Worst Withdrawl- Gaba drugs or opiates?

[5StarSquatHotel]

I need off asap and don't know if I should cover the opiate w/d with gaba selection or visa versa? The gaba drugs cover w/d to a manageable degree but then have to come off them. Pregablin, Nifoxipam, etzi, diclazepam and zopiclone. What path is best?

Tanks in advance Trancepants

 

[Allein]

I've never had a significant opiate habit but I've had serious issues with Diaz in the past.

Using a planned taper the physical symptoms are greatly reduced but the extended time period is a serious grind, you soon get to a point where the daily dose seems to do nothing other than take the edge off, if you can hang in there you'll feel almost fine by the time you stop them altogether. I truly believe that as long as you taper Benzos are largely a mind game

 

[Runtoparadise]

Go with the GABA meds IMO, the wd from them is minimal if all, esp if used short term. I personally use pregabalin EVERY time I wd,- which is pretty often, & find it covers any physical symptoms. Best of luck,

Rtp

 

[HouseFever]

What opis do you use?

 

[BigG]

I need off asap and don't know if I should cover the opiate w/d with gaba selection or visa versa? The gaba drugs cover w/d to a manageable degree but then have to come off them. Pregablin, Nifoxipam, etzi, diclazepam and zopiclone. What path is best?

Tanks in advance Trancepants

Unless you're withdrawing from methadone then the opiate withdrawal will be over before you e had time to gain a dependence to the gaba drugs (I.e. A week to ten days for most opiates). On the other hand the WDs from gaba drugs (notably benzoa) can be very protracted indeed so using opiates to cover gaba withdrawal seems unwise.

I'm using pregabalin and low doses of diazepam to cover my methadone withdrawl as although methadone withdrawl is very protracted, gaba drugs are relatively easy to taper from without too much discomfort as long as the taper regime is planned carefully. For some people opiate tapers are painful no matter how slowly or carefully they are done.

In short, using gaba drugs to cover opiate WDs - Yes
Using opiates to cover gaba WDs - No

 

[5StarSquatHotel]

Thanks for the replies guys, appreciate it. I do have a Gaba tolerance to a degree as scripted pregablin. I am stupidly back on subutex but am doing a 2mg jump as cant be dealing with a drawn out taper, I was thinking 2 weeks of heavy Gaba drug use to knock myself out but don't want to come out of it with a new addiction....

 

[pjd555]

To answer the question in the title is quite difficult because it depends on the definition of "worst" and the subjective response of an individual. Any level of pain beyond a certain degree is deemed unbearable at the time it is happening to an individual. From an objective perspective abrupt opiate withdrawal is considerably safer than abrupt benzodiazepine withdrawal but I wouldn't recommend either to anyone. With opiates the acute phase of physical withdrawal will be nearing the finishing line after 4 days for most people with another 2 days to get over the shock of the experience. If curing an opiate addiction were as simple as getting beyond the acute phase of withdrawal everyone who wants to become clean would do it with a quick visit to a doctor to get a short course of benzodiazepines to take the edge off and loperamide for the diarrhea. It isn't that simple because without support such an approach hardly ever works and, worse, repeated failure cements further the idea in an addict's head that they can never become clean. That particular issue means that opiate withdrawal should be planned with a proper support system in place to avoid a pointless and painful repetition which has the effect of extending the addiction. Benzodiazepine withdrawal must always be planned because the acute withdrawal symptoms are far more dangerous than those associated with opiate withdrawal but, on the plus side, the success rate after a properly managed withdrawal is pretty good.

 

[pjd555]

Thanks for the replies guys, appreciate it. I do have a Gaba tolerance to a degree as scripted pregablin. I am stupidly back on subutex but am doing a 2mg jump as cant be dealing with a drawn out taper, I was thinking 2 weeks of heavy Gaba drug use to knock myself out but don't want to come out of it with a new addiction....

If you are taking buprenorphine what is the hurry to withdraw?

 

[Runtoparadise]

When you say you have some degree of tolerance to Lyrica as you're scripted it, what dose are you on & do you take it as prescribed? Also, I was gonna ask what opiates & what doses you use, but i see you just posted above that you're "back on subutex". So this is not a one off? Could you add a lil more to your story pls?, we might have some more suggestions or be able to offer more support. Also, why the need to quit so abruptly?

Rtp

 

[5StarSquatHotel]

If you are taking buprenorphine what is the hurry to withdraw?

I been on this ride for over a decade and I just want off squire. I did do the bupe jump not too long back but stupidly listened to my key worker and thought it would help with the GAD but alas no. Oh and the bupe w/d takes 2-4 weeks with serious PAW's after.


Runto- 600mg a day and yes 90% of the time. Just the bupe man, been on and off maintenance replacements for too long. I just want off all chems as what I am scripted does not work...

 

[Treacle]

If you're not currently taking GABA acting drugs, you're not going to come out of a two week stint with a new addiction, unless you're seeking one. Benzos are normally prescribed for 14 day periods, because there's not much of a chance of dependence becoming an issue in that space of time. More information about your situation is needed.

