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Detox Help with Methadone detox and gabapentin use

JT 1980

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I've started to detox from methadone and I'm using gabapentin and I'm not sure how I should dose the gabapentin? My first day was today and I took 1200mg 3 times a day and it's working but I'm wondering when I should taper the gabapentin. I don't wanna have bad withdrawals frof that too... Any help?
 
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I've started to detox from methadone and I'm using gabapentin and I'm not sure how I should dose the gabapentin? My first day was today and I took 1200mg 3 times a day and it's working but I'm wondering when I should taper the gabapentin. I don't wanna have bad withdrawals frof that too... Any help?

You should be able to go a week or more before you get any gabba wds some people are able to use gabapentin or pregabapentin for longer without any wds. I only get a little mental wd from it no physical wds, a bigger problem will
be you will develop a tolerance pretty quick with gabapentin so day 2 thru 4 maybe 1200mg 2 times a day thru the accute stage then start lowering dose its not bad at all for a week to ten days on it. Im sure you know how long the half life of methadone is it might take a day or two before the worse accute wds kick in. Theres lots of good help on this forum best of luck JT btw are you taking anything for blood pressure like clonidine just saying cause bp rises as you lower your opioid dose.
 
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Welcome to BL JT!

With methadone the worst of the withdrawal will generally begin to present around day 4-5 and taper off over the course of 10-14 days.

Most people don't need to worry about tapering off the gabapentin if you only take it for under a month. The one caveat to that statement: If you have even been dependent on gabaergic substances like alcohol or benzos then you might have a bit of rebound withdrawal when you get off the gabapentin, from your earlier experience with gabaergic dependence, but it won't be nearly as intense as what you experienced before.

If you haven't ever had to withdrawal from anything like alcohol or benzos you should be fine taking it for a few weeks to a month and then just stopping. You may experience a bit more anxiety or sleep disturbances than normal for a few days, but that doesn't really have anything to do with pharmacological withdrawal or dependency per se.

You can always taper a bit for the last week you're on it to ensure it isn't a harsh transition, and it may be worthwhile staying on it longer than just a month at a reduced dose to help you transition to a life of sobriety post opioid use (in which case tapering off it is recommended).

Questions:
  • How long were you on methadone and what dose were you on?
  • Did you taper off methadone? If so, what kind of taper did you do?
Answering those questions will help us get a better sense of what your w/d will look like.
 
I haven't been taking anything for BP but I haven't checked it either. I don't feel like it's going up... what signs do I need to look for for high bp?
 
I was on methadone for over a year but this is a relapse. The first time I was on 140 mg a day of methadone for over 4 years and quit cold turkey and accidentally overdosed on ativan because I didnt realize I kept eating them every cpl minutes.. I took 30 of them in an hour.... Luckily I was at my sisters house and went into her room and collapsed on her bed for some reason...(I don't remember doing that) She called 911 and I ended up in an induced coma for a week...
This time I was taking 60-80 mg of methadone a day. I went down 10 mg a day...
 
I haven't been taking anything for BP but I haven't checked it either. I don't feel like it's going up... what signs do I need to look for for high bp?

You don't really need to worry about your blood pressure per se, unless you have pre-existing cardiac issues. Clonidine is used more for RLS and the hot/cold flashes than anything, although it does have quite the effect on one's blood pressure (it isn't used primarily for its effects in terms of blood pressure when it comes to opioid withdrawal however).

I was on methadone for over a year but this is a relapse. The first time I was on 140 mg a day of methadone for over 4 years and quit cold turkey and accidentally overdosed on ativan because I didnt realize I kept eating them every cpl minutes.. I took 30 of them in an hour.... Luckily I was at my sisters house and went into her room and collapsed on her bed for some reason...(I don't remember doing that) She called 911 and I ended up in an induced coma for a week...
This time I was taking 60-80 mg of methadone a day. I went down 10 mg a day...

How long has it been since you quite the 140mg cold turkey?

How many days were you taking 60-80mg between when you came off methadone previously and now?
 
It was 2 years between quitting and the relapse. I was on the 60-80 for about 14 months.
 
