Using tramadol to help get through methadone withdrawal

[hikfromstik]

SoCal424, you are my inspiration. I will be jumping off my 20mg methadone after the 4th of July. I have friends coming in for our vacation at a local lake and don't want to "seem" ill and bed ridden . I'm at the thresh hold of withdrawal and at this point I'm just extending the pain. Luckily I'm not at a clinic, so I have a great doctor that is letting me do it my way. I've gone from 130mg to 20mg in 6 months. It's time to make the jump. I've been on this crap for 15 years ,so I've been reading about what meds can cushion the jump. Looks like tramadol, clonidine and gabapentin is the way to go. I tried my wife's tramadol 50 cut in half to 25mg for a base line to see how it would help the RLS. It completely eliminated it . Since I'm still on the done, I'm probably not getting the opioid like effect, but the uplift from the serotonin norepinephrine, dopamine was the biggest surprise. My plan is to use the tramadol for 10days then the gabapentin for 20 or so days then only the clonidine. A close friend of mine is a drug treatment counselor. He said that tramadol is the most successful drug for methadone withdrawal symptoms.

 

[EPL1]

Hi hik,

You have found the best person in Dale/Socal to answer all your methadone quit questions. I just wanted to say I'm proud of you for quitting and I wish you the best!!

Here for you anytime,
your friend,
Ash.

SoCal424, you are my inspiration. I will be jumping off my 20mg methadone after the 4th of July. I have friends coming in for our vacation at a local lake and don't want to "seem" ill and bed ridden . I'm at the thresh hold of withdrawal and at this point I'm just extending the pain. Luckily I'm not at a clinic, so I have a great doctor that is letting me do it my way. I've gone from 130mg to 20mg in 6 months. It's time to make the jump. I've been on this crap for 15 years ,so I've been reading about what meds can cushion the jump. Looks like tramadol, clonidine and gabapentin is the way to go. I tried my wife's tramadol 50 cut in half to 25mg for a base line to see how it would help the RLS. It completely eliminated it . Since I'm still on the done, I'm probably not getting the opioid like effect, but the uplift from the serotonin norepinephrine, dopamine was the biggest surprise. My plan is to use the tramadol for 10days then the gabapentin for 20 or so days then only the clonidine. A close friend of mine is a drug treatment counselor. He said that tramadol is the most successful drug for methadone withdrawal symptoms.

 

[SoCal424]

hik- Hello and welcome to my thread. Thanks for your post.

Do you feel that you are pretty stable now at 20mg/day? If not, I would recommend you wait until you are. The taper or cold turkey quit from 20mg to zero can be hard to get through if you go fast. Are you employed or in school? If yes, please don't cut down like I did. I don't know that I'd have made it if I had to go to work through those first four weeks. Instead, taper very VERY slowly. By that, I mean 1 or 2mg per week. I tried crushing a pill into "dust" then mixing it with juice so I could closely measure my dose and it works fine as long as it's a regular methadone pill you get at the pharmacy. If you do this, stir it well each time before you drink it and keep it refrigerated if you do use juice. In my case, there was no way I could break one into 1 or 2mg doses. As it turned out, I got too impatient and just quit entirely after a few tapers. I suffered for it, but I did get through it faster (not that fast though). I am doing really well now. I have no withdrawals of any kind now. I haven't touched any opiate type of drug since the day I quit (see thread, I don't remember which day that was anymore). I am kind of afraid to take even one for any reason. In my mind, that's a good thing.

Tramadol... This is an addictive milder pain pill. Did you know that? It will cause physical withdrawal if you take it every day for more than 7 - 10 days. You may need it, but try not to use it if you don't.

Gabapentin... This didn't do much to help me to be honest, but a lot of others in this forum do recommend it. If you start it, don't suddenly stop it - you have to taper off it.

Clonidine is a drug I have never tried. Your blood pressure will likely go up if you taper fast, and I've heard this drug helps that. If you taper fast, you will very likely need something to keep your blood pressure in the normal range. I used Atenolol for that and I took 25mg every 12 hours. This drug does slow your heart beat down. Mine was in the low 40's when I was resting. Blood pressure drugs can be dangerous if used incorrectly, so please get them from your doctor so he/she knows about your health.

