Meth lisdexamfetamine reduction regime for acute methamphetamine withdrawal

[bablyonee]

Hi I'm new here. I've benefited greatly from some of the stuff I've read here though, so I thought I'd share some notes on what I'm about to do in the hope it can help anyone else.

So, I find myself in another meth addiction bind (no sick left at work yet need to stop and sleep for a week). Then I came across this study

https://www.sciencedirect.com/science/article/pii/S037687162200429X?casa_token=szB0x15FY2oAAAAA:OxUEGu7a6u1R2G0QC-aepUmhPssVqGXuiYKM1dl-uqSZV4yseapMs-ukOrIC8Yz6zD1HdtG55A

And I was fortunate enough to be able to source a daily tapering dose. So today I've had 240mg of Vyvanse (40mg x 6 capsules). taken 40 mins ago. No effect as yet. Apparently peak onset is 3.5 hours, so I'll update my post later.

Associated drugs include my decision to REMAIN on 50mg desvenfexaline (I'll cease it if symptomology gets too gittery). Also, I'll have 50mg modified release quetiapine as a PRN, and 80mg propranolol PRN

Sick of being told by seemingly indifferent doctors how there is no pharmaceutical help for meth withdrawal or for meth treatment generally. Feels like they ?enjoy witnessing my self-induced distress. Vyvanse seems dogs-balls obvious to me.

I hope this works. Quietly confident. The despondence associated to this particular binge on meth has been just horrible.

Tomorrow will be 200mg, next day 160mg and so reducing on for 5-6 days.

 

[bablyonee]

2 hours in. feeling a bit wired. not necessarily euphoric or anything.

 

[tryptakid]

The biggest difference between meth and dextroamphetamine is the lack of SERT agonism and the presence of increased norepinephrine. Meth is less stimulating in therapeutic dose ranges, but the serotonin release from higher dose use (I believe over 25 or 30mg) blends with the dopaminergic effects to create a unique euphoria which is less self-limiting. The norepinephrine released by dextro/levo-amphetamine (and vyvanse which becomes dextroamphetamine) increases stuff like muscle tension and likely leading to that wired/jittery feeling.

That said, continuing with the vyvanse while also being on the desvenla will probably be broadly enough to land the plane, but it will not feel as smooth as meth.

If you can trust yourself with a small amount of oral methamphetamine concurrent with your vyvanse, it could be helpful, but I would only do this if you have a solid plan and failsafe to prevent lapsing back into ongoing use.

If you can also utilize N-Acetyl Cystine, that may help with compulsivity and urge to continue to use stimulants.

What's your ultimate goal here? Will you continue to be able to access the vyvanse for a period of time and taper down?

 

[bablyonee]

Wow thanks for such a detailed response tryptakid.

Yeah, Not 100% sure I can trust myself with oral meth.. By a small oral dose do you mean, like a point? Half a point?

I haven't taken any of the Seroquel XR or the propranolol yet. Hoping these might take the edge off the wired feeling. Any thoughts on this?

Will def get some of that N-Acetyl Cystine.

My goal here is to cease meth and stimulants altogether as the cons outweigh the pros for me. My goal here is to just try to be less irritable and have energy. I've an apt with my psychiatrist in June. I've asked him to consider trialing me on Lamotrigine for my (CPTSD-related) tendency to get pugnacious.

My CPTSD sees me struggling to regulate my emotions and my reactions. This damages my marriage and my relationship with my 2 kids. Desvenfexaline doesn't feel enough.

Below is a transcript of this video:



I love to prescribe Lamotrigine (brand name Lamictal) because it is effective and often has no discernible side-effects. It is useful in treating depression, bipolar disorder, mood swings associated with ADHD and stimulant meds, and some types of anxiety and agitation. I also find it very helpful for men (or women) that tend to be perceived as irritable and reactive. Some guys I treat call it their "anti-asshole pill." It gives that microsecond between stimulus and response that can keep our brains for being triggered and yielding a knee-jerk and potentially unhelpful response. Those dealing with pornography or other compulsive behavior often benefit by taking this medication as well. Unlike the SSRI and SNRI antidepressants, there is generally no emotional blunting, sexual disfunction or weight gain. There is no attendant drowsiness or sleep disturbance. Most people taking it do not feel medicated in the least. While it has a mood stabilizing effect, it does not cause the drowsiness, lethargy, weight gain, metabolic effects and akathisia that can result from atypical and typical antipsychotic medications.

