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Need advice and help for opiate detox

Greed420

Greed420

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Joined
Oct 21, 2016
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47
Hi everyone. Im a 26 yo male, and I have a history of addiction to H (smoked then snorted). The past 4 years I was on methadone (100mg/die) and succesfuly quit thanks to my program, ( I live in italy and the addiction support and programs are free, thanks to god). This happen last march, but I relapse smoking opium and shit this summer, i wasnt physically addicted but my doctor suggest me to start suboxone (2mg/die) on August.
I stick with that, meanwhile I pass a test to study nursing at University, now my life is conpletly change, i dont care to get high, i want only to follow the lessons and get through the exams.

Now the tricky part, im physically addicted to bupe, i want to quiy and be clean and feel good the First of february (i will start to work on hospital for the School) and dont wont to br addicted anymore, but... I know that the WDs from bupe are beareble but too long in term of time. I got only 2 week to pass the WDs and I think something, now Ill explain:

Currently Im on .8mg bupe/die, i taper to .2 in couple weeks than switch to oxycodone to taper(I have some percocet 10/325, dont use to get high, i have it and stop) on 20th November, i taper down to 10mgs daily to 20th december and use the Christmas vacancy to get clean.
I now that may be sounds odd, but i need a quick WDs,i cant get sick for a month, i need to follow lessons and do 2 exams on January so i got only 2/3 weeks to complete recovey, thats why I choose to switch from an long lasting opiate like bupe to another with shorter half-life. Already detox from methadone, took me a month and a half to feel not-too-sick and sleep at least 5 hours,cant do it anymore like that.

Someone can suggest me a taper plan? How much oxy I will need to feel normal while tapering (from .2/.3mg bupe), should I took it extended or instant release? How much?

Thanks in advance for the help guys
 
Instead of using oxycodone towards the end of your taper, can you not continue your bupe exclusively? Or was this something your doctor suggested? It seems counterproductive to start taking oxy again if your goal is to quit opiates. I'm going to move this to Sober Living so you may get some tips on tapering.
 
Hi Greed, welcome to SL! Thanks T :)

Your goals with transitioning onto a shorter acting opioid to get off buprenorphine is something we run into occasionally. The idea generally is that the user is afraid of how drawn out the buprenorphine withdrawal will be and figure that if they "transfer" their dependency onto a shorter acting opioid it will be an easier kick. However, the reality is that it doesn't actually make it any easier or harder. I have yet to see someone who tried this approach end up finding lasting success, which it sounds is what you're looking for.

Now, that doesn't mean you don't have options or that your plan isn't viable in a sense. For one thing, if you were to take a low dose of other opioids for a week or two, you might theoretically be able to avoid much of the acute buprenorphine withdrawal. Given the kind of proper taper you're engaged in, the acute buprenorphine withdrawal shouldn't last more than 7-14 days. It will not be very intense however, likely limited to mild insomnia, GI issues and RLS.

The trouble with using something like oxycodone is that it has such a short half life. That will mean you'll probably need to take it more than once a day to stabilize during the acute withdrawal. However, taking it more often risks it turning into a self-reinforcing habit, which is something you definitely want to avoid if your goal is is abstinence from opioid substances. I really wouldn't suggest using the oxycodone to help you get off buprenorphine. If you must use an opioid, find yourself some methadone or do a 30 days methadone detox/taper at a clinic.

In terms of staying functional during withdrawal, first off it is important you continue to taper for as long as you can, to get as low as you can on your dose. How long have you been (a) using opioids, (b) using buprenorphine, (c) tapering off buprenorphine? When do you want to be off the buprenorphine?

You mentioned you want to get off the buprenoprhine because of your work environment. I will caution you that life transitions like that can be very difficult. I know in my case my drug use always escalated during transitions like that, whether new job, school or living environment. It took a long time and a lot of effort to overcome challenges inherent with life transitions, and frankly I have a lot more work to do yet.

