What is a good taper to get off 25mg methadone
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Jabberwocky
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It varies, but in average 5-7 days. With big drops (so kinda what you were doing) it can take a longer. Some people end up needing a slight increase before they balance out (slight meaning 1-4mg).
I felt pretty good yesterday afternoon, but when I went to bed, the RLS (restless leg syndrome) started immediately. I had it in all four limbs very intensely. I took gabapentin - did not help, then .5mg of clonazepam - still no help and last I tried quinine (each an hour apart). Nothing helped it. It lasted 7 hours before I finally fell asleep. I did sleep from 4am til 8am this morning. I've got a headache this morning - maybe from taking those drugs to stop RLS? I don't feel any withdrawal symptoms at all today. I think I'm going to cut by 2.5mg today as I doubt it will affect the RLS problem. It's been a week since I cut last time. I'm going to get some cimetidine to see if it will help RLS - but I'm not sure how much I need to take. If toothpastedog is online today - please post and give me a suggestion on the cimetidine dose. The only other drugs I take now are lipitor (cholesterol meds) and 25mg of atenolol (blood pressure). I didn't need the atenolol until I began reducing opioids, so I probably won't stay on it. The Lipitor is for life. I know statin drugs (Lipitor) can cause leg cramps and maybe RLS, but it has never affected me that way - I've taken it for at least 20 years.
When I get RLS, it starts just as I get relaxed enough to fall asleep. It feels like sharp pain going down the nerve branches in my limbs and it grows in intensity until I move the affected limbs, then it stops. Only a few seconds later, it does it again - over and over for hours. If you can imagine it, I'm laying in bed doing "Laying down" jumping jacks with my hands and legs just to stop that pain. If I get up and go sit on the couch, it stops instantly. I've tried falling asleep while sitting up, but it still does it. I'm getting desperate to stop the RLS but I'm not taking more opioids. If anyone out there has experience with finding a good cure for RLS, please post.
When I get RLS, it starts just as I get relaxed enough to fall asleep. It feels like sharp pain going down the nerve branches in my limbs and it grows in intensity until I move the affected limbs, then it stops. Only a few seconds later, it does it again - over and over for hours. If you can imagine it, I'm laying in bed doing "Laying down" jumping jacks with my hands and legs just to stop that pain. If I get up and go sit on the couch, it stops instantly. I've tried falling asleep while sitting up, but it still does it. I'm getting desperate to stop the RLS but I'm not taking more opioids. If anyone out there has experience with finding a good cure for RLS, please post.
Jabberwocky
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It looks like there will be some interaction between atenolol and cimetidine.
If you only take cimetidine for a couple day it shouldn’t be a problem, but I’d tread really lightly and do your own research on the combo. Try to keep the cimetidine infrequent. Don’t need to deal with any more side effects on top of everything else.
To potentiate methadone folks usually use about 600mg cimetidine like 15 minuets before taking methadone. But again I’d be cautious combining it with your BP meds. It doesn’t look there are life threatening interactions right off the bat, but enough interaction to be concerning with heavy or long term use.
How much gabapentin did you take last night? Bad RLS has required 1200-3000mg gabapentin for me in the past, so if you took less than 800mg gabapentin you might want to try taking more of that tonight. Same with the clonazepam, generally folks will use 1mg or more for withdrawal symptoms as opposed to the 0.5mg you took.
I doubt your headache is from the gabapentin and clonazepam. Normally they can be good for headaches, but who knows. I’d imagine it is more from lack of sleep/stress of the withdrawal from this rather aggressive taper.
How is your food intake and hydration going? That could also making the tapering withdrawal worse.
Have you tried taking a nice hot, long bath or shower prior to going to bed? That can really help with RLS, if only for a while. Also do try some Tiger Balm if you can find it. That stuff really is golden for RLS.
If you’re able to perhaps you could get a massage somewhere? That can really really help with withdrawal shittiness. Likewise stuff like manicure where you take care of your body can actually also really help.
Tapering and withdrawal is a great time to pamper yourself!
If you only take cimetidine for a couple day it shouldn’t be a problem, but I’d tread really lightly and do your own research on the combo. Try to keep the cimetidine infrequent. Don’t need to deal with any more side effects on top of everything else.
To potentiate methadone folks usually use about 600mg cimetidine like 15 minuets before taking methadone. But again I’d be cautious combining it with your BP meds. It doesn’t look there are life threatening interactions right off the bat, but enough interaction to be concerning with heavy or long term use.
