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Need help

JunkyBritt

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Aug 3, 2017
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Hey guys I'm Brittanie
Ok so I'm on methadone. I used heroin for years. I quit and got in the clinic. Well I'm fucking tired of all the bullshit at my clinic. Having to wait 2 hours to see a dr. Every 60 days, the groups I have to do, the lines, etc. ok there are 1,000 people in my clinic. So I'm tapering. Down to 27. Lately I'm having mad cravings though. Anyone else feel like this when on a low dose/ tapering? Like I'm not sitting here making a plan or walking out the door to score some dope but I'm thinking about it!!!! Ugh fuck all this don't know what to do. Maybe I'm stuck in this bullshit clinic for life or on the streets using dope!
 
I did a long taper off oxy i was on ops for many years, now im almost 9 months clean. Anything is possible just imagine not having to dose around the clock just to feel normal anymore. Stay Strong! its all worth it!
 
Thank you for your response! I know it will be worth it you are totally right! It's just hard sometimes. Congrats on 9 months clean!
 
Tapering any opioid is really tough, and methadone is no exception. As others have said, you're doing great!

How long have you been on the 27 dose? Were you on a much higher dose previously?

In any case, cravings are natural (to some extent...if you're tapering too fast, the cravings might be intolerable, and that's not to your advantage) during a taper. The good news is that so long as you taper at a reasonable--not too fast--pace, you're likely to find that you stabilize and adapt to the lower dose. I recommend dropping your dose further only once you feel fairly stable on your current level.
 
Thanks for your response simco! I go down 3mg per week right now. Yes I tapered down starting at 123mg. From 123g to 78mg I did 5 per week. Had to stop a bit at 78mg to let my body catch up. Then been going down 3mg per week. Maybe I will stop here. I get 13 take home bottles so I'm not due back until next Friday (A week from today) so I'll tell them to hold me where I'm at when I go in. I havnt relapsed since I started at the clinic so I'm doing good on that front not using heroin. But I don't want to fuck up. But I also don't want to be in the clinic too much longer either!
 
Simco offer sounds advice. I'd also recommend reducing your dose reductions to 1mg/week in the future.
 
Also just want to note... I'm scared to relapse... I don't know if I have another one left in me. I was hard core addicted. I lost my best friend to an overdose her body was found in an alley(known her since I was 8) still kept using, I overdosed and had a drug induced heart attack ( heart was only working at 50%) at age 19, overdosed again at 20 was in coma for 3 days doctor thought I had brain damage they had to give me narcan twice literally was dead for a couple minutes... still kept using, in and out of rehabs, tried suboxone, nothing worked. And at the end when I got in my clinic I was using 15 bags a day and only getting right from it. So methadone has saved my life and I gave myself time here but I'm ready to try to do this without methadone. People at NA tell me "you aren't really clean brittanie you just replaced one drug with another"
 
Here's to hoping the times continue to change with that!

How is everything going with you and the methadone/tapering?
 
Yes I really hope so!!! I actually find AA meetings better in my area in that scense.

It's going well other than the cravings. I'm going to hold my dose here for awhile then taper 2mg a week instead of 3mg per week. I feel like 3 is a lot now that my dose is getting pretty low (24mg now). thanks for asking ?
 
I also have found AA meetings a little more accessible, although when I was on ORT I was careful to avoid that topic or rock the boat in any real way. Part of me feels like it is the NA scene where I live, given what I've been told about the character of meetings elsewhere. But my experience with NA as someone who was sober on ORT has been pretty oppressive.

Sounds like you have a good plan. Keep in mind that slowing the taper further, there is NO shame in that if it's what you decide is right for you. A lot of people I met at the clinic struggled with the final leg of the taper, below 20mg I mean, so there is no need to rush the process if you can avoid it.
 
Thanks TPD.... you have been clean awhile right? What do/did you do about cravings? I try to get my mind into something else but it's hard I swear when I was on higher doses it wasn't this bad.
I think that's true about the final 20mg. I'm finding it harder lately since below 30. Maybe I should blind dose.
 
Blind dosing can be helpful for some people. I found simply not being told what my dose was when I took it was helpful. If you get mostly take homes the dose will still be on the bottle (law), so its more so about how you let yourself think about it IMO.