Okay, so you should expect to get to the around the most intense part of the methadone detox around day 4-5. Your acute detox will likely last about 10-14 days, and you should be out of the woods around a months time. I suggest you use gabapentin for at least two weeks to manage the acute detox. If need be you shouldn't feel uncomfortable about taking it for a month or more, just keep in mind that it will be most important for the first two weeks.

Please look into getting other comfort meds such as clonidine and diazepam for the first two weeks. You shouldn't need them after 10-14 days, gabapentin should hold you just fine if need be after that, although you will likely still still suffer minor issues with insomnia and mood instability.

There are many other things you can do to help get you through the acute withdrawal and it's effects as they taper off after about two weeks. These include keeping busy, engaging in healthy activities you enjoy, keeping yourself well nourished eating three nutritious meals a day, and working to improve you sleep hygiene. Furthermore, spending time with friends and loved ones is probably the best medicine.

Is anyone you know aware of what you're going to be going through over the coming weeks? You've done this before, cold turkey no less, so you already know what to be expect. It won't be nearly as bad as cold turkey off 140mg, but coming off 60-80mg cold turkey is no walk in the park either. The first two weeks will be difficult; the first month will be difficult. Things will however improve as time passes. All you have to do is keep yourself healthy and from going crazy between then and now. It is just a matter of passing the days without doing anything to unskillful.

EDIT: sorry, so you tapered off 60mg at 10mg a day over six days? Or how long did you taper in total?
 
It was 2 years between quitting and the relapse. I was on the 60-80 for about 14 months.

Quitting methadone is a great challenge, it can work but it takes a long time to come out from the withdrawals. Both physical, mental and emotionally. You'll probably need some help with benzodiazepines for 10-15 days max. I suggest you consider having a doctor to help you with all needed meds and support. I have succeeded but it took a very long time until I felt okay. Life will change, and by overcoming the obstacles you'll feel indestructible. Wish you all the strength and patience!
Keep us posted!
 
Thank u Ericmen!!!

Yes, over 6 days... And yes my family knows and my gf and brothers and sisters are helping.. it seems like the gabapentin helped the first day but seems not to be working much anymore.... Does your body get used to it in 2 days?

And ur right, this time is alot easier than the first time. I'm having trouble getting comfortable, insomnia and diarrhea. The first time was horrible...

Tomorrow is day 5 so I'm not doing too bad... I'm just worried about the right dosage of gabapentin. I took 1500mg the Wednesday because I didn't know u could use it for withdrawals. I read it on a thread here but it was saying to take 2-3000 mg at once and I was too scared to do that...
 
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Generally GBP works better by taking small frequent doses throughout the day (300-1200mg every couple hours) along with a small snack (like a cracker with a piece of cheese, something with a little protein and sodium). Even with massive doses you're likely to need to dose 2-3 times a day to achieve desirably effects. Yes, tolerance to GBP builds super quickly, but it will still be doing it's job helping to prevent anxiety and RLS even if it doesn't produce the same obvious, subjective effects on day fourteen as it did day two or three.

Generally speaking though, for someone with your kind of opioid habit it will take more than GBP along to be comfortable throughout the acute detox. With the addition of buprenorphine, clonidine and a longer acting benzo such as diazepam for 10-14 days you would be golden. Even just the addition of one or two of those medications would make a big improvement over GBP alone.

It will have been helpful to have tapered a little bit, but a 10mg/day taper off 60mg is not going to make as much difference as more robust six month taper would have (obviously). You six day taper coming off 60mg of methadone will be significantly easier than cold turkey off 140mg, but it will still be quite challenging - particularly if all you're working with is GBP. That said, you should be getting a good idea of how bad it is going to be around now.

Most people I hear from seem to end up wanting to relapse most around day five, with the restlessness, depression and agitation generally beginning to taper off slowly shortly thereafter, clearing up around the end of week two. Given how you got off this your recent habit, it may take a bit longer, but even then you should be feeling remarkably better at the two week point.

That is great you don't have to hide this from the people around you. I take it they are supportive of what you're doing? That is so much more than most people seem to have who come off methadone, you're already ahead of the game.
 
