Kicking recipe for opiate withdrawals (Thomas recipe)

[witchychick]

Originally Posted by piggyinthemiddle

Going cold turkey and using benzo's to try and get to sleep is a recipe for disaster. They don't work, and if one were to try to force the issue you could get yourself into all sorts of trouble. T.o.m tried it once and spent the following morning wandering around the neighbourhood hallucinating. Treat the original posts advice with caution IMHO.

maybe it does not work for everyone but swim got clean using a few blue valium and it did take the edge off of things definately for swim.

[klonopinz]

Swim doesn't know if the main reason people can't sleep while on opiate withdrawal is RLS; swim though it was akathisia.

RLS has a ~60% correlation with PLMS which aparently is inherited. Akathisia usually occurs when a new agent is introduced or an old one is removed suddenly. Antihistamines, along with benzodiazepines are know to both, cause and resolve most of these symptoms. (that's why some people claim they help and in others just makes it worse)

Ironically, most of the things on the Thomas Recipe are the usual treatment for akathisia, and gastric issues.

If you ever taken some tylenol PM (Diphenhydramine & apap) and felt like crazy for a bit, that's kinda like how opiate withdrawal feels, but 24/7.

[tyrus568]

SWIM has a laughably weak habit that hasn't been sustained for very long, yet he suffers pretty severe withdrawal (from light-to-moderate levels of poppy tea use only). RLS is one of the biggest factors in his (week-long?) WDs.

RLS certainly makes sleeping more difficult and in his experience bendaryl certainly worsens the effect. He is currently taking an antidepressant called citalopram (celexa) combined with wellbutrin (bupropion extended release) and he didn't realize that these two medications could possibly be making the quitting harder? As far as he's been on anti-depressants for over a decade (paxil, zoloft, cymbalta etc) and they're never done jack for him he is about to cease using these medications (20 mg celexa shouldn't be difficult to stop, but he may titrate if he has to) - and he's not going to see his doctor about it first. It's his problem and he knows what he is doing and the possible ramifications... considering now the reports are coming out about anti-depressants causing suicidal ideations he is sick and tired of the whole thing.

[Richard_smoker]

in response to the issue of long-term buprenorphine maintenance therapy--this is something that is currently being done in the U.S. For the last year or 2, suboxone & subutex have been available in MASSIVE doses, and the physician requirement is laughable (you can find the tests online...i think they're at the suboxone website). takes about 30 minutes to read thru some generalized b.s. about opiate withdrawal & how bupe works...

I must say that this several-year long "forever"-maintenance therapy is creating some serious monsters.

Bupe is perhaps the weirdest drug ever in terms of getting off it. Is this the normal experience: to feel sleepy for several weeks? i know of someone who literally couldn't get off the couch for a period in excess of an entire month after stopping the bupe. unfortunately, that person found a tiny speck of a pill in his dresser drawer, and discovered that it was the fucking BUPE WITHDRAWAL itself that was keeping him permanently glued to his couch in continuous exhaustion and lethargy!

Unless you are just impossible at staying clean, I would think long and hard before I asked a doctor to place me on long-term bupe therapy! -DICK

[imyourlittlebare]

clonadine takes care of the symptoms because most of the symptoms are due to overloads of norepinephrine. But most people bitch about how it makes them tires so they stop. Its funny how swims work. Swim is getting off suboxone soon. l-tyrosine wont help much. It increases the chemical changes of phenylenaline which may decrease the breakdown of endorphins. Clonadine helps. So does lycira. Lycira or Pregablin inhibits glutamate, norepinephrine and other neurotransmitters involved in your pain. Benzos can help with the pain because they decrease norepinephrine peripherally too on top of in the brain. Cant get those then a certain breed of skullcap contains an alkaloid that binds to the benzodiazepine receptor and l theonine increases the amounts of GABA released so you may increase the amount of relief you get.

Reputation Comments on this post:

	fantastic info
	very helpful. thanks.

[lorzapmail]

Swim has seen this on the web many times, but here it goes again. Unless you shoot "H" every four hours this should work. Start Imodium right away 4 mg every 4 hours. Take Clonezapam or Valium ( the long half-life benzos) every 6 to 10 hours. Swim is not allowed to say how much. Take B-complex 50's (not 50 pills) vitamins twice a day. Take potassium,bananas, etc, 3 or 4 a day. Alieve for RLS (restless leg syndrome). Get plenty sunlight vitamin d3 . Plenty of sleep. Chicken noodle soup and jello. After a three days take walks. Try to remember your favorite hobbies and do them. This is the short version. In 3 or 4 days the pain will be gone. Then you can deal with the mental problems. There are many books on it. Use them to hit yourself over the head with them. Don't get into this situation again. Like right.

lorzapmail added 19 Minutes and 3 Seconds later...

