More about my drug and health history, a list of the symptoms I am currently experiencing so I can easily compare if any improve or worsen after I start the naltrexone, and details about the naltrexone I will be taking.
1. More about my drug and health history
Off opioids completely for over a month, aside from 2mg of loperamide a few weeks back and a very low dose of DXM (an extremely weak opioid) maybe a couple wks ago.
I was addicted to heroin for around 10 years and on methadone for around 10 years. There were maybe 5 years or more of overlap where I was using heroin as well as methadone. I have not used heroin for years and have been off methadone for 4-5 months. I spent over 1 yr slowly tapering the methadone. I feel this was a mistake in retrospect. After I got down below a certain dose I felt withdrawal symptoms most of the time and I think that continuing such a slow gradual taper after that point did me a disservice, slowed/delayed my recovery and conditioned my brain to feel sick all the time, not to mention that it has been hugely stressful on my mind and body for numerous reasons. I do have chronic pain from various injuries (presumably, it's hard to tell what is still directly related to those injuries since a normal healthy person should have long since recovered) but was also diagnosed with fibromyalgia, however my current doctor believes the fibromyalgia may be primarily opioid-induced and I agree. Look up opioid-induced hyperalgesia and allodynia for more info.
I tapered down to under 10mg of methadone a day, and I was so sick by that point and continued to get sicker after stopping the methadone completely, so drug-wise I still used mainly: very low doses of oral morphine, low doses of benzos for a while, and gabapentin. I tapered off all those, it's been around 5 weeks+ since I completely stopped the morphine. I also wanted to be drug-free from all types of drugs for a while before starting the naltrexone so as to see what my current state is without any drugs and to be able to properly assess the results of my experiment with naltrexone. I do have problems sleeping and I've read that insomnia can sometimes be a side effect of LDN, so I can't guarantee that I won't take anything for sleep while taking it, but if I do I will make a note of it in my blog. Sometimes I take naproxen or ibuprofen. As for vitamins/supplements, right now I am just taking high doses of Vit D, fish oil, and I plan to get a good amino acid complex because amino acids are important for proper brain function, rebuilding opioid receptors and lots of other good stuff. I have tried a ton of other stuff in the past, but am in a phase where I want to simplify things.
I smoke cigarettes and my smoking has gone up since quitting opioids.
2. Long list of the symptoms I am currently experiencing:
- difficulty sleeping (trouble getting to sleep, restless sleep, lots of dreams, waking up early and being wide awake and unable to get back to sleep)
- feelings of dread, anxiety and discomfort upon awakening, my mind is wide awake but body feels very tired and I don't feel refreshed or energetic at all
- lack of motivation/initiative (this is a huge one for me)
- lack of energy; easily fatigued; feel weak
- absolutely no sex drive
- anxiety is slowly improving but I still have a lot of physical feelings of anxiety in my chest, like my chest/stomach is tight and I'm not breathing deeply, even when I don't feel mentally anxious, if that makes sense
- diarrhea, seems to be slowly improving (I had chronic diarrhea ever since getting below a certain dose of methadone, it's only recently begun to improve compared to then, but right after I stopped the methadone and stopped the morphine it was very bad)
- frequent headaches
- extreme sensitivity to cold
- sweating (I never used to sweat like this!)
- general aches and pains (often feels like it's "in my bones" but that type of pain is improved compared to when I was tapering and compared to right after I quit)
- general heightened sensitivity to pain
- "trigger point" pain, there are a ton of spots on me that hurt when pressed
- slight tremor noticed in hands
- general anhedonia (difficulty experiencing pleasure from things usually found enjoyable, lack of desire to do these things)
- random occasional bouts of sneezing or runny nose, etc
- random occasional bouts of what feels like mild acute withdrawal symptoms
- freezing cold feet all the time, hands often cold too
- very sensitive to everything (touch, temperature, foods, odors, light, noise, sensations, etc)
- extremely painful tongue (and sometimes lips)
- occasionally, cravings for heroin or romanticizing the time I was using (I deal with these pretty well though)
- memory problems
- unrealistic expectations of myself
- guilt
- internet and smoking addictions are worsened
- various nervous system issues
- sometimes a burning skin sensation
- pupils still not normal (sometimes dilated, sometimes fluctuating)
- probably more things I've forgot to mention but you get the idea, LOL
Many of my symptoms come and go or improve and worsen with wave-like reoccurrences or fluctuations in severity of symptoms, which is pretty common for both acute and post-acute withdrawal and many chronic health conditions.
