Re: Quitting oxycodone with methadone and loperamide
well, this sucks, my friend just wrote a huge post after waking up but lost it when trying to post it. aargghghg! looks like this will be the shorter version (luckier for u guys)
anyways, my friend relapsed yesterday again and took 90mg of codeine (less than the 120mg from the previous night). He had taken diazepam and clonidine but maybe waited too long (like 10:30ish PM) and it didnt set in before the dreaded midnight hour. he slept like crap, mostly because he felt bad over the relapse and kept obsessing about having thrown away 24 hours with no opiate usage. it sucks to be counting time in hours still....
when he woke up he started looking through DF and found a comment which seems to reflect his main problem. Some girl mentioned that the habit of going to sleep in an opiate bubble was hard to let go. For my friend that is a major issue, since he has just gotten so used to not losing sleep over ANYTHING due to the drugs. the prospect of sleepless nights scares the shit out of him (unfortunately not literally at the moment, still backed up). he has got to find a way to simply embrace the suck and accept that sleep aint coming for a while! To make it more clear, his main hurdle always seems to be the period between when the hold/cot flashes set in and the runs/vomit phase. Once he gets to that second phase the mental aspect just becomes soo much easier (based on previous experiences detoxing) since he knows it cant get worse and its pretty much all uphill from there on out.
What pisses him off so much about this is that he sees posts about people jumping off larger and longer methadone/heroin/whatever addictions and pushing through it all. He is simply frozen mentally at the 24 hour mark, he just cant seem to make it past that even though at that point the worst he is feeling is some hot/cold flashes but mostly the restlessness that prevents any position from being comfortable for more than two seconds. sorry if this sound like whining, but my friend just feels like a giant sack of pathetic shit for not having the mental strength to push through. He has been trying to quit for two years (even did a quick 10 day methadone inpatient detox and relapsed on day 11, HA!) and has tapered his use with limited success two or three times before, but honestly, this feels by far the closest he has been to making it through. success feels so close but so far away at the same time, its driving him mad!
On a positive side, the fog of oxycontin and methadone has lifted and my friend believes they are pretty much out of his system, as its been 13 days since last oxycontin dose and 9days since last 10mg methadone dose from the original taper and 5 days since he chipped 2.5mg methadone. He managed to string together two days with only loperamide since then and then there are these last two days with the codeine relapses also.
so, my friend has some ideas of things to try differently. additional suggestions are welcome, since it is very hard to think up healthy ways to keep motivated and push through this.
1st- spend some time writing about what has been lost due to opiates and what he wants so desperately to gain by letting the opiates go. sometimes he just feels so consumed by the guilt of what he has not done in life due to addiction and perversely this drives him to want to use more to numb the guilt! he has to find a way to accept the damage that has been done and prepare to move on. put this on paper and then read this when the dreaded midnight feening starts.
2nd- probably the most important by far, flush the little remaining codeine and methadone on hand, since he has no easy access and it would take over a day to get anything, thus making it more likely to get past the 24-48 hour barrier which keeps tripping him up.
3rd- take the diazepam and clonidine earlier and try to get some rest before he inevitably starts losing it with the restlessness that sets in around midnight.
4th- and this one he is unsure off, is to take loperamide for another day or two to let most of the codeine leech out of his system. he is worried that this use is reaching into the second week (yesterday was 7th day) and is concerned addiction wise of simply trading 6 for half a dozen (as they say in his native language). he has managed to drastically cut the use from a 32mg max to only 10mg last night, although making it through with the lower dose was only possible probably because of the codeine. Last night's loperamide probably wasn't even needed technically because of the codeine but obviously he wasn't thinking of relapsing when he dosed the loperamide. he has read comments all over the place about loperamide usage, ranging from those that managed a successful detox with it to horror stories of addiction (main one he saw was by Nefret he thinks)
5th - and this is probably a horrible idea and my friend is pretty sure most will advise against, but what about using a tiny sliver of the suboxone on hand to help soften the landing from detoxing from the codeine and loperamide left in his system. Anyone ever had success with just chipping once to take the edge off or does it have to be a proper taper to work? The idea is to use the sliver as a "comfort med" of sorts to take the edge off. he has no access to more suboxone since it is not sold in his country and the little he has came from a friend that brought it from the US and has no more left.
6th - pretty sure he had a 6th thing in the original post but doesnt remember it now!
well, any and all suggestions are welcome and thanks to anyone who had the patience to read through the long post, my friend appreciates you taking the time!
paregoric added 460 Minutes and 57 Seconds later...
ok. so im at the 22 hour mark and feeling fine. had some VERY mild hot/cold flash. a yawn here and there but it almost seemed out of tiredness, not sickness. now comes the hard part, which is making it through the night. i havent flushed the opiates i have left (hope that doesnt come to bite me in the ass, but its soo nice to have that little crutch in the back of the mind). All i have taken is a little bit of diazepam, ibuprofen, and magnesium (and a multivitamin earlier in the day, having been take it every day since day 1). I only took 250mg of magnesium and am considering an additional 250mg to see if it helps with the RLS that has come in previous nites.
On the positive side, ive read several threads of people coming off larger doses and while there very intense withdrawals were psyching me out i feel a bit stronger mentally, since taking less codeine and less loperamide on sat nite compared to friday nite had little to no effect on how i have felt in this first 23 hours, making me feel a bit less afraid. I guess alot of the success of detoxing is in the mind.
Dont know if there are many fans of the novel Dune out there, but i started reading it again today since it usually gets me upbeat about personal strength, especially the Litany of Fear - "I must not fear, fear is the mind killer. Fear is the little death that brings total obliteration. I will face my fear....".
anyways, i just gotta find a way to make it through the nite without my monkey brain getting the best of me and relapsing. gotta keep calm and keep going, cos although right now all i can think about is how its only gonna get worse, i guess the only way out of the mess of addiction is through the pain of withdrawal. i guess there is no easy way to detox (except for those lucky few that pop up once and a while on DF with cakewalk stories; in me early opiate naive days it was so easy...not anymore)
at the moment i consider my taper to have been partiallly successfull in case anyone is wondering. I have significantly lowered my dose (and with that libido and appreciation of music have come flooding back). just gotta get the balls to make the final jump.