More.. Imodium (lopamide) was first made in the hopes of a new pain killer, sadly it didn't work But is related to opioids. It will help the W/D's. Swim has been through this many, many times. Liquid imodium works best but pills also will do the trick. A post swim read about taking 50 or a 100 Imodium is nosense, do not do this. Don't forget Valium or Clonzepam, B-complex,Potassium and alieve or the new RLs med for leg flopping. If you can get them, try to buy ahead. Taper down your opioids. If swim can cut down so can you! Take these items for 4 days. You should do fine. Swim did not make this up it it is commonly known.

Reputation Comments on this post:

Good advice, you seem to have couvered the major bases here

[Dickon]

In a hypothetical dream a rabbit told me this: no idea why.

I wish I could cut through all the confusion here. My favourite thread on this subject is called "How to go cold turkey from 150mgs methadone! the easy way" in this section. It's not altogether practical for home use (i.e. iv nutrients etc.), but is written by a medical doctor with 18 years of personal experience with opiate addiction, and can be adapted.

Personally I'd say the one ESSENTIAL is clonidine or lofexidine or other alpha-2 adrenergic agonist. Everything else is window-dressing.

I'm 20 days into a methadone w.d. and have used god knows how many supplements (including alpha-lipoic acid, milk thistle (both for detox), multi-vits and minerals, Omega 3-6-9 (both general good stuff), amino acids (body repair), diclofenac (NSAI pain killer), Valerian capsules and Chamomile Tea (sleep), antihistamines (non-sedating, just in case there's a histaminic component to w.d.s, I don't get on with anticholinergics), adrenal extract (lethargy)). I have deliberately avoided sedating-antihistamines (reason stated above), loperamide (it's an opiate. Isn't that what I'm trying to quit!!!????). I have also avoided benzodiazepines. I didn't have any. I am actually glad about this with hindsight. For a baby habit you can basically do a home detox-5 by simply drugging yourself to semi-sleep for a week using benzodiazepines and taking clonidine to alleviate the w.d.s. This will not work for a serious habit, and I think benzos might remove inhibitions and also leave a hang-over, for which the obvious cure is using opiates. I remain ambivalent about benzo use in w.d.

Oh and don't kid yourself if you get rid of restless-leg you'll sleep. That is simply wrong in my opinion. There is too much multi-dimensional shit happening for sleep to follow from the alleviation of one w.d. symptom. My own experience is that one achieves a state of quiescence where one can lie relatively still in bed quite a bit before one actually gets much sleep. This intermediate phase is actually a Godsend because it means one can REST, even if not sleep. My one little bit of advice for restless-leg is to ham it up a bit, and go crazy! Just spasm away for a few minutes and that will bring a brief respite (well we are playing the percentages here).

You will not sleep for some time. Or if you do it's more by luck than judgment. But I think all-in-all the main ingredient is nothing other than attitude of mind. Search for the painless one, believe it will be easy, but don't give up when it's not, and maybe convince yourself that all the weird and wacky pills and potions will make the w.d. end tomorrow. That way getting through the day will be a lot easier. Then when tomorrow comes just realize you were one day out. The best part of supplements is it gives you something to do, and maybe a bit of placebo effect. Who knows they might even work, but I'd not hold your breath, at least not in the acute phase of w.d.s. Clonidine is a different matter. It turns the unbearable into the almost-unbearable, and that with the right mindset is ALL you need!

Best of luck to all who attempt this difficult journey. My own story is on the "Screaming in the night air...." thread. It may or may not be encouraging and/or contain useful information, but we're all different and what works for me might not work for you.

Dickon

Reputation Comments on this post:

Great post, lots of helpful tips

[lorzapmail]

Some of your ideas will work for some, others not. As swim has said many times everyone is different and addiction degree varies greatly. Swim has never know of anyone getting addicted Lopermide the chemical makup just isn't there. Swim finds benzos great for lowering blood pressure, anxiety and sleep. The the vitamins, etc. work for swim. Again everyone is different. Good luck.

[imyourlittlebare]

Originally Posted by Dickon

In a hypothetical dream a rabbit told me this: no idea why.

