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Opioids Can anyone give tips on how to sleep during opiate/opioid withdrawal?

plumbus-nine

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Apr 4, 2021
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Mexico
Loperamide to stop the shits and pregabalin (best aid, w/o tolerance to it it's pretty much like a narcotic), centrally acting antihistamines like OTC diphenhydramimne/doxylamine, or mirtazapine (strongest antihistamine available) ... clonidine, possibly a SSRI aid with the restlessness. If you respond to it and don't have tolerance too, OTC DXM can be a very good aid too.
 

Sunyecho

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Trying to find my self but unable so far.
Depends on the severity of the withdrawal. For me, a few times sleep was not an option, and when I stopped buprenorphine a year and a half ago I haven't slept more than 2 hours a day, in 3 weeks, no matter what I took. I used pregabalin (Lyrica) + clonazepam (Klonopin) + diazepam (Valium) + midazolam (Versed/Dormicum) + zolpidem (Ambien) +mirtazapine (Remeron) + melotonin +..."all other natural sleep aids". I have big tolerance to benzos though. The only thing I haven't tried is quetiapine (Seroquel) and clonidine. Sometimes sleep is really not an option. For less severe withdrawal pregabalin should suffice. From there on you add on what you are most comfortable with (near full list disclosed in this post and post above already). Hope it doesn't get that rough though.

-echo (formerly PL)
 

plumbus-nine

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Joined
Apr 4, 2021
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Mexico
For higher doses tapering is easier imho and becomes more and more difficult the more you get close to zero. Also I'd really really invest into some emergency stock which you buy and put somewhere deep into the cabinet only to touch when you're running out. Taper down with that as much as possible - it can save you big amount of suffering. Also really really get a script for pregabalin - if you can get only one med, get that! Dunno, the docs say clonidine, don't know whether for serious dependencies that one is to prefer but imho pregabalin is a different level, without tolerance you won't need the supratherapeutic dosages sometimes mentioned but tolerance builds incredibly fast so don't use until necessary.

Seroquel is shit. The only usable dosages are like max. 50mg and below, better 25mg and below. With any higher you'll get relevant amounts of a metabolite which acts as a norepinephrine reuptake inhibitor and this increases withdrawal intensity. Also the dopamine antagonistic properties will add to the shitty feelings of which a good amount comes from the sudden drop in dopaminergic activity, you want more of that not less.

If you happen to have an open minded doc, or to live in a part of the world where access to medicine is more liberal, get memantine. Really. Research it beforehand, it's a strong tool when used above the indicated dosages, but also exceptionally safe for the body (people tolerate 200mg and upwards - depending on your individual constitution, this much can and will put you into a coma for several days, but it won't kill you). For me like 60mg could mask the withdrawal from 120mg morphine XR completely and after the second administeration tolerance was low enough for regretting to take 15mg. It's got its rough edges but it works. Pregab + memantine (+ loperamide and other comfort meds if needed) make the best currently available withdrawal aid imho. The memantine is initially stimulating (not the cold restless variant but usable energy) but at day 2 or 3 you'll sleep.

Dextromethorphan might work similarly when tolerated.
 

Xorkoth

Administrator
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Messages
57,026
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In the mountains
Clonidine helps a lot, it removes the RLS and creepy crawlies pretty well and also makes you somewhat tired. Gabapentin or, even better, pregabalin, will do the best of anything (besides an opioid which obviously is counterproductive) at eliminating withdrawal and will help you sleep, though they can be kind if stimulating. But phenibut, though it is also a gabapentinoid, is not so good as it increases the limb pain and can increase RLS as well, though it is good for mood.

Loperamide is an opioid and helps a LOT (at 40mg-60mg) in removing the physical symptoms, it does not cross the blood brain barrier but will attach to peripheral neurons throughout the body and will help a lot because of that. But I don't like to take it daily, so my preference is alternating gabapentin or pregabalin and loperamide, with clonidine as needed (as it is not addictive).
 

FunctionalJnkieGrl

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Joined
Mar 22, 2020
Messages
510
Location
OK/TX, USA
Loperamide to stop the shits and pregabalin (best aid, w/o tolerance to it it's pretty much like a narcotic), centrally acting antihistamines like OTC diphenhydramimne/doxylamine, or mirtazapine (strongest antihistamine available) ... clonidine, possibly a SSRI aid with the restlessness. If you respond to it and don't have tolerance too, OTC DXM can be a very good aid too.
I take ZzzQuil nightly (which is basically just diphenhydramine with alcohol) and it does help with restlessness to some extent.
 

FunctionalJnkieGrl

Bluelighter
Joined
Mar 22, 2020
Messages
510
Location
OK/TX, USA
Depends on the severity of the withdrawal. For me, a few times sleep was not an option, and when I stopped buprenorphine a year and a half ago I haven't slept more than 2 hours a day, in 3 weeks, no matter what I took. I used pregabalin (Lyrica) + clonazepam (Klonopin) + diazepam (Valium) + midazolam (Versed/Dormicum) + zolpidem (Ambien) +mirtazapine (Remeron) + melotonin +..."all other natural sleep aids". I have big tolerance to benzos though. The only thing I haven't tried is quetiapine (Seroquel) and clonidine. Sometimes sleep is really not an option. For less severe withdrawal pregabalin should suffice. From there on you add on what you are most comfortable with (near full list disclosed in this post and post above already). Hope it doesn't get that rough though.

