Opioids Simultaneously kicking low dose habits

[ValaisFendant]

Hi all -

Just sharing a personal story, not really asking any questions.

I was a heavy opioid user for about 3 years, peaking at 500mg+ of daily oxy (originally to deal
with back pain, but then it became psychological as well). Despite the impacts to libido and digestive system and emotional control, I wouldn't have stopped on my own.

About 18 months ago I got a wake up call from
the postal inspector, and started to taper down to 80mg a day, which I found difficult. Felt off kilter every day.

About 12 months ago I moved primarily to suboxone (and was very careful to use the minimum needed out of the gate... within a few days, I found 2mg was enough). I mixed suboxone and opiates for awhile, but for several
months it has been almost only suboxone.

Flash forward to a couple weeks ago. I was taking a little bit of a lot of things. Including suboxone, clonazepam, gabapentin, and poppy seed tea. And I have decided to move on from as much of them as I can, because I am tired of being tired and groggy all the time.

For context, we are talking 1.5mg suboxone, 600mg gabapentin (sporadic use... some days more, many days zero), and 0.25mg clonazepam (never more than 0.5mg), and poppy seed tea maybe 2x a week using 300-400gm of seeds

Two weeks ago I stopped the poppy seed tea. Four days ago, I stopped clonazepam and gabapentin cold turkey. And I've also reduced suboxone to 1.2 mg/day.

And... I feel FINE. The only comfort med I'm using is clonidine, to help with anxiety and sleep... and only 0.1mg/day spread across two doses.

So - that means right now all I am taking is 1.2mg suboxone and 0.1mg clonidine. And I have quit the other three other substances all at once.

I read all of these horror stories about multi-year gabapentin withdrawal, and brain zapping and crippling anxiety from low dose clonazepam withdrawal. And poppy seed withdrawal being worse than pills are. And ... for me... it's just not happening.

I have no meaningful withdrawal symptoms, I just still feel the "groggy and tired and foggy" that I have felt for the last few years... and hopefully that will fade too.

Perhaps it's too early, but I'm pretty hopeful that in a couple of weeks, I will be down to 1.0mg of suboxone and have everything else cleared from my system including clonidine. (the suboxone is for chronic pain... it's way better for pain than high dose opioids, depending on the nature of your pain).

And then let the suboxone drift lower until the pain returns, and just hang out there at the threshold (i would love to be down to 0.5mg/day, or lower, if my body allows it)

The opana and oxy were dreadful to quit. But so far, everything else is going well. Maybe it's just too early, but I am feeling better now, not worse.

Don't forget how good clonidine can be. It lowers your blood pressure, and for me, that means reduced anxiety, better sleep.

The bottom line here is - just because a lot of people have horrible stories about kicking low doses of gaba and benzos, that doesn't mean it works the same way for everyone. People are more likely to post their horror stories here, than positive surprises.

I just want to feel "normal" again and I know it will take time, but the path to getting there doesn't feel scary, for the first time in several years.

 

[GetMeOutOfThisCRAP]

Oh boy that was quite a lot to withdraw from. There will definitely be some struggles going forward, but as you know life can change on a dime. You'll always be fine in the end even though the thought of living without opiates seems unbearable. It's okay really, just a little bit boring but pros and cons.

I would try to slow down the medication switches or desire to get off them quickly however. I think that the process (when rushed) encourages a high chance of relapsing. Mentally, it does take some time alone to adjust to life without pain medication. It was pretty uncomfortable for me the times I was going through it and even past the withdrawals.

 

[ValaisFendant]

Oh boy that was quite a lot to withdraw from. There will definitely be some struggles going forward, but as you know life can change on a dime. You'll always be fine in the end even though the thought of living without opiates seems unbearable. It's okay really, just a little bit boring but pros and cons.

I would try to slow down the medication switches or desire to get off them quickly however. I think that the process (when rushed) encourages a high chance of relapsing. Mentally, it does take some time alone to adjust to life without pain medication. It was pretty uncomfortable for me the times I was going through it and even past the withdrawals.

Thanks for your comment

I am now two weeks clear from gabapentin and three weeks clear from poppy tea. i felt weird the first day and a half off of gaba but fine since then.

clonazepam - i had to take 0.125mg three days ago because of brain zaps. but in the last two weeks i have had well less than 0.5mg cumulative. i will take a tiny amount if i get more brain zaps but we are talking less than 0.05mg per day if you average it.

i've also reduced suboxone to 1.33mg simultaneously.

i also quit the clonidine altogether.

the one thing i added was a small amount of cbd/thc tincture. to help me sleep. i have not abused thc in the past and have never smoked weed. i will only use the tincture as needed and in very low dose

it's all going well, odd as it sounds.

