A how-to guide to opiate detoxification.

[gaulois]

SWIM said....

bupe/add:
SwimIs/ am steady on 2mg Suboxone. Went down from taking irregular doses 4-6 to sometimes 8. Once the pharmacist screwed up and gave swim 60 8mg tabs instead of the 2s ....never had that kind of "luck". Sometimes I took an 8mg orally, and strangely I would get more of an "effect".
Anyway, the problem being that swim was using the sub like an addict, instead of either tapering or maintenance. Wim moved back to his home in Maine, intending to taper rapidly. He did, and stayed off for 4-5 days. This did not workout and ended up back on the subs. But swim am at a steady slightly-less-than-2mgs. He take 1/2 in the am, and about 1/4 pill in the afternoon. So, simply being steady and on a low dose and being motivated to use the bupe as it is intended has made a huge difference. Swim want to taper, but having read a great deal about people like swim who have been on bupe for 3+yrs it is not easy. So, for myself, I am trying to stabilize at each reduction. Then when ready -decrease, and again stabilize.
I have used Tramadol. All the crap you hear about it not being addicted is BS. I dont know how the FDA did not arrest or fine the company that marketed Ultram. Swim took Tram for about 3 weeks once. When he stopped he went into the most weird scary w/d that swim have every had. His legs would not function. He was extremely weak and dizzy. He had to go back on, then went back on oxys then that was when he started Suboxone.
If swiy finds it necessary to use something other than bupe to taper- and I do not think there is anything much better than bupe imho. But if one is are serious about stopping, some people return to short acting opiates. What that does is take you from a long acting opiod w/d to a short acting opiod w/d. Problem- once you start on a short acting opiod (including tram) you start to get a buzz (unlike suboxone). Swim would like the buzz and would not want to taper, then end up on subs again. But should that be swiys preference- If swiy has been using bupe/sub for only a few months, the going to short acting might help. But should swiy be like swim, then even tapering using the short acting, since one has been on the long acting for so long- there is no avoiding the PAWS.
All this to say- Swim finds tramadol very scary, and also deceiving. Everyone is different though, as has been mentioned above. I knew someone taking small doses of tram legitimately for a long time and they stopped w/out much problem. But most people I know are freaked out about it like me.
I would suggest the taper Dilon's cat suggested w/suboxone. In swims/ case, am steady at 2. Then going to go very slow from there. I know a lot about
suboxone. Bupenorphine (bupe) and the treatement med suboxone-bupenorphine +Narcan have v. strong long lasting affinity to the opiate receptors. As a pain med- bupe is prescribed in tiny doses- .2mg. So, the true taper from bupe starts at 2mgs from my experience. There is a feeling of uncomfortability and fatigue as one goes from, say 8mg, down to 2, but the w/d really begins under the 2 (this is swims experience- everyone is different). Like Dilon's cat said, when you get to the fragment doses, might be better to mix w/ a bit of water. But I have taken fragments and it has worked. One of the several times I tried to stop, I had been off subs for about 4 weeks. I went to the hospital for kidney stones. I got a shot of Dilaudid (hydromorphone). Went home, woke up the next day totally destabilized, craving. Low and behold by chance swim found a fragment (about less than 1/4 of a 2mg tablet). He put it under his tongue. In an hour all w/d was gone, felt great, and next thing you know, unfortunately, was back on again. Just to illustrate how strong bupenorphine is. less than .5 mg. To reiterate: Swim had been shot up with dilaudid like 5 times while in the hospital. So, he had some nice doses of a normal and strong short acting opiate. Next day, he went into a mental w/d, which felt like a physical w/d,. Then less than (1/4 2mg tab,or .5 mg) bupe pulled me out, and I actually got an effect from it.
Don't hesitate to PM me if you want more info on Sub. It has both good and bad results.
PS- Dillon's cat: I have meant to say a few times that I really get a lot from your posts. Looks like you are an ocean fanatic like me.