Opioids Questions about severity of fentanyl withdrawal and treatment options

[aspiringchemist]

I’m currently dependent on 1-1.5g/day smoked street fentanyl and have been for about 9 months. I’m so exhausted by it and I cannot afford it anymore: like literally cannot afford to buy another bag or I’ll go upside down on my finances.

My last use was about 2 hours ago, smoked a small amount (.2 probably) and when I woke up. I have today off work and am currently just letting go and allowing withdrawal to start but I don’t know how safe or realistic this is because I have to work tomorrow.

With that said, I have large quantities of clonazepam, clonidine, methocarbamol, pregabalin, lomitil (diphenoxylate/atropine) which is a low dose opioid itself, 7OH and pseudoindoxyl, and buprenorphine. I also have ketamine, which I’ve found manages withdrawal symptoms rather well in low doses and there is some medical literature supporting this.

I’m currently microdosing suboxone. If I was able to get up to 4mg by tomorrow morning, would it be realistic to think I could go to work? Does the suboxone help that much with the symptoms that you go from non functional to functional?

Would it be better to not use suboxone and instead rely on large doses of 7OH, pseudoindoxyl, and plain leaf kratom? Perhaps diphenoxylate as well?

I’m not concerned with becoming dependent on either of these replacements (kratom alkaloids or suboxone). At this point, it’s much more affordable than a fent habit and I have a large quantity of both which i could use to tower over a couple months. I need off fentanyl.

So I guess my question really is, will either of these approaches allow me to be semi functional and go to work tomorrow (24 hours post last use)? I’m a bartender so my job isn’t difficult, I just have to be “on” and engaged in conversation often.

In either case I will be using a lot of comfort medications as well. I just don’t really know what to expect and I’m curious to know just how much suboxone really helps reduce withdrawal symptoms.

I’ve made several attempts at induction by replacing fentanyl with IR morphine for 1-3 days but either don’t make it to induction or when I do induce I end up relapsing anyway; this is really the way to go but unfortunately I don’t have access to any more short acting opioids.

I can feel the early signs of withdrawal at the moment

 

[agoraphobe]

I’m currently dependent on 1-1.5g/day smoked street fentanyl and have been for about 9 months. I’m so exhausted by it and I cannot afford it anymore: like literally cannot afford to buy another bag or I’ll go upside down on my finances.

My last use was about 2 hours ago, smoked a small amount (.2 probably) and when I woke up. I have today off work and am currently just letting go and allowing withdrawal to start but I don’t know how safe or realistic this is because I have to work tomorrow.

With that said, I have large quantities of clonazepam, clonidine, methocarbamol, pregabalin, lomitil (diphenoxylate/atropine) which is a low dose opioid itself, 7OH and pseudoindoxyl, and buprenorphine. I also have ketamine, which I’ve found manages withdrawal symptoms rather well in low doses and there is some medical literature supporting this.

I’m currently microdosing suboxone. If I was able to get up to 4mg by tomorrow morning, would it be realistic to think I could go to work? Does the suboxone help that much with the symptoms that you go from non functional to functional?

Would it be better to not use suboxone and instead rely on large doses of 7OH, pseudoindoxyl, and plain leaf kratom? Perhaps diphenoxylate as well?

I’m not concerned with becoming dependent on either of these replacements (kratom alkaloids or suboxone). At this point, it’s much more affordable than a fent habit and I have a large quantity of both which i could use to tower over a couple months. I need off fentanyl.

So I guess my question really is, will either of these approaches allow me to be semi functional and go to work tomorrow (24 hours post last use)? I’m a bartender so my job isn’t difficult, I just have to be “on” and engaged in conversation often.

In either case I will be using a lot of comfort medications as well. I just don’t really know what to expect and I’m curious to know just how much suboxone really helps reduce withdrawal symptoms.

I’ve made several attempts at induction by replacing fentanyl with IR morphine for 1-3 days but either don’t make it to induction or when I do induce I end up relapsing anyway; this is really the way to go but unfortunately I don’t have access to any more short acting opioids.