RLS: I had that so bad I thought it would never stop. Sometimes it kept me awake all night long, but after a while, it stopped.

When you hit bumps in the road, look ahead to the time when you will feel normal again without methadone. I promise you it will happen - you'll get there just like me if you can just keep going when you don't feel good during withdrawals.

By the way, congratulations on making it from 130mg to only 20mg! That impresses the heck out of me.

Try to get some outdoor time if you can and get some exercise as you feel up to it - going for walks is good. During my withdrawals, the only running I did was when the ice cream truck was getting away

Your friend,
Dale

 

[Jabberwocky]

SoCal424, you are my inspiration. I will be jumping off my 20mg methadone after the 4th of July. I have friends coming in for our vacation at a local lake and don't want to "seem" ill and bed ridden . I'm at the thresh hold of withdrawal and at this point I'm just extending the pain. Luckily I'm not at a clinic, so I have a great doctor that is letting me do it my way. I've gone from 130mg to 20mg in 6 months. It's time to make the jump. I've been on this crap for 15 years ,so I've been reading about what meds can cushion the jump. Looks like tramadol, clonidine and gabapentin is the way to go. I tried my wife's tramadol 50 cut in half to 25mg for a base line to see how it would help the RLS. It completely eliminated it . Since I'm still on the done, I'm probably not getting the opioid like effect, but the uplift from the serotonin norepinephrine, dopamine was the biggest surprise. My plan is to use the tramadol for 10days then the gabapentin for 20 or so days then only the clonidine. A close friend of mine is a drug treatment counselor. He said that tramadol is the most successful drug for methadone withdrawal symptoms.

Assuming you can't get your hands on buprenorphine, tramadol (or codeine/DHC) is the next best things. It'll be safe to use for 1-2 weeks, especially if you keep the dose moderate (ideally under 300mg/day, space out).

Gabapentin and clonidine will do a hell of a lot to help with RLS and hot/cold flashes. Tramadol (perhaps with some loperamide) will do a lot to get your through the withdrawal as well.

Coming off 20mg, expect to feel pretty shitty for about two weeks. Not like a horrible cold turkey dope sickness kick, but it'll still be hardly pleasant.

Gabapentin can make a really huge difference. Don't feel ashamed at having to take a lot of it. Standard doses (for what you're doing, 400-800mg two to four times a day) makes a big difference, but higher doses often are much more useful. Since you have tramadol, it shouldn't be as important, but it'll still make a big difference.

Likewise the clonidine.

No benzos? Diazepam (or clonazepam) are also important detox meds for coming off a methadone habit like yours. Likewise is a non-habit forming sleep aid (trazadone worked well for me, but to each one's own).

Maybe you can find some Tiger Balm to help you get rest at night?

 

[hikfromstik]

Assuming you can't get your hands on buprenorphine, tramadol (or codeine/DHC) is the next best things. It'll be safe to use for 1-2 weeks, especially if you keep the dose moderate (ideally under 300mg/day, space out).

Gabapentin and clonidine will do a hell of a lot to help with RLS and hot/cold flashes. Tramadol (perhaps with some loperamide) will do a lot to get your through the withdrawal as well.

Coming off 20mg, expect to feel pretty shitty for about two weeks. Not like a horrible cold turkey dope sickness kick, but it'll still be hardly pleasant.

Gabapentin can make a really huge difference. Don't feel ashamed at having to take a lot of it. Standard doses (for what you're doing, 400-800mg two to four times a day) makes a big difference, but higher doses often are much more useful. Since you have tramadol, it shouldn't be as important, but it'll still make a big difference.

Likewise the clonidine.

No benzos? Diazepam (or clonazepam) are also important detox meds for coming off a methadone habit like yours. Likewise is a non-habit forming sleep aid (trazadone worked well for me, but to each one's own).

Maybe you can find some Tiger Balm to help you get rest at night?

