Taper Strategy

[Match]

Hi all

SWIM has a question for anyone who knows anyone who has successfully quit using a quickish taper prior to stopping.

The question is at the end of this post so peeps may wish to zoom to the bottom if they think they can help rather than read this horribly familiar story.

SWIM thinks that he needs to give a potted history of his fall from 'normality' partly as a therapy and partly as a salient warning to others.

He has a close friend who has a strong habit which has ruined his life. He tried to help his friend when many others had turned their backs on him.

One day around 2 years ago he tried smoking an amount of his friends gear just to see what it was like. He is now in his 50's and has taken pot regularly (daily) through his 20's and 30's and some time in his mid 40's it just sorted drifted out of his life. He has the occasional joint but it is once a month at the most. He thought he could try the Heroin and it would not be a threat. He is a happy optimistic sort of person.

The first smoke was enjoyable apart from a bit of nausea. Over he next 18 months he would occasionally buy some (half a bag) which would last days. He has a job which means he has to travel so he could not do it regularly. He had a period of half a year last year when he stopped smoking cigarettes and the gear and got fit and life was great. In August last year his father died and for some crazy reason he tried some gear again which obviously was an evil but effective way of coping with the grief.

His dosage levels were low (1/4 bag - 0.1g ish) per day and he had 'house rules' such as never smoking in the evening just in the morning before work. At Christmas time the feeling of guilt grew and grew. Up to that point although he know it was wrong he enjoyed it and lived with his guilt - because he had stopped regularly in the past he felt in control.

7 or 8 weeks ago a switch got turned. SWIM caught a cold and felt shit. He smoked more gear than usual. Within a week he was smoking a bag a day. He started sweating at night. He started smoking in the early evening. He lost interest in DIY projects he used to enjoy. The effects of the gear were short lived. At first he thought the bags were smaller or that it was weaker. He realised he was wrong.

A monster grew that was attached to the guilt. This was the feeling that he was frightened of stopping and a fear grew of would he be able to stop. He felt he had lost control. Desperate.

He developed a cough and sometimes felt it hard to breathe. He decided to stop again. He would taper. He tried it Day 1 and failed, day 2 the same thing. Now 5 weeks later he is in deep shit.

His wife has been worrying about the cough and wheezing.

Last night he told his wife. Partly to try to stop her worrying and partly as a cry for help.

SWIM is a very lucky man. His wife was totally shocked however she said whilst she would not live with an addict she would help him. SWIM explained the taper method and she has agreed that he should do it.

He told her that at the end of the taper he would need support and that she could take some days off work and comfort him. She agreed - I told you he was lucky

For his part, SWIM has made her a promise and a deep down decision himself that when he stops he cannot ever try it again.

Now the indulgent crap is over - if anyone read that pathetic story then thank you. If anyone is dabbling - then I am sure SWIM would say - 'stop now'. No matter how strong you feel you are most likely going to get got. It is not instantly addictive as the newspapers would make you believe but it can creep up and get you without warning.

Here is the question.

He is smoking 1 bag a day - he thinks this is around .2g. He has read a very good post on this forum about the taper method of a 33% reduction every 4 days. SWIM believes in tapering - it sounds rational.

This method would mean 1 bag would gradually become a fifth of a bag and then zero in 14 days. He plans to score for the last time tomorrow and divide up the doses and put in sealed envelopes.

If there is anyone who has quit with this taper method who has any comments - is it too long or too short? Is SWIM deluding himself and should he just stop now?

Thanks for listening - I promise to pass on any advice

[Dickon]

There is no answer one can give here, at least in one sense. As you probably know opiate withdrawal is, in general, not dangerous, and so the point of a taper is simply to make the process either more comfortable or achievable.

I suggest you read the "how to guide to opiate detoxification thread": Here - http://www.drugs-forum.com/forum/showthread.php?t=76991 , or at least the relevant parts. As I remember, I was mostly writing about methadone w.d. but the same principles can be applied. I suggest you get hold of some lofexidine, at least if you have a friendly doctor available, as this, or clonidine can be very helpful. As you are in the UK, I'd suggest lofexidine as it is a better choice for home detox. In case you've never heard of these drugs, they are not themselves opiates, but they help a lot with the withdrawal symptoms.

