Zag -
Here is what *I* would do. I have no real expertise, just a lot of personal experience and have been reading for years on BL and other forums what does/doesn?t work for others. Also, nothing I say is intended to offend you - I may be snide about the process or my behavior in said process, but I don?t mean that to be directed at you.
I would proceed as follows:
is there a family member/friend who could hold your meds for you so it?s not as easy/tempting to binge? Its probably a good idea to find a way to not have access to as many of them. Also, I have heard that tolerance builds quickly to the gabapentin. Has that been your experience? Either way, I would probably quit those ASAP and save them for when you are down to quitting entirely or right before so they can be utilized in a productive way in the worst of the acute wds phase and to avoid dependence.
Ok, so between now and March 17th is a little less than six weeks. I think you need to first decide if you are a rip off the bandaid person or if you want to slow it down to as slow as possible? You could go down 7.5 mgs every three days and get there fairly painlessly, relatively speaking and provided you can stick to a taper. or you could take 80 for two more days, then cut it to 60 for 5 days, 40 for 5 days, then down to 25, 15 and 10 until you get to zero every five days. That?s more of a middle option. Or you go quick and cut it by 50% every 3-5 days depending on how bad you want to feel - and what your obligations are and how sick you can be.
In the tapering phase I think clonidine is your new best friend. You can take up to .2 mgs 3 times per day according to webmd, but follow the instructions of your doctor. I would encourage taking as little as possible because, again, the point where you will need the most ?comfort? is when you get off of the opiates all together. The benefit of tapering is that you hopefully feel well enough to conduct life at least semi normally (as opposed to 7-10 days of hell and spending 50% of your time in the bathroom in one capacity or another) - clonidine works well to lower blood pressure and works on chills and anxiety, at last for me. It also helps with sleep.
If you are really struggling you can take Kratom on top of everything when you taper - sparingly. Using Kratom will significantly slow down opiate wds and eventually negate them as you will develop a dependence to Kratom before feeling ?great? off opiates. Just keep that in mind, but, I do think it?s better than going up in dose on a taper.
Once you you get off of the opiates, I would recommend using every comfort med you have as much as you responsibly/medically can and as much as you have to for the first 3-5 days. The goal of that time period is literally to just make it through the day without the opiates. Until you feel like you can live.
As far as taking Kratom, can you tell me what you have as far as type/amounts? Capsules? White vein? Do you have access to as much as you need? Have you ever taken it before? That woulda go in to dictating how to take the Kratom.
At that point, you want to slowly taper off of the comfort meds, most importantly the ones that create physical dependence. Personally, I find that Kratom loses its usefulness by about the day 10 mark. I would recommend using it much past that.
In addition to what you have I would pick up Imodium and some Gatorade or something similar for the days after you get off entirely. It?s rough but it does get better. Also, I find that if I eat healthy and take vitamins it makes a surprisingly great difference. There are also lists of supplements and extra things that may add comfort such as melatonin for sleep (which reminds me, your asshat doctor should write you a script for something for sleep. It?s the least he can do.) or calmomile tea and a hot bath to calm the nerves and restless legs. Let me know if you need any help finding that and I would be happy to figure out how to post a link.
Two more things I would ask your doctor for is muscle relaxers and since you said you take antidepressants, I would ask to increase the dose for the first month or so until you start feeling human again. He may so ?hell no? but I would ask.
Once you get off of the comfort meds, and aren?t taking anything that you don?t tend to take long term, you will feel better. Slowly but surely. Until then, you should expect to feel in varying degrees of discomfort. But you can totally do it if you are ready to quit. Honestly, out of everything I said, I think finding someone to hold your meds is going to be one of the most important parts.
Phew - sorry for all the information and for what doesn?t make sense. let me know if you have any other questions.
- VE