I can feel the early signs of withdrawal at the moment

My brains not working but I want to help. Want me to run that through chatgpt pro?

 

[Ballu]

Does the suboxone help that much with the symptoms that you go from non functional to functional?

In my experience, yes. Suboxone does work well enough to the point where you can go from non functional to functional, but I haven't seen someone transition as fast as you've mentioned in your post. Is it possible? It really depends on how much you were using, how long you were using, and how much of it is stored in your body fat cells.

Normally you can transition from opiate use to Suboxone fairly well with microdosing and slowly transitioning over to straight suboxone. It's a schedule similar to 0.5 to 1mg to 1.5mg to 2mg to 3mg to 4mg while still using opiates/opiods for the first few days to avoid wds, and then when having 4mg of Suboxone built up in your system, stopping the opiate use, and continuing to build up the Suboxone mg if necessary.

But again, it really depends on how much you were using and how well your body handles it. It's different for everyone. For weaker opiates like H, or regular opioids it's much easier. Fentanyl being much stronger, can make the transition a bit more difficult, but not impossible. It's been a couple days since your post, would love to hear how it went for you and which path you choose to go. Congratulations on stepping to the plate to get off fetty. It's a nasty opioid, that lacks the euphoria of H but has such a wicked wd that it ultimately isn't worth catching the habit in the end.

 

[aspiringchemist]

In my experience, yes. Suboxone does work well enough to the point where you can go from non functional to functional, but I haven't seen someone transition as fast as you've mentioned in your post. Is it possible? It really depends on how much you were using, how long you were using, and how much of it is stored in your body fat cells.

Normally you can transition from opiate use to Suboxone fairly well with microdosing and slowly transitioning over to straight suboxone. It's a schedule similar to 0.5 to 1mg to 1.5mg to 2mg to 3mg to 4mg while still using opiates/opiods for the first few days to avoid wds, and then when having 4mg of Suboxone built up in your system, stopping the opiate use, and continuing to build up the Suboxone mg if necessary.

But again, it really depends on how much you were using and how well your body handles it. It's different for everyone. For weaker opiates like H, or regular opioids it's much easier. Fentanyl being much stronger, can make the transition a bit more difficult, but not impossible. It's been a couple days since your post, would love to hear how it went for you and which path you choose to go. Congratulations on stepping to the plate to get off fetty. It's a nasty opioid, that lacks the euphoria of H but has such a wicked wd that it ultimately isn't worth catching the habit in the end.

Thats good to hear. In your experience, how long did it take to safely transition to subs and be functional enough to fake it through work?

I unfortunately bailed on the microdosing strategy a few days ago. Bought a bag, then 3 more. Spent all day today IV’ing methamphetamine on my weekend. I copped 80mg methadone, which i know brings me farther from bupe but with the amount of spun i am, im gonna need it.

I’ve been on fent about 9 months, 3 years of suboxone before that, and about a decade of morphine, hydrocodone, and kratom use before that (this is going backwards in time). An 8 year clean span preceding all of this use before which I was a heroin addict for about 5 years. I’m in my mid 30s and have spent well over half my life dependent on opioids. The last 10-12 years without missing a day/night. I was a pain management patient in my late twenties due to a congenital spinel deformity which causes discs to herniate prematurely.

I appreciate your kind words. I’ve made several failed attempts to quit at this point. The furthest I’ve made it is 3 days without fentanyl but directly replaced it with 45mg IV morphine per day (lowest amount I could use to keep sickness at bay 15mg x3). Had I only inducted suboxone on that 3rd day instead of relapsing.

 

[agoraphobe]

I’m in my mid 30s and have spent well over half my life dependent on opioids.

I feel you bro. Exhausting life.

 

[Ballu]

In your experience, how long did it take to safely transition to subs and be functional enough to fake it through work?

I've done it in roughly 7 days on more then one occasion.

You can attempt to microdose your way thru it without continuing to use opioids with the microdosing.. or you can microdose + continue to use your opioid until you have enough of the suboxone built up in your system to make things a little easier(it's referred to as the Bernese method, if you want to research and learn more about how it works and why it works and helps prevent pwd).

