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Fairly quick taper. From a stable dose of methadone, reduce by 5mg a day until you stop. From 20mg down use alpha-2-adrenergics (preferably lofexidine, if available, otherwise clonidine). On the 20mg methadone day take 2 0.2mg pills lofexidine (Britlofex) each pill being 0.2mg) or 2 0.1mg pills clonidine [clonidine is available in other doses, but I shall assume henceforth that a pill of lofexidine is 0.2mg and a pill of clonidine is 0.1mg] at bed time. On the 15mg day take 2 pills (either...
If you wish to switch to buprenorphine, reduce as above (if necessary) until you hit 20 mg, then after 5 days of methadone 20mg, wait between 36 and 72 hours (the longer the better) until you are experiencing as severe a withdrawal as possible then switch to 16mg mg buprenorphine a day. I have uploaded some guidelines for this transfer to the document section, which I suggest you consult, as if you do not wait sufficiently long, or try to transfer too soon you are liable to experience...
From a stable dose of methadone, reduce by 5 mg every 5 days until you hit 20mg. Then reduce by 2.5mg every 5 days and then stop. Although adding an alpha-2-adrenergic agonist to a slow taper is not shown to significantly increase success rates, I would nevertheless suggest consider taking 2 0.2mg lofexidine (Britlofex) tablets or 2 0.1 mg clonidine tablets at night when you reduce to 2.5 mg methadone or when you stop, if you are finding yourself in serious distress. These can be increased...
Chances are you're going to resort to more conventional means. The fact that there are so many tapering strategies rather than one definitive method lends credence to the idea that no one way is universally better. To get some idea of the complexity of the issue, the following meta-analysis in the document section runs to 219 pages, of which about 100 are relevant: PCSS Guidelines - Transfer from methadone to buprenorphine In brief, there are 3 commonly used detox strategies; buprenorphine...
The final minority detox is the rapid/ultra-rapid opiate detox; known as the Asturian method, UROD, Detox 5 or the Waissmann Method. This is in theory another "magic detox", but frankly it scares the hell out of me. Essentially you are heavily sedated, or put under anaesthesia, a nappy seems to be involved in many places, injected with opiate antagonists (naloxone or naltrexone) and wake up cured. Searching bulletin boards I have found horror stories, and the odd success story, although no...
The latest "miracle cure" added to the pantheon is ibogaine. I have provided what I consider the most important information from what seems a reliable source below in an appendix to this post, together with sufficient references to articles etc. posted on DF to allow interested people to research this further. Please notice a less than one in three chance of "long-term" abstinence, and a one in three hundred chance of dying. I have no reason to doubt these numbers. I'd strongly advise not...
I shall now outline a list of the more common and a couple of less common detox methods. Please bear in mind that there is no "one size fits all" solution, and I am only giving specifics to be used as rough guidelines that may prove more or less useful. My own prejudice, or perhaps "post-judice", in that it's a conclusion I've arrived at from experience, is that quicker detoxes are better than slow ones. Even the slow tapers I give are fairly quick by some standards. Detoxing isn't rocket...
If you have clear answers to these questions then skip this section. Otherwise, seriously addressing these issues can make a huge difference to your chance of success. There is no getting over the fact that a) state of mind is of paramount importance; far more so than the actual method of detox used and b) chances are you will be stretched close to breaking point unless you have success at one of the "painless" methods described below. It is important to realise that dependence and...
In the past, substance use disorders have been considered a reflection of the sufferers’ lack of willpower (Vaughn & Perron, 2012). This assessment does not represent the complete picture however. Approximately 50% of sufferers of severe mental disorders experience problems with substance use (Rosenthal, 2015). We also know from research (Rosenthal, 2015) that the development of mental disorder often precedes the development of a substance use disorder, and that sufferers of different types...
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