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Bupe Relapse 2 days into sobriety - seems to have shortened WD's?

lol to me that's one of the worst parts, waking up because of anxiety! But hey at least you've got your energy back- that's great!!
 
Yeah it is good having energy again. And my head is working marvellously - even though I can't concentrate for more than a few seconds - and this is a big deal for me because of my field.

Something happened last night. So, for the 8 days between quitting and last night I had been using, at night, 2-4mg diazepam and 60mg codeine. Last night I had 2mg diazepam and 30mg codeine a few hours before bed to loosen up and sit still, and then another 2mg diazepam and 30mg codeine when I got into bed.

I couldn't sleep at all. The RLS was as intense almost as the first few nights of quitting. Is this because I started using snus tobacco again? Or because I went to bed much later than usual? Or because I also ate much later than usual that night?

I ended up having way more stuff than usual: 10mg diazepam and 90mg codeine.

The plus side is that it was enough diazepam to last into today; the 2mg never extended beyond waking. But I'm concerned about this level of use: even though 10mg diazepam and 90mg codeine are small objectively, for an ex-addict they are clearly a recipe for disaster.

If I was going to try to kick either the codeine or the valium, which one do people think it would be more sensible to stop?

S
 
Yeah this is my feeling too. I think I probably will get some more codeine 30mg's tomorrow if only for the reassurance; I have always found, unlike some people, that my chances of success in abstinence increase dramatically if I have some sort of store. Knowing that I could make things easier if I wanted to, without having to go out sourcing, has a beneficial effect on my thinking.


S

I actually know what you mean there. A lot of people seem to feel that way...even with something as tempting as hydromorphone, it seems to be, somehow, a means of alleviating pain in and of itself, to know that if you really felt the need you could, even if you don't plan to do so.

As far as whether to stop the codeine or the valium, I would recommend stopping the valium immediately, and continuing the codeine (perhaps tapered if need be) at your current dose or lower...benzo withdrawals are a whole new can of worms, and since you've used only low doses for a fairly short period of time I don't think that that will be an issue - but why take the chance of getting to the point at which it will be?

The codeine I would think should help with avoiding PAWS a little, especially if you taper it. Not that I don't think that you could easily stop taking it right now, just that if you're going to keep one or the other, it's probably best to keep the codeine.
 
Yeah thanks man. I seem to be able to tolerate all the bullshit during the day but I just can't hack it at night. Sleeplessness makes all the trouble fifty times as bad.

I have been addicted to benzos previously. At that time I thought they were great, but now, having been clean and having seen how much better I am, I really hate them. Still, they are so effective when used legitimately. The codeine seems to be doing very little for me in terms of noticeable relief; the valium just bang eliminates 90% of the shit as soon as I take it - no restlessness, no pain, no discomfort, no intense sadness, and maybe most importantly, no anxiety, so that even the symptoms it doesn't treat seem like small matters and unworthy of attention.

How long do you think diazepam use at 2-4mg would have to continue to create difficulties upon cessation? I'm a bit over 9 days presently. Would 2 weeks be reasonable? It's been over 6 months since I last used any benzos at all, even though I have had very easy access, so I'm not attracted to the idea of using them anymore, which I think is important.

But the reason I'm slightly more attracted to valium than I am to codeine atm is that, by using codeine I'm not getting to the root of the problem. If I used valium - even though it's a whole new hazard - the opiate addiction would be subsiding completely, you know?

S
 
My thinking here is that it's not really safe to use benzos, in any dose, for two weeks straight - especially if you're been addicted previously, as you'll likely be a bit more susceptible than baseline to dependency. That is a very low dosage, but even on low doses the withdrawal process is more drawn out than that of opiates, and much more difficult to just taper through/tough out. That's not to say that I think that you'd necessarily experience withdrawal syndrome after that length of time - but why take the chance, or the chance that you'll be tempted to raise the dose or to continue dosing after that time is up? Personally I'd recommend stopping daily use of the valium immediately...it might be better to save it for, say, one or two (I'd be very, very cautious about exceeding that) days per week when you feel that you really need it most until you're starting to feel better psychologically.

I remember seeing a study on benzo withdrawal in which one patient was using 4 mg of diazepam per day (though this was the lowest dose out of the group) and did experience what could be called relatively significant withdrawal, but that individual had been using the drug for, if I recall, a period of more than a year - though I don't remember exactly how long. I don't think that nine days is enough to seriously worry about having an issue with physical dependence...but any more than that is really playing with fire - and it's not likely going to be any easier to stop the diazepam after 14 days than it would be after 9.

