I wrote this up in guide form forever ago. I could update it if you need. What kinda daily dose are doing now?
Below is the copy/paste:
I can't really call this a guide to stopping opioids because it wouldn't work for everyone, but there are a lot of useful hints and strategies for reducing the pain of withdrawal here that come from my own experience with dealing opioid withdrawal. I've kicked 3 major habits in the past and I'm going through a 4th thanks to the DEA's war on doctors (I have chronic pain and I've been on opioids for the past two years and change as part of the treatment). I've also dealt with a number of smaller habits from shorter periods of use. I'll try to write this in an organized manner, but my thought process is somewhat off at the moment. All of the drug names are from the US, and any discussion of legal status (OTC, Rx only, controlled substance) is based on US laws.
If you know you are going to have to kick the habit in the not so distant future, tapering down as much as possible will help immensely. I had warning this was going to happen so I started cutting my intake down gradually. Dosing to stay well rather than get high is crucial to effective tapering, but it is really hard to do. I've been pretty good during the last two years about not getting high all the time and taking my meds pretty much as prescribed, although there were times where I was using to get high on a very frequent basis. I reduced my daily dose by about 20-25% every 5 days (for example if you are on 100mg of opioid x a day, you drop to 80mg/day for 5 days, then 64mg/day, then 41mg, obviously it's really hard to get to the exact dose, but try to stay close to it) because until I ran out of meds. I was able to get to a reasonable jump off dose, but I did not have enough meds to taper all the way to zero. Some people say you can taper by as much as 33% every three days, but I find the amount of withdrawal from that schedule is much worse than the slower schedule I used. You also will still have some withdrawals when the dose reaches zero (and even some during the taper), so getting there a bit slower but less worn out because of the taper is good. Everything talked about below can be used to help with the withdrawal during the taper as well as after jumping off completely or if you just stopped with no taper.
OTC Drugs
Loperamide (Immodium) is an opioid agonist that doesn't cross the blood brain barrier. It will help immensely with the peripheral withdrawal symptoms. You will have to taper off the loperamide to avoid dealing with the peripheral symptoms, but because it doesn't act centrally (meaning it doesn't do anything for pain or cause euphoria or a number of other things, you can find out a lot more detail by researching peripheral and central opioid effects) it is very easy to do. If you use nothing else I've written, please try the Immodium. It really is a miracle for withdrawal.
OTC pain meds (ibuprofen, APAP, aspirin, etc) can do wonders for the cramps and joint pain of withdrawal.
Cyclizine and Meclizine are pretty strong antiemetics for OTC medicines.
Diphenhydramine and doxylamine can help with sleep, although not much is going to make you sleep for the first few days of a hard kick.
Personally I don't find DXM useful, but some people do. Just make sure you get something where DXM is the only active ingredient. And don't dose to the point of robotripping, 30mgs 2 or 3 times a day should be plenty.
Non Chemical Aids
Distraction is awesome. Get some good tunes, some favorite movies, and someone to keep you company. I'm quite partial to video games myself.
Sex and/or masturbation is great. Opioids reduce the sex drive and make it harder to achieve orgasm, so it's often been a long time. Withdrawal has the opposite effect, in the words of a friend of mine “When I'm kicking I'll get hard from a stiff breeze.” I personally find I get off in like 3 seconds during withdrawal, but I forget all about the misery for those three seconds. And I recharge pretty quickly. Performance with a partner can be a source of anxiety for many people. I'm lucky that I currently have a partner who is understanding and doesn't mind that I get off faster than lightning during withdrawal, so it's not a concern for me right now.
Hydration and nutrition are IMPERATIVE so stock on some fruit juice you like. Avoid soda and try to drink juice rather than water, those calories are important to keeping your strength up.
I find soup is pretty easy to stomach as far as food goes. Yogurt is great too, and it has the added benefit of helping to repair your damaged GI track.
I find that taking warm/hot showers or baths helps with the muscle and joint ache, and makes me feel cleaner. I hate the cold sweats.
Multivitamins are really good too. A healthy body will endure withdrawal better and help make the process go by faster.
Once you are up to it, exercise is great for helping repair the endorphin system, and it helps speed up the withdrawal.
