(Bupe) This is really starting to get to me...

[Woodsong]

Sorry to keep making threads on the same issue...

I don't know how to handle this anymore. I've been off of Subutex for six weeks now. (TL;DR: 16mg a day for over a year, stopped cold turkey) After the first two, I simply couldn't take the agony anymore after nearly collapsing in the grocery store, so I switched onto loperamide, and I've been slowly tapering down off that since. I'm down to 12mg of lope/day now, and this seems to be the lowest I can go... Makes me dehydrated and thirsty no matter how much I drink, clogs me up something fierce no matter what I eat, more weakness in addition to the usual, headache; it sucks but it's better than the alternative...

I still wake up every morning with snot dripping out of my nose and my legs on fire... I do have some clonidine, but even after only .1 mg it makes me feel like my heart's gonna stop beating, so I'm very tentative about taking it. It doesn't really do much else besides lower my BP. I can't take benzos... I mean, I can, but I have absolutely no control over my use of them. Last time I took Xanax ended up with me calling my old roxi dealers, but luckily they all changed their numbers. Very bad idea.

I (stupidly) got some kratom in the mail about a week ago, and that went pretty much like I expected. 50 grams of powdered Bali, gone in four days, I imagine that probably set me back pretty good... Only lasted a few hours anyway, and gave me horrible migraines...

I'm trying my damndest to weather this out as best I can. Six friggin weeks... I took the loperamide this morning, and even though I feel alright physically now, I'm just gritting my teeth and trying not to scream or punch the wall... I feel so damn stressed without anything even going on. In this kind of state, I know I'm sitting on a hair trigger; I'd relapse on oxy or even bupe again given the slightest chance to... I don't even want to get high, I just want this to go away... I imagine I'd be feeling a lot better by now if I hadn't picked up that goddamn bottle of Imodium to begin with......

Got fired last October, no vehicle, nowhere to go, nowhere to run or exercise, no one to physically talk to, just this tiny freezing-ass room with a hard bed and a laptop... At least the blinding, agonizing pain those first two weeks blocked out everything else........ I'm starting to find it hard to see the upside to quitting in the first place, even though mentally I know there is one, eventually... I just want it to stop... It's been this long already, I think I've paid my fucking dues...

GRRRR, buprenorphine is such a stupid ass drug... Hell of a price to pay for something with no recreational value whatsoever... (Never did for me, anyway.)

 

[Ferox]

I don't believe the lopermide to be delaying any of the withdrawals associated with Bupe, especially at the dosage you are using. I've used upwards of 50-100mg daily for a week and besides the fact that I felt like I was going to shit out of my belly button, I didn't notice much of a rebound effect when I stopped taking it. It helped take away a few of the withdrawal symptoms and absolutely plugged me up beyond any belief, which was almost worse than some of the symptoms it took away (OT: I remember waking up one night sick to my stomach, I threw up what I expect should have been coming out of the other hole and then finally proceeded to pop a couple red woods out the other side. Definitely one of my worse nights next to experiencing food poisoning).

I remembering being in your situation around week 4 of oxycodone/oxymorphone withdrawals and I was so ready to give up and get back to the grind, but thankfully, like you, I couldn't source anything except kratom and was left to grin and bare the following weeks. At around six weeks, like emerging from a tunnel, I saw the light of day.
I know the withdrawals from sub can last much much longer than some of the more typical opioid medicines, but I'd have to imagine you are so very close to the finish line. Don't give up just yet!!!

Have you tried stool softeners to combat the constipation? What about a liquid only juice diet? There are many vegetables out there that you can juice that can help flood your system clean, not to mention, you could probably benefit from the nutrients!

 

[mrflowers00]

i still felt like shit after nine months w/o any oxy i'm back to using again because i just couldn't take it anymore but getting and staying sober is really worth it i was just too weak

 

[Swimmingdancer]

Congratulations on being of buprenorphine for 6 weeks! Remember that that is a huge accomplishment and that you are already feeling better than you were a month ago. I know it's not getting better as fast as you like and it's hard to keep up hope but try to focus on the positives and be proud of yourself. Not everyone understands what you're going through, but you should at least try to be kind to yourself and remember how strong you are being. At least I know for me I'm not always good about that - it's easy to get into harmful thought loops like "this is my fault", "I just want this to stop", "am I ever going to feel better?" etc.

I agree with your assessment that the loperamide is probably doing you more harm than good but you didn't have any way to predict that so don't beat yourself up over that either.