I don't quite understand your maths, as surely a 33% reduction every 4 days would give you 2/3 bag for 4 days, 1/3 bag for 4 days and then off. Unless you mean 2/3 bag for 4 days, 4/9 bag for 4 days, 8/27 bag for 4 days, 16/81 bag for 4 days and then quit c.t. Yes, this must be what you mean.

As far as tapers go, it's fairly quick, but it will help somewhat. Also, may I suggest you mix up all the bags you are going to use before divvying it out into portions. That way you can make sure the dose is consistent.

If you do get hold of clonidine or lofexidine you should not need to taper, or at least can do so a lot quicker.

I hope all goes well

Dickon

Reputation Comments on this post:

Very helpful adice; especially about mixing up the bags so that the taper is of a consistent dose.

[rokman nash]

Congratulations on realizing that a problem existed and for finding a resource to help you through this difficult process.It sounds like you have a sound plan in place for the initial acute phase of getting clean.

Now would be a good time to start preparing for life after.Although everyone is different,my friend has had more trouble with the mental part of getting clean,than the initial acute w/d phase.There is a lot of good information above in the sticky section right above Drd's thread on "how to".It seems that in the initial phase your concentrating so much on getting to a certain place(clean),that the mental part doesn't kick in till after you get there.

Good luck and keep your thread posted on your progress.


Good thoughts

[ex-junkie]

swim thinks tapering heroin is a silly idea. this is in no way trying to beat down the OP, however its not going to work.

swim does however suggest temgesic. swiy can find a doctor to prescribe it, and you pop a tablet under your tongue when youre suffering from withdrawal. the withdrawals will go away. etc.

it rids your body of addiction quicker, in a nicer, much more comfortable way than a heroin tapering ever could. swim slept every night of her detox except for the one night, but she wasnt that uncomfortable. she had cholonodine and promethazine to help- and it did. the promethazine was extremely helpful.

temgesic detox will be all over in 5-7 days, going by the usage stated in the first post.

goodluck with your journey, and dont be afraid. within a fortnight you should be feeling better, and compared to the rest of swiys life, its only a small amount of time. massive props to your wife, and be good to her/dont do anything to put her off swiy. swim seriously thinks heroin tapering would lead to the sort of behaviour that would put her off swiy.

swiy doesnt want to be seen begging for rations of heroin from his wife. it will scare her. please take swims advice and seek some temgesic so you can do this properly.

[Match]

Dickon - he thanks you for taking the time to reply. The second part of your maths is the one SWIM is using (spreadsheets are useful at times!).

He does not want to go to the Doc's (family Doc situation) unless it is a final resort. He may try to find an online source. Do you say it is good for reasons of health or that it helps stop discomfort?

He also thanks you for the tip of making sure the strength (nearly used the word 'quality' there!) is as uniform as possible.

rokman - thanks to you also for your advice. He thinks he should not have too much difficulty staying off it when he has stopped. He realises that the memory removes many bad thoughts over time and you remember the good times only so he has to keep that in his mind. That is one of the reasons for the post he made. Now it is on record for him to look at if he is ever tempted. Sometimes he has thought of making a video confession to keep but that is too weird! or is it ....

SWIM plans to keep an update on this thread.

Match added 12 Minutes and 38 Seconds later...

E-J. Thanks to you - you raise various interesting points there. SWIM needs to think these over ....

[ex-junkie]

please dont be embarrassed to speak to your family doctor. failing that, swiy could always visit a different doctor?

swim wouldnt recommend leaving things until things get any worse. the longer swiy leaves it, the worse swiy's problem will get.

if swiy is to go ahead with the heroin tapering, be sure to tell your wife that if the outcome is unsuccessful, then there is the temgesic. at least that way she can be prepared if things go belly up. better to be safe than sorry.

[Match]

e-j , Hi. With regard to your first post, SWIM is realistic and knows that he may not stick it right to the end. He thinks that if he can get nearly there then the dosage levels will be significantly less so ultimately it is going to be easier. He also knows that it is something he has to do himself so does not plan to have his wife hide it. He has an agreement just to say 'It's OK' each evening when she gets home from work.

