Harm Reduction Need Help Choosing a Path: Brixadi vs Sublocade vs Ibogaine vs SSRIs vs Adderall (Detailed History)

[pnillyg]

I’ve been active in this forum for a while and I’m at a point where I need help deciding which direction to take next. I’ve been through multiple treatment approaches—some have worked temporarily, others not at all—and I’m trying to figure out a sustainable strategy for long-term recovery and functionality.

I had a solid period of around 3 months clean from kratom and opiates, but I recently relapsed. Lately I’ve been using about 15mg of oxycodone on 1–2 days a week, sometimes more. I’m also currently using between 1 to 3 grams of ketamine per day just to avoid cravings and stay out of withdrawal. I’ve done two ibogaine treatments, both of which gave me windows of clarity, but I failed to capitalize on them long-term. It hasn’t spiraled fully, but I’m trying to stop this now before it does.

Background Summary

Struggled with dependency on multiple fronts: opioids (oxy/kratom), ketamine, benzos, and occasionally stimulants. Also dealing with underlying depression, trauma, and attention/motivation issues.

I’m fairly athletic and generally active—I try to walk or run around 5 miles at least 2–4 times a week, and I aim to get some form of movement in daily. Physical activity helps, but it’s not enough on its own to keep me stable when things start slipping chemically.

What I’ve Tried

• Ketamine: Daily use for months in troche, nasal, and IM forms. Helped short-term but became a problem. Currently using 1–3g/day to manage cravings and avoid deeper relapse.
• Ibogaine (2 treatments):
  • First flood: this dose was a full flood dose broken up over about six mini doses over 2 weeks so like 2 days in between dose days. After my first full flood dose, I felt the best I’ve ever felt in my life. I was truly happy, without being on drugs, for the only time I can remember. I wasn’t taking anything daily—just drinking socially at night and using Valium occasionally for hangovers—but overall I felt clear, alive, and at peace in a way I’d never known before. That period lasted about 3 months until I got COVID and relapsed on codeine cough syrup.
  • Second flood: Much weaker result. I was back on kratom within weeks. Didn’t feel the same post-treatment lift.
    I do have access now to do another round, either with new providers or the same ones I’ve worked with before. I’m trying to decide if it’s worth giving it another real shot, and how to structure it better if I do.
• 
  
• NAD+ Therapy: IV and IM. Helpful for mental clarity and withdrawal support, but not a full solution.
• Suboxone: I’ve used strips multiple times. Works for cravings, but I hate the feeling of dependency and daily dosing. I’m more interested in long-acting options now.
• SSRIs (Remeron, Prozac): Took both several years ago. Mild improvement in mood, but they left me flat and emotionally numb.
• Adderall: Very helpful for focus and motivation, especially when I’m sober. The crash usually pushes me to exercise, which isn’t a bad thing—but other times, I feel the need for a benzo to manage it, and I don’t like stacking that on top of already taking Lunesta nightly. I’m cautious about the long-term balance here.
• Other: I’ve tried a variety of natural and supplemental supports—microdosed psilocybin, B12/NAD+ injections, CBN, ashwagandha, passionflower, etc. None have worked as a complete solution.

Current Situation

After about 3 months clean, I relapsed. I’m currently using oxycodone (15mg) on 1–2 days a week, sometimes more. I’m also using 1–3 grams of ketamine daily to manage cravings and avoid deeper relapse.

At night, I take 2mg Lunesta with 5–10mg melatonin, and I use large amounts of cannabinoids (both smoked and tincture) to get to sleep. It works, but it’s a heavy combo and I know it’s not sustainable long-term.

I’m not physically dependent yet, but I feel like I’m walking the edge. I need to figure out what direction to commit to before I fall further back into this cycle.

Options I’m Weighing

1. Buprenorphine Injection (Sublocade vs Brixadi)
   I’m considering switching to a long-acting option to get off the rollercoaster of daily self-management. If you’ve done one or both, I’d love to hear about the differences, side effects, and results.
2. Another Ibogaine Round
   I have access to do this again—either with a new provider or someone I’ve worked with before. I know ibogaine works for me in the short term, but I’m unsure how to structure the follow-up to make it last. Any advice from people who’ve done repeat journeys or found ways to make it stick would be helpful.
3. Revisiting SSRIs (Possibly With Augmentation)
   It’s been a while. Thinking about whether to revisit antidepressants with more structure—possibly combined with something like NAD, ketamine taper, or low-dose stimulant.
4. Controlled Use of Stimulants (e.g., Adderall)
   Has helped me stay focused and productive when I’m sober. Could be a tool if used sparingly and with accountability—but could also be destabilizing.
5. Other Protocols I Haven’t Considered
   Open to anything: meds, supplements, microdosing, or long-term structures that worked for you. Especially if you were juggling multiple substances and found a way through it.

