Expert: Jacqui - 9/15/2008

Question
QUESTION: Hi, I have not told anyone about this yet, but I am addicted to hydrocodone and benzodiazapines. I take 15-20mg hydro a day and 2-4mg Ativan daily. I know I need to get off this stuff and I am unwilling to go thru any programs or tell my family who do not know about any of this. I know I cannot get off the Ativan alone and am going to see a specialist about that the end of September, but I would like to know the best way to get off the hydrocodone right now without too much withdrawal. I only have a month's worth of medication left (about 85 pills at 5mg each) and was wondering if you could tell me a good taper schedule that would make the withdrawal not too terrible. I know I can do this. I quit drinking years ago by myself, I quit smoking cold turkey and never looked back. Once I make up my mind I can do anything, and I have made up my mind about this. I am finished with this crap, it is ruining who I am. I hope you can help me and thank you for listening. Oh, I get withdrawal symptom fromt he hydro pretty fast, like within 10 hours of my last pills so I think this will be hard. Diana

ANSWER: Hey Diana,

You have clearly done your homework re: the benzos.  Yes, they need to be withdrawn very slowly and under medical supervision as side effects from withdrawal can be serious (seizures).

As for the hydrocodone, you will need a pill cutter, or be able to crush up the tablets.  If you have a months worth at 15 to 20 per day, then it will stretch out a bit more than a month soI have come up with the following (over a couple of months):

Week one:
Monday - 15mg
Tues - 15mg
Weds - 14mg
Thurs - 13mg
Fri - 12mg
Sat - 12mg
Sun - 12mg

Week two:
Mon - 11mg
Tues - 10mg
Weds - 10mg
Thurs - 10mg
Fri - 9mg
Sat - 9mg
Sun - 9mg

Week three:
Mon - 8mg
Tues - 7mg
Weds - 7mg
Thur - 7mg
Fri - 6mg
Sat - 6mg
Sun - 6mg

Week four:

Mon - 5mg
Tues - 5mg
Weds - 5mg
Thurs - 4mg
Fri - 4mg
Sat - 4mg
Sun - 4mg

Week five:
Mon - 4mg
Tues - 3mg
Weds - 3mg
Thurs - 3mg
Friday - 3mg
Sat - 3mg
Sun - 3mg

Week six:
Mon - 2mg
Tues - 2mg
Weds - 2mg
Thurs - 2mg
Fri - 2mg
Sat - 2mg
Sun - 2mg

Week seven:
Mon - 1mg
Tues - 1mg
Weds - 1mg
Thurs - 1mg
Fri - 1mg
Sat - try nothing
Sun - if you are really suffering take one

Week eight:
Try nothing this week.

Coming off opiates isn't going to kill you, but you will feel lousy.  There are things you will need to do to minimise potential problems.  I know it sounds a bit "new age" but you have to be kind to yourself.  Try to avoid stressful situations (if possible).  Doing things to get your natural endorphins going is a good idea - warm relaxing baths, sex (if this is a safe option), relaxation techniques, sitting in the sun.  Also, make sure you get enough good food.  You may have a reduced appetite, but it is important to get enough vitamin and other nutrients otherwise you will feel more run down.

I am not sure whether your use was related to a chronic pain issue or recreational, however if you do have unresolved pain problems it will be important to get this addressed.  There are other approaches to managing pain, which are not as easy as medication, but rather based on psychological approaches.

Diana, I wish you all the best.  Remember though, if you are unsuccessful in your aim of stopping altogether, try not to see it as failure.  People who have drug dependencies often take many attempts to get their use down to the desired level (whatever that might be ... total abstinense or just a reduction), so you are not a "failure" if it takes more than one go.

Finally, you might have some emotional ups and downs over the next few months.  Remember, that despite what governments and the popular media suggests, drug users are just normal people.  Often people who use opiates are derided as weak or "bad", but this just isnt' the case.  People use a variety of substances (from caffeine, alcohol to heroin and meth) for a variety of reasons, and humans have done this for thousands of years.

Let me know if there is anything more I can do to help.

Kind regards,

jacqui


---------- FOLLOW-UP ----------

QUESTION: Thank you for your non-judgemental attitude and I agree with everything you said..and I thought I was the only one! I do have a follow up question though. My pills are 5mg, scored in the middle. I can break them in half to 2.5mg, and split them again with a pill splitter to 1.25, but any smaller than than that, or if i try to shave off some of it, the thing just shatters to dust. Can I use your time table but with reductions of 1.25mg instead of 1mg? Will that be tolerable? Is there a different time table if i do it that way? Thank you again for your help!  Diana

Answer
Hey Diana,

I am pleased that I could be of help!  Try what I put above but reducing 1.25 instead of 1.  If it gets too much, just slow it down a bit and stay on each level for an extra day or two.

I would love to hear how you go with it.  Like I said, it is unlikely to be a walk in the park, but more than anything it is important that you don't get too frustrated.  If it gets to hard, then just stop for a while.  Don't punish yourself!

Best of luck!!!!!!!!!

Jacqui