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Opiate Withdrawal Resources & Helpful Tips

jiveturkey11

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Apr 29, 2011
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I've gathered information from all over the web to help me in getting through the w/d's...I've never had the self-discipline to taper, so if you're like me, you may find this information useful. Feel free to correct an misinformation, mistakes or methods not worthwhile. I've collected info abt both acute withdrawals, and those dreaded PAWS. You may have seen this info elsewhere, as much of it is cut and paste, but perhaps my endless hours of collection can save you time and energy!

POPULAR METHODS:
1. AMINO ACID PROTOCOL:
2. THOMAS RECIPE
3. WAYSMAN METHOD


This chart is a summary of all the info I've collected.
NMDA’s: in addition to preventing tolerance and dependence, combining NMDA-receptor antagonists with both opioid and nonopioid analgesics may increase their analgesic potency. The ability of NMDA antagonists to inhibit tolerance to drug effects and contribute possible antidepressant and anxiolytic effects are also important from the perspective of drug development. Antagonists include: DXM, PCP, Ketamine, N20, Memantine, magnesium, zinc
AMPA’s: AMPA receptors also play a big role in withdrawal guys, NMDA is the major player in tolerance but for proper withdrawal supression i would combine a ampa antagonist (like topiramate) with a NMDA antagonist like memantine.
BEST PLAN = NMDA + AMPA + Adrenal Support

Level 1 = Opiate Substitute KRATOM
Level 2 = NMDA Memantine
Level 3 = AMPA Topiramate
Level 4 = Attitude & Energy Adrenal Repair



POTENTIATE ATTENUATE ALLEVIATE PRECIPITATE
RECREATIONAL DRUGS
Cannabis Mixed reviews
Alcohol Mixed reviews
NMDA Ketamine X
Kratom Legal substitute
Wild/Opium Lettuce Legal substitute
Peyote Legal substitute
Iboga Legal substitute
PRESCRIPTION DRUGS
Naltrexone X
Buprenorphine (Suboxone) Maintenance
NMDA Methadone Maintenance
AMPA Topiramate Most symptoms
Benzos Anxiety; sleep
Clonindine Anxiety; sleep
Seroquel Sleep
OTC DRUGS
Loperamide Same receptor; diarrhea
NMDA Dextromethorphan Tolerance X
Antihistamines (Diphenhyd) (Doxylamine/NyQuil) Sleep
Gravol Sleep

FOOD & DRINK
Quinine (Tonic Water) Restless legs X
Grapefruit Juice X
5 Hour Energy Shots As needed
Alka Seltzer X
Antacids
VITAMINS, MINERALS, SUPPLEMENTS
Vitamin/Mineral Supplement Double dose (3-4wks)
Free form amino acids Double dose (3-4wks)
Vitamin B Aids absorption; 500mg-1g/day
Vitamin C 2-3g/day (split doses)
Vitamins A, E Remove free radicals
Potassium Relieves RLS
NMDA Magnesium X X Relieves RLS
Fish/Flax Seed Oil Anxiety (4-6g/day)
Oxytocin Tolerance
NMDA Memantine X
Milk Thistle Liver detox
Metamine 10mg/day; gradually increase to 30mg
Valerian Root Fatigue; anxiety (1-1.5g/4hrs)
Skull Cap
Kava
Passion flower
Nigella Sativa X X
AMINO ACIDS
*studies support use as pharmacological adjunct in opiate withdrawal
N’Acetyl L-Cysteine Liver detox
Acetyl L-Carnitine* (Phenibut) X X Muscle aches; cramps; insomnia (up to 2g/day)
L-Theanine Mood; anxiety
L-Tyrosine 2-4g/day
L-Taurine
NMDA L-Glutamate
L-Glutamine (GABA) 2-3g/day (split doses)
L-Glutathione 300mg/day
D-phenylalanine (DLPA) Converts to L-tyrosine (0.5-1g/day)
Lecithin
D-Leucine
L-Methionine (SAMe) 500mg (2/2xday)
Glycine
SAMe


