About to come off dihydrocodeine - any advice?

Question

I have been on it for two years awaiting an operation. That is over now, but I have been taking far more than I should. i feel humiliated going to my doctor and asking for help but I am going to in 2 hours. Any advice as to what I should be asking for. The last time he weaned me off and the cold sweats, stomach cramps and restlessness were unbearable. Please help.

Answer 1

First of all, good for you for asking for help. You don't have to be ashamed of having a problme; it takes guts and intelligence to ask for help.

Now, as to how to lessen the withdrawals. You could do a taper, decreasing your dose day by day, if the doc is willing, which can get you off the drugs comfortably. If you go this route, make sure you are TOTALLY honest with your doctor about how many pills you have been taking every day, because they will use that number to determine how many pills to give you on the first day and how much to reduce the dosage every day. If you lowball the number, you're going to wind up in bad withdrawals. If you're admitting you have a problem you should go ahead and admit how much of a problem it really is anyway, right? :)

There's also the Thomas Recipe for detox, which you can do at home with a little help from your doctor. There are two different versions of it; the main difference is that one has an extra ingredient or two. I'll give you both-- and give you the complete list of ingredients and the all the steps for each one; you can print this out and take it to your doc and get his opinion on which is best for you to use. The prescription parts of these recipes are VITAL, and I can't imagine the doc not wanting to write a scrip for something to help you in your quest to end your dependance on the pain meds.

For BOTH recipes, have on hand:

--Ibuprophen (take 800 mg every 6 hr) or Aleve (You can take up to 3, twice a day). NOTE: For the second recipe, use these meds ONLY if you are using the once-a-day Ultram if you are using the 50 mg Ultram you will not need the NSAID's .

--Gatorade: DON'T FORGET TO DRINK... if you get dehydrated you will feel worse!!

--Heating pad, ice, pillows, aromatherapy candles... anything that will make you feel better.

TIPS for both recipes:

Once you have all of your supplies, you will already feel less anxious and ready to commit. If possible, go stay with a friend or family member you trust and have a good relationship with... you will need a quiet place, love and support, and NO access to the drugs! Plan on at least 4 days of doing nothing but healing... no responsibilities! You'll be in the bathtub frequesntly, as the hot water helps with the muscle spasms; putting lavender oil in the water during your soaks will help calm you naturally. You can also get some homeopathic Calms Forte (or something like it) for your nerves on the days after you discontinue the Valium (or similar). After taking your last dose of your pain medication, wait at least 12 hours unless you begin to feel withdrawals sooner. The main thing is to let your body begin to withdraw from the meds because then you know the narcotic is starting to leave your system-- if you don't, taking the Valium could cause respiratory/CNS depression and death. Your apetite will probably suck and you'll likely be terribly nauseous, but if you can eat, try to. The best food is the BRATT Diet: Bananas, Rice (steamed, no butter), Applesauce (Plain), Tea (brew it on the weak side, and put in plenty of sugar), and Toast (minimal butter, if any at all). Ready? Ok... here we go...




Thomas Recipe #1:

For this version of the recipe, you'll need your doc to prescribe Valium or another benzodiazepine such as Klonopin, Librium, Ativan or Xanax. Of these, Valium and Klonopin are best suited for tapering since they come in tablet form. Librium is also an excellent detox benzo, but comes in capsules, making it hard to taper the dose as you can't cut it into halves and/or quarters. Ativan or Xanax should only be used if you can't get one of the others.

For the Recipe, you'll need:

1. The Benzodiazepine prescribed by your doctor.

2. Imodium (over the counter, any drug or grocery store).

3. L-Tyrosine (500 mg caps) from the health food store.

4. Strong wide-spectrum mineral supplement with at least 100% RDA of Zinc, Phosphorus, Copper and Magnesium.

5. Vitamin B6 caps.

6. Access to hot baths or a Jacuzzi (or hot showers if that's all that's available).

How to use the recipe:

Begin your detox with regular doses of Valium (or alternate benzo). You can experiment with the Valium dosage, you may be more or less sensitive to it, and be sure to ask your doctor what the max dose is. (You can also ask the a pharmacist.) Start with a dose high enough to produce sleep. Before you use any benzo, make sure you're aware of how often it can be safely taken. Different benzos have different dosing schedules. Taper your Valium dosage down after each day. The goal is to get through day 4, after which the worst WD symptoms will subside. You shouldn't need the Valium after day 4 or 5.