 

[bablyonee]

Right. Well, I didn't post updates on my METH DETOX (using the lisdexamfetamine reduction method), however here I am 8 or so days in reporting that IT WORKED!

I started on 6 x 40mg Vyvanse capsules, then each day I reduced by 1 cap.

Day 1 on 6 caps had my facial skin all oily from the stimulation BUT NO stimulant detox symptoms.

As stated, I utilised a range of sleep helpers such as Olanzapine, Quitiapine and/or Doxylamine. In fact I smashed it with these at times because

THE NAME OF THE GAME was normal sleep patterns. Do everything I can to restore normal sleep patterns.

And here I am feeling good. Reducing the sleep assistance. Running daily (I introduced short walk/runs when I got down to about 80mg Vyvanse per day)

It must be about 3 days since my last dose, and Ive come back to say:

1. I'm shit at daily journalling, and

2. This process works. It's bullshit when academics/doctors etc tell you there's not really any medication for getting off methamphetamine. I just did it and I did it following the attached 8 client- successful study (which is attached to this thread), and I did it whilst turning up for work each day.

Ive an initial appointment with my local public addiction service in a couple of weeks. I'm still going to turn up to this appointment because I want to tell them this:

No I don't need to go on Mirtazapine (That shit makes people fatigued, and fatigue usually makes meth users want to use meth).

No I don't need naltrexone because it's made little impact on my desire to use meth in the past.

And No I don't need any help because rather than wait for the world of public alcohol and other drug services to get their shit together, I was fortunate enough to be able to gather the obvious drugs that would work (or dex or lisdex), myself and demonstrate what this study has already proven:

*Vyvanse reduction got me off meth.

*Vyvanse reduction assisted my MH.

*Vyvanse reduction got me that critically needed sleep hygiene.

*Vyvanse reduction saved my career.

Inbox me for any further support/info. Unfortunately I cannot access medication for you but you could use this study to show your doctor (I mean not my posts, but the Australian study that I've attached at the start). This is the study that I based my little project upon.

It's frustrating waiting for actual public services to catch up with such things as these. My support to you is try to access meds and do it yourself. Even if you could use meth itself in appropriately divided reduction dosed ratios in itself.

You do not need 2 weeks off work for a bed ridden meth detox.

Go well.

 

[Jnowhere]

It is good to see, that your less than ideal early experience on Bluelight, has not soured you on the whole site.
Sincerely Jnowhere

 

[femhag]

I’ve been lurking the forum because I took two weeks off of work so I could get off meth from a month and a half long relapse. I created an account JUST to say I think the issue with the doctors is that Vyvanse and Adderall are tightly controlled substances on their own. The way you couldn’t trust yourself to taper oral meth is the same way that they can’t responsibly trust that things will go as planned when giving it to a patient.

The maximum daily dose that they are legally able to prescribe (no matter the reason) is 70mg and you started at 240mg. I doubt that they could even legally prescribe the maximum amount to someone that is new to Vyvanse, even if they claim that they were doing more meth than that. Multiply a starting dose (30mg) by a 30 day supply anyway and would that have been enough to cover your 840mg? Maybe. Would it have been enough for someone else? Maybe not. Could it have become a new full blown addiction for someone else. Probably.

I guess I just wanted to say that it’s cool that it worked for you but there are reasons they can’t just write you a script and it’s probably the same reason you couldn’t just taper with oral meth. I have an adderall script and I’m maximum dosage and I’ve got plenty of it since I’ve not been taking it this past month… I’m STILL trying to get onto Naltrexone and Wellbutrin instead. Overdoing the adderall has a weird, deep, empty hangover for me and I can’t even fathom doing that to myself right now mentally. I tried to go cold turkey last week but I could hardly take care of myself and no one else is here to take care of me. Now I’m back at the drawing board…

So you’re really out of the woods? I guess your main goal was to not lose a single day of work. Maybe I’m too worried about feeling “okay enough” to go back to work. Congratulations on getting the job done.

 

[bablyonee]

Hey Femhag. It's good to come at this with a critical approach. I hope you get through your detox or reduction or whatever it is you were aiming for during your time off work.

And thanks for creating an account! As a newbie I'd still like to welcome you. Using can be isolating. I'm glad you bothered to join. Heres to many future interactions

I suppose my response to there being certain reasons as to why my local Acohol and Other Drug service wouldn't engage with this treatment regime, (and indeed, GPs etc), might best be understood via my quoting that Little Brittain character who coughs in people's faces after declaring "computer says no".

