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Suggest Remedy To Quit Tobacco
Question: I am taking about 20-25 percocet per day, it has gradually increased over the past year. In addition, I am taking 30mg of dexadrine xr and have started wellbutrin at 300mg p.d. 10 days ago in attempt to quit a 'tin a day' nictotine habit. This all started 4 years ago after blowing out my knee while playing professional football and having medications thrown at me to get me back on the field. When I elected to retire, I was on my own. I am planning on going cold turkey here at some point, I have a 90hr a week finance job and a young family, so inpatient, or anything that is going to involve me away from work or family is simply not going to happen. I have a tonne of supplements and nootropics from various attempts at righting this ship, but I know it is going to be hard regardless. I can take the pain of withdrawls, but no more depression. Whether its been trying to come off dexadrine or on and off cipralex, I feel like I have no natural production of anything in my brain. Please help - tired of doctors giving me medicine but no one helping me get off.
Brief Answer:
As below.
Detailed Answer:
Hi XXXXXXX
Welcome to Healthcare Magic!
That you have decided to quit is appreciable. It takes a lot of guts to even contemplate quitting and many people prefer living the same life everyday rather than take the trouble of doing something about it. Well done!
I have a few words of advice for you which may make things easier for you. Do not try quitting more than one substance at a time. For example, if you quit Percocet and Dexedrine along with tobacco all at a time, you are going to find it very difficult. I would have preferred that you first get off Percocet, before starting anything else. I personally advise my patients to try quitting tobacco at the end. However, since you have already started Wellbutrin, we can first start with tobacco. You have been on Wellbutrin for 10 days now. Set a quit date for four days from now and on that day, stop tobacco completely. Two weeks is usually enough for the anti-craving action of Wellbutrin to start. The first few days will be difficult. Keep yourself busy. Avoid being in the company of people who smoke/chew tobacco. Sight and smell act as cues and can trigger strong craving. Whenever the craving is strong, try chewing something else or drink a cup of tea/coffee. Or make a long phone call. Craving usually comes down in around thirty minutes and if you can manage to pass that period, it becomes easier. Involve your family in your efforts and share your problems with them. A supportive family will make things much easier for you. Also go through the NHS guide on quitting smoking (gosmokefree.nhs.uk/downloads/108281_main_guide_double.pdf). The tips here are useful for quitting all kinds of tobacco.
Do not stop Wellbutrin, even after being off tobacco for a few months. Usually it is prescribed for only around three months for people using it to quit tobacco. But since you have had a past history of depression, it will be better for you to continue it longer, till you are off other substances as well.
After you are off tobacco, try getting off Percocet. I would suggest that you try to gradually taper it off rather than quitting cold turkey. Be patient and go very slow, listening to your body. Do not try to reduce more than a pill a week. You may have to go even more slow, especially at the end, but do not feel bad about it. The techniques described in the NHS guide to help quit tobacco can also be used while quitting other substances.
Once you are off tobacco and Percocet, then only think about Dexedrine. Taper it off rather than stopping cold turkey. Wellbutrin should be continued for a few more months after this.
I hope this helps you. Please feel free to ask in case you need any clarifications. If you need me later on, I can be reached directly at http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=66024
Best wishes.
Dr Preeti Parakh
MD Psychiatry
As below.
Detailed Answer:
Hi XXXXXXX
Welcome to Healthcare Magic!
That you have decided to quit is appreciable. It takes a lot of guts to even contemplate quitting and many people prefer living the same life everyday rather than take the trouble of doing something about it. Well done!
I have a few words of advice for you which may make things easier for you. Do not try quitting more than one substance at a time. For example, if you quit Percocet and Dexedrine along with tobacco all at a time, you are going to find it very difficult. I would have preferred that you first get off Percocet, before starting anything else. I personally advise my patients to try quitting tobacco at the end. However, since you have already started Wellbutrin, we can first start with tobacco. You have been on Wellbutrin for 10 days now. Set a quit date for four days from now and on that day, stop tobacco completely. Two weeks is usually enough for the anti-craving action of Wellbutrin to start. The first few days will be difficult. Keep yourself busy. Avoid being in the company of people who smoke/chew tobacco. Sight and smell act as cues and can trigger strong craving. Whenever the craving is strong, try chewing something else or drink a cup of tea/coffee. Or make a long phone call. Craving usually comes down in around thirty minutes and if you can manage to pass that period, it becomes easier. Involve your family in your efforts and share your problems with them. A supportive family will make things much easier for you. Also go through the NHS guide on quitting smoking (gosmokefree.nhs.uk/downloads/108281_main_guide_double.pdf). The tips here are useful for quitting all kinds of tobacco.
Do not stop Wellbutrin, even after being off tobacco for a few months. Usually it is prescribed for only around three months for people using it to quit tobacco. But since you have had a past history of depression, it will be better for you to continue it longer, till you are off other substances as well.
After you are off tobacco, try getting off Percocet. I would suggest that you try to gradually taper it off rather than quitting cold turkey. Be patient and go very slow, listening to your body. Do not try to reduce more than a pill a week. You may have to go even more slow, especially at the end, but do not feel bad about it. The techniques described in the NHS guide to help quit tobacco can also be used while quitting other substances.
Once you are off tobacco and Percocet, then only think about Dexedrine. Taper it off rather than stopping cold turkey. Wellbutrin should be continued for a few more months after this.
I hope this helps you. Please feel free to ask in case you need any clarifications. If you need me later on, I can be reached directly at http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=66024
Best wishes.
Dr Preeti Parakh
MD Psychiatry
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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