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Time to taper down and/or get clean .... pain meds hi jack the brain again.
  1. #1
    Anonymous Guest

    Default Time to taper down and/or get clean .... pain meds hi jack the brain again.

    Hello All,

    About a week ago I began to take on a taper plan / detoxification from pain medication.

    Late fifties male with a history of addiction treatments for over 40 of those years. Have had successful business and gainful employment. Just recently left a management position to take a leave of absence for health reasons.

    Nine months ago - i was diagnosed with 2 forms of cancer. Pancreatic neuroendocrine tumors that have metastasized to my liver & hepatoceluar liver cancer. In October after 12 hrs surgery i was given an all clear signal. 45 days later the PNET reappeared in my liver - thus a Stage IV diagnosis. During that time i was also treated for Kidney Stones so that i could be clear for Chemo therapy to begin in the new year.

    Up to last week - I was abusing my prescriptions. I was taking up to 8 x 20mg Oxycodone/day on top of a 75mcg Fentanyl patch. In my mind I know I don't need this much medication. But my addictive brain was hijacked and all wanted was to play with my meds and take them as desired... the meds were driving the bus.

    My daughter & loving wife & several of my network of friends became concerned. Confronted me & with that I agreed to begin a serious effort to taper/detoxify.

    I have gone from 8 x 20mg/day to 5 days of 5 x20mg/day & today is my third day of 4 x 20 mgs a day.

    My plan is to go another 4 days at 4 x 20mgs. Then go a 5-7 days at 3 x 20mgs. Then 2 x 20mgs and eliminate the oxycodone.

    From there I plan to decrease the patch. From 75mcg to 50mcg etc.

    Any thoughts on this taper plan are welcome - please. Comfort suggestions? I hate the long taper idea as its about being uncomfortable over time. The alternative of cold turkey - i can't put myself through at home.

    I'm also aware that at some point here I expect to hit the pain from my cancers & I am of the mindset to push through it and keep forging the taper - I want to learn how to be a cancer patient with out pain medication....I'm hopeful that I can do that.

    I have the love and support of my family. I go to recovery groups regularly. I am trying to return to regular exercise... and from there will look for what's next employment wise.

    Thanks in advance for any comments suggestions and or support to follow.

  2. #2
    Thisweekforsure is offline Advanced Member
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    I see nothing wrong with your taper plan. The best thing about tapering as low as you can is that if (when?) the cancer pain returns or becomes worse, the drugs will be more effective. If you can get completely off opiates all the better. Keep in mind that your level of pain in the first days off the opiates will be worse than what your real pain level is. I'd give it a few weeks off all opiates to see if your pain is actually at a low manageable level. If the pain seems too much, nothing wrong with getting back on them. Quality of life is the priority. But I'd see if you can change the regimen. More on that in a minute.

    I have a theory, don't know if anyone has done a study, but I think the short acting (for breakthrough pain) pills might tend to lead to abuse more as compared to extended release. The reason is the short acting gives you a spike, then rapidly your blood level decreases. The rapid decrease signals the brain to crave another dose. The extended release doesn't bounce you around like that. It's my theory that this is one reason users rapidly escalate daily doses into very high numbers, because they keep chasing the high that becomes only an hour long, where a daily dose of extended release might keep a person content at only a fraction of the number of milligrams. My theory is the addicted brain responds not only to the level of opiates at any one moment, but also to the direction of change of level and the speed of that change. So if you find you do need to remain on opiate therapy, I suggest talking with your doctor about using only extended release forms and if necessary, trying different types of various pain medications to get you on a regime that keeps your pain under control to a reasonable level but does not require using the short acting much if at all. Remember you don't need the pain to be zero at all times during a day. It just needs to be low enough and manageable, so you have good quality of life.

    So without the brutal pull of cycling blood levels several times a day, you MIGHT find that your addictive brain doesn't try to hijack you as much and you are able to control any urges to go outside prescribed dose more easily. I feel this is a possibility FOR YOU because you are able to taper. That demonstrates you do have the ability to exercise some amount of control over your use.

    Keep that in mind for the future but for now I support your effort to get off them completely. Remember, how you feel just off them will not be the end result. Give it six or eight weeks before you decide whether you can be happy off of them.

  3. #3
    Anonymous Guest

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    I agree with your theory. Thank you for the prompt feed back.

