Opioids Questions about severity of fentanyl withdrawal and treatment options

[Pickledlemons]

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

In my experience I actually think its closer than you might think. People think fentanyl is way stronger than it actually is. Don't get me wrong, it is strong. But this whole 2mg will kill a grown man crap is BS.

Though my experiences was several years ago and after learning about xylazine I've stayed away. I knew where my limits were with fentanyl and felt pretty safe around it.... But rotting limbs no thanks. It even creeps me out to realize I must have taken it unknowningly before. Sometimes my product came from a lab in China, but sometimes I couldn't wait and went to the street. Sometimes the stuff you got lasted way longer than it should have. I remember wondering, "does this have some additional analogue in it to increase duration?" but seems it wasn't even an opioid at all....

But even that is old news at this point. For all I know things have changed again. Every time the US tries to get rid of a drug it just gets replaced by something worse. If they'd just let the heroin in, maybe we wouldn't have so much xylazine, fentanyl and incredibly potent benzo analogues.

 

[4DQSAR]

But even that is old news at this point. For all I know things have changed again. Every time the US tries to get rid of a drug it just gets replaced by something worse. If they'd just let the heroin in, maybe we wouldn't have so much xylazine, fentanyl and incredibly potent benzo analogues.

It's almost as if a clear pattern had emerged and yet governments either haven't cottened on and/or it's not politically expedient to admit the fact.

I admit I was amazed to discover that IC-26 is seeminly being sold in Dutch Smart Shops and nobody seems to have noted any harms.

I should explain that When Eislib discovered that an ethylsulfonyl moiety acted as a bioisostere of the ethylketone in bemidone, that same substitution was made in every other opioid with an ethylketone so in fact it's just a less potent homologe of methadone.

The vendors make no bones about what it is and maybe because of that most people make the informed choice NOT to use it. I strongly suspect that very few people would buy oral methadone for a buzz. But even at €4/pill, it must surely offer a much cheaper alternative to things like H but only in dependent H users?

The Dutch are very pragmatic about drugs and I suspect that they are watching closely but the sad thing is that it only takes one idiot to neck a dozen pills for the media to invent hypotheticals in which this potent opioid could kill us allll!

I'm sure it's inevitable that a few people are harmed but it would surprise me if overdoses don't go down and the number of people seeking support from HR agensices doesn't go down because now opioid users have a legal way to substituted and potentially reduce.

It dose seem at least some Chinese manufacturers have noted that at some point almost all of those who use unprescribed opioids want to stop but since the logic 'well, it's their own fault' prevails, nobody stops to ask 'but what is that attitude costing ME'. The Swiss did their sums and quickly realized that when crime, neglect, illness and fatalies were all factored it, it turned out that just giving users the stuff worked out to be cheaper.

I always point out that in bulk methadone only costs about $400/Kg, it the legal controls around it that make up 95% of the cost. So ironically, just letting users buy this stuff is the very cheapest option.

I remain to be convinced that we know enough about it to be certain of it's safety, it seems like a good idea. I noted that the tablets are large and black and have a break-line. So some amount of thought has gone into designing pills that are anathama to injection.

 

[aspiringchemist]

In my experience I actually think its closer than you might think. People think fentanyl is way stronger than it actually is. Don't get me wrong, it is strong. But this whole 2mg will kill a grown man crap is BS.

Though my experiences was several years ago and after learning about xylazine I've stayed away. I knew where my limits were with fentanyl and felt pretty safe around it.... But rotting limbs no thanks. It even creeps me out to realize I must have taken it unknowningly before. Sometimes my product came from a lab in China, but sometimes I couldn't wait and went to the street. Sometimes the stuff you got lasted way longer than it should have. I remember wondering, "does this have some additional analogue in it to increase duration?" but seems it wasn't even an opioid at all....

But even that is old news at this point. For all I know things have changed again. Every time the US tries to get rid of a drug it just gets replaced by something worse. If they'd just let the heroin in, maybe we wouldn't have so much xylazine, fentanyl and incredibly potent benzo analogues.