I’ve been on fent about 9 months, 3 years of suboxone before that, and about a decade of morphine, hydrocodone, and kratom use before that (this is going backwards in time). An 8 year clean span preceding all of this use before which I was a heroin addict for about 5 years. I’m in my mid 30s and have spent well over half my life dependent on opioids. The last 10-12 years without missing a day/night. I was a pain management patient in my late twenties due to a congenital spinel deformity which causes discs to herniate prematurely.

I can relate to your story, as I battled a heavy opiate addiction for a good 10-15 years. I tinkered with other drugs thru out that same time, but opiates were the one that I ultimately used daily, due to not wanting to go thru wds.

Today, I'm opiate/opioid free and have been taking suboxone for 10+ years or so without any real desire to use illicit drugs, more so because it takes much longer to recover from light drug use then it did back when I was in my 20s. I used to be able to tinker around with drugs, and be good to go the next day. Nowadays, I still feel the affects for several days, it's just not as forgiving as it was back then.. so I just ride it out with the subs, and toke on some marijuana thru a dry herb vape occasionally(for context, I'm in my 40s).

I’ve made several failed attempts to quit at this poin

It's never too late. The part that you have on your side is that you're still wanting and willing to try and get off.. which is a much better position then just being strung out on drugs, with no desire to want to get off them.

I think we've all been in that position, where we're an everyday user.. and others around us want us to quit, but us ourselves have no desire to want to quit. So while maybe you weren't able to stick it on your first attempt, at least you still have the willpower to want to make the change. Stick with it. Failed attempts/relapses are all part of the game, it can happen to any one of us.

 

[kinkyjohn]

Ok .. so I used to be a fentanyl addict. I used to microdose bupe .. but that is a load of faff. In my experience the withdrawl from fentanyl is so batshit that if you trigger precipitated withdrawal it doesn't make that much difference (though doing it from well ... can feel like dropping in the pit of hell .. better to wait for WD first). You can do it under the tonogue, but you're likely to lose the bupe when the withdrawal kicks in so I'd recommend snorting it for fent withdrawal. You won't feel well .. but you won't be delirious / partially conscious like you are in withdrawal and it'll also mean that taking more fent won't do much good (unless you do bat shit loads). In fact if your withdrawing you should not have any more fent when you do it .. that'll stop you taking it when you recover.

I remember once having bupe and meth on a tray and snorting the meth instead of the bupe but being so out of it in the withdrawal I didn't know I'd done the meth. In fact I didn't realise I was on meth until the bupe I had taken kicked in. Don't mess around with a withdrawal like that .. just bupe through it.

Guess the OP has found their answer by now .. but still .. I remember withdrawing from fent. Fun times!

 

[Ballu]

In fact if your withdrawing you should not have any more fent when you do it .. that'll stop you taking it when you recover.

If you do it correctly, then you 100% can still continue to do fent while transitioning over to suboxone.. there's literally a entire medical method referred to as the Bernese method, that instructs you on how you should do it if you're choosing to go this route. The reason behind the method is to reduce the chances of getting pwd while transitioning over to bupe. Using the Bernese method, prevents you from having to wait to feel the effects of wd before starting induction.

Bernese Method

Bernese Method | Helps patients wean off of substances gradually and minimize withdrawal symptoms through the use of buprenorphine.

drugfree.org

I can only speak from my own experience, as I have done on it on more the one occasion.. and when done right, then you don't ever feel any affects of wd. By the time you stop taking fent, you will have enough bupe built up in your system that your body doesn't end up getting any wd.

I was probably just as skeptical about it as you probably are, based on past experiences.. but when done correctly, following how they recommend in the method, it works. I didn't make the method up, this isn't some backyard method made up by some dopefiend who happened to have some extra subs laying around.. a medical professional came up with the method, and its used by medical professionals in many suboxone programs. Do your research on it, give it a try it you ever end up in the position that you need to transition back on to subs after a fent or h run.