3. Details about the naltrexone I will be taking:
I got mine prescribed and prepared by a compounding pharmacy in liquid form. It's not cheap, but maybe I can switch to capsules if I find this first trial worth continuing and figure out a set dose. I thought liquid would be easier in order to measure very tiny doses and gradually titrate up the dose if I think that's a good idea. With capsules I would have had to have a set dose per capsule. I discussed more about the different options for LDN preparations in this thread in OD. (Maybe after some more research I will post instructions for making it oneself from 50mg naltrexone tablets if anyone wants that info - I know it's not possible for everyone to get it compounded from a pharmacy like me, you need a Rx and it's not exactly cheap).
Even though I said before that I wanted to try just 10mcg naltrexone initially I now think I'm just going to go with 100mcg the first time and see what happens. That's still a very low dose compared to the "LDN" doses of 1-5mg recommended for various issues. I will be measuring it with an oral syringe. I'm going to try taking it at night as that's what is generally recommended, the idea being that if it partly blocks your endorphins it will be while you're asleep and you will get an increase in endorphins around when you wake up. Who knows, maybe 100mcg will not be enough to notice anything, but I don't want to be too impatient or assume a higher dose = better. I figured better to take too little and have it do nothing perceptible then take too much, get unpleasant side effects and be afraid to take it again, right?
[EDIT: changed title to differentiate as I will use "Day 1" etc once I actually start the naltrexone; added categories]
[EDIT 2: added a symptom I'd forgotten to mention]
1. More about my drug and health history
Off opioids completely for over a month, aside from 2mg of loperamide a few weeks back and a very low dose of DXM (an extremely weak opioid) maybe a couple wks ago.
I was addicted to heroin for around 10 years and on methadone for around 10 years. There were maybe 5 years or more of overlap where I was using heroin as well as methadone. I have not used heroin for years and have been off methadone for 4-5 months. I spent over 1 yr slowly tapering the methadone. I feel this was a mistake in retrospect. After I got down below a certain dose I felt withdrawal symptoms most of the time and I think that continuing such a slow gradual taper after that point did me a disservice, slowed/delayed my recovery and conditioned my brain to feel sick all the time, not to mention that it has been hugely stressful on my mind and body for numerous reasons. I do have chronic pain from various injuries (presumably, it's hard to tell what is still directly related to those injuries since a normal healthy person should have long since recovered) but was also diagnosed with fibromyalgia, however my current doctor believes the fibromyalgia may be primarily opioid-induced and I agree. Look up opioid-induced hyperalgesia and allodynia for more info.
I tapered down to under 10mg of methadone a day, and I was so sick by that point and continued to get sicker after stopping the methadone completely, so drug-wise I still used mainly: very low doses of oral morphine, low doses of benzos for a while, and gabapentin. I tapered off all those, it's been around 5 weeks+ since I completely stopped the morphine. I also wanted to be drug-free from all types of drugs for a while before starting the naltrexone so as to see what my current state is without any drugs and to be able to properly assess the results of my experiment with naltrexone. I do have problems sleeping and I've read that insomnia can sometimes be a side effect of LDN, so I can't guarantee that I won't take anything for sleep while taking it, but if I do I will make a note of it in my blog. Sometimes I take naproxen or ibuprofen. As for vitamins/supplements, right now I am just taking high doses of Vit D, fish oil, and I plan to get a good amino acid complex because amino acids are important for proper brain function, rebuilding opioid receptors and lots of other good stuff. I have tried a ton of other stuff in the past, but am in a phase where I want to simplify things.
