Just some background information. SWIM has chronic pain and Bipolar type 2.
SWIM was controlling his pain fine with Tramadol 100 - 200 mg. Because of his doctor, his scripts became smaller and less frequent. This might change in the future, but in the mean time he had to buy opiates illegaly to address my physical pain. He bought buprenorphine as these have a long half-life and are not as recreational. 8 mg was the only thing available, and he have had to split it into roughly four pieces ~2 mg. This has unfortunately increased his tolerance dramatically, and he has now had a daily opiate consumption for 2 months. Lately he has had some days where he has woken up and been pain-free, but later in the day felt some pretty harsh withdrawal effects (and no pain). Now as long as he had nearly daily chronic pain, the fact that he knew he was building dependence was easier to swallow, but now he is worried. He needs to reduce his tolerance down to pre-bup levels to have a sustainable use of scripted opioids. SWIM is seeing a specialist for his pain in a month or two, and would like to do a quick taper, and hopefully only use weaker opiates again. Hard meds are really overkill.
SWIM has gotten a hold of 20 x 10 mg valium, and would like some advice on how to attack this situation. He is not going off cold turkey.
SWIM is on Lamictal for BP2, and has been very effective in stabilizing him against the dopaminergic rollercoaster of painmeds. He is not too concerned about this part of the equation.
SWIM was controlling his pain fine with Tramadol 100 - 200 mg. Because of his doctor, his scripts became smaller and less frequent. This might change in the future, but in the mean time he had to buy opiates illegaly to address my physical pain. He bought buprenorphine as these have a long half-life and are not as recreational. 8 mg was the only thing available, and he have had to split it into roughly four pieces ~2 mg. This has unfortunately increased his tolerance dramatically, and he has now had a daily opiate consumption for 2 months. Lately he has had some days where he has woken up and been pain-free, but later in the day felt some pretty harsh withdrawal effects (and no pain). Now as long as he had nearly daily chronic pain, the fact that he knew he was building dependence was easier to swallow, but now he is worried. He needs to reduce his tolerance down to pre-bup levels to have a sustainable use of scripted opioids. SWIM is seeing a specialist for his pain in a month or two, and would like to do a quick taper, and hopefully only use weaker opiates again. Hard meds are really overkill.
SWIM has gotten a hold of 20 x 10 mg valium, and would like some advice on how to attack this situation. He is not going off cold turkey.
SWIM is on Lamictal for BP2, and has been very effective in stabilizing him against the dopaminergic rollercoaster of painmeds. He is not too concerned about this part of the equation.