How much gabapentin did you take last night? Bad RLS has required 1200-3000mg gabapentin for me in the past, so if you took less than 800mg gabapentin you might want to try taking more of that tonight. Same with the clonazepam, generally folks will use 1mg or more for withdrawal symptoms as opposed to the 0.5mg you took.
I doubt your headache is from the gabapentin and clonazepam. Normally they can be good for headaches, but who knows. I’d imagine it is more from lack of sleep/stress of the withdrawal from this rather aggressive taper.
How is your food intake and hydration going? That could also making the tapering withdrawal worse.
Have you tried taking a nice hot, long bath or shower prior to going to bed? That can really help with RLS, if only for a while. Also do try some Tiger Balm if you can find it. That stuff really is golden for RLS.
If you’re able to perhaps you could get a massage somewhere? That can really really help with withdrawal shittiness. Likewise stuff like manicure where you take care of your body can actually also really help.
Tapering and withdrawal is a great time to pamper yourself!
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Thanks for the advice TPD. I took one 300mg gabapentin. I have no fear of cimetidine and atenolol. I am on the lowest dose of atenolol and I could stop it. I normally have good blood pressure. My concern about taking more gabapentin is having to go through some kind of withdrawal later from it. I will try the hot shower tonight - it does sound like it would help. Massage? Yes, yesterday and the day before. My back has been sore from lack of pain meds and the massages have helped a lot. As far as diet goes, I'm mostly vegetarian with diet, but I do eat a good variety - just no animal products and I stay hydrated. I think I'm doing this the right way - but I absolutely have to stop the RLS. Maybe tonight will be better... Anyway thanks.
Jabberwocky
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Most folks don’t have issues taking gabapentin for a month or even more. If your RLS is really bad I’d highly recommend 800mg or 900mg tonight (900 is you only have 300mg pills/capsules). Compared to opioids or benzos dependency, it’s takes quite a bit more gabapentin use for it to be an issue.
Just trying to say I don’t think you have anything to worry about the gabapentin. Worse case scenario you can taper off it if you use it for like three months, but you very well might not even have to. And that’s taking it daily for three months. Very forgiving stuff. Dependency can be nasty, but it seems to develop over longer periods of time (in many cases like years).
Just trying to say I don’t think you have anything to worry about the gabapentin. Worse case scenario you can taper off it if you use it for like three months, but you very well might not even have to. And that’s taking it daily for three months. Very forgiving stuff. Dependency can be nasty, but it seems to develop over longer periods of time (in many cases like years).
N2theavenue
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Ok, so I will try this again! Lol. To answer your first question it took 28 days. Which feels like a lifetime when you are that sick, but it was so entirely worth it. I was 8 days before I got my first nights sleep. I actually found the Thomas Recipe online on that 8th day. I immediately went to the health store and bought every vitamin on the list. I didn't look for and wasn't interested in any of the prescription meds recommended.
I did read in the same post where I found the Thomas Recipe to take high doses of the melatonin. So I did some research to find safety facts and potential risks, and couldn't find any. I took upwards of 150 milligrams. The very first night I tried it was the first night I got sleep.
The RLS was the hardest part for me. Diphenhydramine made it 100x worse! I did find though that I could take small doses of Nyquil and it wouldn't exacerbate my RLS. It faded after about day 12. After that was the general body aches, vomiting whenever I ate, no appetite, severe stomach upset, the chills and hot flashes etc. But getting the sleep helped so much. I'll never forget on that 28th day actually feeling hungry and eating a meal that didn't make me sick. It was the best feeling in the world.
Nights were the worst for me, and I lived in a hot bath. I did force myself to be somewhat active in this time. I went to the beach, out to the store, even took my kids to the zoo one day. Walking felt like I was constantly walking through water and I was weak from dehydration and not eating enough. It's important to try and hydrate as much as you can. I forced myself to drink Gatorade.
I have to mention that I am a particularly strong willed individual. I decided early on that I was going to get through this if it killed me, that I would not get inside my own head and that I would keep a positive mind. My husband, on the 4th day, tried to talk me into going back to the clinic. He was weaker just watching me suffer than I was doing the suffering!
Having him was a huge help. He was very against drugs of any kind but completely supported me, albeit angrily, when I confessed my addiction and started methadone. He was my number one fan.