5HTP
Melatonin Sleep aid (3-5mg)
Noradrenal – “Adrenal Plus” or “AdrenaPlus” – 1000mg/split doses over day sweating
Rhodiola or Rhodiola rosea may be effective for improving mood and alleviating depression. Pilot studies on human subjects showed that it improves physical and mental performance, and may reduce fatigue. Rhodiola rosea’s effects potentially are related to optimizing serotonin and dopamine levels due to monoamine oxidase inhibition and its influence on opioid peptides such as beta-endorphins, although these specific neurochemical mechanisms have not been clearly documented with scientific studies. Rhodiola is included among a class of plant derivatives called adaptogens which differ from chemical stimulants, such as nicotine, and do not have the same physiological effects. In Russia and Scandinavia, Rhodiola rosea has been used for centuries to cope with the cold Siberian climate and stressful life. Such effects were provided with evidence in laboratory models of stress using the nematode C. elegans, and in rats in which Rhodiola effectively prevented stress-induced changes in appetite, physical activity, weight gain and the estrus cycle.
*Adrenal Support: Research has shown that methadone, and drug use in general, has profound effects on the adrenal glands. In fact, research shows that there is a profound negative effect by methadone on the hypothalamic-pituitary-adrenal axis. This is why those that withdraw from methadone have protracted fatigue and problems with anxiety and insomnia. I often use freeze dried adrenal extracts in treatment with fairly good results. You’ll find these products listed under names such as Adrenal Plus, or Adrenplus…the starting dose is around 1000 mg per day in split doses. •


AMINO ACID NUTRITION THERAPY
Supplemental Ingredient Restored Brain Chemical Addictive Substance Abuse Amino Acid Deficiency Symptoms Expected Behavior Change
D-Phenylalanine or DL-Phenylalanine Enkephalins
Endorphins Heroin, Alcohol, Marijuana, Sweets, Starches, Chocolate, Tobacco Most Reward Deficiency Syndrome (RDS) conditions sensitive to physical or emotional pain. Crave comfort and pleasure. Desire certain food or drugs. Reward stimulation. Anti-craving. Mild anti-depression. Mild improved energy and focus. D-Phenylalanine promotes pain relief, increases pleasure.
L-Phenylalanine or L-Tyrosine Norepinephrine
Dopamine Caffeine, Speed, Cocaine, Marijuana, Aspartame, Chocolate, Alcohol, Tobacco, Sweets, Starches Most Reward Deficiency Syndrome (RDS) conditions. Depression, low energy. Lack of focus and concentration. Attention-deficit disorder. Reward stimulation. Anti-craving. Anti-depression. Increased energy. Improved mental focus.
L-Tryptophan or 5 hydroxytryptophan (5HTP) Serotonin Sweets, Alcohol, Starch, Ecstasy, Marijuana, Chocolate, Tobacco Low self-esteem. Obsessive/compulsive behaviors. Irritability or rage. Sleep problems. Afternoon or evening cravings. Negativity. Heat intolerance. Fibromyalgia, SAD (winter blues). Anti-craving. Anti-depression. Anti-insomnia. Improved appetite control. Improvement in all mood and other serotonin deficiency symptoms.
GABA (Gamma-amino butyric acid) GABA Valium, Alcohol, Marijuana, Tobacco, Sweets, Starches Feeling of being stressed-out. Nervous. Tense muscles. Trouble relaxing. Promotes calmness. Promotes relaxation.
L-Glutamine GABA (mild enhancement)
Fuel source for entire brain Sweets, Starches, Alcohol Stress. Mood swings. Hypoglycemia. Anti-craving, anti-stress. Levels blood sugar and mood. GABA (mild enhancement). Fuel source for entire brain.
Note: To assist in amino-acid nutritional therapy, the use of a multi-vitamin/mineral formula is recommended. Many vitamins and minerals serve as co-factors in neurotransmitter synthesis. They also serve to restore general balance, vitality and well-being to the Reward Deficiency Syndrome (RSD) patient who typically is in a state of poor nutritional health (see paragraph above chart for explanation of RSD).