It's also very easy to romanticize the positives of being on opioids and over-emphasize the negatives of quitting. I find it helpful to:
- remember all the reasons I wanted to get off opioids
- focus on any improvements in the way I feel, no matter how slight
- brainstorm ways to speed my recovery and ways to actually force myself to do them (baby steps so it's not overwhelming, like "today I will take my vitamins and go for a short walk")
- prevent myself from being able to use drugs in a moment of weakness
- and to try to look at my current situation with non-judgemental mindfulness instead of reacting emotionally and wishing for it to stop, while still having aspirations for the future - how I might envision my life and the way I feel without opioids.

If you want some help with any of those things or just need someone to talk to please let me know.

As far as the loperamide, I'd suggest trying to taper off it as quick as you can. Once you get to that point where you feel stuck it's like ripping a bandaid off - it hurts more and just prolongs the pain if you do it slowly. But if you truly feel that the loperamide is the main thing stopping you from using other drugs that is something to consider.

i still felt like shit after nine months w/o any oxy i'm back to using again because i just couldn't take it anymore but getting and staying sober is really worth it i was just too weak

You are not "weak"! Staying clean is hard, especially if that's the only change you make to your life. Relapse does not make you a failure or set your progress back to zero. Maybe you have learned some things for next time you want to try to get off Oxy. Pretty much everyone has to try to quit multiple times before they succeed.

 

[Ferox]

You are not "weak"! Staying clean is hard, especially if that's the only change you make to your life. Relapse does not make you a failure or set your progress back to zero. Maybe you have learned some things for next time you want to try to get off Oxy. Pretty much everyone has to try to quit multiple times before they succeed.

It's not about how many times you fall, it's about how many times you get up!! Relapse is just another step to recovery! We've all been there and I think we would all agree it's helped shape the persons we are today!

 

[mrflowers00]

i've tried to quit hundreds of times usually lasting a couple days i was just saying the longest i stayed sober was nine months and i still felt awful even though i was exercising, going to AA meetings, being social, eating better (still not great) and i still felt physically and psychologically felt like shit so i said fuck it and got high again

 

[Woodsong]

@Ferox
Huhuh, I've had to do unspeakable things to myself on a few occasions thanks to loperamide...... I get plenty of nutrients though. Those 'Ensure' shakes were about the only thing I could keep down at first, and I've been drinking em ever since. Fruits, veggies, non-red meat, all that healthy crap. I still take caffeine in the morning and suck on nicotine lozenges all day, so that could be a contributing factor...

@Swimmingdancer
Truth be told, I didn't really want to quit. I mean, I did, but ... I originally got on bupe after my dad approached me about my opiate habit, not really cause I wanted to stop. I'm trying to survive on a small unemployment check for now, and that won't last forever, so after a big hiccup at the pharmacy, I was already feeling sick and just ultimately fed up, so this is where I ended up, and it just doesn't seem feasible or reasonable to go backwards... I don't even remember what oxycodone feels like, so ... I don't know. I'm just tired of it all...

 

[Woodsong]

The longer I stay off of bupe it seems, the less of a zombie I become, which leads right back to the reasons I started using in the first place, not the least of which was this little back pain issue I've had for years that has now returned with a vengeance... Also boredom with life in general, various emotional scars, yadda yadda yadda... When opiates were no longer a viable option for obliteration after getting on bupe, I started taking Xanax occasionally as a sort of substitute, which led to its own myriad of even worse problems... After all these years of abuse, I feel completely lost without some sort of chemical crutch to keep me afloat... Before the opiates and benzos, it was alcohol, and all that does now is make me feel sick and gross... I dunno how to explain it, I feel like I've blue-screen-of-death'd and need to be rebooted...

 

[Swimmingdancer]

@Swimmingdancer
Truth be told, I didn't really want to quit. I mean, I did, but ... I originally got on bupe after my dad approached me about my opiate habit, not really cause I wanted to stop. I'm trying to survive on a small unemployment check for now, and that won't last forever, so after a big hiccup at the pharmacy, I was already feeling sick and just ultimately fed up, so this is where I ended up, and it just doesn't seem feasible or reasonable to go backwards... I don't even remember what oxycodone feels like, so ... I don't know. I'm just tired of it all...