I wish I could cut through all the confusion here. My favourite thread on this subject is called "How to go cold turkey from 150mgs methadone! the easy way" in this section. It's not altogether practical for home use (i.e. iv nutrients etc.), but is written by a medical doctor with 18 years of personal experience with opiate addiction, and can be adapted.

Personally I'd say the one ESSENTIAL is clonidine or lofexidine or other alpha-2 adrenergic agonist. Everything else is window-dressing.

I'm 20 days into a methadone w.d. and have used god knows how many supplements (including alpha-lipoic acid, milk thistle (both for detox), multi-vits and minerals, Omega 3-6-9 (both general good stuff), amino acids (body repair), diclofenac (NSAI pain killer), Valerian capsules and Chamomile Tea (sleep), antihistamines (non-sedating, just in case there's a histaminic component to w.d.s, I don't get on with anticholinergics), adrenal extract (lethargy)). I have deliberately avoided sedating-antihistamines (reason stated above), loperamide (it's an opiate. Isn't that what I'm trying to quit!!!????). I have also avoided benzodiazepines. I didn't have any. I am actually glad about this with hindsight. For a baby habit you can basically do a home detox-5 by simply drugging yourself to semi-sleep for a week using benzodiazepines and taking clonidine to alleviate the w.d.s. This will not work for a serious habit, and I think benzos might remove inhibitions and also leave a hang-over, for which the obvious cure is using opiates. I remain ambivalent about benzo use in w.d.

Oh and don't kid yourself if you get rid of restless-leg you'll sleep. That is simply wrong in my opinion. There is too much multi-dimensional shit happening for sleep to follow from the alleviation of one w.d. symptom. My own experience is that one achieves a state of quiescence where one can lie relatively still in bed quite a bit before one actually gets much sleep. This intermediate phase is actually a Godsend because it means one can REST, even if not sleep. My one little bit of advice for restless-leg is to ham it up a bit, and go crazy! Just spasm away for a few minutes and that will bring a brief respite (well we are playing the percentages here).

You will not sleep for some time. Or if you do it's more by luck than judgment. But I think all-in-all the main ingredient is nothing other than attitude of mind. Search for the painless one, believe it will be easy, but don't give up when it's not, and maybe convince yourself that all the weird and wacky pills and potions will make the w.d. end tomorrow. That way getting through the day will be a lot easier. Then when tomorrow comes just realize you were one day out. The best part of supplements is it gives you something to do, and maybe a bit of placebo effect. Who knows they might even work, but I'd not hold your breath, at least not in the acute phase of w.d.s. Clonidine is a different matter. It turns the unbearable into the almost-unbearable, and that with the right mindset is ALL you need!

Best of luck to all who attempt this difficult journey. My own story is on the "Screaming in the night air...." thread. It may or may not be encouraging and/or contain useful information, but we're all different and what works for me might not work for you.

Dickon

dont have alot of time. loperamide does not pass the BBB. Wont hurt. Will stop diarehea

[Aberdonian]

Hi folks, happy new year, Swim would like to offer his advice on kicking, swim had a 10 yr long heroin habit of an average of 0.7 g a day plus 8x 60mg dihydrocodeine tabs(sr)which he chewed , he went to a clinic where they used subutex and on day one waited till he was in w/d, then gave him a 4mg test dose then 4 hrs later another 8mg , he felt shady but nothing compared to normal w/d, then day 2 16mg, felt fine slept etc,day 3 was 12mg, still felt same, no appetite tho, day4 8mg same feelings, day 5 4mg, no change again, day6 2 mg still felt reasonably ok , day 7 0.8mg , slightyly yawny etc nothing else, then day 8 0.4 mg, he felt fine for next 24 hr but then had a couple restless nights before starting to feel better , was easiest detox i have done by far, subutex seems better as the pills go all the way down to 0.2mg whereas suboxone is just 8mg and 4 mg unless im mistaken, swim knows how hellish it can be to be on buprenorphine even in small doses for a long time as he was addicted to temgesic for years before trying heroin and even in the small doses he was taking then found it too hard to stop eg 4x 0.4 mg snorted daily and when rattling off those his friend offered him heroin to take that rattles away and 12 yrs later after many failed attempts swim is still addicted to h!!


A day wasted is not a wasted day

[~lostgurl~]

I guess that is a matter of opinion, although this girl I know is positive it is RLS. She had it for 4-7 days going through heroin withdrawal and has had exactly the same symptoms for years after stopping the use of methamphetamine.

