Opioids is it better to quit cold turkey or minimize dose?

[milagro]

I find myself in a situation that I am certain many of us have been in before. I have a prescription for a full month of 120mgs of oxy Ir and ER/day which what I have been taking but cannot fill it for 10 days. I am seen at a clinic and running out early, losing meds, having them stolen, and any # of excuses is not an excuse for an early refill. Particularly with the new laws in place.

Having said that, here is my situation and a bit of what led to it; I have either misplaced pills or they have been stolen by my room mate's guest who happens to be a homeless alcoholic. I know what is going through everyone's head in reading that blurb but I know this guy and trust him as does my room mate. I do not know what happened but I have 50-5mg oxy's to last for 10 days.

I know I am going to go through hell at some point because I have tried to cut dose on methadone and was in the throws of WD by the 4th day of abstinence. I am certain that the WD will occur more rapidly with IR meds.

My question is; How in the hell can I manage this? I will not ask for an early refill because my PM doc will dismiss me. So, I must go through WD. Would it be better to go into WD and take one pill at a time or would that be completely useless? Like I said, I have 10 days until a complete renewal of medication and this time it is going into a lock box.

I would just like anyone's advice that might have gone through a similar circumstance before. I have been in full oxy WD before and thought I would die with vomiting, diarrhea, depression, RLS, profuse sweating, hell, you know the symptoms if you have read this far.

I have to try and work a couple of days through this on coming nightmare. Any suggestions would be greatly appreciated.

 

[RobotRipping]

take the oxy when u have to work and suffer it out with immodium and whatever else u can find during the other times. that's just my recommendation as i know how important work can be.

 

[CinnamonGirl]

Can't you ration out your Oxy to 5 a day, one 5mg pill every 5 hours? That would give you 250mg a day.

Or will you be in full blown W/D with that amount? That is what I would do.

Then as ^^^^^^ says take a lot of lopermide (between 25-50mg) & if you have any benzos take those for sleep. Also get some Potassium for restless leg/arm/body syndrome, a vitamin & mineral supplement, & L-Tyrosine between 2000-4000mg) is also supposed to help with W/D symptoms.

Good luck & hope this helps. BTW, everyone thinks they can trust a good friend or a close family member, but when it comes to narcotic pain medications you have to treat them like you have a big pile of money or a pot of gold. Anyone will be tempted to take medications lying around.

I take my meds EVERYWHERE I go. I mean everywhere. I don't leave them at home when I'm not there, I don't leave them in my car unattended, in a hotel room (employees steal them), etc etc etc you get my drift. I have heard story after story of "I can't believe HE/SHE actually stole from me!" It's just TOO big of a temptation.

 

[Mass08]

It's only 25mg a day, not 250. I would see how the 25mg per day treats you man, if it makes it bearable then I would just take 5 everyday.

 

[RaceHorse]

I'm sorry you're going through what you are, its the worst. Your situation is much harsher then mine was when it comes to the strength and kind of opiate. After my father passed I went a good 6 months constantly high, using at least 75mg of hydro a day, occasionally i'd find some oxy 10s but those were just a treat. In my case I went cold turkey. Prior to my abusing I had severe anxiety, so lucky me was able to get Xanax which helped a lot with the cravings and such. First couple days, I felt great, after a week the cravings hit hard, this is the hardest part of the WD. I do not know if you actually need the oxy for pain or whatever or just for recreation and to keep the WD symptoms away, and I don't want to know. My advice is to use the recommended dose, if it is for legit reasons, and thats it. I know it sucks. It's the worst, but it has to be done sometime or later. You're in a vicious cycle right now, next month is gonna be worse and you're gonna have the less pills to get you to your next script, so might as well do it now. weaning off does not work, at least for anyone i've talked to. Maybe go to the doc, talk about anxiety and perhaps get some benzos. I've said this many times, Opiates are the BEST/WORST THING EVER MADE. You will experience some terrible symptoms after not abusing it, BUT YOU WILL GET THROUGH IT, and when you do, and all is over with, you feel on top of the world! PM with any questions or if you just need someone to talk to! Good luck, and just always remember, WD is only temporary!

