Opioids Naive about this subject and would appreciate educated opiate users intake

[GABAking]

Sorry I know I posted a similar thread not too long ago, but I didn't get too many answers and my situation has changed.

A quick recap of myself: I have been using opiates on and off (mainly on) for 3 or 4 years. I usually was able to make sure I never became physically dependent, but there have been a few instances where I binged too long/too hard and felt like absolute shit (Opana and fentanyl are unforgiving--esp cause of how short the half life on fentanyl is).
For the last 14 days, I have used heroin non stop (IV, dosages ranging from .2 to .7 throughout the day. Usually around .3). I also have been eating oxy, about 60-100 mg a day to potentiate the heroin.

I have 32 mg of subutex and 90 tablets of tramadol, 50 mg. I also have 30 2 mg lunesta and about 55 mg of klonopin. I don't have any immodium currently, but that's only a few minutes drive away if you guys think it'll help.

I really just wanna be done with opiates. I'm at a point in my life where I just don't even enjoy doing them anymore. I don't get high. I don't nod. All of these things I used to love about opiates just don't happen to me anymore. Plus, school is gonna get really intense for these upcoming years, and I can't be battling an opiate problem during this time. I want to continue to maintain my high GPA and bright future but I feel myself slowly slipping away into oblivion. I wanna catch this thing before it gets any worse.

Anyway, I know I am going to experience w/d. It's been a constant 14 days of usage (always high, from the moment I woke up till I passed out). Before then, it was about a 3-4 times a weak ordeal, mainly heroin and insufflated roxis (usually about 120 mg in a sitting).

I've read up on some people's opiate tapers, but still have lots of questions. I would really appreciate your guys' input.

I wanna take low doses of the buprenorphine (maybe 6 mg the first day, then 2 mg every day after that until I run out of the 32 mg). Am I wrong to assume that I will not experience buprenorphine w/d after using it for 14 days or so?. If I am wrong, what's the best taper method?

I've read that tramadol can ease the w/d symptoms for some people. Would it be better to supplement my subutex doses with 50 mg of tramadol, 3-4x a day or up my dosage of buprenorphine and save the tramadol for when I run out? From what I gathered tramadol and buprenorphine pose no threat in terms of percipated w/d or any other interaction.

I'm going to take the lunesta at night to sleep and the klonopin as it's prescribed to me, 1 mg BID to help with any anxiety I am going to experience.

Does this seem like it will work? I was in this same position last year (in terms of using constantly for a few weeks, etc etc), except I was using opana [insufflated, 40-80 mg a day] and fentanyl [chewed, 75 mcg patches] instead of heroin and roxis. I didn't think I was going to experience any w/d after only a few weeks of use but boy was I wrong. It wasn't nearly as intense as some of the w/d stories I've been reading about, but I was getting the restless legs, insomnia, crazy crazy crazy anxiety, depression, and flu like symptoms (although I never vomitted thankfully).


Any input, whether it's to say I'm an idiot and my plan is horrible and offer some adivce, or to say that I got the general jist of it would mean a lot to me.

Peace out everyone. Enjoy your Cinco de Mayo!

 

[tricomb]

TL ; DR, will check this out in the morning!!! I'm sure I'll have some insight. take care for now, I'm going to bed.

 

[phatass]

I've also read about tram+bupe not causing precipitated w/d.. if this is the case it would be to your advantage as it wuld enable you to spread out your bupe more and make the taper slower and less painfull.. but wait for other opinions on the combo.. i think it's greart that ou're quitting.... the meds will help with the physical w/d but once you're out of meds and done the detox comes the hard art. because the psychological addiction will still be very uch present. ty to compensate with something, ... sport, sex, i dunno.

good luck!

 

[served00]

I'm sorry but I do believe you will experience some withdrawals after the bupe; although they will not be as bad as if you just cold turkey'd right now. And your bupe withdrawals generally last 7-10 if I had to guess (for what youre gonna take). I could be wrong though, but I was on bupe for a verrrrrrry long time so I have some experience with it.

I'm sorry you have to go through this, welcome to the world of opiod addiction.

 

[served00]

phatass,

my doctor was prescribing me tram and bupe at the same time with no bad effects. The problem was, it just didnt do anything.

