Med Student Going Through Opiate Withdrawls

[meduser33]

Ok, so first post here, so please let me know if I am violating any rules (I read the rules and I think I'm ok though).

I am currently in my second year of medical school in the U.S. and have been plagued by an opiate addiction through part of this year. I took the opiates (large amounts of oxy) as a form of anxiety relief, sleep aid, and due to several other types of pain (torn ACL, and also gastritis) I had throughout the year (I completely realize that pain medication for anxiety and sleep are totally off-label uses, but I personally preferred it over other anxiolytics and such). But let's face it, I also just enjoyed the feeling. Also, please do not flame me just because I am going to be a doctor, yet have an addiction as well......I am human just like everybody else, and my plan is to stop using this month so that I can focus more on my studies.

Anyways, I am currently going through some significant withdrawals (not my first time) with medical school finals this week. I have managed to remain in the top 15% of my class rankings despite my addiction, but taking these finals while going through withdrawals is going to take all that I have in me I think (probably one of the hardest things I will ever have done).

Anyways, I am just curious, but what is the hardest thing you have ever undertaken while going through major opiate withdrawals?

 

[Rybee]

Did you actually want any help/advice on how to manage withdrawals, or were you simply seeking other people's experiences?

And don't worry, no one on bluelight is here to judge anyone, that's one of the good things about it. Also, well done on opening up and being honest with yourself about opiate abuse. It's a nasty thing to go through.

 

[neversickanymore]

Hey meduser and welcome to Blue Light. I feel that this could have a negative effect on your finals. Why dont you use Loperamide to help you get through the finals? Other than that here are some medications that I would explore to lessen opiate withdrawls.

>Clonidine< DOSED EVER FOUR HOURS..

one of either
>NEURONTIN< >HERE< >HERE<
OR >Lyrica<
if these cant be found then > phenibut<

>A BENZO BUT JUST AT NIGHT<
>a nsaid<
>melatonin<
tylenol

Best of luck with the exams

 

[meduser33]

Did you actually want any help/advice on how to manage withdrawals, or were you simply seeking other people's experiences?

And don't worry, no one on bluelight is here to judge anyone, that's one of the good things about it. Also, well done on opening up and being honest with yourself about opiate abuse. It's a nasty thing to go through.

Mainly I was looking for similar stories of triumph over opiate withdrawals during periods of high stress and responsibilities.

But I would love opinions about the best way to manage withdrawals. I know that buprenorphine would probably be the number one pharmaceutical remedy, but that is out of the question for me due to several reasons (one of which, I cannot be seen by any addiction specialist physician in my area, because next year I will be doing clinical rotations with many of these physicians as part of my 3rd year of med school).

My current withdrawal medication list I am using is as follows:

1. Tizanidine (zanaflex) - which is an alpha 2 agonist and the same category of drug as Clonidine and proven through peer review studies to help with opiate withdrawals......see source: http://www.ncbi.nlm.nih.gov/pubmed/10808729. the study showed that "tizanidine treatment decreased the intensity of the withdrawal symptoms in every symptom type examined."
2. Loperamide
3. Carisoprodol (Soma) - I have several of these from my friend
4. Ondasentron (Zofran) - also proven to help with withdrawals
5. Acetaminophen and Ibuprofen - for aches and pains
6. Diphenhydramine (benadryl) - big doses to help with sleep (150 mg)
7. Dextromethorphan
8. Acetyl L-Carnitine
9. Multi-vitamin
10. Phenibut (I use this periodically to help with sleep.....a great supplement).
11. Gabapentin (neurontin) - I have about 15 of these left

Are there any good medications that I should be adding to this list to help? I know benzos work great but I haven't been able to find any lately.

Any further suggestions or stories (see above) would be greatly appreciated!

Thanks!

 

[meduser33]

Hey meduser and welcome to Blue Light. I feel that this could have a negative effect on your finals. Why dont you use Loperamide to help you get through the finals? Other than that here are some medications that I would explore to lessen opiate withdrawls.

>Clonidine< DOSED EVER FOUR HOURS..

one of either
>NEURONTIN< >HERE< >HERE<
OR >Lyrica<
if these cant be found then > phenibut<

>A BENZO BUT JUST AT NIGHT<
>a nsaid<
>melatonin<
tylenol

Best of luck with the exams

Thanks!