There are 2 forms of RLS, primary and secondary, primary is a condition that is usually hereditary and has no cure. Secondary is a result of some other disease/illness/ailment. Considering the large effect methamphetamine has on dopamine, and that RLS is considered to be caused by low or unbalanced dopamine the correlation is fairly clear.

Akathesia and RLS are often confused though so if anyone has a link to a study showing one or the other that would be interesting to look at, as I believe treating opiate withdrawal by treating this symptom of opiate withdrawal could open up many more treatment options for opiate withdrawal.

[Horiz]

I've often wondered if GHB would have any use during opiate withdrawel, especially with the sleep/RLS. Has anyone considered this?

[klonopinz]

Originally Posted by ~lostgurl~

I guess that is a matter of opinion, although this girl I know is positive it is RLS. She had it for 4-7 days going through heroin withdrawal and has had exactly the same symptoms for years after stopping the use of methamphetamine.

There are 2 forms of RLS, primary and secondary, primary is a condition that is usually hereditary and has no cure. Secondary is a result of some other disease/illness/ailment. Considering the large effect methamphetamine has on dopamine, and that RLS is considered to be caused by low or unbalanced dopamine the correlation is fairly clear.

Akathesia and RLS are often confused though so if anyone has a link to a study showing one or the other that would be interesting to look at, as I believe treating opiate withdrawal by treating this symptom of opiate withdrawal could open up many more treatment options for opiate withdrawal.

The problem with RLS and akathisia is that its very subjective. To prove RLS as hereditary, (and hence primary) they do a sleep movement test and measure your movements through several nights.

The main difference between RLS and akathisia is that one occurs specially when trying to rest and Akathisia appears usually as a reaction to the intake or withdrawal of drugs.

RLS has just been recently added to official disease list, and it's guidelines for RLS say that the effects are more pronounced when trying to relaxed, as opposed to just akathisia which is more related to drugs and overall emotion of bad feelings... They are VERY similar and until some Iron channel deficiency test appears to prove RLS without having PLMS, there is no real way of knowing and is usually decided by the doctors judgement.

Also, RLS can easily be seen on a sleep test, where the subject has no objectivity on the symptoms and you can clearly see the PLMS, and akathisia symptoms dissipate when really asleep.

Oh and primary and secondary doesn't exactly mean that. Primary means that its the underlying cause for problems and its still untreated. Secondary are thing that come out that primary cause.

[~lostgurl~]

Originally Posted by klonopinz

RLS has just been recently added to official disease list, and it's guidelines for RLS say that the effects are more pronounced when trying to relaxed, as opposed to just akathisia which is more related to drugs and overall emotion of bad feelings.

This is what differentiated the two for this girl I know, at first she thought it was akathesia but as she found that the effects were far more pronounced when trying to relax or sleep, both during heroin withdrawal and more recently in the years since first quitting methamphetamine, she realised that her symptoms fitted those of RLS much more than they fitted akathesia. Many of the medications to treat akathesia are the same as those used to treat the less severe cases of RLS.

[klonopinz]

The thing is if Swim doesn't know if a person can differentiate between RLS and akathisia because both in neither you are able to really relax and be stress free (in this case) because the drug addiction.

Swim doesn't doubt that what people get is a combination of both; only that when it's akathisia it is usually confused by a panic attack.

[dkorleone]

Figured it out finally, anyway about to take the hard road but swim will try IBOGAINE, does anyone know about this?

[CrookedEye]

Originally Posted by dkorleone

Figured it out finally, anyway about to take the hard road but I will try IBOGAINE, does anyone know about this?

There are several threads about iboga/ibogaine, and by using the search engine, you should find them easily.. SWIM has taken ibogaine and had success, and thinks it is one of the best experiences he has ever had, although it was a bit rough.. Definitely took care of almost all of his withdrawal.

[twoofus2]

10+ yrs of this ride and we are here to learn~win and start living again... thank you for the recipe...

[bonghed]

Originally Posted by bcStoner420

Why is this exactly?

Well in rare cases (maybe lots of cases just my opinion)

I just really wouldn't advise use unless really neccessary, because although tapering really slowly can avoid most withdrawal symptons, i went through HELL with it and feel so strongly it obviously effected my jundgement and the possible benefit of methadone, it's still not i a decision to be taken lightly.

Well young people aren't even fully developed, i mean yea it can help but that is rare?

all what i typed here is all my opinion no facts, so i would learn what works for you yourself

Honestly probably just because i was fairly young when i done done, it might be life changing in a good way to others, i understand everyone is different, sorry bout that there mate(s)