Tapering Benzo withdrawal: Losing my mind

[Enough999]

It's so sad. At my worst as a junky at least I knew what to expect. Every time I taper down I get hit with another curveball. It's the excuse I used to pick horse back up in the first place. If I don't stop this sniffing a bag every other day soon I know where I'm headed

 

[Jabberwocky]

CJ can you please check into a hospital or detox place? Even if it is just temporary. You did write how you had a psychotic break. At least you are with your family who can look after you, please do not kill yourself, and have a safe and happy new year and 2017.

I strongly believe that the best thing CJ can do right now is simply work on stabilizing. While some sort of inpatient program would be ideal for this, the practicality of finding one in America that will allow you to take methadone, or even a maintenance regiment of buprenorphine (one of which I think CJ is far better stabilizing on than trying to get off ORT at this point of extreme instability), and take a regular doses of potent gabaergics like a benzodiazepine is very, very difficult (if not impossible 99% of the time).

There is a really great buprenorphine specialist I can get the name of for you CJ, who I am sure would be able to find you something along the lines of a facility that would at least allow you to continue on benzos and buprenorphine. Please let me know.

I think a big part of stabilizing is going to be finding ways to stay away from your connect and using friends. Anyone who's company leads you to binge on IV coke and research chems is just going to lead you further and further away from your goals. They cannot help you, and now that you have a benzo script again there is no reason to remain in contact with them - short of falling back into a place where you're living just to use of course. That would be the only use of remaining in contact with them, to use them to get high (and in turn be used by them for their own selfish, no matter how well intentioned, ends).

Have you considered increasing your methadone dose? That could help you stabilize, as well as helping with cravings for benzos. What dose are you taking these days? Remember that there is no ideal dose, it is always individual. There are people I have met who, god only knows how, remain function on doses over 300mg. I am not suggesting any particular number for you mind you, just making the point that you shouldn't limit yourself to remaining at the current dose just because you think it is too high if it leaves you craving other substances.

I'd seriously consider thinking about increasing your dose ASAP, while you have a steady and reliable supply of benzos (even if it isn't as high as you like perhaps, it is far better than nothing as you well know). Remember that tolerance to gabapentin build very rapidly, so enjoy it while it lasts (considering you are already tolerant to benzos I honestly don't know how well it will work for you, but it should help reduce your cravings).

Along those lines, have you ever taken baclofen? It is used to treat alcohol use disorder and dependency, and works quite well IME to curb cravings for gabaergic substances. It will also fuck you up like you probably want, without being as dangerous as continuing to binge on various other gabaergics like the benzos. If they're willing to prescribe you clonazepam, I highly doubt they'd have a problem doing so with baclofen. Mind you, the withdrawal is super shitty, but it is a lot easier to taper with than a benzo.

Whatever you do, I highly encourage you to think about increasing your methadone dose, if only for a few months until you're feeling more stable.

Have you considered some kind of healthy extracurricular activity, like yoga for instance? It would be an easy way to get you out of the house and give you something very healthy to do, and is more accessible in your part of the country than the MBSR stuff I'm into (it would be worth research if you can find an MBSR course in your area, as this would be even better).

Though, realistically, full time school isn't the best idea right now given how unstable you have been recently, I still think pursuing healthy activities involving learning, but only subjects you are generally interested in, would be a very, very positive step for you to take. Are there any local community college you might be interest in finding a class or two to take at? The workload at a junior college is pretty minimal (it is essentially the same as high school, just with more interesting subjects).

I think you should keep in mind that, god forbid, if you have another episode while taking a class you can always easily get medical leave so a leave of absence won't affect your grades or anything. Plus you can always start with just one entry level class, there is no need to start with a large class load.

Perhaps most importantly, I saw your earlier post about how you felt you let you fellow BLer supporter down in your most recent "adventures." Fuck no dude! You're still here, plugging away. If anything, going through what you have, and coming out of it as you have, deserves NOTHING BUT PRAISE and celebration. The only way you could let us down, shit, I don't even know. Maybe offing your parents

Keep your head up my friend. You have nothing to be ashamed of, just a lot of wonderful shit to look forward to as you extricate yourself from this very dark place you've found yourself in over the last year or so of escalating stress and problematic patterns of substance use.

Take your time, because it is also true you have a lot of hard work ahead of you. Stabilize itself with be a huge accomplishment, and that is only the beginning. But it is also, as you probably imagine - even if you might not be able to actually visualize the sense of accomplishment of submitting your mountain of guilt and shamed at your (merely perceived) failure - it is all more than worth it.

