Opiate and opioid withdrawal: Coping strategies and medication

[brimz]

Personally i would jump off n do dfs 30mg for a week maybe start on 7 n take it down 1 a day job done sorted .

Best of luck whatever though mate.

 

[mydrugbuddy]

i havent fully woken up yet, so another dumb post from me im afraid, but what is / are dfs ?

cheers for the good luck anyway. I have 1 partially used blister of 0.2 mg bupe pills left, i was thinking i might as well stretch that out and hopefully make it easier to stop this time round by halving the pills and trying a 0.1 step. A couple of people have suggested dhc codeine to make getting off bupe easier.. Another suggestion has been to use Kratrom. I could even get back on the AH7921 and reduce down low with that, allthough i failed at that too last time so that doesnt seem like a good idea at all.

I dunno, i could keep replacing one substance with another for ever, but sooner or later, and it really has to be sooner, my opiate receptors are gonna have to adjust to not being bombed with opiates.

 

[Sammy G]

DFs = dihydrocodeine.

It used to stand for 'Dihydrocodeine Forte', which was a 40mg tab.

 

[mydrugbuddy]

ah, cheers Sammy G.

 

[wcote]

This might be a bit cruel but you have a lot of this worked up in your head. Just go from .1 to 0 and be done with it. No kratom or AH7921, codeine, DFs.

Its going to hurt, you have got to the point where you just have to take the jump and deal with the WDs.

 

[Shambles]

This might be a bit cruel but you have a lot of this worked up in your head. Just go from .1 to 0 and be done with it. No kratom or AH7921, codeine, DFs.

Its going to hurt, you have got to the point where you just have to take the jump and deal with the WDs.

Truthquoted.

Tempting as it is to try to switch from one opi to another to try to avoid that last bump there really is no way of actually avoiding it I've ever found. And when you're using bupe to taper there's the added complication of it being a combined agonist/antagonist which just makes things more fiddly. This is all very much YMMV territory obviously, but bupe w/d were by far the easiest and most comfortable to taper down to nothing with for me. My situation was completely different though cos I was at the tail end of a lengthy strong opi addiction and viable options were limited.

"Listen to your body" is my usual top tip. Trite I know but also true. Only you know how you react to these things and ultimately only you can decide what to do. If it were I, I would stick with the devil I know and keep whittling down the bupe dose. You're so close to getting there it just seems to me like a bit of a backward step to be thinking of making another switch at this stage. You could wait until you're in w/d then use codeine to do the final push with (I wouldn't recommend kratom personally as it's so variable and hits more than just opioid receptors which puts it in a somewhat different category to "normal" opioids) but the end result will be the same: you'll be a bit rattly at the very end. There really is no avoiding that but at least with bupe you can get it down to 0.2mg in a single tablet which is easily divisible if needs be.

You're doing great, MDB. Keep doing what you are doing and try not to worry to much about how it's gonna end cos it only causes stress and anxiety. Take each day as it comes and as long as you don't start upping the dose or scrabbling round adding stuff to it you're virtually there. I know there is a limitation cos you only have so many pills left to get you over the finish line but I don't see any real need to be unduly concerned unless/until there is an actual problem. Think positive (yeah, I know ). It really does help if you can even if you kinda know you don't really mean it. Anything you can do to distract yourself through the day (and night) that doesn't involve other (or more) drugs will help. In my head, bupe was always "the easy way" to get off opies so that's how it actually is in my world. In many ways, withdrawals are only as hard as you make them. In many other ways they're just plain hard, admittedly. But you are not as powerless and helpless as you may think or feel sometimes

 

[mydrugbuddy]

cheers for the messages. I do agree with you both. I stand a greater chance of success this time round for several reasons, the time of year is 1 month better, christmas and new years is done, we are in the final half of winter, not the run up to it, which is allways the worst time of year for me regardless if im quitting opis or not, ive given up nicotine, this makes it easier for me to eat properly, sleep far easier and better, and generally feel much physicall fitter and stronger. Finally a relative is in the same circumstance as Walt senior / Eisenberg in Breaking Bad. Stage 3 lymph node lung and other organs cancer in other words. They live abroad, i will have to be there for my family if and when the worst happens, this could be days, weeks, months or years away, we dont know yet.

I just know the stakes are far higher this time round, i dont just have to do this for myself, i have to do this for other people in my family who will be counting on me to a certain extent. I cant possibly say "im not coming" and give no explanation, and i couldnt give a false explanation nor the real explanation that i cant come because i couldnt get off opiates. So, i have to do it, its 0.1 from today onwards. There will be nothing else after the bupe runs out. If i adjust to 0.1 before the remainder of my supply is consumed i will flush it. As it happens, i think there is roughly the right amount of pills left to allow me to adjust to 0.1 before jumping.

 

[brimz]

This might be a bit cruel but you have a lot of this worked up in your head. Just go from .1 to 0 and be done with it. No kratom or AH7921, codeine, DFs.

Its going to hurt, you have got to the point where you just have to take the jump and deal with the WDs.

yeah tbh there is no such thing as a painfree cluck n the going through thev pain will give you summat to remember n hold on 2 if tempted again.