 

[ferinox]

I would put a rush order for phenibut and those ridiculously large loperamide bottles they have online. It won't take much searching to find those. I've seen anywhere from 50 mg daily to 200 mg daily for loperamide when used for wd depending on the severity of the dependence. Take the lope as soon as you can before you wd. It actually takes 12 hours to peak in my experience. Start with the lower doses first and try to figure out what you can get by on bc lope can actually raise tolerance. You won't feel great but you can expect to feel normal whatever that is for you. I don't know how bad your pain condition is but i hope it's not too horrible. People can be insensitive assholes.

 

[rmike]

Lope has been very helpful to me in the past. I usually take 50mg and I'm good through the next 24 hours but I suggest you start low and find the dose that alleviates your wd symptoms. If I were in your shoes I'm sure I would run out of oxy before my dr appointment and end up on lope anyways

 

[Permanent Jones]

I feel your pain. Been there too many times. Here' s what worked the best for me: immediately, cut the normal dosage in half, so if you usually take 120mg day, cut it to 60mg for the first 24 hrs, then cut your dose in half again the next day, say from 60mg to 30, then from 30mg to 15mg. With whatever little remains, save it for when the worst hits (RLS for me) or when you have to work, and take only just enough to alleviate the worst symptoms. During this entire time of course, you want to be proactively treating all symptoms with OTC meds, ie immodium and ibuprofen. I would also get some kratom overnighted asap. You will still experience serious withdrawal, but this is the best method of minimizing it and stretching whatever meds you have left. If you don' t have to worry about drug tests, I' d get some good weed, too. It' ll do wonders helping you sleep. Good luck, man. Sorry you' re going through this.

 

[milagro]

"I do not know if you actually need the oxy for pain or whatever or just for recreation and to keep the WD symptoms away, and I don't want to know. My advice is to use the recommended dose, if it is for legit reasons, and thats it".

I was too lazy to quote the whole response and delete sections so I took the part I found troubling. Perhaps I didn't make myself clear. Did I say I didn't know why I that I actually needed oxy? I have been in Pain Management for 8 years now. I know why I take it and I also know that life without it is unbearable. Sounds like an addict rationalizing but I have tried everything short of major surgery. I don't ever want to hear 'recreational' when it comes to my medications. I have had assholes ask me to sell my meds and those were the final words I ever heard from them again. That sounded kind of eery. Sorry.

I use it as recommended but when you sneeze and the pain is so great that you swerve into the next lane I believe that the "recommended dose just aint cutting it". I cannot take nsaids anymore because they destroyed my stomach.

I hear about other CPPs taking incredibly high doses beyond mine and wonder how they are able to function. I think it is necessary to get off this stuff but the work conundrum is pissing me off. I told my doctor that I was having increased pain due to the work and she was just glad that I was working but would not increase my dose and kept pushing the bupe which has been a proven failure for my pain.

I have already portioned out 25mg a day in my pill dispenser but I know I am in for it and the damn temptation when you feel ill and you have something that will cure it immediately is difficult to overcome, particularly when you have to work.

I had completely forgotten about loperamide. I used it once in a pinch and it worked but I hated the intestinal freeze. I suppose that the symptom of constipation is far more attractive than the symptoms of oxy WD. There are so many variables at work here. I shouldn't be performing the type of work that I am but I cannot even afford to buy a prescription if I dont. It really is that bad. I dont want to get political but asking someone who cannot work to live on 11000 dollars a year is almost cruel.

I should be in the pain management section. It seems to be a highly misunderstood medical practice, even among doctors. I am just going to have to go through some hell for a spell, eh? I will try the lope again. Thanks for the suggestions.

 

[RaceHorse]

My apologies! I did not know your situation. But the only option is to tell your doc whats going on, increase the dosage or quanity refilled each month, I guess just next time make it demanding you need more. My opinion now that I know the reasoning for taking the meds the times of day that are the worse. I know what you mean, my father had stage 4 cancer and he'd have to do the same, because the "recommended" dosage never cut it. He passed away before he even created a tolerence so he never had to go through WD symptoms, but again i'm sorry and did not mean to offend you by claiming recreation in my post.

 

[Druidus]

Quotes from other times I've suggested this method (PLEASE try it, it WILL work, and is probably JUST WHAT YOU NEED):

You should be able to find poppy seeds in any bulk food store. They're a common food ingredient. It's the kind of seed that you find on bagels or that poppy seed cakes/muffins are made of.

If you check multiple stores, the best seeds are the ones with the most brownish and white stuff in them and general dust-like debris. Often this is left over latex or at least bits of pods.