Stabilizing will not be easy, but more than ever it is possible. Increase the methadone. Encourage your mom to continue helping you managing your meds (frustrating though it is, this is more crucial than you might imagine; she might be annoyed as fuck with you somethimes, but as you get more stable your progress with be its own reward for her). Find something healthy you can do and master outside the house and world of drug use, whether something like yoga, MBSR, art, learning an instrument, school, use you imagination! You're smart and more capable than you know dude! Anyone can make it this long shooting psychosis enducing amounts of coke and eating huge amounts of benzos is far more capable than most at survival.

I also suggest you save up the money you've been using to buy you drugs with for some great adventure you are able to take once you get stable (I know you're not working, so I know it must be precious; do you have to do anything particularly distasteful (such as less than legal stuff) to get what you've needed to purchase drugs? If not then save it up!).

Even if it isn't moving to a new place (as methadone makes this very difficult, though not impossible), you can go on a vacation to visit a friend (you have lots of us you know) for a week or two would almost certainly be just the breath of fresh air the doctor ordered. We all need things to look forward to, especially we find ourselves in a place as dark as that you are in right now.

 

[cj]

I strongly believe that the best thing CJ can do right now is simply work on stabilizing. While some sort of inpatient program would be ideal for this, the practicality of finding one in America that will allow you to take methadone, or even a maintenance regiment of buprenorphine (one of which I think CJ is far better stabilizing on than trying to get off ORT at this point of extreme instability), and take a regular doses of potent gabaergics like a benzodiazepine is very, very difficult (if not impossible 99% of the time).

There is a really great buprenorphine specialist I can get the name of for you CJ, who I am sure would be able to find you something along the lines of a facility that would at least allow you to continue on benzos and buprenorphine. Please let me know.

I think a big part of stabilizing is going to be finding ways to stay away from your connect and using friends. Anyone who's company leads you to binge on IV coke and research chems is just going to lead you further and further away from your goals. They cannot help you, and now that you have a benzo script again there is no reason to remain in contact with them - short of falling back into a place where you're living just to use of course. That would be the only use of remaining in contact with them, to use them to get high (and in turn be used by them for their own selfish, no matter how well intentioned, ends).

Have you considered increasing your methadone dose? That could help you stabilize, as well as helping with cravings for benzos. What dose are you taking these days? Remember that there is no ideal dose, it is always individual. There are people I have met who, god only knows how, remain function on doses over 300mg. I am not suggesting any particular number for you mind you, just making the point that you shouldn't limit yourself to remaining at the current dose just because you think it is too high if it leaves you craving other substances.

I'd seriously consider thinking about increasing your dose ASAP, while you have a steady and reliable supply of benzos (even if it isn't as high as you like perhaps, it is far better than nothing as you well know). Remember that tolerance to gabapentin build very rapidly, so enjoy it while it lasts (considering you are already tolerant to benzos I honestly don't know how well it will work for you, but it should help reduce your cravings).

Along those lines, have you ever taken baclofen? It is used to treat alcohol use disorder and dependency, and works quite well IME to curb cravings for gabaergic substances. It will also fuck you up like you probably want, without being as dangerous as continuing to binge on various other gabaergics like the benzos. If they're willing to prescribe you clonazepam, I highly doubt they'd have a problem doing so with baclofen. Mind you, the withdrawal is super shitty, but it is a lot easier to taper with than a benzo.

Whatever you do, I highly encourage you to think about increasing your methadone dose, if only for a few months until you're feeling more stable.

Have you considered some kind of healthy extracurricular activity, like yoga for instance? It would be an easy way to get you out of the house and give you something very healthy to do, and is more accessible in your part of the country than the MBSR stuff I'm into (it would be worth research if you can find an MBSR course in your area, as this would be even better).

Though, realistically, full time school isn't the best idea right now given how unstable you have been recently, I still think pursuing healthy activities involving learning, but only subjects you are generally interested in, would be a very, very positive step for you to take. Are there any local community college you might be interest in finding a class or two to take at? The workload at a junior college is pretty minimal (it is essentially the same as high school, just with more interesting subjects).

I think you should keep in mind that, god forbid, if you have another episode while taking a class you can always easily get medical leave so a leave of absence won't affect your grades or anything. Plus you can always start with just one entry level class, there is no need to start with a large class load.

