Question about Loperamide for Opiate Withdrawal

[pseudonymph]

Hello fellow Bluelighters!
As many say, longtime lurker, first time poster. I was happy to become a member of this site because I've witnessed the overwhelming support and sencerity from all members and, although I'm quite nervous, I figured I'd share my experience and ask a few questions. I'd like to apologize beforehand if I am posting in the wrong section and/or breaking any rules.
NOTE: I am aware of The Loperamide Megathread however, I was unable to find the answers to my questions. Sorry if this post is redundant.

I'm twenty-five, recently engaged and a long time opiate user. It all started when I was a senior in high school. A friend of mine was addicted to numerous substances, I was naive and it wasn't until almost 5 years later whenever I was on a weekend trip and I'd run out of hydrocodone that I realized I was addicted.

At the first sign of addiction, I wanted to be done. I did everything that week to get clean and was determined to never use again. I was at work when I felt my first rush of sobriety, a smile smeared across my face due to the overwhelming joy of knowing my happiness was coming from a place of purity instead of a pill.

However, as luck would have it, on my 7th day sober I went to a local show and hugged a friend when my ear suctioned to his sweaty chest...I woke up my ex boyfriend at 4 AM the next morning screaming in pain and we went to the emergency room. After waiting 3 days to see my PCP and nearly losing my hearing (doctor said if I'd waited any longer I would've been deaf in said ear), I was put on anti-inflammatories, a steroid, antibiotics and...you guessed it – hydrocodone for my pain.

Needless to say, I relapsed. Went on Subutex for around 1 1/2 years and decided to stop a couple of months ago. Again, just my luck, I'd run out of my klonopin at the same time and I began praying for death. The withdrawals were unbearable. I wound up getting some klonopin from a friend who also had hydrocodone. That weekend, I was heading out of town to float the river with my fiancé and his family so, I bought a few.

It's been about a month or two now that I've been taking the hydrocodone again. My dose never went back to where it was. When I was at my worst, I was taking 80-130 mg per day of 10mg Hydrocodone. Now, I'm somewhere around 40 mg a day, sometimes less, sometimes more.

What I'd like to know is:
1.) being that I was on Subutex for all of that time and suffered through those w/ds only to cowardly fall back on my original DOC, how severe do you think the w/d will be?
2.) I've read about the wonders of Loperamide but I am a bit skeptical, is it possible that they will only prolong the w/d?
3.) If they will NOT prolong the w/d and this is a good route to take, how should I dose the Lope?

All input, personal experiences and opinions are appreciated. Again, I'm sorry if I didn't meet the guidelines and it was not done intentionally as this is my first post. I am more determined than ever to get off of opiates and be myself again. Thank you for reading. I am very eager to begin this journey. I only have a few Hydrocodone pills left and I am tempted to just toss them out and begin the w/d process. I hope to build some relationships on here to help the process along, have someone to talk to and potentially help others in similar positions.

 

[Thinkwithportals]

I have used loperamide twice now during my current withdrawal. I can't say how bad your withdraws will be. I would begin a slow taper down tbh, and go from there. Be forgiving with yourself, and take as long as you need. But stick to a taper. Overall I feel loperamide extends my withdrawals. There's many reports that it can't cross the blood brain barrier unless taken in heroic doses. Those doses often leave the person feeling very dehydrated and bloated, not to mention - when I have used it in high doses - the next day the gastrointestinal pain made everything about withdrawal worse. I would say use it as necessary, as directed. (For any GI discomfort.)
It DOES relieve some symptoms, and it helped me sleep a few times. But overall not worth it IMO. I have no real idea how it works or why, but it does - minutely. I have seen success stories of people using it and tapering, but I have also seen horror stories. I'd err on the side of caution.

have you heard of Kratom? It has its own set of withdrawals (I have a thread right now about what I'm experiencing) however, used cautiously it can be a godsend. I would gradually taper and look into Kratom, use Kratom once you jump off, then slowly taper the Kratom. Unfortunately there is no pain free withdrawal, what goes up, must come down. But it can be done! Happy to have you here at bluelight!

 

[simco]

Thinkwithportals is spot on in her post, OP. First, loperamide is great during acute WDs, taken as directed for GI distress. But taking large doses to stave off withdrawals will just kick the can down the road, at best. Lope definitely has a place in a modern kit of comfort meds. But I would be very careful about raising the dose above recommended levels.

TWPs is also right that it's very hard to gauge what withdrawals will be like before the fact. Over the years (in my own experience and reading the experiences of others on BL) I've been struck by how much variation there is from one kick to another. By and large, longer periods of using and higher doses *tend* to bring more severe WDs, but the uncertainty is too high to make any real prediction.

The surest way to reduce the severity of WD symptoms is to taper. Unfortunately, tapering with fast-acting opioids like hydrocodone is extremely hard for many people. With that in mind, TWP's suggestion about kratom is a good one. Kratom is, for the most part, much easier to taper than the kinds of opioids you've been using. You do need to watch out with kratom, as it can be habit-forming in its own right. But (and this is just my opinion) if the choice is between continued use of opioids and using kratom for a while, I'd definitely pick kratom. If that's something you're interested in, let us know...I'm sure several of us could recommend schedules for a kratom taper.

