Quitting Oxycodone

[dayandnight]

This is my first post in probably 2 years. To make a long story short, for the last 4 years Dr. B has tried all meds and tricks known to mankind, and do to serious augmentation or side effects that were not tolerable,we had to settle on taking solely Oxycodone. I slowly had to ramp up the dosage to 80 mg a day and here lies the problem. I have become dependent on it and 80 mg is not dealing with the RLS anymore. Dr. B. said I have to taper it down to 40 mg at the most. I have done that and 40 mg doesn't come close to treating the RLS. I have it 24/7 depending on the activity and of course there is the withdrawal symptoms to deal with too. At the present time I'm lucky if I get a total of two hours of sleep a day. He wants me to go cold turkey for the remaining 40 mg in order to "reset the RLS clock" and to get it down to its normal level, whatever that is. The problem for me is how do you deal with the withdrawal and not being able to sleep at the same time. It's a double whammy. I have gotten off of Norco three times before but always had a DA running in the background to take off the edge of the RLS. But this time I will have nothing on board to deal with the RLS. I understand this will last a minimum of a month. And let's say the RLS clock is reset and we start all over with the Oxycodone, won't things just go back to the the need to keep ramping-up the Oxycodone again? I don't understand the concept of getting off a drug if you're just going to start taking it again with the possibility of being right back to where you are now in a couple of months. Any ideas?

[jmg416]

I'm in the exact same boat as you, except with kratom. And I've learned that my limit for not sleeping due to RLS is no more than 2 weeks. I can handle the initial withdrawal as bad as it is, knowing it won't last forever. But night after night of sleeplessness I can only tolerate for so long. I really can't say I know where this cycle will end for me. I'm currently just trying to take the bare minimum of kratom that I can to get through the day and nights.

Since you need the Dr. to prescribe your meds, you kind of have to go by his schedule. Did he say he would put you back on them in a month? And how long did it take you to get from your initial starting dose to the maximum 80mg he capped you at? It's up to you to decide if that torture to relief ratio is acceptable.

Kratom is a possible solution, unless it isn't legal in your state. But I would still recommend you take as much time off the oxy as you can handle before starting it. The receptors it affects are the same, and you would want to start (and hopefully stay on) as low a dose as possible. So that follows along with your Dr's advice of resetting your RLS clock. It is also much more susceptible to abuse as there is no Dr. limiting your use.

Anyway, there are people far more knowledgeable on this forum than myself that you hopefully will get input from. I just wanted to give some feedback and support since I am in the exact same boat at the moment, or at least was a few weeks ago when I took 2 weeks off.

[ViewsAskew]

One of our longtime members has done this at least three times.

He basically suffered for a few weeks. There just isn't much of an alternative that I know of. If you work, maybe you can take time off of work, do it during a vacation? No matter what, it's going to be hard. You aren't going to sleep much at all - at least EeFall didn't.

A lot of us are in the dependence boat - I am, too. Not that it helps us now, but I'd highly recommend to anyone using anything that can create dependence to alternate if at all possible. It's so hard to say that you can suffer a few days - with no sleep or with crappy side effects - but it may be the only way for us to prevent these problems. While I hate the worst of the DA side effects (there are many for me), taking it a few days a week has allowed me to keep my opioid dose consistent for over 5 years - prior to that I had to increase it every 8-12 months. I haven't been able to reset my dose downward, but I started this before it got so high that I was maxed out.

[dayandnight]

Thanks for the above responses With regard to EeFall, did he/she go back on the same opiate they just got off of? Once the clock was rest, did they ramp up the dosage over time and thus starts the cycle all over again? This all seems like a hopeless never ending mess. One thing in my favor, I just got laid off from work a week ago, so I'll have plenty of time to walk around.

[ViewsAskew]

There is a 30 or longer page post by EeFall cataloging what he went through - if you can't sleep some night, you may want to find it (there is a search function at the top right of the page) and read it. I only say that because I don't want to misrepresent it. If I remember correctly, he went on a different drug - but one that still causes dependence. I believe - again, cannot be sure I'm remember correctly - that his dose has so far stayed constant.

So sorry you were laid off....but, maybe it is a silver lining!

[Rustsmith]

The 37 page discussion thread that Views describes can be found at

http://bb.rls.org/viewtopic.php?f=5&t=8892

The thread is quite long, but it is an very interesting read because EeFall provides a day to day log of his experience as he detoxed from the cocktail of medications he was taking.

There is even an earlier thread where it all starts that is just as long. EeFall started the Riding the Big One topic because the other was getting too long.

As for the question of whether he went back on the same opiate, the answer is no. His doctor had hit the end of the road for the standard list of RLS opiates, so they had to start experimenting. As I remember, he started up again using Suboxone. The thread describes the miseries that he went through for quite a while to get things worked out. In the end, it involved a combination of figuring out the timing each day to take his Suboxone to minimize the hyperalerting effect, going on the paleo diet to lose about 50 lbs and diligent use of his CPAP machine to treat his sleep apnea.

[Joanie60]

I was hitting my doc's limit of 15-20mg of oxycodone per day and still having symptoms (up and down and up and down). She switched me over to Methadone and so far, I love it!! Much smoother coverage. I started low and slow but quickly have fallen into a 10mg one day, 15mg the next, then back to 10mg. I have never needed nor been tempted to take 20mg in one day. This has only been since February of this year so it is still early, but I have not had this much "comfort" since I initially took 0.50mg ropinerole. (which, over a period of a couple years became 4.0mg!!!) I actually have fond memories of that first couple months on 0.50mg ropinerole. I had been up so many nights for the ENTIRE night and Requip (ropinerole) seemed like a miracle drug lol. Boy, did it turn on me!!!!