So lets see, I stopped using heroin/other opioids over 3.5 years ago, methadone a bit over a year ago, so I guess I have a little time dealing without. The single best things I did for cravings was learning to meditate. That was a big thing for me in cultivating an overall healthier lifestyle. Having good teachers was very important though.

As I finished my taper off methadone and for a time after I had stopped taking it, I used a fair bit of iboga and NMDA antagonists (DXM, MXE, ketamine, PCP). They were very helpful in helping me distance myself and change the way I thought about opioid use, but they're very tricky for most people to use. I don't really advise people to use such drugs for dealing with cravings, but they can be very useful in overcome one's harmful relationship with opioids.

For instance, I experience perhaps the first time I've ever been content with just existing, with the way things are as imperfect (and they're quite imperfect given my life) as they are, without having any desire to use a drug, all as a direct consequence of my NMDA antagonist use during this period. That was pretty profound for me, and I've since experienced glimmers of this again after stopped that kind of drug use (related to potential health issues surrounding it). But as anyone knows who is familiar with severe opioid use disorder, feeling content without any need for opioids is a profound experience after years of misuse.

These days, I guess my issues with cravings have more to do with my other mental health issues. When I'm dealing with post traumatic stress, intense anxiety or depression, my cravings (not for opioids really, those are mostly gone because when I think about them I've trained myself to focus more on their total cost to me, which is undeniably negative, if almost entirely for the social consequences of heroin/opioid use) are most intense. But these days I don't really crave opioids, and I most certainly have no cravings for heroin or methadone in particular.

Sacred medicine (entheogens: mescaline, DMT, LSD, mushrooms, etc) has also been very helpful at helping me restructure how I relate to some of my past drug use. It has all been about coming to terms with where I'm at versus where I want to be (and am capable of being), and basically realizing on a more foundational level that if I continue to use opioids I won't be able to achieve the most important goals I have long for myself (most interpersonal goals, but also professional). The opioid using lifestyle has turned out, for whatever reasons, to be incompatible lifestyle that I wish to achieve for myself.

When I do think about using heroin, normally it's some visually based thoughts (mindful awareness practices/meditation has been super helpful at helping me cultivate sensory clarity, concentration and equanimity, three extremely useful skills to have when working with cravings of all sorts) about it connected to memory. That seems to go to, well, if I use now, what do I risk? Frankly I could get away with using heroin recreationally (at least for a time) without really endangering myself, but the risks are simply too great. I've put a LOT of work into not using heroin, and using it is counter productive to the lifestyle I've cultivated since getting off, one I've decided I much prefer to that my using has necessitated previously (or would now).

Self care and taking good care of my mental health is the best way I now deal with/avoid cravings. It can certainly be a struggle when you're not living in a particularly supportive environment, but as long as you meet yourself where you're at anything is possible :)
 
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I think seeing my dose get smaller and smaller in the bottle is a mental thing for me.

It's inspiring to see all you guys on here doing so well! 3.5 years off heroin is a big deal! Being off the methadone is too! I have been off heroin for almost 2 years. Which sometimes I still can't believe and I am proud of myself for that. I'm scared if I don't succeed with this taper I'll either be stuck driving to the hood everyday to cop or in the clinic the rest of my life. I asked my counselor at my clinic what the success rate is like with people tapering and she goes "I don't want to answer that because I don't want to put negative thoughts in your head". So clearly it must not be good. My life is so much better now. I can afford a nicer car and nice things now when before all my money went to drugs. My relationships with my friends, family etc are all better now, so I have the motivation to want that to stay that way. So when I have cravings I think about all those things. When I'm busy I don't think about it as much, like at work. I haven't ever tried meditation but I'm going to try that.

When I'm overly stressed, anxious, etc I do crave opiates still. I have dreams about using sometimes too. When I wake up I'll either be relieved that it was just a dream or I'll want to really use. I really just wish I had never messed with heroin to begin with. Actually the first time I ever used heroin I was tricked. I was with this guy and we went to score some cocaine(or that's what I thought) and it's really dark in the truck. He starts getting the lines ready, hold up his phone so I can see when I do mine and I'm like "why is this shit brown?" He's like "don't worry about it it's good shit" so I did it anyways. That one moment right there destroyed a lot of years of my life. I knew as soon as I started feeling the high it wasn't cocaine. I had the hiccups, I was nauseous but the high was amazing. I wish I would have just listened to my instincts and said no.