 

[Mr.Scagnattie]

You didn't have that big of a habit and weren't doing it for very long...so your withdrawals really shouldn't be too bad. That being said, the 32 mg's of bupe is more than enough to kick with by itself. You can set up a taper on the bupe, use it for a week or two and then come off of it. Klonipin, lunesta, and loperamide will help while you are weening off of the bupe. You have enough suboxone to make for a pretty painless withdrawal for what your habit is.

 

[daveykronick]

I have combined Suboxone with Tramadol and felt no positive effects, I just felt jittery. It is quite easy to have a seizure on Tramadol so if you must take it never take more than 400mg in a day, spread out over a few hours. There is no need to take 6mg of Suboxone a day, when you could get away with taking 1-2mg. I wouldn't take more than 4mg of Suboxone a day because I've been on Suboxone for 1.5 years, been on various dosages ranging from 1mg-32mg. I feel no benefit to taking more than 4mg a day because I honestly can't tell the difference between 4mg and 32mg besides the fact that I get more side effects like constipation and inability to urinate and it stays in my system longer. If it was I who was kicking I would take 2-4mg of Suboxone per day for 4-5 days then stop. If I felt withdrawals after that I would start a Suboxone taper at 1mg a day and cut the dose by 1/4 every other day or so until I tapered down to nothing.

 

[GABAking]

Thanks a lot guys. I think I'm just gonna hold off on the tramadol, don't see any huge benefit from taking it. Maybe save it for a rainy day, although I never really liked that drug.

I figure this is gonna be my plan:

Day 1: 4 mg
Day 2: 2 mg
Day 3: 1.5 mg
Day 4: 1 Mg
Day 5: .5 mg
Day 6: jump the wagon

I figure bupe will build upon itself in my system given its long half life, so I'm cautiously optimistic that this dosing will work. If I feel like crap on day 6, I'll dose .25 mg of bupe every 45 minutres or so till I feel OK (I'm gonna try and keep it low. I'd rather be slightly uncomfortable on a lower dose than have to w/d from bupe). This will leave me with some extra pills in case of a future mishap.

 

[tricomb]

Skip the tramadol completely IMO, it will complicate/mess things up. Tramadol w/ buprenorphine is great for minor chronic pain which is often prescribed to addicts, instead of a full agonist, although it is specifically indicated NOT to be used for this.

For the purpose of a taper/detox, it will hinder, not help, IMO.

That looks like a good plan, but do you really have to do your detox in less than 1 week?

 

[Znegative]

I agree about skipping the tramadol. It's such a weak opioid that it would not benifit you in the least, and like others have said, 32mg is definately enough to kick. I would allow myself to be a little more liberal with the subutex though. For instance, I would start off dosing 2mg at a time, but allow myself to take up to 8mg on day 1. While increasing the dose of suboxone past 4mg will not increase any agonist effects, it sometimes helps people feel more "stable" or "secure", and it certainly does ward off the withdrawal for a longer period of time.

The trick with doing a quick detox with suboxone though is to really only stay at dosages of 4-8mg and above for a day (2 MAX), and then start to decrease the dosage by 25% each day. You will ironically feel better from the buprenorphine towards the end when your down to .5mg, since lower dosages tend to feel more like full agonists. The key really is to not stay at any single dose for too long (if you want to avoid replacing the smack for the sub). When you jump off you will have to deal with a certain level of unpleasantness, but it will be short lived, and a walk in the park compared to say, a 1 month taper.

 

[Mr.Scagnattie]

Thanks a lot guys. I think I'm just gonna hold off on the tramadol, don't see any huge benefit from taking it. Maybe save it for a rainy day, although I never really liked that drug.

I figure this is gonna be my plan:

Day 1: 4 mg
Day 2: 2 mg
Day 3: 1.5 mg
Day 4: 1 Mg
Day 5: .5 mg
Day 6: jump the wagon

I figure bupe will build upon itself in my system given its long half life, so I'm cautiously optimistic that this dosing will work. If I feel like crap on day 6, I'll dose .25 mg of bupe every 45 minutres or so till I feel OK (I'm gonna try and keep it low. I'd rather be slightly uncomfortable on a lower dose than have to w/d from bupe). This will leave me with some extra pills in case of a future mishap.

