Buprenorphine - Switch to full agonist to shorten withdrawal

[TahitiMel]

Hello,

I have been on subutex (buprenorphine without naloxone) for 4 months to detox from a 3 months heroin binge.

Before that I was occasional user of heroin, morphine and 3-meo-pcp for 2 years to help with my lower back-pain issue and enhance / stabilize my mood, trying each time to stop before being physically dependant on it.

I started at 4mg and am now stable at 2mg : 1 on morning and 1 on mid-afternoon.
However, I’ve never felt that good with this treatment which gives me tons of anxiety (specifically on evening, even when I split my dose), lack of motivation, anhedonia, irritability...
I wake up every morning in mild-withdrawal and when it kicks in, I feel physically better but have no desire to do anything nor talking with people (normally I am a very sociable person).

4 days ago, my back pain was so severe and I relapsed on heroin. It tooks care of my pain, gave me back my energy, made me sociable like I was before sub and so on...
A lot of positive things happened in my life recently, I have a wonderful girlfriend (note that she is a doctor and doesn’t know I am an addict) and I am about to launch my own business so I really want an opiate-free life to enjoy all of that.
I am afraid to switch back to sub and feeling weird again, as I am to continue my taper plan. In addition, I know that withdrawal becomes harder as the time on sub increases and I can’t afford a month long w/d.

I am strongly thinking being 3 more week on full agonist to get rid of the subutex withdrawal then go cold turkey. I know it sounds risky but I really want to live sober again and a long withdrawal could really have consequences on my job and relationship.

Do you think this plan could work ? If not, any advice to avoid those nasty side-effects ?

Is the PAWS worse on full agonist than on partial agonist ?

Thank you

 

[Mafioso]

Seems pretty risky to me, a lot of things could work but doesn't mean they are good ideas.. what was the reason for going on Subutex in the first place after the 3 month h binge?

I would think PAWS would be less severe on a partial agonist, but you are going to experience PAWS from both.. it's not just the last drug you used unfortunately. It would be more dependent on what type of drugs you were using for how long, and in what amounts.

 

[TahitiMel]

Thanks for your response.



I started with subutex mainly to avoid withdrawal and seeing if this could help with pain.

The goal when starting was to do it for a short period. I followed my two weeks plan and reduced from 4mg to 0,2mg with minimal pain. Unfortunately, I had stressful days at the end of this taper and decided to increase my dosage to 3mg (supported by my doc), thinking it was not the best time to stop opiates for good.

Then I had serious mood issues at this dosage (the weird feeling I was talking about) so slowly diminished to reach the 2mg mark but even with this « low » dose I am not feeling like myself and have a lot of anxiety / pre-withdrawal 10 hours after my last dose.

This and the bunch of horror stories I read on the long withdrawal associated with long-term buprenorphine usage made me think that maybe it’s the good time to stop it all

 

[Eastender]

Hello,

I have been on subutex (buprenorphine without naloxone) for 4 months to detox from a 3 months heroin binge.

Before that I was occasional user of heroin, morphine and 3-meo-pcp for 2 years to help with my lower back-pain issue and enhance / stabilize my mood, trying each time to stop before being physically dependant on it.

I started at 4mg and am now stable at 2mg : 1 on morning and 1 on mid-afternoon.
However, I’ve never felt that good with this treatment which gives me tons of anxiety (specifically on evening, even when I split my dose), lack of motivation, anhedonia, irritability...
I wake up every morning in mild-withdrawal and when it kicks in, I feel physically better but have no desire to do anything nor talking with people (normally I am a very sociable person).

4 days ago, my back pain was so severe and I relapsed on heroin. It tooks care of my pain, gave me back my energy, made me sociable like I was before sub and so on...
A lot of positive things happened in my life recently, I have a wonderful girlfriend (note that she is a doctor and doesn’t know I am an addict) and I am about to launch my own business so I really want an opiate-free life to enjoy all of that.
I am afraid to switch back to sub and feeling weird again, as I am to continue my taper plan. In addition, I know that withdrawal becomes harder as the time on sub increases and I can’t afford a month long w/d.

I am strongly thinking being 3 more week on full agonist to get rid of the subutex withdrawal then go cold turkey. I know it sounds risky but I really want to live sober again and a long withdrawal could really have consequences on my job and relationship.

Do you think this plan could work ? If not, any advice to avoid those nasty side-effects ?

Is the PAWS worse on full agonist than on partial agonist ?

