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24mg of subs (6, 4mg strips) IS IT ENOUGH????

VictorZ06

VictorZ06

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Joined
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I have been doing a lot of reading and research for my friend who is trying cut his habit. He is on 32mg of dialudid a day along with a "bun" of smack. He has some very extreme back problems, they want him to go under the knife...but he won't because others in his family have had similar problems, had operations, and ended up worse. So he does PT and takes main meds and occasionally H when he is in extreme pain.

Long story short, he is moving to a country where he will not be able to find his dialudid or any H. So he decided to kick it all together...because if he doesn't, he can't move. And where he is moving (country), he can't even find a script for some of these high strength pain killers.

I was able to get him 6 4mg strips. That's all I could find. I MIGHT be able to find more later, but I hardly doubt it. With that said, and with what he has on hand (24mg of subs), what is the best way for him to proceed? I told him to wait at least 24-32 hours after his last shot or dose of whatever he is taking. I had read that one should feel real crappy once he starts to take subs.

He has Seroquel on hand, as much as needed.
As much Xanax Klonopin as needed (less clonopin actually)
Tramal 150mg tabs (10 tabs)
Benadryl
Kratom
Potassium
Vitamin B 100
Immodium
Plenty of Gatorade and water
Protein Shakes
Amino Acids
Fish Oil
Folic Acid

I know he takes a good amount of xanax a day. What I really need to know is how to go about dosing his subs. Like I said, he only has 6 strips of 4mg....this is all he has to work with right now. So please, I heard of sooo many conflicting protocols.....I hoe it can be done with with what he has. Please....any help would be greatly appreciated. THANKS!!


/V
 
this is a tough one. Due to the extent and term of his dependency to opiates you may need a little more bupe to make a good rapid taper. Also, while he is on subs, the kratom won't really help.

I would highly suggest going to a detox program. They are usually a week, and they will detox you with comfort meds and the such. They also will take into account his xanax and klonipin use. That is the best I can do for you considering his situation with chronic pain. They will also help stabilize that while he is there.
 
Yeah....he won't do the program. But thanks...I didn't think it was enough...
 
I think it was more then enough for a short detox. He just should not expect to feel %100 afterwards. I do not see why he would need more then 24mg over 4 or 5 days.
 
totach said:
I think it was more then enough for a short detox. He just should not expect to feel %100 afterwards. I do not see why he would need more then 24mg over 4 or 5 days.
Click to expand...

If you think it's possible, could you PLEASE be so kind as to write out a schedule for me to give him? Trying to get him more Bup....I was told it would be enough, but I guess MAYBE not. How would you suggest he run it?? Thank you?


/V
 
I think something like
Day 1- 8mg
Day 2- 6mg
Day 3- 4mg
Depending on how he feels on day 4 he can either take 4 again or 2mg and by day 5 6 7 if he wants to extend it that far 1mg then .5mg
The whole point is a rapid taper. I always used to try to take as little as possible.
Also depending how fast his metabolism is he might want to take one dose a day or split doses like on day 1 4mg in the am and then pm.
Unless he is looking to do maintenance then in my opinion 24mg is more then enough for a 5-7 day taper.
If he was coming off subs that's something else but he is coming off of a run. So that's more or else the way they do it in detox except I think they start at 16mg but I never needed that much.
 
Cool....I will give him the schedule, thanks so much. Any advice on how to use the products he has on hands to help him? Thanks again!! Still trying to get him more...but I can't find it. :(
 
Is it better for him to take small doses first like in the article above, or a high dose and climb down as suggested?
 
VictorZ06 said:
Is it better for him to take small doses first like in the article above, or a high dose and climb down as suggested?
Click to expand...

24mg isn't enough to taper down with a serious multi-year habit. He's going to need to get professional treatment, or source more buprenorphine.

Either way, he's going to run out of the drug and feel like shit, no matter what. There is no avoiding this.
 
Captain.Heroin said:
24mg isn't enough to taper down with a serious multi-year habit. He's going to need to get professional treatment, or source more buprenorphine.

Either way, he's going to run out of the drug and feel like shit, no matter what. There is no avoiding this.
Click to expand...

He said it's been about of year with his pain meds, and about 6 months with the H.
 
That's not enough sub to do much far as a taper is concerned. It's going to be a really rough kick. Keep him loaded on benzos and hydrated with Gatorade is my best advice. Also loperamide can help with GI issues and some of the symptoms at doses from 7-10mg. I wish your friend good luck.

Also see if his doctor or any doctor really will write him scripts for clonidine and a strong muscle relaxer.
 
crimsonjunk said:
That's not enough sub to do much far as a taper is concerned. It's going to be a really rough kick. Keep him loaded on benzos and hydrated with Gatorade is my best advice. Also loperamide can help with GI issues and some of the symptoms at doses from 7-10mg. I wish your friend good luck.

Also see if his doctor or any doctor really will write him scripts for clonidine and a strong muscle relaxer.
Click to expand...

OK....so he should get some clonidine. Gotcha. What is loperamide? Where does he get it from? I'm going to see if I can try and score him some subs. I've asked everyone I possibly know. NOTHING. I work with him and really need him to be able to travel abroad for long periods of time.
 
Loperamide=Immodium=Anti Diarrhea OTC medication. In larger doses it can be used to help combat other aspects of withdrawal than just the runs. Some seem to say 20-40mg 2-4x/day help with GI symptoms, and much higher (and not so healthy) doses from like 80-150mg can alleviate nearly all symptoms of withdrawal, although there are side effects from taking so much fucking lope and it is quite dangerous if you have a seizure history or heart problems (it also dehydrates the fuck out of you, will probably make you feel a little dysphoric, but well at the same time, and won't help with sleeping).

