Long-term cravings while in substitution treatment

[Ignio]

I posted this in the methadone mega thread, but it seems like it is more suited for this forum.

About one year ago I started in substitution treatment. First it was suboxone which did absolutely nothing for my cravings. After that I started on methadone. First 40 mgs for 3 month and then 60 mg for 3 months up till today.

Methadone did wonders for me and I have been functioning and working for over a year, but lately I have had cravings I almost can't control. I have had them for weeks figuring they would pass, but it continues to be the same. I have tried potentiating the methadone and taking one 20 mg pill three times a day instead of taking it all at once. I also get 5 mg diazepam each day which has been reduced from 10 mg of clonazepam each day. An obvious solution would be to ask for 80 mg, but to be honest that would be a never ending solution. I can't keep upping my dosage every time I feel like it. The thing is, it isn't just opiates I crave. It's coke, different benzo's, everything that will do something to blow me out.

Tomorrow I have to renew my script for diazepam. I am considering asking my doctor to prescribe clonazepam instead just to make some small changes to see if this can satisfy me for a while. Clonazepam works quite differently than diazepam does for me. But I fear that the worst outcome of this request isn't a not but that the doctor sees some warning signals here and stops prescribing or something. After all 5 mg diazepam is a low dosage and it is not far fetched to go form 5 mg to 0 mg. I overthink everything

Why do I start loosing control as soon as I "stabilize"? At least I figure it is correlated to me getting used to the dosage I take. But then again, 60 mg is a very small dosage compared to the amounts I took before.

I don't know why I post this. I don't know what answers you could provide that would help anything. But I don't have anyone to talk to about this, so first of all I just need to get this out.. My circumstances probably isn't different from a lot of other people. I think I have this tendency to escalate things from justifiable to bat-shit insane. How do you handle these "long-term" craving periods? My day is exactly the same as it was when I didn't have these cravings, so I can't really identify anything that could be described as triggering this emotion.

 

[MrRoot]

You might feel like losing your control after you have been "stabilized" because you want to alter your reality the same way as you did before.

I'm going through tapering from 140mg oxycodone a day use and I am halfway there decreasing 10mg at a week now.

I too have drug cravings and it too isn't just for oxycodone that I crave for but every benzo I have used and wanted to use, z-drugs, ritalin etc. and only way I have been able to cope with is therapy, group support and doing stuff which gives endorphine rush to be honest. Diazepam at therapeutic doses won't do anything for it so I have quited taking them and same goes for alprazolam and clonazepam.

 

[Cosmic Trigger]

Why do I start loosing control as soon as I "stabilize"?

IMO and from personal experience it's due to the fact that something is really missing in our lives. That same something that got us using in the first place. This world, the way it is, with all is minor joys and major sufferings is abhorrent to me. I'll never more feel at home here. That's what it is for me. This quote I found sums it up.


My hopes are blighted, my heart is broken, my life a burden, everything around me is sad and mournful; earth has become distasteful to me, and human voices distract me. It is mercy to let me die, for if I live I shall lose my reason and become mad.

YMMV
/I]

 

[Cdkman]

This is the part of the recovery that u need to find activities to replace drugs with..elevating your dose will just make u feel good for a month and u will be right back here and it will be harder to get off in the end..you are craving that endorphin rush and your mind knows right where to get it..that's why u need to try new things so your brain can relate pleasure to something other than opiates..best of luck I'm right there with u trying to get clean..it's a war but u need to win the daily battle.

 

[Ignio]

IMO and from personal experience it's due to the fact that something is really missing in our lives. That same something that got us using in the first place. This world, the way it is, with all is minor joys and major sufferings is abhorrent to me. I'll never more feel at home here. That's what it is for me. This quote I found sums it up.


My hopes are blighted, my heart is broken, my life a burden, everything around me is sad and mournful; earth has become distasteful to me, and human voices distract me. It is mercy to let me die, for if I live I shall lose my reason and become mad.

YMMV
/I]

That exact feeling that you are describing in your post keep returning to me. As soon as you think have have lost the feeling, it comes back even stronger. In particular "I'll never feel at home here.

