I thought this would be helpful to all of you trying to get clean. I spent the last hour revising it, and editing it. Feel free to pass this along.
A Guide to Opiate Withdrawal by cashtothemoney
(w/ help from our over-the-counter friends)
DISCLAIMER: I'm not a doctor, but I have been reading about this sort of thing extensively for a very long time. This is not medical advice, but rather my own experience which you can take from what you want. In order to be in line with my own morals (and the LAW!), I have to say that it would be best to review this with a doctor before making any decisions. All drugs listed, with the exception of one, can be bought over-the-counter, but this does not mean that it is automatically "safe".
Expect the worst in withdrawal. It might not be "crazy", but it sure as hell won't be comfortable. At the same time, for some of you, it will be the hardest experience of your life. Lack of energy, muscle/bone aches, diarrhea, insomnia, depression, anxiety. It can be hell, but you can ease all of these withdrawal symptoms with over-the-counter drugs. I've survived it a few times, and as long as you keep yourself busy it can be made a bit easier. The physical part is somewhat similar to having the flu, but magnified depending on the dose/frequency of use/duration of use; however, I think I can speak for most people when I say, the mental struggle that follows the physical withdrawal is MUCH worse. This is given as a possible alternative to therapies such as methadone, buprenorphine, etc. Good luck to all of those attempting to rid themselves of addiction.
The intensity and length of opiate withdrawal will depend on a few factors. The larger the dose, the more intense the withdrawal. The longer you have been using, the longer and more intense the withdrawal will be. If you did it once a day, it might take a few days for the withdrawal to kick in. If you took opiates shortly before bed, insomnia might be the biggest problem. If you took opiates when you woke up, you might not feel like getting out of bed without them. All of this could be wrong, or it could all be right on the money. The point is opiate withdrawal will differ for everyone; however, it will universally suck.
- Positive mindset
- A multivitamin
- An understanding that this is not forever.
- Immodium A.D. - 4-6mg loperamide per 50-60mg of oxycodone/hydrocodone. (May vary!)
- Try not to take this too often as it can make you REALLY constipated, but it can get rid of (in my experience as well as others) the majority of the physical withdrawal symptoms. Just remember that loperamide is an opiate, so it's better to only take if NEEDED. Laxatives can counter the constipation or try the natural route, fruit or olive oil.
- Note: It is very important that you keep in mind that loperamide is an opiate, so you must also taper yourself off of loperamide, which can be done over the period of a few weeks to a month. This will let you start dealing with any mental dependency issues almost right away, which will be the hardest part of coming off opiates.
- Benzodiazepines: Exercise EXTREME caution if you plan on using any sort of benzodiazepines to ease the insomnia. Examples of benzos include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin/Rivotril). For myself alprazolam and clonazepam work the best, although I will not recommend obtaining these illegally. Working your way up from 0.5mg (assuming you have no tolerance) until you find your dose may be helpful. ONLY take these if you absolutely need them. I can't stress that enough. Benzodiazepines are, in my humble opinion, more addicting than opiates, and it is a fact that they are more dangerous. They are one of the few classes of drugs that can include DEATH in the withdrawal. Another positive aspect of using benzos would be the fact that it can really take the edge off if/when you are feeling stressed out and anxious. Research them extensively before you use them, as you do *NOT* want to trade addictions. If you are taking buprenorphine as an aid during withdrawal, do not take any benzodiazepines, as this combination has resulted in death.
- Diphenhydramine: This is an antihistamine which includes drowsiness as one of the side effects which makes it a great candidate for a sleep aid. It works wonders for many opiate addicts and I think this would be better to use than any benzos.
Bone/Muscle Aches (with a little bit of advice for the mental part as well)
- Ibuprofen, Naproxen (Recommended dose/as needed)
- ABSOLUTELY NO OPIATES! The only way one can use opiates is if they are tapering. There are hardly any people with the willpower, and self-discipline to actually complete a successful taper. The road to becoming clean must be taken one day at a time, maybe even one hour or one minute at a time. Tell yourself to get through the next minute or hour. Reward yourself for getting through that period of time. If you start thinking about the next week, month, or year, you WILL overwhelm yourself.
Lack of Energy/Depression
- EXERCISE! This is, by far, the number one way of combating the physical and mental part of withdrawal, including depression. You may not want to do anything, which could even include getting out of bed, but if you can motivate yourself to exercise, you will notice a dramatic increase in your energy levels and your mindset. This is what has made a dramatic difference each time I've gone through withdrawals. It is THE wonder drug, not to mention you can obtain the infamous “runner's high” after running for a certain amount of time.
- L-Tyrosine: (Available at GNC) Studies show l-tyrosine will help with depression, energy levels, and other mood disorders. It is a precursor to dopamine (the Almighty), norepinephrine, epinephrine, and L-dopa. Epinephrine and norepinephrine are two of the body’s stress-related hormones, and l-tyrosine’s role in their creation can help ease the negative effects of stress. Starting at 2000mg per day, and adjusting is one way to begin. Vitamin B6 is essential in the creation of the neurotransmitters, so be sure to take the it along with the l-tyrosine.
- Vitamin B6: Vitamin B6 helps in the creation of serotonin (the “happy” neurotransmitter), dopamine, norepinephrine, and GABA (the mechanism in which benzodiazepines work through; reduces stress levels; induces relaxation). So one can easily see why B6 is beneficial. It also provides energy, and as said before, is essential in the conversion of l-tyrosine to the various neurotransmitters.
- FIND SOMEONE YOU CAN TALK TO! We all need to vent. Find a friend, someone on this forum, a psychologist, etc. It is essential if you want to succeed.
- Think about all of the things that can be done now. Money in the bank, be around for family/friends, not worry about your next fix, not be sick all the time, etc.
Other supplements that could help: Kava (anxiety), valerian root (anxiety/insomnia).
The worst of the physical withdrawal will most likely be over after the 4th day. It typically lasts 3-5 days and fades off after that, but can last as long as a week (longer with opiates with a long half-life, such as methadone). I've found the fourth day to be the worst, and once you are over that hump you start to feel physically better. Then, it is time to deal with the mental problems that result.
If you have friends that do drugs, you have to separate yourself from them. Unless you are superman, or have an abnormal sense of self-discipline, you will have to do this as the temptation is too great for most. Getting away for a week can really make all the difference in the world. Staying clean is a lifelong journey, and if that is what you are after, YOU CAN DO IT! Don’t give up if you have a bad day or are feeling a bit down. Keep yourself busy. It can make all the difference in the world. Start a new hobby, continue an old one, spend time with the family, go hiking, go for a walk, talk to a stranger, have a cup of coffee (avoid it in the beginning as this can worsen anxiety), etc.
As addicts, we might have started doing opiates for fun, or maybe to cover up problems. It might have only been a weekend romance, but that changed into a daily obsession. We might be broke, losing friends, and at rock bottom. Sometimes there are problems that we try to cover up, and a lot of emotions come out as the drug leaves our body. We have to get used to living a “normal” life, and dealing with “normal” problems. It is important to get to the root of the problems, and face them head on. There is no more hiding. After all, the REAL you is coming out from hiding as well. You mine as well make the most of it.
Best of luck to all of you in your endeavors. Godspeed.
L-tyrosine - http://www.mothernature.com/Library/...cfm/Id/2919008
Vitamin B6 - http://lpi.oregonstate.edu/infocente...ins/vitaminB6/