    Couple of things at work here. I totally agree with the mercurial nature of IR opiates being an attraction to the addictive personality. The ER opiates are just not as 'pleasurable' in the sense of 'feeling' your medication. As a person that has a history of using substances intended as medication for recreation it's one of the most perfect roller coaster rides.
    The other is the creeping sense of pain that i have from the scarring of my liver. Nothing I would turn back from the path I'm on but just the mind & body trying to put obstacles in my path.

    Today is one of the first days I'm feeling the taper side effects. the burning eyes, sniffly nose, stomach aches, general sense of irritation and internal dialogue that is trying to discuss all the benefits of using tomorrows medication today.

    I went to an early morning recovery meeting where there is some degree of understanding - but going to an AA meeting for Prescription Drug dependency is in some ways like using a screw driver to open a bottle. It probably can be made to work but there are likely better fits. I went to the gym and got pretty good cardio work out in. Got an estimate on the garage door fix & then went visit a new coffee cafe in the next town.

    Taking it one day at a time - I am committed to making this work.
    Thisweekforsure likes this.

  4. #4
    Stell76 is offline Junior Member
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    Well done John keep up the good work
    Just dont beat yourself up...
    After what you have just been through you do have a bit of a right to be on pain killers
    But I understand you want to get off so you can be healthy and ready to fight Cancer and of course so the meds will work if and when you need them...
    I found tapering or coming off Fental patches the hardest thing but I did it with great determination as they made me really depressed
    They work really well for pain I admit that...but its a short acting drug even slow release like transdermaly
    The WDs hit fast and strong I found ...like say if you are just a few hrs late changing the patch...I found it a sort of an all encompassing kinda drug...hard to explain...it just sort of takes over ...you're life...not a good thing to say please excuse me
    I actually have to wonder really if you are actually feeling any other drugs you are taking for break through pain while having a 75 mg patch on...
    As a matter of a fact I would bet that if you went on a 100mg patch and stopped the pills totally or maybe took say an extra 20 to 40 mg of fental say in lolipop [sucker in US ??] form that would combat or knock out the WD from the pills...
    Then after a week or even less start to taper the fental very slowly and carefully...
    You do realise that then there would be no way you could abuse your medications besides you would not want to...
    Because no way do you fool around with Fental
    When I was on 50 micu of Fental....I also had a script for Oxy..I was supposed to take 1 10mg tab twice a day...but even if I took 8 at a time something I can do quite easily I felt nothing no buzz at all fental overtakes and deadens everything IMO
    Anyway just a thought
    I agree toally too with what this week for sure has to say re sticking to slow release meds I myself try to do that as with my script of patches and Oxy...I go use all 60 tabs of oxy in 3 days and I am left with my Burp patches that are a lot harder to abuse [although I manage to do that too hence my dilemma at the moment !! to weeks of quarter dose till next refill...lesson dont be like me !]
    There is of course the option if you taper off the Fental you could use the slow release Burp patches it is a very good steady painkiller and is used for severe pain here in Aussie not as it is used in Subexone in USA mainly to help opitae WD ...I think it is called a Burp trans patch in America...you do have it and it is not used as much as it should be for long term severe pain...most of your Docs seem to love dealing out the hydro or oxy
    I wish you all the best of luck and strength to do what ever you decide Cheers Stell
    Thisweekforsure likes this.

  5. #5
    Anonymous Guest

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    Thanks Stell - the words of encouragement are most appreciated. i do not envy what you're going through. I have tapered and jumped a coupled of other times in my life. I've also detoxed using methadone using a 4 day taper plan - very rapid and very uncomfortable.
    i agree with what you say about the Fentanyl - putting a patch on immediately raises tolerance to the point where a 20mg Oxycodone can not be 'felt' for breakthrough discomfort.
    Most importantly to me is getting out of the opiate haze & having control of my life back - after nine months of surgery, kidney stones, liver scarring & living with two cancers - yes i could easily rationalize life on opiate based pain meds - but its being dependent that bugs me. Having to rely on a source - my doctors for continued support of using this stuff. Starting to deeply dislike the lack of 'caring' about things that matter as a consequence of being on this medication.
    I'm holding right now at 4 x 20 /day (plus the patch)... I need to work out getting my patch prescription refilled - I'm six days short from having lost 2 patches (swimming & showering)...so if my Oncologist is OK to refill early and I know i can continue seamlessly on the patch - I'm going to drop to 3 x 20/day for about 5 or 6 days.

    I'm praying for you (and for me too) that your struggle over the next couple of weeks is less difficult than your brain tells you. Much good luck in you efforts.

