Tapering 101 – Addictive Pain Killers and Opiates

• Heroin
• Demerol
• Methadone
• Morphine
• Hydrocodone
• Oxycodone
• Suoxone
• Dilaudid
• Vicodin
• Percocet

Cold Turkey – Stopping Suboxone or Opioid Medications

What to do if your doctor says you can stop pain killers cold-turkey?

Question: I’ve been on Suboxone. My doctor has now said I can stop taking the medication. I’ve heard from others that you should not stop taking this medication cold turkey but should wean from

it using a gradual reduction in dose over time. The doctor said I should be fine that 4mg daily is not that much to stop. Should I just stop or taper on my own?

—Carlos, Sanford, Florida

ANSWER: Opioid medicines have common and easily seen withdrawal symptoms and some have rebound effects. Overall, pain killers can be tapered without problem but when your physician says you can stop them, most likely, you don’t need to worry about tapering off. (Ask questions if you’re not sure.)

Some other medications, such as antidepressants and blood-pressure meds, do need a tapering schedule. Sometimes docs will taper them over a short timeframe like 2 weeks or sometimes over a long period such as a year.  It depends on how long you’ve been taking them and what dose.

What can happen if you stop taking certain opioids (pain-killers) cold-turkey?

For opioids such as (Opiate, Methadone, Morphine, Hydrocodone, Oxycodone, Suoxone and Dilaudid):

• high blood pressure
• rapid heart rate
• seizures
• anxiety

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My Opioid War Story

Something is wrong… something is damn wrong… fix it now

If you have been addicted to any opioid then you are well aware that quitting an opioid is much more difficult than anyone else knows.  They refer to the time they quit smoking, or they time they stopped drinking soda and think that quitting opioids is some decision that you can just make and do it.

I would never wish the pain of withdrawal on any of my friends, but I can’t deny there have been times I wish that they could experience the feeling of being without opioids for just one hour and then let them tell me how easy it will be.

We have suffered through the many sleepless nights where our our body spasms unexpectedly like some sort of a seizure.  Some people say their arm twitches, some people experience severe restless legs but everyone experiences some soft of visible twitching body movement where your brain is telling your body that something is wrong, something is damn wrong, fix it now!   We are the ones that can share war stories about quitting opioids and the withdrawal that kept is in the bed (or hospital) for a week, and we’d watch the clock for what felt like eternity.  The opioid withdrawal made minutes feel like hours, and hours like days.

The worst withdrawal symptoms for me:

• Pain – full body pain
• Severe Anxiety and Restlessness
• Nausea and Vomiting, Gut wrenching feeling
• Cold and Hot spells
• Inability to sleep
• More pain and leg kicking
• GI Joe Squirts (late stages of withdrawal)
• Runny Nose (early stages of withdrawal)

What physical thing do you remember while suffering through opioid withdrawal?

My opioid withdrawal happened several years ago and other than the feelings that I felt there is one thing I have a very detailed image of in my mind.  The clock that was hanging near the bed I was laying in as I suffered through opioid withdrawal.  I can remember every detail about the clock on the wall as I suffer through days of opioid withdrawal.  The big round clock made of plastic and colored like aged brass.  It had a tan background and roman numerals and the hour hand had a strange pointer almost like the devils pitchfork.

I have visions of that clock burned into my mind at various time through out the day and when the hour hand had moved from four to six I recall wondering if I was going to make it and if the opioid withdrawal would ever end.  The pain did end, and going through the pain was worth it, but the pain never ends for an addict in my mind.  There is a different pain once you are sober called boredom but that is for another day.

So let me know about your war story.

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The Trick to Quitting  Buprenorphine Naloxone with Minimial Withdrawal Symptoms

Withdrawal from Buprenorphine Naloxone or other Opioids

Quitting opioids really sucks, for lack of better words.  I’ll never forget the many sleepless nights spent kicking my legs because they hurt so bad.  I’ll never forget the opioid withdrawal symptoms where my body would change from hot to cold in a flash, literally.  One minute I’d have ten blankets on and be shivering and the next I’d be sweating profusely.  And the clock watching I’ve mentioned in other articles… that is something I’ll remember to the day I die as minutes went by they felt like hours.  I’ve got another article called war stories of quitting opioids where I describe my “war story” in more detail.

The Trick to Quitting  Buprenorphine Naloxone  (Suboxone)

As I promised, there really is a way to quit  Buprenorphine Naloxone (Suboxone) that involves very little withdrawal pain, and I suspect you can handle some pretty intense withdrawal pain if you are here unless you had an unlimited supply of money and drugs and somehow remained alive.  I used the word “TRICK” on purpose because in a way this is some sort of trick or decption that we play on our mind.

Yes you are going to deceive your body, play a trick on it by weaning it off of opioids  to taper off of the drug so slowly that your body doesn’t notice it.

The Pacifier

This may sound crazy but it really works, it reminds me of a similar method of deception that I played on my daughter when she was a child.  As a parent we used a pacifier to keep our daughter satisfied when we were too busy to do it ourselves, it sounds evil but it is quite common and not really mean at all. If you don’t know what a pacifier is… well a plastic rubbery sucking thing that a baby sucks on to “pacify” themselves and deceives them into thinking they are sucking on a bottle of milk or the mothers breast.

, The baby becomes emotionally attached to them especially if you use them too often, and when the baby starts to grow older it can become a challenge to make the baby stop using the pacifier without driving you crazy by crying too much.

So, I got creative and decided to try something other than cold-turkey and just taking the pacifier away.  I took out the scissors and cut a very small portion of the tip off of the pacifier and gave it to my daughter… as I expected she took to it like an addict would take to a couple crushed Oxycodone 30 and a straw.  Bingo! I thought this just might work, but the key was going slow I made the mistake of cutting off too much a few days later and my daughter made a funny face, spit out the pacifier and started crying.

So each day, I would cut a sliver of the pacifier off and there would be no problems.  As the days went on the pacifier would start to fall out of my daughters mouth but it was gradual so she got used to picking it back up and putting it in her mouth, or she would hold it with her hand.  This is the way to quit Suboxone or any other addictive substance, by tricking your body very slowly and gradually.  Several weeks had gone by and the pacifier was cut so small that my daughter had to hold it to keep it in her mouth and we found that she didn’t cry for it very much at all.  Eventually she stopped using it because it wasn’t worth the effort of holding that nub of a pacifier in her mouth!

The Tapering Plan – Plotting your Taper from Buprenorphine Naloxone

The tapering strategy will work for any opioid, from Oxycodone and Hydrocodone to Morphine, Methadone, Heroin & Hydromorphone.  The reason you don’t hear of many success stories of persons tapering from Oxycodone is because it has too short of a half-life, meaning that the time it takes for the drug to be eliminated from your blood stream is short.  Buprenorphine Naloxone is an extremely long lasting opioid with a mean half-life of 37 hours.  The speed at which you taper is different for everyone.

Tapering off of any drug should always be planned and completed under supervision of a doctor.  I will be writing about this subject soon, and will go into detail about the actual tapering plan.  You can use my Suboxone Taper Charting tool to plot a taper plan off of any drug!

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