Hi Davey,
I'm in Ottawa and I've had my share if prescribed opiates over the years as a result of spinal nerve damage, failed back surgeries, fibromyalgia and rheumatoid arthritis (heh, I must have been something nasty in my last life an I'm clearing out a lot of karma in this one).
I was scheduled for methadone treatment as a form of pain relief, which I had been avoiding like crazy.
A couple of months ago, a transdermal patch was approved by both the FDA and Health Canada that boosts the value of the opiate considerably and yet the drug in the patch is considerably low dose (the patch, BuTrans, itself is measured in micrograms and systemic levels are measured in picograms and lasts a full week).
I went from taking 8 8mg hydromorphone (Dilaudid) tablets down to one or two every four hours. This is nothing short of a miracle, as my tolerance was only going to keep climbing. Now that I have been on this patch for a few months, I'm still getting the same level of pain coverage.
Regarding withdrawal symptoms, there are a few things one should know.
There's the 2 brain concept that says whenever we have a craving, the brain the wants to indulge grows at the expense of the rational, will based brain. If, however, one does not give in, the rational brain grows. Imagine if one has experienced years and years of giving into impulse and desire. The other brain is so atrophied that it can barely put up a fight. This explains why will power is so lacking when some of us need it the most. It just is so tiny, it can't fight. Therefore, one needs to grow that brain and shrink the other by refusing to give in to impulses. One could easily start with simpler impulses by purposefully placing oneself around minor temptation and resisting giving in. This helps build the rational, will power side.
The other thing, and I'm sure you know, is that it is easier to treat the withdrawal symptoms (nausea, hot/cold flashes, aches, etc.) in concert with gradually weaning off, than to wean off without such supports.
The weaning off triggers all sorts of things, including partial withdrawal and a return of whatever reason one was taking opiates.
If chronic pain is the reason, a chronic pain clinic should be sought. In Canada, this if free under your provincial health care, provided you are referred by your family doctor. There are many ways they can help with pain, including nerve blocks, meditation, etc.
If pain is no longer as severe, it may be possible to learn mental techniques of dealing with or blocking pain.
As mentioned earlier, the EE program, which is a series of breathing exercises (similar to yogic breathing) are really helpful. EE also helps with some of the symptoms of withdrawal.
Finally, I have found taking (he supplement 5-HTP quite beneficial. 5-HTP is a serotonin precursor. Since serotonin is the satisfaction chemical of our body, there is a strong connection between addiction and serotonin.
I hope some of the responses you have received offer you some comfort. I have a pretty good idea what you have gone through vis a vis withdrawal.
Oddly enough, I never had much withdrawal with hydromorphone, other than my brain increasing in pain perception to trick me into taking more. Morphine was the absolute worst though.
Kind regards,
Gonzo