SWIM now would love to know the answer to two questions that probably cannot be answered.
First does the taper actually reduce the level of addiction in just in a week or two? and second, how bad is the withdrawal process going to be now he has a habit of 0.2g a day compared to 0.05g ish.?

If he thought the unpleasantness would be the same as it was in November last year when he quit on his own from 1/4 - 1/3 bag habit then he would have no fears. It was not nice but not the end of the world. If he has his wife with him for the 72 hours he would walk it. He fears it is going to be a lot worse.

As regards the Temgesic, there is a Addiction Clinic in our town. SWIM's friend has got something called sub.... from there without the need for a doctor - he thinks what you are talking about may be similar. SWIM wants a fully stocked armory

It is now 0530 and another day dawns - not the nicest spring, he cannot even look at the daffodils. SWIM wants Captain Kirk or Doctor Spock to tele-transport him forward three weeks to a clean healthy world.

[ex-junkie]

swim is a realist. shes not trying to put a wedge in your plans by all means, but generally a heroin addiction, once formed, leads to increasage of dose by any means possible. if swiy reduces heroin daily, swim will have withdrawals. worse still, the heroin wont do anything to stop the withdrawals once swiy has tapered down. swiy will want to use more.

swim suggested temgesic. its the same as the subutex, only in smaller dosings. buprenorphine (temgesic/subutex), is the easiest most comfortable way to detox. heroin tapering involves a lot of suffering tbph. when swiy starts to hang out, swiy will just use more. just like any other day of the week.

[Leftöver Crack]

of course some people have tapered successfully, but it has never worked for swim. swim sees it as: if there is any on hand, swim will do it all. there is no tapering. swim thinks most people are 100% unable to taper. especially with dope. not saying it's impossible, just that cold turkey is usually the most successful.

[Match]

OK Guys - got the message - decision time for SWIM

Match added 361 Minutes and 26 Seconds later...

Would one take the Temgesic as well as taking the Lofexidine? SWIM thinks he is now going to go to the Docs however he wants to know as much as poss first.

As far as he understands it, the Temgesic kids the brain that it is getting an opioid so there is not so much withdrawal and then you stop the Temgesic over a week.

The Lofexidine sounds very good. As far as he understands it, that regulates the amount of noradrenaline which causes the high blood pressure and lots of the feeling shit symptoms.

If SWIM was on the Temgesic why would he need the Lofexidine - he presumes there would not be such a noradrenaline surge?

Does that make sense?

What do you guys think

Match added 32 Minutes and 53 Seconds later...

Edit - SWIM has spoken to his friend and the Temgesic are very difficult to get here. You have to go to a specialist drug Clinic. So SWIM is now trying to decide to go to his Dr and get some of the Lofexidine which is not an opiate or just do it on his own ....

[ex-junkie]

it is well worth taking the effort making an appointment to go to the clinic, so swiy has something to fall back on.

for the now, do what you can today to make things easier on swiy. in all honesty, its better to have a script of temgesic to fall back on. that way if swiy relapses, he can pick himself straight back up again if needed.

it really is best to cover every base.

today go ahead and get the lofexidine or cholonodine, and also consider some of the drowsy over the counter anti histamines. promethazine is a good one. only please dont take more than prescribed of either, and take it easy if swiy takes them. swiy will have lower blood pressure than normal, and it is important swiy takes it easy.

GOODLUCK!!!!!!!!!!!!!!!1111111111

EDIT: swim took chlonodine whilst on buprenorphine, and it heightens the chance of relaxing/sleep. temgesic/subutex has a tendency to hype you up whilst youre on it. sort of like the feeling of being on amphetamines in a way. it perks you up. chlonodine/lofexidine is still necessary/beneficial, and increases ones chances of a successful detox.

[Match]

Just a quick update.

SWIM has decided that he wants to try to do this on his own with his wife. He now realises that a taper is not going to work - it is two issues - when you use your resolve goes & when you start to withdraw you do not resist!