So I should take it every cpl hours instead of every 8 hrs? And yes I have a great family and they are how I got off of it the first time. I relapsed because my dumbass got a percocet prescription after surgery and thought I could control it. Then started buying methadone and then it got to the point where I was just taking it to not feel like shit... I'm sure u know what I mean...

And I don't want to take benzos because I would just overdo those. My overdose has scared me of benzos...and yes I'm feeling like shit really bad right now but I'm scared to take more GBP? ANY IDEAS?
 
How much GBP have you taken today? I have taken very large doses of GBP during the day, far exceeding a total of 10g. There is very little point to such high doses though, the therapeutic effects don't really increase much past a certain point. In other words, GBP can be a big help during acute withdrawal, but for a habit the magnitude you're dealing with it won't cover all the symptoms of acute withdrawal by any means.

Whether you want to dose at lower dosages more frequently or at slightly larger dosages every 6-8hr is up to you. Experiment and see what works better. GBP is absorbed more effectively with a little sodium and fat/protein, so try having a small snack (read: small) with each dose.

Any chance you could get some loperamide to help with your withdrawal? Perhaps one of your family members could hold onto a benzo for you while you're kicking and dose it out to you twice a day at dosages equanxiolytic to 10mg diazepam?

Hope things don't get to much worse for your during your withdrawal! I know how shitty it can be when one jumps right into off a significant habit as you have, but you can do this - you did something significantly more challenging coming off the larger, longer methadone habit before. You can (will) do it again :)
 
Ive taken methadone but never detoxed on it i have friends that have and one was in jail for a month during detox. My blood pressure was only slightly high before tapering then when i was near the end of taper and in wds it shot way the fuck up 190/110 so i would still keep an eye on bp even if you dont have high bp clonidine is the staple as it will help relieve some wd syptoms too. I agree to take the gabapentin for a month i miss stated about week to ten days thats all i needed with oxy wds but forgot your wd are on meth will take longer between the relief from wds and helping with sleep very important. The wds from gab are minor no where as bad as benzos i really felt no physical wds maybe a little sluggish mainly more mental shit. I know they say 4 to 5 days for accute wds to really kick in with meth but over the years ive seen couple friends say on day two and three they already are there. Try to eat as healthy as possible and when you can go for long walks. When your able up the exercise amount i trully believe that helped me so much!. best of luck JT
 
It takes a little longer than short acting opioids for enough methadone to really leave the before one gets into the nastier part of acute withdrawal, but I do agree that after being on it/opioids for years the days it takes for methadone withdrawal to start peaking are certainly no walk in the park either.

My blood pressure also spikes during withdrawal and as was said I also believe this is common. With methadone it was high for maybe three months after getting off, but for my age it wasn't really something of an issue (late 20's) that required to be dealt with in specific. I guess that is why I said what I did about it in my easier post. I imagine the blood pressure issue is more significant for those pre-disposed to cardiac issues and/or folks in their 40, 50's or older.

Propranolol controlled my blood pressure really effectively during the post acute withdrawal when I'd take it for social phobia related performance anxiety. It kept it a lot more stable than clonidine did and lasted longer. It takes a bit longer than clonidine to kick in in my case.

As has been already said, clonidine is great during acute withdrawal as it will kick in quickly and have a very powerful effect on one's body, but its effects also can seem to wear off pretty abruptly. I'm not saying one if better than the other (well, clonidine is certainly more effective during the acute detox, and a bit overkill afterwards); they have different uses.

What was honestly more disturbing was how high my resting heart rate was during the first three months off methadone. Regularly around 90-100. Shit, my grandfather on my mom's side died of a heart attack. I gotta start taking better care of my heart, other than just being careful about cholesterol issues my family is also predisposed to :(
 
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Toothpaste dog, I've taken 1500 mg today..I tok that in one dose a cpl hours ago.. It does seem to help but doesn't feel like enough... I wish I could get some Diazepam but I don't have anyone to hold onto it so I just have the gb and I have hdroxyzine but don't know if that'll help...
 
Hydroxyzine may help with anxiety. Try to avoid taking it before bed though, many have issues with antihistamines increasing RLS.
 
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