Perhaps most importantly, I saw your earlier post about how you felt you let you fellow BLer supporter down in your most recent "adventures." Fuck no dude! You're still here, plugging away. If anything, going through what you have, and coming out of it as you have, deserves NOTHING BUT PRAISE and celebration. The only way you could let us down, shit, I don't even know. Maybe offing your parents

Keep your head up my friend. You have nothing to be ashamed of, just a lot of wonderful shit to look forward to as you extricate yourself from this very dark place you've found yourself in over the last year or so of escalating stress and problematic patterns of substance use.

Take your time, because it is also true you have a lot of hard work ahead of you. Stabilize itself with be a huge accomplishment, and that is only the beginning. But it is also, as you probably imagine - even if you might not be able to actually visualize the sense of accomplishment of submitting your mountain of guilt and shamed at your (merely perceived) failure - it is all more than worth it.

Stabilizing will not be easy, but more than ever it is possible. Increase the methadone. Encourage your mom to continue helping you managing your meds (frustrating though it is, this is more crucial than you might imagine; she might be annoyed as fuck with you somethimes, but as you get more stable your progress with be its own reward for her). Find something healthy you can do and master outside the house and world of drug use, whether something like yoga, MBSR, art, learning an instrument, school, use you imagination! You're smart and more capable than you know dude! Anyone can make it this long shooting psychosis enducing amounts of coke and eating huge amounts of benzos is far more capable than most at survival.

I also suggest you save up the money you've been using to buy you drugs with for some great adventure you are able to take once you get stable (I know you're not working, so I know it must be precious; do you have to do anything particularly distasteful (such as less than legal stuff) to get what you've needed to purchase drugs? If not then save it up!).

Even if it isn't moving to a new place (as methadone makes this very difficult, though not impossible), you can go on a vacation to visit a friend (you have lots of us you know) for a week or two would almost certainly be just the breath of fresh air the doctor ordered. We all need things to look forward to, especially we find ourselves in a place as dark as that you are in right now.

Im at 170mg of methadone. My state limits you too 190 so I don't think going up is smart in case I was in an accident or something. Plus I am on contract for the coke so I cant up my dose. I wont to start tapering my methadone dose anyway in the near future. I am going to drop it 10mg and see what happens. I haven't been taking any potenators lately so if its hell I can use those to soften the landing.

Not going to rehab. The hospital will only take me if I am actively suicidal. Which I was the other night I am just terrified of saying that and loosing all my rights in a state where 90 percent of doctors think methadone is equivalent to heroin. So yeah Ive been taking 20mg of Seroquel a day since that night and the psychosis has ended. There was a second voice in my head that wasn't mine. It was fucking scary because she just told me all the bad things about myself. She basically said the rational option was suicide. But like I said the Seroquel knocked her out of my head. I never actually saw a doctor at the hospital I left after 6 hours of waiting. Hopefully my insurance picks up my ambulance bill.

Ugg what else?... Umm my parents gave me my car back today which is cool. I am also gathering my medical records to file for disability. I also convinced some dumbass vredit card company to give my unemployed ass a card with a 1 grand limit. Its my safety line. If shit goes south here it will get me a plane ticket somewhere else. Overall I still feel a little suicidal but I am too lazy to do it. I just feel like a burden on my parents. I really hope all this suffering has a point to it. I guess that why I keep this thread going I hope someone reads it and avoids the mistakes I made. Tripping is fun and enlightening but doing it hundreds of times is liable to fuck your brain up especially if your adding MDMA and RCs into the mix. I really believe that's one of the major fuck ups I did to myself. The sexual abuse is a whole different ballgame but I didn't do myself any favors with the excessive tripping. I was trying to find something that was right in front of my face. The purpose of life is too live.

 

[Jabberwocky]

Well, I've said if before and it needs to be said again, despite the psychosis and somewhat depraved drug use of late, you've got a wicked good head on your shoulders CJ. I think playing around a bit with your dose is a good idea. I concure that getting off anytime soon isn't a good idea at this point, but that isn't going to happen one way or another (short of a fucking administrative discharge), simply because the amount of time it would take to comfortably taper off 170mg is two or more years.

I found that I actually started to reduce my dose I actually began to feel better. I was taking bupropion, gabapentin, for a while pregabalin, and a significant dose of trazadone (honestly this medication alone has been a huge lifesaver when it comes to my PTSD and depression). The psych meds, not too unlike those you are on (I can't tolerate antipsychotics, otherwise I'm sure those would have been part of the mix), were really a life saver for me.

