Opioids Is this opiate PAWS? Please help...

[erlenmeyer]

Hi,
you might have been following my struggle with ODT withdrawals in the special thread. Now I've kicked moderate Tramadol and DHC habits in the past, which took me 3 or 4 days to be feeling pretty much normal again. But the current run with ODT proves to be a different kind of beast: I've used it over the course of 2 months and ended up doing about 600mg daily towards the end. During the last month I tried a couple of times to kick it but was unsuccessful due to job/family reasons.
Fast forward and I'm 9 days into my first true attempt of withdrawing from this evil ****. Now I certainly felt a break after those 3 or 4 days, in which the common effects of acute opioid WD subsided and turned into something else, which I'm totally not familiar with: I am emotionally numb and pretty much depressed with episodes of strong derealisation (which I had on several occasions in the past, but it was due to stress reasons and in a much milder form). What baffles me is that I'm also experiencing physical sensations of jitteriness (especially at night and in the morning), strong paraesthesia and insufferable lethargy. I honestly can't tell if I'm feeling better or worse now compared to the first few days. It's just a different way of feeling like ****. Walking outside is as if I'm stuck in a space suit on a mild trip of ketamine. Another problem may be that I've used benzos during that last month in my failed attempts at withdrawal. Not continuously, rather it was on and off (up to 4mg of Clonazepam). Plus I used clonidine for a couple of days until the day before yesterday (that could at least explain the lethargy). It helped a lot, but now I'm wondering: WTF did I get myself into? Is this opiate PAWS or acute benzo withdrawal (never experienced it before)? Should I try a low dose of each on separate occasions to see if my symptoms get better? I really can't nail down the cause of them. It's the uncertainty that's killing me at this stage. Does anyone have similar experiences? How much longer will I have to suffer this?

 

[BuddingPharmacist]

It sounds like a mix of both.

If it has lasted this long, it is highly likely to be linked to the benzos.

Benzo withdrawal can kill and last for a month, and obviously you are in a lot of distress.

It will get worse until you get treated.

Go to an instacare and explain everything you just explained to us. Ask for a taper on benzos so you can do this safely. Tramadol increases seizure risk, and I think it is also heightened while withdrawal from tramadol, too. This places you at some serious risk, because benzodiazepine withdrawal is infamous for seizures.

You really need to go see a doctor. Don't drive or go swimming or any of that. If you do and have a seizure... Well, you get the idea I think.

Don't be your own doctor right now. You need a doctor.

I speak from my training in medicine and situations like these are familiar to me.

Get someone to drive you to an instacare or your doctor, and do not delay. Tell the whole truth of everything so they can help you.

 

[Thou]

It can take a very long time to get through the post-accute stage of opiate (or any other physically habit-forming drug) withdrawal.

Have you tried suboxone to taper off? Sounds to me like you just went cold turkey. I'd discuss it with a doctor or read into opiate maintence programs a bit before you do anything so brash as getting yourself hooked on something just as addictive, but theoretically it can help. I know at least during benzo withdrawal the only safe and painless (well, almost) way to do it is by decreasing your daily dose in small increments with a schedule derived from the charachteristics presented by the substance in question.

IE: Xanax 6mg/d>Klonopin6mg/d>Klonopin3mg/d>Klonopin1.5mg/d>Valium30mg/d>Valium15mg/d>Valium7.5mg/d>? Eventually: Profit. (Drug free.)

Etc. Etc.

You need to of course gather more information before you make any final decisions, and wait for others to chime in here because I'm by no means an authority on opiates. There are certainly more experienced, knowledgable members that can give you advice. Check out the Mega-Merged suboxone thread, I believe its in OD. I'd look up a link but I'm just heading out the door.

Feel Better.

 

[erlenmeyer]

Tramadol increases seizure risk, and I think it is also heightened while withdrawal from tramadol, too. This places you at some serious risk, because benzodiazepine withdrawal is infamous for seizures.

Thanks a lot for your time, though from what I've read the O-Desmethyltramadol doesn't have any SSRI activity and thus shouldn't increase the risk for seizures. Otherwise I wouldn't have done this cold turkey. And I wasn't even thinking about the benzos when I got off, it just occurred to me now that it's been taking this long...

 

[erlenmeyer]

Have you tried suboxone to taper off? Sounds to me like you just went cold turkey. I know at least during benzo withdrawal the only safe and painless (well, almost) way to do it is by decreasing your daily dose in small increments with a schedule derived from the charachteristics presented by the substance in question.