Thank you

Hi , I'm going through a similar situation myself, I'm down to 4mg daily but occasionally relapse smoking 1/2 a gram daily then switch back to espranor, surely a partial agonist will be a better option to taper down than a full, maybe get some benzos , sleepers etc ready for when you come off either, best of luck ,

 

[TahitiMel]

Thank you Eastender, good luck too if you want to stop. How long have you been on espranor ?

I have some benzo and Lyrica to ease the symptoms, I will ask my doc for Clonidin because the hot / cold flashs are my worst ennemies during withdrawal.

I have been on full agonist for 10 days now and feel tired of this opiate life, this routine of waking sick, alternating between sadness and fake happiness during the day... I really hope this time will be last.
My plan is to switch to prolonged release Dihydrocodeine on next week and gradually taper from 240mg to 0 (with 60mg increments).

 

[Eastender]

Thank you Eastender, good luck too if you want to stop. How long have you been on espranor ?

I have some benzo and Lyrica to ease the symptoms, I will ask my doc for Clonidin because the hot / cold flashs are my worst ennemies during withdrawal.

I have been on full agonist for 10 days now and feel tired of this opiate life, this routine of waking sick, alternating between sadness and fake happiness during the day... I really hope this time will be last.
My plan is to switch to prolonged release Dihydrocodeine on next week and gradually taper from 240mg to 0 (with 60mg increments).

Hi , I've been on espranor for about 8 months, 4 mg daily although I have relapsed a couple of times , I seem to do 6/7 weeks then think I deserve a treat & go get a gram of heroin to smoke over the weekend, crazy really as I drive for a living & have a lovely gf who knows nothing about this sordid secret of mine, hate the guilt etc so really wanna hey away from all this , I'm daily pick up at my local chemist so will try a slow taper off, dont know what to expect with the withdrawal etc, I live in the uk & it's so hard to get meds to help , also dont know what would help anyway, have you any advise on meds that would help me once I'm off to ease withdrawal off buprenorphine, hope your transition goes as smoothly as possible, keep me posted on how you do etc , will give me an insight , best of luck

 

[TahitiMel]

Hi, I know how terrible it could be to keep that kind of secrets to protect loved ones. I strongly advise to start your taper asap, either on bupe or other opioid.

Confort meds like Lyrica or Neurontin are a godsend and can strongly reduce withdrawal. Some people recommend kratom but it could just prolong withdrawal. Also if you can get a prescription of Clonidin, it should help with hot/cold flashes and RLS. Maybe some benzo for sleeping and a lot of willpower.

I started my DHC taper this morning using 360mg pronlonged release (3x120mg) and I feel ok, maybe some RLS but bearable. I plan to decrease by one pill every other day and see how I feel.
The main goal is to stop completely on next week, so 3 weeks after my last bupe dose.
Hope the taper will be ok and reduce withdrawal.
I had a taste of what it could be yesterday morning and have been affraid by the severity of the symptoms. However, I am ready to face this challenge if it’s the price of my new sober happy life.
Good luck with your taper Eastender, I will continue to post here some news about mine hoping it could help others.

 

[Eastender]

Hi, I know how terrible it could be to keep that kind of secrets to protect loved ones. I strongly advise to start your taper asap, either on bupe or other opioid.

Confort meds like Lyrica or Neurontin are a godsend and can strongly reduce withdrawal. Some people recommend kratom but it could just prolong withdrawal. Also if you can get a prescription of Clonidin, it should help with hot/cold flashes and RLS. Maybe some benzo for sleeping and a lot of willpower.

I started my DHC taper this morning using 360mg pronlonged release (3x120mg) and I feel ok, maybe some RLS but bearable. I plan to decrease by one pill every other day and see how I feel.
The main goal is to stop completely on next week, so 3 weeks after my last bupe dose.
Hope the taper will be ok and reduce withdrawal.
I had a taste of what it could be yesterday morning and have been affraid by the severity of the symptoms. However, I am ready to face this challenge if it’s the price of my new sober happy life.
Good luck with your taper Eastender, I will continue to post here some news about mine hoping it could help others.

Hi Tahitimel good luck hope it works out for you, like me we both have a life worth fighting for with gf & work etc, where do you live? Cos I'm a bit worried about going to the doctors & asking for meds to help as dont want social services crawling around & making my gf aware etc, would love to know where to get online meds to help me once off buprenorphine, thanks hope you make it through

 

[TahitiMel]

Sure we have, and we’ll do that for them, and ourselves. Think of the joy you’ll feel when you’ll wake up not sick and full of energy, ready to live your best life... I think a week or two of pain (which can be minimized by tapering and confort meds) is really worth the gain.

