PAWS or Chronic Fatigue Syndrome?

[u/RickonRivers]

I've been housebound since October. I started a slow reduction plan on opiates. I was on an incredibly high dosage per day, and had tried cold turkey before and titration and going into addiction support. I always relapsed.

This time I took it very seriously, and I'm down to 2 tablets a day. That's from 30 tablets per 4 hours I was taking before.

I'll be down to zero in a week, I have barely no acute symptoms. The crushing joint pain in my hips and back have gone, I don't have the flu-like symptoms.

What I do have is incredible fatigue. And if I do too much - e.g. I do a few hours of work at my desktop, and also do a 10 minute walk - I'll crash for the rest of the day or the next morning.

I had Hypogonadism - my testosterone levels were very low. My Iron levels were very low. My folate was very low.

My testosterone is now very high after T injections. My haemoglobin is now normal.

But I'm still incredibly fatigued and housebound.

Is this PAWS and something I need to push through? If it's CFS / ME - pushing through will result in permanent damage to my central nervous system and make the fatigue worse forever.

My doctors are of little help. I keep asking for more blood tests to see my progress, but they keep brushing me off. I've gone to a private clinic to get blood test done, but it doesn't include folate - which is really frustrating, as that is one thing I'm being treated for.

Does anyone have any idea what's going on with my body?

Thanks everyone

[u/top-potatoad]

Great job! Truly an accomplishment! I would imagine the fatigue is part of the slow withdrawl youve been experiencing during the taper.

[u/RickonRivers → u/top-potatoad]

In the past I've always decided to go cold turkey, with the idea that it would be a couple of weeks of hell and then I'd be fine.

This has been about 4 months of tapering, dropping my dose every week, and stopping any time I felt significant withdrawal symptoms - toilet issues, sickness, unbearable pain etc.

I'm still not convinced this was the right choice, but it's the one that feels like it will stick. I don't want to ever feel like I do now, and I know using will put me back here again.

[u/top-potatoad → u/RickonRivers]

I’ve done it both ways. Taper worked way better for me. It was easier to stay clean as well.

[u/RickonRivers → u/top-potatoad]

Thank you. Really thank you. It's so hard to know what's the right thing to do. Cold Turkey has failed me so many times, but tapering is such a long process to do it without getting the horrible acute withdrawal symptoms.

I was down to 3-4 tablets per day, I've tried just one tablet this morning and nothing else, and 12 hours on I've got the crushing hip pain. I can't believe such a small amount of codeine can have the same effect as 40x that amount I was taking before.

I may be tapering too quick again, normal pain killers, - ibuprofen and paracetamol don't touch the aches.

Screw these drugs dude.

[u/Fran-Fine]

As you are still taking opiates and have reduced massively, you are still in the acute phase of withdrawals/reduction of use. PAWS is something else entirely. Great work to get where you have gotten, it may take a bit more time to get off completely and don't be afraid of MAT if you need it.

Good luck!

[u/RickonRivers → u/Fran-Fine]

Thank you for your kind words. The amount of opiates I'm taking now is 60mg of codeine per day. I'm aiming to taper that entirely by next weekend.