Suboxone substitution appears to be a bit exaggerated, at least I thought so until know. I mean O-Desmethyltramadol is basically a more potent (2-3x) metabolite of Tramadol. So I reckoned the withdrawals should be similar to a moderate-slightly larger Tramadol habit minus the lowered seizure threshold (as explained above.) If you look into the thread, it appears that most people have no problems with kicking it. But it's been taking so much longer for me, that's why I'm bringing up that month of on-and off benzo use now.
I'm fortunate enough to have a doctor as my mother. She has been monitoring me so far, otherwise I'd have visited a doc by know, that's for certain...
Thanks for your advice, i'll wait for more input...

 

[rob007]

a month of on/off benzo use would not warrant such withdrawals.

 

[erlenmeyer]

a month of on/off benzo use would not warrant such withdrawals.

I had the same thoughts. What do you think about trying 0.5mg Clonazepam tonight in order to find out?

 

[Cyb]

I don't think .5mg of Kpin is going to do any harm. While everyone is different, I really do not think you are physically addicted to benzos. I've personally come off 4mg Kpin daily for 1.5 years with no ill effect. I also was not aware there was 'supposed' to be a wd period after that long of use...

Anyways, back OT; After discontinuing a mental and physical dependence on opiates, you are going to feel quite simply, like shit for a long, long time. Physically, and mentally, you are lacking the chemical you relied on to sustain your sense of normalcy for so long.

It's going to take a while, but it does eventually get better. Take it easy, take it slow, and don't look back.

Be well.

 

[erlenmeyer]

I don't think .5mg of Kpin is going to do any harm. While everyone is different, I really do not think you are physically addicted to benzos. I've personally come off 4mg Kpin daily for 1.5 years with no ill effect. I also was not aware there was 'supposed' to be a wd period after that long of use...

Anyways, back OT; After discontinuing a mental and physical dependence on opiates, you are going to feel quite simply, like shit for a long, long time. Physically, and mentally, you are lacking the chemical you relied on to sustain your sense of normalcy for so long.

It's going to take a while, but it does eventually get better. Take it easy, take it slow, and don't look back.

Be well.

I decided to take 30 mg of Valium (almost the equivalent to 2 mg of Clonazepam, as I used to take 4 mg on-and off during that month) and those strange physical symptoms seem to have subsided. I'm basically feeling normal in my own body again. And there's definitely some sedation too, so the dose might have been excessive. Of course this could mean I'm just covering up long term symptoms of opioid use, if that's indeed what it is. Hmm, shit's hard to nail down . At least I feel that I'm gonna be able to get some decent sleep tonight.
Thanks a lot for your support.

 

[JJ-180]

I think most of what you're feeling is down to the benzos- Opiate/opioid wihdrawal can be unpleasant but doesn't usually engender these sort of responses. I know exactly what you mean by "walking outside in a spacesuit", that's classic benzo w/d depersonalization.If I were you(and I know we're all different) I'd get the ODT withdrawal over and done,using as many benzos as you need to get clear of it, then think about tapering on the benzos. Trying to do both together is admirably heroic, but I think you could be setting yourself up to fail. The acute phase of ODT w/d is going to last 4 or 5 days but my experience suggests that it's over a week before "Normality"(whatever that is!) really re-establishes itself. It's almost exactly 7 days now since my last dose of ODT and only in the last 24 hours has the tiredness and deep bone-aching lethargy eased off. Some w/d symptoms are still apparent at the end of the day even after a week. Go easy on yourself, my friend,take the advice offered by wiser heads than me and may it pass quickly.

 

[erlenmeyer]

I think most of what you're feeling is down to the benzos- Opiate/opioid wihdrawal can be unpleasant but doesn't usually engender these sort of responses. I know exactly what you mean by "walking outside in a spacesuit", that's classic benzo w/d depersonalization.If I were you(and I know we're all different) I'd get the ODT withdrawal over and done,using as many benzos as you need to get clear of it, then think about tapering on the benzos. Trying to do both together is admirably heroic, but I think you could be setting yourself up to fail. The acute phase of ODT w/d is going to last 4 or 5 days but my experience suggests that it's over a week before "Normality"(whatever that is!) really re-establishes itself. It's almost exactly 7 days now since my last dose of ODT and only in the last 24 hours has the tiredness and deep bone-aching lethargy eased off. Some w/d symptoms are still apparent at the end of the day even after a week. Go easy on yourself, my friend,take the advice offered by wiser heads than me and may it pass quickly.