I'm glad to hear you are responding so well to the Seroquel - definitely stick with that and the clonazepam for the foreseeable future. In nothing else they will help you deal with coping with living with the effects of trauma, such as anxiety and self hatred. Not something you want to be on forever, as I know you well know, but there isn't anything wrong with stay on them while you adjust your dose of methadone and stabilize more generally.

Psychosis is super fucked up my friend. I've only experienced it to a very mild degree in terms of depersonalization and mania from the use of dissociatives (well, and cocaine use as a teenager come to think of it) but it was super fucking scare, both during the episodes and especially coming out of them, knowing full well how close I'd come to the point of no return.

You've got yourself a healthy war chest of helpful medicine. If there is anything I can recommend, try your best to stick it out with your parent for a while. Using a credit card is a horrible idea without a regular source of real income. Chances are if you end up using it you will either go into the kind of debt it is really hard to get out of (short of bankruptcy) or end up relying on your parents to bail you out. Trust me, I have personal experience with this exact situation from really early in recovery after getting super desperate, needing to find a safe place to live, like in emergency fuck all else fashion, after being severely physically and psychologically abuse at the first rehab I went to.

You clearly have enough shame and guilt as it is when it comes to your folks. And the particularly sad, fucked up thing is that, again speaking from personal experience, no matter what they are your parents and love you (well, I actually forget anything you might have mentioned about your relationship with your father, but I am quite confident with this of your mother given what you've shared). There is no doubt in my mind all they want is to see you happy and healthy (that is all the desire when it comes to family members struggling to find themselves, particularly when it comes to harmful substance use, and this kind of unconditional love). I have a feeling your mom would do anything for you, I have a feeling you know the kind of damage it would do to her if you just up and leave with working it over, at the least, with her first. No to send you on a guilt trip, I'm just trying to highlight the fact that, no matter how bad it gets, you must try and keep in mind, telling yourself even if you don't believe it over and over again, that what your folks want is to do all they can to help you get well.

Now, being the identified patient is a fucking horrible role to end up filling for loved ones, particularly parents - especially when they don't necessary know what the fuck to do about what is going on. Just keep in mind the damage you can cause them in making any rash decisions, and the instrumental support they can provide for your in your recovery if you only work with them and help educate them to provide support you in receiving the kind of care you need (such as continuing on methadone, taking clonazepam and an antipsychotic in particular).

What do you think about finding some kind of extra curricular activities? There is no rush, you have enough on your place for the immediate time being. But after a week or two of just hanging around playing video games, watching movies and generally vegetating it will get to a point where you will either feel like you're going crazy or end up deciding to start self medicating again unless you find some kind of healthy creative outlet(s).

Oh, and about adjusting your dose of methadone, most people I've talked to, with a few exceptions, found that they could go down by 5mg or 10mg a week when at doses over 60mg very comfortably. Who knows what you will experience. Try not to have any expectations, because the fact is you won't know the change affects you (assuming you haven't been using other opioids on top of your dose recently for any length of time) for about 4 or 5 days into the adjustment. That is why it is ideally done no faster than one reduction a week, because that is about how long it will take for your to genuinely know how it physically affects you.

A lot of people I have met get caught up in a kind of psychological trap, letting themselves believe that simply because they're reducing their dose by any amount legitimate withdrawal is the inevitable outcome. That kind of somaticized type of thing actually will end up producing symptoms nearly indistinguishable from classic withdrawal, so be careful what you let yourself believe. It is better to error on the side of using the evidence at your disposal (for instance, the knowledge that the vast majority of patients don't experience anything significant in the way of withdrawal until they get well, well below what you would be transitioning to) and, if anything, err on the side of "I will be fine" as opposed to letting yourself percevorate on your fears and anxiety surrounding the beginning of a potential tapering.

The nice thing about tapering, like I said, is that things often improve. At least as often if not more so than otherwise actually. And plus you are accomplishing something tangible, something you can genuinely feel good about (because no matter how well you structure and plan for tapering, it is never a cake walk no matter how much easier it may be than you once might have imagined). Plus you'll know that there is a light at the end of the tunnel.

When you are finally ready to get off, no matter when that is (and I must again emphasize that there is no rushing this, as there isn't any sense running any good thing - and I think we agree methadone has and is a good thing for you), you will find yourself untied from the clinic and so much more free. No more waiting in line, dealing with - however nice and supportive some may be - clinic staff and, my personal favorite, no more having to put up with and deal with seeing the other clients who are really struggling with their lives, seemingly forever stuck at the clinic.