Amino acids are the “building blocks” for neurotransmitters in the brain, such as serotonin, dopamine, GABA, and many others that are manipulated by opiate use. There are 3 amino acids that you will want to begin taking when you start your detox. You should take 1000mg in the morning, and 1000mg in the evening, for a total of 2000mg per day. Amino acid capsules generally sell for $10-$15 for a bottle of 100 capsules, with each capsule containing 500mg.
1. L-Glutamine: Building block for GABA, which is the primary inhibitory neurotransmitter in the brain. L-Glutamine also helps heal the gut. (You’ll probably notice that GABA itself is sold as a supplement, but you won’t want to take it – GABA is made inside the brain when in the presence of L-Glutamine, but GABA molecules themselves don’t cross the ‘blood-brain barrier,’ so the most effective way to produce GABA is to take plenty of L-Glutamine.)
2. L-Methionine: Used for the production of SAM-e, which is one of several factors needed for the production of serotonin, dopamine, and a handful of others.
3. L-Tyrosine: Useful in naturally boosting your energy levels, as fatigue is one of the most common symptoms. And, like, L-Methionine, L-Tyrosine has a positive effect on your serotonin and dopamine neurotransmitters. Note that L-Tyrosine requires additional Vitamin B-6 for proper absorption.
A very important, but commonly overlooked, consideration when taking amino acids is that you must take them on an empty stomach. You should take them with a glass of water, and not with any other drink. Why? Amino acids compete with each other for entry into the brain. If you eat or drink anything with protein in it with your amino acids, those amino acids will prevent your chosen amino acid supplements from doing their job properly!
Melatonin is a useful supplement, both as a sleep aid and as an antioxidant. Typically, melatonin supplements are sold in tablets of 2.5mg to 5mg. It’s safe to take more than that dose, but low doses have been found to be just as effective. Melatonin only lasts in the body for a few hours or so, so if you wake up in the middle of the night (which you probably will), it’s fine to take another one. The room should be dark when you take melatonin, as this is how the hormone is released naturally.
For more natural ways to induce sleep you might try Kava Kava (either as a tea or in capsules), or Valerian Root supplements. If that doesn’t help, over-the-counter sleep aids like Unisom (diphenhydramine) can be helpful, in doses of 25-50mg. If you have a prescription (I do not condone taking prescription medication that isn’t prescribed to you), a benzodiazepine such as Xanax, Valium, or Klonopin can help you fall asleep if nothing else will, as well as reduce anxiety. Just take care not to take them too often (why go to all this work just to substitute one addiction for another?), and do so only under the supervision of a doctor. Valium or Klonopin are the most useful of the benzodiazepines, since they also have muscle relaxant qualities. If you are dependent on opiates as the result of an injury for which you are also prescribed a skeletal muscle relaxant such as Flexeril or Soma, these medications can help with your muscle cramps, and also help you sleep.
Fish oils (Omega 3, 6, and 9) are some of the most important supplements you can take, as these fatty acids lay the foundation for several important body functions. Fish oils are needed for the functioning and repair of cellular membranes. Of these, Omega 3 is of particular importance. You should also take Vitamin E supplements with your fish oils, as fish oils cause an increased requirement for fat-soluble antioxidant vitamins.
Liver Detoxification
Milk Thistle, N-Acetyl Cysteine, and Alpha-Lipoic Acid are important supplements to restore full liver functionality. Whole Foods sells a product called Opti-Liver, which contains all three, plus more. It’s important to take these supplements with food to ensure proper absorption. As with most supplements, it’s a good idea to spread your dose throughout the course of the day. You’ll want to take in 1200mg of milk thistle, 400mg of Alpha-Lipoic Acid, and 600mg of NAC each day. If you eat three meals a day, you could divide those doses by three to take with each meal. Milk Thistle, along with dozens of other liver-healthy ingredients is included in this detox comfort supplement formula.
Special Note about NAC: Vicodin and Percocet users sometimes take N-Acetyl-Cysteine capsules with their pills, as NAC helps the liver break down Tylenol more easily. NAC actually helps break down many drugs in the liver, not just analgesics. It can really save lives by reducing stress on the liver. In fact, very high doses of NAC are given intravenously in hospitals to patients suffering from Tylenol overdoses.
Adrenal Health
Fatigue is one of the most common and the most persistent of the opiate withdrawal symptoms. Fortunately, there are ways to combat it, and restore your energy levels gradually back to normal. Adrenal support is vital in this process, as opiates are particularly hard on your adrenal glands. Take two capsules a day for at least 3 months, as fatigue is a long-lasting PAWS (post acute withdrawal symptoms) symptom.

