• H&R Moderators: VerbalTruist | cdin | Lil'LinaptkSix

Detox IV fentanyl withdrawal

I'm 33 now. Started heroin iv when I was 15 to 21ish few jail visits to get clean, did about 2years clean on naltraxone (hated that drug) got habbit again and went on subutex for few years still using gear. then meth for about the last 7 years. Dabbled a lot while on meth, not used anything for months now, just meth. Finally had enough, I would panic and go score within a day of withdrawals if this was a year ago. I hate that I've wasted so much of my life on that shit
 
Gotcha. So you know the deal. It isn't going to be easy coming off it. The hardest part is going to be the support system you can create for yourself IRL. Life family, friends, hobbies, and some kind of community. Do you feel like you have people who can support you in your efforts? Finding people you can rely (relying on reliable people LOL) is so necessary if you want to change things up in a sustainable way.

At least with the comfort meds you listed, you should get through the acute withdrawal syndrome relatively comfortably (all things considered). Again, it isn't going to be a walk in the park, but it won't be nearly as bad as it could be either. It's important you take the medications at regular intervals systematically and plan everything out in advance. Have you formulated a dosing schedule for the meds you're going to be using?

I'd be happy to work with you to help you do that, at least come up with a rough draft like.

TBH I also used DXM and iboga when I was coming off methadone, and those two substance (both aren't necessary, either one would suffice) can truly make a huge difference in overcoming the psychological aspect of the cravings during withdrawal/detoxification.
 
Yes any advice is greatly appreciated, only time I've ever detoxed properly was forced by jail, last time was years ago.hardly used benzo's and not used seroquel.not heard of dxm before.
Im back at mother's for time being to sort all this out, so I have great family support, and have normal friends that don't use. Even brought a mountain bike 6weeks ago, use that regular now. But the lower I get on the meth, the more I got to force myself to go out on it lol.
 
Can you put a list of all the medication you will have access to for your detox together for me? Then I will whip up a schedule for you as far as dosing goes for your meds. I just need to know what medications you will have (diazepam, loperamide, codeine+APAP and buprenorphine IIRC) and what dosages you have access to.

That is awesome to hear you have your family supporting you. That makes a huge difference. And the bike is awesome as well. When I was detoxing off methadone I would go out night hiking when I couldn't sleep just to keep myself occupied, so going for a late night bike ride sounds like it might work out just as well for yourself :)
 
I'll have 56 diazipan, 18 lopermide, 24 Nurofen + ( they are 200mg ibuprofen + 12.5 codine) 10 x 200mg seroquel. I can get more of all of them except the seroquel. Can only get subutex if i swap from meth with my drug worker. Plus I can get any otc meds. I'm coping a lot better than I thought, but know it's going to get worse when I get to 10ml and below. I will defobstard riding at night, might help with the sleep.
 
What dose are you currently at and what do you envision the rest of your taper looking like? Have you chosen a dose you want to jump off from or are you planning to go all the way down to 0mg by reducing your dose 1mg/week?

Is that 56mg of diazepam or 56 pills? And is that 18mg of loperamide of 18 pills?

Basically once you get around 10mg/day of methadone you can switch to taking codeine (do a cold water extraction to avoid messing up your liver/stomach from all the IBU) for a couple days, then hop onto buprenorphine for a week to get through the acute withdrawal. You'll probably still need to use the diazepam, loperamide and seroquel to get through the other symptoms comfortably, but the buprenorphine will really help if you can get it.
 
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I'm on 14ml daily meth now. Planning on reducing 1ml/day getting to 2ml the stopping completely. I have 56 x 10mg diazipan. 18x 2mg lopermide. Also thinking about getting some sleepers. Can get good amount of zopiclone 7.5mg , nitrazipam 5mg or xanax 1mg any advise on 1 of them. Can also get 60mg codine tablets? If that's better than the Nurofen plus?
 
Yes, 60mg codeine tablets would work much, much better for your purposes than Nurofen Plus. In terms of sleeping meds, I'd suggest zopiclone 7.5mg over nitrazepam or alprazolam (considering you're already going to be taking diazepam, you don't need to add another benzodiazepine to the mix). If you can, do try and get yourself some clonidine and gabapentin (those two meds help a lot for opioid withdrawal - there is literally no reason a doctor worth their license wouldn't prescribe them to treat the symptoms of acute opioid withdrawal).