 

[ValaisFendant]

Thanks for your comment

I am now two weeks clear from gabapentin and three weeks clear from poppy tea. i felt weird the first day and a half off of gaba but fine since then.

clonazepam - i had to take 0.125mg three days ago because of brain zaps. but in the last two weeks i have had well less than 0.5mg cumulative. i will take a tiny amount if i get more brain zaps but we are talking less than 0.05mg per day if you average it.

i've also reduced suboxone to 1.33mg simultaneously.

i also quit the clonidine altogether.

the one thing i added was a small amount of cbd/thc tincture. to help me sleep. i have not abused thc in the past and have never smoked weed. i will only use the tincture as needed and in very low dose

it's all going well, odd as it sounds.

also - my big battle with coming off of opiates was 18 months ago. since then there was some dabbling, but it never escalated again. i got as high as 500mg oxy equivalent in 2019. not good.

i'm found opiate withdrawal to be way harder than other tapers. i never really abused other substances in a compulsive way... just used them as needed.

magnesium supplements have been very helpful. i think i was deficient based on fitting 12 out of 14 of the symptoms. it has helped to relax me and helped me to be less anxious and had also helped with digestive issues.

so - for now - it is 1.33mg of suboxone a day, and a small amount of cbd/thc tincture, and magnesium and vitamin D. that's it now. i will likely stay on suboxone because the spinal pain is very real. it is WAY more effective for pain than oxy or opana ever were for me.

 

[GetMeOutOfThisCRAP]

also - my big battle with coming off of opiates was 18 months ago. since then there was some dabbling, but it never escalated again. i got as high as 500mg oxy equivalent in 2019. not good.

i'm found opiate withdrawal to be way harder than other tapers. i never really abused other substances in a compulsive way... just used them as needed.

magnesium supplements have been very helpful. i think i was deficient based on fitting 12 out of 14 of the symptoms. it has helped to relax me and helped me to be less anxious and had also helped with digestive issues.

so - for now - it is 1.33mg of suboxone a day, and a small amount of cbd/thc tincture, and magnesium and vitamin D. that's it now. i will likely stay on suboxone because the spinal pain is very real. it is WAY more effective for pain than oxy or opana ever were for me.

That is incredibly interesting because most people say the opposite about suboxone (it being 'useless' for pain relief). Everyone's different, but it would be long lasting pain relief if it did work. I also found with suboxone there's not much incentive to increase the dose actually over time... there may be something to that. For instance everyone notices with oxy that if they stick to the same dose day after day, inevitably the sickness ensues between doses and encourages them to use more and more. I've never found this to happen with subs.
Keep it up. I can't put into words how fucking hard it is to not use opiates and I feel like I have to indulge here and there because the voices in my head are relentless until I satisfy them

Kratom helps me a lot with cravings and getting past weeks I cannot indulge, but it does not substitute the real deal. I was never an addict until touching percocet. Abusing adderall is one thing because it's legal for me and I don't find it to have the same soul-crushing grip, but opiates made me something darker. It is objectively easier to be happy without opiates once you get past the withdrawal and the endorphin plateau for months on end until one feels "normal" again. It's just getting to that normal part is very trying and the brain literally experiences severe boredom due to the endorphins remaining low for quite some time. Out of curiosity, what was wrong with the gabapentin? I thought that for nerve type pain that was considered even better than opiates to some degree.

 

[angelomorgano]

Maybe you can also try using high-dose vitamine C to get through the last bits when you finish suboxone. I'm trying that right now (7g of natrium ascorbate every 2.5 hours) and it works so far, no real problems. I do use 3-5g kratom 2 tot 3 times per day to aid with sleep and get some energy for work but I am reducing that kratom dose daily as well.

 

[ValaisFendant]

That is incredibly interesting because most people say the opposite about suboxone (it being 'useless' for pain relief). Everyone's different, but it would be long lasting pain relief if it did work. I also found with suboxone there's not much incentive to increase the dose actually over time... there may be something to that. For instance everyone notices with oxy that if they stick to the same dose day after day, inevitably the sickness ensues between doses and encourages them to use more and more. I've never found this to happen with subs.
Keep it up. I can't put into words how fucking hard it is to not use opiates and I feel like I have to indulge here and there because the voices in my head are relentless until I satisfy them

Kratom helps me a lot with cravings and getting past weeks I cannot indulge, but it does not substitute the real deal. I was never an addict until touching percocet. Abusing adderall is one thing because it's legal for me and I don't find it to have the same soul-crushing grip, but opiates made me something darker. It is objectively easier to be happy without opiates once you get past the withdrawal and the endorphin plateau for months on end until one feels "normal" again. It's just getting to that normal part is very trying and the brain literally experiences severe boredom due to the endorphins remaining low for quite some time. Out of curiosity, what was wrong with the gabapentin? I thought that for nerve type pain that was considered even better than opiates to some degree.

