What is the best equivalence fast-taper plan?
Date created:
Wednesday, January 7, 2026
editing There is NO best plan, but for equivalence this is what I have seen work best.
Suboxone (buprenorphine/naloxone) helps by replacing full agonists with a partial agonist that has very high receptor affinity. It suppresses withdrawal and cravings while producing less euphoria and respiratory depression. Because it saturates receptors, it allows a large initial cut without triggering severe withdrawal. The tradeoff is precipitated withdrawal if started too early and a distinct buprenorphine withdrawal if tapered too slowly or used too long.
Kadian (extended-release morphine) helps by converting short-acting opioids into a long-acting full agonist with stable blood levels. This removes the peaks and crashes that drive withdrawal and compulsive redosing. It does not block receptors, so the taper is smoother day to day, but it relies more on discipline and symptom control since cravings are not pharmacologically blocked.
Comparison summary
Speed: Suboxone faster. Kadian moderate.
Withdrawal suppression: Suboxone stronger early. Kadian steadier.
Craving control: Suboxone stronger.
Risk profile: Suboxone risk of precipitated withdrawal. Kadian risk of ongoing full-agonist dependence if taper stalls.
Daily opioid load you listed (rough equivalence)
Very approximate totals to frame the taper:
40 Percocet (assume 5 mg oxycodone each) ≈ 200 mg oxycodone ≈ 300 MME
12 Oxycodone 20 mg = 240 mg oxycodone ≈ 360 MME
14 Dilaudid 8 mg (hydromorphone) = 112 mg hydromorphone ≈ 560 MME
4 Hydromorph 30 mg capsules (hydromorphone ER) = 120 mg hydromorphone ≈ 600 MME
FAST taper using Suboxone
Induction
Stop opioids!
Wait for clear moderate withdrawal.
Start low to avoid precipitated withdrawal.
2-week Suboxone timeline
Days 1–3: 8–12 mg/day total, divided.
Days 4–7: stabilize at 8 mg/day.
Days 8–10: reduce to 4 mg/day.
Days 11–12: 2 mg/day.
Days 13–14: 0.5–1 mg/day, then stop.
Expect discomfort after stopping but usually shorter than full-agonist withdrawal.
6-week Suboxone timeline
Week 1: stabilize at 8–12 mg/day.
Week 2: 6–8 mg/day.
Week 3: 4 mg/day.
Week 4: 2 mg/day.
Week 5: 1 mg/day.
Week 6: 0.25–0.5 mg/day, then stop.
This reduces post-buprenorphine withdrawal.
FAST taper using Kadian
Conversion principle
Convert chaotic short-acting use into one or two daily ER doses.
Start lower than calculated equivalence to force a meaningful cut.
2-week Kadian ultra-fast taper
Goal: Rapid stabilization, aggressive reductions, short exit. Withdrawal increases at the end but is usually less chaotic than cold turkey.
Days 1–3: Convert to 30 percent of calculated morphine equivalent, once or twice daily.
Days 4–7: Reduce by 20 percent.
Days 8–10: Reduce another 10 percent.
Days 11–14: Drop to near-zero, then stop.
Fastest, hardest landing.
Best for: High motivation, strong support, prior tolerance for discomfort.
Trade-off: Sharper withdrawal in final days.
Key point: This succeeds or fails on good sleep preservation.
Days 1–14
Add Clonazepam/Ativan, if needed: scheduled, then as needed.
Add Tryptophan/Gabapentin, if needed: nightly, may require daytime dose early.
Add Magnesium/Bowel relief, if needed: daily.
Days 8–14 (final drop)
Tight sleep discipline.
Stop Clonazepam/Ativan around day 9: Expect poor sleep for several nights.
Add Celexa/Wellbutrin, if needed: mornings, if your mood worsens or waking becomes difficult.
Add Herbal Tea after stopping Clonazepam/Ativan, if needed: nightly, if sleep won’t come.