Using opiates makes it harder for the body to produce a chemical called noradrenaline. So your system learns to work extra hard at producing noradrenaline. When you reduce or stop using opiates, the body carries on working extra hard and produces too much noradrenaline. It is thought that most physical withdrawal symptoms are caused by excess noradrenaline overstimulating the brain and central nervous system.
Most of the physical symptoms should begin to fade after 14-21 days, as the production of noradrenaline starts to get back in balance. Withdrawal symptoms are usually at their worst around the second and third day after stopping or reducing the dose.
Another possible physical cause for some of the longer lasting problems following detox, including feeling low and sleeping badly, is lack of natural endorphins. Endorphins are a natural part of the body’s painkilling and ‘feeling good’ systems. It is thought that when you take opiates your body gives up production of endorphins - and that, once stopped, it can take up to six months for them to return to normal levels.




AMINO ACIDS AND THEIR FUNCTIONS IN THE BODY
INTRODUCTION
Here, are the 22 amino acids that will tend to benefit specific organs, systems, and functions of the body. Please note that an individual amino acid listed for a particular organ, system, or function may not benefit every problem that affects it.
This page is for your information only.
ARGININE
Studies have shown that it has improved immune responses to bacteria, viruses and tumor cells. Arginine promotes wound healing and regeneration of the liver. It also causes the release of growth hormones; considered crucial for optimal muscle growth and tissue repair.
ALANINE
This non-essential amino acid-which may be considered essential under some circumstances, is an important source of energy for muscle tissue, the brain and central nervous system. It helps in the metabolism of sugars and organic acids, and may also help stabilize the blood glucose levels in people with hypoglycemia.
ASPARTIC ACID
Aspartic Acid is a non - essential amino acid, aiding in the expulsion of harmful ammonia from the body. When ammonia enters the circulatory system, it acts as a highly toxic substance which can be harmful to the central nervous system. Its ability to increase endurance is thought to be a result of its role in clearing ammonia from the system. Athletes use it to promote stamina and endurance. The popular sweetener Aspartame is a combination of Aspartic acid and phenylalanine. Aspartic acid is considered nontoxic. Some research has shown that Aspartic acid might be useful in opiate withdrawal.
CYSTINE
It functions as a powerful antioxidant and an immune support substance, neutralizing free radicals. It can help slow down the aging process. It is necessary for the formation of the skin, and aids in the recovery from burns and surgical operations.
GLUCOSAMINE
Glucosamine consists of glucose combined with the amino acid Glutamic Acid. Studies have shown that Glucosamine Sulfate may be of use in treating osteoarthritis or degenerative joint disease. This natural nutrient provides the body with an important raw material that appears to halt the disease process itself. In the body, the main action of glucosamine on joints is to stimulate the manufacture of substances necessary for joint repair.
Glucosamine has also been shown to exert a protective effect against joint destruction and, when taken orally, is selectively taken up by joint tissues to exert a powerful therapeutic effect.
GLUTAMIC ACID
This amino acid has been shown to improve mental capacities, speeds the healing process of ulcers, and gives a lift from fatigue. It also helps control alcoholism and the craving for sugar.
GLYCINE
This non-essential amino acid, is required by the body for the maintenance of the central nervous system, and in men, glycine plays an essential role in maintaining healthy prostate functions. It helps trigger the release of oxygen to the energy requiring cell-making process as well as providing nutrients to support a strong immune system and free radical fighters.
ORNITHINE
Ornithine is important since it induces the release of growth hormones in the body, which in turn helps with fat metabolism. It is further required for a properly functioning liver and immune system. Ornithine assists in the ammonia detoxification and rejuvenation of the liver. It is also useful in healing and repairing skin and tissue and is found in both these body parts. There are some unsupported claims that ornithine also promotes muscle building, but this has not been proven.
PROLINE
Proline is a non-essential amino acid, which improves skin texture, and proper functioning of joints and tendons. It also helps maintain and strengthen heart muscles. Proline is most effective when adequate Vitamin C is supplied at the same time.
Get the Essential Amino Acids!
SERINE
Serine is a non-essential amino acid that is needed for the metabolism of fats and fatty acids, for muscle growth, and for a healthy immune system. There is some concern that elevated serine levels (especially in sausage and lunch meats) can cause immune suppression and psychological symptoms such as cerebral allergies.
TYROSINE
Tyrosine is a non-essential amino acid that is used by the thyroid gland to produce one of the major hormones, Thyroxin. This hormone regulates growth rate, metabolic rate, skin health and mental health. It is used in the treatment to control anxiety, allergies and headaches. Tyrosine is known as the "anti-depressant" amino acid ands serves as the building block for the hormones dopamine and norepinephrine which create a sense of pleasure and well-being. Tyrosine can also act as a mild appetite suppressant.
TAURINE
Taurine is a non-essential amino acid that functions in electrically active tissues such as the brain and heart,to help stabilize cell membranes. Supplements decrease the tendency to develop abnormal heart arrhythmia after heart attacks. People with congestive heart failure have also responded to supplementation with improved cardiac and respiratory function.