I'm also positive that there shouldn't be a trace of acute ODT WD left (I mean it's been almost 10 days ffs). It's just that I'm not familiar with benzo withdrawal symptoms at all. Except for some less severe derealisation/depersonalisation I'm doing quite fine today. The improvement might very well be from the 30mg diazepam I took yesterday. I reckon I'll sit and wait for a couple of days and if any symptoms come back/get worse then it's definitely all benzo related and i'll do a quick taper from then on. Though I'll probably start somewhere lower than 30mg. Still astonished at how little time it took me to apparently become physically dependent on that stuff. Seems like the evil shit is indeed the Clonazepam and ODT is still "God's own medicine" . Thanks and God bless you for your support.

EDIT: I'm definitely feeling (very close to) normal today apart from the depersonalisation. Did yours go away right after dosing back to equilibrium levels or was it a protracted symptom? I'm familiar with non drug-induced derealisation (limited to one's perception of the environment), but this seems a bit different. It's rather like all the accounts I've read about depersonalisation (feeling somewhat like a robot). I sure as hell don't want this to become chronic...

 

[Escapedysphoria]

Walking outside is as if I'm stuck in a space suit on a mild trip of ketamine.

Reminds me of the strange anxiety that becomes visually apparent during the bad benzodiazepine withdrawals I've had to expirience. Makes you just wanna keep your eyes closed, agoraphobia...

 

[erlenmeyer]

What total length would you guys suggest for a rapid taper off the benzos (I'm going to start from 20mg of Diazepam)?

 

[JJ-180]

Two to three weeks is the absolute minimum. You don't want it to hurt more than it has to! (yeah, I know, I'm a fine one to talk...)

Even if you do it at the rate of 1mg a day,you're still looking at 3 wks....

 

[erlenmeyer]

Two to three weeks is the absolute minimum. You don't want it to hurt more than it has to! (yeah, I know, I'm a fine one to talk...)

Even if you do it at the rate of 1mg a day,you're still looking at 3 wks....

UPDATE: I'm feeling fine now . Diazepam is now at a stable 15mgs a day and I will continue that for a few more days, then drop down to 12 or 10. I realise that benzo WD might only rear its ugly head some time after stopping your last (tiny) dose of the taper. In that case I'll just plan on reinstating and going down more slowly from then on. All in all, my rationale for a rapid (about 3 weeks as you suggested) taper is that if it took my body such a short time to downregulate, then those same mechanisms should still function to upregulate rather quickly (as opposed to neuronal changes in a long term user).
And I'm glad I was able to call your attention to those last bags of ODT . Self-limiting supplies and being unable to source 'real' opiates/opioids (or any hard illicit drugs for that matter) is really the best thing that can happen to you as a recreational opiate user, at least in my opinion . That reminds me of the very first (and last) time I came into contact with the 'real' thing and any opiates for that matter. I was backpacking in Cambodia and taxi/moto drivers there constantly annoy you with their offers ("want girls, want ganja, want opium?"). Once I told myself: Hell, you're on holidays and about to go to Indonesia. So I gave in and bought some Heroin (greyish powder, seemed quite pure) and thought that if you're going to try it once, then at least do it properly. I ended up IVing half of the minute quantity that I had bought (again being opiate naive). And damn did it hit me. I remember sitting there in my hotel room, drooling, watching CNN where all hell was beaking loose with Lehman Bros & co. at that time. BTW, I flushed the rest down the toilet. Don't tell me how crazy of an idea that was, but that's just me. We seem to have something in common with respect to this JJ-180 . On the other hand I've always been very pragmatic when it comes to kicking and flushing .
Well, that little story just came to mind as another example of an opportunity for self-limiting opiate use .

 

[erlenmeyer]

Two to three weeks is the absolute minimum. You don't want it to hurt more than it has to! (yeah, I know, I'm a fine one to talk...)

Even if you do it at the rate of 1mg a day,you're still looking at 3 wks....