Day 15-30 (post taper)
Stop Tryptophan/Gabapentin around day 15-22: Expect troubled sleep for several nights.
Stop Magnesium/Bowel relief around day 15-22: Expect soreness/cramps for serveral days.
Stop Herbal Tea at the end: Expect mild anxiety for several nights.
6-week Kadian fast taper
Goal: Balance speed with tolerability.
Week 1: Convert to 40 percent of equivalent.
Week 2: Reduce 20 percent.
Week 3: Reduce 10 percent.
Week 4: Reduce 5 percent.
Week 5: Reduce to 3 percent of start.
Week 6: Drop to near-zero, then stop.
Best balance for most people.
Best for: High tolerance with sleep or anxiety vulnerability.
Trade-off: Requires discipline to keep reductions moving.
Key point: This succeeds or fails on good sleep preservation.
Weeks 1–6
Add Clonazepam/Ativan, if needed: scheduled, then as needed.
Add Tryptophan/Gabapentin, if needed: nightly, may require daytime dose early.
Add Magnesium/Bowel relief, if needed: daily.
Weeks 4-6 (final drop)
Tight sleep discipline.
Stop Clonazepam/Ativan around day 9: Expect poor sleep for several nights.
Add Celexa/Wellbutrin, if needed: mornings, if your mood worsens or waking becomes difficult.
Add Herbal Tea after stopping Clonazepam/Ativan, if needed: nightly, if sleep won’t come.
Weeks 6-8 (post taper)
Stop Tryptophan/Gabapentin around day 15-22: Expect troubled sleep for several nights.
Stop Magnesium/Bowel relief around day 15-22: Expect soreness/cramps for several days.
Stop Herbal Tea at the end: Expect mild anxiety for several nights.
10-week Kadian controlled fast taper
Goal: Minimize rebound withdrawal and relapse risk while staying time-boxed.
Week 1: Convert to 50 percent of equivalent.
Week 2: Reduce 30 percent.
Week 3: Reduce 20 percent.
Week 4: Reduce 10 percent.
Week 5: Reduce 8 percent.
Week 6: Reduce to 4 percent.
Week 7-8: Reduce to 2-3 percent.
Week 9-10: Drop to near-zero, then stop.
Safest when prior fast tapers failed.
Best for: Multiple failed fast attempts, fragile sleep, severe anxiety.
Trade-off: Risk of stalling if the end date is not enforced.
Key point: This succeeds or fails on good sleep preservation.
Weeks 1–10
Add Clonazepam/Ativan, if needed: scheduled, then as needed.
Add Tryptophan/Gabapentin, if needed: nightly, may require daytime dose early.
Add Magnesium/Bowel relief, if needed: daily.
Weeks 5-10 (final drop)
Tight sleep discipline.
Stop Clonazepam/Ativan around day 9: Expect poor sleep for several nights.
Add Celexa/Wellbutrin, if needed: mornings, if your mood worsens or waking becomes difficult.
Add Herbal Tea after stopping Clonazepam/Ativan, if needed: nightly, if sleep won’t come.
Weeks 10-12 (post taper)
Stop Tryptophan/Gabapentin around day 15-22: Expect troubled sleep for several nights.
Stop Magnesium/Bowel relief around day 15-22: Expect soreness/cramps for serveral days.
Stop Herbal Tea at the end: Expect mild anxiety for several nights.
Practical takeaways
At very high daily opioid loads, Suboxone is usually more reliable for a true fast taper because it allows a large initial cut with receptor blockade.
Kadian works when structure and adherence are strong and cravings are manageable.
Fast tapers succeed when paired with sleep protection, autonomic control, and a clear stop date.
Below is a side-by-side alignment of 1-week, 2-week, and 6-week Suboxone fast-taper models, followed by the common failure points and how to prevent them. This is structured for very high baseline opioid exposure where the goal is exit, not maintenance.
