The OD Opioid Withdrawal Megathread and FAQ

Status
Not open for further replies.

amapola

Bluelight Crew
Joined
Mar 23, 2010
Messages
4,796
Treatment of Withdrawal Symptoms

There are only two ways to cure withdrawal. The first is by taking more opiates and it is really not the answer we are looking for. The second is time. No matter what you do to help ease your way through withdrawal, the only real way to get better is over time. During this time, since we can't directly treat the cause of the withdrawal by taking more opiates (or we only partially treat them if tapering), we treat the symptoms of opiate withdrawal.

Supportive Treatment
Supportive treatment is a term in medicine where if you can't treat the cause of a disease to cure it, you manage the symptoms as best you can.
First and foremost (much like surviving on a desert island) we take care of our basic bodily needs.
  • hydration
    Your body needs water to survive and stay healthy. While detoxing from opiates you'll likely be suffering from diarrhea, nausea, and profuse sweating, all of which contribute to dehydration. Maintaining good fluid levels is integral to getting and feeling better and should be a priority whenever you are sick including withdrawal. Water, juice, soup, whatever you can take and keep down you should be consuming. Although people say detoxing from opiates isn't inherently deadly (as compared to benzos/booze), it does put a lot of stress on your heart and other organs and dehydration can be dangerous as well.

  • electrolytes
    Along with needing fluids in your body, you need ions in those fluids which are known as electrolytes. They are integral to proper muscle and nerve function (including your heart) and a lack of them will result in cramps, seizures, and other nasty problems. Just as diarrhea, vomiting, and sweating decrease fluid content, they also decrease electrolytes (especially sodium and potassium) and need to be replaced. Sports drinks are an excellent source, but juice and soup will do as well. Hydration is important but be sure you don't over do it on just water.

  • vitamins/minerals
    Although some of these fall under the category of electrolytes, vitamins and minerals are important for proper bodily functions. Although they can be obtained naturally from dietary sources, in the midst of opiate withdrawal you might not be feeling to hungry and taking a good multivitamin can help supply your body with everything it needs to get back on track.

  • food
    Your heart pounding shivering body will surely be craving some energy, and calories in the form of food is where it comes from. That being said if you are way to sick to eat then there is nothing wrong with sticking to juices and soups until feeling a little better. Getting some fresh fruit in your stomach can do wonders for your mentality though and sometimes help with nausea as well.

  • sleep
    It may be hard, but your body and brain needs sleep to heal and repair. There are drugs which can help but resting and at least trying to sleep is just as important as keeping active and trying to keep your mind off of withdrawal.

OTC Drugs
There are many drugs which are often available over the counter (without a prescription) that can do wonders for helping alleviate certain symptoms of opioid withdrawal. Some of the more commonly used ones are listed here.
  • diphenhydramine (for sleep)
    Diphenhydramine (Benedryl) is an antihistamine which is used to treat allergies. It is also used off label as a sleeping aid and just a few pills will help you get to sleep. Taking too much it acts as a psychedelic deliriant and there is no need to go much beyond the recommended dosage. Some other antihistamines, including promethazine and diphenhydrate, have this property as well.

  • naproxen sodium (for muscle aches and pains)
    Like other NSAIDs (nonsteroidal anti-inflammatory drugs) naproxen (Alleve) is a pain killer which can help treaet pain in your muscles caused by withdrawal. Ibuprofen and aspirin are other drugs in this category which could be used instead though naproxen is often preferred for withdrawal. These drugs should not be used beyond the recommend dosage as they can cause intestinal issues and should not be mixed.
    Acetaminophen is also a non-narcotic pain killer but is less effective for muscle pain.

  • dextromethorphan (opiate action)
    DXM (a cough suppressant) has some opiate action and can be used to help reduce symptoms but is not active enough to be considered a drug you can taper on. It is more commonly used to potentiate other opiates thereby allegedly preventing tolerance. In higher doses it is also a dissociative which people experienced in it's own recreational use find helpful to reach while in withdrawal.

  • lopermide (opiate action) Loperamide
    Lopermide (Immodium) is a very strong opioid. However in low doses it does not cross the blood-brain barrier (BBB) and therefore only acts on your peripheral nervous system and not your central nervous system (CNS). In lower doses it is extremely useful for limiting diarrhea and related symptoms, and in high doses it actually does somewhat cross the BBB and can almost completely eliminate withdrawal and can actually be used to perform a taper of its own.