UPDATE: I'm feeling fine now . Diazepam is now at a stable 15mgs a day and I will continue that for a few more days, then drop down to 12 or 10. I realise that benzo WD might only rear its ugly head some time after stopping your last (tiny) dose of the taper. In that case I'll just plan on reinstating and going down more slowly from then on. All in all, my rationale for a rapid (about 3 weeks as you suggested) taper is that if it took my body such a short time to downregulate, then those same mechanisms should still function to upregulate rather quickly (as opposed to neuronal changes in a long term user).
And I'm glad I was able to call your attention to those last bags of ODT . Self-limiting supplies and being unable to source 'real' opiates/opioids (or any hard illicit drugs for that matter) is really the best thing that can happen to you as a recreational opiate user, at least in my opinion . That reminds me of the very first (and last) time I came into contact with the 'real' thing and any opiate for that matter. I was backpacking in Cambodia and taxi/moto drivers there constantly annoy you with their offers ("want girls, want ganja, want opium?"). Once I told myself: Hell, you're on holidays, about to go to Indonesia and have no connects whatsoever at home. So I gave in and bought some Heroin (greyish powder, seemed quite pure) and thought that if you're going to try it once, then at least do it properly. I ended up IVing half of the minute quantity that I had bought (again being opiate naive). And damn did it hit me. I remember sitting there in my hotel room, drooling, watching CNN where all hell was breaking loose with Lehman Bros & co. at that time. BTW, I flushed the rest down the toilet. Don't tell me how crazy of an idea that was (the IVing, not the flushing), but that's just me I guess. We seem to have some things in common with respect to this JJ-180 . On the other hand I've always been very pragmatic when it comes to kicking and flushing .
Well, that little story just came to mind as another example of an opportunity for self-limiting opiate use .

 

[Captain.Heroin]

Some people are very sensitive when they come off of a certain type of drug. For instance, when I quit heroin, I wasn't using a whole lot of it either (0.25g per day max intranasal? I mean I guess with an unknown purity what does that tell us? - I can just say I've seen people go through a gram a day, I never went through that much, I'd make a gram last me) - when I got on bupe, the first 2mg dosage - I didn't feel anything and was starting to feel nervous, hoping it would work. I took another 2mg, and waited more time, and then finally felt some relief. For the sublingual ROA I'd use up to 6 to 8mg per day in 2mg sections, for the first few weeks, then I kept it to 4mg per day.

I hear a lot of people on similar dosages of bupe for a significantly different volume of heroin intake. Some of these people live where they got equally as good dope as what I was used to getting where I was living at the time... so I'm sure it's not that people are just getting cut dope.

I just feel that I was way more sensitive to the effects of a full agonist opiate like heroin, than I am to buprenorphine. I am still slightly sensitive to buprenorphine as it has a full agonist metabolite, and now that I don't have any opiate tolerance I can get nicely faded on buprenorphine but, that's not what I aim for. I am for being relaxed but comfortable while also not nodding out, as this isn't going to help me driving or being productive in life.

UPDATE: I'm feeling fine now . Diazepam is now at a stable 15mgs a day and I will continue that for a few more days, then drop down to 12 or 10. I realise that benzo WD might only rear its ugly head some time after stopping your last (tiny) dose of the taper. In that case I'll just plan on reinstating and going down more slowly from then on. All in all, my rationale for a rapid (about 3 weeks as you suggested) taper is that if it took my body such a short time to downregulate, then those same mechanisms should still function to upregulate rather quickly (as opposed to neuronal changes in a long term user).
And I'm glad I was able to call your attention to those last bags of ODT . Self-limiting supplies and being unable to source 'real' opiates/opioids (or any hard illicit drugs for that matter) is really the best thing that can happen to you as a recreational opiate user, at least in my opinion . That reminds me of the very first (and last) time I came into contact with the 'real' thing and any opiate for that matter. I was backpacking in Cambodia and taxi/moto drivers there constantly annoy you with their offers ("want girls, want ganja, want opium?"). Once I told myself: Hell, you're on holidays, about to go to Indonesia and have no connects whatsoever at home. So I gave in and bought some Heroin (greyish powder, seemed quite pure) and thought that if you're going to try it once, then at least do it properly. I ended up IVing half of the minute quantity that I had bought (again being opiate naive). And damn did it hit me. I remember sitting there in my hotel room, drooling, watching CNN where all hell was breaking loose with Lehman Bros & co. at that time. BTW, I flushed the rest down the toilet. Don't tell me how crazy of an idea that was (the IVing, not the flushing), but that's just me I guess. We seem to have some things in common with respect to this JJ-180 . On the other hand I've always been very pragmatic when it comes to kicking and flushing .
Well, that little story just came to mind as another example of an opportunity for self-limiting opiate use .