His new strategy is to use up the amount he has for the taper, orally for 2 days. Anything left over then is going to be ritually disposed of where it belongs, down the toilet! Then his wife can be with him for 4 days after he has stopped. In his experience after 96 hours the worst is over although this time is going to be worse as his dosage is 3 times higher but he is not sure if the time is going to be longer.

He knows this is very innefficient way of taking it - there is no high but no WD either so he thinks it is similar to a replacement which a Drug Clinic may prescribe and so far has worked.

He hopes to report good news.

[ex-junkie]

orally isnt going to knock the sides off, though if you leave it inside swiy's mouth, swiy might get some psychological comfort from the taste of it.

swiy is a fighter, he can do this. never give up, even if one step forward meant taking two steps back. you can do this.

[Match]

Update - SWIM is now 48 hours in. It is 0430 and sleep is not an option. He has some Vallium which he has just resorted to so hopefully some shuteye in the next half an hour

FYI - tapering off smoking H is not an option for him - he thinks he is very disciplined but this is just too difficult. The oral route helped buy some time so his wife could take time off work to supervise/comfort him - the rest got flushed away as planned.

60mg Codeine phosphate relieves the runny nose & eyes but not the shit feeling. Just the impending feeling of 'shit what have I done/got to stay clean this time' plus numerous aches and pains.

No desire whatsoever to score at the moment - plan to report again in 4 days when the worst should be over.

[ex-junkie]

^taking codeine during withdrawal is not beneficial in the slightest. get some promethazine. its an OTC hayfever medication, and its DROWSY.

take it easy over the next few days.

[Match]

Day 6 0445.

Endorphin activity!!

SWIM just woke up after 5 hours of unassisted sleep and feels the first glimmer of optimism and normality.

This is the 6th or 7th turkey that SWIM has endured and has been far, far worse than any other. 7 months of use culminating in a bag and a half of dragon food per day has knocked him for six. There was a false dawn on day 3 when some of the worse symptoms abated but the dysphoria hung over him as a giant cloud even yesterday on day 5. In the past the whole process took 3-4 days. Yesterday SWIM started feeling that maybe he was really ill and that the symptoms had been masked by his indulgence.

Have to take gentle issue with e-j. The 60mg of Codeine really helped SWIM. Maybe it was a placebo but 30 mins after each dose the most unpleasant physical symptoms went away. Of course they are as nothing to the depression. He did take them for one day too long he thinks and is now proud that he is 72 hours opiate free.

He hopes this part of his journey is coming to a close. In the past when he has done this as he has been going on holiday or a business trip he was quickly tempted to start again on his return thinking that it was not too difficult and he would just have to do it again. This time, the last 8 weeks have spiralled out of control and SWIM knows the love affair is over.

Just as a parting note on this thread (he hopes), he wants to outline how the love affair worked for SWIM. This may give others the chance to see where they are on the slope downwards and make the break earlier than SWIM.

Falling in Love - SWIM was a happy chap. Loads of interests, comfortable life with a lovely wife. He loved Saturday & Sunday mornings when he did not have work and made sure he drank very little achohol on Friday & Saturday night so he felt at his best on his days off. One day, his friend offered him some H. Although SWIM was a bit of a drug friend 20 years ago, he had only ever tried it once before. A few months past and for some reason one day he asked his friend to get him half a bag. His weekend was amazing and he did all his usual activities with a giant spring in his step. Half of the half bag was kept for the following weekend as a tiny dosage was required for 12 hours of enhanced life. A few months passed and he repeated the process.

The Courtship - SWIM started to plan to have a half bag available for most weekends when he was not away. He went to bed on Friday night excited by the thought of the morning to come and felt comfort from having his friend available. This went on for a year or so with only a few weekends missed.

The Marriage - SWIM was in love and started getting one whole bag which would last Friday through Monday. Some weeks another one was got on Tuesday and he had periods of a few weeks/months of usage. He was disciplined to only use a tiny amount when he got home from work as if he was too high he would lie in bed with fantastical thoughts and not get to sleep for an hour or two. When he did awake, he felt completely refreshed. He stopped a few times and felt the first ugly WD signs. At first these were just heavy legs, lethargy and mild depression.