Suboxone FAST taper timelines aligned
1-week (7-day) ultra-fast taper
Goal: Rapid receptor capture, minimum exposure, fastest exit.
Day 1: 2–4 mg induction → up to 6–8 mg total
Day 2: 6–8 mg
Day 3: 4 mg
Day 4: 2 mg
Day 5: 1 mg
Day 6: 0.5 mg
Day 7: 0.25 mg or stop
Best for: Highly motivated individuals with strong support, low relapse risk, and tolerance for discomfort.
Trade-off: More short-term sleep and energy disruption after stopping.
2-week (14-day) fast taper
Goal: Balance speed with smoother landing.
Days 1–3: Induction and stabilize at 8–12 mg
Days 4–7: 8 mg
Days 8–10: 4 mg
Days 11–12: 2 mg
Days 13–14: 0.5–1 mg, then stop
Best for: High tolerance with moderate anxiety or sleep vulnerability.
Trade-off: Slightly longer buprenorphine exposure.
6-week controlled fast taper
Goal: Minimize post-Suboxone withdrawal and relapse risk.
Week 1: 8–12 mg
Week 2: 6–8 mg
Week 3: 4 mg
Week 4: 2 mg
Week 5: 1 mg
Week 6: 0.25–0.5 mg, then stop
Best for: Repeated failed fast tapers, fragile sleep, or severe anxiety.
Trade-off: Risk of psychological dependence if not time-boxed.
Where FAST tapers fail (and why)
1. Induction too early
Causes precipitated withdrawal. This is the single biggest failure point. Wait for clear moderate withdrawal, not clock time.
2. Over-dosing Suboxone early
High doses above symptom control increase receptor saturation and make the exit harder. The goal is functional suppression, not comfort.
3. Lingering at 2–4 mg
This traps people. Withdrawal severity is determined at ≤1 mg, not at higher doses. Forward motion matters.
4. Poor sleep protection
Sleep loss drives relapse more than pain. Gabapentin, clonidine, magnesium, and rigid sleep timing matter more than extending Suboxone.
5. No plan after stop
Days 3–7 after stopping are predictable. Expect low energy, light insomnia, temperature dysregulation. This is normal and temporary.
Bottom line
1-week: fastest exit, hardest landing.
2-week: best balance for most fast tapers.
6-week: safest when previous attempts failed.
If you want next, I can map adjunct meds and supplements to each timeline or help you formalize this into a printable taper protocol.
Do the same for kadian over 2, 6, and 10 weeks
Below is a side-by-side Kadian (extended-release morphine) FAST-taper framework over 2, 6, and 10 weeks, followed by common failure points. This is structure and logic, not a prescription. Exact milligrams vary by person and must be set by a clinician. Percentages are used intentionally.
Why Kadian works in a fast taper
Kadian converts short-acting, high-peak opioid use into stable 24-hour blood levels. This removes peaks and crashes, reduces compulsive redosing, and allows planned, linear reductions. It does not block receptors or cravings. Success depends on adherence and a firm end date.
Where Kadian tapers fail
Starting too high: Comfort dosing defeats the taper.
Rescue short-acting opioids: Breaks stabilization and resets withdrawal.
Stalling below ~15 percent: This is where most people linger. Reductions must continue.
Ignoring sleep protection: Insomnia drives relapse more than pain.
No stop date: Without a fixed end, Kadian becomes maintenance.
Clonazepam or Ativan (Lorazepam) can reduce specific opioid withdrawal symptoms, but they are high risk tools and should only be used short term, carefully, and ideally under medical supervision.
They help by suppressing central nervous system hyperarousal. During a fast taper, this can blunt acute anxiety, panic, muscle tension, tremor, and severe insomnia. For some people, a brief course can prevent total sleep collapse, reduce autonomic surges, and stop anxiety spirals that derail the taper. Ativan acts faster and shorter, useful for acute spikes. Clonazepam lasts longer and may smooth symptoms overnight.
