar, but less intense on the GI symptoms and for some more intense on the neurological symptoms).

But when taking tramadol and then taking buprenorphine there isn't an issue of precipitated withdrawal such as with morphine or oxycodone (or any opiate/opioid agonist) and then buprenorphine.

do you remember what kind of doses you were taking? i've been taking pretty large amounts of tramadol (around 800 mg). i know that's dangerous but i've been also taking klonopin on top to hopefully minimize seizure risk. if it's a dose dependent thing, i don't want to take the risk, and might just taper off the tramadol as much as i can, get past the acute heroin withdrawal (now 48 hours without shooting up!), but do it quickly enough to hopefully not to get hooked on tram, whose withdrawals i've heard are particularly terrible. then i'd switch to sub if i feel like i need it.

man, i started taking opiates because i was very dissatisfied with my life, and they made me a much more outgoing, fun to be around person. i even got a girlfriend, the first relationship in something like 5 years. i actually got 2 girlfriends, one on each coast (i'm not a sleaze, they knew that long distance stuff wasn't for us, and we were free to explore when were were apart). they both dumped me by the way, in the same week too. what a bummer. they didn't know about my drug use, but they definitely noticed me gradually turning into a zombie.

anyway, i really envy people who are capable of natural happiness. i'm much worse off than i was to start with. opiates taken over my life and i'm more depressed than ever. it's definitely time to quit--i just wish it was easy to stop as it was to start.

thanks for the advice guys, tho the past two posts contradicted each other, so i'm still sort of confused.

 

[Jabberwocky]

If you have been taking that much tramadol, I suggest you take a more reasonable dose prior to switching onto the buprenorphine.

I have combined large (as in whoppingly large) doses of tramadol with buprenorphine before, similar to what you described (for some reason I seem to remember the number 700mg), although I truly do not recommend it. Having something like clonazepam in one's system is better than nothing but hardly a safe alternative to taking a more reasonable dose of tramadol.

Tramadol is not and does not act similarly to full agonist opioids, which are what you need to worry about when it comes to precipitated withdrawal. Start your own thread specifically on this topic if it is not addressed satisfactorily here (so you are feeling more comfortable I mean).

The reasons you started to use opioids sounds precisely why I was drawn to them. They are an incredibly effective remedy for malaise and dis-ease, just as long as one can find ways of keeping use from getting out of hand (I would say rising seizures taking as much as you are is getting a bit out of hand TBH).

Hope you are able to find some success getting to a more balanced place with your use!

 

[gmlifer]

Anyone had any success with mushrooms? I took some last night and I'm having next to no withdrawal symptoms today. I'm actually in a good mood and have energy.

I'm basically on day three which is the worse for me. I CT 120+mg of oxy a day. I guess I'm wondering if this is a fluke or if the mushrooms actually did something to make the withdrawals go away.

 

[KraziKat]

It may have worked! I'm toying with dropping a half hit of L to combat some acute WD symptoms, yet fearful of being a tippy, uncomfortable mess for hours on end... keep us posted if your symptoms do or do not return!

 

[gmlifer]

It may have worked! I'm toying with dropping a half hit of L to combat some acute WD symptoms, yet fearful of being a tippy, uncomfortable mess for hours on end... keep us posted if your symptoms do or do not return!

So far so good man. Almost feel like a normal human being right now. It's freakin nuts. ABSOLUTELY NO SYMPTOMS AT ALL!

 

[Needingafriend17]

I realize this is an old thread and I'm not really comfortable (just yet) with sharing my story with just anyone and that is mainly because I'm ashamed and I've hid for so long I mean if my own friends and family cant see something is wrong then idk what I can do but I need to do something. So if any of you kind people are willing to chat with me I promise I'm not a random psycho I just really need someone who can relate to me and help me out a little bit through verbal support. I'm at the point where I can't go any further w helping myself until I get some advice... please

 

[gmlifer]

I realize this is an old thread and I'm not really comfortable (just yet) with sharing my story with just anyone and that is mainly because I'm ashamed and I've hid for so long I mean if my own friends and family cant see something is wrong then idk what I can do but I need to do something. So if any of you kind people are willing to chat with me I promise I'm not a random psycho I just really need someone who can relate to me and help me out a little bit through verbal support. I'm at the point where I can't go any further w helping myself until I get some advice... please

We are all here to help but if you're more comfortable one on one you can pm me.