Prescription Non-Opioids (benzos etc.)
Although the OTC drugs listed above do help with some symptoms, there are more potent prescription drugs which would be considered preferable; if you can get your hands on them. The most notable of these are benzodiazepines which, depending on the specific one, can be a combination of a sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant. Benzos are often prescribed by detox clinics and are definitely a good thing to have.
Some others include:
  • muscle relaxants (eg. carisoprodol) to help with muscle aches
  • alpha blocker (eg. clonidine [prescribed for opiate withdrawal]) lowers blood pressure and limits hot/cold flashes
  • beta blocker (eg. propranolol) lowers heart rate and blood pressure
  • ondansetron - a 5-HT3 antagonist which has been shown to treat opioid withdrawal

Other Recreational Drugs (marijuana etc.)
It is debatable whether substances like weed, booze, coke, ketamine, etc. should be taken during opiate withdrawal. They have the potential to make the situation much worse, however they can help both with physical symptoms and with taking your mind off of withdrawal. It basically comes down to a personal choice but anything that is hard on the body or has a hard comedown is probably not going to help anything (eg. stims and booze). Smoking weed is probably the most common and can definitely help people relax and take their mind off the withdrawal but it does elevate your heart rate and can make anxiety worse.


Endorphins (natural opioids)
Endorphines are natural opioids created by your body in response to certain situations. They are what is needed to get you feeling better again and there are several ways you can trigger their release.
  • exercise
    This is the big one. Getting up and moving about is important for mental reasons as mentioned below, but vigorous exercise (whether running, weight lifting, or playing sports) can really improve how you feel. Even if you feel like utter crap and can't imagine getting out of bed, remember that you don't have the flu and breaking a sweat is a sure fire way to actually feel better. An exercise regime is also very important to getting over PAWS and maintaining your sobriety (never mind living longer and looking super sexy). You might as well start now when it'll also help with withdrawal.

  • sexual release
    If you find there is simply no way of getting out of bed, this can give you a much needed break from the pain. Although reaching orgasm will flood your system with endorphins, even just being sexually stimulated (mentally and/or physically) will help somewhat.

  • chocolate and candy
    Who cares if these release endorphins, (they do by the way) they taste great anyways. Feel free to indulge.

  • spicy foods
    The pain inflicted from spicy foods is another way of getting some endorphins released in your body. This one you may want to leave until after the diarrhea has stopped however.

  • anything else that feels good
    Not all of these release endorphins per se, but they all feel great.
    • hot showers
    • heating pad
    • massage
    • stretching
    • a hug
    • talking to a loved one

The Mental Aspect
One of the worst things about withdrawal is the time you used to spend just lying in blissfully in bed enjoying every moment is now spent lying torturously in bed hating every minute. Time passes slower than can be imagined and thinking about how much longer you have to go is often much worse than any symptoms you are actually experiencing. Along those lines it is important to keep your mind as occupied as possible and once you are able to get out of bed your body as well.

Ideas for things to do include: watching movies or TV shows (laughing at a comedy is the best medicine ;)); playing engrossing games (a complex one like chess completely takes over your mind but something intense like poker or the latest shoot-em-up might give some needed release); or anything else that takes your mind off the situation - like coming onto Bluelight :). If you find yourself just too restless to watch TV or play video games, try doing something more complex. Learning about a subject that interests you for example can hold your attention better than a mindless game and though it seems counter-intuitive to do something harder it often works out.

Sitting and staring at the clock is a lot more difficult than just doing something. If withdrawal doesn't have you stuck to the bathroom floor or physically bedridden then get out of the house, walk to the store, hang out with friends, anything. It might seem like you aren't up for it, but taking your mind off withdrawal is the key to success.

For any detailed and specific information on any of the mentioned substances or concepts beyond simply being used for opioid withdrawal, please search for threads on them or check out
**The Other Drugs Directory**
 
Last edited:
This is a great start and a fantastic FAQ, kudos to amapola for taking the time to research and write all this!

I want to chime in and "second" the concept of keeping yourself busy and, more importantly, physically active, to help deal with WD. So much time and energy is spent focusing on drugs drugs drugs, quitting them, tapering, OTHER drugs to help deal with WD from the FIRST drug, I find the non-medicinal ideas often get overlooked.

I'm hooked on dilaudid so WD is no stranger to me. In fact, even though I'm not quitting, I deal with WD on almost a daily basis; in an effort to make sure i don't take even more drugs, I rigorously maintain a dosing schedule - I wont let myself take my meds unless at least 6-8 hours have passed between doses. If I've binged and taken more than I should have on occasion, I make up for it later by either lowering my dose later or letting more time pass between doses.

Either way, WD rears it's ugly head as the clock gets near "happy time." And it's very unpredictable; sometimes when the clock chimes I barely feel any WD, other times I feel strong symptoms hours before I'm scheduled, but I force myself to just deal with it - taking meds before it's time will screw up my self-imposed schedule so i make myself sweat it out.