Ideally this is what I would suggest (it will result in a pretty darn comfortable experience coming off the methadone):

  1. Continue your taper reducing your dosage at 1mg/week until you are down to 10mg.
  2. Discontinue your methadone completely and start taking 300mg of codeine once to twice a day for three to four days (you won't need any other meds when taking this much codeine, other than MAYBE seroquel or zolpiclone for insomnia).
    • Make sure you don't take more than 300mg at a time; there can be a dangerous histamine reaction that happens to many people around 400mg.
    • Do not take a second dose of codeine while you still feel the effects of the previous dose of it. It will make you feel "good" but don't try and chase the high, or else you risk a codeine OD - which is a very unpleasant histamine reaction (hives on steroids basically).
  3. Discontinue the codeine and begin taking buprenorphine, waiting to induct yourself on the buprenorphine 12-24hrs after your last dose of codeine.
    • DO NOT take the buprenorphine on the same day/right after taking codeine.
    • Wait until the following day to take it, at the very least 12 hours after your last dose of codeine.
    • The longer you can wait to take the buprenorphine the more effective it will be, so if you can make it a full 24 hours that is grand.
    • Take 2mg of buprenorphine intranasally or sublingually twice a day.
    • If you have Subutex it is more effective to sniff the stuff, but if you have a sublingual only formulation like the Suboxone strips you can use an ethanol based mouthwash like Listerine to increase the bioavliability and make it almost as effective as sniffing it.
      • Take the buprenorphine at the same time and in the same fashion (the same route/method of administration) each day. It is important to be as consistent as possible with this.
      • Continue to take the buprenorphine for a minimum of seven days and a maximum of two weeks (the acute withdrawal of methadone doesn't last longer than 7-14 days).
      • You don't need to taper off the buprenorphine. On the last day you are taking it just stop taking it. Ideally you should only really be taking it for seven to ten days, if you can get away with only taking it for a week it would be safer (in terms of making it easier on your body to transition to a state of existence that doesn't involving eating potent exogenous endorphins like methadone, codeine or buprenorphine).
  4. Each day you take the buprenorphine take 10mg of diazepam twice a day; 10mg diazepam with each dose of buprenorphine.
  5. At night take a Seroquel or zopiclone when you are going to bed.
  6. Take loperamide as needed for GI issues (you may not need any of this at all, especially if you make sure to eat a high fiber diet and hydrate, which which are both very helpful in withdrawal).
  7. When you discontinue the buprenorphine, discontinue all the other medication as well except what you need to help you sleep (so stop taking diazepam and loperamide when you stop taking the buprenoprhine)
    • Continue taking sleeping meds to help you get through the first month off methadone.
    • Be aware that you can become dependent on z-drugs like zopiclone, so be careful not to take the stuff longer than necessary - and if you struggle to sleep for a while when you stop taking it be aware that this is why.
    • Non-gabaergic stuff like Seroquel and Trazadone may be more helpful to treat the insomnia during the PAWS, once the acute withdrawal is over.
    • Avoid using benzodiazepines and z-drugs to treat insomnia any longer than absolutely necessary

The only symptoms you'll probably struggle with are going to be some minor RLS and hot/cold flashes/sweating (if you had clonidine it would prevent the latter). Remember that it will take your body a while to transition to life without opioids. It takes a while no matter how you do it. So expect a certain level of "natural" discomfort as your system acclimatizes to life without exogenous endorphins.

You can do this brother! Remember that a constructive/positive and realistic (not fatalistic, but practical) attitude is probably the most important piece of the puzzle when it comes to moving beyond the acute withdrawal from methadone and other opioids :)
 
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Seriously thank you for spending the time preparing that, It looks like it will help so much. Ill sort out all the meds then I'll let you know when I'm at 10ml, and how it goes ??
 
Yes, 60mg codeine tablets would work much, much better for your purposes than Nurofen Plus. In terms of sleeping meds, I'd suggest zopiclone 7.5mg over nitrazepam or alprazolam (considering you're already going to be taking diazepam, you don't need to add another benzodiazepine to the mix). If you can, do try and get yourself some clonidine and gabapentin (those two meds help a lot for opioid withdrawal - there is literally no reason a doctor worth their license wouldn't prescribe them to treat the symptoms of acute opioid withdrawal).

Ideally this is what I would suggest (it will result in a pretty darn comfortable experience coming off the methadone):