The Bernese Method: Microdosing Buprenorphine for OUD

Discover the Bernese method, a microdosing approach using buprenorphine for opioid use disorder treatment and learn how it differs from standard methods.

ophelia.com

 

[opiatekrzy]

Your best bet is to take 7oh For the fentanyl withdrawal for three days and then switch over to buprenorphine. Keep in mind you are still going to feel discomfort and some level of withdrawal even with the buprenorphine in your system for at least a week two weeks and major sleep disturbances

 

[kinkyjohn]

If you do it correctly, then you 100% can still continue to do fent while transitioning over to suboxone.. there's literally a entire medical method referred to as the Bernese method, that instructs you on how you should do it if you're choosing to go this route. The reason behind the method is to reduce the chances of getting pwd while transitioning over to bupe. Using the Bernese method, prevents you from having to wait to feel the effects of wd before starting induction.

Bernese Method

Bernese Method | Helps patients wean off of substances gradually and minimize withdrawal symptoms through the use of buprenorphine.

drugfree.org

I can only speak from my own experience, as I have done on it on more the one occasion.. and when done right, then you don't ever feel any affects of wd. By the time you stop taking fent, you will have enough bupe built up in your system that your body doesn't end up getting any wd.

I was probably just as skeptical about it as you probably are, based on past experiences.. but when done correctly, following how they recommend in the method, it works. I didn't make the method up, this isn't some backyard method made up by some dopefiend who happened to have some extra subs laying around.. a medical professional came up with the method, and its used by medical professionals in many suboxone programs. Do your research on it, give it a try it you ever end up in the position that you need to transition back on to subs after a fent or h run.

The Bernese Method: Microdosing Buprenorphine for OUD

Discover the Bernese method, a microdosing approach using buprenorphine for opioid use disorder treatment and learn how it differs from standard methods.

ophelia.com

You don't need to do bernese .. you just snort 20mg every 40 minutes till your at about 6 or 7 mg of bupe (the total amount is probably person dependent tho - that's just how much I need to be out). Better with fent cos it fits the frantic 4 hour boundary .. you might not have enough bupe to be well but you've got enough not to be sick.

Worked when I did it. Much easier than pissing around with bernese and you experience no proper withdrawal.

Wouldn't get too far from the bathroom though.

 

[aspiringchemist]

You don't need to do bernese .. you just snort 20mg every 40 minutes till your at about 6 or 7 mg of bupe (the total amount is probably person dependent tho - that's just how much I need to be out). Better with fent cos it fits the frantic 4 hour boundary .. you might not have enough bupe to be well but you've got enough not to be sick.

Worked when I did it. Much easier than pissing around with bernese and you experience no proper withdrawal.

Wouldn't get too far from the bathroom though.

How long in your experience do you wait after last fent use to begin snorting the suboxone?

I made my biggest attempt yet a few days ago, went over 24 hours cold turkey and wasn’t feeling too terrible, not great but not the nightmare I’ve heard about. Then I took ~4mg of suboxone over the course of an hour and I swear within 20 minutes I was experiencing withdrawal like you see in the movies; thrashing on my bed, not able to stop shaking, couldn’t really talk normally, anxiety was through the roof. I didn’t vomit or have diarrhea.

This was about 30 hours post last use so idk if it was just the normal course for withdrawal to take or if it was PW? Idk if it was precipitated withdrawal, but I’m thinking it likely was given it went from manageable to completely unmanageable within 20 minutes of take suboxone. It grew so intense that I couldn’t stand it any longer and went a relapsed; this was with 7OH and a host of comfort meds.

I wanna give it another go but wait a bit longer to take suboxone. The only time suboxone has felt good while trying to come off fent was when I used morphine for 3 days to bridge and the morning of day 4 I took 4mg suboxone and it actually felt good.

 

[aspiringchemist]

If you do it correctly, then you 100% can still continue to do fent while transitioning over to suboxone.. there's literally a entire medical method referred to as the Bernese method, that instructs you on how you should do it if you're choosing to go this route. The reason behind the method is to reduce the chances of getting pwd while transitioning over to bupe. Using the Bernese method, prevents you from having to wait to feel the effects of wd before starting induction.