We all know what it's like - you lay there in bed, on the couch or curled up into the proverbial ball in a corner, staring at the clock and begging time to move quickly. You have no energy and all you can think of is your next dose.

Yeah, that's the usual scenario, but I have always learned, without exception, if you force yourself to get up and DO SOMETHING, it works wonders.

The initial effort and willpower to pick yourself up and get out of the house can be staggering, but as soon as I'm even dressed and putting my shoes on I begin to feel better - I'm conquering the beast!

And as soon as I walk out the door and breathe the (hopefully) fresh air, the WD symptoms are already cut in half. Just taking a walk around the block or doing some window shopping can often give you just as much relief as that needle.

Going for a drive can be even better, since your attention and body muscles are now focused on the road and your car. If you can go to a friend's house or even a store/coffee shop/comic book shop or anyplace where you know people and can just hang out a while and be sociable can sometimes make you totally forget about your WD! I've had this experience many times, when I suddenly realize "wtf, my WD just vanished!"

Of course physical activity, from taking a walk to a full body workout will also do wonders - the endorphins released from a real workout will kick WD in the nuts and make it go running home crying for it's mother.

And it doesn't matter how bad your WD are, these ideas WORK EVERY TIME. If you're really jonsing bad it may not make you ALL better, but it will help enormously.

It's just the initial energy it takes to get you up and out that's the hardest. But once you get up and even just wash your face or change that smelly underwear, you're home free - once you get the process started, following through is a piece of cake.

Mmmmm, cake. Definitley remember that feeding your sweet tooth can also help turn that frown upside down!

Chances are, by the time you get home and are ready to dose, you'll feel like you don't even need it.

And that, my friends, is the feeling of you WINNING.
 
For OTC meds to add:

Ibuprofen (advil)-works very for aches and pains during withdrawal.
DXM-also helps to. The why i dont remember so much but it does.

Other to add:

Heating pad (for leg, back and other aches)

Massages

Sleep- as MUCH AS POSSIBLE. I know for many this is hard, but the more you sleep the better. It'll bring you that much closer to the end of W/D and will just make you feel better. Rest is important, w/ds take their toll on your body

Stretching (falls under exercise?) helps a LOT with the leg aches and pains. In fact it helps so much mentally i can only try to describe it

It by no means makes your legs better for real: the relief lasts minutes at best, seconds at worst, but sheesh....the simple RELIEF of stretching your legs out and feeling the relief of it for even a few brief seconds is basically orgasmic. What I feel is the best method to sit like a baseball catcher position almost, bending your legs fully down like that...good god just THINKING about the relief this would give me during w/d is making me smile. It is bliss
 
Speaking of orgasmic, another way to kill time and get your mind off WD is to... Um... How to put this... WANK YOUR WRISTS OFF!

Unfortunately, for many people, being in WD brings premature ejaculation to bold, new heights, so a good session of self-gratification might only last a minute.

So start over :)
 
^However, the reduction or elimination of opiates/opioids tends to cause one's sex drive "to come back with a vengeance" (to quote Trainspotting).

Prescription Non-opioids
benzos
weed [is it a good idea ProsVsCons]
other???

I don't know if its mentioned elsewhere, but clonidine is commonly prescribed for opiate withdrawal symptoms as well.

weed [is it a good idea ProsVsCons]

This will vary considerably according to personal chemistry, drug tolerance to cannabis/experience with cannabis and severity of opioid withdrawal:

Pros:
-Relaxation, anti-anxiety effects, helps sleep
-Stimulates appetite
-Shifts mental focus away from withdrawals (sometimes)

Cons:
-Could cause panic attacks/anxiety (worsening of already existing anxiety)
-Panic
-Paranoia
-Increased focus on withdrawal symptoms.
 
Speaking of orgasmic, another way to kill time and get your mind off WD is to... Um... How to put this... WANK YOUR WRISTS OFF!

Unfortunately, for many people, being in WD brings premature ejaculation to bold, new heights, so a good session of self-gratification might only last a minute.

So start over :)

^lol, THIS. i hate to admit it but in really bad dope WD's i would just wank it till i couldnt wank it anymore. talk about a quickie too, everything is all sensitive and weird feeling.

for otc meds i do think diphen has its place, but during bad WD's it has always made me MORE uncomfortable. like it makes the rls worse and increases that hot burning feeling and throbbing. to add to the list..
rx-
Clonidine--alpha blocker, lowers BP and curbs "wet" symptoms, 100mcg to 300mcg (more than that and you will be passing out when you stand up
Soma- 2 every 4-6 hours
Tramadol--not an opiate or opioid but works surprisingly well to take the edge off.
Zofran--works in the stomach and brain to reduce crmaps and nausea. not great but better than nothing.
Phenegren--strong antinauseant that will knock you out zombie style
Inderal--propanolol, beta blocker that helps to lower BP and make you more comfortable.