As I’m tapering, I start to get more energy and more life feeling if it makes sense. I have tapered to 360mg on morning and 240mg of DHC on evening with minimum disconfort (some restless legs and anxiety but reduced with the help of 200mg dose of Lyrica).
I hope it will be the same when dropping 120mg on morning (finger crossed). If all go well, I’ll jump off next week with a smaller withdrawal.

I live in France and have a very comprehensive GP, she is always ok to prescribe me what I need if I don’t abuse it. Here even the bupe is prescribed by your GP, which makes the process easier.
I don’t know if it’s the same in England but here we don’t need to worry about social services and your medical infos are confidential and no one can access them.

Maybe ask your doctor if it’s ok, and tell him the truth about what you are trying to do (detoxing with taper and confort meds) and it should be ok.
Are you trying to taper your bupe or you want to jump off ?

Best of luck to you !

I’ll do a surprise to my girlfriend and come to visit her (3 hour drive from home) to spend two day with her. I hope I’ll be ok !

 

[Eastender]

Sure we have, and we’ll do that for them, and ourselves. Think of the joy you’ll feel when you’ll wake up not sick and full of energy, ready to live your best life... I think a week or two of pain (which can be minimized by tapering and confort meds) is really worth the gain.

As I’m tapering, I start to get more energy and more life feeling if it makes sense. I have tapered to 360mg on morning and 240mg of DHC on evening with minimum disconfort (some restless legs and anxiety but reduced with the help of 200mg dose of Lyrica).
I hope it will be the same when dropping 120mg on morning (finger crossed). If all go well, I’ll jump off next week with a smaller withdrawal.

I live in France and have a very comprehensive GP, she is always ok to prescribe me what I need if I don’t abuse it. Here even the bupe is prescribed by your GP, which makes the process easier.
I don’t know if it’s the same in England but here we don’t need to worry about social services and your medical infos are confidential and no one can access them.

Maybe ask your doctor if it’s ok, and tell him the truth about what you are trying to do (detoxing with taper and confort meds) and it should be ok.
Are you trying to taper your bupe or you want to jump off ?

Best of luck to you !

I’ll do a surprise to my girlfriend and come to visit her (3 hour drive from home) to spend two day with her. I hope I’ll be ok !

Wow sounds like your doing great at the min & really doing good, pleased for you & its giving me motivation to sort my shit out too. I used this weekend but today went back to espranor (buprenorphine) 6mg daily, I'll do that for 3 days then cut down to 4mgs daily then will probably start a slow taper off buprenorphine, I know I have to do this properly now but my main concern is when I stop taking buprenorphine.. I'm reading about wd symptoms etc , so was just looking into meds that might help me get through that really, I've heard lopermide (immodium) apparently helps those first few days quite well & I can get that otc , it's very hard in the uk to get any sort of meds really now, I'll arrange a meeting with my drug counsellor too maybe I might get some joy.. glad that I have someone who is going through the same to talk too.. wish I had your meds haha, keep me posted on your progress, best of luck bud

 

[Xorkoth]

If you can get gabapentin, it can really help for when you jump off all the way. It is addictive too, but you can take it for a short time (a week or so) to deal with the worst of withdrawal and stop taking it without any issues.

 

[Mafioso]

Sure we have, and we’ll do that for them, and ourselves. Think of the joy you’ll feel when you’ll wake up not sick and full of energy, ready to live your best life... I think a week or two of pain (which can be minimized by tapering and confort meds) is really worth the gain.

As I’m tapering, I start to get more energy and more life feeling if it makes sense. I have tapered to 360mg on morning and 240mg of DHC on evening with minimum disconfort (some restless legs and anxiety but reduced with the help of 200mg dose of Lyrica).
I hope it will be the same when dropping 120mg on morning (finger crossed). If all go well, I’ll jump off next week with a smaller withdrawal.

I live in France and have a very comprehensive GP, she is always ok to prescribe me what I need if I don’t abuse it. Here even the bupe is prescribed by your GP, which makes the process easier.
I don’t know if it’s the same in England but here we don’t need to worry about social services and your medical infos are confidential and no one can access them.

Maybe ask your doctor if it’s ok, and tell him the truth about what you are trying to do (detoxing with taper and confort meds) and it should be ok.
Are you trying to taper your bupe or you want to jump off ?

Best of luck to you !

I’ll do a surprise to my girlfriend and come to visit her (3 hour drive from home) to spend two day with her. I hope I’ll be ok !