  6. #6
    Stell76 is offline Junior Member
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    Hey John
    Thank you for your reply and encouragement too !
    I understand only too well the feeling of dependence...it really is almost the worst part esp if you have trouble keeping on the strict dosage amounts Drs seem to demand
    I feel such a failure...all the time that I have to basically grovel if I take an extra few tabs in a bad pain week
    In the same boat as you 2 patches lost this month
    I tell my Doc I have trouble keeping them on esp in the heat we have in Aussie or now it is cold with clothing hot showers
    I also travel so am forever misplacing them...and sometimes I just need extra !! I admit that
    I have got to the stage I just cant think up any more excuses true or un true
    So I just tough it out...not good
    I feel like a naughty girl all the time these days
    Let us know how you go with the next drop...I think you should be fine but if you are uncomfortable I am sure if you put the patch up for a week [to 100] and then came back to the 75 micg the next week that would work with very little difference in pain management
    Cheers Stell

  7. #7
    Anonymous Guest

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    Quote Originally Posted by Stell76 View Post
    Hey John
    Thank you for your reply and encouragement too !
    I understand only too well the feeling of dependence...it really is almost the worst part esp if you have trouble keeping on the strict dosage amounts Drs seem to demand
    I feel such a failure...all the time that I have to basically grovel if I take an extra few tabs in a bad pain week
    In the same boat as you 2 patches lost this month
    I tell my Doc I have trouble keeping them on esp in the heat we have in Aussie or now it is cold with clothing hot showers
    I also travel so am forever misplacing them...and sometimes I just need extra !! I admit that
    I have got to the stage I just cant think up any more excuses true or un true
    So I just tough it out...not good
    I feel like a naughty girl all the time these days
    Let us know how you go with the next drop...I think you should be fine but if you are uncomfortable I am sure if you put the patch up for a week [to 100] and then came back to the 75 micg the next week that would work with very little difference in pain management
    Cheers Stell
    Hi Stell... hope you're doing ok. And getting through the weekend with some joy in your life and not just this constant voice of should I, can I, how much longer will this feel like this or that.
    My update is that I've been on 4 x 20 mg for about 8 days now. On Monday i'll step down to 3 x20 - the patch remains at 75.

    I agree with you that if i could get a 100 mcg patch the cravings for the Oxy pills would probably be diminished. but at this going no one is going to give me more Fentanyl. My wife has a lot of fear as it relates to fentanyl - her baggage is real & understandable - we lost one of my closest friends in life to an opiate / benzo OD. A young, vivacious, friend & father of two. Our families were extremely close. She was the first one on the scene...before EMS service she was there at the house. Separating the kids from their dad & the wife from her trauma. The news of Prince's OD from Fentanyl worries her as it relates to my struggles with all opiates.

    I'm staying active. Gym every other day. Lots of fluids. Cleaning & organizing areas of the house. Back in 2010 I did a long taper off of methadone - I had lots of other comfort drugs to go along with that taper. All along I knew it was more about getting off the methadone than it was about getting sober emotionally. Not just abstinent but truly working toward changing the the way I felt, thought and responded to the world. Back then I started using other opiates including H almost immediately after the final jump to zero. Then I hit a bottom - a really tough one and was hospitalized for treatment in August of 2011 - and until the cancer & kidney stones diagnosis 9 months ago I had been completely abstinent from all substances. Understandably I agreed to the opiate pain meds. And now its time to find out how to live as a cancer patient without opiates. I HATE WRITING THAT. There is a part of me that wants to be on opiates every day for the rest of my life... and another part that believes that's my hi jacked brain thinking that way. I know how good I am when my mind & soul are free of these deceiving life sucking medications. I'm angry at my loss of self that occurs. i do things - such as lying - to help maintain access to these meds - with full knowledge I am trying to get them to feel good, to party, in some way but that i don't really need them for pain related to cancers. Thats my truth this evening. It helps having this community to write to. I need the help, the support & the understanding.

    xo
    JAE aka OrangeLude.

  8. #8
    Anonymous Guest

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    [QUOTE=johnalec;505842
    My update is that I've been on 4 x 20 mg for about 8 days now. On Monday i'll step down to 3 x20 - the patch remains at 75.

    [/QUOTE]

    Hello all, been a little quiet here this week. Just checking -- in today is day two on 3 x20mg Oxy + 75mcg Fent patch.

