Hey Wildman!

Happy New Year! Good to see you back.
So are you ready now to get off this stuff or are you still deciding if you can do it or not with your medical issues? I can't tell for sure by your post if you are just wanting an idea to get past your w/d symptoms until you go back to the pain management dr or if you are ready to really do this but just wanting to do a rapid detox rather than a slower taper.
I want to add here that if you are having these cardiac issues and your bp is spiking like you describe the rapid detox is probably going to create more stress for you than doing a slower taper. I'm sure you realize that already without me saying it but I need to do it anyway to be sure.
I'm not positive doing something that may elevate your bp too much more or cause additional amounts of high anxiety are best for you right this moment while these other symptoms are so bothersome. Have you thought about that? Not trying to talk you out of anything. I just don't want to do anything that would harm you.
I've had bp as high as what you describe and higher in fact. 240/140 is not likely to kill anyone or stroke you unless you do something to make it worsen drastically and suddenly. I just don't want to be a part of something that would do that to you. Trying to look out for you is all. I agree that it's wise to get off any drugs that are contributing to your problems as you describe with the oxy. I do think though that you need to be cautious as you proceed forward doing this while these symptoms you describe are so serious.
Tell me what exacty you're wanting to do so I can better advise.
To answer your initial question though you need to be at a 26 score or above on the COWS worksheet. From the way you describe yourself and your symptoms and considering that was four hours or so ago you're probably getting pretty close by now. Update me and let me know how it's going. I can kind of walk you through this but I need to know more as I just mentioned about what your plans are so I tell you the right thing. God bless.