Bupe Coming off subs - questions on loperamide, restless leg syndrome

[Crankinit]

Been on subs for 6 years, after 18 months of tapering from 24mg to 0.625mg (had been dropping by 8th's or 16th's to keep it as painless as possible) I decided to try jump off. It didn't work out so I've settled for a rapid taper over the next week or two before trying again. I've got a few questions for people who've done this before:

Loperamide - is it useful for anything beyond diarrhea? I've read mixed reports on this, with some claiming it doesn't do anything else, while others claim it helps with the cramps and aches. I don't need it for the diarhhea yet, but the leg cramps are insane and anything which could help would be welcome.

How does loperamide interact with suboxone, if at all? I know it's not supposed to pierce the BBB, so I assume there's no risk of any kind of weird precipitated withdrawal type effect, but I'd rather be safe than sorry.

Finally, the leg cramps and restless legs. I'm open to any and all suggestions on this, I can tolerate the other symptoms, but this one is just driving me insane. For some reason it seems to be occurring at a much greater intensity than any of the other symptoms. I'm taking 30mg of valium a day, but my tolerance is so high it's not doing a ton. I'm taking as much panadol as I feel is safe for my liver. I tried voltaren but it eats holes in my stomach - ditto for aspirin and ibuprofen. Magnesium capsules by the handful. Weed helps a little, but only so much, and I don't like being in that weed fog constantly, even when I'm in withdrawal. The only one of the usual suggestions I haven't tried is gabapentin/pregabalin - I made the mistake of experimenting with IV gabapentin and telling my doctor about it, so I suspect I'll have a hard time getting a script. Even if I go to the effort of talking her into it, I've never found it to be a great drug for much of anything.

Anyway, any thoughts, suggestions, links or experiences are much appreciated

 

[tacodude]

It does pass through the BBB only to be pumped out shortly after. Besides that I can't help you as I'm not experienced

 

[Jabberwocky]

Loperamide and buprenorphine don’t seem to really interact in terms of precipitated withdrawal, at least not IME. Higher doses of loperamide will be helpful for RLS, but it isn’t a long term solution given side effects. Clonidine, gabapentin, baclofen and benzos are much more useful for RLS IMO.

 

[Crankinit]

Jesus, totally forgot about baclofen. Not sure how, since I used it for my back way back in the day when I was first getting into painkillers. Benzo tolerance is too high, gabapentin is unlikely for aforementioned reasons and clonidine is on the shelf for now because I already have borderline hypotension, but I'll definitely check with the doctor about baclofen tomorrow. Thanks

 

[Jaymanaa]

Gabapentin works wonders for me to prevent sheet karate as I call it. The minimum effective dose is around a gram though, lots of powder, and best done by parachute. Valium, while it might get me to sleep, only lasts for a couple hours where Gaba can last up to 6 or so. So for me, when I'm withdrawing from opiates, it's Valium to get to sleep, and Gabapentin to stay that way. Another good one that a lot of people forget is Librium, which is often given to folks suffering from the "shakes" due to giving up alcohol.

 

[Banus]

Let me share my experience. I have been taking 16mg of Subutex a week for a few years (a very low dose), and then I wen't off it cold turkey, and not many days after (I was in rehab) I discovered that Loperamide could possibly help me. And let me tell you - I've been using Loperamide for a year now, I take it once every 20-40 hours. I have been through doses of as low as 32mg and all the way up to 200mg (100x Loperamide pills). And right now I am on a daily 50tabs (100mg daily). I combine it with a handful of other drugs to prolong the effects by inhibiting the efflux of P-Glycoprotein and a few other potentiators. And it is indeed a real opiate, that works really well. The shit thing about this is that I am highly addicted to it. I have tried stopping - but withdrawals are really harsh, alot worse than Buprenorphine withdrawals. (Although I was only on 16mg a week, which is like 2-3mg a day.) And I have tried Buprenorphine two times in the last year - and it simply does not work for me anymore, my body goes into precipitated loperamide withdrawal, while my head gets the normal opiate feeling from Bupe, but my stomach is really upset and hardcore restless legs. Note that this was when I had taken Buprenorphine one day instead of Loperamide which I had taken daily for a long time.

Loperamide can be a life saver as a replacement if you can't get your hands on anything else, or if you want to stay "clean". Although I don't feel clean while I use it. Atleast not in the way a rehab result "clean" should be like. If you want to try Loperamide - be need to be aware of that it will cause your opiate tolerance to SKY-ROCKET.