The abusive relationshsip - SWIM was now using daily. He know he had a problem and spent a year with three protracted sessions and then WD's and a few months clean. During his use he knew his dosage was low, he did not want full sex (he had been there and got the T-shirt with other drugs years ago), he just liked the gentle warm glow of the embrace.

The breakup/breakdown. SWIM started using when he got up before work and again on his return. This started in August last year and for 7 months things have spiralled out of control with the dosage increasing very very slowly. SWIM let many financial and other practical issues slide. Nothing mattered when the dragon kissed him. He started using to hide from the work problems he created. It was remarkably efficient and the dragon would never let him down. As stated in his original post, around 8 weeks ago he started to think of a taper so he bought four bags at a time. Each visit would be the last. Four days leter he was back. Then three days. He was a wreck with his business life crumbling around him, his wife thinking he must be ill.

The Divorce. He told his wife. It had to end. He would have a final taper. He bought 7 bags. He had no chance. They lasted 3 days. He was proud to throw the last one down the toilet 6 days ago.

SWIM never thought he was the one that could be different and live with his friend, it just crept up, embraced him and they fell in love. It took 3 years for the whole process to unfold and for 2.5 of them he was sort of in control. In the end, once his tolerance developed he was done for.

For any others on an early part of this journey SWIM would advise an early separation. The end is bad. He hopes he has not done any lasting mental or physical damage. The lack of attention to the small business he runs has cost him thousands. He hopes he can save it.

SWIM's heart goes out to those with 3 years+ habits and he knows there are many with much higher dosages than him. He saw his friend last night and he had taken 10 bags yesterday. He is 5 years+ into his nightmare. Lost his job as a Doctor, lost his partner, lost his house, now lives with his parents and is in the process of losing his brother and sister as they are so angry with him for torturing his parents.

I suppose for SWIM the ultimate decision was that he had to stop or die (physically or mentally).

Love and peace to all

[Match]

Day 7 1118 In the office

False dawns.

A quick question if anyone has had this experience please.

SWIM has now got over the horrific WD's, however for the last 2 months when using larger doses he has been getting night sweats which leave his T-shirt soaking wet. This has continued after his cessation - his regime is get to bed at 2330. Wake at 0200-0300 cold and wet. Get up and then go back to bed for an hours fitful sleep at 0600.

Has anyone else had these continuing night sweats? SWIM is now worrying about other health damage he might have done.

Other than that, he has no energy and the dysphoria still envelops him - he did a crazy thing yesterday and booked a long haul flight to the other side of the world for a business trip (which he had been putting off the last 3 months and has/should be done). This is in 16 days time. He used up air miles to upgrade to first class for added pampering which he fears he is going to need.

In the last year SWIM has lost 2 stone in weight (lunchtimes involved going home for dragon therapy) and at the end of his love affair he had lost all fitness. Yesterday he got on his cross trainer and managed 7 mins at zero resistance before he hit his peak heart rate! It nearly killed him and recovery took 30 mins. Not suprising as he is no spring chicken at 55 next birthday and smokes 30 a day (they are next on the list obviously).

The business trip gives SWIM a focus for an exercise based recovery. He is quite anal and has a chart of what he can do in two sessions each day. He has 16 days to get some kind of fitness level so a high protein diet and this exercise has to do it. He has the opportunity to bale at the last minute if he thinks he is not fit enough - what is one more lie after 2.5 years of them .... "oh I am sorry I have the flu and cannot come" would do the trick.

This trip also means that any thoughts of entertaining the dragon are out of the question. The programme he has set himself is ambitious and so a slip up is not an option. Although SWIM's concious brain thinks he has made the final decision to stop he can hear the dragon pacing around in its lair and a few times a day it is growling (or whatever dragons do) that it wants to help SWIM one last time.

As stated earlier SWIM has stopped a low dose - short duration (2-3 month) habit on several occasions and has bounced back to normality (including sleep) after 5 days. This time he thinks/knows he has crossed the rubicon as 7 days in and all he can do is watch the hours pass and now has started reading the PAWS threads here. The various characters and their journeys have helped SWIM. So a big thank you to them. This thought of the point of no return is a mixed blessing. It means that SWIM is going to be in the shit for some time he fears but it does make him realise that it is a point of no return.