I had heard that mantra one time "this too shall pass" it's something they have children in the burn unit repeat to themselves when things get particularly bad. And when I was rocking back and forth in the bathtub, skin crawling and belly clinching, I would repeat that to myself over and over. And it did pass, all of it. And I had many good years of sobriety before a stupid simple surgery put me right back into it.
I did read in the same post where I found the Thomas Recipe to take high doses of the melatonin. So I did some research to find safety facts and potential risks, and couldn't find any. I took upwards of 150 milligrams. The very first night I tried it was the first night I got sleep.
The RLS was the hardest part for me. Diphenhydramine made it 100x worse! I did find though that I could take small doses of Nyquil and it wouldn't exacerbate my RLS. It faded after about day 12. After that was the general body aches, vomiting whenever I ate, no appetite, severe stomach upset, the chills and hot flashes etc. But getting the sleep helped so much. I'll never forget on that 28th day actually feeling hungry and eating a meal that didn't make me sick. It was the best feeling in the world.
Nights were the worst for me, and I lived in a hot bath. I did force myself to be somewhat active in this time. I went to the beach, out to the store, even took my kids to the zoo one day. Walking felt like I was constantly walking through water and I was weak from dehydration and not eating enough. It's important to try and hydrate as much as you can. I forced myself to drink Gatorade.
I have to mention that I am a particularly strong willed individual. I decided early on that I was going to get through this if it killed me, that I would not get inside my own head and that I would keep a positive mind. My husband, on the 4th day, tried to talk me into going back to the clinic. He was weaker just watching me suffer than I was doing the suffering!
Having him was a huge help. He was very against drugs of any kind but completely supported me, albeit angrily, when I confessed my addiction and started methadone. He was my number one fan.
I had heard that mantra one time "this too shall pass" it's something they have children in the burn unit repeat to themselves when things get particularly bad. And when I was rocking back and forth in the bathtub, skin crawling and belly clinching, I would repeat that to myself over and over. And it did pass, all of it. And I had many good years of sobriety before a stupid simple surgery put me right back into it.
CfZrx
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O.M.G. I can't even imagine. You mean it STARTS getting really bad then?? I was so ill by day 2 I could barely leave the house to get my refill. From what I read though, many, many of us have gotten off the Done. I bet I could do it if I had a lot of benzos like SoCal424
That, some kratom, and weed, and a taper would be possible if one didn't need to go to work imho.
CfZrx
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What an AMAZING story!!! Are you back to Done, or just measly old painkillers like oxy?
Thank you N2theavenue. Maybe I just need to give it more time - I'm feeling impatient that I have symptoms day after day. I'm sitting here now feeling very tired and sleepy, but I have RLS (restless leg syndrome) so bad that I can't get sleep. This one symptom is just about the worst of it. I think I'm 14 days into this, but I am only halfway to zero as I'm cutting bit by bit. Thank you for posting. Sounds like you have a very caring husband. I'm glad he stood by you.
Jabberwocky
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O.M.G. I can't even imagine. You mean it STARTS getting really bad then?? I was so ill by day 2 I could barely leave the house to get my refill. From what I read though, many, many of us have gotten off the Done. I bet I could do it if I had a lot of benzos like SoCal424
Well, I mean that by day five most of the methadone built up in someone system has left, so the withdrawal sets in in fuller force than it would while there is still a little bit in there hanging around. For someone who tapered down to a very low dose it can get bad before day five, but yeah... day five is generally when it begin to peak.
The good news is that withdrawal can be managed fairly easily, just as long as one doesn’t jump off at a high dose (say, 60 mg or 80mg or more). Just as long as they have access to basic comfort meds (especially buprenorphine, gabapentin, clonidine, and diazepam).
Acute withdrawal from methadone takes about two weeks, but if someone gets off at a higher dose without tapering that can really get drawn out. But with a taper it isn’t comparable to what it’s like if they jumped off a high dose. The caveat is that by “taper” I mean at a minimum no more than 10% dose reductions per week. That is the fastest taper that seems to work well generally speaking, and even then it would be better if the person had time to take breaks from their taper as well. Rushing to try and get off can be counter productive; the key to managing an effective taper is taking ones time without losing the motivation to get off. It’s a kind of balancing act, and it helps to have things like quality therapy, stuff like MBSR/MBCT/MBRP
A good reason why tapering is so important. There are different ways to taper, but my strategy was a really slow taper over about 18 months. At the beginning, starting from 80mg, I would drop by 5mg a week. I took a few weeks off tapering around 60mg, then I reduced the taper to 2 or 3mg per week. Around 40mg I took another break, and reduced the taper to 1mg a week. I took another short break from tapering at 30mg and then again around 20mg.
