Opioids Maintenance to a shorter acting opioid?

[Knarf]

Hey, I apologize if this has been answered before, but after going through detox about a month and a half ago I'm back to where I started; with an even larger tolerance to boot.

I could deal with the withdrawal symptoms, I simply took a week off and only attended a few of my classes. By day 10 I felt good, but was smoking pot every waking hour of the day. The thing that got me back on though, was as much the lingering withdrawal effects as it was my lifestyle. Old habits die hard, and none of the issues underlying my opioid abuse were dealt with. Detox was simply that; detox.

Onto my question:

Would I be able to get on suboxone to stabalize and taper, and than switch to a shorter acting opioid before jumping off? My one issue with the maintenance programs are the long duration of action regarding the drugs; 3 weeks of withdrawal symptoms do not sound pleasant. My current thinking would be to get my life back on track so to speak, before stopping opioid use period.

Any input would be greatly appreciated,

Knarf

EDIT:

A high-stress lifestyle in a world renowned university, and a demanding job have made it difficult to quit cold turkey. If I could simply take a month off for home rehabilitation that would be possible, but like I said my lifestyle and mental state have played as much a role in my addiction as the withdrawal symptoms. I failed my attempted detox, but that's not due to weakness as some of you may think.

 

[ro0ga]

A longer acting agent is always the best choice for weening off nearly all classes of drugs. A lot needs to happen in your body to completely free yourself of an addiction. You can take a month off and go through the initial phase of withdrawal, 10 days or so, but the post-acute withdrawal syndrome (PAWS) is something that will last beyond one month. Your body needs to downregulate all the additional opioid receptors it made as a result of your drug use, and you need to essentially "re-boot" your endorphin system that has been dormant throughout your addiction. These things take a long time, and though the physical symptoms will subside somewhat, the psychological symptoms will remain. It's best to start a long acting opioid and slowly, over months to years, reduce your dose which allows your body ample time to slowly restore itself to its original state. Start up suboxone, 8 mg or so a day, and slooowwly reduce your dose all the way down to 0.5 mg daily or less. When you jump off, you might feel some physical symptoms, but if you do it right, they will be minimal. Most people will tell you that the 15 days of very mild withdrawal from an extremely low dose of suboxone is highly preferred to the 10 days of hell followed by months of PAWS by jumping off a short acting opioid.

I feel like people complain about the awful withdrawal effects of suboxone because they jump off too early and don't taper down enough. So in short, you gotta let nature take it's course and allow your body time to restore itself, and using a long acting agent to slowly taper will allow your body to do that while at the same time enabling you to function in your daily life without feeling significant physical symptoms. There's no quick fix to this, it takes time and inevitably a little suffering. But if you want it bad enough, you'll do it.

 

[Knarf]

Thankyou for the very informative post. I have even heard of people weaning to .25mg and than .125mg to make the transition back into an opioid free life as smooth as possible.

 

[mr. mudd]

I think roOga is right, even though it will make your withdrawal longer to jump off sub. the time to do a detox off a short-acting opiate seems to have passed and gone for you, having classes and/or a job. you just can't do that on a short-acting cold turkey detox (and usually that doesn't work anyway).

I started a sub detox two months ago, and at the same time my friend did a cold turkey ms contin detox on his mother's island somewhere in Canada. He started feeling better after a week on the toilet (the bastard), whereas I've been through two months of insomnia and insane RLS. apart from the first week of transition, though, I've been able to work somewhat. the w/d is longer but less intense, so if you have committments I'd say go with the sub. (it's about day 20 at zero now and with a whack of exercise I can sleep 4 or 5 hours, hallelujah).

I jumped off from 1mg of sub to 0mg, which actually didn't feel much different from the 1mg (but then I wasn't on it long). I *think* you're better off doing it slower. for me, though, if I'd been able to taper off relatively painlessly with effective sleep aids or kratom or loperimide and as such I'd be more likely to relapse. the worse my w/d, the less likely I am to convince myself I could go through it again. once stabbed repeatedly in the lung, twice shy.

 

[phr]

Would I be able to get on suboxone to stabalize and taper, and than switch to a shorter acting opioid before jumping off? My one issue with the maintenance programs are the long duration of action regarding the drugs; 3 weeks of withdrawal symptoms do not sound pleasant. My current thinking would be to get my life back on track so to speak, before stopping opioid use period.

Any input would be greatly appreciated,

Knarf

You don't specify what you're using, how much you're using, and for how long you've used...

Still, the detox method- which is what you're looking for, not maintenance- with the easiest ride is one with a gradual decrease in dose.

Again, you don't specify exactly what your habit is, which would be helpful, but if it's a moderate one you could most likely do a comfortable bupe detox in one month. Just make sure you start with the MINIMUM dose. You don't want to feel any type of buzz, and then gradually lower your dose over a month's time.

There's no point to switch to a shorter acting opiate. It won't make the detox any more bearable and it would most likely lead to recreational use again.

 

[Knarf]

Started using opiates at 14 years old, been addicted for almost 3 years. They have obviously played a massive role in my life seeing as how I am still doing my undergrad; that's just so you get a sense of my age.

I use anywhere from 120mg-400mg of OC per day, with the prior keeping me at baseline, and allowing a full nights sleep; 80mg can last through the day, but not the subsequent night.

EDIT:

It's funny how when I first got into this, I'd see threads like this, with people throwing out dosages like this. All the while wondering how it would even be possible to get a tolerance that high...

 

[phoenix_risin]

You stated also a important detail that without it will keep you coming back to the same point and that is dealing with the issues you are numbing to begin with.
That part to me was even more unpleasent then the actual WD's I have dealt with.
I honestly believe that is the purpose of a maintenance program to help one who has had long term drug addiction issues learn how to handle and how to live life. As well as learn to deal with the things that usually send us fying back to the dope dealer.

I have never dealt with Suboxone but have jumped off Methadone 2 times and am on my third so far at 15mgs after being on for 10 or so years at 120 for most those years.

Slow and steady is important in coming off though i honestly belive that and when you get to 25 or so take it real sow if you have to do 1 or 2 mg's a week. That is how i came off on the last and this one The other i did a jail detox and believe when i state that is NO fun.

Good Luck

 

[Knarf]

Thanks again for the input everyone. I booked an appointment at the local clinic for tomorrow and I'll give an update sometime in the next few days.

That is not to say, however, that I do not want you guys to continue posting; I'd like my perspective to be as broad as possible. After all, the more educated I am, the more involved my position in treatment can be.

 

[phoenix_risin]

Great to hear I hope the clinic you have in your area is a good one (sadly some are a waste of space) Will you be doing Suboxone or Methadone? If I am not too nosey.

Which ever one you do Just be sure to take advantage of the counseling and groups aspect of it as you already know.
and Good Luck You can do it Just work on YOU while stable and take up slowly make sure you really need that increase and when you finally area ready to come off do it Slowly that makes a real difference it also healps to take vitamins and eat healthy etc

A lot of us here have been there and so you have a good support system

 

[phr]

So 120mg of oxy to keep you normal? Yeah, you're a good candidate for Suboxone.

Make it clear that you don't want maintenance and that you want the lowest dose possible. (Some clinics push for higher than necessary doses as well as for maintenance instead of detox. It's in their benefit for you to be there longer...)