During detox, hit the hot bath or Jacuzzi as often as you need to for muscle aches. Don't underestimate the effectiveness of hot soaks. Spend the entire time, if necessary, in a hot bath. This simple method will alleviate what is for many the worst opiate WD symptom.

Use the Imodium aggressively to stop the runs. Take as much as you need, as often as you need it. Don't take it, however, if you don't need it.

At the end of the fourth day, you should be waking up from the Valium and experiencing the beginnings of the opiate WD malaise. Upon rising (empty stomach), take the L-Tyrosine. Try 2000 mgs, and scale up or down, depending on how you feel. You can take up to 4,000 mgs. Take the L-Tyrosine with B6 to help absorption. Wait about one hour before eating breakfast. The L-Tyrosine will give you a surge of physical and mental energy that will help counteract the malaise. You may continue to take it each morning for as long as it helps. If you find it gives you the "coffee jitters," consider lowering the dosage or discontinuing it altogether. Occasionally, L-Tyrosine can cause the runs. Unlike the runs from opiate WD, however, this effect of L-Tyrosine is mild and normally does not return after the first hour. Lowering the dosage may help.

With breakfast, take the mineral supplement.

As soon as you can force yourself to, get some mild exercise such as walking, cycling, swimming, etc. This will be hard at first, but will make you feel considerably better.


Now, Thomas Recipe #2.

For this version of the recipe, you'll need your doc to prescribe the Benzodiazepine as mentioned in the first recipe, Ultram (100 mg ER-- once a day extended release-- is best, because you can't over-use it. It also comes in 50mg tabs, in which case you can take 50-100 mg every 4-6 hours; this is for the pain that withdrawals cause), Clonidine (this is going to keep your blood pressure down, and kinda "settle" you), a muscle relaxer, which is optional but I recommend it since the muscle aches in the legs and back are for many the very worst symptom of withdrawal use a mild one, since you're also using the Valium or similar). Also ask the doctor about Cymbalta if you are not already on a antidepressant. This is a fairly new drug that is the first antidepressant that is also used for muscles spasms and pain. The Valium and Clonidine are VERY important, as well as the Ultram, and possibly the muscle relaxer (Skelaxin is nice and mild).

For the recipe, you'll need:

1. The Valium (or similar), Ultram, Clonidine, Skelaxin (or similar), and Cymbalta

2. Imodium (over the counter, any drug or grocery store).

3. L-Tyrosine (500 mg caps) from the health food store.

4. Strong wide-spectrum mineral supplement with at least 100% RDA of Zinc, Phosphorus, Copper and Magnesium.

5. Vitamin B6 caps.

6.Hyland's homeopathic Leg Cramps with Quinine

7. Access to hot baths or a Jacuzzi (or hot showers if that's all that's available).

How to use the recipe:

DAY 1-3

Take the Clonidine (0.1 mg) three times a day. Use the Benzo in a dose that will induce sleep. If you want to sleep all or most of the day through the worst of the withdrawals, that's fine. After that, about the middle of day 3 or the morning of day 4, try not to use the Benzo excessively. Try to dial back the dose on both it and the Clonidine after day 3. Use the Ultram, Imodium, and Skelaxin ONLY if you need them. Take the Hylands by dissolving 3 under your tongue every 3-4 hr. (You may not need this if you get a muscle relaxer.) If you have the Skelaxin or other muscle relaxer, take it as directed by the doctor. Take the Cymbalta (if you get it) before bed. Drink plenty of fluids, take the Immodium as needed, and if you can eat, try to do so.

DAY 4

Take your Ultram, Skelaxin, Valium, Clonidine and CYmbalta as you have been. Dial back on the Valium and Clonidine. Follow the day 4 dosing instructions for the vitamins and mineral supplements and L-Tyrosine; take that on an empty stomach. Try and eat (using the BRATT Diet) about an hour after taking the vitamins and L-Tyrosine. Use the Ultram, Skelaxin, and Imodium as needed. This is the day you turn the corner!

DAY 5, 6, 7

Take your vitamins and L-Tyrosine on an empty stomach. Eat after an hour. Assess your need for the Clonidine; if your heart is racing and you feel jittery, take some (but taper the dose daily until you're not taking it at all. Otherwise, don't take it. (It's advisable to do this prior to taking the L-Tyrosine.) Take 1/2 a Valium (if you need to during the day otherwise take it at bedtime), your Ultram or Skelaxin if you need it, and the Cymbalta.

