So I have been successfully tapering from my peak usage of Oxy @ 640 mg daily (I am now on Dilaudid, 24 mg daily) and though I could share some experience and thoughts on the subject. Anyone with some experience that would like to add something are welcome.
First thing, my biggest drop in daily usage and tolerance always were following a few days off. Of course when you deal with withdrawal, it is not always possible to do if you have a life and it takes lots of discipline to not touch your drug of choice when it is sitting there while you are experiencing withdrawal but it is quite useful when you want to drop your usage from either a relatively high dosage and or to shed off a substantial % of your daily regimen.
I found 3 days gives you most bang for your bucks. Longer will work too but if your goal is only to reduce tolerance and continue to taper, 3 days does it (I will use before going to bed at the end of the 3rd day, or the be honest, somewhere during the evening. I would say I can drop my daily usage on the order of 35% to 50% with 3 days. More than 3 days and I don't feel I get a lot more than that unless we are talking 7 - 9 days where you are basically anyway out of the acute phase.
2 days works (at least for me) but not as much as 3.
24 hours also helps when, on a tapering schedule, I've allowed myself some sort of break, enjoyed more (or way more) than my daily dose and now when I try to get back to where I was and my body disagree. Stopping for 24 hours helps resetting this.
Another thing I've experienced, when tapering slowly (cutting down my daily dose once in while) is that using a bit more the day before helps. What I mean is I would increase my daily dose by 20% and even sometime up to 100% (doubling the dose) before cutting down and weirdly enough, it helps a lot. Not sure why but I have experiment this a lot.
WARNING : DOUBLING A RECREATIONAL DOSE CAN BE AND MOST LIKELY IS DANGEROUS. What I am talking about is doubling the minimum dose you take to avoid the withdrawal symptoms. If you are a recreational user and are considering starting a taper, you do not need to do this nor should you. The gap between what you need to get high and what you need to function might be wider than you think. That being said, I will rarely double my maintenance dose and usually will take a fraction of it on top of my usual dose before dropping. Another important information I would like to add is that I started doing so after having cut down my usage under 60% of what it once was (at its peak) and might be useful and safe only when you hit those marks. Maybe someone else having experienced it can add some light to this.
That being said, I found useful to use a bit more before cutting back.
Another technique that helps me would be to take higher dose but less of them. So say I want to go from 40 mg of Dillies a day (8mg 5 time a day) to 36 (10% less), I would for the 1st few days go with 3 total doses (instead of 5) of 12 mg. Or most likely go with a 12 mg dose than 8 mg - 8mg - 8 mg (4 doses instead of 5).
When tapering slowly, I try to cut back only 5% to 10% of my current dose. I also allow myself at least 2 weeks to get accustom to the new dose before doing it again. It is slow, less aggressive than most schedule I've read, however it is easier for me to stick to it and not to relapse like there is no tomorrow. As I said earlier, tapering and occasionally quitting altogether for a few days have allowed me to go from 640 mg of Oxy daily to 24 mg of Dilaudid and it still goes on.
Sometime it's harder than others. I don't know why but it seems there are some threshold and that going under them is more difficult. Usually at that point I will try at least a 24 H or more to pass them. It is hard and it takes motivation but knowing it is only temporary and that you'll get your dose back is really helpful.
When I dont have the courage to go through withdrawal to pass the rough patch, I do use some other drugs.
Clonidine helps a bit.
I've also try Agmatine and Proglumide. Both have been helpful but mostly in the beginning. Somehow they do not work as good on me as they used to even if I do not use them for months.
Memantine has always worked and is my favorite drug to help me go through the difficult part when cutting back.
My personal opinion based on different testimony I've read online is that it probably is different depending on metabolism and such things and to put those differences on individual variations. My best advice would be to try them all, one at the time, and use what works. However I am confident that most of opiate users trying to taper would benefit from at least one of them or more than none.
At one point I tried cycling opiate to help reducing tolerance and taper and it has been somewhat useful but when I switch opiate, I can strangely feel a bit of high AND some mild withdrawal symptoms at the same time which I am trying to avoid as much as I can. Or I experience them full on for a substantial gain.
That is about it for my own experience. I've been tapering for months (and even tried to quit a few time) and slowly but surely progress is made.
Personally I find it hard to deal withdrawal but manageable. It is the PAWS that was unbearable. I am working on the hypothesis that the lower my daily usage will be, the easier it will get to go though PAWS. At the moment I am trying to find some Fentanyl patch to replace the Dilaudid. I've quit smoking a few times and it always been relatively easy because I would cut a small amount from the patch until I switched to the next level. I am hoping the Fent patch will do that as well and that the constant release as opposed to the constant high / low concentration of fast action Dillies will make the process easier.
ANOTHER WARNING : If you want to do the same, I do not think all Fent patch can be cut and you should consult a pharmacist or the Fentanyl patch cie before attempting it.