Ya idk percentages or anything. Just guessing based on pharmaceutical fent being dosed in ug and fent powered usually by points of a gram.

God I wish they’d let the heroin back in. It is in all respects a better drug to be dependent on… it’s still a waking nightmare but at least the high lasts a few solid hours.

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.

Ya man, you have to use it like every 3 hours at most, maybe 4-5 but that’s pushing uncomfortable. It’s not really equatable to heroin, which I’d much prefer and miss dearly. The TID aspect alone makes it so much better. Having to use so often really is chaotic and it’s kind of frightening how quickly the withdrawal hits and how quickly it gets bad. Just comes on out of nowhere and gets exponentially worse in minutes.

It used to be youd use your last high to go and re up somewhere but now your last high doesn’t even give you enough time to find the next fix. It’s disgusting. I want more than anything to be off of it but I’m struggling so badly with the withdrawal.

 

[4DQSAR]

But this whole 2mg will kill a grown man crap is BS.

I'm guessing that an agency whose role it is to overstate the risk as much as possible will search to find an outlier.

 

[trndvd]

Man I remember going through this 5 years ago, heavy habit round same amount of time, shit humbled my ass that's for sure. Be careful with that sub man pwd happened to me after way longer than 48 hours, that stuff lurks in your system for a while now granted I was iv moa instead of smoke idk if that makes a difference but dude good luck stay strong

 

[aspiringchemist]

Man I remember going through this 5 years ago, heavy habit round same amount of time, shit humbled my ass that's for sure. Be careful with that sub man pwd happened to me after way longer than 48 hours, that stuff lurks in your system for a while now granted I was iv moa instead of smoke idk if that makes a difference but dude good luck stay strong

Thanks. I’ve been trying the Bernese method at an accelerated rate but I think I pushed it too fast, getting close to 3mg on day 1; I used to use suboxone and fentanyl interchangeably for years so part of me thought I could just rapidly titrate suboxone but I was wrong… it put me in a state of PW, albeit not too bad, but simultaneously the bupe blocked the effects of further smoked fentanyl for the most part so I couldn’t really escape it.

Before that, I went into actual withdrawal for a couple hours and went and copped to feel better but felt that weird fever dream feeling all day from being so sick. It hits like a ton of bricks for me. Profuse sweating, intensely uncomfortable in my skin, pain, strong anxiety that almost makes my vision different. I tried 7OH and pseudoindoxyl but they did absolutely nothing. Not a single thing to stop the withdrawal, so I downed 65mg methadone and headed out to score. Then I got the bright idea of again attempting an accelerated Bernese as stated above. And my prescription 40mg adderall...

I’m sitting here, at 4am, wired and wide awake from the stimulation that episode caused. Feeling like a fool for smoking a gram of fentanyl in a couple hours to try and feel normal again. This shit is so awful. I’m a hot mess. I so badly want off of it, and my family is trying to force me off of it, but I cannot seem to endure the withdrawal. I unfortunately suffered a rather severe drug induced psychotic episode about 4 years ago and though almost all of the symptoms dissipate, I still hear voices; something rather difficult to overcome at 33 years old. The addition of auditory hallucinations (voices), which get progressively louder and more intense when I’m in withdrawal, with the usual physiological and psychological symptoms of withdrawal, make it fucking scary and feel like an impossible feat. I’ve really backed myself into a hole here.

 

[TheGyattDamnRizzler]

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

You could easily skip the suboxone and go with the 7-oh or kratom. Kratom is kind of underwhelming when experiencing opiode withdrawal but it will get you through.
Ketamine and meth will over power the opiode withdrawal as well.

Good luck.

 

[aspiringchemist]

You could easily skip the suboxone and go with the 7-oh or kratom. Kratom is kind of underwhelming when experiencing opiode withdrawal but it will get you through.
Ketamine and meth will over power the opiode withdrawal as well.

Good luck.