Bernese Method

Bernese Method | Helps patients wean off of substances gradually and minimize withdrawal symptoms through the use of buprenorphine.

drugfree.org

I can only speak from my own experience, as I have done on it on more the one occasion.. and when done right, then you don't ever feel any affects of wd. By the time you stop taking fent, you will have enough bupe built up in your system that your body doesn't end up getting any wd.

I was probably just as skeptical about it as you probably are, based on past experiences.. but when done correctly, following how they recommend in the method, it works. I didn't make the method up, this isn't some backyard method made up by some dopefiend who happened to have some extra subs laying around.. a medical professional came up with the method, and its used by medical professionals in many suboxone programs. Do your research on it, give it a try it you ever end up in the position that you need to transition back on to subs after a fent or h run.

The Bernese Method: Microdosing Buprenorphine for OUD

Discover the Bernese method, a microdosing approach using buprenorphine for opioid use disorder treatment and learn how it differs from standard methods.

ophelia.com

So you actually didn’t experience any withdrawal while doing this by the book? I’ve tried a few times but I always get discouraged when the bupe starts to block the fent. I also am afraid I’ll put myself in this state where the subs won’t be strong enough to keep me out of withdrawal but fhe fent is blocked by the subs.

 

[aspiringchemist]

Your best bet is to take 7oh For the fentanyl withdrawal for three days and then switch over to buprenorphine. Keep in mind you are still going to feel discomfort and some level of withdrawal even with the buprenorphine in your system for at least a week two weeks and major sleep disturbances

When I did 3 days of morphine and on day 4 took 4mg suboxone, the subs actually felt really good. This listening time in all these attempts that suboxone had felt good. Unfortunately I don’t have any more full agonists other than pseudoindoxyl and the partial 7OH; however I must be the odd man out but they seem to do nothing for me in fent withdrawal, otherwise that’s probably what I’d try doing. I still may try it once more.

I’m also considering just going to the methadone clinic at this point. A family member found out I was using and gave me an ultimatum to get clean via some kind of program or leave their house; I can’t really afford to leave their house and don’t wanna be homeless.

 

[aspiringchemist]

I feel you bro. Exhausting life.

For real. I used to think it was cool or some shit. I also have a legitimate diagnosed chronic pain condition that was treated with opioids. So I built this persona around opioids.

I finally see it for what it really is. Certainly not cool, but rather sad. Lifetime of loss, pain, and trauma on the daily that most people don’t ever experience. Hell, just the lingering fear of sickness and needing to cop every day is traumatic, let alone actually going into withdrawal. I’ve always had a decent life, held professional jobs. Kinda a double life; nobody knew I was on opioids unless I told them. It’s exhausting keeping that false identity alive, and feels like so much to lose when everything comes crashing down.

 

[Pickledlemons]

I got off fentanyl with bupe. That was like 11 years ago or something. I'm pretty dependent on bupe but its free so thats nice. Cold turkey off fentanyl is hell. I once asked a friend of mine to hit me in the head with hammer (with the idea of being knocked out) because I was in so much agony. Glad she didn't do it in hindsight... but yeah.

Sorry didn't read the whole thread but cold turkey might be possible if its a young addiction (like <6 months maybe) or perhaps a rapid taper (a few weeks) off methadone or something. But talk to a doctor about that. If a doctor isn't an option, there's kratom which you can easily buy online in most places. It works good as long as the dependence isn't too severe. But there's a couple downsides, one is inconsistent strength from one batch to another.

The other is its duration. I used to have to take it like 5 times a day (or more) though some people say they can get by on 3. Honestly its probably best to see a doctor but if you live in the US without coverage or for whatever other reason thats not an option, kratom may be the other way out.

Bupe (suboxone), methadone, and kratom are all opioids so they will all keep you dependent but methadone is the worst in that regard. But its also the best in the case of... say... getting back to work as soon as possible, there's not really a transition period like with bupe. Just god help you if you ever want to get off a high dose of methadone. Also for some dependencies, its the only thing strong enough.

