What do I tapering off 1st? Opiates or xanax?

opiates
#1

Addicted to opiates over 10yrs. 10mg hydros 10-15X daily. Other pain meds when I could. 6mg of xanax daily too! Lethal combination

#2

This is something that should be consulted with your medical doctor, as tapering off of both of them requires medical monitoring, and everyone is different and has a different path in recovery. Tapering off of both can be dangerous without the monitoring of a doctor and treatment team so I encourage you to reach out to local resources: your medical doctor, local detox facilities, any other treatment providers you may have.

Below are diagnostic criteria for withdrawal from both substances taken from the DSM V:
Opioid Withdrawal
Diagnostic Criteria
A. Presence of either of the following:

  1. Cessation of (or reduction in) opioid use that has been heavy and prolonged (i.e., several weeks or longer).
  2. Administration of an opioid antagonist after a period of opioid use. (Naloxone or Naltrexone)

B. Three (or more) of the following developing within minutes to several days after Criterion A:

  1. Dysphoric mood.
  2. Nausea or vomiting.
  3. Muscle aches.
  4. Lacrimation or rhinorrhea. (teary eyes or runny nose)
  5. Pupillary dilation, piloerection (hairs standing up), or sweating.
  6. Diarrhea.
  7. Yawning.
  8. Fever.
  9. Insomnia.

Most individuals who are physiologically dependent on short acting drugs such as heroin begin to have withdrawal symptoms 6-12 hours after the last dose. Symptoms may take 2-4 days to emerge in the case of longer-acting drugs such as methadone or buprenorphine. Acute withdrawal symptoms for a short-acting opioid such as heroin usually peak within 1-3 days and gradually subside over a person of 5-7 days. Less acute withdrawal symptoms can last for weeks to months.

Sedative, Hypnotic, or Anxiolytic Withdrawal
Diagnostic Criteria
A. Cessation of (or reduction in) sedative, hypnotic, or anxiolytic use that has been prolonged.
B. Two (or more) of the following, developing within several hours to a few days after the cessation of (or reduction in) sedative, hypnotic, or anxiolytic use described in Criterion A:

  1. Autonomic hyperactivity (e.g., sweating or pulse greater than 100 bpm).
  2. Hand tremor.
  3. Insomnia.
  4. Nausea or vomiting.
  5. Transient visual, tactile, or auditory hallucinations or illusions.
  6. Psychomotor agitation.
  7. Anxiety.
  8. Grand mal seizures.

The time course of withdrawal is generally predicted by the half-life of the substances. Medications whose actions typically last about 10 hours or less (e.g., lorazapam, oxazepam, temazepam) produce withdrawal symptoms within 6-8 hours of decreasing blood levels that peak in intensity on the second day and improve markedly by the fourth or fifth day. For substances with longer half-lives (e.g., diazepam), symptoms may not develop for more than 1 week, peak in intensity during the second week, and decrease markedly during the third or fourth week. The longer the substance has been taken and the higher the dosages used, the more likely it is that there will be severe withdrawal.

By you reaching out for help you are taking the first steps on your road to recovery which is brave and courageous! We encourage you to continue that momentum by looking into the treatment resources. We wish you all the best on your journey. if this is an emergency or if you feel you are a danger to yourself or others please call 911 or go to your nearest emergency room to ensure your safety.