 

[Ignio]

Thanks for your replies everyone. I didn't even realize the simple fact that it's because the need to alter reality returns as soon as I stop feeling high from my medicine. It never stops to amaze me how blind it is possible to be in relation to your own addiction. In the beginning I was just glad that I took the step to maintenance treatment and in some way I probably felt clean because I followed the directions given by my doctor. Now I realize that I just went from one addiction to another and the controle I thought I had gained was in reality insignificant.

Before my addiction and the few times I have stopped taking opiates before I was using all my time on something related to strength training and competitions, but after I broke my shoulder one and a half years ago I have been able to train so I am weaker than ever and I don't feel I get the same joy from training when I can't compete.

But at least now I can avoid increasing my dosage as I know it is only a temporary fix and one further step in the wrong direction.

 

[Ignio]

You might feel like losing your control after you have been "stabilized" because you want to alter your reality the same way as you did before.

I'm going through tapering from 140mg oxycodone a day use and I am halfway there decreasing 10mg at a week now.

I too have drug cravings and it too isn't just for oxycodone that I crave for but every benzo I have used and wanted to use, z-drugs, ritalin etc. and only way I have been able to cope with is therapy, group support and doing stuff which gives endorphine rush to be honest. Diazepam at therapeutic doses won't do anything for it so I have quited taking them and same goes for alprazolam and clonazepam.

How is your tapering of oxycodone going?

I probably have to start therapy again. I have started so many times and also stayed for months but soon or later I just stop coming to my appointments, but I obviously still have issues I need to talk to someone about.

 

[MrRoot]

It has been fine and cravings habe subsided mostly. Might be because I am in love since I have started dating Still a month to go and I am free of oxycodone.

Talking with others do wonders. I would suggest that you start that again.

 

[Ignio]

Congratulations with both things Love can do wonders. One month and you are free of oxycodone and you are in love, you seem to be moving towards good times.

 

[Cosmic Trigger]

That exact feeling that you are describing in your post keep returning to me. As soon as you think have have lost the feeling, it comes back even stronger. In particular "I'll never feel at home here.

amen. i just want to be released. I don't see that changing so it's better i'm gone. but then I'm old tired and ill. my time has passed. it's usually different when you are young

 

[Moreaux]

Ignio - I agree with other posters - it does sound like something is missing. If you have to much free unstructured time that can certainly cause cravings, especially in early recovery. Try to find ways to occupy you time. At some point you will have to make the jump to sobriety, so it's better that you establish healthy habits and routines now than after you are done with your taper and have to fly solo.

I relapsed several times because of boredom. You have to learn how to find pleasure in sobriety somehow. I think we are used to being able to instantly feel good by using, and the intensity of the good is significantly stronger than the pleasure from sobriety that it takes time to transition back to a natural feel good from life without substance.

I have been completely sober of everything for two years and felt very little pleasure for the first year. I had to force myself to engage in activities, and I primarily did so just to avoid relapse. I feel much more pleasure now from sobriety than I did, but I can tell that I am still adjusting. It takes time, and outside of rare events, I don't think that sobriety offers the same intensity of pleasure that getting high does. I know that sounds discouraging at first, but it's really not.

Sobriety offers a much greater overall quality of life, and the level of stress and axiety is much lower. Physically you feel much better, and as you get acclimated to sobriety, you will find much comfort in an ordinary routine where you're eating and sleeping properly, and are not preoccupied with the stress of getting your next fix.

It has been fine and cravings habe subsided mostly. Might be because I am in love since I have started dating Still a month to go and I am free of oxycodone.

Talking with others do wonders. I would suggest that you start that again.

Congratulations MrRoot!

 

[Ignio]

Thanks for your reply, Moreaux.

Boredom is definitely one of my biggest problems in regards to staying clean. I have stopped cold turkey several times, but after a couple of months I am bored to death. Even the one time I was in rehab I was bored after a week clean even though I was surrounded by people and activities. I am working hard at establishing healthy routines again. Before my addiction I was always proud of my self-control and the dedication required for the activities I enjoyed. Now I can hardly stay focused in 15 minuts during the things I used to love the most. But it takes some time to establish a routine, when it starts being more routine-like I hope to find some of the joy in the things I liked before.

I think my longest stretches of sobriety have been around 6-8 months, but I continuously felt depressed and like nothing matters. Thinking back now a few more months might have made the difference as it took you one year. Hopefully the next time I become completely clean I will have the experience to know it is completely normal to feel bad in an extended period of time.