I'm very confident about the dosages, at least for me, and I'm a 160-ish pound male who was VERY addicted to hydromorphone.

Actually, one of those bottles tends to be good only for 7-9 hours. You are supposed to dose twice a day, one or two bottles each time. If you want, you can do it in three doses, and just reduce the dose accordingly. That gives a more even level throughout the day. Obviously stick to one bottle if you can, but if it's too hard and the symptoms are bad, go for two. Or, if you want, one and a half.

Remember to only use it for 3-4 days [this is for minor cessation of opiates, use more/longer in your situation, if you need to]. If you continued for a week or so, you'd get morphine withdrawals. And it's not a bad idea to reduce the dose each day on the last two. If you follow these rules and don't end up taking a bunch of it in order to get high (unless you are using it to get high as a replacement for your opiate of choice), then you shouldn't get addicted. There's no rush, it's subtle, it takes away the negative symptoms, and you've got to take a lot (for most people) to have a really euphoric noddy type high. Really we're just aiming to fill in some of your opiate receptors while still letting your body know it's got to start producing its own again. It's best to still feel a little uneasy, don't remove ALL the symptoms. But get yourself some sleep, eat, drink, have fun not shitting and puking in the bathroom. These are the benefits of the tea during withdrawal.

If, by some chance, you DO get addicted to the tea, well, at least it's very cheap. <snip - no prices> a kilo, I think, and you need like 300-400 grams for a low withdrawal maintenance dose. If you find you've got some minor withdrawal symptoms after tea cessation, keep taking the tea a little longer, but reduce it by 15-25% every week or so each dose.

Even if you do have some withdrawal from the tea, it'll be much easier than the intensity of oxy withdrawal, due to the dosing levels.


Try looking up bulk food stores in the phone book and asking if they have poppy seeds. If, by some unlucky chance, you buy seed from a bulk store that ACTUALLY did what they were supposed to and washed the seeds extremely well, you'll need a lot more seeds or it won't work at all, so buy a kilo only first, for a test dose. If it works, buy more. Otherwise, look for a different store. In my location, it's pretty easy, because none of them wash well. I doubt they do there either.

Let me know how the tea goes if you try it. One tip: I don't do this because it tends to make me sick, but if you want to increase the morphine yield from each wash, put in some lemon juice. As much as you can while still keeping the tea palatable. Morphine citrate forms, and is much easier dissolved in water.

BTW, for BEST results, take some antacids before taking the tea, about 40 mins before. Also, the standard potentiators apply.

I would use 60-100mg of loperamide per day to avoid physical withdrawal and attain some mental ease. It's not as good as poppy seed tea, or as cheap. A couple kilograms go a long way, used right. I'd dose the strongest one in the morning, right after waking, and within thirty minutes I'd be starting to feel better. Within hours, I'd be normal feeling, and could forget the withdrawal. I'd dose a lighter moderated dose somewhere just after, about, or before morphine's half-life, and that'd usually be good enough to sleep with if I didn't stay up too late. A final third strong dose was occasionally needed; likely also due to differences in quantity of morphine in different samples. If the third dose was strong enough, I wouldn't even wake up in withdrawal.

Seriously, I've quit a few times, and honestly, poppy seed tea saved my life. I couldn't have done it without. It was so much the same as being high on the hydromorphone, but without the need to procure illicit substances and IV them, and lacking the terrifyingly addictive rush. Once I found that dose, I just lowered it over weeks.
Btw, quitting IV opiates, or any route of admin., really, is incredibly easier if you use the OTC resources available to one in need. Loperamide, or Immodium, actually helps a lot when taken in massive doses. People say it doesn't cross the BBB well enough to be psychoactive. That's bullshit, IMO and IME. Butr we're talking fifty plus milligrams. I needed over 100 per dose. That's over fifty pills, and it's so expensive it might as well be from the street. Less helpful, I find, is the codeine you can get OTC in many countries, though only 8mg tablets here, combined with 15mg of caffeine each and a ton of acetaminophen to CWE out. The caffeine stays, mostly, so it kind of really sucks.

