New guy looking to fix an old problem

[ConstantDenial]

Hi.
I am new to the forum but like many others have been lurking via google searches for months. I've been an opiate/oid addict for over ten years with brief stints of clean time. I am currently addicted to codeine, commonly considered an easy one to quit. However with 'stronger' opioid dependence in my past, this one is the one that I'm stuck on! I've read about many withdrawal aids and I have got my hands on all Thomas recipe ingredients except benzodiazepines which I refuse to touch, and boxes of loperamide. I also have doctor prescribed amitriptyline for sleep and would like to introduce DXM in small regular doses through the first 4-5 days. I also have my last 200 codeine phosphate 30mg tabs of which I take 1000 mg per day in two 500 mg doses, and want to rapid taper by dropping by one quater of the doses per day as I introduce the 'withdrawal aids'.

My question, if anyone can help, is does anyone know if there are any complications using these things together?! On paper it seems like a great plan, but I need the help of better minds here.
Huge hello to all and big respect to Bluelight, genuinely reducing harm with us lot.

 

[herbavore]

Welcome to Bluelight! I'm going to move this over to Sober Living.

 

[Jabberwocky]

Thanks herbs

As a general rule, you really want to avoid taking drugs like amitriptyline and dextromethorphan. The amitriptyline will be helpful in terms of GI issues (it will only be a little helpful) and possible insomnia (again, of limited value).

The DXM at first to second plateau dosages will pretty much negate the majority of your withdrawal symptoms other than some insomnia and light RLS. It is really quite astonishing. I found trazodone really useful in aborting DXM trips at bedtime, but I'd really caution you to avoid mixing antidepressants and DXM.

Now, IIRC I have used amitriptyline following DXM before without issue, but I've been pretty risk-friendly with my drug use. Not at all a good role model in that regard for most of my career with this. Chances are you won't have any issues combining a low dose of amitriptyline and low dose of DXM, but there are risks involved (and some quite serious). Plus, the risk/reward ratio is really large (meaning lots of risk for little reward) when combining DXM and amitriptyline, so I really would advice you to just use one or the other.

Any chance you can get some gabapentin and clonidine for withdrawal? Those are pretty standard go to detox meds for any doctor worth their salt, and they aren't really something anyone can abuse (they only serve to get you through withdrawal, nothing more or less). Some of the most comfortable and enjoyable detoxes I've had involved using gabapentin, clonidine, benzo and DXM.

I mean, using DXM to kick involves a lot of risks. That said, it can work really well for those who can tolerate the DXM. Make a point to avoid making it a habit though, that's the only thing. It's not something you want to use on a daily basis even at moderate 1-2nd plateau dosages, certainly not for more than a week, without risking some unfortunate cognitive-social symptoms developing but for that one week it can be a god send.

What are your plans?

 

[ConstantDenial]

Hi Toothpastedog and thanks so much for your reply. Also to Herbavore for getting me to where I needed to be. Great feedback thank you. So at this point I get 200 codeine a month along with as much ami as I want to sleep. This is for genuine pain. I do of course however acquire a further 600ish tablets from alternative sources (which just for cost reasons has to stop) which the doc doesn't know about. I've tried CTing from the aforementioned dose and I struggle. I once got as far as PAWS but then that kicked me over and straight back I went. I asked the doc about gabapentin last week to lay some groundwork for opening up to her about the addiction and asking for help. I think no matter what I go with I need to focus on just getting through that first week. The pain etc is the least of it for me, but the mental aspect is crippling. I mean tears, acute anxiety and general feeling of impending doom! Also I get restless whole f#%king body! I mean beyond anything I've had before, codeine withdrawal gives me crazy rls. I guess letting go of ami for my sleep will be tough as I trust it to knock me out, but I also know DXM gives me a lot of relief.
Is this one of those times where I'll be encouraged to just man up and be totally honest with my doc?! Of course they have no idea I have other sources and this is the only reason they keep prescribing me the stuff at all! Either way, I'll book an appointment today and the rapid taper needs to start now. It's been happening tomorrow for ten years!!