 

[reasonfreak]

I need help figuring out a induction / taper schedule. I have been using black tar heroin for 1 year at 2 grams a day. I was able to buy seven, 8 milligram subs off the street and this is all I will have access to. Advice on how to do this would be much appreciated. I have tried to kick 5 times this past year and have failed every time. PLEASE HELP

 

[No time for pain]

It may have worked! I'm toying with dropping a half hit of L to combat some acute WD symptoms, yet fearful of being a tippy, uncomfortable mess for hours on end... keep us posted if your symptoms do or do not return!

Congrats on your decision, KraziKat. I've been in the same place, detoxed inpatient (I'm middle-aged and was too naive to know that wasn't my only option. Traumatic lesson learned!), but because being locked down for the first (only) time was so unpleasant, I toughed it out and fast-tracked my taper to 3.5 days on minimal suboxone. I agree that subs are rough and not ideal for everyone. For reference, I have a rare, severe form of rheumatoid arthritis in my spine that's caused an unfortunate dance with pain management methods. When I kicked inpatient, I went in on 125mcg fentanyl patches, and 150mg/day oxy & hydro. Yikes. Seeing that # again still shakes me up. I had an old school doc that was obviously liberal with the meds. Well, since I'm in Utah, the holiest, puritanical state of the Southwest (no doubt ground zero for anti-opioid mania) they yanked his license. Leaving me without the epic amount of opiates. Apparently, I was on the lower end of his patients in the amount prescribed, so I was able to go to another pain clinic, provided I detox and start over. That was November 2016. I was scared at first, but I'm so glad I did it. That was an insane amount for a 36 year old with a long road of worsening symptoms yet to travel.

Fast forward to last week: I had a rough, rough month of pain/anxiety from life and I threw all self-control out the window. I went through my entire month of 10mg oxy, 5x/day in 2 weeks, with 2 weeks of SOL, nada ahead of me. I battled the demon monkey perched on my back hard enough to have 3 pills left to taper. Of course, that was a joke. I took the last of it on Friday, 6 days ago. However, there's a light at the end of this tortuous tunnel. I had 2.5 days of decent discomfort (yawning, sneezing, nausea, EM EFFING UBER RESTLESS LEG SYNDROME), all of which were manageable enough with OTC Imodium, dxm cough syrup/Benadryl, lots o' edible MJ, and alternating Flexeril and Zanaflex muscle relaxers for the RLS/knocking me out enough to sleep a few hours. By the 3rd day, the most unbearable symptoms of yawning and kicking were substantially better. Days 4 & 5, I just felt mildly fluey with low fever, achy and generally run down. Day 6 today, and I feel completely human again. & with a stronger resolve to take my meds as prescribed because it's not fun otherwise. So, it's possible and not unbearable without subs. No w/d is painless, but I wish success to all of you trying. Hang in there!

 

[No time for pain]

I need help figuring out a induction / taper schedule. I have been using black tar heroin for 1 year at 2 grams a day. I was able to buy seven, 8 milligram subs off the street and this is all I will have access to. Advice on how to do this would be much appreciated. I have tried to kick 5 times this past year and have failed every time. PLEASE HELP

Congrats on trying again, I'm sure you'll be successful this time. 1/2 the battle is mentally prepping yourself. Even with subs, it's not painless. You just have to constantly remind yourself that the discomfort is temporary and a hell of a lot better than waking up in w w/d and the rough lifestyle that accompanies most heroin use. Besides subs, your next best friend is Imodium, ibuprofen, & any form of fluids with electrolytes. I had a monster tolerance when I detoxed the first time, & figured out that I was super dehydrated on the 3rd day. 3 Smart Waters later, I felt so much better. A good chunk of my misery was from dehydration (also the reason that separates a normal hangover from a class V bangaroo, FML hangover).