I'm not familiar with dihydrocodeine dosage, but 500mg/day seems like a fairly decent amount. I believe that's roughly equivalent to around 80mg of hydrocodone, which isn't a huge amount but still definitely enough to cause quite a bit of discomfort coming off. The withdrawals from that alone will likely last 1-2 weeks, 1st week being pretty horrible, 2nd week things start improving.

I would start trying to get that 500mg/day DHC closer to 250mg/day before stepping off, if possible.

From the sound of it, this is your first time really going through serious opioid withdrawal?

However, I’ve never felt that good with this treatment which gives me tons of anxiety (specifically on evening, even when I split my dose), lack of motivation, anhedonia, irritability...
I wake up every morning in mild-withdrawal and when it kicks in, I feel physically better but have no desire to do anything nor talking with people (normally I am a very sociable person).

This will pretty much be par for the course, regardless of what opioid you are withdrawing from. The bigger difference is in drug half-life, which will determine how fast and intense the WD symptoms will onset and the lift. There isn't a way to completely avoid these things, as they are very common symptoms of post acute withdrawal, but there are ways of managing them other than with more opioids. This is where group therapy, cognitive behavioral therapy, relapse prevention, and other treatments really come into play. To put it simply, recovery is the process of finding healthy ways to stimulate yourself. This is generally extremely uncomfortable at first, and I've yet to meet anyone that enjoys early recovery(withdrawal, heavy PAWs).

4 days ago, my back pain was so severe and I relapsed on heroin. It tooks care of my pain, gave me back my energy, made me sociable like I was before sub and so on...

To be completely honest, this is a bit concerning. If severe back pain is causing you to use, and is part of why you even began using in the first place, then that back pain will need to be addressed in a way that doesn't involve opioids. Whether that means joining yoga, starting physical therapy/rehab, or whatever it may be... it's going to have to be addressed. Just as someone who uses to cope with childhood trauma must address their trauma in order to prevent relapse, addressing your pain will also be key for you.

 

[Eastender]

If you can get gabapentin, it can really help for when you jump off all the way. It is addictive too, but you can take it for a short time (a week or so) to deal with the worst of withdrawal and stop taking it without any issues.

Yeah I've heard that could help, thanks for the info will try to get hold of some

 

[TahitiMel]

A lot of helpful advices, thank you very much Mafioso.
Yesterday I took two pills on morning (240mg) and one on evening (120mg) and felt ok.

So this morning, I only took 120mg with 200mg of Lyrica (a lot of business interactions today so even a mild withdrawal was not acceptable).
Again, I haven’t felt any kind of withdrawal, even on morning before my dose (14h after last dose).
I am very glad this taper is actually working ! I plan to stay on 120mg twice a day till the end of the week (60mg would be great and I will try) and then jump off with the help of Lyrica (really this guy is a godsend and maybe my next painkiller of choice).

My theory is that the DHC covered the bupe / H withdrawal that is now gone, and that’s why I feel better (mentally and physically). I’ll do my best to adjust on the minimal amount before jumping and maybe I would be mildly sick regarding the short time I used this med. Is it possible ?

To answer your question, it’s not my first time dealing with pesky withdrawal but it is my longest period with daily opiate consumption so it could be the worst one. However, I see that I feel good on low doses of DHC, so maybe I’ll dodge the bullet if I tapered seriously !

Further, your concern about my back pain is very pertinent. I think I will try yoga and acupuncture. Opiate worked good to mask the pain, but this experiment on daily opiates showed me it was not the life I want. Maybe the opiate induced hyperalgesia makes thing worse so I will judge the level of pain and how to live with that when opiates will be out of my body. I have a lot of medical appointments to find the root cause. This is a big trigger that made me relapse several time, but this time I will do all I can to stay away from opiates.

 

[Eastender]

If you can get gabapentin, it can really help for when you jump off all the way. It is addictive too, but you can take it for a short time (a week or so) to deal with the worst of withdrawal and stop taking it without any issues.

Hi I've just got a load of 300mg gabapentin tablets of a friend of mine who gets monthly scripts, I have no experience of these early all , so can I pick your brain about info etc? So what sort of dosage would you recommend for when I jump off etc & for how long? Thanks

 

[Xorkoth]

I wouldn't take it more than 7 days in a row, as it has a pretty severe withdrawal when you become dependent. Your gut can only absorb about 300mg of gabapentin per 30-45 minutes, so if you take a bunch at once, most of it will pass through without absorbing and be wasted. So what I do is take one 300mg pill per 45 minutes until I'm where I want to be. Although it won't peak until about 2 or 3 hours in, you'll start feeling it after about an hour (depending on your sensitivity... I've met people where 300mg was enough to get a strong high, but t hat's very rare, usually it requires around 900-1200mg, but again, you have to take them spread out otherwise you're only going to absorb a fraction of it).