Thanks for the kind words of encouragement, that really helps my reinforcement to quit. I've was on benzo's years ago.I've had others tell me that it'll help cushion the WD's . When I was was on them the first time ( 1 month ) the WD's were bad enough that it scared me , but they ended in 2 days ,soooo it's kinda like a balance scale . I have a boat load of soma on hand also. I take those here and there for insomnia, but limit how often I take them because those are addictive as well. I feel like I've reached the age where I'm mentally ready to get off the methadone.At 20mg I'm so sick I can barely walk ,because my legs hurt so bad . I have elevated liver enzymes , so my 20mg may be like others 5 or 10mg. Actually I started getting mental withdrawals ( insomnia , weakness , depression) at 70mg. Methadone is a whole different animal than other opiates . I believe the tramadol with its serotonin/norepinephrine/dopamine activity that may be the key. I believe that there maybe a way to cushion the worst (3-9 days) without getting hooked on another opiate . I'll probably open a new thread when I start . I don't want to hijack this thread anymore. SoCal424 has really motivated a lot of folks it looks like.

 

[Jabberwocky]

SoCal424 is the man

Thank you for being so open to share what's going on for you hikfromstik. To be frank, your health does worry me a bit.

As a general rule, it's really worth waiting to make the final jump off methadone until one's stable on their current dose. The difference in intensity of acute withdrawal (and PAWS) between someone who's recently tapered down to 20mg and hasn't stabilized versus someone who has fully stabilized on 20mg is pretty dramatic.

I just wanted to echo SoCal424's suggestion about trying to stabilize a bit more before making that final jump off to 0mg methadone. How long have you been on 20mg?

Especially because under a year is not at all a long time to go from 100mg+ to 20mg of methadone, it's really going to be helpful if you can get as stable as possible with your current dose. Worst case scenario this means sticking with 20mg/day for a week or two longer. It might not be the most fun, as when someone wants to get off staying on methadone can be pretty painful (tapering withdrawal aside), but you'll thank yourself down the road.

And with benzos, using 10mg diazepam twice a day for 14 days (or the equivalent) is highly unlikely to cause major issues. I'd recommend trying to stay on gabapentin for a month though, and having clonidine and a non-habit forming sleep aid available during this time. Actually I tend to recommend people have a non-habit forming sleep aid available for the first year post methadone.

Tramadol is, in my humble opinion, an ideal med for treating methadone withdrawal. With a habit like what you're coming from, I will be surprised if anything under 200-300mg/day makes a huge difference though. No reason not to start low with it, but if it isn't helping at 50mg 3x/day, it isn't really a huge surprise.

Hopefully the gabapentin/clonidine/etc helps enough to make going to crazy on the tramadol something you'd serious consider doing, but when someone knows how fucking annoying a serious methadone habit can be they tend to understand the significance of using opioids as sparingly as possible.

You'll get there my friend, just please don't get too far ahead of yourself. Yes, it sucks. I can't frankly imagine how much more it would suck if I was in middle age when I got off than when I did, as a young adult. And you are clearly ready to get off the stuff. Yet, when you feel the urge welling up inside to move on with all the bullshit already, keep in mind the following:

The slow and steady are the winner of this race.

I think that becomes even more significant the older one gets or the longer one uses.

I'm actually going to move these posts into your own thread mate. Feel free to start a new one once you've jumped off or just start where we leave off.

 

[hikfromstik]

I guess that I can stay on the 20mg a bit longer and see if I can tolerate maybe a 2 or 3mg drop here in my last few weeks . I'm really in a time crunch guys . I own a large farm and I'm going to have lite work ( morning piddling) for 6 weeks until corn harvest comes in late Aug early Sept. I've got to be ready to work by Sept. The corn usually is ready Sept 1st. That will give me 45 days to get the bad stuff over with .I'm 40 years old and in pretty good health except for my bulging disk in my neck which is what I get my Soma 350mg for . I took those for 6 months last year and had only minor sleep issues for 2 nights after I quit them CT .Man those things make you hungry and forgetful and luckily I don't like the feeling they give , but its another tool in my arsenal if needed . How bad is the first 2 weeks ? Is it the usual sweats, chills, diarrhea, anxiety ? I'm already at the emotional state were I'll cry listening to some music and some emotions that I buried are coming back . I haven't cried in years ,but now I tear up at every sad country song ,lol. These pills are the little 10mg Roxanne. I think I can split them in 2.5mg pretty easy ,but less than that may be difficult to get consistent day to day . Any other advice is appreciated. Thanks for listening.