a good strong benzo tho is my fav, like a high dose of valium since it lasts forever. one thing i would say to stay far far away from are stimulants. they raise the BP and make eveything intensified. they can help during trhe paws phase because they give you some energy and help keep your mind off of the WD.

one otc product i have found to work is
DXM--cough suppressant, does something to help like speed up the WD it felt like, plus you can get something like nyquil that has antihistamines that will zonk you out and dxm in it. i think psych drugs are going to be huge in the treatment of addiction one day...there are so many and so much we dont know about)

also you can get some good tea with KAVA, passion flower, valerian root, melatonin--those will not knock you out, but will help you feel more relaxed.


sorry if i repeated anyone elses info.

eidt: alomst forgot weed. it has always done me well during WD, and i know some ppl that cant stand to smoke when they are sick, but i love it. its relaxing enough to help me chill and relax. especialy a really stoney variety.
 
Tramadol--not an opiate or opioid but works surprisingly well to take the edge off.
This is an opioid.

DXM has opioid action as well.

Good ideas all! I'll try and work on the 2nd page write up later this afternoon.
 
An opioid is merely a substance that has action at an opioid receptor. The traditional opiates are full agonists of the mu-receptor. Tramadol and Immodium do hit mu while dextromethorphan is primarily delta with some mu action and there are others (salvinorin A for example) that hit kappa.

Interestingly the suffix -oid mean "like" e.g. planetoid (like a planet), spheroid (like a sphere), opioid (like an opiate). :)
 
Of course a LOT of this will be completely avoided if you TAPER OFF. Honestly, I'm not sure why anyone goes cold turkey. I can understand the emotional reaction to your habit by going "that's it! No more! I stop now!" But you're really just going to put yourself through unnecessary torture.

If you taper slowly over a few weeks, you'll come down nice and easy. I've tapered my meds down 50% on two occasions when I thought I might be losing my meds and it was no big deal.

If you don't have enough drugs to last through a taper, well, that was really bad planning. But I'd think in most situations you're going to know it's time to quit and you can prepare yourself with enough meds to get you through it.

It's just SO much better than going through hell and trying to fight it with even MORE drugs...
 
^^^ I just want to point out that the taper you are describing is either a shorter-term dependency, lower-dose dependency, or very unique body chemistry.

If one has been on a long-acting opiate/opiod (from oxycodone to methadone) for years or even 1 year consistently... you WILL (maybe besides a ridiculously small % of the population whom I have never met) feel every single 1 mg reduction. Trust me, I know because I am doing it right now. Every single other person I know in my situation is enduring the same. This is not us being "pussies" - I puke many mornings and have just had to get used to it. I reduce about 1 mg every 2 weeks and it is never easy. If you have a pain issue that got you into the situation in the first place, expect worse - that pain is the first thing that comes (back pain in my sit). A friend of mine used to comment on how he doesn't understand why its so painful for me or why I can't skip a day (obviously he was at a lower dose, for a shorter time-period... with probably a slower metabolism). Now days he is singing a completely different tune. Its funny how people will be new to it and act like "oh its not so bad" - purely naive. I'm not referring to anyone posting here - just my friend, so please don't take that the wrong way.

~Responsibly used psychedelics (with much effort from myself to make sure its serious-therapeutic-progress) help very much... far more than anything else. If anyone is interested in details related to my success with therapeutic anti-addictive psychedelic use, I will be glad to post. I have reduced from 120 mg of methadone to 35 mg where I am at as of last week. It has been a long road, but I honestly couldn't have sped it up without missing work - which I still have some. I am actually putting together a more formal record, but in the meantime I would be glad to pass on the info in a more casual manor.
 
Last edited:
question i hope this is the right place to ask, i just quite suboxone a month ago and am almost through all the withdrawl symptoms but last night in a moment of weakness i did about 30 mgs of roxycontin anyone know if this is gonna cause me to be sick again?
 
question i hope this is the right place to ask, i just quite suboxone a month ago and am almost through all the withdrawl symptoms but last night in a moment of weakness i did about 30 mgs of roxycontin anyone know if this is gonna cause me to be sick again?

You'll be fine.
 
^Don't think you've ever said that one out loud eh? :)

Helps with a lot more than the shits as well but thanks for the input.
 
Bump.

Okay first 2 posts in this thread are relatively done. I'll have to let it sit for at least 24 hours or so before I can clear my mind enough to proofread and I can maybe have another mod go through it for spelling/grammar/punctuation, but for now if there is any content I should still add speak up. Obviously we can edit it once it is in circulation if there is anything that comes up as well.

edit: still need to add in some links to other threads as well...
 
Status
Not open for further replies.
Top