I'm not sure your motivation for pointing out several reasons as to why those with power wouldn't (and are you also saying/implying 'Shouldnt') provide this as a service, however my reaction is to say I feel it's easy to list off reasons for not doing stuff. Here's some counter reasons as to why I still say they should do it.

- There's a need. This is the ultimate point. The patient should always come first. Not the clinicians testicles. Frankly I'm sick of public services risk assessing their way into not doing anything substantial for 'the need' in the community that they serve. Drug use changes over time, depending on supply and sociopolitical changes. Drug services must keep up if they're to not lose relevance. In the case of both you and I, career/livelihood is at risk. Don't know about you but losing MY job would probably see me spiral downwards quite a bit further.

- A precedent has been set. The ultimate cover-your-arse is the attached study. If this study was about cancer, and it had the same level of success, there'd be no sitting around on our hands. It would be implemented asap. I hate to say this, but the reasons given almost sounded like the public service clinicians themselvess.. "oh but what about" "oh this aspect is risky" and of course my favourite "oh but what if".
-
And Femhag, respectfully. I feel a bit stockholmish & a bit sad to see you yourself (a person in perfect need of this treatment), making the excuses for them. Do you not believe the study? It clearly sets out why this large initial dose is physically and psychologically justified. It's a bloody study. They always do things by the book. And as for scheduled drug restrictions, think methadone.. think all other scheduled drugs. We don't just put them in a safe and declare them useless. Instead we just comply with their restrictions. In my case I had a friend give me my daily dose. Outpatient setting could be the same. Daily pick up. Easy as.

Bottom line.. it can be done. You have a right to evidence based care. They have a moral obligation to do what they can.
But because it's junkies like us.. evidence based treatment has to wait years before anyone with some balls finally comes along and gets shit rolling!

 

[femhag]

Don't know about you but losing MY job would probably see me spiral downwards quite a bit further.

So if you had become a doctor and that was your job and you knew the laws and you knew you could lose your medical license … would you risk it for a patient that went on a bender? I guess your writing is directed more at the institution or professional medicine itself but it sounds pretty close to the kind of complaints I’ll hear from patients in cases where the customer isn’t always right, even if the information they present might be true.

Thanks for the warm welcome and yes it’s very isolating.

After I replied I kind of wished I hadn’t. I work in medical and I guess in my heart of hearts my intention was to help you see the circumstances in (what I would consider to be) a more balanced way.

I think you use strong language but strong in like an emotional way. If I didn’t know any better I would believe you and think that life was unfair. Saying I have the “right” to “evidence based care” and that a doctor has a “moral obligation” to do what they can… doesn’t mean I can pull any study and demand that they risk their job because I made a decision to risk -my- job.

I would LOVE for someone to come babysit me and precisely taper me off
in exchange for my participation in their study. I would be very satisfied with that too just like the participants of the study you referenced

 

[bablyonee]

Femhag in regard to spinning some postivity in relation to my local Alcohol and other Drug service, I hear you. Valid point. Parapraxis suggests I'm really angry at myself. That's a good pickup and I appreciate your honesty. Gratitude for simply being in this minority world (aka First World) is really important for my mental fitness. And MF is going to be needed if I'm to keep going forward in the direction I need to go. Please know this.. I do advocate industrially and socially. Our local Mayday march is a regular event for our family, as are various other campaigns/strategies that advocate for better community needs. I'm not an armchair socialist. Ive been involved in in my union on a semi formal bases (president/secretary etc) for virtually all of my 30+ years in clinical roles (paramedicine & mental health).

Perhaps I'm angry because this won't be the first time I've engaged with the A&oD service. The first time was to request a home-based opiod detox. I'm afraid Computer said No to this. Apparently codiene was an addiction they had no treatment for.

Sometimes later I engaged again for methadone addiction. Same again. No catch-all program.. the program as to getting oof opioids (heroin I assume) was to get ON methadone or Suboxone, however the clinic was full and had a waiting list to boot.

Both times my public health electronic records will then mark me out as the substance-dependant person that I can be. I blew my anonymity (to any former colleagues or future clinicisns). I'm due a colonoscopy soon. The scoping team will be privy to those electronic records. It's hard to not be frustrated when I remember how both my engagements were a complete waste of time. It's hard to go get the scoping now as Ive always seemed to lean towards social anxiety. I'll feel judged and unworthy (despite no indication of that happening I'm guessing)

Another frustrating part is when I consider how I could return in 5 years and I'd wager that nothing has been done to fix this methadone or codiene bias issue.