The risks are significant. Benzodiazepines are addictive, rapidly tolerance forming, and can cause rebound anxiety and insomnia even after short use. Combining them with opioids or alcohol increases overdose risk. They also worsen long term recovery outcomes if used beyond a few days. Benzos do not reduce cravings, shorten withdrawal, or treat the underlying process. They only suppress symptoms temporarily.
Bottom line: benzodiazepines can be a short term rescue option for severe anxiety or sleep loss during a fast taper, typically measured in days, not weeks. They should never be a standing medication, never escalated, and never used casually. In most cases, agents like gabapentin, clonidine, sleep hygiene, and structured support are safer first line options.
SSRIs like Celexa (citalopram) and NDRIs like Wellbutrin (bupropion) do not treat opioid withdrawal itself, but they can help with secondary symptoms during or after a fast taper. Their role is supportive, not curative. They do not reduce cravings, shorten withdrawal, or relieve core physical symptoms such as chills, diarrhea, muscle pain, or restless legs.
Celexa may help by stabilizing mood and reducing baseline anxiety that becomes more visible as opioids are removed. This can indirectly improve sleep and emotional tolerance of the taper, but benefits take weeks to appear and early use may briefly worsen anxiety or insomnia. It is most appropriate when depression or generalized anxiety is present or expected to persist beyond the acute withdrawal phase.
Wellbutrin can help with low energy, apathy, and depressive symptoms after stabilization, but it often worsens anxiety, agitation, tremor, and insomnia if started during acute withdrawal. It also lowers seizure threshold, which is relevant during aggressive tapers or severe sleep deprivation. For that reason, it is usually better reserved for later recovery rather than the peak withdrawal period.
Tryptophan can help during a fast opioid taper by supporting serotonin and melatonin production, which directly affects mood and sleep. As opioids are reduced, serotonin signaling often drops, contributing to depression, anxiety, and insomnia. Supplemental tryptophan can modestly improve sleep onset and sleep continuity and may slightly reduce irritability and low mood. Its effects are mild and gradual, not acute. It does not treat physical withdrawal symptoms and should be avoided or used cautiously with SSRIs due to serotonin syndrome risk. Its main value is sleep support once the worst autonomic symptoms have begun to settle.
Gabapentin can be more directly helpful during opioid withdrawal. It reduces central nervous system hyperexcitability, which can lessen anxiety, restlessness, muscle tension, neuropathic pain, and especially restless legs and sleep disruption. Many people experience improved ability to stay asleep and reduced nighttime agitation. It does not eliminate withdrawal but can make symptoms more tolerable, particularly during the first one to three weeks of a fast taper.
Important limits apply. Gabapentin can cause sedation, dizziness, and cognitive dulling, and tolerance can develop if used long term. Abrupt discontinuation after regular use can cause rebound anxiety and insomnia, so it should be tapered if used beyond short-term support. It does not reduce cravings or shorten withdrawal duration. Used carefully and temporarily, gabapentin is often more useful than antidepressants for managing the physical and sleep-related components of opioid withdrawal.
Magnesium helps during opioid withdrawal and fast tapers by calming an over-activated nervous system and reducing neuromuscular irritability. Opioid withdrawal produces excess excitatory signaling, particularly glutamate activity. Magnesium naturally blocks NMDA receptors, which reduces this excitatory overload. The result is less restlessness, muscle tension, and “wired but tired” agitation.
It also supports sleep physiology. Magnesium improves GABA signaling and melatonin regulation, helping with sleep onset and nighttime awakenings. This is particularly useful when insomnia is driven by nervous system hyperarousal rather than pain. Many people notice fewer leg cramps, less restless legs, and reduced nighttime anxiety.
