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A guide to opioid addiction treatments and other medications used for withdrawal

Ungoliath said:
Fentanyl is perscribed around here to oc and dilaudid addicts to get off.

The strong sustained release (me 150mcg/h) removes all cravings for 3 days solid per patch, its a miracle drug.
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Wow thats a novel method to help with opioid withdrawal. Usually full agonist opioids, fentanyl especially, aren't really useful for detox. Unless, like i stated in my FAQ, they're used in a strictly regulated fashion (i.e.- time release, administered by a doctor, etc). Where are you from?

Still, i'd be interested to hear what the conditions of fentanyl detox treatment are? There are all sorts of factors that could hinder a detoxing individual, for instance- the patients destroying the time release mechanism or applying heat to transdermal systems to increase absorption (if the treatment uses transdermal patches), excessive withdrawal after treatment is discontinued, inadequate blocking of other opioid agonists, failure to decrease mental cravings, etc etc.

Is this for inpatient use only? Is it for detox or just to alleviate cravings for a period of time? What sort of tapering process is used? And what form of fentanyl is used, transdermal? Sublingual powder or liquid? IM injection??
 
personally.....i found rehab was the best method, heh......particularly one that doesn't prescribe its patients with methadone. They gave me muscle relaxers, sleeping pills, and some other shit, and besides having a wicked stomach ache i was alright....i had weined myself off a little bit before i went into the rehab anyway. i couldn't imagine quitting any opiate without a rehab....it would mean willpower, which is not something most opiate addicts have.
 
PIC said:
"i have plenty of credibility here both on this board and from real life experience and education"

Yeah, whatever man, do you have scientific literature to back it up? I just want to see where it says that one can withdrawal from Immodium. Forget your credibility, that is quite subjective.
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i'll tell you for a fact mister, that you CAN withdraw from loperamide because i HAVE. ok?
 
malfunkshun said:
i'll tell you for a fact mister, that you CAN withdraw from loperamide because i HAVE. ok?
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I saw a medical journal article once about a middle aged woman that had been taking ridiculous amounts of loperamide and yes was having trouble quitting because of gastrointestinal distress. So it would seem at least you could suffer loose bowels from an extended period of taking lope.
 
easyes said:
it would mean willpower, which is not something most opiate addicts have.
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Willpower is learned and cultivated, its not a genetic trait.
And willpower of course doesn't mean much to someone who is already in the depths of a serious opiate addiction, but it can help them taper down without "cheating".
 
Just to add my 2 cents on the Loperamide kick:

I recently got out of the hospital. I was on about 24 mg of hydromorphone a day. I brought myself down to like 25 mg oxycodone a day. I headed off on a flight like two days after I got out of the hospital and accidentally put my percocet into the checked luggage. Uh-oh! Got through security and PANICKED! I headed over to the nearest news stand and picked up 5 packs of Loperamide. I ended up consuming about 16 mg just as the skin-is-burning heart-is-racing hair-standing-on-end began. About two hours later I noticed this sensation was gone. I was still in *pain* from the stomach problems I was hospitalized for, and I honestly think the immodium made them worse, not better, but the burning-prickling anxiety was gone. It was just plain ol' "hurts like fuck".

My point is, it *does* work. There's gotta be some peripheral contribution to withdrawal symptoms, and there's always feedback between the peripheral and the CNS. Take, for example, epinephrine. It's not crossing the BBB, but the peripheral effects "inspire" a central response.

I've taken loperamide experimentally in massive doses (88 mg) when I was *not* opioid dependent, and found its effects to be the following:

*Sedation and tiredness for the next few days
*Throat and voice "scratchiness" like you'd get from opioids
*All the standard peripheral symptoms

It was kinda like all the side-effects with none of the high. I did feel remarkably calm, but definitely not euphoric. I felt shitty, to tell the truth.

Also, my bowel movements returned to normal about three days later. It didn't take weeks on end like I'd feared.

Conclusion? Yeah, it helps with withdrawal. I'd say start with 24 mg and head up toward 48. Give it a couple hours to kick in. It'll take the edge off, I promise.
 
^Yeah defintly, im at a 40mg oxycodone tolrorance, i took 15mgs of loperamide in desperation. Took away the shits quick, but an hour later still had strong WD. Im now about 3 hours into my experiment and i know this sounds ridiuclas but i feel fine. I don't know if i'll be able to sleep but im blown away that i feel somewhat ok ( as anyone knows whos WD'd its terrible ). No hot cold flashes, no sneezing, no watery runny eyes. Let just hope this stays this way. If so this wont be half as hard as it has been before.

