**This is my story, and know upfront I have been working with my Doctor on this. ALWAYS CONSULT A PHYSICIAN BEFORE CHANGING YOUR MEDICATIONS.** (Phew got that out of the way. I don’t want someone reading this to attempt it without their doctor’s supervision. It could kill them if not done properly!)
So before I get started, I want to mention that medical marijuana is like any other medicine. (See the blog about the marijuana pharmacy). There are strains like aspirin, strains like ibuprophen, all the way to strains like Opana. Some are like Ambien and some like Zofran. Basically, you have to do some research and try different things out. Don’t give up if you don’t find a good strain the first time. It took a couple weeks before I found the Alien OG that replaced my Ambien.
Most of you know that this was a forced process, but for those who don’t here is a short recap: I was unable to reliably get the narcotic extended release medicine that I had been on over 18 months. In total, I have been on narcotics for almost 5 years. Not as long as some, longer than others. So I really just walked into a recreational shop (no red card at the time) just as clueless as could be, told the budtender what I needed and followed their recommendations. I don’t recommend you start that way. I walked away with one strain that worked well for sleep (Nehi Grape) but 2 that didn’t work too well for me.
My research was done after having cannabis in my possession. Because my initial reactions to cannabis were not that fantastic, I had not been considering it as a medicine. However, my ability to sleep was really amazing! That was what kept me interested enough to start the plethora of research that led to this blog! I was sleeping! That was HUGE! I usually got no more than about 10 hours of sleep a WEEK! Sometimes I would be awake for 7 days straight! I did not sleep well before marijuana, but had been consistently sleeping since (but was waking up with a little grog)! So the more research I did, the more I knew what to ask for and how to find it. I also saw the CBD information which completely made me salivate! By this time I was almost out of the Nehi Grape (I only bought a joint to vaporize, but it lasted almost 3 weeks.) I found a store that sold Harlequin and R4, so I decided to head up to Denver. (I don’t live in an area that allows recreational marijuana sales.)
Whilst in Denver, I was able to get the Harlequin, but I was exposed to Alien OG! That was the best strain for my insomnia! No groggy feeling in the morning and continuous, restful sleep! Finding something that effected me so differently let me see that the different strains all offered different possibilities! Still though, I was only looking at relief for my insomnia. UNTIL…
No pharmacy in my entire city had ANY Opana ER. None. Some pharmacies mentioned that they had ordered it, only to be shorted that in their shipments. The soonest any of the pharmacies would get it would be 7 days from that time. Unacceptable. I had used the same pharmacy for the last 7 months, but now the DEA decided to short the enitre city of patient’s medicine. Nice. I started calling Denver (60 miles away) and the only pharmacy that had it, only had half. I decided to fill that part, but this fiasco left a bad, bad taste in my mouth. I didn’t want to half to worry about this any more. Abruptly stopping Opana ER can cause both respiratory and cardiac arrest. Running out is a trip to the ER, and not having medication for 7 days is a serious flare in addition to the withdrawal! There had to be another option.
Doing the research prepared me to actively wean off the oppressive narcotics. While I am not off ALL narcotics (as you will see), I am off Opana ER, which is HUGE. The first thing I did was google weaning stories. Most were written by addicts and recreational users, anyone who has been on them for a long period of time is physically addicted to them. Try to glean any important information from these articles. What worked and what didn’t? Take notes. Research what options are available to you, and come up with a treatment plan for after narcotics. It is easy to say that you want to wean, but you need to work out a plan that both you and your physican are comfortable with.
Once my research was complete enough for this, I presented a plan that I thought might work for me. I was currently taking Opana ER 60mg daily for long term pain management and tramadol 50mg for breakthrough. We decided to switch the Opana ER (oxymorphone) for Ultram ER (tramadol) then switch out the tramadol 50’s for oxycodone 10mg. This would allow me to continue weaning, but have something for breakthrough whilst coming up with a plan for daytime pain management. I have not told my doctor about using cannabis. This is a new physician for me, and I don’t know him very well. Ultimately I would like to address this with him (he is an awesome rheumy, and the apprehension is very unreasonable with this doctor.)
The idea was to reduce the Opana ER by 25% every 5-7 days. When I got to 20mg, I would switch over to the Ultram ER while replacing my breakthrough medicine with oxycodone 10mg to complete the wean, if possible. Remember, I can’t take NSAIDS because of my kidneys. My pharma options are tramadol or narcotics. This is it. This last phase is where I am at in the process. I am off the ER narcotic and down to about 20mg daily of oxycodone. Basically, I am off 2/3 of narcotics and on a less dangerous one for the other 1/3 of pain management. Despite the fact that I am not completely off narcotics yet, I am incredibly excited to be able to say that I no longer need 3 pharmacuticals that I had been on for years!
- Only wean one medicine at a time to see how your body reacts to it. Not everyone is going to be able to wean, simply because their pain may be too great.
- Wean slowly. Never reduce your opiates more than 25% at a time, and some may require an even slower reduction. Listen to your body. If you are using cannabis to ease the withdrawal symptoms, be sure you stay on top of it. Us ladies know when you let the cramps get super bad, they are harder to stop. Same principle here. Don’t let the withdrawal get bad before you use cannabis to treat it, else it will be harder – if not impossible to treat.
- For the first few days you lower a dose, you will feel some withdrawal. The idea is to keep your dosing to where the withdrawal is minor and managable. You don’t want to reduce so much that you are in a dangerous situation. Keep in mind you are weaning, and be okay with that taking some time. Some people take months before getting to where they are comfortable. Be willing to adjust your dose back up if you have to, and to be on specific reductions longer to allow your body more time to adjust.
- When using cannabis to help, it is a good idea for you to be using cannabis about a month before you start the weaning process. You need to know how you react to cannabis and have found both daytime and nighttime strains/products to meet your needs. You don’t want to be withdrawing from opiates and experimenting with cannabis regimens at the same time. First decide if cannabis is right for you – and IT IS OKAY IF CANNABIS IS NOT FOR YOU!
- Be okay with what ever end result you have. Not everyone will get off narcotics. I am actually not expecting to be able to discontinue ALL my narcotics. I am a former JRA patient and now have 40 years worth of damage and morphing into that ridiculous autoimmune soup that we all eventually get. Even if I stay where I am at, 20mg of oxycodone daily, I am super happy with where I am at!