The best thing, barring methadone or suboxone, which many cannot get on (or off, I've heard), is poppy seeds. I'll stand by them to the grave. They don't get completely washed of opium latex, especially in bulk stores; meaning you can have morphine/opiate tea. Just find a store with cheap bulk poppy seeds, test it by using 300mg to measure potency, if any. I could use a kilogram to a kilo and a half and actually catch a nod. Used two to three times a day at the dose you need to kill the cravings and the withdrawal symptoms, it's a Godsend. And you can slowly reduce the dose every two or three days, more if you need it. Until you feel if not the best, at least good, without opiates in your system.

I'm amazed they're legal, lol. So ridiculously cheap compared to street prices. <snip - no prices> gives you a good day, two if you stretch it. You can't inject it, and as long as you don't dose it too frequently or too heavily, it's relatively safe. People have died from it, though, so be careful. Test the potency of every new batch, it varies quite a lot, not all seeds have the same latex coating left. You could OD on as little as a kilo if it's too potent. If anyone asks why you buy so many poppy seeds, tell them you absolutely love poppy seed cakes and other baked goods. It's still legal to have whatever amount, until the minute you start making the tea, which would be considered a preparation of morphine.

To make the tea, simply put your dose of seeds in a container, fill to a little above the seeds with WARM water, and then shake/let sit for thirty to forty mins. Strain the seeds from the liquid, and squeeze them inside the container to push out the water they soak up. Rewash the seeds, same drill, but don't combine the washes. Taste the first wash, and it shouldn't be unpleasant, but rather, earthy, tealike, and, here's what to taste for: bitter! You can generally gauge the strength of a particular wash by tasting for bitterness alone. Test that, taste the second wash. Still bitter, but very noticeably weaker. Still diminishing returns don't crop up too much till the third wash, which I don't bother with.

Dose every six to ten hours, depending on need, and stabilize without the horrors of withdrawal. Literally, folks, you can KILL the symptoms completely; I cannot praise this stuff enough. To anyone trying to quit, please, just give seeds a try. You won't regret it. It literally saved my life, I wouldn't have got on the bus to leave street opiates behind without it; I just took enough seeds for two weeks and left.

It sounds too good to be true, and it almost should be, lol, but I swear, this is legitimate. Poppy seeds, at least from bulk stores (IME), contain more than enough morphine for opiate tapering, and even if you don't want to quit, you can get a damn good high from it, even a nod. And it's long lasting, so you don't need to redoes that much at all. In fact, I could get by on one strong dose a day, but I took a second one around supper time in order to mitigate symptoms upon waking the next day.

Seed tea, FTW.

 

[RobotRipping]

yeah seed tea will completely kill your withdrawal, but in terms of long term, maybe methadone is a better option, unless you plan to get off opiates eventually.

 

[poppyplanet]

Please please please, scatter out your doses. Don't quit them cold turkey because as you know, withdrawal will be hell and you will be kicking yourself in the ass for not saving some.

 

[Mr.Scagnattie]

Tapering is always going to be easier and less painful that kicking cold turkey.. That goes for any drug one is psychically dependent on. You want to get down to as a small a dose as you can. By doing this, the remaining drugs you have left will last longer, and your eventual withdrawal will be much less severe.

 

[milagro]

Thanks for all the suggestions-

I never thought of PST. I have never tried it. Hopefully, it is not a controlled substance. Controlling seeds? What next?

Opiates truly are the best/worst meds ever made although that holds true to many addictive medications. I intend to speak to my doc and push a bit harder for either a higher dose or something different.

I have done the methadone dance and having kicked it on my own, I will never use it again. The PAWS for methadone was horrific and I had only been on it for 5 months.

I have heard about new meds that use micro doses of bupe in a patch. I know about Butrans, but once again, it is insanely expensive and prevents the use of any med for BT pain IME.

Another BL'er suggested Temgesic but of course, that is only available abroad (Europe mostly). For such a progressive country, we seem to digress in many areas. Having worked in the healthcare field and laboratories for over twenty years prior to this onslaught of personal pain has given me a slight edge in understanding pharmacolgy.

I am off subject now but truly appreciate the helpful words provided.

 

[RobotRipping]

no PST is certainly not nor will ever be controlled due to the food industry and people who love their poppy seed recipes. It's a dirty mix of opiates though, thebaine, codeine, morphine and about 20 others. All come together to make a very interesting, speedy, yet sedating heavy high that lasts forever. The side effects are also terrible, especially if you are a habitual user. I'd really only use it if you need to get through a certain period of time, i wouldn't rely on it as a regular opiate of choice though.