The reason that I suggest the codeine over the diazepam is that you're on a low enough dose of codeine and codeine is a weak enough opiate that you could reasonably just stop the codeine even if you did continue using it for weeks more with far greater ease than you could with the diazepam. Codeine, of course, is also a lot more easily tapered. It really depends, though, on how you think that the benzo will affect you, and if you're comfortable with becoming dependent on it, should you choose to continue use. The best thing would probably be to stop both, but if you were going to use either one or the other, the codeine seems much milder and less potentially destructive in the long-term (so long as you are able to stick to your current dose or less, and to taper off/jump off over time) than using any dose of any benzo on a daily basis.

Congratulations though; you've made it through by far the toughest part already - I'm sure that whatever you choose to do with the comfort meds, things will work out...just be cautious about acquiring a new dependency. No one ever wants that.
 
Thanks for the detailed reply.

I think that I will try to be off the diazepam within 2-3 days. Already I'm becoming enamoured of it and have been dosing a little bit earlier each day. Also (I can't remember if I mentioned) I had a terrible night yesterday and used 10mg, which is clearly a whole different game to 2mg, even though they're both small doses.

Also I hate the feeling benzos produce of disjointed thinking; I suppose it comes with the anxiety relief but I just hate not having a functional brain. Benzos do fucked up shit to my moods, my decision making and my cognition. My family would probably begin to suspect something.

One thing I am concerned about is this: that when I stop the valium, the codeine may not by itself cut it, and that I may on this account take more of it, say 120-150mg instead of 30-60mg. It's incredible that at TEN DAYS I'm still barely able to sit still, no matter what the time of day. Benzos are really great for the RLS.

Thanks for giving me straight up advice, and I know that it's totally on the mark. One final question, given that I had 10mg of diazepam last night (after 5 days at 4mg and then 2 days at 2mg), how quickly could I reduce from that to 0? 4mg tonight then 2mg tomorrow, then maybe 1mg the day after?

S
 
I think the last 1mg of bupe is helping ease you down just like a taper should. I don't believe you are out of the woods yet but if the next time you are hurting your try .5mg and then later .25mg you can gently withdraw over a period of time. Buprenorphine has a long half life so it is tricky to determine exactly how much is in your system and when you'll be hurting but slowly working your way down is a good way to go about getting off of it.

Bupe is bloody strong stuff and I can't imagine cold turkeying even off a few milligrams never mind 15 8(. Work your way down as needed and jump at .1mg or so and you'll be much more likely to succeed. Though of course it will take longer to get clean and you'll spend more time quasi sick which is the downside of the extended taper :\.

Great post.
 
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^ yes, a very good post, but as I explained I do not have the time or the mind to taper anymore. I started at 90mg methadone and have tapered since then.

At any rate it's been 10 days now without bupe and I don't think I could bring myself to touch it at this stage.
 
I think that you'd be fine just stopping the valium, after only nine days and at so low a dose that's probably the easiest route psychologically. If you do experience any physical symptoms (which I very much doubt, of course,) then it would probably be worth doing the 3 mg, 2 mg, 1 mg thing.
 
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Yeah, under ordinary circumstances I would agree, but the thing is that I've only been taking the valium at night, pretty much immediately before getting into bed. Even with the valium it takes me 1-3hrs to get to sleep so I know if I just cut it I probably wouldn't sleep for even longer.

I had 4mg yesterday, will have 2-4mg tonight, 1-2mg tomorrow.
 
^ yes, a very good post, but as I explained I do not have the time or the mind to taper anymore. I started at 90mg methadone and have tapered since then.

At any rate it's been 10 days now without bupe and I don't think I could bring myself to touch it at this stage.

That's great news about the bupe, BTW.
 
That sounds reasonable. The sooner the better, of course, but you've come far enough that I think you're a better judge of what is and isn't a good idea for you than anyone else could pretend to be, and I'm sure that you will continue to be successful. At this point it looks like you're pretty much out of the woods - the physical symptoms should start to disappear fairly quickly over the next week give or take a bit of time, and very shortly, I'd imagine that you'll be feeling better than ever.
 
Fuck man thanks so much. And thanks to Janja as well.

It makes things so much easier when you find people with experience and concern who are willing to give genuine answers to your questions. I think it must be the secretive nature of opiate addiction that makes interactions like these - especially when a person is in dark places - so deeply satisfying.

