Help with quitting hydromorphone & tapering

[Loki Irish]

Hey all, I'm a new member, love this site and need some advice. Because of a fall I'm a recent paraplegic and experience moderate to severe pain on a daily basis. I've been taking roughly 12-16 mg of hydromorphone daily for over a year now and want to stop because my mind is foggy, irrational, dazed and I experience severe constipation. Would it be possible to taper the drug and eventually get off of it on my own? If so, what dosage etc..? I love this forum as it assures me that I'm not alone and I would truly appreciate your help. Much love - L.I.

 

[theartofwar]

hey LI you might wanna talk to your doctor about tapering with a longer acting opiate like methadone or bupe (suboxen/subutex) - these will be much easier to handle on your body. Problem with the short acting opiates is that you come down so fast and you are left their sick. Not a pleasant place to be.

 

[Lolie]

This is probably more a question for BDD, but I would suggest that before you taper off the hydromorphone you have a comprehensive plan for pain management in place. You'd need to consult a specialist but such plans often include physical therapy, non-narcotic drugs, and a variety of non-drug pain management techniques. The aim is generally not to eliminate pain entirely but to keep it at manageable levels and minimise its impact on your daily life. You may still find that you need some kind of narcotic pain medication but possibly at a much lower dose or only occasionally.

For what it's worth, some types of pain respond best to non-narcotic drugs so I really think that a comprehensive assessment of both the type and extent of your pain would be extremely beneficial.

 

[Loki Irish]

Thanks for the responses t.a.o.w and lolie, i appreciate it. So I'm guessing that it isn't possible to simply lower my dosage over a gradual period of time and quit without any side effects?

 

[theartofwar]

youll feel sides, it's unfortunate fact of quick acting opiates.

bottom line on any opiate for YEARS , comin off is a matter of how to minimize the withdrawals. Hang in buddy,i been down thtatroad a few times, few hundred thousand.

 

[dirtyoldman]

possible?

Hey all, I'm a new member, love this site and need some advice. Because of a fall I'm a recent paraplegic and experience moderate to severe pain on a daily basis. I've been taking roughly 12-16 mg of hydromorphone daily for over a year now and want to stop because my mind is foggy, irrational, dazed and I experience severe constipation. Would it be possible to taper the drug and eventually get off of it on my own? If so, what dosage etc..? I love this forum as it assures me that I'm not alone and I would truly appreciate your help. Much love - L.I.

possible? yes... just do one less pill a day.... then one less... etc.

talk to your doc though... you'd probably be a good candidate for fent patches or similar

 

[Help me please]

I quit taking oxymorphone by going on straight, fast acting morphine at a much lowered dosage. I went into severe WD at first but then the dr gave me clonidine patches which helped greatly with the symptoms.

I am now tapering off the morphine slowly and not having any WD at all.

I was taking the morphine every 8 hours and then my PCP told me to cut the pills in half and take them every 4 hours. After a few weeks I cut my 4 am dose in half for a week and then eliminated that dose completely. Who wants to get up at 4 am to eat a pill? The goal is to lower all my other doses to 1/4 pills and then go back to every 8 hours and jump. It can be done but use patience!!! See about getting the patches for WD too. You won't need them throughout the whole taper but it's nice to have them.

 

[Bojangles69]

The rate at which you taper any opiate will determine the amount of pain you go through. I think 3 months is ideal for moderate to severe physical addictions, 2 months for less severe ones. Some people do it in 4 weeks but the majority of the time its rather uncomfortable. Also, like TAOW said long acting opiates generally have you feeling more stable as you taper, theres a lot less zigzaggin emotionally/physically like you would with short opiates.

Loperamide helps many taper because it plugs all the opiate receptors in your body. Although it barely passes the BBB (blood brain barrier) itself it will take up receptor space forcing more of the oxymorphone into your brain. Loperamide is both a potentiator and at higher doses can relieve quite a good deal of wds, but if you stay on it too long you have to taper off the lope itself. Drinking grapefruit juice will also eat the enzymes many opiates need to break down, keeping higher concentrations of it in your blood as you taper.
I don't do either or anymore though because in the end all they actually do is slow down the process, but for people doing forced rapid tapers (usually from running out) it helps a lot. That doesn't seem like your predicament so just do a nice slow taper for a few months and you should be ok. Also PAWs is rarely stopped by tapering but I do believe it helps minimize the intensity of it a great deal.

G/luck!