Anyone in pure despiration and if you have no other opitions if your tolorance is around the same as mine, this may help you out.

be safe,

- B
 
I would also add the recommended dosage of 5-htp (also available at GNC) to that list. 5-htp is a precursor to serotonin which as everyone knows is the "happy chemical." It improves mood, helps you to sleep better, and helps with anxiety
 
ANewKindOfArmy said:
^Yeah defintly, im at a 40mg oxycodone tolrorance, i took 15mgs of loperamide in desperation. Took away the shits quick, but an hour later still had strong WD. Im now about 3 hours into my experiment and i know this sounds ridiuclas but i feel fine.
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It takes about 3 hours for Loperamide to be fully absorbed. You should be set for awhile.
 
First of all good work! I don't want to take away from the OP's contribution, but i have a similar, more in depth FAQ floating around (its linked to in the sticky thread- useful links). Here's the URL:

A guide to opioid addiction treatments and other medications used for withdrawal
http://www.bluelight.ru/vb/showthread.php?t=307488

Its my personal opinion that moderate to severe opioid addiction needs some form of professional attention in order to be effectively treated. Therefore, in my guide, i go into depth on the various methods used for both detoxing and replacement therapy (methadone, bupe, ibogaine, LAAM, ultram, opioid agonists, rapid detox using naltrexone, etc)- For each drug i explain their pharmacology, their advantages and disadvantages, side effects, and effectiveness relative to other popular treatments.

In the second section I list a SHIT load of OTC meds, Rx's, and herbs that can help alleviate withdrawal symptoms, and everything is organized according to specific symptom. Although, i merely provide a list; i don't expand on the effectiveness or action of any drug that only provides symptomatic relief from withdrawal. I do, however, list the medications in order of most effective to least effective (from my own subjective view point of course!).
 
Yes a good source of information also. By far th ebiggest factor IMO is determination, though loperamide to combat the shits is always nice. :)


Merging them ...editing them... hmmm can't wait, or can I ? ;)
 
C00P said:
I would also add the recommended dosage of 5-htp (also available at GNC) to that list. 5-htp is a precursor to serotonin which as everyone knows is the "happy chemical." It improves mood, helps you to sleep better, and helps with anxiety
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Additional serotonin in the synapse can actually aggravate certain withdrawal symptoms; during w/d usually all of the neurotransmitters are on rapid fire, so you definitely don't want to increase their activity (thats why CNS depressants like carisoprodol, diazepam, lorazepam, or even alcohol are more effective; they immediately inhibit neural transmission via GABA-A agonism).

5-htp may help w/ PAWS after the initial withdrawal has passed; but i doubt ANY drug that solely increases serotonin will help w/ acute withdrawal.

enoughorangejuice? said:
i've heard that taking benadryl can help with insomnia and opioid w/d's and i've heard it can make it worse. whats the truth on this ?
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As previously stated, diphenhydramine and dimenhydrinate can both increase RLS symptoms (and aches/pains); in addition to increasing hypertension, blood pressure, and anxiety. I've personally experienced this effect during w/d and did not use it thereafter. Generally speaking, anticholingerics should only be used as a last resort during opioid withdrawal.

MT1 and MT2 agonists (drugs that act on melatonin receptors) are a much better option for treating symptomatic insomnia; they are usually very selective and don't show cross activity on other receptors (for example, they show virtually no activity on HTP, DA, MU, KAPPA, DELTA, and norpinephrine receptors). So generally, they don't produce additional, adverse side effects. Ramelteon, agomelatine, and melatonin are all examples of MT agonists; but only the latter of which are available OTC.
 
Quick question, since Immodium is an opiate, can you use it with Suboxone while withdrawing? Or can you not use it since it is an opiate and could cause problems with the Suboxone.
 
It doesn't cross the blood/brain barrier in significant quantities so far as I am aware to be relevant, unless you consume vast amounts.


You ought to be able to use it yes.

Consult your medical practitioner first though.
 
More on Loperamide

TheTripDoctor said:
and yes loperamide likely DOES get into the brain in only slightly higher than normal doses if you use an enzyme inhibitor like cimetidine
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Sorry if this is already covered extensively somewhere else, but I was wondering about any successes in increasing the CNS activity of Loperamide with Cimetidine or even Ranitidine? Is it significant enough to pursue? Anyone have any luck?
 
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