 

[hikfromstik]

Toothpastedog , I've been on 20 for about 2weeks . I was on 25 for a month ,but never stabilized on 25 either. The RLS didn't start till 25mg . I'm at the heavy feeling stage, like my legs weigh a ton each and my feet are hurting after about 6hrs after dosing in the am . I've tried dividing the dose twice daily, but it's worse. Now it's just 2 in the am (6ish). I get the wet dogs shake so bad the bed rattles right before dosing in the morning.

 

[Jabberwocky]

In that case, stay at 20mg for another couple weeks and see if anything improves before trying to taper further.

During this time it would be a great idea to invest in your bodily and mental health as much as possible. That means getting therapeutic exercise (like yoga, for instance), accessing peer support (which in your situation on a farm is probably going to be a little challenging), basically doing as much as you can to get yourself ready for transitioning off. The more you invest in your health now, the easier transitioning off ORT will be.

Tramadol will definitely help you transition off the methadone, but you also would be wise to consider finding a buprenorphine program to help aid the process.

You sound like an ideal candidate for an extended outpatient buprenorphine detox to help with the final transition from methadone. That is what's become the standard to transition people off high dose/long term methadone programs. The extended detox first stabilizes you on buprenorphine (in your case it will probably be 2-4mg 2x/day, or 4-8mg once a day), over the course of about a month. Then over the next five months you slowly taper off the buprenorphine.

I suggest this because, while it'll add more time to the process, it will get you off methadone sooner than later and allow you to function for the harvest even while you're taping the buprenorphine.

You can aid the transition from methadone to buprenophine with stuff like gabapentin, but again comfort meds will be most important when you're ready to come off buprenorphine itself. Transitioning from methadone 20mg to buprenorphine is going to be a pain, but done right (especially if you have tramadol) it won't be too difficult.

 

[EPL1]

Hik you and I sound quite similar, I am a chronic pain patient that got sick of jumping through hoops to get my prescribed opiate pain medication. So I quit ct a few weeks back now.

What will you take for pain instead of the methadone? I take nothing now but I feel it. I have had a spinal fusion and have Degenerative disc disease and other herniated discs. Be well my friend,


P.S, I hear you about the little crying jags, lol, I posted about them A LOT on my thread "when will the WD depression stop". I was on an emotional rollercoaster, hang in there, mine only lasted until about the 10th day ct.


Ash.

I guess that I can stay on the 20mg a bit longer and see if I can tolerate maybe a 2 or 3mg drop here in my last few weeks . I'm really in a time crunch guys . I own a large farm and I'm going to have lite work ( morning piddling) for 6 weeks until corn harvest comes in late Aug early Sept. I've got to be ready to work by Sept. The corn usually is ready Sept 1st. That will give me 45 days to get the bad stuff over with .I'm 40 years old and in pretty good health except for my bulging disk in my neck which is what I get my Soma 350mg for . I took those for 6 months last year and had only minor sleep issues for 2 nights after I quit them CT .Man those things make you hungry and forgetful and luckily I don't like the feeling they give , but its another tool in my arsenal if needed . How bad is the first 2 weeks ? Is it the usual sweats, chills, diarrhea, anxiety ? I'm already at the emotional state were I'll cry listening to some music and some emotions that I buried are coming back . I haven't cried in years ,but now I tear up at every sad country song ,lol. These pills are the little 10mg Roxanne. I think I can split them in 2.5mg pretty easy ,but less than that may be difficult to get consistent day to day . Any other advice is appreciated. Thanks for listening.

 

[hikfromstik]

Thanks friends , I need to find a local doctor that can write bupe . My neck is so jacked and next year I'll probably get surgery on it. The insurance wants me to do spinal injections ( nerve blocks ) first before surgery. I've already done 4 physical therapy sessions in the last year ( 36 sessions ). All of my cervical disk are bulging. I also have spinal stenosis. I have my good days and bad days .

 

[EPL1]

You sound like me, what will you take for the pain until surgery Hik?

Thanks friends , I need to find a local doctor that can write bupe . My neck is so jacked and next year I'll probably get surgery on it. The insurance wants me to do spinal injections ( nerve blocks ) first before surgery. I've already done 4 physical therapy sessions in the last year ( 36 sessions ). All of my cervical disk are bulging. I also have spinal stenosis. I have my good days and bad days .

