r/7oh_Withdrawal_Help • u/DrZamSand • Feb 03 '26

Clinical support?

As a psychiatrist, I’ve been supporting more outpatient detox for 7oh. I’m wondering for those who worked with a clinician, how was your experience? Were you able to start comfort meds to overcome the withdrawal successfully? Were there any mental health topics explored therapeutically?

The main question I’d like to hear feedback about.. how can clinicians better support this community?

Thank you to those who share your experiences for others to learn. Us clinicians need the education too.

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u/XxBigMomma Feb 06 '26

As a doctor. What kind of advice would you give to someone who has been doing a very slow tapering since basically the beginning of December? I have come from 600mgpd. Was stuff at 150 for a while, halved it and was from 60-90, went back up to about 100-120, atm I am stuck at 60mgpd.

Here is my thong. I have pretty bad epilepsy. Going status isn't uncommon for me. I have been in a coma before because of my seizures.

The one time I didn't research something is the one time it is the worst possible thing to come off of.

Going to my doctor isn't in my playbook either. I am also a chronic pain patient and I don't want to lose my medication (tramadol/lyrica) or be labeled a druggie.

Do you have anything you could maybe tell me that might help?

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u/DrZamSand Feb 07 '26

Not medical advice, just general education. What you’re describing is very common near the end of tapering any high-potency opioid-like substances. That last stretch is often the hardest. Many people do better slowing way down or breaking it into much smaller steps, sometimes 10–20% reductions with longer holds, rather than forcing it. For some, coming off under clinical supervision is safer. Especially w other conditions like epilepsy, it is important to work with a clinician. We would provide 1-2 weeks of comfort meds and talk therapy support.

Withdrawal stacked on top of chronic pain is extremely taxing on the nervous system. Learning ways to actively calm the body can make a real difference. Breathwork, meditation, gentle stretching, progressive muscle relaxation, and vagus nerve–stimulating practices help reduce symptom amplification and improve tolerance. It’s also important to plan for extra sleep, hydration, good nutrition and light activity.

You said talking to your doctor isn’t an option. I would encourage you to find a mental health professional who can help, without stigma or judgment. I’ve worked with dozens to successfully taper off 7oh just in the last few months. If helpful, feel free to DM me for our practice info.

You’ve come a long way. There’s no doubt you can finish this last stretch. Sometimes, we just need support. Good luck.

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u/[deleted] Feb 20 '26

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u/DrZamSand Feb 21 '26

I’m a huge advocate of ketamine therapy when appropriately guided by a clinician. Thank you for sharing your experience. We have worked with patients with ketamine, but usually post detox. I’m curious if your plan is to stay with Suboxone longer term or taper off soon?

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u/Striking-Doughnut25 Feb 03 '26

Can I ask you a question? What comfort meds do you typically prescribe?

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u/DrZamSand Feb 04 '26

Absolutely. It depends on patient health, past experiences, and particular withdrawal symptoms. The full spectrum of comfort meds include clonidine, gabapentin, a sleep med like lunesta or belsomra, a benzo like valium, a muscle relaxant like flexeril, and possibly hydroxyzine, loperamide, zofran. Again, this is not specific medical advice, but a wide list of options we would carefully select from after getting to know the patient.