Opioids Don't experience regular withdrawal after once having precipitated withdrawal

[ThePharmacist25]

I am going to try to sum this up best I can.

Basically I went to a detox place that detoxifies the individuals via treating the symptoms rather than taper from Buprenorphine or Methadone. I was hooked on Oxycodone (~120-150mg/day) for about three years and I have been through full blown W/D about '4' solid brutal times.

So basically after my 'urine test' came back clean the patient is started on Naltrexone (an opiate antagonist) by either a 50mg pill taken daily or a subcutaneous injection, once monthly (which is like $800/month). I needed a letter to prove I completed the detox there and due to going once a week (after the first week or so) anyone can take something on a Friday and be 'clean' until next Friday.

This is what I am confused about. I took about 80-90mg of Oxycodone right after my appointment (right before she was gonna right my letter the next meeting with her (the P.A.). So Monday morning I get a call and I had to go in for a 'urine test' and if I failed I wouldn't have earned the letter. So I took the Naltrexone (which makes you have precipitated W/D's like in thirty minutes) and lasts about 8-10 SOLID HARSH BRUTAL HOURS!!! I called the hospital and explained and they told me they couldn't do anything, believe that, NOT ANYTHING!! So I almost called an ECNALUBMA for myself, but stuck it out (14-16 showers, and about 6-8 pounds of vomit, sweat, spit, urine later).

I had to have the correct and designated level of a person that typically takes 50mg of the Antagonist (Naltrexone) daily. Words absolutely CAN NOT NOT NOT describe even remotely the brutality (I think you get it now, it's basically your 3-4 days of withdrawals all packed into 8-10 hours.

So:
Typical Withdrawals (T.W.D.) = 96 Hours
Precipitated Withdrawals (P.W.D.) = 8-10 Hours
(T.W.D.) / (P.W.D.) = 9.6-12x as harsh

I TOOK HALF OF THE TABLET BEFORE THE APPOINTMENT!!!!!!

So I was in pain!

Okay, here is the BOTTOM LINE. Since I took that antagonist and suffered pretty harsh all other W/D seems like a breeze. I don't get it?!?!? For example, for the past 10-12 months I have been addicted to Oxymorphone, Oxycodone, Hydromorphone, Fentanyl, OC, etc.. My last ingestion was about 90mg of Oxycodone on Monday the 14th and since then have NOT FELT ANY discomfort!!

What could this be? I mean I am used to HARSH W/D when I don't have anything, but since I took that Naltrexone (antagonist) and when through them Precipitated Withdrawals it's like they don't exist or I don't feel them..

Can anyone please help me out here and help me understand this? Thank you for everyones time who reads this and to also further, who replies!

Take care...

 

[Captain.Heroin]

It's just your perspective has changed.

You haven't gone through precipitated withdrawal due to naltrexone before, and it sounds absolutely horrific from what you say.

However, I guess what has happened is that the precipitated WD was sped up significantly by the use of an antagonist, and then the 8 to 12 hours of hell have basically helped you feel the milder withdrawal-like symptoms as feeling more "back to normal" and less "oh no, the withdrawals, they're starting!!!" - this reduces your anxiety about going through mild withdrawal-like symptoms, and consequentially you are more confident about making it the rest of the way through.

So, to summarize,

If all you know is using heroin, or coming down from not using it, the coming down part will seem pretty bad.

If you go through this naltrexone induced precipitated withdrawal, it will seem the worst, by at least 10 fold.

After going through this second scenario, the first one, by comparison, seems a lot better.

An analogy:

If you haven't been to jail before, probation will seem really shitty. If you've served 10 years in jail, probation will seem AWESOME because you're not in jail anymore.

I hope that makes sense.

 

[CitioKid]

But I've heard from various people here on BL that naltrexone made their withdrawals dramatically shorter. Like, went from a 200mg a day OC habit and, after violent PWD's, were able to get a semi-decent rest 48 hours after quitting.

I believe PWD's shorten and intensify the entire WD experience. Except for maybe Methadone or pods, I think they can make the physical withdrawals all get busted out in a 24h period.

 

[amapola]

^The OP is talking about detoxing again months after the precipitated withdrawal and still having no real symptoms. As Captain.Heroin said it is probably just perception of lesser symptoms due to the worse ones experienced that one time.

 

[ThePharmacist25]

I gotcha. I sort of had an idea that this was the case, however, it's just so weird that I can take nothing for like 3-4 days and be at WORSE, mildly withdrawn. To be honest, if I didn't go through that I probably wouldn't choose to knowing the W/D would be lesser. However, anyone that is willing to tolerate these PWD's I would recommend it. It's really really shitty.. OH MAN, Imagine almost calling an ambulance on yourself because it's that bad.. I won't go through it again, but experiencing these lesser W/D is a great feeling.. The hardest part is just the psychological part which can be beaten with a little determination! But, thanks for the replies, I got my confirmation.!!