RECOMMENDED READING:
Amino Acid Protocol
Most of this program is from the book END YOUR ADDICTION NOW.. the doctor who wrote it ran a treatment facility in UPstate New york where they gave patients amino acids and vitamin via IV during treatment.. He also counsels patients individually.. All of these things are meant to rebuild activity in the major neuro transmitters.. as addicts our neurotransmitters have been disrupted by our use of drugs.. even stuff like cigarettes and eating alot of sugar can disrupt them.. with drugs however it can be more damaging.. I will list the aminos maily used for addiction, their dosages etc.. everything should be taken on a empty stomach... an hour b4 meals.. Take all of them together with lots of water... I have added stuff as I have done more research on this...

THE 'MOOD CURE' BY JULIA ROSS IS AN EXCELLENT BOOK AND A
GREAT RESOURCE FOR RECOVERING ADDICTS.


And, finally, SOME INSPIRATION & MOTIVATION!
“Stuck In a Moment”
“I’m not afraid
Of anything in this world
There’s nothing you can throw at me
That I haven’t already heard
I’m just trying to find
A decent melody
A song that I can sing
In my own company
I never thought you were a fool
But darling look at you
You gotta stand up straight
Carry your own weight
These tears are going nowhere baby
You’ve got to get yourself together
You’ve got stuck in a moment
And now you can’t get out of it
Don’t say that later will be better
Now you’re stuck in a moment
And you can’t get out of it
I will not forsake
The colors that you bring
The nights you filled with fireworks
They left you with nothing
I am still enchanted
By the light you brought to me
I listen through your ears
Through your eyes I can see
And you are such a fool
To worry like you do
I know it’s tough
And you can never get enough
Of what you don’t really need now
My, oh my
You’ve got to get yourself together
You’ve got stuck in a moment
And you can’t get out of it
Oh love, look at you now
You’ve got yourself stuck in a moment
And you can’t get out of it
I was unconscious, half asleep
The water is warm ’til you discover how deep
I wasn’t jumping, for me it was a fall
It’s a long way down to nothing at all
You’ve got to get yourself together
You’ve got stuck in a moment
And you can’t get out of it
Don’t say that later will be better
Now you’re stuck in a moment
And you can’t get out of it
And if the night runs over
And if the day won’t last
And if our way should falter
Along the stony pass
And if the night runs over
And if the day won’t last
And if your way should falter
Along this stony pass
It’s just a moment
This time will pass”
U2, All That You Can’t Leave Behind

K'S CHOICE LYRICS

"Not An Addict"
Breathe it in and breathe it out
And pass it on, it's almost out
We're so creative, so much more
We're high above but on the floor

It's not a habit, it's cool, I feel alive
If you don't have it you're on the other side