  1. Continue your taper reducing your dosage at 1mg/week until you are down to 10mg.
  2. Discontinue your methadone completely and start taking 300mg of codeine once to twice a day for three to four days (you won't need any other meds when taking this much codeine, other than MAYBE seroquel or zolpiclone for insomnia).
    • Make sure you don't take more than 300mg at a time; there can be a dangerous histamine reaction that happens to many people around 400mg.
    • Do not take a second dose of codeine while you still feel the effects of the previous dose of it. It will make you feel "good" but don't try and chase the high, or else you risk a codeine OD - which is a very unpleasant histamine reaction (hives on steroids basically).
  3. Discontinue the codeine and begin taking buprenorphine, waiting to induct yourself on the buprenorphine 12-24hrs after your last dose of codeine.
    • DO NOT take the buprenorphine on the same day/right after taking codeine.
    • Wait until the following day to take it, at the very least 12 hours after your last dose of codeine.
    • The longer you can wait to take the buprenorphine the more effective it will be, so if you can make it a full 24 hours that is grand.
    • Take 2mg of buprenorphine intranasally or sublingually twice a day.
    • If you have Subutex it is more effective to sniff the stuff, but if you have a sublingual only formulation like the Suboxone strips you can use an ethanol based mouthwash like Listerine to increase the bioavliability and make it almost as effective as sniffing it.
      • Take the buprenorphine at the same time and in the same fashion (the same route/method of administration) each day. It is important to be as consistent as possible with this.
      • Continue to take the buprenorphine for a minimum of seven days and a maximum of two weeks (the acute withdrawal of methadone doesn't last longer than 7-14 days).
      • You don't need to taper off the buprenorphine. On the last day you are taking it just stop taking it. Ideally you should only really be taking it for seven to ten days, if you can get away with only taking it for a week it would be safer (in terms of making it easier on your body to transition to a state of existence that doesn't involving eating potent exogenous endorphins like methadone, codeine or buprenorphine).
  4. Each day you take the buprenorphine take 10mg of diazepam twice a day; 10mg diazepam with each dose of buprenorphine.
  5. At night take a Seroquel or zopiclone when you are going to bed.
  6. Take loperamide as needed for GI issues (you may not need any of this at all, especially if you make sure to eat a high fiber diet and hydrate, which which are both very helpful in withdrawal).
  7. When you discontinue the buprenorphine, discontinue all the other medication as well except what you need to help you sleep (so stop taking diazepam and loperamide when you stop taking the buprenoprhine)
    • Continue taking sleeping meds to help you get through the first month off methadone.
    • Be aware that you can become dependent on z-drugs like zopiclone, so be careful not to take the stuff longer than necessary - and if you struggle to sleep for a while when you stop taking it be aware that this is why.
    • Non-gabaergic stuff like Seroquel and Trazadone may be more helpful to treat the insomnia during the PAWS, once the acute withdrawal is over.
    • Avoid using benzodiazepines and z-drugs to treat insomnia any longer than absolutely necessary

The only symptoms you'll probably struggle with are going to be some minor RLS and hot/cold flashes/sweating (if you had clonidine it would prevent the latter). Remember that it will take your body a while to transition to life without opioids. It takes a while no matter how you do it. So expect a certain level of "natural" discomfort as your system acclimatizes to life without exogenous endorphins.

You can do this brother! Remember that a constructive/positive and realistic (not fatalistic, but practical) attitude is probably the most important piece of the puzzle when it comes to moving beyond the acute withdrawal from methadone and other opioids :)

That's a solid plan
 
That's basically how I got off methadone. In a nutshell, more or less ;)
 
Yay! Free rides to the methadone clinics :)

But will you be taking him on your motorcycle, and will you be wearing any underwear when you do, is the question ;)
 
I drive a big truck babe....no motorcycles here...just a Ford on 12 inches and sum 38's....
 
Started a new job today... working w my BF, he a lineman and underground utility contractor ....I drive one of the bucket trucks or the big deisel and pull underground wire and fiber optic lines....right now he's about 6 months into an almost 2-yr long job pulling new optic line updating and connecting the new line to every cell tower from here (Jax) to Miami for Verizon...the Jacksonville part alone is the 2yr bid, so got lots of work for a long time... fucking sick money too...gotta stay clean(er) than I have been these last few days...

K....gotta be totally honest now, cause otherwise,what's the point.... I fucked up and got a couple bags the end of my first day at the job, (as I write this is day 3...bag-free so far, TPD :) ) Got the dope figuring, cause my muscles were sore, and hey, I busted ass today at a physically demanding job a lot of men can't handle and I need a little relief...(haven't been very physically active in the last 9 or 10 months other than copping, walking to cop, walking into store to boost, u see the theme develop?)....used the soreness and backache as a persuasive argument to myself as to why it would be ok to do it, what's it gonna hurt, IM HURT, it's only a couple bags ....so, of course, it felt amazing (and anticlimactic at the same time) which led me to buy 2 more to "make it through the day tomorrow pain free"....back that quickly to my old logic and habits....key is I gotta STOP THIS NOW. nip it in the bud....a few more days in a row like this and I'll be throwing away the hard work I did to make it the 7 days i managed to stay sober
 
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Good on you for shining some light on that little slip, Zoe. Are you feeling like you can get by today without copping/using? As you said, best to nip these things in the bud.
 
I'm 33, been IV since age 15... Spent almost 5 years at the clinic, kicked the done, lasted a month or 2 before picked up a habit all over, which I am trying to get a handle on currently.

Thx simco...didn't get any this morning.... co-worker had some meth so I ought to make it thru the day without passing out
 
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My pleasure mate! Happy to help <3

Hey. Just a update, I got down to 10ml methadone and quit 3 days ago. I've been taking 300mg codeine first thing in morning, then 300mg codeine in the afternoon for first 2 days, then today I took 240mg codeine in morning, then 240mg late afternoon. Going surprisingly well at the moment, feel a bit rough and sweaty before second dose but still getting 5 hours sleep a night.my worker is sorting me 7 - 10 days subutex, but cant get them for 2 week ish. I have more 60mg codeine phosphate tablets on way but taking to long, so I've ordered 30mg dihydrocodeine. Should I take them in the same mg as codeine phosphate? Thanks again for advice! ?
 
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