I smoke cigarettes and my smoking has gone up since quitting opioids.
2. Long list of the symptoms I am currently experiencing:
- difficulty sleeping (trouble getting to sleep, restless sleep, lots of dreams, waking up early and being wide awake and unable to get back to sleep)
- feelings of dread, anxiety and discomfort upon awakening, my mind is wide awake but body feels very tired and I don't feel refreshed or energetic at all
- lack of motivation/initiative (this is a huge one for me)
- lack of energy; easily fatigued; feel weak
- absolutely no sex drive
- anxiety is slowly improving but I still have a lot of physical feelings of anxiety in my chest, like my chest/stomach is tight and I'm not breathing deeply, even when I don't feel mentally anxious, if that makes sense
- diarrhea, seems to be slowly improving (I had chronic diarrhea ever since getting below a certain dose of methadone, it's only recently begun to improve compared to then, but right after I stopped the methadone and stopped the morphine it was very bad)
- frequent headaches
- extreme sensitivity to cold
- sweating (I never used to sweat like this!)
- general aches and pains (often feels like it's "in my bones" but that type of pain is improved compared to when I was tapering and compared to right after I quit)
- general heightened sensitivity to pain
- "trigger point" pain, there are a ton of spots on me that hurt when pressed
- slight tremor noticed in hands
- general anhedonia (difficulty experiencing pleasure from things usually found enjoyable, lack of desire to do these things)
- random occasional bouts of sneezing or runny nose, etc
- random occasional bouts of what feels like mild acute withdrawal symptoms
- freezing cold feet all the time, hands often cold too
- very sensitive to everything (touch, temperature, foods, odors, light, noise, sensations, etc)
- extremely painful tongue (and sometimes lips)
- occasionally, cravings for heroin or romanticizing the time I was using (I deal with these pretty well though)
- memory problems
- unrealistic expectations of myself
- guilt
- internet and smoking addictions are worsened
- various nervous system issues
- sometimes a burning skin sensation
- pupils still not normal (sometimes dilated, sometimes fluctuating)
- probably more things I've forgot to mention but you get the idea, LOL
Many of my symptoms come and go or improve and worsen with wave-like reoccurrences or fluctuations in severity of symptoms, which is pretty common for both acute and post-acute withdrawal and many chronic health conditions.
3. Details about the naltrexone I will be taking:
I got mine prescribed and prepared by a compounding pharmacy in liquid form. It's not cheap, but maybe I can switch to capsules if I find this first trial worth continuing and figure out a set dose. I thought liquid would be easier in order to measure very tiny doses and gradually titrate up the dose if I think that's a good idea. With capsules I would have had to have a set dose per capsule. I discussed more about the different options for LDN preparations in this thread in OD. (Maybe after some more research I will post instructions for making it oneself from 50mg naltrexone tablets if anyone wants that info - I know it's not possible for everyone to get it compounded from a pharmacy like me, you need a Rx and it's not exactly cheap).
Even though I said before that I wanted to try just 10mcg naltrexone initially I now think I'm just going to go with 100mcg the first time and see what happens. That's still a very low dose compared to the "LDN" doses of 1-5mg recommended for various issues. I will be measuring it with an oral syringe. I'm going to try taking it at night as that's what is generally recommended, the idea being that if it partly blocks your endorphins it will be while you're asleep and you will get an increase in endorphins around when you wake up. Who knows, maybe 100mcg will not be enough to notice anything, but I don't want to be too impatient or assume a higher dose = better. I figured better to take too little and have it do nothing perceptible then take too much, get unpleasant side effects and be afraid to take it again, right?
[EDIT: changed title to differentiate as I will use "Day 1" etc once I actually start the naltrexone; added categories]
[EDIT 2: added a symptom I'd forgotten to mention]