Anyways sorry this is all so choppy and random I have to go get ready for work. I can relate to a lot of what you said. And you gave me some really good insight on things that might help for me too. Thank you TPD for taking the time to put so much detail in to this. It means a lot to have you guys to talk to about these things here on BL :)
 
TPD, you did a really nice job describing your approach to dealing with cravings in your post above. I'm curious if you could elaborate a bit on one issue...

Your approach makes perfect sense. Building an awareness of the risks/threats that using presents has obvious appeal in terms of dealing with cravings. But in my own case, drug cravings make it very difficult to give these kinds of issues the weight they deserve. For me, the immediacy of cravings tends to overcome how I consider longer-term consequences. Basically, the urge to get high (sometimes) presents itself NOW, while the very real risks are likely to materialize later...and on this subject, NOW tends to win, for me. So I'm curious--did you experience this tension between immediate payoff vs future payoff, but find ways to consider the choices more rationally?

I ask because this is something I would really like to be able to do for myself.
 
For that kind of perception of scarcity that craving almost always relates to (which is essentially what it is - not enough safety/whatever, present moment intolerable for such reason, need to change how I feel now! etc - learning to look at cravings as a product of various forms/experiences of scarcity is a powerful tool in itself) I have basically two strategies.

There are some situations I encounter that promote that kind of "I need to change how I feel NOW urge", and I do try and avoid them when possible - and then in my free time, when I'm not feeling so disregulated, I'll also practice thinking in this kind of "play the take through" sort of way, so it becomes almost second nature.

The probably more useful, but also more challenging, strategy is urge surfing. That tends to require a lot of practice when not dealing with the more intense urges (so for instances practicing riding out the urging associated with an intense itch is a good starting point), but it can be very useful. Have you read much about urge surfing simco?

Really, the best things I've done to help understand and manage cravings and urges has been to practice (a LOT) working with less intense/problematic ones. Such as exploring the urge to scratch an itch (essentially the same nature of craving is at work here as it is with craving something like opioid use disorder), or the urge to flip out on someone, or the urge to tell someone I love them. Now, it doesn't mean I don't scratch the itch, tell someone off or express my love to strangers, it just means that I don't do so while I'm actually experiencing the urge. I try to let the urge pass before making a decision to follow through with associated behaviors, or not.

Having that choice is what it's all about, after all. Awareness is really important, as I've found it much easier to address things I'm cognizant of. Awareness also requires exploration, as little to nothing in this life is always self-evident, and that seems to be more where people can struggle (in terms of them having to find the tools helping to exploring awareness that works for them, as we all have slightly different needs and capabilities).

So, at the end of the day, I guess it's also about just setting your intentions (and being clear with yourself about them), and try try try again kinda thing. It's pretty amazing when you get good with urge surfing, although there is always a more difficult challenge in terms of relational shit out there. It often seems as soon as I've accomplished gain more equanimity in my relationship with someone I find that I need to work on exactly that in often more challenging relationships with others.

I like started with the easier ones, given the learning curve and experiential nature of this I guess.

And to be clear, urge surfing is essentially a set of skills that enable one to experience urges without losing agency to them. STOP/SOBER is one very useful tool. I particularly like STOP. The simplest tools often have the most depth and broadest, most useful application. Try practicing STOP whenever you feel yourself getting activated by something (well, try doing it whenever possible, ideally most of the time and multiple times a day - basically whenever possible when you become aware of some present moment impulse/compulsion/craving you're working with), and you'll noticing your ability to surf the urges and cravings lessen dramatically (over time, although sometimes people experience fairly dramatic results off the bad).

Having a daily meditation practice, where I devote time each day to nothing but taking care of my internal space, makes acquiring skill sets like urge surfing much easier. They are after all learned skills, stuff you can only master (not that you can actually ever master them in a finite sense) through practice. That requires integrating the practices into one's daily life in consistent ways, and that is where most people struggle. Another reason why the most basic, most accessible, simplest practices are the most important IMO.
 
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