I am actually using everything you mentioned except for Benzos (can't find them at the moment for some reason) and also Melatonin (I might add this).

Thanks again!!

 

[neversickanymore]

I also used methylphenidate to combat the fatigue, depression, and inability to think clearly.. but as it manipulates the adrenals it can increase withdrawals associated with them. I would have prefered to use Amphetamine, Dextroamphetamine Mixed Salts salts as i think their effect on the adrenals is much less, but I didn't have access.

 

[meduser33]

Hey meduser and welcome to Blue Light. I feel that this could have a negative effect on your finals. Why dont you use Loperamide to help you get through the finals? Other than that here are some medications that I would explore to lessen opiate withdrawls.

>Clonidine< DOSED EVER FOUR HOURS..

one of either
>NEURONTIN< >HERE< >HERE<
OR >Lyrica<
if these cant be found then > phenibut<

>A BENZO BUT JUST AT NIGHT<
>a nsaid<
>melatonin<
tylenol

Best of luck with the exams

I gotta say, it feels really good to be able to open up about this and commiserate here on bluelight without being judged. If I were to tell my classmates about my problems I would be immediately judged, ostracized and quickly stoned (if not burned at the stake) for indulging like I have.

What a great outlet!

 

[meduser33]

I also used methylphenidate to combat the fatigue, depression, and inability to think clearly.. but as it manipulates the adrenals it can increase withdrawals associated with them. I would have prefered to use Amphetamine, Dextroamphetamine Mixed Salts salts as i think their effect on the adrenals is much less, but I didn't have access.

Funny you should mention that......I actually have a few methylphenidate right now lol. I was just worried when I was coming down off of it I might feel way worse. I will definitely consider it. Thanks!

 

[neversickanymore]

I gotta say, it feels really good to be able to open up about this and commiserate here on bluelight without being judged. If I were to tell my classmates about my problems I would be immediately judged, ostracized and quickly stoned (if not burned at the stake) for indulging like I have.

What a great outlet!

Blue Light is a pretty special place.. there are allot of really pretty special things going on here. Thanks you for the link on Tizanidine (zanaflex). Im going to check that out now.

 

[meduser33]

Blue Light is a pretty special place.. there are allot of really pretty special things going on here. Thanks you for the link on Tizanidine (zanaflex). Im going to check that out now.

Here is another peer reviewed study about Tizanidine and Dextromethorphan combination for opiate withdrawals: http://www.ncbi.nlm.nih.gov/pubmed/7711985

Unfortunately it is just the abstract and I can't find the conclusion to the study......I will try and log into PubMed later with my med school account and see if I can find it.

 

[RTrain]

I can't imagine taking a stimulant is a good idea during acute opiate withdrawal. This is just my opinion and its not something I would even want to consider trying. They are common as a pick me up for post acute W/Ds and I have used adderall during PAWS with some success. But during acute w/d you are already unable to sleep and unable to sit still, you are only going to increase anxiety and restlessness/RLS with a stimulant. And as you mentioned OP, the comedown will also be much more harsh. I think you really have to consider how stimulants effect you, I know I get very anxious and edgy on a comedown, so myself would steer clear.

If anything you should be going with the other end of the spectrum and using benzos or Z drugs to help ease w/d symptoms. Obviously 2 issues with those, one is getting them is tough. The other is the addiction potential. In the past my Dr has Rx'd me a small script of 20x 1 mg Lorazepams. With that many addiction risk is very low and my Dr provided a taper plan. I basically only really needed them for 3-4 days to induce sleep. After that sleep was attainable but a small dose was needed for perhaps a week after to gain near a full nights sleep.

 

[BigG]

I was also a medical student in the late 1990s early 2000s although my addiction hadnt took hold as seriously back then, I studied whilest suffering wds many times. While benzos, loperamide and lyrica are probably my personnal choice for helping opiate wds the onpy thing that truly takes away the sickness is another opiate agonist (or time obviously). The main thing is to dig deep push forward and know that eventually this will be over. As im sure u know once you are qualified you will have access to more prescription drug that the average addict could only dream about so best nip this in the bud now mate.