I do clucks all the fukin time in fact i have a nasty one on teh horizon but i ain't gonna bitch about it in fact i wouldn't have even mentioned it had it not been for this post but seeing as i have i will say that it makes coming off .1 of bupe like a walk in the fukin park .

You are over thinking this mate jus fukin do it n then when u have tell us n we well i n i'm sure the rest of us will be well happy 4 ya .

 

[mydrugbuddy]

Right, ok, message received and understood. Maybe i am making a mountain out of a molehill. If i can turn the mountain back into a mole hill then that will help. Cheers for that. Good food for thought. There is a large psychological aspect to all this I agree.

 

[Shambles]

So, i have to do it, its 0.1 from today onwards. There will be nothing else after the bupe runs out. If i adjust to 0.1 before the remainder of my supply is consumed i will flush it. As it happens, i think there is roughly the right amount of pills left to allow me to adjust to 0.1 before jumping.

I'm sure you'll be just fine - I tend to agree with Brimz and wcote that you're maybe thinking yourself into problems that you may well never actually find. The last stage of any taper is the hardest part so it's no wonder you're having a few anxious moments. Bear in mind that when you are withdrawing from opies your mental state will be pretty frikken low (to say the least) but that this will pass. Things look and feel much worse, much bleaker, than they are in reality. It is hard. But it's eminently doable and you've very nearly done it.

It's great news that you're pretty sure you have enough pills left to get you through but don't feel bad if you end up dropping from 0.1mg to 0.05mg on the way down to 0.00mg if needs be - it's still going the right way. Obviously if you can go straight from 0.1mg to 0.0mg then all the better. Just watch out for the purely psychological attachment that tends to linger on waaaaaaay past the point where the physical side is all but negligible. We all know the stories (and indeed the people involved in some cases) of folk being "stuck" on a ml of methadone for years on end cos they just can't bring themselves to take that final step. The final step will be a bit bumpy but the more you build it up in your imagination the worse it'll feel. Alternatively you'll be gobsmacked at how relatively easy it actually was. My money's on the latter. I expect to collect my winning on that too

 

[mydrugbuddy]

Bear in mind that when you are withdrawing from opies your mental state will be pretty frikken low (to say the least) but that this will pass.

That's what got me last time, especially as i wasnt clear what stage of W/D i was in. I think i mistakenly thought i was into PAWS when in reality i was probably still in the acute physical WDs stage, as this can be quite drawn out for bupe. Again this is another positive, as i know the acute physical wds last only 1-4 weeks. I was confused last time i attempted to quit, thought i was in PAWS which can last months, and thought "i cant cope with feeling like this for months". I wouldnt have felt that bad for months, it would have been much shorter.

Yeah i have to be prepared for a mood plunge, hopefully the Mirtazapine will help prevent that from dropping too low, partcilarly as ive stopped taking modafinil and reduced my etiz consumption the mirt might stand a better chance of working this time round. No one knows the effects of the interactions of the combo i was taking on the efficacy of mirtazapine, but a GP assured me confidently that the combo i was taking would certainly have an effect on Mirt, or there were additional complications to say the least

Anyway, diolch yn fawr iawn, for your ongoing support. It is genuinely appreciated, and really does mean more coming from people that have been there and done that, which includes practically everyone on this thread.

 

[Eveleivibe]

Hiya Mysrugbuddy,

My advice would be to go on the bupe. Reason being you usually get a key worker who you see regularly n can help you work through why you became addicted. It's well worth it. On the other hand do you feel that this will benefit you? If you feel like you've completed your taper n just want off don 't. Are you struggling with cravings? Are opiates impacting on your life? Your health? Only you can decide. We 'll be here to help you through it no matter what. From my personal experience suboxone has helped me get my life back on track - however, I'm afraid of coming off it now.

All the best n really pleased that a doctor has come through for you.

Evey

 

[mydrugbuddy]

Hi Eve, yeah ive been on bupe for several months. I attempted to quit at the end of November/ beginning of December but failed to hold out. Extremely luckily, i dont know why or how but i was OK on just 0.2 after a 2 week relapse. I'm better prepared and motivated this time round.

 

[Eveleivibe]

DFs = dihydrocodeine.

It used to stand for 'Dihydrocodeine Forte', which was a 40mg tab.

Interesting. I've never seen it pronounced like thar. Usually as DHC x

 

[Shambles]

^ 'DFs' (dee effs) is a bit of an oldskool term for DHC in any form. They were an actual brand of DHC at one point but, like 'hoover' and other things I can't currently think of, it's come to be used as a catch-all generic term for DHC pills.

Yeah i have to be prepared for a mood plunge, hopefully the Mirtazapine will help prevent that from dropping too low...

I really don't know for sure how much it helped but I do know I was given a mirtazapine tab before bed each night when I was in inpatient detox. Dunno the dosage but was a fizzy orange pill that dissolved on the tongue. I did notice that I felt generally better once it had kicked in (still shitey but my particular situation was a bit complicated cos of that medical trials thing being involved). It's a fairly standard medication for w/d afaik so should help somewhat with mood and (hopefully) sleep too.

