Need help tapering/combining to avoid opioid w/d

[monkeybutt215]

Okay, this is my first post so forgive me if I do it wrong. I've been a steady opioid user for about 5 months, with scripts to hydrocodone and getting roxy whenever I can if my script runs out to fast, I usually take 2-3 doses of 20-30 mg of hydro per day, 1 roxy is enough and although I loooove it, it's just when I can get it and until my next script. My script is SUPPOSED to be filled next week, if my doc decides that he doesn't want to (I'm in non "long term" pain mgmt, so it has to end sometime, I've only seen him for month, but he gave me 180 10 mg hydros for a month, do u think he would just cold turkey me?!) Anyway, I need the best and least harmful way for the next 5 days. I have 45 mg hydrocodone, 5 tramadols, 4 mg dilaudids, 25 .25 mg Xanax (and Adderall and vyvance but I don't think those would help). Of course, because I suck, I would love to just take all the hydro and feel awesome...but then I would die until Wednesday. Also, I have a 3 month old son, and I DON'T like the nods or being sleepy. I like to be functional but just warm and happy. I need help, how do I make these last/dose/combine right for five days? I won't IV, but oral, nasal, and plug if in desperate. Please give me some advice! I'm in so much pain anyway, withdrawals will suck and I want to be happy around my baby. Any advice? Also, I don't drink/smoke. Thanks

Side note: I ONLY took my Meds as prescribed when pregnant. So using for about 5 months, abusing for a little less than three. Hydro is fine during pregnancy if used as prescribed.

 

[RobotRipping]

ok, so you like about 40-90mg of hydrocodone/day, which means 1/3 of that should keep you out of withdrawal.

you have:
45 mg hydrocodone
5 tramadols
4 mg dilaudids
25 .25 mg Xanax
Adderall and vyvanse

do you have only 4mg of dilaudid or a bunch of 4s? i don't think you'll even come close to facing a withdrawal if you plug 4mg/dilaudid per day, the duration is like 4-5 hours though so you kind of have to do a bunch of plugging. Either way, plug 1-2mg at a time and see how that treats you. Even with a moderate tolerance 2mg plugged got me warm and itchy last time i tried. Don't bother insufflating or taking dilaudid orally, if you're not going to IV it then rectal is the only way to go.

so if u just have 4mg in total, that'll definitely hold you for a day. Then you can take 15mg/day of hydro and that should keep you out of withdrawal, though it will suck, if it gets too bad get loperamide (immodium) or take 1 or 2 tramadol. and on day 5 take 2-4 of the tramadol (not sure what dose you have but do not exceed 400mg due to risk of seizure).

use xanax as needed and you won't kill yourself with it, just watch your dose if you're plugging dilaudid as you may nod out with the combo and/or kill yourself if you take too much xanax.

I find stimulants helpful with opiate withdrawal for some reason (maybe just need to get that dopamine going) as do others but it really depends on the person.

if you have to go longer than 5 days then you'll have to get a bunch of immodium to keep you out of withdrawal. Just remember this cycle never ends unless you have unlimited opiate access. It just gets worse each month and tolerance gets out of control, that's when the idea of IVing dilaudid all of the sudden becomes rational. not to preach, i'm sure you know this.

i think you have almost enough to get through without any withdrawal, your hydrocodone doses are pretty low (watch out for the APAP consumption though) so i doubt the withdrawal would be that bad anyway, i'm sure immodium alone could take it away.

 

[monkeybutt215]

Thank you so much, that's a HUGE help and exactly what I was looking for. I can handle some discomfort but just need to make the best of it since I have a sweet little baby to take care of. I know it's never ending, and I know myself...if I ever IVed I wouldn't stop. The only time I've been in control was when I was pregnant, because I would never want to hurt my son. I'm gonna have to suck it up soon and either deal w my pain or learn to live without that warm happy feeling. Thanks a ton though.

 

[tentram]

yeah i agree with robo to get some imodium regardless.

another way to approach it is to initially take the loperamide (imodium) at sufficient doses for the first couple days to keep you out of wds, saving the proper opioids when theyre absolutely necessary for the pain.

my two cents and how id approach it as ive done this countless times when im coming up short.

 

[RobotRipping]

^yeah that's good advice, loperamide takes a while to kick in and to really kill the withdrawal but would definitely hold you over almost completely. I could switch from 90mg/day oxycodone to 24-32mg of loperamide without much of a problem other than craving euphoria. Loperamide is still an opioid tho and jacks your tolerance up, but it works. Even when i had a monster tolerance, loperamide still eliminated the majority of symptoms for me.

you can get that warm happy feeling without opiates; it just takes a while to get it back normally. As much as i love opiates, i also hate them. If you have chronic pain then that's another issue, it's hard to treat your issues with a euphoric medication and not go overboard every now and then but it can be done. the negatives of having to go without or struggle in between outweigh the positives of stability and reliability of having just a dependency and not an addiction.