Opioids Switching from low dose Bupe to Tliidine with the intention of quitting.

[Zerwas]

Hey fellow Bluelighters,

I am currently addicted to ~0,5mg Buprenorphine/day which I insufflate. I know this seems very low and benign but I am not able to taper further down and the last WD was one week+ of puking, not being able to eat and surprisingly hellish for this low dose.

Since I have the access I thought about switching to Tilidine (short acting, lower potent opioid with Naloxone in ER form) because I kicked that back then without much problems.

I know that switching to a full agonist is generally not smart if one wants to taper and kick the opis. But after the last Bupe-WD I don't want to experience this kind of WD again.

My plan would be taking an equivalent dose of Tilidine (~300mg) in the morning and add another smaller dose (~100-200mg) when the first wears off.
I have enough Tilidine to taper down and I can use the ER-mechanism to my advantage when it comes to the last doses.
And I can cover most of the Tilidine-WD with Gabapentin which did not help much with Bupe...

I am aware of the negatives but due to my inability to taper the Bupe further and "positive" experience with Tilidine WD, I think it would be better to take and withdraw from a low potent Opioid (potency ~0,2 instead of 30-40 with Bupe).

What do you think? Thanks in advance!

Z

 

[Zerwas]

Nobody?

I'd just like to hear your opinions on this. Yesterday was pretty good with the mentioned doses. And my bowel seems to work more normal again maybe due to the Naloxone?
Today I crave my Bupe even with 250mg Tilidine in my system. It just does not sedate much and is generally one of the most activating opioids I have tried.

 

[Mad Dash]

can you get tilidine in the US?

 

[Zerwas]

No. Thanks for your constructive post towards my question

 

[Larc]

What makes you tink Tilidine will be easier? Generally an opiod with a longer half life will be easier to quit.

You're going to have to pay the piper. I would reccomend kratom or seeing a doctor if you aren't capable of mustering up the willpower to quit bupe.

 

[Larc]

How long have you consistently been using bupe. Whats your opiate history? This will help us answer yojr questions and give better advise.

 

[Mad Dash]

No. Thanks for your constructive post towards my question

Well I am sorry, I would also like to get off bupe and was curious about it.

 

[clubcard]

One thing to remember is the Naloxone in Valeron N has a phenolic -OH so, just like the separation of codeine & morphine, the calcium salt is insoluble.

 

[Zerwas]

Mad Dash: No problem dude, I was just waiting for replys after~100 views

How long have you consistently been using bupe. Whats your opiate history? This will help us answer yojr questions and give better advise.

First of all thanks for the answers guys, I really appreciate it.

Well my history short:

I started about 8 years ago but got physically addicted like ~3 years ago.
Opioids of choice: Tramadol, Tilidine, Codeine, DHC, Desmethyltramadol, Kratom, Buprenorphine.
Never touched the needle or big doses of the higher potent stuff and was generally always using low doses for productivity and recreational purposes.
I kicked at the end of last year and started again in February until now...(guess Bupe for about 4-5 months)

The Tilidine WD is short and my last Bupe-kick was surprisingly bad and very long even with a 1mg habit tapered down to ~0,4mg.

I also know that the WDs become harder with time but Tilidine is much less potent than Bupe and does not fully cover me 24h/day which is a good thing because I can gauge what I am in for dosing 2x a day and my bowels have some time to adjust accordingly. The 0,4mg Bupe leave me craving, upping the dose a little or taking benzos...

It is worth a try cause I know I cant taper further and I could get a very small amount of Bupe if it does not work.

I was more sceptical about the Naloxone and such.

I tried Kratom to quit but I do not react that well to it. It covers some WD-symptoms but leaves me uncomfortable and craving. Last kick I took it for 5 days after the last Bupe dose and started puking intensely one day after the 5 Kratom days because of Bupes long half-life I guess.

So I took my last 0,5mg yesterday after one day of Tilidine only. Today 300mg + later 200mg. Tomorrow: 250mg + later 200/150 and so on until the last pill which I will take normally and not crush it for the ER-mechanism.

 

[Larc]

Is seeing a doctor an option? A cocktail consisting of baclofen, librium, and clonidine is enough to knock bupe withdrawal out especislly at low doses.

After 3 years of abuse the acute withdrawal phase will pale in comparison to the post acute phase. Exercise goes a long ways for most people. Others find 1 on 1 or group counseling to be effective.

The key is to keep yourself busy and don't give in to the urge to lay on a couch all day watching netflix.

 

[Zerwas]

Yes, it is an option but only if I really have to and can't do it by myself with Gabapentin, some Benzos and maybe some weed.
Librium is not prescribed here and I dont know about Baclofen because iirc it is used for Gabaergic drugs.
The clonidine could be very useful though.

And regarding keeping yourself busy: I was bedridden for over a week and couldn't eat for 3 days. Even walking to the toilet was exhausting.
Impossible to do anything else than lying in my bed. If it weren't for the puking I could ride it out again but that was by far the worst thing.
I would be glad to be able to actually do any activities during WD but I wasn't even capable of standing straight.

 

[5StarSquatHotel]

Zerwas I got down to 0.5mg a day and that was a walk in the park compared to some of my experiences and that was after being on previously high doses for 2 years. You cant go much lower really, you are best off to start skipping days and aim for more days off. Kratom would help but use it sparingly, pregablin would help as well but you would need to takes high doses 600mg, which happens to be the limit in the NICE guidelines (UK). Good luck shagg.

