Should I get on methadone or keep tappering the trams/fents and morphs?

[Jabberwocky]

So as some of you know I'm still addicted to tramadol, as my tolerance is at 1500 mg again (very dangerous dose for someone with low tolerance so WARNING! ) and I'm using fentanyl and morphine ( IV both) frequently as tramadol (orally, not worth it shooting over 30 ampoules) does no shit apart from keeping my brain zaps away and maybe keeping the w/d at bay.

Do you think I should move on to methadone and tapper that or just tapper the tramadol and ignore the rushes of morph + fents?

I'm a bit skeptical as the methadone would replace the o-desmethyltramadol but not the nortramadol (snri side of things -> brain zaps, depression, mood swings).

Or what about subs? I need an all day option this is why I like to take trams with everything the extended release ones as I take 15 x 100 mg they last me all day without w/d and the rest of the cocktail is just for risky fun but I'm very calculated when it comes to my dosing and ROAs.

The all day thingy would help me with me getting a job in IT again and going to college more often as I rarely nod out nowadays.

 

[apocalypse_when]

Hmmm that's a tough one. Normally I would recommend that people stay away from methadone as it's a real bastard to come off and if you try to cold turkey, it is literally the definition of hell (and believe me I know). However, the amount of tramadol you're on is really dangerous in terms of possible serotonin syndrome so finding a level that keeps you stable (after eliminating the morphine and fentanyl) and then being able to taper from that amount would be quite tough as I imagine this would involve an awful lot of tramadol. As for subs, I think this would probably be a better idea although subs themselves are quite difficult to come off involving a lengthy taper and cold turkey being an absolute pitch as with the methadone. Fom your posts, am I'm right in thinking that you're from the States? If so, then I gather you are able to get monthly prescriptions for subs whereas methadone involves having to turn up at the clinic every day for supervised consumption I believe... That being the case, you would need to weigh up how much of an inconvenience this would be for you. I would love to hear other people's opinions on this before coming to a solid conclusion but I think subs would be the best choice all things considered...

 

[Jabberwocky]

I'm from Romania in the North-West region, methadone is pretty rarely prescribed anymore, in south where the heroin scene is big ( Bucharest) they have lots of clinics but the waiting lists are long and the road to bucharest is long too but I got pharmaceutical owners in my pocket to say so so it's pretty easy to get anything with the original pharmacy price no plus added money wise.

 

[apocalypse_when]

I'm from Romania in the North-West region, methadone is pretty rarely prescribed anymore, in south where the heroin scene is big ( Bucharest) they have lots of clinics but the waiting lists are long and the road to bucharest is long too but I got pharmaceutical owners in my pocket to say so so it's pretty easy to get anything with the original pharmacy price no plus added money wise.

Ahh OK. Irs just when you mentioned the price of something in dollars i though you were from the US. Your English is so good i would never have guessed eastern Europe. Pretty much flawless English... better than many English people

If you can get anything then id suggest oral morphine to taper on... my only concern for you would be if you got cut off half way through and were stuck with not being able to get it...

Would subs be easy for you to get worth a prescription then?

Would it be possible for you to stock up on something with enough to do a taper on?

 

[steewith2ees]

I do not think that their is anything that would mitigate the discontinuation symptoms from the selective re - uptake component of the tramadol with the exception of perhaps a quick taper simultaneous to the final upward titration of whatever opioid you use to manage the situation overall, but it seems to make sense to address that side of things while stabilising on a substitute opiate and not to even think of stating a reduction until the brain zaps and mood issues have abated.

Getting a rush really isn't going to be an option if you are going to get this down a few levels at least. If you have access to prescription only drugs and are not beholden to methadone, there are xr oral morphine products available which might split the difference in terms of user satisfaction but if you find difficulty in managing and / or funding any or all of your drug use methadone is always a good option for regaining overall control of your life.

 

[Jabberwocky]

My english is pretty good because I always read studies,books, I watch movies and listen to music only in english even the books which are translated I always read the english version bc the sense of the words is not changed in such a way. I think I'm gonna tapper down to 25 mg, 50 mg - per week it will take me 5 months but I have a constant supply. easiest thing to get is the tramadol as I'm an artist in manipulating fragile pharmacist minds.

 

[Mr.Heffo94]

I would suggest Methadone to regain full control of your life. Yout addiction to opiates seems to be pretty out of hand and with that amount of tramadol even with a tolerance iss extremely dangerous. Go with Methadone and go over tapering off that with the help of your doctor, it's easier than most people think. Of course you'll get withdrawls but that's the joys of opiates. Best of luck and hope everything goes well for you bro, Stay Safe, Peace, Mr.Heffo94.

 

[Jabberwocky]

I'm still thinking about the switch, but even if I decide to do it it will be made after the trams are reduced to more than half of my current dosage so the brain zaps and mood swings would not be as noticeable, only a big fat shot of morphine or fent make them go away but even those two tend to do it just because I nod the hell out so I don't really notice having them but this whole snri part of trams is anoying.

thinking of the snri part, I find it ironic that when I got out of rehab (and even in the rehab) around this time last year, they prescribed me seroquel (anti-psyhotic), valdoxan (anti-depressant) , convulex (anti-convulsant) and effexor which is an snri and ssri veeeeery similar to tramadol. of course as soon as I got out I tappered of those 4 quickly but the effexor withdrawals ( the last ones I got rid of from all those 4 ) had veeeeery similar effects on my mood and physical well being ( with the brain zaps and all that neurological jazz )

 

[blondin]

if you have access to methadone a 2 week taper is possible. I have posted how before but if your interested will post again.

