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Opioids Helping someone through a codeine addiction

Exoaria

Greenlighter
Joined
Apr 18, 2017
Messages
4
This is my first time posting in Bluelight though I have followed this forum for years.

Ironically, the one time I needed to post here, I'm not using the SWIM abbreviation to reference myself. Someone very dear to me is getting very sick.

I've been abusing codeine for a long time. It's only recently that I've stopped taking it, and it was hard. However, it was the mutual drug addiction between me and my best friend that brought us together. She'd recently been having terrible stomach pains, and I deduced it down to the APAP toxicity. It wasn't hard to figure out with the amounts she was taking, and so she was in a great amount of pain but couldn't take any more of the drug. I helped her by sourcing some medical marijuana and she was okay until she took another 30-something tablets of APAP/Codeine yesterday, and that was when her liver collapsed. Thankfully it was a minor failure, as far as failure goes. Heavy symptoms of a paracetamol overdose.

This friend of mine is very fragile. She won't see a doctor. She won't go to a hospital. Sources all her pills through family. She's extremely antisocial, seldom leaves the house, and I'm quite literally her entire friendship group. Caring for someone this dysfunctional is hard, but it's a decision I've made, and I want some advice before I take any action. I'm not a professional. She's very clever, and if she'd gone to hospital she'd just leave. The laws here require certain requirements to be met before someone is able to be detained, and she has a perfectly clean record in terms of drugs and mental health. I say this because assisting her in seeking medical help is not an option. I understand someone else's life is their responsibility and not mine, so with that information granted I'd appreciate some advice as to what my options may be.

Here are the current (immediate) paths I feel I can take in assisting her:
  • CWE a lot of codeine and give them to her in small amounts that can't be abused.
  • Give her some oxycodone, methadone, morphine or endone in small amounts.

We've spoken, and we both agree that the goal here is to subside the withdrawal symptoms as much as possible until she is able to taper off. Rehabilitation and medical assistance is not an option. Tapering off using paracetamol based products is not an option, she's pushed her liver too far. She's suffering, and the bottom line in our eyes is that she basically needs something to get her through these withdrawals until she can manage things herself.
She's irresponsible and most of you would probably feel that she's being a brat and should suck it up and see a doctor. I agree, but it's not going to happen.

I understand that nobody here is [likely going to be] a medical professional. I'm not looking for professional advice, just advice from other people who've had similar experiences or have some input as to what they would do if they were in my shoes.
 
Hey Exoaria, & welcome to the BL community. Sorry that your first post is due to your unwell friend.

Firstly, I would in no way introduce stronger opioids into the mix if you & your friend are truly committed to ditching a codiene addiction.

CWE is probably the only way to do a safe taper. I guess hindsight is a wonderful thing. Lack of knowledge prior to coming across BL many years ago was my downfall into liver failure. Poppy seed tea might help,- worth trying.

There are many opiate wd threads, however usually relying on other substances/meds to get through the first five or so days of acute wd.

Your friends liver is clearly under pressure, & adding other toxins to make it work harder are not advisable. With the exception of vitamin k. This is needed for blood clotting. Once your liver reaches a certain stage of failure you can only survive with regular blood transfusions, not an option if your friend won't be admitted to hospital.

Not sure where you're located, however if your friend is showing signs of more than apap poisoning eg: vomiting regularly, no appetite, yellow tone to skin & whites of eyes, itching all over, grogginess, I'd call an ambulance & if she is as unwell as it sounds, the hospital will section her against her will. (Reminds me of running away & cops being sent after me. Though they also would allow family to take me back).

Yes, you might be the arsehole for some time, but you could also be saving your friends life.

I went from palliative at 24, to being a strong & healthy mama at 27 yrs old. Don't wait until it's not such a happy ending.

Glad you reached out,

Rtp
 
I went from palliative at 24, to being a strong & healthy mama at 27 yrs old. Don't wait until it's not such a happy ending.

Glad you reached out,

Rtp
Thank you for your response. It was helpful and contained valuable insight. You've certainly come out of a lot of shit for the better, and that gives me some hope both for me and the people I care about.

I'll definitely keep in mind everything that you've said to me here.
 
i would go for the CWE codeine if you trust in your own ability to safely filter out the paracetemol, if not i would try and get her on bupe or methadone.
that being said, those two are pretty heavy duty substances to go from just codeine - but if your friend is killing her liver with all those unfiltered tablets and you don't feel you could safely give her pure codeine extract then they may be the only way to go.
 
The "best" codeine to paracetamol ratio I've seen in pills was 20/300 which is still hardly good enough for you to be able to take a high enough dose of codeine to feel much opioids effects and get addicted without suffering from liver toxicity very shortly. 30 15/500 pills were enough to send a friend of my friend into a coma, she managed to survive only because people were present when she collapsed and called the ambulance right away. Your friend might not be as lucky if she keeps doing this.

As shocking as it may sound, at the moment I guess she's better off progressing into harder opioids than continuing to take higher and higher doses of codeine in pills with paracetamol, seriously. As for stabilization and tapering off, buprenorphine is her best bet if she can't do a CWE (and there is really no good excuse not to do it!). If you fail at filtering, then filter again, really, you neither need any advanced lab skills to do it nor advanced or expensive/hard-to-get equipment, basically two glasses and a few tissues or some toilet paper is all you need to do it properly, some tea strainer for more convenience and control at most. IMO it's not about trusting your ability, it's about 10-minute practice at most to do it right.
 
i would go for the CWE codeine if you trust in your own ability to safely filter out the paracetemol, if not i would try and get her on bupe or methadone.
If I were trying to give myself advice, this is probably one of the first things I'd say. It's something that definitely went through my mind, but a few years ago I was doing this regularly. Besides, anything that I gave to her, I'd consume first to make sure it's okay. This sounds like the best method.

As for stabilization and tapering off, buprenorphine is her best bet if she can't do a CWE (and there is really no good excuse not to do it!). If you fail at filtering, then filter again, really, you neither need any advanced lab skills to do it nor advanced or expensive/hard-to-get equipment, basically two glasses and a few tissues or some toilet paper is all you need to do it properly, some tea strainer for more convenience and control at most. IMO it's not about trusting your ability, it's about 10-minute practice at most to do it right.
You're correct. There's not really any excuse to not do CWE. Bupe would be expensive and carry other risks, whereas CWE is straightforward and I'm very competent with the procedure.
 
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