 

[Zerwas]

Thanks man, but like I said even at this low dose the last WD was nearly unbearable, especially the puking and not being able to eat for ~ 3 days.
I can handle the sweats and insomnia, chills, craving whatever. But the damn bowels....by the way I did not have diarrhea, like at all. But projectile vomiting until only bile was left...

I was never on high doses, 1mg max and was maintaining on ~0,5mg the last months.

Gonna take 250mg Tilidine now (which does not get me high). Feeling good after 18h without a dose but yesterday evening I got pretty depressed.

 

[Zerwas]

*bumpthisformyself*

So, last week I took Tilidine for 3 days, then went back to ~0,5mg of Bupe 2 days and am now on my second day of only Kratom. Feeling good so far but was waking up early in slight WDs.
I am taking 3-4 doses of 4-5g a day and plan to do that two more days and then jump on the weekend.

Got a few Diclazepam, a lot of Gabapentin, MCP, Loperamide and Weed. This time for real. It is scary to look back and realize after my last kick I was suddenly back to basics for over half a year...

 

[Larc]

Yeah, relapses are a bitch and a half. I always get clean for a year or so then I start to chip. I can usually maintain the chip for a couple months, but always end up fully addicted again.

Hoping that sht will get easier as I age and progress through life. Good luck to ya.

 

[Zerwas]

Thanks dude,

I woke up at 5;30 today feeling pretty shitty but after 1mg of Diclazepam and some masturbation i slept another 3 hours
After taking my morning dose I feel great, must be the Diclaz in combo...
Also got my hands on some Magnesium + B-Vitamins and prepared some easy to consume groceries.

I just hope it won't be as bad as last time...but then I did not have MCP nor Gabapentin and came of a slightly higher dose but also with this kind of Kratom taper.


And yes, the relapses: 2 years ago I got completely clean before my 30th birthday and felt great, going on vacation etc.
It just got worse after that. I can't imagine how the WD from H/Oxy and similar potent opioids or IV use must be.....

 

[Zerwas]

Well, 3 months after my last post in this thread I am still in the same position: Taking Tilidine and/or Kratom after quitting Bupe at ~0,3mg last sunday.

I know I do not have to justify myself but the main reason I did not quit when I started this thread is that I have to be able to work. If not I can't pay my rent and even if welfare here in Germany is easy to get, I wont fucking do it. Did that for 2 months after college and it sucked!

Now I have to get clean until christmas: 13 days...more like 12 because I have some left for tomorrow after tapering.
Still taking 3 doses a day of 200 or 150mg Tilidine or 4g Kratom and I feel between ok and on the edge.

I just want to hear some opinions regarding the oncoming withdrawal even if Tilidine is not that common outside of Germany.
Still got the same meds to combat it as well as some Tramadol which was my favorite drug when I started and now I hate it so I probably won't use it anways.

 

[serotonin2A]

Sorry for the delayed reply. You are mistaken about one thing. 0.5 mg buprenorphine is not a low dose. The typical clinical starting dose for pain is 0.2 mg. You could potentially get addicted to 0.2 mg doses. Is it therefore suprising that the withdrawal is severe at a higher dose? I would recommend going very low, for example 0.05 mg twice a day sublingual. You could try making a tincture in alcohol or another suitable solvent.

I find this is a really common problem. People base the dosing on maintenance doses and think that 0.5 mg is a low dose. Unfortunately bupe is a partial agonist and people have to take relatively high doses to achieve maintainance if they are used to full agonists. But 0.5 mg bupe can still produce painful withdrawal.

 

[bingey]

What makes you tink Tilidine will be easier? Generally an opiod with a longer half life will be easier to quit.

You're going to have to pay the piper. I would reccomend kratom or seeing a doctor if you aren't capable of mustering up the willpower to quit bupe.

I don't agree with this , long-acting opiates are much harder to quit but easier to stay addicted to.

p.s OP did you know that at your kind of doses (below 1 mg) most of the bupre gets converted to norbupe whhich is a full agonist , I think the whole plan is good actually , I did the same thing with codeine to quit low-dose metahadone.

 

[Zerwas]

Thank you both for the replies.

sero: I mean low dose in relation to the usual maintenance doses. Of course Bupe is really potent which is why I tried this way.

BingeBoy: Yeah, I know about the Norbupre. Thanks for your opinion and its interesting that you did a similar thing.

Unfortunately I went back to the Bupe again yesterday due to the fact I got briefed that my job won't be continued in 2016 and I have to earn as much as I can in the next two weeks (I am self-employed).
Another reason besides the general addiction is that I have to function during the holidays after being sick last year and my family can't know whats up
It would be too obvious if the same thing happens again this year.

This really sucks because I was down to 100mg Tilidine ER but I took more and more Benzos and definitely won't get addicted to them too!

So now I need to maintain until after New Years Eve. The minimal positive aspect of my future job loss is that I can afford to be sick when the new year starts but I can't acquire Tilidine anymore so then Kratom will be the taper-substance.
I hate it so much to be forced to function...if it would not have been for the bad job-news I probably could have managed it pretty ok but now I just need the god damn money to pay my rent for January etc.
I just want to live a normal life again.

Further input is appreciated. I will stay on ~0,4-0,5mg and won't take any Benzos anymore. Then in January I order 100g of Kratom and taper with that in about a week.

Z