After Day 7, you can continue on the Cymbalta if you have emotional issues, because it's a great anti-depressant and helps with the pain. If you still have the pain that led you to the surgery/meds in the first place, you can continue to take the Ultram and taper it down veeeeeery slowly. You can also continue all the vitamins/minerals, but not the L-Tyrosine.

Sorry for the novel! Good luck, and feel free to e-mailme if you need.want to talk to someone!

Answer 2

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Answer 3

There is nothing to be humiliated about. Your doctor is the best place to start. Weather you took the medication as persceibed or took more than you should have 2 years is going to cause a physical addiction that is very uncofortable to deal with. The doctor should ween you off the medicine, lowering the dosage over a monthly period. You should give the medication to a loved one who will keep you from taking more than perscribed. Allthough this may also cause a little withdrawl symptoms and some depression it is faar better than going cold turkey. Joining a self help group such as Narcotics Annonmyous or A.A. can be very helpful and provide a strong support system. Even if you feel you are not an addict, a few months or years of these meetings can truly help in changing your lifestyle. What they teach is positive and can be very helpful. I went through exactly what you are going through so please take this infromation seriously. Now, you mentioned an operation. I too was hoping that after lower back surgery I would no longer need to take narcotic pain meds and was looking forward to being away from them and the stigma. For a while this was so, but I found myself in alot of pain and very miserable... After consulting with my family and doctors as well as TRUSTED members of my self help group I opted to continue pain medication.. Operations do not always help. I have had three so far. Besides pain medication I also use music, meditation and the love of my wife and children to help me cope with the pain. I go to a pain clinic monthly in Philadelphia and though at times I become frustrated with the doctors. I have to remember that I have choices to make, changing doctors, etc... But always use a support group of loved ones to help make decissions. Somtimes the drug could cloud our decission making. I hope the best for you and will keep you in my prayers. the physical addiction to narcotics is the most powerful thing I have ever dealt with in my life. But with love and support all is possiable. Stay strong and don't be afraid to pray, even if you don't beleive, it can't hurt... Good Luck. If you ever need more help contact me at [e-mail] or through my 360 page..

Answer 4

Your doctor was a bit careless to say the least, you should have been given help to withdraw... "When physical dependence has developed, withdrawal symptoms may occur if a person suddenly stops the medication. Withdrawal symptoms include: drug craving, runny nose, yawning, sweating, insomnia, weakness, stomach cramps, nausea, vomiting, diarrhea, muscle spasms, chills, irritability, and pain. To minimize withdrawal symptoms, long-term users should gradually reduce their codeine medication under the supervision of a healthcare professional." Go back and describe your symptoms and ask for some help. None offered, ask to see another doctor.

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Answer 5

There's no reason to be embarassed...doctors are who got you in this mess in the first place. The fact is, there is NO reason why anyone needs to "suffer" when coming down off of an addictive medicine. The medical community has created all sorts of ways of weaning people off of addictive substances, with a minimal amount of discomfort. DO go to your doctor, and let him either create a program for you to go on, or send you somewhere that specializes in this sort of thing. Once done, you can get on with your life!

Answer 6

you really shouldn't be embarrsed but the only advice i can give you and hope you listen to what i say is never never never try to come off this type of medication without the help and knowledge of a doctor. Coming off medication of any type when taken for a long period of time can be dangerous. Please get advice off your doctor.

Answer 7

your doctor will most probably put you on subutex. he will also prescribe buscopan(stomach cramps), stemitil, (anti nauseant), lofexidine( blood pressure and 2 stop your brain being scrambled), omeprazole( heartburn) and loperamide( the runs ) . your doc will tell u how too use all these in combination. the subutex will gradually be reduced till u feel fine , (subutex is far easier to maintain ) and difficult too overdose on . you will be very lucky these days finding a gp or clinic willing to prescribe valium, but will prob give you something less potent like zopiclone, anyway , good luck , plenty of rest , and in a couple of weeks you will feel great. all the best . ps the lofexidine will also stop the hot and cold sweats.

Answer 8

Ive heard tramadol can help it is a synthetic type opioid but not as strong as morphine, maybe you could get valium as well for muscle relaxant effects , you may have to say you've been taking more hydrcodeine than prescribed otherwise you might get too low a dose. Other alternatives are detox clinics good luck.

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