I hope you understand how such experiences have tarred my bias towards the beurocratic adhesion that I see in clinical staff. I make no apology for this. It's stupid

"this opiod addiction we will treat, but not that one"

Another aspect to me: I speak up for others. Not just myself. Ive in-house clinical knowledge and in my 50s. Going from emergency ambulance to mental health nursing has opened my eyes to just how slow change comes along. I get frustrated because it feels we live in a world where certain people who feel no Moral Distress at the limitations of what they are allowed to do ...don't affect them. They don't feel any frustration. These are often the ones who end up in management. This is just my opinion, but anyways..

I like to treat stuff.

And if I can't, I'll research and implement a Quality Improvement Program (Ive learnt how managers like to be able to boast about these things).

I don't need to quote or promote or defend this Vyvanse experience. I'm sorry if you feel Ive an aggressive approach. I'm passionate and I'm a sharer. The thread is there not to boast but to help plug a gap. The only technicality I can see would be obs monitoring. Instead of criticising it I suppose ive hoped someone could get something from it. Even if that is just a teeny weeny bit of hope.

Also. I don't feel guilt for being able to access this amount of Vyvanse, and I don't need a baby sitter. Not sure where you were going with that

 

[bablyonee]

Well, I just deleted my last posts because a day later, re-reading them has helped me realize how they were mostly defensive justifications. Lordy my half dozen first posts here really have been a faceplant in poor decorum. It's interesting how I can be so quick to get riled up when reading, and then so unnecessarily pugnacious/conclusive/overly sensitive/arrogant & judgmental when I start writing. And STILL people (usually gently) help me to understand the groove here.

Not too long ago, I'd be a bit horrified by my performance, but I've been working on not indulging this emotion. It's not the thinking that I want to engage in. Instead, I've been hoovering up, taking responsibility, apologizing and (most importantly to me), not indulging in any naval gazing. If I don't like to post-post embarrassment, then stop bloody doing the actions, right?

And hey Femhag, I'm sorry to hear you're stuck in that situation. I didn't even address that in my last rant. I don't think of stuff like that when I smash out my 'opinions' on this keyboard. I was indeed very fortunate. I had pharmacological access, and I had human support. I can understand how it looks particularly ungrateful when I take stock of such a fortunate circumstance.

I hope that feeling of wishing you hadn't joined up goes away. I'm sure in one of my spleen vents I mentioned how happy I was since shutting all social media down. Forums like this can be bloody traumatic. Please know how that reason you cited for signing up -To try and have me see another perspective, or as you put it, help me achieve a more balanced view. Please know how that was a solid 'Mission Achieved'. Thank you for helping me. I spend a lot of time alone & well, what do they say about listening to your own advice or something? Actually, 30 seconds later.. I'm thinking there is NO saying about that! I just imagined that one. Too much time alone!

If I could summarize what I gained, I might describe it as a reminder of how I could, and how I probably should, be more compassionate to those clinical people, and/or service directing staff, and GPs, nurses, psyches etc. I particularly like myself when I'm compassionate in my outlook. Brings to mind Pete Walker's fantastic theory on how if I shrink my Inner Critic, there's then this bonus result: The process shrinks my Outer Critic, and how he suggests that this secondary achievement ousually occurs on a subconscious level (less work..Yay!)

Pete can be read here:

https://pete-walker.com/shrinkingInnerCritic.htm

I was also thinking of how maybe that's just one of the benefits of Bluelight. By lifestyle (or illness or whatever else each member might describe their engaging with drugs), we're sort of in the same clan, and maybe that can come with a bit more license to help each other to be nicer, or to help each other by lessening harmful use of drugs, and even by way of identification. that secure feeling that there are others just like me. Simply knowing there are people who give enough fucks to sign up and to speak their mind in the name of the 'good stuff', makes me want to log back in ASAP, and ask that you to please hang around. I know my drug use has seen quite a few friends/relatives withdraw their support and their concerns for me. You too have loads of good stuff to say Femhag, and you've got a good moral compass.

So, now that I've done that logging in, I shall resume my trawling through the good stuff here. I'm finding it really nice, this having a place I can be more open about myself. Hopefully i might one day get to read further posts and/or threads from yourself

High regards,