We have a four day holiday coming up so an opportunity to force himself to sow some vegetables and do some other things that he used to love.

It does seem to help to project thoughts out into cyberspace so a thank you to the forum guys. It is a place of contradictions - we have this opiate addiction sub-forum and just a couple of mouse clicks away we have the heroin forum full of optimistic young bucks & does wanting to maximise their first experiences with our respective monkeys. This tickles & at the same time saddens SWIM and he just hopes some come here as well as there.

Love to all

[pinksox]

SWIMs dyphoria after a several year opiate habit lasted a good 6 months. At times it was overwhelming. It's funny, because SWIM didn't have places like DF to turn to when she went through her thing, but SWIM also relied on DXM post acute-withdrawal. It can help somewhat with the mood issue.

SWIM also developed a strange habit in the first post-year of taking 50-75mg of benedryl in the evenings...but she wouldn't recommend that course, especially for smokers, as benedryl is very drying and pretty much cements mucus in the airways(thereby narrowing them) with daily long-term use. SWIM worked herself into a Dx of "adult-onset asthma" with that little habit, LOL. Fortunately, for SWIM, that issue resolved when she finally stopped using benedryl as a daily crutch. SWIM has also read recent studies regarding guaifenesin use as a mood-elevator as well and it certainly does have some skeletal muscle relaxant-properties to it. Again, it's very drying to airways, like benedryl.

The DXM in cough syrup or gelcaps works well as a mood elevator. SWIM found just double the OTC dose did her fine(just make sure one isn't taking double acetaminophen with that dose!)...none of these crazy recreational doses that some enjoy around here. Just enough for a bit of a pick-me-up. Although plenty of people around here will recommend staying away from ALL substances post-acute withdrawal while the body resets itself, these helped SWIM quite a bit.

So does exercise and natural endorphin release. Doesn't have to necessarily be running on a treadmill. Start with walking and work ones way up from there. Of course, quitting the smokes is always beneficial as well. Even reducing by half will have one feeling a bit better aerobically. then work on reducing by half after that as well.

It's not uncommon for nightsweats to continue for sometime. Even though acute symptoms of withdrawal have passed, it still takes months for the body to fully reset itself to it's pre-opiated state of stasis. Keep up the good work. The PAWS thread on here is an excellent source of info SWIM thinks too.

[Match]

Thanks pinksox

Your last paragraph has eased SWIM's unease.

Us two SWIMmers have a common bond - SWIM also had adult onset asthma (heroin lung) from his habit. He started getting inhalers over the net so he did not have to go to the Doc's where he would be sussed (apparently 40%+ of patients presenting with late onset asthma have a heroin problem). It was ludicrous that SWIM would wake in the night not breathing well and then go and see the dragon as that eased the symptoms in the short term even though he knew it was making them worse in the long term - how crazy is that!

SWIM knows the ciggies are the next thing. At the moment he is living off the dopamine hit they provide.

As regards short term mood boosters, SWIM wants to try to stay off as much synthetic stuff as he can. He is probably older than pinksox and so has to allow his body to recover as fast as it can. He did have a stash of coke he was saving for the WD process as in the previous WD he was offered some on day 5 and he thought that had jerked him out of his depression. It must have been a short lived affect as after 2 days of feeling normal he went to see the dragon again. SWIM used to do coke many years ago and now maybe once a year tops. The stash went on day 3 this time and had zero effect. SWIM is quite pleased it is gone. Thanks for your thoughts though.

I have read a lot today - particularly Rokmans story. There are good posts on there from various people that make a lot of sense.

Quite a 'club like' feel on this forum - not sure I want to be a member but I think it was Oscar Wilde who said that one should try everything in life apart from incest and Scottish country dancing.

[BumpBump]

has swiy thought about tapering with codeine?
swim does this alot, and makes swims life alot easier, and its easiest thing to get.
Look up cwe... visit that leading brand chemist on the high street, get a bottle of aspring and codeine(they seem to work clean and best)... Use quater of the solution as a starting dose... probably about 50-60mg of codeine. If this stops you rattling, then take less next time. Then taper with the codeine