Well I don't know if it's even all that common to emotionally have a strong desire to quit. Like I never thought "I suddenly feel like I don't even want to use anymore", it was more like a rational decision to not go back to using based on all the negative impacts to my life and I made the decision to learn how to use my rational brain to help overcome my addiction. When I quit methadone it was kind of different because I didn't really feel like I was mentally addicted to methadone the way I was with my drug of choice (heroin) - I have never had cravings for methadone and it didn't get me high or give me a mood lift, it was just the fear of withdrawal and pain motivating me to take it, and I did make a conscious decision to taper off the methadone. The only drug cravings I ever get are for heroin, not methadone. So anyway, regardless of whether or not you feel you "wanted" to quit either oxy or bupe, you can still think of all the disadvantages to being on either in order to help motivate you right now. Like it might be financial costs, limits on your ability to do things (for example not being able to function when in withdrawal or not being able to travel or move), having to go to the pharmacy/doctor all the time (or even worse, unreliable drug dealers if you get drugs illicitly), getting treated differently, letting your family down, having to live in fear of your drugs being cut off or not being able to afford them, those kinds of things. And the disadvantages to going back to opioids, like for me I feel like I would just be setting myself back and it wouldn't solve anything, I've made it this far so I might as well keep on trying and see if how I feel improves.

I think that you really need to work on how to do things to help yourself recover instead of just sitting around waiting. I find it hard to believe that you literally have nowhere to go, no way to exercise, no one to talk to, and no way to improve your home environment. It just might feel like that right now. But we do have some power over these things. Obviously some things, like going somewhere awesome/far away or getting a new comfy bed, would require money that you don't have right now, but there are lots of little things you can do.

No job - what about volunteer or temp work?
No friends - talk to people online, get out in situations where you might make friends or at least speak to people, even if it's as small a conversation as saying hi to a neighbour, petting someone's dog at the park, getting a coffee from a cafe, going to a free class, going to a recovery meeting, etc. Even a little human contact is much better than holing up in your apartment by yourself.
No vehicle - see if there is a program for free bus passes for low income people or something.
Just this tiny freezing-ass room with a hard bed and a laptop - are you confined to your room for some reason? If not, then you can go outside for a change of scenery. It's supposed to be 72°F where you live on Sunday - that's not bad. I know that if you're like me you feel cold all the time but if you bundle up and are being active I think you'll be able to handle it, even if you just get out for a little while. And it's supposed to get sunny next week - sun is very good for withdrawal/post-acute withdrawal/depression/etc.
Nowhere to exercise - again, are you confined to your room? If not, go for a walk. If you can't force yourself to that then try doing some yoga in your room.

Maybe you are like me and your biggest problem is motivating yourself to actually do this kind of stuff?

By the way I can totally related to feeling like you've been "blue-screen-of-death'd and need to be rebooted".

 

[Woodsong]

@Swimmingdancer
That's a good way of putting it, yeah...

As for getting out, I'm kinda stuck in the middle of the hood right now. There really isn't much out here besides liquor stores and gas stations. All the roads around here have no shoulder and are very busy, with drug dealers and whatnot roaming everywhere. Not the best place for a shy white dude with a drug problem to be out and about. Buses don't run within walking distance; I have to borrow my grandmother's car to go anywhere, and she'll only let me if I say I'm going to the store, otherwise she'll think I'm just going out to get fucked up in my old town... This house is small, there's no heating or A/C... My mom and grandmother are always fighting over stupid shit, my little sister's always bouncing off the walls on Adderall, the walls are paper-thin... I really do feel like I'm stuck in a cage here, lol...

 

[neversickanymore]

Hey woodsong.. Sorry it is so hard. Keep at it. It really does get better quick. Also, sitting around focusing on the withdraws will kill you, as soon as I could (could as in was possible), week five, i got moving, just battled through the residual pain. Every single day, I had something planned for the whole day, getting moving hurt, but I new I wouldn't last if I sat around, as then there was nothing for me to focus on except for using to get rid of the BS lingering withdraw. plan something for tomorrow and do it no matter what. I'm so glad you are still in the fight, your doing great, it has to be getting better a little every day, 7 months clean for me now and all that crap is GONE.. fight fight fight!!! its just temporary and it gets better!!!

 

[Woodsong]

@neversickanymore
Thanks man, you've been encouraging me the whole time.
I was feeling GREAT for a while once I first started on the Imodium, I dunno what happened...

Edit: All the info I've read says loperamide doesn't get into the brain in significant amounts unless you take a crapload (har har) or use liver enzyme inhibitors and whatever, so ... if it doesn't get into the brain, then how does it relieve the "brain" symptoms of w/d?

 

[Ferox]

As far as lopermide, I've never had it really relieve the mental side of withdrawals. But from the cessation of the physical manifestations of withdrawals, I felt as though I got mental relief. It could be psychosomatic in your case. Like swimmingdancer mentioned, try to taper off of it and see how you feel. Since you know it doesn't effect the brain side of things, maybe it will make it easy to deal without as I don't think you could psych yourself into feeling better if you don't even believe it works in your brain, which it doesn't.