 

[pjd555]

I been on this ride for over a decade and I just want off squire. I did do the bupe jump not too long back but stupidly listened to my key worker and thought it would help with the GAD but alas no. Oh and the bupe w/d takes 2-4 weeks with serious PAW's after.


Runto- 600mg a day and yes 90% of the time. Just the bupe man, been on and off maintenance replacements for too long. I just want off all chems as what I am scripted does not work...

I realise it is difficult to consider but even taking into account that you want to come off the buprenorphine quickly it is a bad idea to mix benzos and benzo-like drugs available on the RC market. Buprenorphine's safety stems in part from its ceiling effect on central nervous system depression. Higher doses do not cause further CNS depression but benzos seem to interact with buprenorphine to remove the ceiling effect which means even your lowered dose could cause greater CNS depression which is then made even worse by the same effects from the benzo itself which can lead to serious respiratory depression and death. There is also a danger that your withdrawal symptoms will lead you to increase your benzo intake to mitigate the symptoms leading to a very nasty spiral, indeed. The fact you are asking the question about covering your opioid withdrawal with benzo-like drugs tells me you know what you are in for in terms of your withdrawal speed and you are anxious about it but benzo-like drugs are not the answer. It's not the answer you want to hear but I think you need to go back and discuss this before continuing..

 

[5StarSquatHotel]

I realise it is difficult to consider but even taking into account that you want to come off the buprenorphine quickly it is a bad idea to mix benzos and benzo-like drugs available on the RC market. Buprenorphine's safety stems in part from its ceiling effect on central nervous system depression. Higher doses do not cause further CNS depression but benzos seem to interact with buprenorphine to remove the ceiling effect which means even your lowered dose could cause greater CNS depression which is then made even worse by the same effects from the benzo itself which can lead to serious repertory depression and death. There is also a danger that your withdrawal symptoms will lead you to increase your benzo intake to mitigate the symptoms leading to a very nasty spiral, indeed. The fact you are asking the question about covering your opioid withdrawal with benzo-like drugs tells me you know what you are in for in terms of your withdrawal speed and you are anxious about it but benzo-like drugs are not the answer. It's not the answer you want to hear but I think you need to go back and discuss this before continuing..

I was more thinking sticking to the prescribed dose with possibly a few of the rc benzo if needed. I suffer psychosis bought on by sleep deprevation so w/d is hard for me but have done it several times in past few years so I can do it. I want clonidine and may a few benzos but no chance, not from the doctor. They don't know the hell I go through.

 

[Treacle]

As I already stated, there's nothing with using benzos to cover some of the withdrawal, and they are indeed prescribed for this purpose. Just know when to stop...

 

[pjd555]

The licence for buprenorphine in the UK requires that the patient information leaflet points out that benzodiazepines should only be used when prescribed by your doctor because the combination can be fatal if the correct dose is not carefully determined. Determining the right dose when combining buprenorphine with RC drugs with no trial data and little guarantee of purity and dosage is dangerous.

 

[5StarSquatHotel]

As I already stated, there's nothing with using benzos to cover some of the withdrawal, and they are indeed prescribed for this purpose. Just know when to stop...

Problem is when you are in w/d and cant sleep and have a high tolerance its easy to go overboard and still not sleep. I been p for 6 days straight before with psychosis not brought on by drugs.

 

[5StarSquatHotel]

The licence for buprenorphine in the UK requires that the patient information leaflet points out that benzodiazepines should only be used when prescribed by your doctor because the combination can be fatal if the correct dose is not carefully determined. Determining the right dose when combining buprenorphine with RC drugs with no trial data and little guarantee of purity and dosage is dangerous.

If the doctor/services would help then I would be not even considering Rc's. once they CDS you you get poor treatment.

 

[pjd555]

I was more thinking sticking to the prescribed dose with possibly a few of the rc benzo if needed. I suffer psychosis bought on by sleep deprevation so w/d is hard for me but have done it several times in past few years so I can do it. I want clonidine and may a few benzos but no chance, not from the doctor. They don't know the hell I go through.

Seeing it is not like experiencing and you are right. Most doctors do not know what withdrawal is like (quite a lot do because the medical profession has far more alcoholics and drug addicts compared to other professions) but your doctor is well aware of the dangerous interaction between buprenorphine and sedating drugs - particularly benzodiazepines.

 

[pjd555]

If the doctor/services would help then I would be not even considering Rc's. once they CDS you you get poor treatment.

Most doctors would be unwilling to prescribe buprenorphine for pain management if the patient is prescribed a benzodiazepine.

 

[5StarSquatHotel]

Seeing it is not like experiencing and you are right. Most doctors do not know what withdrawal is like (quite a lot do because the medical profession has far more alcoholics and drug addicts compared to other professions) but your doctor is well aware of the dangerous interaction between buprenorphine and sedating drugs - particularly benzodiazepines.

yeah 'liabilty' all petrified about it, that's why I don't get the treatment I need. I have a cpn, a psyc and a carer but its all bollocks bar the help I get from carer. The 'addiction specialist' doctor at the services said I know more about the drugs than she! Now that scares me! The ones I have experienced have no idea about the hells of w/d from Gaba or opiates.