Gabapentin will help quite a bit with the RLS, and the depression and anxiety, and the physical discomfort. It really does work quite well, it will almost totally block minor withdrawal... major withdrawal it will be less effective against.

 

[Eastender]

I wouldn't take it more than 7 days in a row, as it has a pretty severe withdrawal when you become dependent. Your gut can only absorb about 300mg of gabapentin per 30-45 minutes, so if you take a bunch at once, most of it will pass through without absorbing and be wasted. So what I do is take one 300mg pill per 45 minutes until I'm where I want to be. Although it won't peak until about 2 or 3 hours in, you'll start feeling it after about an hour (depending on your sensitivity... I've met people where 300mg was enough to get a strong high, but t hat's very rare, usually it requires around 900-1200mg, but again, you have to take them spread out otherwise you're only going to absorb a fraction of it).

Gabapentin will help quite a bit with the RLS, and the depression and anxiety, and the physical discomfort. It really does work quite well, it will almost totally block minor withdrawal... major withdrawal it will be less effective against.

Thanks for your invite, very helpful, I'm tapering down off a buprenorphine script , 6 week slow taper , then just wanted something incase I feel uncomfortable for a week or so , hopefully gabapentin & lomeride will help which I've been told , thank you again

 

[TahitiMel]

Hey all,
Thanks for all your useful reactions. i would like to give you some news about my taper and jump.
I tapered comfortably to 240mg once a day the last 3 days.
Even if the best would be to taper from this dose, I jumped to nothing this morning and I’m actually in cold turkey.
It is the best time for me because my girlfriend is gone for 2 weeks, I strongly hope that I’ll be free from opiates and feel humain again when I’ll see her.
I have all the symptoms of withdrawal (RLS, Hot / Cold flashes, headache, etc.), it is not that bad because I have all the comfort meds I need to control the symptoms. The most useful being Lyrica (300mg when needed, calms down RLS and anxiety), some nice hash for the mood and pain, and maybe xanies that seems to help me sleep.

Let’s see how it goes tomorrow, I hope I will sleep and it will reach a plateau tomorrow.

So to sum up, I stopped bupre 3 weeks ago, took h for about 2 weeks and switched to DHC foe one week to taper. Now I’m 1 day free from opiates and it’s not too bad.

Thank you all for support ! I’ll post some updates later

 

[Eastender]

Hey all,
Thanks for all your useful reactions. i would like to give you some news about my taper and jump.
I tapered comfortably to 240mg once a day the last 3 days.
Even if the best would be to taper from this dose, I jumped to nothing this morning and I’m actually in cold turkey.
It is the best time for me because my girlfriend is gone for 2 weeks, I strongly hope that I’ll be free from opiates and feel humain again when I’ll see her.
I have all the symptoms of withdrawal (RLS, Hot / Cold flashes, headache, etc.), it is not that bad because I have all the comfort meds I need to control the symptoms. The most useful being Lyrica (300mg when needed, calms down RLS and anxiety), some nice hash for the mood and pain, and maybe xanies that seems to help me sleep.

Let’s see how it goes tomorrow, I hope I will sleep and it will reach a plateau tomorrow.

So to sum up, I stopped bupre 3 weeks ago, took h for about 2 weeks and switched to DHC foe one week to taper. Now I’m 1 day free from opiates and it’s not too bad.

Thank you all for support ! I’ll post some updates later

Tahitimel well done you, glad to hear your on track with your taper & doing well, hope it all works out for you, you seem pretty determined so I'm sure it will, as for myself I've gone down from 6mg daily subutex (espranor) to 4mg , this week will go to 3 & so on , I've got hold of some gabapentin through a friend 300mg tablets , been told they will help when I finally jump off, will get some other meds along the way as not looking forward to finally leaving buprenorphine as been told it's not nice etc, keep up the good work & keep me posted on your progress, best of luck Eastender

 

[tukabirdy]

Hey there eastender, I haven't been here in quite a while as I have me own little corner of cyberland to deal with. It's a very small sub detox forum but we invite all sorts of bitching, moaning, pissiness and general Bullshit. It's American but don't hold that against us.
Anyhoo....just go as slow as you can. Rule of thumb for us is 25% reduction every 10 days or until your body reaches homostasis. Some say this is too show but getting into the real low numbers helps very much with the acute shit.
Good luck in your taper and jump, tuka