I jumped off methadone at 14 or 15mg. Would have continued tapering, but I was getting tired of dealing with the new manager at the clinic I was at (the original manager who was there when I started was great, but the new one was a bit less understanding; she tried, she just seemed a little less experienced and overworked). I transitioned off methadone by using codeine for three days, then inducted on buprenorphine.
To treat acute withdrawal I took 2mg buprenorphine, 10mg diazepam and 0.2mg clonidine twice a day, and gapabentin 3-4 times a day, 200mg buproprion (I had been in this while taking methadone) once a day in the am and 150mg trazadone before bed. Also took like 3mg melatonin at night.
Detoxing wasn’t fun, but it was infinitely more manageable than I had expected. Tapering and comfort meds go a long, long way. I had also learned how to meditate while tapering off methadone, and that was incredibly helpful (that was really the core of all this for me, helping me disassociate from the discomfort and withdrawal, which made it much more manageable; sometime I’ll write about this). I did use iboga and DXM while tapering and especially once I finished the acute detox, and especially with the DXM it made the process a lot more manageable, experience very little in the way of cravings or PAWS).
I also did an IOP program for 90 days post detox, which was helpful overall (probably better than nothing, but far from ideal; the program I chose after a lot of research, making sure it would meet my needs in terms of physical, mental and psychosocial/spiritual support). During those 90 days I lived at a “transitional living” place. That was less than ideal, but it was better than the environment at home.
Eventually family I lived with started getting the support they needed to manage their own mental health stuff, and once they started getting support that wasn’t the conventional Alanon crap, that made my life infinitely easier. Doing work with family during this process was very important in terms of my on going process and stability. Having a family member who is getting help themselves and refuses to just ditch their relative suffering from addiction as many will was incredibly supportive, and I doubt I’d have gotten this far without the support they received for themselves.
That’s basically the story of how I got off methadone. I did a little interview about my experience with treatment earlier this year, and this summer I’ll be writing a review of that which will cover a lot of my history in more details. I’ll post it in blogs sometime in June or July, so stay tuned or something
How you doing today OP? Did more gabapentin help with the RLS?
OP here: I cut 2.5mg/day yesterday, so right now I feel cold again - which I expect (I can dress warm). I had RLS again last night and it was honestly pretty rough because it was in both arms and both legs. I took gabapentin last night and one half of a 1mg clonazepam, but the RLS kept me tossing and turning til after 2am. Once I feel asleep, I stayed asleep til 7am. I have two very loving yellow labs that came to make sure I was awake to feed them and they seem to have built in clocks for 7am. They are very therapeutic for me - my best friends.
I was taking 1 300mg gabapentin pill at night, but I'm going with 1 three times a day to see if that helps. Today I am sneezing but that doesn't really bother me much.
I got a book once on how to have an out of body experience without drugs. It was a thick book and I got bored with the slow speed reading. Maybe I'll pick it back up again. I could use a good long out of body experience this morning - and tonight as well b
I was taking 1 300mg gabapentin pill at night, but I'm going with 1 three times a day to see if that helps. Today I am sneezing but that doesn't really bother me much.
I got a book once on how to have an out of body experience without drugs. It was a thick book and I got bored with the slow speed reading. Maybe I'll pick it back up again. I could use a good long out of body experience this morning - and tonight as well b
N2theavenue
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Thank you! It was oxy but I've switched completely to kratom and have been off the pills for a couple of months. So it could be worse for sure.
Jabberwocky
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Overpriced kratom is sold at many smoke shops, but it’s a better idea to order it online. There is a subreddit with info on supplies and such. We don’t allow sourcing discussion for kratom on BL unfortunately.
Funny thing I didn't share earlier: I was sucking on a piece of candy last night when I finally went to sleep. This morning, when I looked in the mirror, I noticed red drool down the side of my face, neck and all over the left shoulder of my tshirt. Reminded me of a drunk that had passed out while still drinking (I saw that happen more than once in L.A.). And here I am doing the same thing - embarrassing, but I can tell you ppl on bluelight and you'll understand - right?
