Thrown back into withdrawl!

[hypernihl]

First off this is my first post here. I read this site every day, and am hoping to get some advice from all the experience on this site.

My question is, has any one else experienced completely destroying their opiate receptors to the point that they have become hyper-sensitive to the point where they cannot do opiates for a single night out of weeks with out getting full on withdrawl symptoms?

My opiate history started in about 1999, started using hydrocodone, and quickly went from a 20mg dose to about 200 mg. Moved to Amsterdam and started using smack (no clue what my dose was, but quickly developed a large tolerance). Came back to the states and stopped opiates for a few months. Then started using oxycotin, and ended up using 600 mg/day. Did a hospital detox. Got back on oxycotin and heroin. Wanting to quit again, I got on methadone (120 mg/day) (2003).

After being on that dose for about two year, things got screwed up and I went cold turkey. Worst 2 weeks of my life followed by about 6 months of "regular"opiate withdrawl. Once I got over that, I was never really the same, hard to explain, my body was never right. Lost a bunch of hair and muscle.

Went about 4 years opiate free after that. Then started using opiates again here and there. Never really went any extended length of times with them, but the problem and what I'm asking, I go into full blown withdrawl after using opiates for a few nights (3-4 times/wek).

Most recently I was using 20mg of oxymorphone at a time (once per day) for several weeks, I quit for 2.5 weeks. Used 10 mg once, and was in full blown withdrawl the next day.

So my question is, does any have similar experiences? I've gone 4 weeks after using with a small tolerance, but can still go into full on withdrawl with one use.

I typically associate this with potential permanent damage from methadone withdrawl, but I really don't know.

Thanks for listening! Hope some one can help!

[Herbs&Hopes]

Sounds like really severe hyperalgesia? Or what I would imagine that to be since learning about it. What do you take if you need a painkiller for surgery? Are you much more sensitive to painful stimuli compared to prior all of this? My condolances to you, hope you can find your body returning to its natural homeostasis before much more problem. Have you considered smoking cannabis? I know it is a totally different buzz but honey oil is quite sedating and enjoyable, just try not to build a huge tolerance, regular breaks, keep it your special thing, maybe just a thought. Do you have a pain condition which drove you to use to begin with?

[hypernihl]

Thanks for the very helpful response Herbs&Hopes.

I was not familiar hyperalgesia. After doing some research on it, I certainly think this is a possibility. I'm still looking into it though.

I have had it with dealing with doctors, so I am treating my pain with opiates I can get else where, primarily oxymorphone. I basically use a minimal dosage (~10-20mg/day) for a few weeks then suffer for a few weeks using kratom to get through withdrawals.

Like I said, it only takes one dose after a 2.5 - 4 week break to induce full on withdrawal.

I have tried cannabis, but I am very sensitive to the mind altering effects of it in my old age, and don't find't it useful.

Again thanks for your very useful response, I will continue to look into hyperalgesia.

hypernihl added 1254 Minutes and 19 Seconds later...

Based on alot of reading, I do have alot effects associated with opiate induced hyperalgesia,

I clearly have an excessive opiate tolerance for no good reason. What got me started on opiates was breaking my neck. I still do find opiates effective, but at smaller dosages than what I would need to get enjoyment from them these days. Sounds like hyperalgesia. I haven't really found much on why I go through severe withdrawl on small dosages of opiate use over a short period of time (this is my real question).

Looking into to hyperalgesia, I found info on alternative treatments, particularly NMDA receptor antagonist, stuff like PCP, ketamine, and DXM (mildly). I did all these drugs as a kid for fun (~15 years ago), but can't see using these type of drugs on a daily basis with the exception of DXM.

So , I guess my question now is, if any one has first hand experience with this, and if so, how did you deal with it?

I'm thinking about trying low doses of DXM since I can go buy it at any local store.

[Herbs&Hopes]

Unless I am musunderstanding you, you get the withdrawal after a break from opiates? and you say a small dose being back withdrawals? So what, after a few days you gain tolerance and dont get the withdrawal but just pain relief? Then after some weeks the dose is not longer effective so you 'reset' by getting kratom, taking that for a couple weeks, then grinning and baring it sober for a while before starting again at a lower dose, and then recieve withdrawal? And you are sure it isnt because your tolerance is dropping so low you are just experiencing nauseau from the dose after the abstinence? Hope that maeks sense, I am laying down for sleep, check back tomorrow. Hope all is well and you have had some peaceful hours.