Another option would be to use suboxone (or subutex) for a taper. In many ways this would be preferable to a kratom taper, provided you have access to it.

The other big thing I wanted to bring up in response to your post has to do with setting expectations during recovery. I was struck by the two events that pulled you back to using when you tried to quit in the past, as well as your responses to them. Unfortunately, those kinds of 'bad luck' are more the rule than the exception during recovery...things like that happen all the time. It seems there's always a good reason to go back to opioid use. My biggest recommendation as you move forward is to try to build a healthy strategy for dealing with these moments. I always found that it was easier to weather unpleasant moments if I had a concrete strategy in my mind *before* the difficulty hit me. Personally, I had a couple people's numbers at the ready on my phone, with those people being alerted that I was likely to call in dire straights. Also I always had a backup strategy--a place I could retreat to when the shit hit the fan, such as a public library, the movies, a cafe, etc...anywhere but alone with my cravings. Unfortunately, tempting situations are always going to find us. The best we can do is to plan for them in advance. And if we slip up and use, the best thing we can do is to be kind to ourselves, understanding that recovery is a long, slow process, and get back on track as quickly as possible.

 

[third_eye_lasik]

I have to second the opinion of using kratom over the loperamide. The lope can help me at about 8-10mg range when I'm w/d from hydrocodone but in combo with kratom it can make the process 95% less shitty over the first few days. I have never been able to get any sort of buzz from high dose of loperamide(and believe me I tried) so maybe I'm less impressed with this otc med than most.

 

[pseudonymph]

Thank you all so much!

I actually have two bags of Kratom that I purchased a while back just to try it out. I don't know much about dosing that either. Although I've never really looked into it, that's absolutely an option.

That was a big concern. You know, usually I knew what to expect from Hydrocodone w/d but it's been so long I've forgotton and the Subutex w/d were definitely overshadowed by my Klonopin w/d which was a bummer because I never take more than recommended of the Klonopin and I don't use it recreationally simply because I don't like it. Now I'm going off on a tangent. Lol.

I will try the Kratom. Any advice on how to dose?

 

[pseudonymph]

Simco: this response was to you. I'm sorry, I don't really have the hang of this yet.

You're absolutely right. Anything can happen at any given time. I've researched everything under the sun for opiate w/d, actually my fiancé always makes fun of me for googling EVERYTHING.

Everyone where I'm from has turned to Heroin and recently, I met with an old friend who I hadn't seen in nearly a year who was a heavy user. Now, she's 10 months clean. I asked her what finally made her quit and she said, "I had to be ready. I didn't just want it, I was ready for it."

Might sound a bit silly but I feel that way as well. Bring it on!

 

[Thinkwithportals]

I would taper down as far as you can, wait until withdrawals are getting bad, and start with 2-3 teaspoons of Kratom scooped into 1 - 1 1/2 cups water, simmer (don't entirely boil) for about 8 minutes. Strain (I always poured it though an old stocking, and squeezed when it was cooled off.) Drink over the course of 10 minutes and see how you feel. Adjust your dose from there.
I would definitely stick to Kratom tea. Don't go get capsules from headshops, and definitely don't do extracts. The tea will also be much easier to come off of than any of that stuff.

 

[simco]

I would taper down as far as you can, wait until withdrawals are getting bad, and start with 2-3 teaspoons of Kratom scooped into 1 - 1 1/2 cups water, simmer (don't entirely boil) for about 8 minutes. Strain (I always poured it though an old stocking, and squeezed when it was cooled off.) Drink over the course of 10 minutes and see how you feel. Adjust your dose from there.
I would definitely stick to Kratom tea. Don't go get capsules from headshops, and definitely don't do extracts. The tea will also be much easier to come off of than any of that stuff.

This is almost exactly what I would recommend too.

 

[simco]

Simco: this response was to you. I'm sorry, I don't really have the hang of this yet.

You're absolutely right. Anything can happen at any given time. I've researched everything under the sun for opiate w/d, actually my fiancé always makes fun of me for googling EVERYTHING.

Everyone where I'm from has turned to Heroin and recently, I met with an old friend who I hadn't seen in nearly a year who was a heavy user. Now, she's 10 months clean. I asked her what finally made her quit and she said, "I had to be ready. I didn't just want it, I was ready for it."

Might sound a bit silly but I feel that way as well. Bring it on!

Doesn't sound silly at all to me.

For what it's worth, I had a very similar experience. I was a heroin user for about six years. I tried quitting for about two years with very little success...just a long cycle of quitting/relapsing and feeling increasingly awful. I certainly don't think I'm out of the woods or anything. But at this point it's been a little over 10 months since my last quit. And the big difference was that this last time I felt somehow 'ready' to done with the whole ordeal. I've never understood why this time was different. But mentally it just was, somehow. So I absolutely agree that a good attitude predisposes you toward success.

 

[Jabberwocky]

^couldn't have said it better myself.

pseudonymph, I suggest you peruse BL's Trip Report forum for trip reports of how people use kratom (not just for coming off opioids, but for dosing). Definitely visit erowid's kratom vault, another helpful resource for getting an idea of what kratom is like and how to safely and effectively use it.