The one thing that I have not stopped doing through all of this is running on my treadmill. I usually do 40 minutes a day at 4mph and 5% incline. I've done this for years and it actually had grown boring. But after I cut down on methadone, it's not boring anymore. Instead, it's a real struggle. First five minutes, my new mantra is "I can't do this today - I have to stop - maybe later on" but if I push through it, I get to six minutes were its "okay - I'll just go for 7 minutes. then 8 and finally after 40 minutes of mind games, I finish feeling very glad that I did it. That reminds me of when I first started using a treadmill. Anyway, I'm glad I didn't quit doing that because it feels like I'm still hanging on to my normal life. It's good to find something - anything - that brings us back to when life was normal - if you can find that, never let go of it. I have that and my two dogs. I raised them from puppies (one is 9 months old and the other 6 years) and I'm sure I'm just as bonded to them as they are to me.
The one thing that I have not stopped doing through all of this is running on my treadmill. I usually do 40 minutes a day at 4mph and 5% incline. I've done this for years and it actually had grown boring. But after I cut down on methadone, it's not boring anymore. Instead, it's a real struggle. First five minutes, my new mantra is "I can't do this today - I have to stop - maybe later on" but if I push through it, I get to six minutes were its "okay - I'll just go for 7 minutes. then 8 and finally after 40 minutes of mind games, I finish feeling very glad that I did it. That reminds me of when I first started using a treadmill. Anyway, I'm glad I didn't quit doing that because it feels like I'm still hanging on to my normal life. It's good to find something - anything - that brings us back to when life was normal - if you can find that, never let go of it. I have that and my two dogs. I raised them from puppies (one is 9 months old and the other 6 years) and I'm sure I'm just as bonded to them as they are to me.
Jabberwocky
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Exercise is great for recovery! Glad to hear you’re taking care of yourself like that
The more resources you devote to passions outside drug use, the easier your recovery will become. You’re fortunate to have a good head on your shoulders.
The more resources you devote to passions outside drug use, the easier your recovery will become. You’re fortunate to have a good head on your shoulders.
TPD: Thank you so much for your kindness and helpfulness. I am glad I'm not going through this alone. I apologize for asking about Kratom. I remember now that I shouldn't ask questions about sourcing. I really feel the withdrawals today more than this morning. Part of me is feeling like "if I'm going to feel like this, maybe I should just go to zero and get it over with." I'm very tempted to do that right now. I know me well enough that even if it got really really bad, it wouldn't make me relapse.
Today is my first day taking gabapentin 300mg 3x/day. I feel a little out of focus but still able to function. I don't know if it's that drug or the withdrawal - but I suspect it's the gabapentin. I do not feel any restless leg syndrome now while I'm up. I did feel it this morning even after I got up. I have Nyquil here. Anyone think it would be unsafe to try it for sleep (while taking gabapentin) if I have RLS again tonight?
Today is my first day taking gabapentin 300mg 3x/day. I feel a little out of focus but still able to function. I don't know if it's that drug or the withdrawal - but I suspect it's the gabapentin. I do not feel any restless leg syndrome now while I'm up. I did feel it this morning even after I got up. I have Nyquil here. Anyone think it would be unsafe to try it for sleep (while taking gabapentin) if I have RLS again tonight?
Jabberwocky
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No, it’ll be perfectly safe to sleep on gabapentin. You’re noticing some of gabapentins side effects, but with a week of use that will mostly go away - tolerance builds fast, but it’ll still help with RLS, it just won’t make you feel as out of it.
And no worries, you didn’t ask any sourcing questions, I just wanted to head that off if anyone saw the question about kratom.
There is a theory that once someone gets to 20mg tapering any further isn’t worth it and one should just jump off. I personally don’t subscribe to that, as my experience was that it was worth continuing to taper. But there is no reason you can play around with it. You can always try going a day without and see how you feel. If it’s too much you can just pick up your taper where you left off.
And no worries, you didn’t ask any sourcing questions, I just wanted to head that off if anyone saw the question about kratom.
There is a theory that once someone gets to 20mg tapering any further isn’t worth it and one should just jump off. I personally don’t subscribe to that, as my experience was that it was worth continuing to taper. But there is no reason you can play around with it. You can always try going a day without and see how you feel. If it’s too much you can just pick up your taper where you left off.