I’m still not finding the 7OH and pseudo helpful with withdrawal. It’s weird, they do produce an opioid effect but it doesn’t seem to stave off withdrawal; it still comes right on time; even if I’m high on the kratom. Unlike any other opioid that basically substitutes.

I haven’t tried in the past few weeks. Been using fent and kinda switching to methadone during the day time. Now I’m considering fully switching to methadone and doing a taper. I have access to large quantities of liquid methadone 50mg containers for relatively cheap. I know I could get in the program myself but I don’t want to fuck up mu relationship with my psychiatrist.

But I’ve found methadone to substitute well at 50-75mg. Thinking about trying to switch and taper relatively quickly. Like over a month. Dropping 5-10mg every week or so.

My main issue is that about 4 years ago, at 33 years old, I experienced a true methamphetamine induced psychosis that persisted after sleep. Spent a month in the hospital. I’ve largely healed from it but I still hear voices daily and sometimes have close eyes visuals. I take medications for this but they don’t fully knock it out. I’ve spent the past 4 years healing and learning to manage with this new cognitive deficit. Anyway, when I go into withdrawal the voices get so loud and upset; exacerbating every little thing I’m experiencing. This, in combination with the regular withdrawal symptoms, is making the withdrawal state unbearable and kind of unmanageable.

I suppose I’ll get used to it as I keep trying. It sucks though. I really don’t want to go back to/end up in the hospital again. I manage it so well that you wouldn’t know unless i told you. I maintain my job and life’s responsibilities. I just hear fucking voices. It’s bizarre honestly and sometimes scary.

Ketamine does work really well at relieving some of the anxiety and physiological symptoms. I worry about getting too dissociated though. Again, the voices. It colors everything I do so to speak, and I have to be more careful now than I would have been in the past.

 

[TheGyattDamnRizzler]

I’m still not finding the 7OH and pseudo helpful with withdrawal. It’s weird, they do produce an opioid effect but it doesn’t seem to stave off withdrawal; it still comes right on time; even if I’m high on the kratom. Unlike any other opioid that basically substitutes.

I haven’t tried in the past few weeks. Been using fent and kinda switching to methadone during the day time. Now I’m considering fully switching to methadone and doing a taper. I have access to large quantities of liquid methadone 50mg containers for relatively cheap. I know I could get in the program myself but I don’t want to fuck up mu relationship with my psychiatrist.

But I’ve found methadone to substitute well at 50-75mg. Thinking about trying to switch and taper relatively quickly. Like over a month. Dropping 5-10mg every week or so.

My main issue is that about 4 years ago, at 33 years old, I experienced a true methamphetamine induced psychosis that persisted after sleep. Spent a month in the hospital. I’ve largely healed from it but I still hear voices daily and sometimes have close eyes visuals. I take medications for this but they don’t fully knock it out. I’ve spent the past 4 years healing and learning to manage with this new cognitive deficit. Anyway, when I go into withdrawal the voices get so loud and upset; exacerbating every little thing I’m experiencing. This, in combination with the regular withdrawal symptoms, is making the withdrawal state unbearable and kind of unmanageable.

I suppose I’ll get used to it as I keep trying. It sucks though. I really don’t want to go back to/end up in the hospital again. I manage it so well that you wouldn’t know unless i told you. I maintain my job and life’s responsibilities. I just hear fucking voices. It’s bizarre honestly and sometimes scary.

Ketamine does work really well at relieving some of the anxiety and physiological symptoms. I worry about getting too dissociated though. Again, the voices. It colors everything I do so to speak, and I have to be more careful now than I would have been in the past.

Bro don't do methadone, I get it if it helps but you should for something you can get away from like suboxone if your going to go that route.

Im with you with the voices I have that shit too now it's rough. I was just throwing options out. You should cut the methadone though, that is not an easy one to get off but if your already in the process of doing the methadone try to cut it down and stay off the fent.

Is it like "black out" tranquilizer fent or like "euphoric" fent.