 

[meduser33]

I was also a medical student in the late 1990s early 2000s although my addiction hadnt took hold as seriously back then, I studied whilest suffering wds many times. While benzos, loperamide and lyrica are probably my personnal choice for helping opiate wds the onpy thing that truly takes away the sickness is another opiate agonist (or time obviously). The main thing is to dig deep push forward and know that eventually this will be over. As im sure u know once you are qualified you will have access to more prescription drug that the average addict could only dream about so best nip this in the bud now mate.

Thanks for sharing your experience! Are you a current practicing physician?

I agree with your last statement (one of the reasons I would never do Anesthesia do to the large numbers of addicts within the specialty) and I am quitting for good (or at least one day at a time!).

Luckily physicians can't really prescribe narcotics to themselves, but I will be friends with lots of physicians who could potentially prescribe me meds. So its best to get a handle on it now and avoid that route completely if possible.

 

[RTrain]

^Not to mention as a MD you probably will make enough money to sustain a sizable street drug habit if you want. Supplanted with the ability to attain pain killers from your profession, seems you'd have the resources to dig quite the hole for yourself. I think I'm jealous...............j/k

 

[meduser33]

^Not to mention as a MD you probably will make enough money to sustain a sizable street drug habit if you want. Supplanted with the ability to attain pain killers from your profession, seems you'd have the resources to dig quite the hole for yourself. I think I'm jealous...............j/k

Actually, it's kinda scary, because if I am not very careful I could potentially see myself getting into some serious trouble in the future within the profession, lol. Luckily, from what I have seen if you get busted on a drug charge there are consequences (like a temporary suspension, etc.) but they very rarely revoke your license to practice medicine on a first offense. I guess because it takes years and years to get the degree (only 2 more years for me YAY!) so they usually do not completely ruin your career for first offenses.

But you are completely right and I will need to employ self-restraint.

 

[neversickanymore]

if only self-restraint is all that's needed

 

[BigG]

Thanks for sharing your experience! Are you a current practicing physician?

I agree with your last statement (one of the reasons I would never do Anesthesia do to the large numbers of addicts within the specialty) and I am quitting for good (or at least one day at a time!).

Luckily physicians can't really prescribe narcotics to themselves, but I will be friends with lots of physicians who could potentially prescribe me meds. So its best to get a handle on it now and avoid that route completely if ptossible.

No mate im not a practicing physician. After 3 years of med school.I.switched to economics and now work in finance/management accounts (ironically ive worked for the national health service here in the uk for the last 10 years or so. A freind of mine from med school whent on to become an anaesthetist and was fired for drug use and stealing drugs. What he used to do was load up a 10ml syringe with say morphine, ketamine or whatever and give the patient say 7ml and instead of disposing of the rest keep it and use it himself. Even though it was delivered via a canula the risk of cross contamination from the patient was massive not to mention the risk of being caught (whixh he was....and fired). I makes me wonder how many patients were denyed much needed analgesia so he could get high. Apparently cases of morphine and fentanyl addiction ammong anaesthetists is huge. Take care mate and let us know how you get on.

 

[BeachBum4u]

Welcome! You are totally right to try and avoid the slippery slope (I know you know). I too studied in the medical field many years ago but I switched up too. Pressures are so high, I can imagine how easy it would be to start and continue a nasty habit. Back then, never had that problem.

My guess is (it's always mine when I'm forced off my pain meds) that sleep is the biggest problem. Obviously, that causes other problems. When I need to, I try to take some Benadryls to help get to sleep and to stay asleep. I wish you all the best in this endeavor!

 

[ohshea]

Oh my I cant imagine taking finals while going thru opiate WD. I just had my finals last week and they are hard enough as is--cant even imagine undertaking them while in WD. Only place Ive fully WD'd was in jail, and just had to sit in my cell all day. I got off heroin thru methadone, though. Just imagining your situation is making me cringe with empathy...best of luck to you! Like the other posters said, small doses of benzos can be EXTREMELY helpful, so long as you don't end up with another monkey on your back.

 

[Dreamboat]

My recommendation is kratom.
Good-luck to you with your finals.