For me, knowing that other people were getting better helped me get past the fear that I would never recover from my withdrawals. Staying busy helps, but when I'm in the mindset completely lacking of any sort of motivation, I tend to just sit in my chair and obsess about everything. I would literally not be able to move because I had no desire to even be standing, let alone awake. If you can sleep, I might recommend just going to bed as early as you can and sleeping in as late as you can. That helped me on my hardest days.

Meditation also does help and it's not hard to do. Simple sit or lay down and focus calmly on your breath. Listen to it's rhythm and don't try to force anything. Close your eyes and try to relax, counting your in-breath and counting your out-breath. If you start to get lost in your thoughts, come right back to your breath and focus on that some more. If anything, that will allow you temporary relief of your emotional pain.

As everyone else has said, six weeks is no easy feat and you should be SO SO proud of yourself for that alone! I never thought I would have ever made it six weeks, but once you get out of the funk, you will be so glad that you stuck it through and the time that you went through will not have seemed that long. Just like the initial physical pains of withdrawal seem to last an eternity until you're out of them, the mental aspect can feel the same way.

In a sense, your brain is rebooting, learning to reproduce all the chemicals that it's been force fed for the duration of your use. Give it time and don't be hard on yourself!

Keep it up!!

 

[Woodsong]

@Ferox
I just figured it would turn off the faucet downstairs. Makes me wonder about the whole pharmacology, how it stops things like the runny nose and watery eyes and the Restless-Body-wanna-curl-into-a-ball-and-scream sensation and whatnot without affecting the receptors in the brain... Unless the receptors in your digestive system somehow regulate more than ... the digestive system. Doesn't loperamide also attach to the spinal cord?

Ah, hell if I know... Research time. Who needs a medical degree when you've got Google. Lol....... All comes down to whether or not it's prolonging this whole process, which I have no idea yet as this is the longest I've ever gone...

I do need a good night's sleep though... I just toss and turn all night, and my back suffers for it. Valerian root, melatonin, antihistamines, combo supplements and potions, various combinations of all of the above; only thing I've tried that gives me quality sleep is benzos, everything else makes me feel like a train wreck in the morning...

I guess like every other extreme of the emotional spectrum I've experienced during this whole thing, it'll come and go for a while...
I don't feel too good about getting more Xanax from my psychiatrist on the first, but maybe I can actually get some benefit out of em if I let someone else ration em out to me or something. Maybe..?

 

[Captain.Heroin]

(TL;DR: 16mg a day for over a year, stopped cold turkey)

Oh man... did you consider a taper?

I'm on a much lower dosage of Suboxone, but the withdrawals are still pretty bad when I start feeling them.

Either way, major congratulations for being able to quit at such a large dosage, that's really brave of you.

 

[Woodsong]

@Captain.Heroin
It's kind of a long story, but here's the non-TL;DR version...

I tried to get it filled at a pharmacy I don't usually get it at, and of course they didn't have it, so I had the script transferred to my usual one. They didn't have it either due to supply issues, and the first pharmacy got my doctor's DEA number wrong or something and it was the weekend so they had to wait til Monday to confirm it was a legit script (even though I'd brought the same exact script in every month for a year)... I was already getting pretty sick at that point, and I didn't have the money for a full script, so I asked if they could do a partial. They said they had only a few left, but I kept going around in circles with the pharmacist and for some reason they just refused to give me anything at all, brand name or otherwise... I was trying my best not to seem sick, but I was getting pretty pissed, so I just stormed out all "fuck your shit" and decided I didn't need it anymore and I knew I wouldn't be able to afford to stay on it much longer anyway... I knew coming off of 16mg was going to suck royally, but I was just so fed up with the crap at that point I didn't really care... (Every damn month there was always SOME kinda problem at the pharmacy. They'd try to act like they were contacting my insurance company when I didn't HAVE insurance on file, or just make me wait for two hours, or something...)

So I guess you can chalk it up to stubbornness, lol...

 

[Swimmingdancer]

I really do feel like I'm stuck in a cage here, lol...

I know how you feel. But I think it's important to convince yourself to at least do little things to improve your situation. It's very easy to think of all the reasons why it's difficult instead of spending that energy on thinking up ways to get yourself to do stuff. Even cleaning your room or rearranging things in it can help because environmental conditioning is a big factor in opioid withdrawal and PAWS. I WISH it was going to be 72° on Sun where I live - surely you can find some way to take advantage of that and it's a little thing you can look forward to?