 

[cj]

In that case, stay at 20mg for another couple weeks and see if anything improves before trying to taper further.

During this time it would be a great idea to invest in your bodily and mental health as much as possible. That means getting therapeutic exercise (like yoga, for instance), accessing peer support (which in your situation on a farm is probably going to be a little challenging), basically doing as much as you can to get yourself ready for transitioning off. The more you invest in your health now, the easier transitioning off ORT will be.

Tramadol will definitely help you transition off the methadone, but you also would be wise to consider finding a buprenorphine program to help aid the process.

You sound like an ideal candidate for an extended outpatient buprenorphine detox to help with the final transition from methadone. That is what's become the standard to transition people off high dose/long term methadone programs. The extended detox first stabilizes you on buprenorphine (in your case it will probably be 2-4mg 2x/day, or 4-8mg once a day), over the course of about a month. Then over the next five months you slowly taper off the buprenorphine.

I suggest this because, while it'll add more time to the process, it will get you off methadone sooner than later and allow you to function for the harvest even while you're taping the buprenorphine.

You can aid the transition from methadone to buprenophine with stuff like gabapentin, but again comfort meds will be most important when you're ready to come off buprenorphine itself. Transitioning from methadone 20mg to buprenorphine is going to be a pain, but done right (especially if you have tramadol) it won't be too difficult.

This is the best advice. Methadone withdrawal is unlike anything else I've gone through. It's really really severe.

 

[hikfromstik]

Ok guys , I'm the OP . I told yall I was gonna quit the methadone after the 4th of July. We got back from vacation Sunday and Monday I quit ( did not take ). I'm on day 4 . I started my tramadol Tues. It does help some . It partially relieves the RLS and the sweating, yawning , runny nose ,etc... I'm still in WD but at about 1/3 of what it would be without it . I'm also on clonidine. Clonidine sucks the life out of me . The tramadol is a 2 week script and I'm not even taking the full 2 pills a day because I don't want to get hooked on something else. I told the doc to not give me any more. He said at such a low dose for 2 weeks won't cause addiction. Today is my toughest day so far . I know I'll have many more days like this and I'm glad I have a Dr that's willing to try something I recommended. I will try to chime in to update , if I feel up to it . I'm so weak I can barely walk today . Supposedly tramadol works on a different opioid receptor than methadone , so its helpful for WD's . It's very weak , but I can tell I take it (no pleasure though) . I think a perfect plan to ovoid Wd's is tramadol for 6 days ,then benzos for 6 days after the tram . I'm surprised nobody has developed a 2 or three step comfort medication step down from methadone. Methadone is one bad MoFo , maybe the worst of all for WDs. Luckily it doesn't cause mental cravings as bad as other opiates. Wish me luck guys .

 

[EPL1]

Hello hik,

Great to hear from you again. We are in similar situations, I'm a chronic pain patient and I sincerely wish you the best in your quit!!! Proud of you!! What do you plan to do for pain after this, I am trying to figure this out myself.

Solid quit/WD plan btw!!!


Here for you anytime,
your friend,
Ashley.

Ok guys , I'm the OP . I told yall I was gonna quit the methadone after the 4th of July. We got back from vacation Sunday and Monday I quit ( did not take ). I'm on day 4 . I started my tramadol Tues. It does help some . It partially relieves the RLS and the sweating, yawning , runny nose ,etc... I'm still in WD but at about 1/3 of what it would be without it . I'm also on clonidine. Clonidine sucks the life out of me . The tramadol is a 2 week script and I'm not even taking the full 2 pills a day because I don't want to get hooked on something else. I told the doc to not give me any more. He said at such a low dose for 2 weeks won't cause addiction. Today is my toughest day so far . I know I'll have many more days like this and I'm glad I have a Dr that's willing to try something I recommended. I will try to chime in to update , if I feel up to it . I'm so weak I can barely walk today . Supposedly tramadol works on a different opioid receptor than methadone , so its helpful for WD's . It's very weak , but I can tell I take it (no pleasure though) . I think a perfect plan to ovoid Wd's is tramadol for 6 days ,then benzos for 6 days after the tram . I'm surprised nobody has developed a 2 or three step comfort medication step down from methadone. Methadone is one bad MoFo , maybe the worst of all for WDs. Luckily it doesn't cause mental cravings as bad as other opiates. Wish me luck guys .