Here in Canada they were actually giving out dilaudid to addictss a while ago... but I think people got mad that they were selling them to buy more fentanyl ( I was actually one of the people doing the buying, you got great prices) so I'm not sure if they do that anymore. Or maybe you have to be witnessed I'm not sure. But out of the normal substitute options, methadone offers the most coverage while also being the hardest to get off of (if you ever plan to, I figure I'm probably gonna be on bupe my whole life, if civilization survives that long, its diazepam I want to eventually get off of)

Anyway good luck.

 

[Keif' Richards]

Hey @aspiringchemist

I think I might be able to give some insight here. Most people I've spoken too need to go 36-48 hours before inducting on Buprenorphine. That's just how it is. You are in luck that you have all of these medications to help you. You are not on an impossible quest. You only must make it 48 hours without Fentanyl.

Furthermore, it is not wise to induct with such large doses. Precipitated Withdrawal is often linear in intenstiy relative to the size of the Buprenorphine dose administered. What that means is that you can test the boundaries of your situation with less fear by consuming very, very small dose of Buprenorphine. This is something I have been describing to folks for almost a decade now. I think it is incredibly lame that our medical establishment refuses to accept this method in any way. You are not going to find any mainstream physicians who are going to tell you to take small doses of Buprenorphine every 45 minutes. They either want to give you your pill and watch it dissolve under your tongue all at once or send you home with the same and not alternative instructions.

Wait until 36 hours okay? Then we can try again. If it doesn't work out, you will just do your best to anesthetize yourself for another 12 hours until it's time for another go.

You are going to want to find a way to make your Buprenorphine into 0.5mg increments. If you have strips, use scissors or even your eyes to rip off a tiny, tiny crumb that you think is close to 1/16th of an 8mg strip or what have you. Ideally, I think you should take the 5 minutes to make a standardized, volumetric dose so you know exactly what you're working with. There is a guide I made in BDD at the top if you need help with that. Alternatively, just ask me and I can run it down with you.

You are going to take a single, 0.5mg Buprenorphine dose under your tongue. You are going to wait ~15-20 minutes. Right around this time , if you are too early you should experience a noticeable, yet mild rise in your discomfort. If that is the case, it will be mild and over within an hour or two at most. If you feel relief from that small dosage (be mindful, pay attention), then you are going to give it 45 minutes and then, if still feeling good, you administer another 0.5mg dosage. You will repeat this process until you've gotten to 2mg/3 hours.

If you get to that 2mg and you feel fine, start adding 1mg increments every 45 minutes until you get to 4mg, constatnly paying attention to how you feel after every dose.

Did I help with your problem dude or is there something else I can answer for you?

 

[aspiringchemist]

I got off fentanyl with bupe. That was like 11 years ago or something. I'm pretty dependent on bupe but its free so thats nice. Cold turkey off fentanyl is hell. I once asked a friend of mine to hit me in the head with hammer (with the idea of being knocked out) because I was in so much agony. Glad she didn't do it in hindsight... but yeah.

Sorry didn't read the whole thread but cold turkey might be possible if its a young addiction (like <6 months maybe) or perhaps a rapid taper (a few weeks) off methadone or something. But talk to a doctor about that. If a doctor isn't an option, there's kratom which you can easily buy online in most places. It works good as long as the dependence isn't too severe. But there's a couple downsides, one is inconsistent strength from one batch to another.

The other is its duration. I used to have to take it like 5 times a day (or more) though some people say they can get by on 3. Honestly its probably best to see a doctor but if you live in the US without coverage or for whatever other reason thats not an option, kratom may be the other way out.

Bupe (suboxone), methadone, and kratom are all opioids so they will all keep you dependent but methadone is the worst in that regard. But its also the best in the case of... say... getting back to work as soon as possible, there's not really a transition period like with bupe. Just god help you if you ever want to get off a high dose of methadone. Also for some dependencies, its the only thing strong enough.

