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Oxycodone reset/detox/taper - can it restore response?


sming
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Hi,

I have TRD and CP and was getting good effect from 4x5mg Oxycodone for about 2 years. It helped a bit with the chronic pain but more importantly it helped with the terrible anhedonia and depression I suffer. I would get a solid 45 minutes of “normality” from each dose - I’d actually care about things.

However in Feb I had an operation which went a bit wrong and left me in a lot of nerve pain. They prescribed extra oxycodone, which let me have a great February but now the 5mg, or even 20mg oxycodone leaves me feeling empty and anhedonic. The obvious conclusion is that my tolerance has shot up. 

This is personally devastating as those 45 minutes of normality allowed me to connect with Normal humans, to feel human, to feel... alive. Not high - just normally alive.

Anyway, my question is: can I get the oxycodone response back? If so, what is the best way to do that? Taper down to 0mg? Taper to 10mg? For how long? How quickly should I taper back up? -  I’ve no idea.

If anyone could shed any light on this area, I’d be extremely grateful.

Be well,
Pete

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Hey @sming sorry to hear this. That's crap...I can't advise about Oxy (never tried) but I relate to the increased tolerance sh&t when it comes to stimulants. Wish I knew what would help, I've been experimenting with dosage, and taking IR instead of LA. But I assume Oxy doesn't have different time release formulations.

Is there a comparable drug in same class you can taper & switch to temporarily? Like do a washout?

Another thing I'm trying again now is NAC. https://selfhacked.com/blog/nac-top-43-science-based-health-benefits-n-acetyl-cysteine-nac/  As a prescription drug, doctors use NAC to treat acetaminophen overdose. As a supplement, people use NAC to try to protect the liver, assisting in detox. There's evidence it can help prevent kidney or neurologic damage caused by some drugs. @notloki could probably add to this. When I tried it in the past, I felt like it increased the potency of ritalin, but as always YMMV.

 

 

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On 4/20/2020 at 4:49 AM, Blahblah said:

Hey @sming sorry to hear this. That's crap...I can't advise about Oxy (never tried) but I relate to the increased tolerance sh&t when it comes to stimulants. Wish I knew what would help, I've been experimenting with dosage, and taking IR instead of LA. But I assume Oxy doesn't have different time release formulations.

It does as it happens. OxyContin is long-acting. I don't think that'd help tho cos LA meds, in my experience, simply give you less control over when you get the active ingredients and naturally spread the same amount over a long period, thus reducing their effect almost completely, in my case 😕 

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Is there a comparable drug in same class you can taper & switch to temporarily? Like do a washout?

That's a very good idea. I tried Tramadol a couple of times and it did zilch for pain or mood. Anyone know any opiates more similar to Oxycodone that I could try. I believe switching things up is referred to as "cross tolerance". I.e. you take advantage of cross tolerance to keep the brain guessing and not down/up regulating to effectively defeat the beneficial effects.

Quote

Another thing I'm trying again now is NAC. https://selfhacked.com/blog/nac-top-43-science-based-health-benefits-n-acetyl-cysteine-nac/ As a prescription drug, doctors use NAC to treat acetaminophen overdose. As a supplement, people use NAC to try to protect the liver, assisting in detox. There's evidence it can help prevent kidney or neurologic damage caused by some drugs. @notloki could probably add to this. When I tried it in the past, I felt like it increased the potency of ritalin, but as always YMMV.

As with all the other nootropics, vitamins and other non-psychotropic substances I've tried over the 20+ years, NAC did zilch for me :(  I just seem to have a tw@t for a brain, quite frankly 😞

Thanks for the ideas though @Blahblah.

Pete

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On 4/23/2020 at 9:16 PM, sming said:

That's a very good idea. I tried Tramadol a couple of times and it did zilch for pain or mood. Anyone know any opiates more similar to Oxycodone that I could try. I believe switching things up is referred to as "cross tolerance". I.e. you take advantage of cross tolerance to keep the brain guessing and not down/up regulating to effectively defeat the beneficial effects.

I sent you a message about all this. But there are ways of augmenting opioids (with other opioids, gabepentin/pregabalin, TCAs, stimulants, clonidine, etc.)

Another thing that you could do is probably cross-taper to oxymorphone (which I believe is brand-name only at this point). It's a minor metabolite of oxycodone, but is a very potent analgesic. Fentanyl is also very, very potent and they have transdermal patches of those, but it might not offer the same mood benefits. Buprenorphine is more potent but not as potent as fentanyl, and has the added benefit of possibly benefiting mood even more than oxycodone and being more potent. There are buccal and transdermal preperations of it for pain, but the sublingual version (generic) is controlled/restricted distribution and only meant for withdrawing from opioid abuse.

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Hi Sming. I haven't read all of the above properly due to fatigue and headachyness, so sorry if I repeat something. In regards to the oxy, I find that after I completely taper off, my tolerance goes down (although I lose it very quickly), so when I start it again, it actually works. I naturally have a high tolerance, and can take 30mg of oxycodone and keep going (and yes, I get that short sense of being alive). In regard to your nerve pain, I had a neurologist screw up some nerves for migraine with botox, leaving me in agony. 20mg of oxy did nothing. Eventually my GP put me on pregabalin. The first day it was half better, second day completely pain free (I don't mean better as in fixed, just less pain). I think it took a couple of months for my nerves to heal up. It was like a magic pill. I did get fluid retention from it and had to go off it, but I was pretty much done with it by then. I highly suggest giving it a go. It is not a pain killer in the usual sense, just for nerve pain. Good luck.

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