Nearly 11 days and I am - sloooowly - getting better. I've had less stomach pain and perhaps a bit less anxiety. I feel like the RLS has been better today - I've been making myself to cardio every day to help with this. That has been fucking hard.

Of course, I'll have to give you guys an update when I come off the valium and the codeine and eventually the doxylamine, if only for the purpose of helping others to decide whether to use things like these in their opiate WD's.

Thanks again!
 
I'm not intentionally bumping but I do need help with something and another thread may be pushing it:

I've spent at least 1 of the past 3 years (for all of which I was on either bupe or methadone) as a real shut-in. I actively severed relationships and avoided people, and after a long-term relationship ended I basically withdrew completely. The opiates interacted in a terrible way with my depression and mood generally and made me more or less content to stay at home, keep to myself and read.

Since getting clean - needless to say - I've been in an odd place. Firstly, I can't read anymore. Or rather, I can't sit still long enough to concentrate, and if I can sit still, I'm intensely disinterested and unable/unwilling to focus. This is greatly distressing to me as I would like to go into academia, and also because I feel like a huge chunk of my identity has just been severed. I used to read and write for sometimes 6hrs a day, and always at least 3. The reading coupled with my OCD and I had to read to feel ok and fortified, but I loved it anyway. Can other people relate to this? How long is it likely to take before I can do what I love again?

Secondly, I have retained the inclination towards inactivity, in my head at least, but physically have way too much negative energy to just stay indoors. The result has been that I've been going to the gym and working out increasingly hard, which is good, but also that I'm a bit torn between habits: being so used to just staying indoors and studying, on the one hand, but being unable to sit still or concentrate, on the other.

It's tempting to just get high in order to be able to do something I enjoy. Is this PAWS? Does anybody relate?

Thanks.
 
I think that, as time passes, you should feel a little more yourself. Have you stopped the comfort meds entirely? It seems possible that that could have caused some of your difficulty. If so, have you experienced benzo withdrawal before? I know that lack of concentration is often indicated as a component of that. Despite your relatively low dose, perhaps what you're experiencing is a very mild form of benzo withdrawal?

I think it's more likely that you're just adjusting to sobriety, however. It can take a little bit of time to get used to doing your regular activities again, but I think that you'll find your passion returning soon. I think that you can and should do what you love now, though you might find it a little bit more difficult than you're used to for a brief period of time. The more you do it the easier it will become, and I expect that you'll be feeling totally back to normal or better in that regard very soon.

Exercise is good, but don't do more than you're comfortable with. Although this probably seems obvious, make sure you're also eating well and staying hydrated - treating your body as well as you can should speed recovery. Regardless of the physiological implications, quitting a habit - any habit, that's been a part of your life for so long can feel strange at first.

How you're feeling is very common, and things will steadily improve until these concerns have all but faded away. You've gotten through the hardest part, and you seem to be in a great position in your life regarding your academic situation and your career path.

Edit: I agree with you about the secretive nature of opiate addiction making it extremely beneficial, valuable, and reassuring to be able to talk openly about those experiences. Physical dependence is an unfortunately complicated and relatively poorly understood phenomenon; subjective experience and anecdotal reporting are great routes to better understanding. How do you feel about the doxylamine, by the way? What dose are you generally using? In many people it seems to exacerbate the RLS, at least until the peak of physical withdrawal have passed.
 
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as others have mentioned, I agree with the slow taper suggestion. I jumped off 2mg suboxone 2x a day last summer, and I relapsed (w/ subs) after 2 weeks of awful, painful withdrawals. No one in my family believed the pain I went through either, it's bullshit.

take your time on this one.
 
I'm not sure if this is even still a discussion, I didn't read through all the posts, just skimmed them. But I have something to add about the benzo's.

Benzo's are FINE to be taken for more than 2 weeks as long as you take them AS PRESCRIBED and you don't abuse them. Trust me, I know this from first hand experience, twice. I was put on xanax when I was 15, I was on it for about 6 months... then was taken off, with absolutely zero problems. I was put back on Xanax about a year ago, .25 to .5 and now at 1mg. I don't take them as prescribed, I take them when I need them and anxiety isn't bearable. And sometimes, every once in a blue moon I'll even take a handful of them if something gets me REALLY upset and I just want to space out and not deal with shit, I'd be lying if I said I didn't. Still, even after over a year of daily use (I'd say I take around 3-4mg on a bad day, and around 1-2mg on a good day), I can go days without taking any and not feel any sort of withdrawal from them. It's possible this is just because I'm one of those people who don't have withdrawal or addiction potential from benzo's (the same way some people don't withdraw from opiates or get addicted to those... unfortunately I'm not one of those people but yeah). But I really think it has more to do with taking them as prescribed and not abusing them (except for the few times I've taken around 5 or so pills at a time). So you CAN take Valium for longer than two weeks and not worry about getting addicted to them... if you really need them for anxiety and aren't taking them to get high, and you stick to what the prescription says... I really don't see why there should be a problem.