 

[tricomb]

Thanks for all the suggestions-

I never thought of PST. I have never tried it. Hopefully, it is not a controlled substance. Controlling seeds? What next?

Controlling plants? Oh wait...

haha, but in all seriousness, I would not recommend you use PST to taper. It's notoriously unreliable for dosing, it is indeed a controlled substance to use for this purpose, there's no quality control, you have no idea whether it's super strong or bunk.

I would recommend against PST even if you have quality seeds. I can't in good faith say that it's safe.

I do not recommend the use of loperamide either.

I do recommend that you taper your oxycodone especially if you can't cold turkey it. You're a CPP therefore there is no reason you should have to cold turkey, let's do our best to minimize your discomfort safely, I really would recommend you reconsider using loperamide for anything other than to treat diarrhea if that becomes a problem, but don't take excessive amounts of it, I know people do it regularly but I have heard really bad things about using loperamide in excess.

You're a chronic pain patient and we have no idea whether it could aggravate your chronic pain condition, therefore in a non-professional way, but coming from fellow-CPP who has been in this position before, be really careful with what you do. I would recommend you take 25mg per day for the next 10 days. It's much better to do this instead of taking more at first and having to go even (and especially) 36-96 hours without anything at all.

I know it's a really shitty and scary situation and I wanted to offer my support during your time of need.

Temgesic is is buprenorphine just like Butrans, just so you know, but it's injectable formulation, not transdermal.

 

[milagro]

You're a chronic pain patient and we have no idea whether it could aggravate your chronic pain condition, therefore in a non-professional way, but coming from fellow-CPP who has been in this position before, be really careful with what you do. I would recommend you take 25mg per day for the next 10 days. It's much better to do this instead of taking more at first and having to go even (and especially) 36-96 hours without anything at all.

I know it's a really shitty and scary situation and I wanted to offer my support during your time of need.

Well Tricomb-

You seem to be the guru when it comes to giving advice that is usually correct. I have read a great deal on PST in the past day and find the stories and recipes so completely contradictory that I have now lost hope of having a possible remedy.

I tried 15mg of oxy today and I was in hell. I couldn't take it anymore so I took 15 additional mg. That is 1/4 of my usual dose and I feel like I might as well be in full WD. I am surprised that I have the mind and strength to write this.

Yes I am a cpp but as you should know, and I am certain you do know, the new laws make early refills forbidden and they put the patient at almost certain dismissal from the clinic. Considering how difficult it is to get into a PM clinic, I cannot take a chance on asking for an early refill because I am in a heightened state of pain, or say my roomate's friend stole my pills, both of which are true but highly suspect.

So I figured that PST would be far too easy a solution to the problem. Having read for the past hours all of the conflicting information, I cannot see it being a solution but I certainly feel that there is room for some relief. It doesn't hurt to try and I am certain that you have been in situations that death may have been of far lesser concern than just feeling a little better.

Lope is not a solution either and taken for a period of 9 days would probably be a very bad thing. I remember a mod cutting in on a thread that I participated in re: Loperamide. That person is no longer a mod, thank God and I was told that it is dangerous and similar to fentanil, misspell intended. So what is a disabled, trying to work, person to do given that I cannot say "my meds were stolen or misplaced?

I think I will give PST a try and perhaps, with Lope, I can make it until the next refill without being on death's doorstep. Then again, I am just cheating death and death doesn't take kindly to being cheated.


Ooh-

I just read what I typed and it came out sounding arrogant and dismissive which is the complete opposite of my intended response. I do appreciate your advice as always and didn't intend any mockery of you or other mods. I am in an extremely compromised state of mind at the moment.

 

[tricomb]

I don't want to hate on PST or lope and I certainly don't want to take away any hope from you, quite the contrary, I'm merely offering you the safest $0.02 I got

If you truly believe that your prescription was stolen from you, file a police report and take that to your pain management doctor and they should give you an early refill. I don't know the specifics of your pain clinic, or even what state your in, but this is what my pain clinic instructed me to do if my RXs ever got stolen, which is a pretty high possibility since we're dealing with opioid narcotics, file a police report, it's the only way most clinics do early refills.

 

[rmike]

I do know for a fact that my old dr would replace my meds if they were stolen bc they did get stolen from my car. I had to file a police report and my health insurance would not pay for the new prescription bc it was too early so I had to pay cash but it did work out. If you don't want to involve the police or alert your dr to your situation that is understandable.