Opioids "Stage Shifting" to escape both wds & paws. Posed only as a theory.

[Bojangles69]

Ok I'm sure this has been discussed before although I've never read it specifically like this.

We have a guy named "Thomas", Thomas is 34 years old and lives with his crazy wife who he can't stand. For the last 2 years he has been using opiates in a very unusual way. He has access to 3 different types, tramadol, oxycodone, and suboxone. And he has consistently used all 3 in the same exact way for the entire time he's been using.

Days 1-3 Thomas always used Tramadol - 200mg a day
Days 4-6 Thomas always used Suboxone - 4mg a day
Days 7-9 Thomas always used Oxycodone - 80mg a day

And he repeated this cycle never mixing an opiate on another opiates day, for 2 years straight.
Thomas did this because he was told your body can not get addicted to opiates in general, but that it can only get addicted to a specific opiate molecule/compound, used everyday.

Thomas is ready to stop now, and is curious if he will experience any form of physical wds or paws. And if you say yes, you have to explain why, and how its even possible his body got addicted to any 1 of those opiates, while he had 6 days off that opiate every 9 days he used.

So, when he stops will Tom get sick?

 

[SPDemon420]

I dont know enough to give you the type of answer you are looking for, but I believe you're going to withdraw regardless, I believe its because your brain receptors get used to the effect and "crave it" when its gone, regardless of if you're switching up (I could be completely wrong) - but I do know from experience of switching Heroin, Morphine, Oxy and Hydro, with Suboxone in the middle on days I couldnt use, that I got sick as fuck regardless.

 

[Bojangles69]

Yeh but I notice its very rare for an opiate addict to not have a baseline type of opiate that they prefer. I've just never met an opiate addict that consistently used a different opiate everyday. Chances are most people repeat a specific alkaloid enough for their body to get dependent on it.

I've just never understood why your brain would begin to down regulate if it was always getting "use" to a different opiate. It just doesn't make biological sense. Unless in fact I'm just wrong and your body still shuts down production in this scenario. I wish there could be more research on this shit but eventually I do think I'm just going to try anyway.

 

[TheAzo]

Opiates, generally speaking, are cross-tolerant. Your body gets accustomed to the mu-opioid receptors being activated, regardless of what chemical is activating them. That's why oxy addicts can switch to heroin without getting sick (or vise versa), and why opiate replacement treatment works (at least in terms of preventing w/d while switching to another drug). However, the cross-tolerance is not complete, for reasons that aren't entirely clear. This is exploited in treatment of chronic pain, where patients are rotated between different opiates in order to help manage tolerance.

This is an interesting case study in rotation in recreational use of opiates...

I think the key factors to note are
200mg tramadol is a low dose of opiates, compared to the other two phases. Opiate conversion charts place it at ~20-30mg of oxy equiv.
buprenorphine is a partial agonist, and those tend to not increase tolerance as fast as other opiates - at the same time, 4mg is not a small dose of it (converters say comparable to 50-100mg of oxy).
Overall doses are not crazy - I commend this "tom" person for his discipline. Not many people can take opiates daily for 2 years and not be in a much worse place by the end of that.

Overall, my betting is that he will experience withdrawal, but that it won't be as bad as if he'd taken the oxy or bupe every day. He should quit on day 4 in the above cycle, taking nothing, or a smaller dose of bupe if needed (minimum dose that will prevent w/d symptoms).

Cross-tolerance is present within many classes of drugs... ex: typical stimulants (meth-heads don't get off on normal doses of adderall), empathogens (you can "lose the magic" of MDMA by abusing methylone/mephedrone), cannabinoids (you can get such a tolerance from blends that weed won't touch you), psychedelics, dissassociatives, benzos, and other GABAergic sedatives (with a strange crosstolerance between benzos and other GABAergics - it's not the same in both directions). In all cases, it's partial, not complete, and drugs that are more similar to eachother structurally have more-complete cross tolerance.

