Heroin Opiate detox confusion

[healthyharold101]

hey there, been using this website for many years to look up info and to get advice but this is my first time posting. Was wondering if anyone could shed some light on a friend of mines current situation.

As of 4 days ago me and a friend left our home country and are currently overseas backpacking. While back home he had quite a heroin habit (0.5-1g a day) of relatively high purity stuff. With it brought typical withdrawals and although he was smoking, not injecting, which from what I understand carries less intense withdrawals, it was still hell on earth. He took some suboxone before jumping on the plane so the withdrawals wouldnt hit whilst flying, but started to feel sick when arriving at our destination. Not wanting to experience the detox until we were settled in to where we were staying, he went to a chemist and bought a lot of loperamide to ease w/d, and was taking 30mgs-40mgs roughly every 20 or so hours to keep himself from getting completely sick (he is aware of the risks involved with taking high doses of loperamide). This went on for about 2 days, and then decided he was ready to detox. It has been about 50 hours since his last dose of an opiate and despite slight leg cramps and being slightly moody there have been no other withdrawal symptoms, which is absolutely not at all what he expected, as he understands the half life of loperamide is roughly 12 hours. Has this ever happened to anyone? Is the worst still yet to come or did he by some miracle somehow skip the withdrawal stage, how could that be possible if so?

thanks

 

[Larimar]

He might be ok. The herion withdrawal prob only lasted 4 -5 days and he masked it with the sub and lope on those days .

 

[Jekyl Anhydride]

It's difficult to pin exact timelines on different people but I'd guess he's on the downslope of the acute WD's with plenty of lethargy and some PAWS, post acute WD's after that. 30-40mg of Loperamide isn't a huge amount but enough to provide a very brief taper of sorts. You mentioned backpacking which might have some influence as exercise can improve his rest at night which might be helpful. Also some people grin and bear it better than others and being outdoors vs stuck in bed def seems like a plus.
As far as skipping WD's, I don't think he's going to be that lucky but coping well is the next best thing. Just remember WD is not always linear and there's no guarantee that it's nearly over.

 

[Gorillaboy21]

Please update us and let us know how things go!!

 

[healthyharold101]

been roughly 24 hours since making the post and still nothing. Think he's on in incline, more social, more energy, obviously not 100% but still dramatically better then expected.
Although definitely not complaining, a part of him was looking forward (for lack of a better word) to going through some kind of hard detox as a way to deter and remind him from possible relapse. That being said, he should be careful what he wishes for, haha. Guess the hardest part starts now - staying clean.
He still feels it is so bizarre the outcome of this as withdrawals back home were the dehabilitating kind.
Like Jekyl said though, maybe the exercise and sunshine has done more for him than we thought possible, and obviously the lope has helped too. Hopefully energy levels continue rising over the next week or two

 

[healthyharold101]

update 2: his energy levels have dropped quite noticeably again, probably beginning to compare to how he felt when starting withdraw in arrival. also had trouble sleeping last night despite double the dose of his normally prescribed benzos (lorazepam and temazepam) He is quite nervous that all he managed to do with the lope is delay the withdrawals, not get through them, which is a bummer because he has a lot of things planned for the next few days which are physically demanding.
hopefully doesnt get any worse, will update in a day or so.
on a side note, could this mean loperamide has the ability to mask withdrawals for a long time? I know the half life and what the body does with it compared to methadone, but my friend has gotten more long term relief from loperamide than methadone eever did for him (he was on Methadone maitancence treatment for about a month a couple of years ago)

thanks

 

[Jekyl Anhydride]

At the levels he's using loperamide is fairly weak as far as a centrally acting opioids go but the peripheral effects can really help. The body has Mu opioid receptors all over, not just in the brain, so having a calm gut, less issues with a runny nose, watery eyes (lacrimation), sneezing, decreased restless leg syndrome, etc.

All these things are easing the WD's, but Lope is still an opioid so if he stops using it CT then things will get worse, quickly. If he has symptoms of dizziness or extreme fatigue after brief exertion then he should cut out the lope immediately as high doses can cause dangerous side effects in some such as long QT syndrome or Tosades de Pointes, though usually at much higher doses than 30mg. Otherwise a steady taper down to 12mg will help finish the WD but even then the lope use shouldn't extend for more than a couple weeks at most as lope dependence is a real thing.

Also with a 12 hour half life the lope is accumulating, if he could extend the time between doses as much as possible it will be easier to cut out the lope later on. Overall it is extending the WD but at least he's WDing in smaller steps vs being really sick & incapacitated for 8-10 days straight. I hope things ease up for him but it truly isn't a linear process sometimes. Wishing you all good luck getting through this.

 

[Gorillaboy21]

Damn tell him to look on the bright side that he can bare going 24 hours with just lope... I couldn?t imagine that... I can?t even wait long enough to take subutex/subuxone and I have enough to take it for days I?m such a bitch when it comes to willpower and doing this I hate it.

Whatever you do don?t irritate him in anyway (I?m sure you aren?t you seem like a really good friend from just the posts).
Tell him he?s doing well for the fact that he?s simply taking lope and that?s it in a foreign country and dealing with this is quite intense. I?m in my country, my city/area, in a really nice room with unlimited weed pretty much, gabapentin, Xanax, bupe in multiple forms, clonodine, and a mom who?s very helpful and understanding and I still can?t even fucking tough out to wait 18-24+ hours to take subutex or subuxone I fuckin hate myself for that so much. He?s making progress so keep reminding him about that and keep his moral high.

My mom keeps asking me how I?m dojng with my ?taper? and waiting for me to basically get over the detox and get my own apartment and I?m lingering this longer than it should. I have everything anyone would need in a rehab or home in terms of comfort, bed, clothes, meds, etc.

Didn?t mean to veer off into my situation but yeah it?s really frustrating when every morning you tell yourself you?ll cut down or take subs or do this or that and another day passes completely wasted with no progress in life or my recovery.

Anyways update us. Also what country did you guys go to ?