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Dihydrocodeine (DF 118) is a medium strength, short-acting opiate that comes in tablet and liquid form. It is a very strong painkiller and is very addictive. A detox on DF118 is similar to methadone but the physical withdrawal symptoms may be less severe and not last quite as long. However, the fact that DF118 feels more like heroin means that it can make the cravings to use heroin worse than if you are detoxing on methadone. Because of this many services won't prescribe it, along with the fact that it can be more psychologically dependency forming than methadone - because it gives more of a rush.
The detox will take place over 7 days using DF118 tablets taken every 4 hours (only lasts that long), usually 4 times a day. The first day is normally bearable with the withdrawal getting worse until you peak on the third day, after which the symptoms will gradually die down. Because DF118's are only painkillers, you will normally be given a course of sleeping tablets to last the week of the detox plus an additional week.
Because it is addictive in itself, your dose will be reduced gradually as you will need to wean yourself off it slowly to avoid additional discomfort. You will also need to get your heroin use to a low amount before starting, as it is a relatively weak opiate and won't therefore be much help if your habit is too large.
A DF118 detox may mean that:
The psychological withdrawals and cravings can be worse (because it can feel better to take a short-acting drug)
The physical withdrawals may be less severe than with methadone
It can cause bad constipation
It can increase the hot/cold flushes
You can't take it once a day and feel OK all the time
You may have times when you are feeling rough and times when your feeling intoxicated
You have to cut your opiate use right down before you start as it is a relatively weak opiate
If you go for a prescribed detox the first task is to get off all other opiates and only take the prescription drug.
Other things that might help are:
Taking the medication in a regular pattern, as described by the Doctor. Don't feel tempted to take more to make yourself feel better.
Expecting to feel rough and sleep badly for several days
Expecting, after a big drop in dose and when you come off, the withdrawals to get worse over the first 3-4 days, to stop getting worse between 4 and 7 days and to have to wait 7-14 days for things to start to feel a little better
Expecting poor sleep to go on for months
A DF118 detox takes place over seven days with the dose reducing each day, as you wean yourself off this highly addictive medication. Whilst each clinic will follow its own rules and programme, in my experience the DF118 detox is as follows:
Tablets taken every four hours, along with two sleeping tablets each night (Nitrazepam) for the week of detox plus the following week.
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