Anyway, have you discussed methadone with him?

PS: the bad news, as my doc pointed out, this is the last stop on the train. She is out of tricks if 10-15mg of methadone doesn't work. She said I'd have to detox off methadone and start all over again on meds that I KNOW don't work for me

[dayandnight]

Yes I have tried Methadone. It makes me extremely nauseated, as with most meds, and after about three days, nausea turns to vomiting. I have tried it three different occasions, several months apart and the result is the same. But thanks for the idea.

[ViewsAskew]

Yes I have tried Methadone. It makes me extremely nauseated, as with most meds, and after about three days, nausea turns to vomiting. I have tried it three different occasions, several months apart and the result is the same. But thanks for the idea.

It definitely can do that. You can try an anti-nausea med. Some people have found that after a few weeks using an antinausea med that their bodies adjust and it doesn't cause nausea any more. But, it doesn't work for everyone.

[QyX]

Such slow limits for opioids would make me go crazy.

What you can do to keep your dose low is rotating the opioids. Like switchting from Oxycodone to Hydromorphone after 6 - 12 months, then to Morphine and after one more year you restart the cycle.

It is not uncommon to prescribe several hundred mgs of Oxycodone for pain management.

There is no way I would agree to these kind of strange withdraw mess. There is no RLS clock. If you have to live a life ... you can't just do a withdraw.

[Joanie60]

I'm in my seventh month with Methadone. 15 mg is the sweet spot. Some days I only need 10mg but the next day I will wake up writhing. Taking 10mg at mid day and 5mg in the evening keeps me fairly symptom free and doesn't make me groggy the next day (as happens if I take it too late in the evening). If I have a bad night, even on 15 mg. I just suck it up and use hot water bottle and move around a lot. I am determined NOT to go to 20mg.

[ViewsAskew]

I tried that, QyX - rotating opioids. Problem for me is that none of them (that worked) were tolerable. I find it fascinating how different we can be regarding meds. We all just have to find a way that works for us and be happy we have.

The first time I had an opioid for dental surgery, I remember going to work and being ANGRY at everyone. Tense, jaw clenched, and irritable! I was in college and a manager at a fast food restaurant. The crew HATED me that day....

Fast forward to now - some opiods make me projectile vomit within 30 minutes, so those are usually out. The rest? Just like that experience the first time, except the clenched muscles in my jaw and neck create a migraine quality tension headache. An ice pick is stabbing me in the eye headache. An I can't stand light or sound headache. Every day.

I tried for three months to find an alternative I could rotate. We went through everything except ones you inject. I finally gave up - I figure I'm stuck.

In the past year, I've had two iron infusions. My serum ferritin is now in the high 100's. I can now take a DA for at least three weeks without augmentation. I haven't pushed it to 4 weeks, yet. I tried a week, then a break, then two, then a break, then three. I'm in the 4 week trial now. I am dependent on methadone, so can't eliminate it, but can go from 25 mg to 5 while using the DA. If I can make it four weeks, I can likely successfully stop the methadone, detox, then alternate the DA and the methadone for hopefully a long time.

Joanie - hope that your dose holds for a long time. It does for many and no reason to think you won't be one of them!

[Joanie60]

Thanks Ann, I sure am hoping. Today was a quirky day. Around 2:30pm I couldn't figure out why my legs hurt so bad. I thought I remembered taking my 10mg pill around noon, as I usually do. I thought, DANG ME!! I can't be ready for my 5mg booster already but my legs REALLY hurt!! So I counted my pills (I keep one week's worth, Friday thru Thurs, in a pill bottle in my purse, rest locked up in a small safe). Sure enough, I forgot to take my first pill today!! So I popped it but, as most of you know, it was too late. I have been uncomfortable all day...better!! but still uncomfortable. Gotta get those meds in at the sweet spot..after antsy and tingly, but before pain. Oh well!! Thank heavens for methadone (as I uncomfortably read all those articles about heroin overdoses and the EVIL methadone and suboxone!!!)

[QyX]

I tried that, QyX - rotating opioids. Problem for me is that none of them (that worked) were tolerable. I find it fascinating how different we can be regarding meds. We all just have to find a way that works for us and be happy we have.

Okay but when I remember it correctly, you are fine with Hydromorphone?

I am on 28 mg of Hydromorphone daily now plus 10 mg Oxycodone Instant Release as needed.

[QyX]

Thanks Ann, I sure am hoping. Today was a quirky day. Around 2:30pm I couldn't figure out why my legs hurt so bad. I thought I remembered taking my 10mg pill around noon, as I usually do. I thought, DANG ME!! I can't be ready for my 5mg booster already but my legs REALLY hurt!! So I counted my pills (I keep one week's worth, Friday thru Thurs, in a pill bottle in my purse, rest locked up in a small safe). Sure enough, I forgot to take my first pill today!! So I popped it but, as most of you know, it was too late. I have been uncomfortable all day...better!! but still uncomfortable. Gotta get those meds in at the sweet spot..after antsy and tingly, but before pain. Oh well!! Thank heavens for methadone (as I uncomfortably read all those articles about heroin overdoses and the EVIL methadone and suboxone!!!)

I read a lot in a forum for patients who are addicted to opioids and are treated with methadone or buprenorphine (suboxone) to avoied withdraw symptoms.

Buprenorphine is a clean drug. It has atypical receptor profile but compared to Oxycodone / Hydromorphone it has a comparable side effect profile.

But for methadone: a lot of patients treated with methadone for opioid dependency complain about weight gain, insomnia, impotence, loss of libido and mood disorders, caused by methadone. Men are also at risk of low testosterone levels. This is what methadone makes in the eyes of many users such a bad drug.

If you tolerate methadone, it might be the best opioid for RLS treatment.