 

[Limpet_Chicken]

IMO I'd not use morphine orally, but if tapering, use it plugged (obviously breaking XR formulations), that way the onset is slowed (make sure your bowels are emptied first, or the drug could be absorbed into a turd and rendered useless as it'd never get into the body)

Being slowed, no rush at all, but the bioavailability is AFAIK not unlike I.M shots. So you'd be able to control it better and waste less using it stuck up the theresa may.

Methadone is potent, it's long lasting, and has some NMDA antagonism, not much, but NMDA antagonism helps lower tolerance, so better it's there than not there.

Bupe too is long duration, but, it's a partial agonist. One must be in withdrawal before taking it, or due to it's very high binding affinity for MORs, it'll, crudely put, rip the opioids in your system already off their receptors and show them the door with a boot up their arse, resulting in horrendous precipitated withdrawal due to it's being a partial agonist. It can't cause the same maximal response as morphine, methadone, H, etc., but it binds to the same target much harder, and displaces the full agonists in question, causing a net decrease in opioid receptor activation, and thus withdrawal if not already IN withdrawal.

But a long acting drug with steady-state plasma levels due to a long half life is ideal for tapering.

As for the tramadol, I'd continue using it, in lower and lower doses, but do NOT take more than 300mg/day due to seizure risk, it's dangerous in ways other opioids are not.

Basically if it were me, I'd get on a long strong opiate, to cover the morphine and fentanyl tolerance, enough to stop WD, and use lowest doses of tramadol, not exceeding 300mg/d total, maximum, because it can cause SNRI withdrawal as well as opioid WD, the replacement, maintainence/detox opioid ought to cover the opioid WD side of it, but the tramadol should be used itself, IMO, as said, 300mg/daily MAXIMUM, and tapered as you can manage without discomfort.

If you can get memantine, online from nootropic sites, or prescribed, or any way possible, do so, it STAMPS on tolerance and cravings both. As well as reduces or eliminates WD of opiates.

 

[Jabberwocky]

thanks guys, blondin I'm gonna search your post about the tapper 2 weeks, it seems a short time, I'm gonna see a doc after the holidays are over because even if he agrees to prescribe me methadone ( from what I understood from a ex-methadone treatment facility here they can give you a script for a whole month so daily visits to the clinic are not required ) I still have to place an order in a pharmacy because in the whole city no pharmacies have Sintalgon in stock which is the main methadone brand used here in romania.

btw idk why but I helped persons before to quit opiates, I know how to do it step by step even docs remain shocked when they hear my knowledge about the subject matter, but I just can't do it, something in me hints that this is a too huge part of me already and it will be for the rest of my life but I'm so sick of lying, manipulating, pawning stuff and just loosing days thinking of how could I quit and using meanwhile ( of course) .

from what I read I could have a pretty healthy life like this, although the tramadol must be cut off totally bc I'm concerned of the damage in can do to my nervous system. it's already damaged a little as I tend to have muscle spams, I yawn a lot etc. physically I'm 100% healthy, every summer I'm doing blood tests and x-rays ( mom works in a blood test company so they are all free) and they seem fine although I'm very young compared to you guys I'm just turning 22 in a month so the ability of my body to regenerate is on another level compared to what it would be if I would be in my mid 30s - early 40s.

addiction tho runs in my family like nice gear on the foil because all the males from my family are or were addicted to alcohol ( those that were are already dead so that's how they quit), I'm not putting the fault on my genes as I don't really believe in transmissions of such "diseases" although a predisposition might be present. for example my dad was addicted from his very early 20s till he turned 42 ( he died at 42, and no I'm not addicted cause of trauma because we did not have a really thight relationship like that)

I'm so psychologically addicted that even if I pass the physical whitdrawal period from the moment I wake up till I go to sleep it's all what I can think of, some therapists told me that it might be from depression or other things concerning my psych but the thing is I got hooked on them when I turned 15 years old, it was sold like candy without a script and when I got sick of the feeling, an year after starting with them, I felt very sick just to find out later that this is the withdrawal and I'm kinda fucked. I find myself so stupid because I always researched shit when I planned to use but I never got to the addiction part because I lied to myself that long term use is not gonna occur with me )))

I was thinking that the age at which I started being the beginning of the formation of my personality and behavioural patterns ( 14-15 years old ) has a big part in this because the whole lifestyle and culture got so sawn in my mind and persona that this is what I'm doing and thinking of everyday, now and then I start to work and I can adapt very quickly but all the lying and stuff tends to put the managers off regarding my usefullness to them. to give you an example I worked at Gameloft as a tester for 1 and a half year, in 3 months I became one of the most skilled juniors with knowledge being comparable only to seniors (especially on the tech stuff) but I always was high on trams, chewing oxies at my desk, shooting up in the bathroom, arriving late daily. when I used to remain with 0 opiates and the old lady pharmacist owner had her bussiness closed during my lunch break I would spend my break trying to score somewhere else and then lie to be able to go to her too.

Sorry for the long post guys I just wanted to give a wider perspective on my situation.