Additional benefits include muscle relaxation, reduced headaches, and mild blood pressure lowering, which complements clonidine. It does not treat cravings or core withdrawal, but it improves tolerance of the taper. Glycinate and threonate forms are best tolerated. Oxide is poorly absorbed and mainly acts as a laxative.
Herbal Teas
Lights out an herbal tea made from chamomile, lemon balm, catnip, and passionflower can provide mild but meaningful symptom relief during opioid withdrawal, mainly through calming the nervous system. These herbs act as gentle sedatives and anxiolytics, helping reduce agitation, inner restlessness, and situational anxiety without suppressing respiration or causing dependence. This can make evenings and nighttime withdrawal more tolerable, particularly when anxiety and hyperarousal are driving insomnia rather than pain.
Their strongest benefit is sleep support. Chamomile and passionflower promote sleep onset and continuity, lemon balm reduces nervous tension and stress related gut discomfort, and catnip has a light sedative effect that can ease jitteriness. Together, they may slightly reduce muscle tension and gastrointestinal cramping and support a more predictable bedtime routine. Effects are subtle and cumulative, not immediate, and they do not treat severe withdrawal or cravings, but they are low risk for most adults and useful as an adjunct to other supports during a fast taper.
AnxieTea an herbal tea made from skullcap, lemon balm, St. John’s wort, lavender, and oat straw can help during opioid withdrawal by calming an overactive nervous system and supporting emotional stability. Skullcap is the most directly relevant for withdrawal related agitation. It reduces neural hyperexcitability and can lessen anxiety, tremor, racing thoughts, and restless body sensations. Lemon balm and lavender add anxiolytic and mild sedative effects, helping take the edge off evening anxiety and supporting relaxation without heavy sedation.
This blend is particularly useful for stress tolerance and sleep quality. Oat straw provides gentle nervous system nourishment and may help reduce fatigue and irritability that appear as opioids are withdrawn. St. John’s wort can support mood in people prone to depressive symptoms during tapering, but its effects are slow and cumulative, not acute. Together, the tea may improve sleep onset, reduce nighttime awakenings driven by anxiety, and make withdrawal more psychologically tolerable.
Important cautions apply. St. John’s wort interacts with many prescription medications including antidepressants, opioids, anticoagulants, and birth control, and should not be combined casually with SSRIs or other serotonergic drugs. This tea does not reduce cravings or core physical withdrawal symptoms, but as a low intensity, non habit forming adjunct, it can be useful for mood support, nervous system calming, and sleep during a fast taper when used thoughtfully.
When to add bowel support
Add bowel support once opioid dosing is clearly reduced or stopped and diarrhea or erratic stools appear, usually days 3–10 after a fast taper or final drop. Do not start too early. While opioids are still present, constipation dominates and adding fiber or probiotics can worsen bloating. The goal is to help the gut re-normalize motility, not to force it.
What works best and why
Soluble fiber (first line)Psyllium husk or partially hydrolyzed guar gum. These absorb excess water, slow transit, and normalize stool consistency without causing urgency. Start low, once daily, then increase slowly. Avoid insoluble fiber early.
Probiotics (after stools slow)Add after diarrhea begins to settle, not during peak watery output. Multi-strain products with Lactobacillus and Bifidobacterium help restore microbiome balance disrupted by opioids and stress. Expect gradual benefit over 1 to 2 weeks.
Electrolytes and hydrationEssential if diarrhea is present. Low sodium or potassium worsens fatigue, cramps, and autonomic symptoms.
Short-term loperamide only if neededUse sparingly for uncontrolled diarrhea. Stop as soon as stools form. Chronic use delays gut recovery.
Avoid early
Stimulant laxatives.
High-dose magnesium citrate.
Large fiber loads during active withdrawal.
Bottom lineSupport the bowel after opioid effect fades, start with soluble fiber, add probiotics once diarrhea eases, hydrate aggressively, and keep loperamide short-term. Normal bowel rhythm usually returns over 2 to 4 weeks.
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