Just to keep in mind, I have come to learn, fairly recently, just how effective loperamide can be in allaying a very great deal of the symptoms of opioid withdrawal. Of course, it is so effective because it is an opioid, and taking it chronically, you remain opioid dependent, physically, but it does not cross the blood brain barrier, and thus does not have any effects on the actual dysphoria brought forth by opioid withdrawal. However, it didn't so much occur to me, until fairly recently, that so much of the psychological agony attributed to opioid withdrawal is likely quite a great deal worsened by the physical symptoms of the withdrawal, which, like I said, can be made better using simple and over-the-counter loperamide. I will reiterate, it will delay the withdrawal syndrome because of the fact that, where it does act within the body, it can act quite potently as any other strong opioid would, provided the proper dose. But, if you simply cannot afford the methadone program as of now, or could see yourself on another form of opioid maintenance therapy, such as with buprenorphine, loperamide may be able to hold you over in a sense - maybe a better way to describe it would be as a stepping stone from methadone to either sobriety in total, or as I said, other opioid maintenance therapy. I know opioid withdrawal on paper, have a had one or two VERY MODEST tastes of it, and even for it being so, so little with respect to other opioid withdrawal syndromes, it pains me to think about what I went through, then, let alone what you must be going through. I congratulate you, most certainly, on your swift drop from 100 mg to 50 mg daily with the methadone, and I would say the fact that the symptoms have not yet been constant and downright awful, is a very good sign if you look at the taper like you have hit the half-way mark, which you have. Don't worry over what might be to come, but do be prepared with methods to combat different aspects of the withdrawal syndrome. Be careful with the benzodiazepines, like Valium and Xanax, just because you might find yourself in the beginning of a benzodiazepine dependence, which you don't want, but don't be too much of hero in that regard, if you do have comfort drugs as strong as benzodiazepines. Use them when it gets worse than baseline bad, and there is anxiety or insomnia or restlessness that is just too miserable to sit out without a little help. You said Benadryl worked well for you - that is very good; it can help with the anxiety, insomnia, restlessness, nausea/vomiting, diarrhea, and likely other aspects of the syndrome. But, with the Benadryl, just be careful with the dosing - too high a dose, even a bit higher than what a doctor might suggest, can cause certain side-effects that are unpleasant in the short-term and potentially dangerous, especially on top of kicking methadone. But, to balance the Xanax or Valium with the Benadryl, keeping either of the benzo's at a lower dose and the Benadryl at a lower dose, but taking them together might allow for even better symptom management with less risk. I did mention loperamide (Imodium), which is a comfort drug, but one that you have to use, or not use, depending on what you want to accomplish with your general situation with opioids. Still, I'd think a fairly modest dose might be fine through the worst of your discomfort, then to discontinue that dose with a bit of a taper.
I wish you the best of luck, really, and I have a feeling you will make through to the other end with relative ease; I am not saying it sounds like it is going to be anything but what it is - methadone withdrawal - but, I think, based on what you've so far written, you won't suffer as much as you might fear, even considering the rapid pace of the taper. I say this just because you sound quite 'grounded', and seem to be quite self-aware when it comes to your situation with opioids, on the whole, and the dependence and addiction thereto related. Let me think - other than comfort drugs, remember to take warm baths/showers as frequently as you like or can, and that just a soak of the feet in warm water is a good coping mechanism. The water things (baths, showers, foot soaks, etc.) can help a lot with general restlessness and with sweats/temperature dysregulation, especially. I am assuming you are a guy, so using frequent masturbation, and consequent orgasm, as a temporary source of relief is another activity you can go to which is something that makes you feel better and gives you relief from the symptoms, but also feels good and is a general distraction which gives your body some natural exercise. Even if you are female, the same would apply, though I have heard much more about that from men during opioid withdrawal, and how it is particularly satisfying during such a time. Try to keep really good sleep hygiene, too, and I know that might be very, very hard to think about, and do, during some points of the withdrawal syndrome, but it is something which does help sleep, naturally, and something which, if you make good habit now during the rough parts of it, may allow for easier sleep earlier on after the withdrawal symptoms have seen their plateau and are dwindling down putting you back to a state in which you will feel much better, after it is all said and done. And, please, don't forget that you can get to that state. Also, to help you now, that will also continue you to help you into full normalcy, is the practice of meditation and relaxation as something you have that allows you to exert control over your body and your mind, which improves drastically with simple practice, each time having the ability to fall deeper into relaxation and better control the certain parts of your perception, if only for a short while, that will help you to get through this with less pain, on the whole. It may sound complicated, but you could call it relaxation, meditation, reflection, introspection, self-hypnosis, or just winding down or chilling out or something like that. The idea behind it is so simple, it can vary as anyone may need it to vary for the individual self. For me, I like to, usually before I rest for the night and allow myself to fall asleep, lie still, close my eyes, and begin talking to myself silently, usually getting into the relaxation with some basic counting to myself, then repeating a general mantra or 'saying' to myself, again silently, before repeating more specific things to myself silently, even if simple. Often times, in between the simple inner-monologue of thought, I go back to simple counting to get myself more relaxed, or go to my personal mantra, and often I will let a lot of silence pass while not trying to say anything to myself aloud or silently, which helps to get deeper and deeper into it, for me. Generally, the better you feel from it after it is over, the better you know you can feel by doing a series of things which involve just my mind, body, and soul. It is a sort of altered consciousness, in which I try to keep myself awake, but while remaining awake, falling into a sleeplike state of relaxation. In this type of state, I can become much more in tune with my own body, mind, and soul, and direct them accordingly by repeating (silently to myself) requests or affirmations such as "My muscles are relaxed. My whole body is loose and peaceful. Now, waves of warmth and relaxation will come over my body, again, from my toes all the way through my body up to my head." It is surprisingly very effective when done with belief that it can be done, and like I said it might just start out with feeling a little better after opening your eyes and take the world in again, which would be how it might go if you used the technique I use, though usually one's eyes are closed for such relaxation techniques. I wouldn't be going on about this technique if I hadn't heard it worked very well for others, too, and then shocked me in how well it worked, and how quickly - it is amazing how you can influence your body's muscles to go from quite tense to quite relaxed with the power of suggestion, from the example I used above. But, it does do with the power of suggestion, and how the mind, and soul (if you feel comfortable using soul or spirit), and the body are all so separate, but all one entity at the same time, where you can use one part to help control another part. You just have to sort of relax down into it, and tell yourself what you want to be with respect to change, to feel better, in the short-term and long-term. I know I keep going on about it, but the initial story of its success which caught my attention dealt with a doctor performing what he called self-hypnosis on himself and bringing to a full stop the fare-up of vicious nerve pain he had been experiencing to the point of being almost debilitated. It certainly was something I had to try, and it is something which I am thinking of now, not knowing so much about your situation, but still feeling it could really help you.