What I’m Looking For

• Experience with Brixadi vs Sublocade—which helped more, and why?
• If you’ve done multiple ibogaine treatments, what made the later ones more effective or not?
• Has anyone made progress using low-dose Adderall alongside SSRIs or recovery meds?
• Any other frameworks, stacks, or strategies that helped you stabilize when nothing else seemed to work?

Peace and love and as always… thank you

 

[rentedbythehour]

I'm surprised no one has answered this yet. I hate to say I won't be helpful here. I was prescribed oxy for about 15 years and when I decided to stop, that was it. I just wanted to wish you well on this journey and I hope you find something that works for you. The one thing I didn't hear you mention is a support system. Most of the people I know who have kicked successfully have a very strong support system, whether it's family, friends or people meet at meetings. Having someone to talk to or a meeting to go to could help when you need it. Just an idea.

 

[pnillyg]

I'm surprised no one has answered this yet. I hate to say I won't be helpful here. I was prescribed oxy for about 15 years and when I decided to stop, that was it. I just wanted to wish you well on this journey and I hope you find something that works for you. The one thing I didn't hear you mention is a support system. Most of the people I know who have kicked successfully have a very strong support system, whether it's family, friends or people meet at meetings. Having someone to talk to or a meeting to go to could help when you need it. Just an idea.

Luckily I have a great support system I know just need to utilize it! And thank you for the response.

 

[emkee_reinvented]

Current Situation

After about 3 months clean, I relapsed. I’m currently using oxycodone (15mg) on 1–2 days a week, sometimes more. I’m also using 1–3 grams of ketamine daily to manage cravings and avoid deeper relapse.

How much Ketamine is too much ? , concerning bladder problems.
Have you checked that, 1- 3 gram s sounds like a lot daily,
but i am gonna check , and report back.

Don t think i can be of other help then support, i only know Kratom.
And the addiction is easy to beat, 5 days but still functional.
Maybe i am lucky with my body chemistry. Or my gut micro-biome.

For me Weed and the prescribed dextro-Amphetamine are necessity s.
To face the daily turmoil of live,
Alcohol still has a role, but i avoid physical dependence.
Might you venture that road tread lightly. Thin line,
like the Benzo s, i feel i need but use from time to time.

But not a addiction to them. Same for o-DSMT lovely stuff.
On it right now, but also way more like Oxy then Kratom.
So also more danger, and i rotate em, the 3. o-DSMT
is to fiending so that is once in a while.
I wonder if i am poly-addicted, or will just miss them.

Just be bored and incomplete a while. If i would stop,
the Wd will be easier then my last experience.
3 weeks suffering, WD when physically Alcohol dependent.

and then PAWS, as there is no after treatment targeting the cause.
Do you know your cause ? That leads to substance [ab] use.

Maybe try stall the intake as long as possible little dose decreases.
Once in a while and keep busy, i got tits and rebuilding my kitchen.
Tits meaning the muscle ones.

edit: i checked there was a very visually detailed thread on it,
but i can t find it. Maybe someone here knows more or where it is.
But daily dosing 50 mg lead to problem s in a individual.
Which is an exception, but 1/ 3 gram s daily i think is to much.

 

[Allylbenzene]

Revisiting SSRIs

PLEASE BE CAREFUL before using SSRI drugs.
At least learn about the common side effects so you can make an informed choice.
On the SSRI fluoxetine (Prozac) causing depression:

Three years before Prozac received approval by the US Food and Drug Administration in late 1987, the German BGA, that country's FDA equivalent, had such serious reservations about Prozac's safety that it refused to approve the antidepressant based on Lilly's studies showing that previously nonsuicidal patients who took the drug had a fivefold higher rate of suicides and suicide attempts than those on older antidepressants, and a threefold higher rate than those taking placebos.
Using figures on Prozac both from Lilly and independent research, however, Dr. David Healy, an expert on the brain's serotonin system and director of the North Wales Department of Psychological Medicine at the University of Wales, estimated that "probably 50,000 people have committed suicide on Prozac since its launch, over and above the number who would have done so if left untreated.
...
Now a decade later, Lilly has targeted Dr. Joseph Glenmullen, whose book "Prozac Backlash" has apparently incensed Lilly executives.
Dr. Joseph Glenmullen, a clinical instructor in psychiatry at Harvard Medical School and a clinician at the Harvard University Health Services, says he wrote the book because he was alarmed by the number of patients who were reporting severe side effects from the serotonin-boosting antidepressants including Prozac, Paxil, Zoloft, and Luvox. "The two most upsetting side effects were patients becoming suicidal on the drugs, and the development of disfiguring facial tics," he said in an interview.

The Boston Globe, 2000.

Prozac Revisited [Boston Globe]