Anyway, diolch yn fawr iawn, for your ongoing support.

Rydych yn fwyaf croeso, bach. Falch o fod o gymorth a phob lwc

 

[Sprout]

Back in WD, I think the only benefit of poppy tea vs traditional opiates/opioids is that WD takes a minimum of 24 hours to appear, and 48 hours to become noticeable, I'm at 84 hours right now and I'm really feeling it, with morphine acute WD it'd be peaking, if not nearly over by now. The shakes are here, diarrhoea, that absolutely terrible, corpse-like, body odour, profuse sweating, full body chills, pain all over and just the general feeling of death.
I was supposed to be baby-sitting tonight so I didn't go and score, I don't care how bad I feel - I can't risk the safety of a 5 month old baby while I'm nodding out, but that got cancelled at the absolute last minute, meaning I'm heading into full-blown opiate WD without any hope of relief until Wednesday.
Hope you guys are faring better!

 

[mydrugbuddy]

at least get some loperamide mate, to help with the trotskys, you dont have to suffer diarrhoea & resulting dehydration on top of everything else. 86p from asda, i buy about 10 packs every time i go lol . Its an extremely weak opi, but does the job of keeping the opi receptors in your gut happy. I dont think it will relieve other wd symptoms much, nor will you get addicted to it unless you start taking 80 pills or something crazy like that, and even then it may not cross the blood brain barrier unles you combine it with other substances.

All im saying is there's one symptom you dont need to be suffering from.

Ive made a tiny reduction in my bupe dosage, but as a percentage drop its 50 % from 0.2 to 0.1 and tbh im barely feeling it, i made the drop on saturday so the half life of the 0.2 dose should have more or less completely gone by now.

I really dont get it, last time dropping from 0.2 to 0 was murder, but i can barely feel 0.2 to 0.1 physically allthough i do seem to be intermittently loosing the plot mentally and talking gibberish. Fuck it, thats nothing new, i cant help it, it should pass in time.

 

[amanitadine]

MDB- 40-80 mg of loperamide will make the physical symptoms from .1 mg of bupe virtually non existent....rough first couple of days as the bupe leaves (37.5 hr half life) and the loperamide builds (10.5 hr half life)....so take 40 mg twice a day and your plasma levels will be rising. I've used it to even kick H, and slept some every night. Does a lot more than just gut issues in the right dose! You still have to taper it, but it helps the physical symptoms immensely, your brain not as much, so I've always viewed it as dividing withdrawal into two easier to swallow portions easy as fuck to taper too, those 2 mg tabs. Just don't stay on it for more than 2-4 weeks, tapering all but maybe the first week, eventually down to zero, as it can have the most hideous withdrawals of it's own with high dose long term use. Check the mega thread in OD for many reports of success, and the WD thread for those that chose to stay on too long....

The piper always does have to be paid, but with loperamide it is in tiny increments, just a skim off of each paycheck. It really is a godsend for those it works a treat on. People seem to vary wildly in how much they need, but take enough and it will do the trick.

 

[Shambles]

Interesting, Amani. I've read a fair bit about the loperamide method for w/d back when I smodded OD (cos it was discussed quite a bit over there at the time) but was always undecided on the matter. Seemed to be very controversial - the very definition of YMMV. If I had to go through a properly nasty opioid w/d now I'd probably give it a go if only to confirm or deny it myself. You are one of those people whose word I tend to trust on here though cos our paths have crossed enough times for me to know you are far from a bullshit artist.

I particularly like the way you've put it there - the piper does get paid but in convenient instalments. Also, splitting the physical side apart from the mental side could definitely have some merit for some. They do tend to feed off each other and spiral in that viciously circling way that vicious circles tend to go in for.

I've never tried the loperamide method so cannot speak to it and I'm sure MDB can and will check for himself how/if it interacts with bupe like "normal" opies do (cos putting yourself into precipitated withdrawals is not so great - believe me I know ). I would probably still suggest that anybody going through opioid w/d proper for the first time tries to just do it - if only so they know how it is and (hopefully) give them a thing to consider when considering using opies recreationally again. It's certainly worth a go if struggling or if other options simply have not panned out though. Nice tip

 

[mydrugbuddy]

Ill come back to this too answer more fully, atm im taking 1 - 3 lopes just to stop the stomach upsets, my bupe dose must be low enough to allow this to work. Apparently lope occupies the opi receptors in yiour gut so more of the bupe goes straight to the brain, rather than being wasted in the gut. im a bit benzoed and drunk and possibly gonna be noided in a bit, the strictest of discipline seems to be becmoing a drag, but im not increasing my etiz dose by much, and a couple of beers and a few tokes of cannabinoids is hardly a big deal. Just breaks up the monotony a bit, and is obviously far better than a full on bupe relapse, and is relatively harmless. Ill study your post more carefully tomorrow amanitadine. I suspect it deserves more sober attention.