One more thing - be active while coming off the methadone, and while going through all the stages of the withdrawal syndrome. I struggle with being active, personally, but it can be a great help, especially in situations such as opioid withdrawal, and I have heard personal testimonies attributing so much of certain individuals' success with detoxing that I cannot help but think it is, indeed, very helpful. It likely eases the restlessness enormously, and also allows the muscles to get stretched naturally, thus decreasing the pain they would normally experience and preventing muscle stiffness and/or tension that often accompanies opioid withdrawal. It, too, would give an outlet of a physical nature to combat, as I alluded to, the restlessness, but also the emotional anxiety, nervousness, uneasiness, etc. Naturally, mood would improve, as well, with activity. But, do what you feel is right for your mind and body in that regard, for there maybe some limits your body is telling you just not to push. After all, you don't want to add to the exhaustion, but rather the opposite, and let the activity one day encourage the same or a bit more activity the next day, because it should feel as good as it can, bearing in mind the circumstances, of course. So, activity not to push you out of something unpleasant, but rather activity to pull you into something pleasant, or at least better, seems like the best way to sum it up. But, do remember you know yourself, which includes your body and mind, better than anyone else. All the knowledge of how a certain withdrawal syndrome, like that from methadone, can be read and studied for days upon days by the leading addiction specialists in the world, but unless one of them goes through it himself, well you will always know that experience in life in ways they never could. And, what is more is that not only is your particular condition not understood as you understand it by professionals, or by family, or by friends, but know one can understand the person who you are the way you can, either, which is important to bear in mind. And, only you can ever know your condition and yourself in that condition in the way you do, so it might be a bad idea to really try to keep very aware of your person, and all aspects of it. Anyhow, beyond that small tangent, though it is important, I wanted to note one more thing. A lot of the greatest artists, whatever art they made, if they wrote, oil painted, came up with a revolutionary set of theories to forever change the world, whatever, did some of their very best work during withdrawal, very often, historically, from opioids, though not exclusively, of course. And, if you have a hobby or hobbies, or interests or some such, I'd suggest you spend a lot of the time going further with that, learning more about it, taking a step deeper into it, all during the time you could be simply thinking about feeling less than great. If you have existing interests, like I said, go with that, if you like, but use your own flavor of creativity - whether it is more with words, mechanics, physical activities, numbers, or whatever - to enhance the experience of it for you. I'd suggest not limiting yourself to one, unless you have one interest which is particularly strong. But, maybe even better as an exercise to get through all of this, would be to go with something new or relatively new. Remember, you are going to be experiencing so much that is not the 'norm' as you've known it for a good while, and with the time you will have, I think your potential for expression, just for yourself, would be able to be channeled to such a great degree via an outlet of your choice that would truly help slide you back into opioid-free life with a little something to look forward to that wasn't there before, or a big something that wasn't there before. Even if nothing more, I would keep a journal to document your feelings throughout the detox experience and after into when you feel naturally well, again. The journal could be personal or shared, via whatever media you'd like, and filled not just with the negative, but with everything you are feeling and thinking that is coming to you - a journal that would end up, whatever else it might be, very frank and very true, and something you could look back upon and see how you were challenged and how you - not anyone else - but, how you, with the qualities you embody as your own person, including strength, of course, not only survived one particular hardship in your life, but how you thrived in the midst of it.
So, everything I wrote does bear importance, or else I wouldn't have written it. I hope you get something from, and I wish you the best. Feel free to contact me, here, or via PM, if you need support, advice, distraction, or whatever. Keep true to yourself, know yourself better everyday, keep optimistic because it is really fucking better than being pessimistic in all things in life, and find beauty in all things in life even if seemingly impossible, and keep strong, too. And, know I am here on this thread, and available for PM, if you want to chat, talk seriously, laugh, cry, etc. But, I said that before. Sorry, if in this lengthy post, I was unduly repetitive, though usually I say things more than once to reiterate, not to be redundant.
- Alex.