Anyways, what I'm trying to say is that if the buprenorphine has been working well for you, continuing a very slow taper while you stabilize at your new job might be the wisest decision. The more time and effort you can put into preparing to get off buprenorphine, the better chances you'll have staying away from opioids and the less uncomfortable it will be. I took my time getting off methadone, and while it took about two years to transition off (taper), my experience of withdrawal was incredibly (mind-blowingly) manageable.

If you feel you absolutely must get off the buprenorphine before you start work, which again I don't think is the best idea given how stressful that transition can be, there are still things you can do outside of relying on opioids. First off, gabapentin, clonidine and diazepam (along with IBU, loperamide and perhaps caffeine before noon) will treat the vast majority of withdrawal symptoms. You'll still feel like crap during acute withdrawal, but these meds should keep you functional.

Are you working with a doctor to help you get off the buprenorphine? Highly recommend that. And in terms of actually getting of it, while I strongly suggest you wait to cross that bridge until you've stabilized at work, I'd definitely recommend looking into an outpatient based methadone detox program instead of using oxycodone or other opioids yourself at home to try and treat the withdrawal. There are just too many risks involved there, and as you mentioned you seem to have other, more skillful options.
 
Last edited by a moderator:
Thanks a lot for the advice thootpaste.
Yes, i currently have a doctor who follows me for treatment.
I wish i will get clean for the 1st february (for clean i mean without any kind of withdrawals) I will have to deal with patiences, in work enviroment, take blood, pressure and take care of them. For that reason bupe scares me, dont want to go there with shaky hands and so, due to the WDs... If it will only took one week or two it will be fine, but last time with methadone everything was beareble but took month and half but i was unenployed and no University. Now i have to deal with real life stuff...
Only for time i though to taper from now to get clean with shorter acting opiate.
I understand your point of view for transiction releated stress, new enviroment, and so on. But the only thing that makes me anxious is that im addicted to bupe, woth all the thing implied. Hospital give bupe, i dont want to took my dose and than go to work in the same building... Dont want to be a junky nurse and, you know, the voices are always in the air if you know what i mean.Im happy with the new lifestyle i took, and want to keep it for me, my parents and my social life that i discovered again.

Ill give you some details,
5 years ago (maybe 6) start using H, first smoked than snorted. When a whole gram taked at once dont got me high i realized that i had a problem.
Go to clinic and start methadone for 4 years, occasionnaly took opiates but i wasnt high with such dose of methadone (100mgs).
Start taper methadone on december, on march i went in a day-hospital detox from 'done, and got clean. Last time i took my dose of methadone was 29 march.
I stayed clean for couple of months than relapse on summer, i wasnt took too much, i stupidly enjoyed so much having bot tolerance at all that i fuck myself up.
Told that to my doctor and she suggest me low dose of bupe.

Taking bupe 2mg (snorted) since August, my dose had some variations, from 1mg to 4mg but in the last month im stable to 2mg. I start taper, and now im at .8-1.0 mg (always snorted, i have pills and i find it easy to take .2mgs multiple times a day)
I can say im stable at this dosage.

For the WDs help:
In my stash I have pregabalin 75mg, a lot of it, xanax 0.5/1.0mg both, klonopin, trazodone (50mgs instant release and 75s extended release), mirtazapine 30mg, zolpidem 10mgs, muscoril, buscopan for IV/IM and NaCl 0.9% for the IV route. Almost everything I need, maybe more, for withdrawal. I miss clonidine that i found really helpful when I quit methadone in past.

Now you have the complete situation, i appreciate your intrest and help.
I have always in mind the oxy taper, but maybe i forget to mention that the equivalent of percocet in italy is called "depalgos" and is extended release (if not broke). So if I will do that I will need only two times a day.
 
I agree with everything tpd said. I think your playing with fire just by having the oxy around you. We often underestimate how awful withdrawal is. Your feeling confident right now because your getting medicated once you stop your going to be vulnerable add in the stress of a significant lifestyle change like nursing and your putting alot of pressure on yourself. I wish you could stop then have a couple months to get used to complete abstinence before you start at the hospital. If that's not possible your going to have to really be vigilant and self regulate your stress level and cravings. It's going to be difficult but if you have a solid support system it's possible. Keep posting here and keep us updated on what's going on with you.