 

[hikfromstik]

Thanks ash , your a great supporter of these threads .
today is even worse. The tears are flowing. Its like my body saying goodbye methadone. Last night I hallucinated at from 2-3am . I don't know if it was from the mixture the tramadol clonidine gabapentin or maybe the last bit of methadone leaving my body and my brain celebrating , but it was very spiritual and soothing ,kinda like twilight sleep . The tramadol is just barely working. I wasn't on methadone for pain . I just have a dr(close family friend) that wrote it for off label for 8 years. Before that I was at a clinic for 8yrs ( terrible clinic) . The clinics here are all owned by the same people and are definitely for profit . When I started the clinic at age 21 I was on hydrocodone and oxycodone. They boosted my dose from 40mg the first day to 80mg in one month . I was puking all day afterwards. I would tell them the symptoms and they would say "you need more methadone, it's the pills coming out of your body". They would race everyone to 100mg to trap them and tell them that you should stay on methadone for 2 years before you try to quit. This was 16+yrs ago . I believe our state has new regulations now on new patients. I think now they give you 30 or 40mg then wean down to 0mg for a month or so. Then if you come back afterwards still on opiates you get maintenance treatment. I could be wrong about this though .I heard it from a friend still in the clinic.

 

[EPL1]

Hello hik!!

Thanks for explaining how it works there, here you have to do all sorts of pt, and try non opiate meds, cortisone shots etc etc etc, before they even consider putting someone on pain management with opiates.

And because of this so called opiate crisis here, true pain management patients are very heavily scrutinized and judged. We have to submit to random UA's use only 1 pharmacy and can have random pill counts at any time.

So I was sick of all that, and although I am in chronic pain still, I found the stress of obtaining my medication wasn't worth it to me. I hope I can find something that helps me.

Please come on here and post more, you are a very intellgent and interesting guy with so much going for you and I will be here to support you any way I can. You have a friend in me for sure, good or bad don't be a stranger.

So very proud of you hik, be kind and patient with yourself. I hope your emotions level out soon, that was hands down the worst part of stopping the opiate meds for me. I can deal with the physical shit all day every day but the emotional outbursts are the fucking worst!!

Big hugs,
feel free to pm me, here for you anytime
your friend,
Ashley.

 

[hikfromstik]

Thanks Ashley, it really helps coming here . It's kind of like home therapy . I've been in rehab twice . Once to quit methamphetamine( before my opiate love/hate) and once for methadone. . I've done the AA ( all we have in my hick town ) and couldn't stand the parliamentary procedure like process of it . The last rehab was a 7 day stay for methadone and they kept me on 5mg of methadone the whole stay and the day I went home they gave me nothing and said I should be over WD's, HAHA . It was a shotty rehab facility, that mostly specialized in crack addiction . They called the dr "dr no not" because he would only give non scheduled comfort meds . I was only given clonidine 1mg twice daily, which was not enough.

 

[Jabberwocky]

Hiya hik, sorry I havent been more in touch. How are you doing today? Any plan for das weekend?

I’m glad to see Ask taking good care of you here. You’re in good hands with her

 

[hikfromstik]

Good to talk again tpd , I told you I was jumping after the 4th of July week .I jumped at 15mg . That was my breaking point . I drank a lot of alcohol over the holiday week to calm the rls . I'm not an alcoholic, but around friends it's a blast on special occasions ( hanging in the water at the lake after a toke or 4 ,lol ).I couldn't dare drink every day. The hangovers are too ruff on the body . I will say that alcohol totally takes the restless leg syndrome away . I have friends wanting to hang out this weekend, but I'm really not in the drinking mood . I think it'll be good to see them . They are are drug free and only smoke pot and drink beer or mixers . What would it feel like if I drank during WD'S ??? I'd imagine the hangover would not be worth it . By the way tpd , I'm wanting to message, but I guess my verification email went to my spam or something. I can't find it and the link to resend isn't working. Got any suggestions