The deeper you stick it in your vein
The deeper the thoughts, there's no more pain
I'm in heaven, I'm a god
I'm everywhere, I feel so hot

It's not a habit, it's cool, I feel alive
If you don't have it you're on the other side
I'm not an addict (maybe that's a lie)

It's over now, I'm cold, alone
I'm just a person on my own
Nothing means a thing to me
(Nothing means a thing to me)

It's not a habit, it's cool, I feel alive
If you don't have it you're on the other side
I'm not an addict (maybe that's a lie)

Free me, leave me
Watch me as I'm going down
Free me, see me
Look at me, I'm falling and I'm falling.

It is not a habit, it is cool I feel alive I feel...
It is not a habit, it is cool I feel alive

It's not a habit, it's cool, I feel alive
If you don't have it you're on the other side
I'm not an addict (maybe that's a lie)
I'm not an addict...

Personally, I think you should regard a detox as being like a prison sentence. Rather than focussing how long you have felt lousy, focus on how much closer you are to feeling better. Make a calendar and tick off the days, or keep a diary and write down how you feel. Identify landmark points so that you can look back over it and see how much progress you have made. Stopping using drugs is one of the major decisions in your life, it will be nice to look back and see how you managed to overcome each of the obstacles, or even just how much you suffered without quitting.

Every time you complete a certain period, congratulate yourself for having made it. Give yourself a reward. For each day you complete it could be something small, like something special to eat or drink. For each week that passes, do something really nice for yourself. Buy yourself something to wear or go out for a meal. Think about both the detoxification and the rewards as investments in the new you - the person that you want to become rather than the person that you were.

Remember, every day that you manage to stay clean is an investment in your own future; and if you can’t be bothered to invest in yourself, you can be pretty damn certain that nobody else will.

But again, remember, recovery is not a race, it doesn't have to be completed in a set time. You have the rest of your life to do this in.
An excellent book to read on brain plasticity is called "The Brain That Changes Itself", the author escapes me at this time. Anyway, the idea of brain plasticity is fascinating to me, and is wholly hopeful. We can learn new ways of existing at any point along this ride...you are not doomed to live in any certain way because your brain has been wired that way. What freedom!
Empathy for the Devil" by Phil Harris

PAWS RELIEF:
1. Laugh tracks (i-tunes, youtube, comedies, etc)
2. Internal Endorphin booster (amino acids, vitamins, diet, water)
3. External endorphin boosters (volunteer, get involved, exercise, ear acupuncture, chiropractor)