And it will be so much easier to travel. If there is anything I know, it is that you really need to take a vacation my friend. It'll take a lot of time and hard work (like I said, reasonably expect to spend two or three years tapering, give or take), but it will happen sooner than you might otherwise think.

 

[PriestTheyCalledHim]

CJ, how are you doing? I hope you are doing well and staying safe.

 

[VastEmpty]

CJ, how are you doing? I hope you are doing well and staying safe.

Ditto!

- VE

 

[cj]

I can't complain things have been calmer the last few days.

 

[Captain.Heroin]

Glad to hear that buddy.

 

[manofadude]

I've been reading your story and want to share mine. I cold turkeyed off klonopin about 4 months ago. I've been having such bad mental wds I don't know what will help me..but time. A lot of it. I'm nowhere near the end of the tunnel but I can see a dimming light and that's what you should think. I am sucked into my thoughts all day and can't even enjoy weed.

Yesterday I almost had a setback with my friend who had some shit we were gonna take but he ditched me and I drove home so angry I almost fucking totaled my car...I feel so bad about it and Ofc the money I now have to drop on fixing it. But hey, I'm alive. And back when I was buying Xanax and cocaine everyday I would've never had the money for a problem like this. Think positive. Best of luck pal

^i wanna say that my biggest mistake was cold turkeying. On my first week wd'ing I was driving home and had a severe panic attack..could barely press my brakes at a red light. This stuff is serious, never cold turkey

 

[Captain.Heroin]

I've been reading your story and want to share mine. I cold turkeyed off klonopin about 4 months ago. I've been having such bad mental wds I don't know what will help me..but time. A lot of it. I'm nowhere near the end of the tunnel but I can see a dimming light and that's what you should think. I am sucked into my thoughts all day and can't even enjoy weed.

Yesterday I almost had a setback with my friend who had some shit we were gonna take but he ditched me and I drove home so angry I almost fucking totaled my car...I feel so bad about it and Ofc the money I now have to drop on fixing it. But hey, I'm alive. And back when I was buying Xanax and cocaine everyday I would've never had the money for a problem like this. Think positive. Best of luck pal

^i wanna say that my biggest mistake was cold turkeying. On my first week wd'ing I was driving home and had a severe panic attack..could barely press my brakes at a red light. This stuff is serious, never cold turkey

Welcome to BL, and thanks for sharing your story man. Congrats on your four months.

 

[cj]

I've been reading your story and want to share mine. I cold turkeyed off klonopin about 4 months ago. I've been having such bad mental wds I don't know what will help me..but time. A lot of it. I'm nowhere near the end of the tunnel but I can see a dimming light and that's what you should think. I am sucked into my thoughts all day and can't even enjoy weed.

Yesterday I almost had a setback with my friend who had some shit we were gonna take but he ditched me and I drove home so angry I almost fucking totaled my car...I feel so bad about it and Ofc the money I now have to drop on fixing it. But hey, I'm alive. And back when I was buying Xanax and cocaine everyday I would've never had the money for a problem like this. Think positive. Best of luck pal

^i wanna say that my biggest mistake was cold turkeying. On my first week wd'ing I was driving home and had a severe panic attack..could barely press my brakes at a red light. This stuff is serious, never cold turkey

Fuck me. That sounds horrible. The panic attacks are the worst aren't they?


I just woke up and can't get back to sleep at 215. Why can't the clinic open at 3am lol

 

[manofadude]

Honestly I think the worst part for me is the tripping feeling and that things won't return to normal. I wanna get my life back, but I guess that's going to come in due time

 

[cj]

Honestly I think the worst part for me is the tripping feeling and that things won't return to normal. I wanna get my life back, but I guess that's going to come in due time

The tripping feeling is crazy. Its like the 15th hour of an acid trip that will not end. I am now stable on 2mg kpin a day. 1mg in morning 1mg at night. I may taper off but right now this feels pretty good.

 

[manofadude]

I can't say what's best for you because I'm not a professional in any way but just remember it's not for long term use. Since I come turkeyed and shocked my gaba receptors I don't even think if I got back on it they would help me feel normal. But honestly the wd's alone make me dread the thought of any benzos. Weird to say these withdrawals are what keep me going hahaha

 

[Jabberwocky]

The tripping feeling is crazy. Its like the 15th hour of an acid trip that will not end. I am now stable on 2mg kpin a day. 1mg in morning 1mg at night. I may taper off but right now this feels pretty good.