All the best
 
Thank you cj, i know i will playin with fire and everything you said its true. When Ill withdrawal i will be a lot more vulnerable. I feel confident because when i quit methadone i had a lot of it in my house, maybe im odd but I want everything under control and paradoxically I was less anxious with that. Like " Im quitting because i want, not because I dont have it".
Yeah sounds weird...
I like take care of people, and this will fill my void left by the opiates.

By the way, thanks for the support, Ill keep posting here, updating my journey.
 
At least with your withdrawal and comfort meds you have you’ll be pretty comfortable making the transition. I would suggest you keep a backup plan in case you find you need to get back on buprenorphine or just some way to address a potential lapse just in case of a worst case scenario. Hope for the best, plan for the worst :)
 
Yeah I planned the taper but I have to think a "plan B" in case i will fail. Thanks for the advice. I have a couple of bupe pills (2mg) extra but I guess I will came back to my doctor if I fail, and she give me the suboxone again, thing I want to avoid but... Only chance in case of failure.
 
Little update:
I spoke to my doc and she will prescribe me clonidine for withdrawal. Working in a clinic for detox she wasnt that happy of my choice, but she trust me and decide to help with prescriptions (obiously not for the oxy, I mean clonidine, muscoril and stuff). Im happy with that.

I switch from bupe (now im at 1mg/day snorted - 0.5mg Morning + 0.5mg Noon)
to percocet this friday, so I have the weekend to find my optimal dosage to minimize withdrawal when the week starts.

Any suggest to tapering?
I guess 50mg a day, splitted in 10s can help me, but how long should I wait til taper again? 3days? 5days? How much to taper, 5 or 10mg once?

Considering that I start on 10th november and start withdrawal on 20th december, so a little bit more of a month. Now i got 650mgs oxy, soon I can get another 280mgs (28x 10/325 box). I wish to stay at 50/60mg for short period and maybe stabilize more on 30mg (only for the amount i have)
 
You can expect acute withdrawal from buprenorphine to last from seven to fourteen days.

How much oxycodone you should take to mitigate withdrawal during that time is really hard to say, but the less you can take the better. Try to just take enough to remain functional. Just barely enough to stop your from shitting yourself and whatnot.

Do not take enough to give yourself a buzz, or if you do try and stay just below that amount. Taper if you can, but as long as you don't take it for more than 10-14 days you won't develop another dependency onto the oxycodone. If you can take oxycodone no more than twice a day I'd shoot for that (once a day probably won't be enough and three times a day is probably more than will be absolutely necessary). There are a lot of unknowns with what you're doing however, so do what works for you. Just be aware that there are very real risks involved in trying to use oxycodone to detox yourself from buprenorphine, and be prepared with a backup plan.

Hope for the bet, but seriously plan for the worst.

Oxycodone is just hard to taper or use for the purposes you are, so I wish you lots of luck!
 
I just detoxed from opiates cold turkey after 8 years of heavy use. From oxy, to heroin, fentanyl, suboxone, methadone, and poppy seed tea. This was all spread out over 8 years, but a combo of heroin, oxy, and pst most recently. My husband gave me the option of him and my children, or my addiction. So I had to pick my family. ***disclaimer; I’m not saying the way I did it is good, but I have made it 9 days so far, and I figure the benefits outweigh the risks. Anyway, I went to a psychiatrist, and got Wellbutrin(for dopamine), and Zoloft (for serotonin), the two things you fry with heavy drug use. I took those for about two weeks so I wouldn’t go suicidal in the process. I kept myself dosed up good on Xanax, naproxen, Imodium, and vitamins, and stayed asleep. I got passionflower, valerian root, and some mineral supplements, and kept Gatorade at all times. I have only been clean 9 days, and it took a lot of support from my husband, and a shit ton of hot baths. The insomnia and restless legs is insane after the 3rd day, and nothing works. (Well, xanax, a muscle relaxer or 2, and a shot of Jim Beam, but I can’t suggest anyone else doing it.) I hate exercise, but that is the main thing that helps get your brain back to where it needs to be. Our bodies need to learn to produce their own endorphins again. The last two nights I went to a gym and got it good, and have managed to sleep through the night. Withdrawals are going to suck regardless, taper or not. It’s mind over matter homie, and just remember, the sickness is only temporary. You can taper the bupe 25% every 3 days, but it’s still gonna suck. Being free is so much better. You can also go to a regular physician and explain you don’t want to continue on government prescribed heroin, and they will give you zofran, clonidine, and a benzo. But holy fuck dude, it’s good to not be held hostage anymore.
 