I like that plan, but I'd allow yourself some more room on the first and second day as far as taking more than 4mg. You should then start decreasing your dose from there for how ever long it takes to get down to like .5 and then stabilize on that for a couple days in a row. Then drop to .25 and jump off.


By the way, this is my first day of not taking any bupe after six years straight of being either on heroin or bupe every day. I weened down to .125mg's and hopped off. I feel pretty good, got some trazedone in case I have trouble sleeping. Hopefully shit goes well...

 

[ANewKindOfArmy]

I agree with that plan from GabaKing. It kinda of reminds me of mine from my last rehab. Just make sure you wait long enough because for some reason with dope, whenever i'd take sub even when i was sick sometimes i'd get precips. This time they started me off with 2mgs then another 2mgs later on and a third 2mg sub dose alone with Phenobarbital, Clonodine and Valium. Benzo's definitely help alot. To be honest though i had a pretty decent dope tolorance at this time and the sub, clonodine and phenobarbital actually had me feeling FINE. i Felt literly no Wd symtoms other than sleeping. So Use them Kpins to sleep but be careful as you don't want to have a benzo problem. Only take the Kpin if you really really have too. The Rapid detox with sub actually does work pretty well. I remember even after my last dose the next day i didn't really feel all that bad at all. And having the Kpin and stuff that could really come in handy for those days after when you still got a little bit of weakness slight shitty feeling afterwards. the rapid detox with sub not staying on a steady dose for long does seem to be the best way to go about it. Start Off low with the sub like we said, try 2mgs at first, wait a couple hours and if needed take another 2mgs, up to 8mgs in a day if you have too, but if not, 6mgs is better. The lower the better and easier it will be to drop down the next day. You can do this, It's just the will power not to take more of something you need.. that's why it's easy in a hab you dont have a choice at home you have the ability too. So keep it honest and you got this. Good luck. Like i said though if you can get your hands on some Clonodine and your blood pressure isnt too low that really does help during Detoxing.

 

[BiggDirty01]

Excellent advice, but based on the research presented to me in my IOP (they conduct studies for NIH and NIDA) it really seems like a HUGE key getting a handle on opiate addiction at any level of addiction (newbie-opiophile) is to maximize your neurochemical rebound.

My only successful detox after surgery last year (which kept me clean til surgery this year) occured when I was presented with a plan that included a psych eval and the use of a specific low-dose anti depressant. IMO, I was able to take the desire to get clean (while still high) and transform that into a usable enthusiasm during the initial weeks of detox (not the acute <72 hr part). I found myself able to take the actions I promised myself while still using and make some of it plausibly do-able.
The wellbutrin I put on really helped me DO the things I said I would before but never could because the malaise and anhedonia of opiate detox eventually just overwhelmed me (like they do us all).

OP, it may not apply to you at all but for me the underlying depression was fueling my using. Not high, I could not handle the idea of life nor get a handle on what was best for me. By submitting to a psych eval (and rehab) I found myself living life again with the same affable attitude and perspective without the cloud opiates dwell on us.

The neurochemistry takes ~120 days (according to the research I had access to in my IOP) to renormalize and for every opiate addict I know that is too long. The idea of suffering away that long, turning away opportunities to chip (and thus return to TDS) just become to attractive in comparison.

I needed just a "tiny" heads start to go with motivation, desire and what not. When I started detox I had been on wellbutrin for 3 weeks. After the physical issues, I found the psychological issues so much more managable because my brains chemistry was more normalized than a similar addict. Rehab went well, I enjoyed it even. Sobriety didn't seem like a fantasy because I was thinking straight. My emotions were more stable.

OP, I commend you for taking this first step. The medication advice you've received is excellent. This is just my experience, but after so many failures at getting clean over so many years, that time was just a little different; a little easier.

 

[ANewKindOfArmy]

and people are right when they tell you towards the end when they give you them lower dosages for some reason you actually feel better towards the end of it rather than bad like you think you would as they cut it down. towards the end the 2mgs or lower actually feel stronger than the 6mgs worth from the first days. Good luck and keep it honest and you got this. You might want to have a good friend or someone you can count on to be with you through all of this to give your medications to you knowing the plan because as much as you may want to do this, at times you may over take stuff simply because you can, and that isnt going to make it any easier it's going tofuck you over. Plus having a good friend while detoxing and starting the recovery process can mean the world. It's what changed me. When i was in hab almost 2 years ago i had no plans of getting clean on the way there. While in detox met a cool girl and a couple cool dudes that were really trying to get their lives together and something changed while i was in the 30 days rehab. Being around positive people that kept me busy and all that changed me and really made me want to stay right, i havn't touched an opiate drugs or other illegal drug since. Then again i am on suboxone matence and valium for my anxiedy but that's all monitored so their is hope, you can do this.