Here in Canada they were actually giving out dilaudid to addictss a while ago... but I think people got mad that they were selling them to buy more fentanyl ( I was actually one of the people doing the buying, you got great prices) so I'm not sure if they do that anymore. Or maybe you have to be witnessed I'm not sure. But out of the normal substitute options, methadone offers the most coverage while also being the hardest to get off of (if you ever plan to, I figure I'm probably gonna be on bupe my whole life, if civilization survives that long, its diazepam I want to eventually get off of)

Anyway good luck.

Thanks for the reply man. Glad you got off it. So when you say to a doctor, what are you expecting them to do to help?
In the US they can’t/won’t prescribe methadone for addiction in a general medical clinic setting, it has to be via a methadone clinic/program (I’m sure you already knew that though). As it stands, idk what else a doctor could offer me but I am not opposed to the idea necessarily.

I actually made an appt with my old suboxone doctor, which is in 3 days from now. Unfortunately I know she will not prescribe any replacement opioid. You guys have it great up there when it comes to opioid dependency. Our policies make me furious as they just perpetuate the problem and offer almost no solution. I heavily considered going to a methadone clinic for the reasons you stated. In attempt to reduce the invasion into my life, I decided to go the bupe route again instead.

I’m curious, when you do take the suboxone initially, at 36-72 hours, how much relief does it provide? Does it relieve withdrawal like methadone does? Do you go from flopping around to functional?
I’m going to try again, probably with the help of this sub doctor in a few days but I intend to use kratom extracts as well. I’ve got about 4g of 7OH and pseudoindoxyl.

on the topic of kratom… I have repeatedly experienced what feels like precipitated withdrawal when taking up to 200mg 7OH/pseudoindoxyl. I’ve tried multiple times and get zero relief, a slight effect for 45 minutes, followed by a sharp drop off into withdrawal. I’ve read that pseudoindoxyl binds stronger than fentanyl and can actually induce PW if taken to soon after fentanyl use because it strips the fent and replaces it with a less potent opioid. I don’t understand why kratom alkaloids don’t seem to work for me. I was a heavy kratom addict for about 10 years (I quit maybe 5 years ago). I was taking 100-120gpd plus opms nightly. So I’m surprised it doesn’t seem to provide me any relief. Needless to say, it is the only comfort opioid, other than diphenoxylate, that I have access to.

Hey @aspiringchemist

I think I might be able to give some insight here. Most people I've spoken too need to go 36-48 hours before inducting on Buprenorphine. That's just how it is. You are in luck that you have all of these medications to help you. You are not on an impossible quest. You only must make it 48 hours without Fentanyl.

Furthermore, it is not wise to induct with such large doses. Precipitated Withdrawal is often linear in intenstiy relative to the size of the Buprenorphine dose administered. What that means is that you can test the boundaries of your situation with less fear by consuming very, very small dose of Buprenorphine. This is something I have been describing to folks for almost a decade now. I think it is incredibly lame that our medical establishment refuses to accept this method in any way. You are not going to find any mainstream physicians who are going to tell you to take small doses of Buprenorphine every 45 minutes. They either want to give you your pill and watch it dissolve under your tongue all at once or send you home with the same and not alternative instructions.

Wait until 36 hours okay? Then we can try again. If it doesn't work out, you will just do your best to anesthetize yourself for another 12 hours until it's time for another go.

You are going to want to find a way to make your Buprenorphine into 0.5mg increments. If you have strips, use scissors or even your eyes to rip off a tiny, tiny crumb that you think is close to 1/16th of an 8mg strip or what have you. Ideally, I think you should take the 5 minutes to make a standardized, volumetric dose so you know exactly what you're working with. There is a guide I made in BDD at the top if you need help with that. Alternatively, just ask me and I can run it down with you.

You are going to take a single, 0.5mg Buprenorphine dose under your tongue. You are going to wait ~15-20 minutes. Right around this time , if you are too early you should experience a noticeable, yet mild rise in your discomfort. If that is the case, it will be mild and over within an hour or two at most. If you feel relief from that small dosage (be mindful, pay attention), then you are going to give it 45 minutes and then, if still feeling good, you administer another 0.5mg dosage. You will repeat this process until you've gotten to 2mg/3 hours.