Yeah, I understand. I don't remember what it's like to feel fully normal... the person who used to be able to work 18 hours a day + still do a 20 mile hike on Saturday... that person has gone missing for the last few years. Right now, I feel a lot more lucid + normal than I have in awhile, but my energy level is still pretty low, and I don't have the energy or drive to do things of my own initiative (except working out a few times a week).

To answer your question - there was nothing "wrong" with gabapentin. I was originally prescribed it to help with the tapering off of oxy + opana. And then when I switched to subs, I kept using it. But, I found that it wasn't really additive. I took it because it was there. But, the suboxone was better for pain than the opiates. And the gabapentin gave ... kind of... a mild buzz... maybe? I thought it was a pretty benign drug as the studies all say there are no withdrawals from it. But then when I read about people having hellish withdrawals, I thought "why not just stop it, I'm not sure if it's doing anything for me anyway". And I did, and so far, there's been no rebound in pain. There were some chills and sweats for maybe 24-36 hours, but that was it. Now it's out of my system.

My doctor actually uses suboxone too. Very low amount, roughly 0.5mg a day. She had debilitating chronic pain issues, and nothing worked. People all thought she was one of those crazy ladies in pain, of course. And then on suboxone, her pain is a zero. I'm the same way.

I don't know why it works for some but not others, but many have said that it's more effective for pain at lower doses (its metabolite - norbuprenorphine - is a full agonist... and it can get to receptors easier when they aren't 100% choked off by a high dose of bupe). I don't feel the full like there's a full agonist in my system, but, for whatever reason, low dose bupe has been a huge helper.

I just wish the medical system would have pointed me in that direction back in 2016/2017 when I was dealing with really bad upper back pain due to a slipped disc (and chronic lower back pain due to alignment issues). All they would offer is procedures (cortisone shots, etc.) and NSAIDs and muscle relaxants. In my case, it was all useless. I'm never getting a cortisone shot again btw. But, if they had just said "try 0.5mgs of suboxone" I would have never had to self-medicate with illicit drugs in the first place. Chronic pain is such a draining thing... you don't want to eat your cereal because each time you bend your neck it hurts just enough to make you know it. You don't want to get out of bed because standing up will feel moderately uncomfortable. It's a conscious decision to do every small thing. And with suboxone I don't even think about it because there isn't any pain.

Not, I just have to make sure that I don't use the THC tincture for too long. It does nothing for me except make me tired + help me sleep. Zero euphoria, zero "relaxation". Much more like a flexeril... zombie feeling. But, it's a really low dose, and I've only been using it for the past week, and THC is less addictive.

 

[ValaisFendant]

Maybe you can also try using high-dose vitamine C to get through the last bits when you finish suboxone. I'm trying that right now (7g of natrium ascorbate every 2.5 hours) and it works so far, no real problems. I do use 3-5g kratom 2 tot 3 times per day to aid with sleep and get some energy for work but I am reducing that kratom dose daily as well.

I'll look into it, thank you. I eat a lot of fruit that's high in Vitamin C, so I'm not deficient. But, sometimes more is better.

I'm not looking to fully quit suboxone, just to taper down until the upper back starts complaining. It's a very clear complaint when it shows up... like fire. But on 1.33mg/day, it's still suppressed. Ideally I will get down to 0.5mg/day, but I don't know if that's realistic or not. Only time will tell.

 

[angelomorgano]

Well, very high dose of vitamin c appears to actually work for pain as well, I think it helps your body to produce more endorphins. DPA (omega 3) and DLPA supplements help keeping and keep them around longer (reducing endorphinase).

I use about 3mg of DLPA and 6 grams of omega 3 per day, and a total of 60g of vitamin c (sodium ascorbate, every 2 hours 5-7g)

Sciencedirect: ANALGESIC PROPERTIES OF D-PHENYLALANINE, BACITRACIN AND PUROMYCIN IN MICE: RELATIONSHIP TO INHIBITION OF ENKEPHALINASE AND BETA ENDORPHINASE

 

[ValaisFendant]

Yeah, I understand. I don't remember what it's like to feel fully normal... the person who used to be able to work 18 hours a day + still do a 20 mile hike on Saturday... that person has gone missing for the last few years. Right now, I feel a lot more lucid + normal than I have in awhile, but my energy level is still pretty low, and I don't have the energy or drive to do things of my own initiative (except working out a few times a week).