Be safe and DO THIS, You can if you really want too, sounds like you have a bright future ahead of you,
-B

 

[ANewKindOfArmy]

I actually do agree with Big dirty to a point. That Psychlogical edge is what i was talking about. It can mean all the difference. Just i didn't get this until i was already in, i have bad anxiedy and depression problems as well. It's that positive attitude and willingness to do whatever it takes is what will get you though. You may and like him/her and i said, you really do, i actually did enjoy rehab i almost didn't want to leave because i felt so great after this inital program. Kind of why i said have a friend or positive family clean family member be with you through all of this because that can be the difference between being clean for good and just getting detoxed and going back.

 

[BiggDirty01]

^^ This and think about how much more likely you are to keep giving it a shot if you feel early on somewhat that you are getting SOME positive results that while not huge in the big picture can make all the difference when early on you are kind of looking for any shit to go south as a reasonable justification to going back.

Having support is huge because if you trust them then you will take value in all the positives that they HAVE and you wamt

 

[muvolution]

I will go against popular opinion and say I have had great luck tapering on tramadol. It certainly is not recreational, but after getting down to under .5mg of bupe, if you are still feeling wd's, you could try taking very small doses 50-100mg of the tramadol.

But yeah. You have enough drugs to taper off that habit at least thrice.

 

[GABAking]

@tricomb: I only decided to keep the detox to a week to avoid forming a new addiction to buprenorphine. I unfortunately do not have an unlimited access to them, so I figure if I can make it through all of this in 1 week's time and still have some left over in case I need it, well, that doesn't sound too shabby. would you suggest a longer detox timeframe?

@Znegative: Thanks a lot for your input; I'll keep the 25% decrease in mind while I work through this.

@ANewKindofArmy: Thanks for the support I do have a close friend that I've been sharing my experiences with lately, and it's really nice to have someone to talk to. He's a great listener and just lets me blab on and on and always offers good input. To do this alone would be very difficult.

@BigDirty: I also feel that the reason why I fell into this opiate problem is because of underlying psychological problems (depression, anxiety). I have an appointment with my GP soon and am going to ask for a psych referral just so I can talk about some things. I've never shared these feelings with anyone (not even my best friends, family), and I think talking to someone would really help me out mentally...which should make this whole ordeal easier (and staying clean). I'm sick of relying on benzos to curb my constant anxiety. I understand some anxiety is normal, but having it 100% of the time isn't. I think the psych should be able to help me out a lot with that.

@Muvolution: Thanks for the input. I'll save the tramadol for the end of my bupe taper in case I have some uncomfortable feelings following the bupe cessation.


Thanks a lot guys. Having a website like this so, so great. The knowledge and support I am getting is really helpful.

 

[rules]

Thanks a lot guys. I think I'm just gonna hold off on the tramadol, don't see any huge benefit from taking it. Maybe save it for a rainy day, although I never really liked that drug.

I figure this is gonna be my plan:

Day 1: 4 mg
Day 2: 2 mg
Day 3: 1.5 mg
Day 4: 1 Mg
Day 5: .5 mg
Day 6: jump the wagon

I figure bupe will build upon itself in my system given its long half life, so I'm cautiously optimistic that this dosing will work. If I feel like crap on day 6, I'll dose .25 mg of bupe every 45 minutres or so till I feel OK (I'm gonna try and keep it low. I'd rather be slightly uncomfortable on a lower dose than have to w/d from bupe). This will leave me with some extra pills in case of a future mishap.

this sounds like a great plan, just like everyone else says. i wish i had 32mg of subs when i was trying to kick last week. instead i kicked trying to use trams and tapering off them. bad idea. all it gave me was the worst symptom of my entire WD, dystonia in my neck. so avoid the trams. i ended up completely kicking and then using just yesterday after waking up to the worst ecstasy hangover ever. now i feel WD's again already...RLS...runny nose. ugh. the hardest part is psychological.