If you get to that 2mg and you feel fine, start adding 1mg increments every 45 minutes until you get to 4mg, constatnly paying attention to how you feel after every dose.

Did I help with your problem dude or is there something else I can answer for you?

Thanks for the information. I started with 1mg bupe doses every 30 min and got up to 5mg. I’m almost certain I induced PW at the 24 hour mark as I went from feeling pretty unwell, though manageable, to frantically flopping on my bed in the most intense, adrenaline fueled, sick feeling I’ve ever experienced. Clonazepam, clonidine, pregabalin, and alcohol didn’t touch it. I then shot 30mg of morphine (which was probably blocked by the subs) which had zero effect. I just couldn’t stop panicking so i went and relapsed on fentanyl and it immediately subsided. I legitimately thought I might pass out or die, the panic and internal pressure were outrageous, mixed with all your other lovely withdrawals symptoms to the max. My body and mind couldn’t handle it.

Yes, I’m so grateful for the medications I have and the doctors who prescribe them. i recognize how unusual it is these days and just acknowledge how lucky I am for that. It makes seeking medical treatment for this seem silly as I already have everything they might prescribe.

This next time I will follow the dosing regimen you’ve outlined. As posted above, what kind of relief should I expect from the suboxone? Comparing it to say methadone, which essentially fully replaces it and takes you out of withdrawal. What does a 4mg dose of suboxone look like at 48 hours into fent withdrawal?

I’m afraid I won’t be able to make it 48 hours because that horrid experience happened at 24 hours; I assume it was PW, but I can’t be certain. I started to feel “off” about 30 minutes after taking my first 1mg sub dose. I appreciate the suggestions around dosing and paying attention to minute reactions.

I’m just fucking scared tbh man. I’ve tried to get off so many times, this last experience being the worst, and longest ive gone without.

 

[4DQSAR]

Is the fentanyl retailed in North America pure because 200mg sounds like a truly spectacular dose.

It's not impossible. I've known people who (after a year+ of unrestrained usage) worked up to such doses, but they were all in the unusual position of being chemists and weren't interested in selling the stuff. It was more curiosity followed with the realization that after their first attempt they had the equivelent of over a kilogram of morphine and broke rule 1 on that terrible belief 'I'm too smart to get hooked'.

As usual, Keif has the practical experience.

 

[aspiringchemist]

Is the fentanyl retailed in North America pure because 200mg sounds like a truly spectacular dose.

It's not impossible. I've known people who (after a year+ of unrestrained usage) worked up to such doses, but they were all in the unusual position of being chemists and weren't interested in selling the stuff. It was more curiosity followed with the realization that after their first attempt they had the equivelent of over a kilogram of morphine and broke rule 1 on that terrible belief 'I'm too smart to get hooked'.

As usual, Keif has the practical experience.

No, it is most definitely not pure or pharmaceutical grade, despite what some people say. It’s a white powder substance that is usually talked about by the “point”, which is 100mg, or one point of one gram. I can’t see how it could ever be pure or pharmaceutical grade based on the size of dose alone.

100-200mg of good street fentanyl will get me good and high with my tolerance, which I know is an astronomical dose if we’re talking about pharma grade fentanyl. For reference it takes me about 80mg - 100mg methadone to stay well with this 1-1.5g/day fent habit

 

[4DQSAR]

Well it's tricky converting to and from methadone because of it's relatively high oral bioavailability and long duration of action but via parentheral administration, an acute dose methadone is reckoned to be somewhere between 1.5 and 2 times as potent as an acute dose of morphine (which even then shows the variability of the stuff).

We used to estimate that for each £10 bag (100mg) of circa 50% pure H a person used per day, 10mg of methadone was the starting-point for titration.

Until today I didn't know that typically fentanyl users need to use 6-12 times per day. In the UK H represents almost 100% of the market and almost all H users fall into a TID pattern of usage. So it must have the potential to produce an even more chaotic lifestyle than that seen in some H users.

We don't see fentanyl in the UK very often. For a decade or more so many predictions have been made about a UK fentanyl epidemic but our WORST year was 2017 when 76 people died.