-echo (formerly PL)
I take Melatonin and ZzzQuil nightly on top of my pain meds. I never cared for xanax, valium, ambien, or seroquel though. They make me feel drained in the worst way.
 

FunctionalJnkieGrl

Bluelighter
Joined
Mar 22, 2020
Messages
510
Location
OK/TX, USA
For higher doses tapering is easier imho and becomes more and more difficult the more you get close to zero. Also I'd really really invest into some emergency stock which you buy and put somewhere deep into the cabinet only to touch when you're running out. Taper down with that as much as possible - it can save you big amount of suffering. Also really really get a script for pregabalin - if you can get only one med, get that! Dunno, the docs say clonidine, don't know whether for serious dependencies that one is to prefer but imho pregabalin is a different level, without tolerance you won't need the supratherapeutic dosages sometimes mentioned but tolerance builds incredibly fast so don't use until necessary.

Seroquel is shit. The only usable dosages are like max. 50mg and below, better 25mg and below. With any higher you'll get relevant amounts of a metabolite which acts as a norepinephrine reuptake inhibitor and this increases withdrawal intensity. Also the dopamine antagonistic properties will add to the shitty feelings of which a good amount comes from the sudden drop in dopaminergic activity, you want more of that not less.

If you happen to have an open minded doc, or to live in a part of the world where access to medicine is more liberal, get memantine. Really. Research it beforehand, it's a strong tool when used above the indicated dosages, but also exceptionally safe for the body (people tolerate 200mg and upwards - depending on your individual constitution, this much can and will put you into a coma for several days, but it won't kill you). For me like 60mg could mask the withdrawal from 120mg morphine XR completely and after the second administeration tolerance was low enough for regretting to take 15mg. It's got its rough edges but it works. Pregab + memantine (+ loperamide and other comfort meds if needed) make the best currently available withdrawal aid imho. The memantine is initially stimulating (not the cold restless variant but usable energy) but at day 2 or 3 you'll sleep.

Dextromethorphan might work similarly when tolerated.
Morphine and oxy are pretty much the only pain meds I mess with these days. I absolutely hate seroquel and DXM though.
 

FunctionalJnkieGrl

Bluelighter
Joined
Mar 22, 2020
Messages
510
Location
OK/TX, USA
Stay away from benadryl and antihistamines during withdrawal as mentioned by a mod in another thread it will trigger horrible rls and anxiety. This actually caused me to ruin a withdrawal and relapse one time because I took a benadryl and it was crazy RLS and anxiety.
I can vouch for diphenhydramine causing RLS in higher doses, but taking the recommended dose has served me well so far.
 

axe battler

Moderator: SLR
Staff member
Joined
Aug 4, 2009
Messages
2,032
Zopiclone or zolpidem if poss. I like quetiapine at doses of 50mg as a sleep aid. Also promethazine. Also obviously benzos and dxm and if you don't need to give up opiates immediately then weak OTC nurofen plus etc also helps with the discomfort, the fever and obviously gives you a tiny amoutof opiate (though this will set you back). Loperimide.
 

Xorkoth

Administrator
Staff member
Joined
Feb 8, 2006
Messages
57,026
Location
In the mountains
That's my fiance's suggestion for anything. Haha. It helps, but I can't stay in there forever and then its back dealing with discomfort once I step out of the shower.

You can't, it's true, but it does help give you a reprieve. The only time I feel halfway decent during opioid withdrawal is during a hot shower.
 

The Shadow Self

Bluelighter
Joined
Feb 17, 2013
Messages
316
I agree with some of those people that said depending upon the severity of the WDs, there are some times when sleep is not going to happen. For example, having been through the drama with various opiates/opiods (Hydrocodone, Oxycodone, Morphine, Fentanyl), I can tell you that Fentanyl was the most extreme WD torture I have ever experienced, by far. There was pretty much zero sleep during the first week or so, which exacerbated the nightmare of the affair wildly. Even after that, the PAWS was insane, and I really did not sleep properly for many months. Again, made the WDs far more torturous. Just what your brain and body DON'T need when you are trying to heal, of course. Even boatloads of Valium did almost nothing, other than make me feel brain dead. Tried Trazadone, did nothing but make me feel like complete garbage. I tried pretty much everything and every combination of things and in the end, I just could not do anything other than pass out occasionally, for short periods, usually minutes. Even the morphine, as bad as it was, was nothing compared to the Fent WDs. There is nothing anyone could ever do to convince me to touch that shit ever again. This Fent experience was the closest thing to a living nightmare that I could have ever imagined, and again, even morphine was easier, as shitty as that was.

Anyway, good luck, my friend. Things will get better if you get off the opiates. Once the hooks are out of you, you will begin feeling better. If I can do it, anyone can.
 
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