To answer your question - there was nothing "wrong" with gabapentin. I was originally prescribed it to help with the tapering off of oxy + opana. And then when I switched to subs, I kept using it. But, I found that it wasn't really additive. I took it because it was there. But, the suboxone was better for pain than the opiates. And the gabapentin gave ... kind of... a mild buzz... maybe? I thought it was a pretty benign drug as the studies all say there are no withdrawals from it. But then when I read about people having hellish withdrawals, I thought "why not just stop it, I'm not sure if it's doing anything for me anyway". And I did, and so far, there's been no rebound in pain. There were some chills and sweats for maybe 24-36 hours, but that was it. Now it's out of my system.

My doctor actually uses suboxone too. Very low amount, roughly 0.5mg a day. She had debilitating chronic pain issues, and nothing worked. People all thought she was one of those crazy ladies in pain, of course. And then on suboxone, her pain is a zero. I'm the same way.

I don't know why it works for some but not others, but many have said that it's more effective for pain at lower doses (its metabolite - norbuprenorphine - is a full agonist... and it can get to receptors easier when they aren't 100% choked off by a high dose of bupe). I don't feel the full like there's a full agonist in my system, but, for whatever reason, low dose bupe has been a huge helper.

I just wish the medical system would have pointed me in that direction back in 2016/2017 when I was dealing with really bad upper back pain due to a slipped disc (and chronic lower back pain due to alignment issues). All they would offer is procedures (cortisone shots, etc.) and NSAIDs and muscle relaxants. In my case, it was all useless. I'm never getting a cortisone shot again btw. But, if they had just said "try 0.5mgs of suboxone" I would have never had to self-medicate with illicit drugs in the first place. Chronic pain is such a draining thing... you don't want to eat your cereal because each time you bend your neck it hurts just enough to make you know it. You don't want to get out of bed because standing up will feel moderately uncomfortable. It's a conscious decision to do every small thing. And with suboxone I don't even think about it because there isn't any pain.

Not, I just have to make sure that I don't use the THC tincture for too long. It does nothing for me except make me tired + help me sleep. Zero euphoria, zero "relaxation". Much more like a flexeril... zombie feeling. But, it's a really low dose, and I've only been using it for the past week, and THC is less addictive.

Quick update -

It's now been over two weeks since I took any gabapentin, and 8 days since I took any clonazepam (i took 0.125 mg after 5 days of abstinence to stop brain zaps...). No poppy tea for almost a month now, and no cravings (I remember the nasty taste, not the morphine buzz). I am also now feeling "stabilized" on 1.33mg of suboxone from 1.50mg a few weeks ago.

I am feeling more normal. Energy levels are improving. I am sleeping better. It's still not all
rainbows and unicorns, but it is improving.

The next medium term steps are to:

- Cut suboxone from 1.33mg down to 1.0mg. Will probably take at least a month for me
to do that comfortably

- Significantly reduce vaping volumes (habit I picked up due to covid boredom). By like 80% in the next month (going from 25-30 cigarette equivalent to 5-ish). Vaping liquids are so strong that it's actually not hard to consume 25-30 cigarettes' worth in a day, which blows my mind. I bought a disgusting flavor this week - so that I only use it when my body needs it. Mint flavor is so pleasant that I use use it whenever, just because it's nice. Yesterday I reduced my nicotine intake by 50%, and thanks to the flavor change it wasn't hard. In fact, I felt better. Too much nicotine can make you feel crappy. Going from down 50% to down 80% will be harder but is doable. The reason I never found cigarettes addictive is because they were so gross that after having 2, I wouldn't want to go near them
again for several days. Vaping is way different. You feel the benefits but not the consequences.



By mid-year, the goal is to stop vaping entirely, and to get suboxone down to the level where my back pain starts appearing again (0.5mg? 1.0mg? I don't know)


It feels good to take back control. I've realized that I hate gabapentin... it made me way more sluggish and drowsy than I ever realized. And because I took it inconsistently (some days 0, some days 1200mg) I was actually having withdrawals on the days I'd take zero, but I never connected the dots. I just would get a little bit sick 3x a month. I felt bad for the first 1-2 days off of gabapentin but have been fine since.

One key insight worth sharing is that if you make it LESS PLEASANT TO CONSUME a substance, you will consume less of it by default. Poppy Tea never had the same grip on me as pills, even though it can be really strong, because it tastes so gross.

Best wishes to all -

 

[ValaisFendant]

Four month later update -

I am now 25 days off of suboxone
I am 3 months off of gabapentin
I am no longer taking clonazepam (except for a few days during withdrawals a couple weeks back... it has no mental grip on me)

This week I did not take any prescription pills for anything.