Taper schedule*: MOST IMPORTANT RULE, don't take your first sub until 24 hrs after your last use. Be in decent discomfort from w/d before starting. Precipitated w/d is a bitch. Day 1, cut the strips into 4. Take a 1/4 piece (2mg) every 4-6 hrs. The longer you wait between, the faster this process goes. Just don't let yourself get miserable. I'd try to 1/2 your entire day's dose, every day, including the times you take it at night to sleep. You don't want to start a sub habit, so the faster you kick, the better. Much luck & I hope all goes smoothly!

*i am not a medical professional, however, I've had experience successfully detoxing from a much higher, longer term dose than should've killed me.

 

[Phil.McKeer]

Just a quick addendum to everything No Time just said which I agree with:

Check out the COWS (clinical opioid withdrawal scale). You want to score at least a 25 before it's safe to induct and you may want to wait even longer for good measure. Remind yourself that relief IS coming; it's worth it to suffer mildly for an extra few hours than to rush it and be in pwd (which is far more painful) for several hours+. So its not exactly a "24-hours fits all" scenario. You may need more time.

Also, for induction, I prefer using even less than 2mg at a time; as a prophylactic against pwd, I recommend taking 0.5mg every 30-40 minutes until well. This will ease the bupe onto your receptors in an orderly manner and won't clash with any lingering opioids still in your system. After around 1.5-2mg and a couple hours have passed, if you haven't gone into pwd yet, you can be reasonably certain that you won't, and will be able to take a larger dose at that point, if necessary (like 2, or even 8mg). You may also find that you are well after 2mg.

Good luck man.

 

[Opiemommy]

Question regarding milder than ever WD

Hi all
I'm new but wanted to chime in and ask for opinions regarding my current WD. Quick background:
I have been an on and off opiate user since 2003. This was when I had to undergo my first back surgery. I, for the most part, used very low level pain meds prior to and following the surgery for about a year in total. My real struggle started in 2015 when I was diagnosed with breast cancer. I underwent a double mastectomy and started chemo. During chemo I began having massive issues with my back. I had re-injured it prior to my cancer diagnosis but managed to stay away from narcotics. What we found was that the chemo has attacked the fast growing cells in my disc and was causing massive pain. This lead to a spinal fusion during which they ruptured the dura causing my spinal fluid to be depleted....And another surgery. Then a prevetative hysterectomy. So after a total of 5 surgery in 1.5 years, I am on some pretty heavy doses of pain meds. Prescribed 2 20mg oxycontin daily and 4 30mg oxycodone daily. Now, I go thru this in about 2 weeks. Occasionally, I will get about 5 75mcg fentanyl patches a month but that's a rarity.

I have been out of meds for 4 days but have taken about 12 mg of lope first time yesterday, 50mg of vyvance (prescribed) and around 1mg of tizanadine (prescribed) 3x during the day and around 4-6mg at night for sleep. I have had almost no WD symptoms. Just feelings of lethargy but not overwhelmingly and a mild case of waking more often through the night. I have been able to sleep an average of 6 hours per night. I've been able to get up and move around. No bathroom issues (even prior to taking lope on day 3) no mind funk, no real cravings, extremely minor sweats, no runny nose, no anxiety or any other symptom that I usually get in a massive way every time I run out of meds. I have gone thru WDs 8 - 10 times and have never found it to be this easy. Even with all of the meds I have taken this time.

So here's the ???...What is going on? The only difference I can think of is that I have given myself 2 B12 shots over the past 2 months and started on a massive dose of vitamin D.

Anyone that has an opinion I am totally open to hearing any and all. I would love to recreate this phenomenon if possible...

