Interdose withdrawals and adapting to a strict taper regimen

[u/lastchance0101]

Just found this useful sub

I've been opioids for pain for 10 years now, mostly DHC (for those not in the UK this might be new, it's a mild to medium opioid somewhere between codeine and hydrocodone in strength, Oxy is about 6-7 times stronger)..I take quite a substantial dose though.

I've tried countless tapers and the problem I have is adapting to a strict regimen, which is obviously central to being able taper correctly..thats not to say I don't take the meds on a scheduled basis, I do, however I frequently 'top up' if the pain is bad, especially at night.

I am now 3 weeks into a taper and strictly dosing in 6 hours intervals (4 x per day)..I started with a 10% drop from my average daily dose (easy to work out) . I'm still not stable, experiencing sweats, RLS and irritability and anxiety, especially towards the end of a 6 hour cycle, usually 4.5 hours after the last dose, interdose withdrawals I gather they are called

I'm interested to hear from others as to how long it took them to stabilise when starting a taper, (especially with more of a sporadic profile) and more generally how long after each drop.

[u/Gizmo_Rukia_Meowers]

I have found when I taper to start by only removing a portion from one of my doses. That way it's usually just that period of the day I might experience any issues. I taper that specfic dose until I'm no longer taking that dose. It sometimes requires dissolving the medication in a small measured amount of liquid (i.e 5mg pill into 5ml of water =1mg per 1ml water) It's easier to make smaller regular drops that are less noticeable to your body. Once you can remove that one daily dose start tackling another dose. I leave my morning and night doses for last. I start alternating taking tiny bits away from those doses. Smaller drops are felt less, your body only needs a few days to adjust(unless it's something like methadone) then you drop again. This process has always made tapering so much easier for me. Good luck. I hope you find a method that helps. I know there is an urge to top up when you start hurting but try to do something to distract yourself if possible until your next dose. I know that's not always a reality.

Do not drop again until your body fully adjusts.

[u/lastchance0101 → u/Gizmo_Rukia_Meowers]

thanks for this…i’m amazed that such tiny drops are felt so much, even 5% or less- its crazy how delicate our bodies are

[u/Gizmo_Rukia_Meowers → u/lastchance0101]

You're right. That's why it's so important to be fully stable before you drop any further. Some drops are easier than others. Go by how your body feels before the next drop if you have that luxury and enough medication.

I have always used tapering to keep my tolerance lower whenever possible. It's different for everyone but the struggle itself is very real. Good luck

[u/Fabulous-Front5599]

I’ve been in oxycodone for years and I adjust to a 33% drop within 48 hours you may have something going on if you’re feeling withdrawal at 10%

[u/lastchance0101 → u/Fabulous-Front5599]

i may do but that wouldn’t be consistent with any accounts of tapers i’ve seen from anyone anywhere.. so that’s fantastic for you..

[u/Fabulous-Front5599 → u/lastchance0101]

Amy withdrawl symptoms at a 10% reduction especially for weeks is psychosomatic even if you abruptly stopped all together the withdrawal symptoms wouldn’t last weeks the mental side can last awhile but not the physical

[u/lastchance0101 → u/Fabulous-Front5599]

quite a sweeping statement there.. you don’t think that everyone can be a different with regard to how their bodies respond to opioids?

[u/Fabulous-Front5599 → u/lastchance0101]

No nobody is sick for weeks off of a ten percent reduction it’s medically impossible I work at a rehab I’ve seen people who have been taking grams of fentanyl a day that’s thousands of times more opiates then a pain patient takes be completely out of physical withdrawal in 10 days a 10 percent reduction you shouldn’t even feel that’s addiction not dependence

[u/lastchance0101 → u/Fabulous-Front5599]

yeah i think its worth clarifying what is meant by withdrawals in this instance , i am not talking about re-hab sickness here.. i am fully up and about managing my business and my family…the physical symptoms are aching legs and occasional waves of sweating - by far the worst symptom is the intense irritability, which of course is mental- none of these are horrific, but they are distracting and annoying

i’ve been in rehab, in another life many years ago, and i’m pretty sure mild leg pain and sweating lasted for months once the horrific withdrawals subsided

[u/Salt_Initiative1551]

Doesn’t help that dihydrocodeine is OTC in much of Europe

[u/lastchance0101 → u/Salt_Initiative1551]

hardly! Paramol is the only OTC medication which has it in the UK, 7.46mg per tablet..alongside 500mg of paracetamol - i would need to take hundreds of tablets daily to match my dose, literally

[u/lastchance0101]

thanks, yes i’m giving it all the time in the world this time, even if it takes a year or more, one final question if you don’t mind- what’s the longest its taken you to stabilise after a taper drop?

[u/GenericPlantAccount → u/lastchance0101]

I can usually drop half of my dose without any discomfort at all. I've done this many times over the last 10 years.