Personally, Valium doesn't affect me though. I'm not sure why xanax works (which is a weaker benzo by far), while diazepam has no effect on me orally. It does intravenously (I only know this because it's what they used for pre-induction during my breast aug to calm me down because I was really nervous, and it made me feel like I was floating on a cloud of rainbows and ponies and sunshine and unicorns). But I was prescribed Valium while I was going through hydro withdrawals, and... nada. Absolutely ZERO effect. It didn't take away the anxiety, the depression, it didn't make me tired. It just did nothing for me. So it's possible Valium is a whole different animal than xanax and I don't know what I'm talking about. But they're in the same class of drug so I'd assume the addiction/withdrawal potential would be about the same.

Sorry for the rambling, I'm really hungover and my brain is like "ZOMGWTFjalfahiaassaa" right now.
 
'xburtonchic' - If anything, xanax would actually be considered by most people to be stronger than valium. At any rate, it is much more euphoric and intense, and is associated with much more addiction problems. It is a short-acting anti-anxiolytic, whereas valium is a long-acting one. In my view the only reason xanax is or seems more intense is because all it's effects are crammed into a much shorter time-frame, whereas with valium the effects are spread over 1-2 days.

I agree that it is imperative to take benzos as prescribed, but I cannot agree that, even taken in this way, it would be advisable for me to continue using them. I've had several benzo habits in the past - they're just too agreeable to my mind, and for a person like me. I think now more than ever before I need to be vigilant.

And I'm seriously surprised that you could be using 1mg-4mg of xanax daily for over a year and have no dependence! That is equivalent to 20mg - 80mg of valium (4 - 16 tablets) and is by all means a 'serious' or at least moderately serious dependence. I think it is probably important that you don't 'feel' addicted and that you take them as prescribed, but I think that as far as your body is concerned you would absolutely have to experience WD's if you simply stopped taking them for long enough.

'allalong' - Hey man. I've been off the valium for 4 nights and the codeine for 1 night. I think, given that codeine has such a short half-life (like <1hr I think), and given that I was only taking a small dose of it at night time, I can probably assume that I'm past the worst of that.

I've been using 50mg doxylamine succinate nightly for 16 days. It seems to work extremely well in my case; seroquel gave me TERRIBLE RLS, but as soon as I started the doxylamine I've been sleeping for at least 6 hrs.

And I've been exercising daily. Physically, actually, it is totally ok; it's the mental shit that makes it hard. The internal dialogue involved in getting up, getting dressed, getting outside and to the gym and forcing myself to exercise for any period of time. So much negativity inside me! Such self-loathing. And the chills are still almost unbearable.
 
I don't think so, but it's possible that if I went like a week or so without taking them (the longest I've gone is three days), I would start to feel withdrawals. But I also feel like a lot of the withdrawal process has to do with whether you actually FEEL like you're addicted or dependent on the drug... which I most certainly don't with Xanax. If it weren't for my anxiety, I know for a fact I would be perfectly fine with not taking another benzo. I just simply wouldn't have a reason to take them and wouldn't have any trouble stopping.

And yeah, I know Xanax is stronger in the way that it hits you faster, but it doesn't really get you "high". Valium most definitely does... which is why I feel like it's stronger, because it's a hell of a lot easier to get addicted to for someone who's chasing the high.
 
I agree about the importance of attitudes - the first time I kicked valium I was not mentally addicted, and it was extremely fucking easy. I wasn't expecting to feel anything and I didn't.

But I don't agree that valium is stronger or more pleasurable - I think most people would rank xanax above valium without hesitation! Indeed, this is the reason why doctors switch xanax-addicted patients from xanax to valium, not just because of the half-lives but because valium is not as euphoric or intense or pleasurable as xanax, to most people. But to each her own!

And I'm going to have say 5mg of valium today I honestly don't give a fuck today I just feel like ass. I had some drinks with a friend last night and it was great fun - drinking off opiates is so much better - but today I'm just so headfucked. Hopefully it will be ok given that there have been 4-5 days since my last dose of valium. Maybe I also feel shit because I stopped the codeine last night.
 
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