Please keep us updated on your progress OP. I am curious if a month on oxy will cut down on the amount of time the withdrawal will last
 
Hi guys, sorry for my delay and thanks again for the advices.
I switched from 1mg bupe to 60mg/daily oxy a week ago. Im fine, and functional, I can go to University and pay attention to the lessons, go out with friends and study. Im happy for that. I tried to taking extended release forst days but I was I was keep redosing. Im trying take a 10mg instant release every 4 hours (sometimes 5), I sleep from 6 to 8 hours x night (thanks to trazodone or zolpidem if the insomnia is more severe).
Sometimes im little anxious when im alone, but with friends or school in happy. Im planning to switch to extended release the next week (when the bupe will be out of my system). 60mgs oxy cover me just to stay functional, to feel good or normal all the way i need a little more but i prefer be stable to this dosage.
I'll keep updating ASAP, maybe this noon, now I have to go.
Thanks to everyone!
 
I need a little advice guys, I found that the last 2 days i need a little more to stay normal. Its possibile due to the bupe that my body is eliminating? The first week 60mgs is enough, now i have to take 70/75.
I know that 1.2 mgs bupe daily is equal to 20/30 mgs oxy, but having different half lifes (oxy 3-4.5h While bupe 24-36h) I have to dosage that amount of oxy every 4 hours right? So its normal my situation? Im trying to keep wds at bay using the minimal amount, im not talking about buzz or anything.
Thanks in advance
 
It's difficult to say exactly what is going on, it could be tolerance. Increasing your dose is definitely not a wise thing to do if you are trying to get off. Tolerance is defined as having to take more of the substance to achieve the same results, but it could also be that the bupe has fully left your system.

Ultimately you are going to have to face WDs if you want to get off opioids completely. If you are trying to taper you shouldn't take enough to make you feel good, only enough to make the WD symptoms manageable so that you can function relatively normal. I would expect that during a taper you would probably be functioning at a level lower than normal. You will probably feel a fair amount of discomfort if you are tapering correctly. Your body will never be able to adjust unless you lower the amount of opioids you are putting into your system.
 
Thanks for the answer Mafioso (are you italian? Ahaha)
Yeah i know, i wasnt taking more to stay good but to stay functional. I saw that the last days 60mgs wasnt enough, especially in the evening. I releated this feeling to the bupe (almost 2 weeks off) but you're right to say on being on lower dosage and feel discomfort, I'll try to stay around 60s. Maybe was only anxiety that I have to face.
 
Greed420 said:
Thanks for the answer Mafioso (are you italian? Ahaha)
Yeah i know, i wasnt taking more to stay good but to stay functional. I saw that the last days 60mgs wasnt enough, especially in the evening. I releated this feeling to the bupe (almost 2 weeks off) but you're right to say on being on lower dosage and feel discomfort, I'll try to stay around 60s. Maybe was only anxiety that I have to face.
Click to expand...

lol no, got the name from a mac dre song I was listening to when I first register lol..

How long are you planning to stay on the oxy for taper?
 
I plan to stay on oxy until 16 december, when the holidays starts and lessons stops. Im stick with 60mgs/daily, my doc prescribe me clonidine yesterday and Im thinking about getting through this cold turkey...
 
Are you able to get anything other than clonidine? Gabapentin would also go a very long way to helping you deal with withdrawal. Clonidine alone is better than nothing, but gabapentin and/or buprenorphine would make an even larger difference. And there really isn't any reason for a doctor not to prescribe gabapentin along with clonidine.
 
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