    I am scheduled to change my patch in the morning. What I have done in the past is on nights like this - the eve of changing - I start cutting pieces of the patch I'm wearing and chew them to get an extra feeling from what's left in the glue. by the time i go to sleep i will have eaten the patch - caught a good feeling and sleep pretty well too. In the morning I'll put on the new patch....

    I may try to reduce the Fent patch as well by cutting a third of it - two thirds of a 75 mcg patch and I'll be managing on a 50 mcg patch and 3 x20 mg Oxy....

    The problem is that this behavior is not as prescribed and my support network - wife & 12 step sponsor would not condone or agree with this behavior - so I either don't do it or do it in secret and feel a little bit like an addict cheating or playing with their meds.

    Thoughts & opinions?

  9. #9
    Ricky71 is offline Platinum Member
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    Quote Originally Posted by johnalec View Post
    Hello all, been a little quiet here this week. Just checking -- in today is day two on 3 x20mg Oxy + 75mcg Fent patch.

    I am scheduled to change my patch in the morning. What I have done in the past is on nights like this - the eve of changing - I start cutting pieces of the patch I'm wearing and chew them to get an extra feeling from what's left in the glue. by the time i go to sleep i will have eaten the patch - caught a good feeling and sleep pretty well too. In the morning I'll put on the new patch....

    I may try to reduce the Fent patch as well by cutting a third of it - two thirds of a 75 mcg patch and I'll be managing on a 50 mcg patch and 3 x20 mg Oxy....

    The problem is that this behavior is not as prescribed and my support network - wife & 12 step sponsor would not condone or agree with this behavior - so I either don't do it or do it in secret and feel a little bit like an addict cheating or playing with their meds.

    Thoughts & opinions?
    Absolutely that is addict behavior not to mention extremely dangerous! I would encourage you to never do this again, Fentanyl is not to be played with and who is to say the the medicine is distributed evenly throughout the patch? You don't know how much medicine is left in that patch even after you been wearing it for a time? Please be very careful, many have overdosed and died by chewing on Fentanyl patches! I wish you the best. Take care... God bless us all!

  10. #10
    Anonymous Guest

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    Quote Originally Posted by Ricky71 View Post
    Absolutely that is addict behavior not to mention extremely dangerous! I would encourage you to never do this again, Fentanyl is not to be played with and who is to say the the medicine is distributed evenly throughout the patch? You don't know how much medicine is left in that patch even after you been wearing it for a time? Please be very careful, many have overdosed and died by chewing on Fentanyl patches! I wish you the best. Take care... God bless us all!
    Thank you - i appreciate what your're saying - your words are a powerful reminder. Much appreciated. No addict behavior as i push forth on this taper plan...

  11. #11
    YouKnow1 is offline New Member
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    johnalec,

    How are you doing?? Have you cut down the oxys? Did you experience any withdrawal symptoms while tapering?

    Have you watched any of the "The Truth About Cancer - A Global Quest"? There are 9 documentary like episodes. They are very informative and many have been cured of different types of cancers.

    Just my 2 cents.
    Best of everything to you!!
    ~M

  12. #12
    Anonymous Guest

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    Quote Originally Posted by YouKnow1 View Post
    johnalec,

    How are you doing?? Have you cut down the oxys? Did you experience any withdrawal symptoms while tapering?

    Have you watched any of the "The Truth About Cancer - A Global Quest"? There are 9 documentary like episodes. They are very informative and many have been cured of different types of cancers.

    Just my 2 cents.
    Best of everything to you!!
    ~M
    Much appreciated. My taper is moving along as planned... yesterday I dropped from 75mcg patch to 50mcg & the oxy's droped from 3x 20 mg to 3 x15 mg/day.... I think this is a significant drop and will see how I feel later today as it will be my first day on this new dosage plan.

    I am exercising - getting some sun - meditating and doing what I can to stay active. I already am feeling a lot more clarity during this taper... and in a way I am enjoying the process and the progress.

    Thank you for all support.

  13. #13
    rob0112 is offline New Member
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    Hello thisweekforsure. How much of Tramadol do I need to take to help cold turkey withdrawal of oxycoddone (I am forced to do this as my pain dr. closed her praactice suddenly with no help to taper.. I am in day 7 taking 2-50mg tablets 3xday.
    thank you so much to anyone who can help me. I also take methadone 15mg 2x day. Eventually I want to taper off the methadone but know this helps with my withdrawal of oxycodone.

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