 

[sekio]

Thomas did this because he was told your body can not get addicted to opiates in general,

This is woefully incorrect. All opioids are cross tolerant.

PAWS is more of a mental dependency than anything else. If you were relying on taking opiates for e.g. stress relief or pain control then of course you will feel funny if you come off of daily usage.

 

[BrainstormWithJace]

u are going to experience w/d symptoms from lack of dopamine and serotonin. instead of going cold turkey why dont u taper down.

 

[ColombianDopeHead]

Interesting

 

[MentalJourney]

From what I've heard, if you mix ops, then come off all of them at once, the WD's hit you much harder. Now I've never known anyone to have a bloody set schedule like you, it was always more of a "what do I have at the moment" kind of thing. If this person you know goes cold-turkey or otherwise stops, I'd be interested to hear the results. OFC you could always just switch to 100% subox and THEN taper that, but then again I've hard that crap is one of the worse to come off of...
And yes, OP's are cross tolerant, all of them. The new synthetics are not something I have a whole lot of experience with personally, but I imagine they work in much the same way.

 

['medicine cabinet']

tom is not going to feel good. toss the oxy taper yourself down using the bupe, tramadol has its place as it has def relieved WD symps in me before. but do some research into that. they are all cross tolerant to some degree. you only have one true mu-opioids receptor(oxy) in there but all the other types of receptors will notice as well "hey wheres the juice" so yea toss the 80s, gert sick as you can bear take the smallest amount of sub you need to stay held, it comes on slow so dont wait 20 mins and take more. Remember its stronger than it looks. once youre helds, taper from there with whatevr youre comfortable with. lots of info on here about that. as for the tramadol maybe someone else can chime in because i have limited experience with them when it comes to something like this. good luck to you.

 

[Mr.Scagnattie]

This is woefully incorrect. All opioids are cross tolerant.

PAWS is more of a mental dependency than anything else. If you were relying on taking opiates for e.g. stress relief or pain control then of course you will feel funny if you come off of daily usage.

Exactly. Not sure where you heard that people got addicted to one opiate and that opiate alone, OP, but that's just not the case. Once you are psychically dependent on a given drug like heroin, any opiate (provided you account for dosing equivalents and tolerance) will stop the withdrawals. Yes people have their DOC's but.. they aren't "exclusively" psychically dependent on them alone.

 

[RedRum OG]

You've been misinformed buddy. Tramadol is not real harmful addiction wise to opiate receptors but bupe and oxy surely are. Oxy because its full agonist, bupe is only partial but stays in your system for up to 36 hours.

Chances are you'll go through some withdrawal but nothing serious. You can most definitely get addicted to opiates in general but "shifting" as you say might make it slightly less horrible

 

[helium-4]

How is this guy taking 200mg of tramadol 3 days in a row and not getting sick for those three days when hes taking 80mgs of oxycodone and 2mg of suboxone for the other days. It doesn't make sense. 200mg of tramadol is no where near 80mg of oxycodone.

Of course if he stopped he'd get sick. It doesn't matter if hes using different types of opioids, he's still using an opioid. His mu-opioid receptors are being agonized from all three, and since he has been on it for years, he'd wouldn't be able to get away with no WDs.

 

[Zgreenzfeanz]

People seem to be suggesting that u pick suboxone as the drug to taper with. I was addicted to opiates for sometime and i wood suggest u taper with hydro. Also people seem to be skippin that here are differnt halflifes? Heroin wd hit u faster than sub wd. In MY OPINON suboxone is the worst thing ever. Its super strong and most ppl up there tolerance with it takin a full 8 or 4 mgs when that eq is much higher. If i was againaddicted to opiates i wood never go om suboxone again. It gets u high it gets u nods. Not good. As for the differ t pills and differnt days... Hes addicted to opiates non the less. My reasoning is that he has been takin opiates for 2 years.