 

[fritzerman]

You may want to try sodium ascorbate (vitamin C) which unbelievably works great to eliminate withdrawal symptoms. I took it for three days, starting with one heaping teaspoon (about 5 g) after my last dose, continuing every two hours until diarrhea sets in, then back off the dose some but continue to take the sodium ascorbate every two hours. You won't feel great, but if it works for you like it did for me you will not have any severe withdrawal symptoms at all. You need to take it every two hours, which means you may need to wake up every two hours. For me, the withdrawal symptoms would wake me up at about the two hour mark, then I would take the sodium ascorbate mixed with a little juice, and the symptoms would subside in about 20 or 30 min. I would not have believed that this simple substance would work to eliminate withdrawal from oxycodone (100 – 120 mg per day) but it does. You can purchase a bottle of the powder on Amazon for about $25.

I was taking oxycodone at this level for about four years. I have some ibogaine here at my house that I was going to use, but decided to give the sodium ascorbate a try. It worked, and in my opinion is easier than the ibogaine. Certainly less expensive.

I have quit oxycodone and Suboxone about five times in the last 10 years. I have never tried heroin, but I understand that oxycodone is basically its equivalent. Obviously, I have trouble staying off opiates. However, for what it's worth, the sodium ascorbate has proven to be the best and easiest method to quit that I have found. Previously, I would have said ibogaine is the easiest method. DO NOT use ibogaine if you are taking Adderall or any other amphetamine because it will mess you up. I found this out the hard way the last time I used ibogaine and I was a mess for about a month.

 

[No time for pain]

Phil.McKeer: very good advice. That was the method that I used when tapering with bupe, but forgot to include that. It works so much more effectively. I didn't know about the COWS chart, so that's really helpful, thanks!

Opiemommy: I'm so sorry for what you've gone through! With my family history of breast cancer and my current Rheumatoid spinal condition, I'm possibly looking at a similar future. As far as easier wd, firstly, I'm glad it's not as bad, you deserve a break! It could be any number of things. I take a pretty heavy duty immunosuppressant (I refer to it as chemo-lite), and it seemed to me that on the days I took it (I take it twice a week, not daily), it seemed to offset my wd symptoms a bit. Has your chemo changed? Maybe the immunosuppressant serves to suppress some of the wd itself. Withdrawal might be partly an immuno response? You also might want to check out the loperamide thread on here. I had some lingering PAWS and was able to abate that with loperamide. I also found that tizanidine was the most helpful for the anxiety and RLS. Your personal chemistry will continue to change throughout chemo and after. It may have just changed in a way that offsets wd. Or, you're in constant discomfort from the chemo and spine problems that wd is less uncomfortable in perspective now. Plus, being women, we build a higher tolerance to discomfort over time I'm interested to see what you find, so please let me know if you do figure it out. Hang in there and feel free to pm me if you need some support, I can definitely empathize.

 

[No time for pain]

Oh yeah, the vitamin boosts of b12 and D are hugely helpful for pain during chemo, and probably helped wd. I didn't know until I had a scary deficiency of B6, B12, calcium and D, that my immunosuppressant BLOCKS absorption of those nutrients from food. Keep on top of those levels and take supplements if needed. Keeping hydrated with electrolytes will also help most of the wd symptoms at least a bit.

 

[Opiemommy]

I've been done with chemo for a while so I don't think that's having much to do with it but I do think the added D3 and B12 probably have been helpful. It's truly the only difference from the last WD I went thru. And absolutely as women we tend to be a bit me able to deal with the pain. ? I'm going to keep up with my weekly & monthly bitamin supplements and hope for the best. Im several days out now and feeling well. I've still had no real cravings but don't for the most part. I'm going to add additional C vitamins as well. I'm seriously considering not reupping my script this month. I still have pain but now that my receptors are beginning to clear it's much more manageable...maybe I'll have my doc prescribe something less heavy and see how that goes.

I'm sorry you're dealing with RA!! Not a pleasant issue!! Stay positive regarding your family history of cancer. It doesn't land on everyone that has a genetic statistical upswing and does land on some of us that have no family history of cancer at all! It's a nasty little disease but I'm kicking it's rear. I'll be sending positive vibes your way!!

Anywho...thanks for the reply and kind words!! ?