Keif richards has had a major epiphany here Tony.
I can't believe this didn't come to me sooner, but then again, Ryan is a bit of a divine hermaphrophrodite, representing the yin-yang of simultaneous intelligence and sheer stupidity. Anyway.
A very common topic that we discuss here in the forums is the induction of Buprenorphine following the use of other, typically short-acting Opioids, which would obviously include Fentanyl. As you probably know, precipitated withdrawal is the primary reason that people seek knowledge and ceratinty in this context. PW is a hellish experience. I've never actually been through it. There was one instance when I took Buprenorphine a little bit too early and definitely felt my legs start gyrating and my anxiety ramp up, but not nearly as severe as what is possible or for that matter, what I have seen.
I know you all get tired of my little stories, but they make me feel important and nobody else will listen to me in real life, so fuck off. I got court ordered to this rehab in Brockton for a month and there was a kid who came in who was on like 100mg of Methadone a day, a serious dependence by any stretch. This kid had serious issues with compulsion and was apparently willing to put anythiing in his body that might remotely affect him in any way different from his reality. He found a random pill on the floor of his bunk. He crushed it and snorted it. I didn't see any of this, I just saw the aftermath and was told the details.
I just saw this kid running, stumbling through the halls, literally screaming like a dying animal, screams that I can remember vividly to this day. He eventually stopped and began writhing on the floor like an epileptic fit, but wasn't having a seizure. He was crying and his face was soaked with the combination of tears and sweat. He tore off all of his clothes and was screaming "I'm so hot. Make it stop. Make it stop!" He was screaming and gurgling for 15 minutes before an ambulance came and scooped him up. He had pissed himself, was covered head to toe in his own vomit, sweat and lacrimation. It was honestly one of the most fucked up things that I have ever seen short of looking at dead, stiff, blue bodies... one of these a good friend, which is somehow less intense to me.
That is pretty much the end of the line; the worst possible outcome. He had snorted a 100mg Naltrexone pill that someone had cheeked and then dropped. This is just a warning. Precipitated withdrawal can be very unpleasant, but it can also be among what I imagine are the most utterly painful and miserable instances of abject suffering possible.
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Which brings me to my point. When we help people induct with Buprenorphine, we are helping them for the very same reasons that you are requiring help. They are concerned about the proper time and dose of their medications based upon their history and habits.
Something that I and many of my colleagues here always recommend first, is microdosing of the Buprenorphine or, in your case, Naltrexone. The mechanics and principles are all the same. If you dose too early, you run the risk of initiating a sudden and powerful withdrawal experience.
Time is arguably the most important variable at play here, but the actual dosage of the medication is a major variable as well, arguably just as important. These medications all come in common dosages for
maintenance but this means that they can't be appropriate for both
maintenance and induction. It's not possible to have both in this situation.
This is why we often recommend microdosing for induction. This means making smaller dosages from your pills, strips or solutions. For instance, Buprenorphine's most common strength is arguable 8mg either in a strip or tablet. This makes people feel that this is a normal, regular or small dosage, when in reality it's a pretty potent dose of Opioid.
This is also true for your Naltrexone. It's probably appropirate for your purposes in maintenance, but that doesn't mean you can't split the pills up to test the waters without having to have either complete success or abosolute misery as your only options. You can ride the spectrum a bit between the two. Split you pill into quarters or eitghths. You can even take crumbs of Naltrexone smaller than these dosages.
Experiment with a very small, yet still perceptible dose of the Naltrexone. I would advise waiting at least 45 minutes before continuing to proceed to your standard dosage. If you feel "normal" or not sick at the 45-60 minute mark, you can then attempt to take a little bit more and follow these same guidelines. I would advise instead of taking the entire pill in one day, to start with say, a quarter of a pill today, perhaps a half a pill tomorrow followed by you making your own decisions regarding dosage based upon how you feel.
On day 3, you can call your woman and your dog and inform both of them that a reunion is in order.