[hypernihl]

Sorry, I'm probably giving to many details in an incoherent way.

My basic issue, is acute withdrawal from a small opiate dose after a break from any opiates.

For example, I start with a small dose of oxymorphone ER 2 10mg tablets per day. After 3 days I'm at 4 10mg tablets per day. My tolerance grows very fast and these are very small doses.

I don't go beyond 4 10 mg tablets per day, that is my maximum dose in a day since I'm paying street prices. I do this for at most 2 weeks with no enjoyable opiate effects except some pain relief. I basically feel normal after 2 weeks.

At this point I stop taking any opiates and go through withdrawal. I use kratom for 3-4 days to get through the worst of the withdrawal.

I stay off opiates for at least 2.5 - 4 weeks. After this period my tolerance drops by about 20%.

Here's what my problem is. After not using opiates for 2.5 - 4 weeks after my last withdrawal. The first opiate dose I take sends me into full withdrawal 24 hours later.

I know 2.5 - 4 weeks isn't a long time, but shouldn't it be enough time to use opiates once without going into full on withdrawal?

I do think this is related to opioid-induced hyperalgesia, which was probably caused by withdrawaling from 120mg methadone dose. I am curious about drugs like Ibogaine, DXM, and other NMDA antagonists that supposedly "reset opiate receptors" as a treatment.

[Dickon]

Although I'm no expert in opioid-induced hyperalgesia, my first thought would be that you are not giving yourself anything like enough time to reset your tolerance. Like you, I've done a withdrawal (or two!) from a large amount of methadone and it has taken a long time for things to adjust back to normal.

I would say that even when I quit heroin directly it took many months (6 + ?) for pain-thresholds to return to a decent level where I wasn't over-sensitive to pain. My feeling is that it takes a considerable amount of time for the body to reset (as best as it can). I also believe, and have found, that escalating tolerance was a lot easier after having used high doses (the doses you describe in this thread were not unusual for me) in the past.

I also think that if you use before things are reset (insofar as they ever can be) you are likely to experience withdrawal symptoms. In part I would suspect this is partly psychological, as there is a huge psychological aspect to withdrawals. And really 2 1/2 to 4 weeks is only just about enough to get through the first flush of withdrawals.

Maybe if you waited 2-6 months you'd not experience the withdrawals the same way. That is not to say you wouldn't just get hooked again anyway and have to repeat the quitting process.

My other suggestion is that experiencing a certain amount of pain may help the body's natural production of endorphins. By that I mean doing something like martial arts, or even yoga (of the right kind) may help restore endorphin production to a more comfortable level. I always was hyper-sensitive to pain for quite a long time after quitting, as I mentioned earlier.

I have never tried anything that purports to "reset opiate receptors". I think DXM has at best marginal utility here, but ibogaine has proven very effective for some who want to quit. It is no magic bullet but does seems to work well in a target group of well-motivated individuals.


If you can quit for 2 1/2 to 4 weeks, maybe ultimately you'll get the best pain relief by not using opiates at all, and letting your own endorphin system kick in. That might then allow you to get some benefit from opiates at times when you absolutely feel you need them.

Just a thought, and I hope all is well

Dickon

[hypernihl]

Thank you for the useful reply Dickon.

I agree with what your saying about more time between doses, but I think it is abnormal to go into withdrawal after using for 2 weeks on such a low dose. My methadone withdrawal occurred 5 years ago. Since then I have gone for periods of months without using opiates. Recently though it just does not make sense. I do get a lot of exercise at my job, but no "runners high" like I used to get years ago.

However starting tomorrow I'll be off opiates. I guess as an experiment, I'll try and go a lot longer then 4 weeks. Key word here is "try". 4 weeks seems to me my limit.

I've got plenty of kratom to get through withdrawal, but I think I'm going to try DXM at low doses ~60 mg, and see if that has any beneficial effects.

Thank you Herbs&Hopes and Dickon for this useful discussion. I'll post my status here from time-to-time, and I'll be elsewhere.

Cheers!