YAY!!!! Fuck yeah dude. I am SO pleased to hear this. You are planning to stay on this dose for a while I hope? As long as it doesn't keep you from being functional, having at least a month of stability in terms of your meds sounds just like what the doctor ordered.

And the Seroquel is still good? How much of that are you taking btw? And I am curious, if this something you started taking again in response to the cocaine/sleep deprivation induced psychosis, or something you had been taking before and found helpful and just stopped taking somewhere along the line?

Full disclaimer: I personally have a lot of mixed feelings about antipsychotics, but you have benefited tremendously from their use, so no judgement. Seroquel made me actually led me to a place of mania and psychosis. Zyprexa caused be to develop what was essentially type two diabetes after only taking it for a month or two at normal dosages. Long term the side effects are just as scary (if not more so) than benzodiazepine (and more so than opioid dependency) when it comes to antipsychotics. But for most people (as in I seem particularly sensitive) that is higher dosages taken longer term than I imagine you will need them.

 

[cj]

I was prescribed seroquel for a long time and never took it because of mixed feelings. I took it at 25 mg a night for the first week after going phychotic. Then I stopped and I'm fine. I have a ton of the 100 mg ones so I keep them around just in case.

But I feel fully functional on my curent med dose. I got a keep my head down at the clinic for a while though because they say I'm a liability for the state audits. Whatever that reallt means.

I also want to switch my gabapentin tp lyrica cause I blow through the gabapentin super fast

 

[CfZrx]

I have a credit card coming soon with a 1000 dollar limit. I may use it for a bus ticket out of here

Santa Barbara California is a great place to start from absolute zero.

 

[Jabberwocky]

That is bullshit, they are just trying to scare you (and understandably the stick seems to be working and, well, whatever works right?). I highly doubt they are actually liable for anything just because they have a patient on benzos and methadone. That happens all the time, and I have heard that threat all the time - it is simply a strategy of scaring the patients to keep them in line.

Be careful with taking pregabalin. Taking higher doses of it (>600mg at a time) regularly is almost guaranteed to lead to complications (including seizures). I found alternating between gabapentin and pregabalin really helpful while I was on methadone dealing with some shit, so perhaps you could try to find a way to get access to both?

Gabapentin, in my experience, is far more benign than pregabalin. The upside to pregabalin is that tolerance doesn't build so fast (though it builds faster than a lot of people think). Just understand that you can't take pregabalin with little to no worry of side particularly harmful effects like you can with gabapentin. They are two very different beasts in that regard.

Santa Barbara California is a great place to start from absolute zero.

I'm curious, as I LOVE SB, why do you say that? They have a great clinic there (one of the best I've been to), but I don't know much in terms of what they have as far as social support goes. I imagine it would be better than LA, as this is a rather tougher town than coastal cities in central/northern CA. But I just don't know anything about the scene there.

 

[Captain.Heroin]

I'm curious, as I LOVE SB, why do you say that? They have a great clinic there (one of the best I've been to), but I don't know much in terms of what they have as far as social support goes. I imagine it would be better than LA, as this is a rather tougher town than coastal cities in central/northern CA. But I just don't know anything about the scene there.

My sentiments exactly. I'm also curious why.

 

[cj]

That is bullshit, they are just trying to scare you (and understandably the stick seems to be working and, well, whatever works right?). I highly doubt they are actually liable for anything just because they have a patient on benzos and methadone. That happens all the time, and I have heard that threat all the time - it is simply a strategy of scaring the patients to keep them in line.

Be careful with taking pregabalin. Taking higher doses of it (>600mg at a time) regularly is almost guaranteed to lead to complications (including seizures). I found alternating between gabapentin and pregabalin really helpful while I was on methadone dealing with some shit, so perhaps you could try to find a way to get access to both?

Gabapentin, in my experience, is far more benign than pregabalin. The upside to pregabalin is that tolerance doesn't build so fast (though it builds faster than a lot of people think). Just understand that you can't take pregabalin with little to no worry of side particularly harmful effects like you can with gabapentin. They are two very different beasts in that regard.



I'm curious, as I LOVE SB, why do you say that? They have a great clinic there (one of the best I've been to), but I don't know much in terms of what they have as far as social support goes. I imagine it would be better than LA, as this is a rather tougher town than coastal cities in central/northern CA. But I just don't know anything about the scene there.

Good advice I didn't realize pregablin was so much more dangerous. The problem I have with gabapentin is that it stops working really fast. My tolerance is just jacked up to it from bring on it for awhile.