I can't even joy IV heroin anymore, because I know how shitty I'll feel the next day from a single dosage. In my experience, that's just not worth it, as other (hard) drugs do not effect me like this.

But hey sounds like you had a pretty sweet high though! Just thinking about the euphoria heroin delivers - it just seems weak. Heroin isn't a weak drug don't get me wrong, but if the amount of euphoria was scored, then deducted for the amount of following dysphoria, that is how I'd say heroin is not a strong euphorant. If you only plan on using it once, it's very easy to have a great experience with little/no comedown. Some people get "opiate hangovers"... I can't really tell you the difference or anything but the withdrawal is fucking hell; I just hate how I feel the day after I do dope now. I haven't done it recently, but it was nice reminding myself of how unpleasant the drug is so I don't have any desire to ever use it again. I now live somewhere that powder heroin is essentially 100% impossible to find, maybe 99.9% impossible (you'd be lucky to find powder).

These are just my own personal opinions derived from my own personal experiences. I'm sure someone else could easily explain how for them it's the opposite, that one dosage of a drug like IV methamphetamine or IV cocaine... will cause them to feel horrible the next day, and they can do IV heroin for 3 days, quit, no cravings, blah blah blah. Everyone isn't equal in this sense, we are all unique and drugs are all going to effect us in unique ways.

For me personally though, drugs like cocaine, methamphetamine, ketamine, or even benzodiazepines like midazolam, temazepam, alprazolam, etc- they don't really leave you feeling shitty the next day. If you go to sleep on midazolam or alprazolam, yeah you might feel bad because you didn't get the proper amount of REM sleep , temazepam doesn't interrupt this though. IME, all those drugs (although I'd prefer never to use cocaine or methamphetamine ever again, when I did use them in the past, it wasn't hard to quit using, even if I went on for a while longer than one originally plans to. I was even still able to take a day's break from it with it still in my possession, and I've talked to plenty of people who are completely unable to do that.)

My advice is, if you have any reason to believe you might find yourself becoming psychologically and/or physically dependent on a drug that you got for recreational use, please, give the rest of it to a trustworthy family member or VERY close friend, who can help you use more wisely. This way, you can get more enjoyment out of your product, and avoid addiction, as well, perhaps there are medications you don't find worthy of taking into your own body, that other people desperately can't self-regulate properly. Maybe you could help them out too, and so on.

I think if families were more supportive towards the individuals within their own families with drug addictions, and showed them that they're all on the same side, and just want to see you get better, or cut back, or quit at your own pace but definitely not increase usage etc etc. stuff like that, then more people would get clean as they would feel in control of their rehabilitation. As well, No matter how angry some people may feel at a family member for their drug addiction, and the actions they may have done to support their usage, just keep in mind, that anything you do to try to come off as judgmental or hurtful or demeaning, that they just won't want to listen to you, and the second they can, they'll just prove you have no control over them by using again. Many people who are addicts feel powerless over parts/whole of their lives, and drug addiction is one of a few things they do to take control of something in life, so to speak. You could compare it to how if some people have nothing else to control, they'll become anorexic or possibly bulimic to regain that sense they have control in their daily lives, etc. (just keep in mind I"m using these two eating disorders as an example, and people can contract eating disorders other ways than due to the need to regain control over any facet of their own lives).

Other people may just be severely ungrateful human beings to any family/friends they've ever had, other people may use drugs because they have too much money for a single individual to have to their own disposal, and yet other people may be self-medicating for otherwise under-treated medical/mental issues... and there are many other reasons why people become drug users. In fact if you wanted to argue determinism you could say that we had no choice... I'm not trying to hit a philosophical side note though.

IMO if you know you want to get high, let yourself do it on something that's safe and not going to harm yourself. If you can't ascertain that, find another drug which is significantly less harmful than shooting street grade cocaine/heroin/etc.

Nonetheless, this is just my 2 cents. If someone is totally satisfied using full agonist opiates - I won't judge you or look down at you at all because it would make me a severe hypocrite since I used heroin and enjoyed it while I was doing it - as well, I thoroughly enjoy buprenorphine more as a medicine than a recreational drug experience but I don't necessarily need to segregate the two in my mind.