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tone
Veteran
Reged: 06/29/03
Posts: 558
Loc: Chicago
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DO you find withdrawl from an opioid or other drug to be hardest the first few times you do it, then a little bit easier from there on?
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or is withdrawl always the same intensity no matter how many times you have done it?
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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For me, there have been many factors as to the severity/intensity of withdrawal.
The BIGGEST culprit of severity for me is an immediate and unplanned withdrawal...for example, someone stealing your pills, being unable to afford your prescription or losing your pain meds. I think the PSYCHOLOGICAL aspect enhances dramatically the physical ramifications of opioid abstinence syndrome.
The next biggest factor of severity is the type and amount plus length of time a person has been on a particular medication/s. For example, after 7+ years on 100mgs total daily dose of methadone, I attempted a cold-turkey detox. Within 48 hours, my blood pressure was so high that capillaries had burst in my face and hands and required an ER visit to bring my stroke-level blood pressure under control. Obviously, this detox was too dangerous to continue. A year later (after I had slowly worked my way down to 30mgs per day) I tried the cold-turkey detox again. I made it 4 days this time until 2 MAJOR problems prevented my continuing safely--blood pressure dangerously high and bone pain so severe I couldn't tolerate even layng down as my own body weight made it excruciatingly painful. Even with SUBSTANTIAL desire to detox and a HUGE support system in place, had I not HAD to quit the detox, I would have eventually had no choice but to use SOME opiate to stifle the severe bone pain (specifically lower back, pelvis and femurs.)
In contrast, I detoxed cold-turkey once from Demerol (between 75-225mgs every other day on average for several years) and the worst symptoms were insomnia, lethargy and cravings. I also once detoxed in a 3 week taper from 400+/- mgs of daily morphine (MS Contin)...the taper wasn't too problematic and the insomnia (very severe) was easily treated with Trazadone. The only other real problems I had was a loss of appetite and lethargy. This went on for about 6 months. Both, compared to methadone, were a breeze!
So, I reassert that drug + dose + time affects withdrawal substantially. The only thing that affects it more is the psychological reaction to the withdrawal.
That's my experience anyway.
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Never underestimate the predictability of stupidity.
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zeuzjuz
Pooh-Bah
Reged: 12/16/01
Posts: 1155
Loc: the milky way
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I am off of Hydro now (22 days and counting - woohoo!) - I have a lower back condition (scoliosis), and had recently injured my back as well - when I started hydro.... Well, I took them for 3 years and I realized (although way too late, like after about the first year) that Hydro was really not the right med for me. I was going thru constant up/down swings with my pain, etc - the short acting nature of the med was literally making my pain worse... That is why I just recently (finally! - the reason it took 3 years is I had become strongly dependent/addicted/whatever - very high tolerance) - Anyway now I am off the hydro, but looking back - I can tell you -
The withdrawals most *definitely* get worse each time. I thought the same way - I wondered, if it was sort of like something I would 'get used to' - Infact, withdrawals are one of the main reasons I got off the hydro. I couldn't take the short acting nature/high tolerance factor of hydrocodone anymore... The balance had shifted (with my tolerance) to where I was in pain more than I was pain-free.... So let's say, as an estimate - I suffered *at least* 20-30 cold turkey or planned withdrawals during my 3 years on Hydro. Some were due to refill mix-up's, not being able to afford refills, bad planning, etc... And some were due to me planning a 'holiday' to try to reduce tolerance... I never tapered hardly - I always did it cold turkey because to be honest I just don't have the willpower to taper. In my mind - it's like, 'why take a med if it is not working?' - So even if I was low on pain meds and knew I would be running short, I would still stick to my high-doses and then just accept the suffering afterwards. 20-30 w/d's over 3 years is probably a low-estimate, probably more like 40-50.... More than any human should have to endure... 
But I can say with 100% certainty - that I had similar thoughts - like the old saying, "the drive always seems shorter on the way back" - Well this is NOT true with hydro or any other opioid withdrawals.... You do not *learn* how to endure them and therefore make them easier. They get harder, much harder, each time.... Infact the last one I had was the reason I decided to get off the hydrocodone... It was horrible.
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//zeuzjuz
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