So, if any of you have some tips or experience with tapering opiate feel free to share.
First thing, my biggest drop in daily usage and tolerance always were following a few days off. Of course when you deal with withdrawal, it is not always possible to do if you have a life and it takes lots of discipline to not touch your drug of choice when it is sitting there while you are experiencing withdrawal but it is quite useful when you want to drop your usage from either a relatively high dosage and or to shed off a substantial % of your daily regimen.
I found 3 days gives you most bang for your bucks. Longer will work too but if your goal is only to reduce tolerance and continue to taper, 3 days does it (I will use before going to bed at the end of the 3rd day, or the be honest, somewhere during the evening. I would say I can drop my daily usage on the order of 35% to 50% with 3 days. More than 3 days and I don't feel I get a lot more than that unless we are talking 7 - 9 days where you are basically anyway out of the acute phase.
2 days works (at least for me) but not as much as 3.
24 hours also helps when, on a tapering schedule, I've allowed myself some sort of break, enjoyed more (or way more) than my daily dose and now when I try to get back to where I was and my body disagree. Stopping for 24 hours helps resetting this.
Another thing I've experienced, when tapering slowly (cutting down my daily dose once in while) is that using a bit more the day before helps. What I mean is I would increase my daily dose by 20% and even sometime up to 100% (doubling the dose) before cutting down and weirdly enough, it helps a lot. Not sure why but I have experiment this a lot.
WARNING : DOUBLING A RECREATIONAL DOSE CAN BE AND MOST LIKELY IS DANGEROUS. What I am talking about is doubling the minimum dose you take to avoid the withdrawal symptoms. If you are a recreational user and are considering starting a taper, you do not need to do this nor should you. The gap between what you need to get high and what you need to function might be wider than you think. That being said, I will rarely double my maintenance dose and usually will take a fraction of it on top of my usual dose before dropping. Another important information I would like to add is that I started doing so after having cut down my usage under 60% of what it once was (at its peak) and might be useful and safe only when you hit those marks. Maybe someone else having experienced it can add some light to this.
That being said, I found useful to use a bit more before cutting back.
Another technique that helps me would be to take higher dose but less of them. So say I want to go from 40 mg of Dillies a day (8mg 5 time a day) to 36 (10% less), I would for the 1st few days go with 3 total doses (instead of 5) of 12 mg. Or most likely go with a 12 mg dose than 8 mg - 8mg - 8 mg (4 doses instead of 5).
When tapering slowly, I try to cut back only 5% to 10% of my current dose. I also allow myself at least 2 weeks to get accustom to the new dose before doing it again. It is slow, less aggressive than most schedule I've read, however it is easier for me to stick to it and not to relapse like there is no tomorrow. As I said earlier, tapering and occasionally quitting altogether for a few days have allowed me to go from 640 mg of Oxy daily to 24 mg of Dilaudid and it still goes on.
Sometime it's harder than others. I don't know why but it seems there are some threshold and that going under them is more difficult. Usually at that point I will try at least a 24 H or more to pass them. It is hard and it takes motivation but knowing it is only temporary and that you'll get your dose back is really helpful.
When I dont have the courage to go through withdrawal to pass the rough patch, I do use some other drugs.
Clonidine helps a bit.
I've also try Agmatine and Proglumide. Both have been helpful but mostly in the beginning. Somehow they do not work as good on me as they used to even if I do not use them for months.
Memantine has always worked and is my favorite drug to help me go through the difficult part when cutting back.
My personal opinion based on different testimony I've read online is that it probably is different depending on metabolism and such things and to put those differences on individual variations. My best advice would be to try them all, one at the time, and use what works. However I am confident that most of opiate users trying to taper would benefit from at least one of them or more than none.
At one point I tried cycling opiate to help reducing tolerance and taper and it has been somewhat useful but when I switch opiate, I can strangely feel a bit of high AND some mild withdrawal symptoms at the same time which I am trying to avoid as much as I can. Or I experience them full on for a substantial gain.
That is about it for my own experience. I've been tapering for months (and even tried to quit a few time) and slowly but surely progress is made.
Personally I find it hard to deal withdrawal but manageable. It is the PAWS that was unbearable. I am working on the hypothesis that the lower my daily usage will be, the easier it will get to go though PAWS. At the moment I am trying to find some Fentanyl patch to replace the Dilaudid. I've quit smoking a few times and it always been relatively easy because I would cut a small amount from the patch until I switched to the next level. I am hoping the Fent patch will do that as well and that the constant release as opposed to the constant high / low concentration of fast action Dillies will make the process easier.
ANOTHER WARNING : If you want to do the same, I do not think all Fent patch can be cut and you should consult a pharmacist or the Fentanyl patch cie before attempting it.
So, if any of you have some tips or experience with tapering opiate feel free to share.