All the info I've read says loperamide doesn't get into the brain in significant amounts unless you take a crapload (har har) or use liver enzyme inhibitors and whatever, so ... if it doesn't get into the brain, then how does it relieve the "brain" symptoms of w/d?

So, I almost hesitate to answer this but I believe in telling people the truth. Loperamide does cross the blood brain barrier, it is just that in normal doses in most people the majority of it is then rapidly removed from the brain by P-glycoprotein. While this mechanism generally effectively shields the CNS from significant exposure, many drugs and foods are known to inhibit P-glycoprotein and when high doses of loperamide are taken it does accumulate in the brain to produce typical opioid effects which last for a number of hours. P-glycoprotein is also variable from individual to individual - high blood and CNS levels of loperamide may result because of decreased P-glycoprotein expression. So it's not accurate when you hear people say that loperamide doesn't cross the blood brain barrier or that it can't affect the brain, or that you can't get physically dependent on loperamide (physical dependence can also happen without significant CNS effects, which is likely why Immodium says on the package not to take it for more than a certain number of days, although of course physical dependence to normal doses of loperamide would be minor in comparison to typical opioid dependence).

In the dose that you are currently taking - 12mg - loperamide alone does not normally cause respiratory depression, which is often used as an indicator of opioid effects on the CNS. If we go with the assumption that loperamide normally does not have significant CNS effects for most people in the kind of doses you are taking, that does not mean it only acts on the gut. Peripheral just refers to outside the brain and spinal cord. There are opioid receptors on peripheral sensory neurons. Tests in rats have shown that the peripheral component of action of loperamide is sufficient to produce some pain relief, and it is well-established that peripheral opioid receptors play a role in mediating pain and in some other opioid effects. I assume oral loperamide does not act on the spinal cord because P-glycoprotein is an active transporter at the blood-spinal cord barrier. I agree with Ferox that it's likely that a substantial amount of the mental distress surrounding withdrawal is caused by the physical symptoms and that loperamide probably reduces mental symptoms in this way.

However, I really think it's probably not doing that much for you and may be holding your body back from recovering.

 

[IHateOpiophobes]

Exactly how I feel...very well said. Just a clean fresh reboot, maybe even a format and reinstall. Its a multi-layered cage that you habitually put yourself in. Where is the rewire button on my head.???

 

[Woodsong]

Down to 8mg of lope. Body not too happy about the drop, but seems to work well enough. Feels like it takes me all day just to wake up.

Not quite as angry and desperate as I was when I first posted this, but still kinda wish I had something to calm my brain down. I just dream of the day I don't have to feel this way anymore...

 

[Bojangles2.0]

Lets reframe something so you know exactly where you stand in this situation.

First, bupe is not a "stupid ass drug".
If anything, you coming off at 16mg makes you look like the stupid one.

I'm not trying to insult you, but its important that we keep it real here.
You decided to use about 4-8xs the amount of bupe you needed for 1 year straight, that was your choice.
You ALSO decided to stop cold turkey at 16mg, which again, wasn't a smart choice.

Whatever you do, please don't blame bupe when all the bad decisions were obviously made by you, not the bupe.
There are people like me who decided to taper their bupe down to .125mg, and stop. And I have nothing but
great things to say about it.

So naturally it makes me angry when I see people talking smack about this drug. The whole point is its not suppose
to get you high. And its suppose to last a long time. Why? Because in a medical setting, that makes for a perfect
tapering drug.

Anyway, I'm not trying to offend you, and good luck with your lope. But something tells me you'll be back on bupe
or a full agonist within 3 months. Why do I suspect that? Its pretty simple. You never allowed your receptors to adjust.
You essentially traumatized them by jumping off at 16mg. So even if you get off lope, you're likely to go through a PAWs
phase thats unbearable.

Thats why I always tell people taper. And if you don't, then don't complain when your back on opiates 3-6 months later.

I've seen this same pattern repeat on this forum one person after another after another. Everyone "just wants to get it
over with". But the reality is, its just an excuse to not have any control over their lives. The last thing they want to do
is try actually controlling their addiction. And with something like bupe, that doesn't even get you high, its the easiest
thing in the world to taper. But still people need to feel this false sense of control by cold turkeying. Like "i'm getting my
shit together finally". Unfortunately, that rarely happens.

Control the addiction, but never overcompensate. Because addiction will bite you in the ass if you do.