The hardest thing about quitting was the resurgence of upper back pain. Constant discomfort - significant discomfort - in weeks 1-3. But - it's getting better each day. It's a combination of posture training + the brain getting used to not being sedated. Phantom rebound pain is a real thing, but it fades.

Now, the frustrating thing is the lack of sleep + the low energy level. I thought the insomnia would be better by now but I am still only getting 4-5 hours of sleep on average. For the last 4 weeks.

I know that energy level will take more time to normalize. Sleep will help when that gets back to normal, but getting to 100% could take 6-12 months. Because dopamine impairment.

Sometimes I think about opiates, but the cravings are not bad + I never ever think about taking suboxone or gabapentin. Suboxone is the scarlet letter.

The thing that keeps me from relapsing is knowing that Opiate kindling burned into my brain. If I use once, I will feel like crap for 4 days. And set the whole recovery process back an unspecified amount.

I wrote a note and stick it on my computer ... it says "kindling is not worth it."

It feels good to take no pills. It feels good to be at 25 days. Looking forward to the sleep + energy returning ....

VF

 

[angelomorgano]

Four month later update -

I am now 25 days off of suboxone
I am 3 months off of gabapentin
I am no longer taking clonazepam (except for a few days during withdrawals a couple weeks back... it has no mental grip on me)

This week I did not take any prescription pills for anything.

The hardest thing about quitting was the resurgence of upper back pain. Constant discomfort - significant discomfort - in weeks 1-3. But - it's getting better each day. It's a combination of posture training + the brain getting used to not being sedated. Phantom rebound pain is a real thing, but it fades.

Now, the frustrating thing is the lack of sleep + the low energy level. I thought the insomnia would be better by now but I am still only getting 4-5 hours of sleep on average. For the last 4 weeks.

I know that energy level will take more time to normalize. Sleep will help when that gets back to normal, but getting to 100% could take 6-12 months. Because dopamine impairment.

Sometimes I think about opiates, but the cravings are not bad + I never ever think about taking suboxone or gabapentin. Suboxone is the scarlet letter.

The thing that keeps me from relapsing is knowing that Opiate kindling burned into my brain. If I use once, I will feel like crap for 4 days. And set the whole recovery process back an unspecified amount.

I wrote a note and stick it on my computer ... it says "kindling is not worth it."

It feels good to take no pills. It feels good to be at 25 days. Looking forward to the sleep + energy returning ....

VF

Good job man. I know how hard it is. tough life. Is sleep getting better by now?

It took me also 1 month to feel normal again, but I had a slip up and after 2/3 weeks of oxy my tolerance skyrocketed like a motherfucker, which is really annoying and hard to get rid of. Kindling is indeed not worth it. I wish I had more sub/methadone to feel safe whenever this happens.

 

[ValaisFendant]

Thanks for the note. Yeah, sleep is getting better though still not 100% normal. Last night I did get 8 hours, but only because I took Benadryl.

Slip ups are tough. It takes a few seconds to make a bad decision and then it takes several days for the consequences to play out. At least the half life of oxy is short, but it's brutal to come off of a high dose (I peaked at 500mg/day, and it took me 3 months to taper to 50-100mg).

In terms of slip ups, Ive had small amounts of poppy tea in the last month, like once a week, but just for relief from spine pain. Not enough to get high, not enough to cause meaningful kindling. Just enough to get through the day on the bad ones, when I simply cannot get comfortable. I'm sure that's slowing the recovery down, but I dumped my seeds in the yard a couple days ago so now I will have to tough it out with the back pain going forward.

And then someday the endorphins will come back.

 

[DeathIndustrial88]

Wow OP. That's amazing.

I've actually been on/taking all the same exact things you mentioned, right down to the poppy tea (lost my heroin & pain pill connects).

I've been feeling the same way. Ironically, heroin & other full agonist opioids use to give me energy and motivation to get up and do things.
Buprenorphine did too for awhile there but it eventually fades & along with the clonidine, clonazepam & everything else, I've become so god awful tired all the time.
So groggy when I get up every day, lethargic, no sex drive, completely bored no matter what I do. But when I try to go without it, I feel almost the same way except it's even more agonizing.

I can't imagine a life without taking some sort of opiate or opioid. I managed to avoid benzo dependence for 20 years. Was able to take them to abort bad trips or for the occasional panic attack. It wasn't until I was prescribed and told to take them daily that dependence snuck up on me eventually. Rebound anxiety is a killer.

Great work though! Takes a hell of a lot of strength to do what you just did! (for some of us anyway!)