trying to quit opiates (tramadol + oxycodone) / questions about detox / HELP needed!

[moonrockinmynose]

Hello, I'm new to the forum and have registered myself to ask some questions regarding the opiate detox.

I've been taking tramadol sporadically since 2014, and in 2015 I started taking oxycodone. With time it turned into a daily habit. In the end, I used to take 60-80 mg of oxycodone daily. This year I decided to try to quit opiates and went to a psychiatrist. He's been prescribing me tramadol since May and as of now I'm taking around 1000 mg of tramadol daily. I know this dosage is pretty high, but my tolerance went up so high that it's no longer dangerous. I wasn't taking oxycodone for two weeks, but since the last week I've been taking sporadically around 40 mg of oxycodone (not everyday, just when I got my hands on some). My psychiatrist wants me to wean off tramadol gradually, minus 50 mg each two weeks, but that would take too long for me and in my opinion it just would prolong the agony. Decreasing the dosage, in my experience, already produces bad enough symptoms, so I think I'd rather go cold turkey. By that I mean taking for example 100 mg of tramadol in the morning and in the evening. That would be quite a difference from what I'm taking now. And after a few days I would decrease the dosage by 50mg, and so on. Do you think that could work? Is my addiction very bad? Is taking 40 mg of oxycodone per day a lot? Especially, considering that I've been taking it for a week or so, and before that I had managed to live on tramadol only. How bad the symptoms will be in your opinion?

To help myself in the withdrawal process, I've been equipped by my psychiatrist and GP with the following:

- alprazolam 0,25 mg (Xanax)

- a dozen or so of Xanax SR 0,5 mg

- escitalopram 10 mg (I've been already taking it for four months - 20 mg daily)

- mirtazapine 30 mg (I've been taking it already for a month - 45 mg daily)

- zolpidem 10 mg

- quetiapine 25 mg (I was prescribed it by my psychiatrist by felt like an emotionless zombie the following day, so I stopped it, but I can always use it if it should help me in the withdrawal process)

- clonidine 75 mcg

I also got myself:

- drotaverine 40 mg (for muscle cramps)

- loperamide 2 mg

- metamizole 500 mg (for general aches and pains)


Do you have any suggestions regarding the aforementioned "aids"? Is there anything else that could help me get through the withdrawal? I do have a lot of tramadol in case it were better to decrease the dose gradually and not going cold turkey.

I would be very grateful for any suggestions

 

[T. Calderone]

I believe your psychiatrist has the right idea in that you should taper Tramadol but I think the dose you're on is too high. Just to clarify, did the doctor prescribe you to take 1,000 mg a day? I know your tolerance is high but too much Tramadol can be dangerous and mixing with antidepressants SSRI's/TCA's can put you at higher risk for serotonin syndrome or seizures. I agree that you could get by with 100-200 mg but make sure that both your doctors are on the same page.

As far as your oxycodone habit, I'm surprised he didn't recommend buprenorphine as opiate replacement therapy.

 

[TheRapperGoneBad]

I would say taper gradually with just the opiates.

Set a day, drop a percentage of your dose, and stick with the plan.
It's not gonna be fun an if it's too much to handle go back up a lil.
It takes like 3-5 days till your back to "normal" after dropping your dose. So once a week you get some rest days vs. every third day your gonna be pushing things.

Save the other shit for later maybe I'd honestly say avoid the benzos all together.
Clonidine is supposed to help I've never takin it tho.

Commit to change.

 

[moonrockinmynose]

The dosage we've agreed on is 600 mg a day, and then, next week, I was supposed to decrease it by 50 mgs. And then I was to decrease the dosage by 50 mgs every two weeks. So as you can see, that would go on for quite a while. As for now, my psychiatrist is on quite a long vacation, so the idea of a more abrupt lowering and detox wasn't agreed on. But the next time we'll be able to meet is the 20th of Septermber, so I can't afford to wait that long to consult what to do next. I'd rather try to decrease the dosage drastically and then detox in a matter of a week. And see where that leads me to.

As for the substitution therapy, it's not as widely available here in Poland, as it is in the United States. There is only one clinic in my city that offers such a therapy, but they use methadone there, not buprenorphine. Patients have to visit the clinic each day at 8.00 a.m. to get their daily dose of methadone. The clinic where my psychiatrist works doesn't offer the substitution therapy. And for some reason, the methadone therapy has got a really bad rep here in Poland, it's presented not as really solving the problem, but only providing the addicted with just an another subtance. Does it work the same in your country? Do patients have to go to a clinic everyday for their daily dose of medicine? On the one hand I can understand that this way, by not prescribing the medicine, they want to avoid people abusing methadone, but that just puts people off, because some people may just as well be working in those morning hours. And to apply for this methadone therapy, you have to have documented two previous failed therapy attempts. So, either way, as for now I can't apply for the substitution therapy, there's only one therapy that I could say was a failure.