Other Substances That Aren't Pharmaceuticals That Help
Weed can work wonders at taking your mind off things and making you feel better. Try to use as little as possible though. You don't want to kick opioids and find out you're now a huge pothead.
Kava supplements are great for the anxiety. Valerian root is good as well.
I haven't personally used it as a withdrawal aid, but I have heard a lot of good things about using Kratom to help taper. My own experience with kratom leads me to believe that it would be excellent for helping withdrawal.
Melatonin may help with the insomnia as well, especially combined with one of the antihistamines listed above.
Prescription Medications That Help
I'm going to split this between controlled substances and non controlled substances. You don't have to go to a doctor to get these (obviously) and you can also go into a walk in clinic and use a fake name if you are concerned about going to your normal doc or being labeled a drug seeker or drug addict.
Non controlled meds:
Clonidine helps a lot with a number of symptoms. Read up on it because it is too much to get into here.
Vistaril (hydroxyzine) is like the antihistamines listed above but also has some anti-anxiety properties.
Zofran (ondansetron) is an extremely potent antiemetic. It was developed to be used to prevent nausea from chemotherapy but it is now used for many types of nausea. Tell your doctor you are got food poisoning or something else that is causing you to vomit. The stuff is pricey (even the generic is a few bucks a pill) but it is worth every penny.
Compazine is an older antiemetic that is still commonly used and fairly good and much cheaper per dose than Zofran. It is related to thorazine, so it can have similar side effects, although the dosage used for nausea is much lower than the antipsychotic dose (or what the antipsychotic dose would be, I don't think it gets used for that anymore). The sedation might be good for helping to sleep.
I've heard about the use of propranolol (it has some similar actions to clonidine, which is a much better choice, but any port in a storm, right)
Muscle relaxants can be very helpful because they can help with the muscle twitches, soreness and tightness that accompany withdrawal. Many are also very good sleep aids. I'm partial to Flexeril (cyclobenzaprine) myself, but Soma may be even better because it is more sedating and can help you sleep more.
Controlled substances:
Benzodiazepines take the edge off, help with sleep and muscle twitching. Be careful with them, a benzo habit is worse than an opioid habit in many ways.
Barbiturates do the same things benzos do, with the added benefit that they induce CYP3A4 and help speed the withdrawal up. They also have the added con of having an incredibly low therapeutic index, and being damned hard to get a hold of legally or illegally these days.
Propoxyphene (Darvacet), Codeine, and tramadol (Ultram, technically not scheduled but it fits with this group) are great for taking some of the edge of withdrawal. They won't get you high (codeine has a ceiling effect of around 400mgs, which is equivalent to about 40mg of oral morphine , ~13mg of IV morphine, ~2mg of IV hydromorphone, or 4-7mg of IV heroin), but even 60mgs of codeine can greatly reduce painful withdrawal symptoms. You will be extending the withdrawal period, but it will be much wilder. Just remember to keep reducing the dose every 2 or 3 days.
Methadone. Books have been written about it's use as a detox med or a maintainence med, so I won't go into detail here. Just be aware that it is harder to stop than heroin and the bullshit policies that clinics have to follow will tie you to the clinic.
Buprenorphine (Subutex/Suboxone) is a wonderful maintainence med or detox med. It will put you into horrible precipitated withdrawal (the feeling you get when you get pulled out of an OD with narcan) if you take it before being in full withdrawal (~24 hours after the last dose of a short acting opioid is required to avoid this, and 36 is even better, wait until you are in withdrawal to dose). It's very easy to taper from, and it blocks other opioids from working sue to it's absurdly high affinity for the mu receptor.
Random Other Stuff
A positive outlook is essential. Keep telling yourself that you can do. Make lists of reasons why you want to get off opioids. Maybe even place them around the house so you keep getting reminded and encouraged. Having people who care about you and are supportive are priceless. They can offer you moral support when things are tough, and help keep you distracted and so many other things.
Stay as busy as you can. It'll give you less time to think about dope. Obviously stay the fuck away from dope when you are kicking. The cravings will be at their worth and it's damned hard to say no when you're sick.
Using CYP3A4 inducers can help speed the process up, but they also make it more intense. It's a gamble.
I'm sure I'm missing a bunch, but I will continue to improve this. I hope it helps someone. And feel free to ask questions or offer criticism.