Clonidine would be great. See if he can get a lot of gabapentin or pregabalin. Take massive doses a number of times a day if he can tolerate it (much less pregabalin than gabapentin is needed, or should be taken). With these, the benzos, the loperamide (start lower and work up, I wouldn't recommend the massive doses unless there aren't any contraindication and he's desperate), I'd honestly dose 2mg 2x/day with the buprenorphine for six days. Start it the day after cessation (that actually will prob help regardless of the schedule, as day one isn't as bad as day two generally, although with that habit it probably will suck). And with that little bupe, there is no reason to taper off it, so at least that won't be a problem. He'd be way better off with enough to use 8mg/day for seven days though, particularly if you expect him to work much or whatnot.

Like has been said, there is no real way to escape discomfort here, with that kind of habit. You can limit it though. If you aren't adverse to it (and especially if you have used it recreationally before), DXM (or if you have it MXE or Ket) can really, really help with a massive habit. Like second plateau 2x/day. If that is what he chooses, cut down some of the other meds, and try to avoid taking anything else with the DXM, especially at 1st plateau or higher doses. DXM and the like probably won't be helpful for him working or traveling for long periods of time, so it doesn't seem to practical in this case.

It's going to be really hard for him to work and travel for the first week or two. Keep that in mind. Expecting him to do so is not really realistic or fair.
 
Thank you for the advice and pointers. He got himself into this mess, regardless of what I told him....and as his partner, I'm doing all I can to help him. He is a very talented man, and I really need him to get his stuff together. I got him as much subs as I could get my hands on, I will try and see if I can get more...but I highly doubt it.

As for this being fair....I know the poor guy has suffered a lot and he does have several medical issues. I really feel bad for him. But I need him to be able to work and travel. I told him many times to enter a program and get rid of the pain meds because I knew we would be having to be traveling to other countries....I gave him many months of notice. I worked very hard to get us where we are....and now I need him to work his magic to keep our business afloat. I mean...I can have his medication sent to him via FedEx, but even he said he wanted to kick it all at once. Thanks again for the pointers fellas. He probably won't start until the end of the week as he needs to work...he will have the following week off so....hopefully everything will work out. I am going to be going crazy trying to help him get more subs....I need him working so he can't be out trying to find the stuff. Thanks again for the help!!!
 
Oh yea, my bad! I didn't mean to come off as meaning you should be fair to him or something. I mean more like it expecting someone in that situation to be near functional during w/d might not work out so well. If properly medicated, it is totally possible though.
 
I hope so!! I am going to be spending the better part of my week trying to get him more subs...I have to put everything else in my life on hold, but hey. I really do need him. It's not his fault he got stuck in the position (well...mostly)...he is a good friend that would give his right arm for me. He has helped me when I once hit bottom, and I owe this to him. I'm going to go and talk to my personal MD tomorrow and tell him about my problems and see if he will give ME some subs to help with the pain I'm having. I dono....thanks again!! Oh, and I hope the seroquel and imodium help him!!!
 
Well dude's a lucky guy to have a friend as supportive as you to get him the core material for kicking! Hope everything goes well. There are ways to potentiate buprenorphine/Suboxone/Subutex, by taking Tagamet/cimetidine with it. Also get him to wash his mouth out with Listerine (or any mouthwash with ethyl alcohol, or he could just wash his mouth out with high proof spirits), and them pop the strip in right under his tongue. It'll melt like butter. The cimetidine is a horrible idea for more than a week or two due to side effects (unless he's trying to grow breasts), but it may prove very useful short term if he's really struggling with the bupe he is taking.

With all the meds you got though, he should be good.
 
Interesting....take Tagamet/cimetidine with his subs? Can you be more specific? How should he take it/how much?? I know you said a week or two....that's a large range since he is doing a short detox. Can you tell me how many days for his case? Also, Tagamet/cimetidine come in 300mg tabs....how should he take them with the subs? Is there a ratio as to how much more potent the subs will become? I told him I would hold his hand thru this mess as long as he just continues to work. I have everything he needs just the lack of the proper amount of subs. I wish I could get more for him...even if it's just one 8mg strip. That would go a long way.

I read off some of the other meds I have for him....if anyone cares to toss in suggested doses or how to make best use of them, I would really appreciate it. I really hope this works....I promised him I would take care of everything as long as he just focuses on work. He knows about the induction period...I told him he has to wait about 24-36 hours before he can begin after his last dose of dilaudid. He knows that and I told him that he probably won't be able to work, I told him about the COWS chart and he thinks that he will hit the 25-36 mark within 24 hours. But just to make sure, I told him to hold off as long as he can before I start to feed him sub. Well, if anyone can think of anything else I can add to this roller coaster ride....please feel free to share. Thanks so much for the help fellas.



/V
 
First I have to warn you....Most addicts want one last blowout before they stop. Please don't let him do this. I nearly died from mine.

Here are some supplements that will help with his withdrawals. Basically when you use opiates your body needs to get back to homeostasis.

Full Spectrum Multivitamin-when in withdrawal sometimes we go without eating...this will help keep the nutrients he needs to fight it.
l-theanine-It will help even his moods
l-tyrosine-helps with cognitive processes, basically your body gets used to being high, so this helps with the fogginess of not being high
magnessium-helps with rls
turmeric-its an antioxident...will help clear the shit out of his body quicker.

good luck...just know that sometimes you can't help an addict unless they want to help themselves...you may be codependent to him...you should research codependency.
 
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