1. Commit: This is the point when you say, “Help!” OR “Enough!”
2. Prepare: Getting ready for your detox process.
3. Taper: Less opiates in body = less severe withdrawal symptoms.
4. Prime Your Body (And Mind): The detox is literally a “shock to your system” but you can prepare it to handle the rigors of withdrawal
5. Conduct your detox: It’s important to think of this process as yours. You are conducting this detox on YOUR terms. There are proven ways to make this process less agonizing!
6. Recover: Patience and acknowledging the little improvements that happen each day.
7. Plan Next Step: What to do now?
Step #1. Commit:
Obviously, this is a crucial part of the process and requires a great deal of courage. This is the point when you say, “enough is enough” and decide that the “fun” is over. Too many things have happened to you and you want to get your happiness back. It’s a small step but a profound one because this when you change the direction of your life.
Your Detox Plan Should Include The Following:
1.Your timetable, taper plan and detox date: I would recommend planning your detox at least 30-45 days in advance depending on your taper schedule (I will go into tapering later on). And don’t get all relieved because you have 30 more days to take pills…that “fun” is over pal. Those people on Suboxone need to taper for at least 3 months so keep that in mind folks or perhaps go to my page on Suboxone withdrawal to get more info on what you need to do for a Sub detox.
2. Your support structure: Is there someone that you can trust that can help you through this? Even if you just tell a good friend what you are planning to do, this is a good thing. It’s always better to have a loved one to be with you (or be on-call) during this process. If you don’t have any loved ones OR friends, isn’t there some cool guy or girl at work that you can trust??? If not, then that’s ok it’s just a good thing to have that support when you need it.
3. Your budget: Although you may be avoiding pricey detox centers and rehabs, you’re going to need to put together some money for supplies, food, movies etc.
4. Your “to-do” list: The Withdrawal-Ease Survival Guide has all of this info in it and should include things like:
-Supplies needed for detox
-Childcare needs. Do yourself (and them) a favor and find someone who can take care of the kids for a couple of days. Even if it is just for a good portion of the day. Spend the money to get a babysitter if you have little ones because you’re NOT going to want to take care of them when you are in withdrawal.
-Job responsibilities and possible comp time. Have any vacation or comp days that you can use for the detox?
-Financial responsibilities that you will NOT want to take care of during detox (electric bills, car payments etc.)
- Any visits or dates that you’ve scheduled. Do you really want Uncle Fester coming over when you’re in withdrawal?
5. Your 5-7 day, daily detox schedule: I have written out a detailed day to day detox plan in the Withdrawal Survival Guide but you can take that schedule and make it your own. Try to fill your days during the acute detox period with a lot of activity and then designated sleeping/rest times.
6. Your Wish List: I think that this is a crucial part of the planning process. You need to put together a list of all the reasons why you are doing this. Getting your happiness back is an obvious favorite of mine but feel free to be more specific. Things like:
-Have more energy and desire to play with my kids
-Improve my marriage
-Do a better job at work
-Save money
-NOT be depressed and moody
-Save Life/avoid unwittingly overdosing on my pills
-Enjoy activities that I used to enjoy but no longer do
-Energy!
-No more guilt
Etc. Etc. Etc….you get it. This list should be with you at all times. You can even dork out and get a card laminated with the reasons why you’re quitting but you need to keep these at the forefront of your mind.
7. Your Plans for After Detox: You’d be really surprised at how much time you spend on your addiction/dependency. All of the doctors appointments, pharmacy visits, counting pills, counting pills again, thinking of excuses why you need your script filled 2 days earlier, counting your pills a third time etc. All of this time needs to be filled by something. so try and think about things you might want to do with that extra time. This could be closely related to your wish list and can be combined but the fact of the matter is that you’re going to have a LOT more time to do stuff than you think. Idle minds lead to idle thoughts which lead to pills.
8. How are you going to STAY off of the pills?: This is the rest of your life that Withdrawal-Ease cannot actively help you with. You need to figure out how you are going to stay off of your pills for good. You can never take opiates again unless you have a medical emergency. Therefore, you might need some support for cravings, triggers and any addictive behavior that you think may or may not manifest itself. Don’t blow this off and say you’re gonna be fine. Assume that you are going to have some cravings and play it conservatively. I don’t care if it’s AA or NA or simply getting a therapist…there’s a multitude of good options out there for you. I know, I know you’re “just physically addicted” but even if that’s the case, plan for the worst and make sure that you have resources that can help you stay off of the pills. This is important.
Step #3. TAPER:
Tapering is critical. If you slowly reduce the amount of opiates in your body, your withdrawals should be less acute and perhaps take less time. Most of the people that have been successful with the Withdrawal-Ease plan have used some sort of tapering method and have been able to at least reduce the amount of their intake before they quit. There are many people that simply cannot taper and that of course is a pretty clear sign of full blown addiction. But those that can get a LOT of benefit from it. It’s just a matter of telling yourself, “I’m quitting now and I’m going to take as little as I need to stave off of the sickness…that’s it…the party’s over”
For a complete step by step process on how to build your own tapering plan, I would highly recommend that you look at my post on “The Art of Opiate Tapering”
Step #4. Prime Your Body (And Mind):
As you taper you also need to start doing things like exercising and perparing your body for the detox process which can be quite a shock to the system. Take the time to eat well and exercise as well as keep your self well hydrated. I also highly recommend that if you have purchased the Withdrawal-Ease product that you start taking it about 5-7 days before your detox. This will allow your body to absorb some of the nutrients and adjust to the new ingredients being introduced. Bodybuilders and others call this “Loading Up” or “Saturation” but I just call it, “taking the product 5-7 days before detox”
There’s also some psychological benefits to priming your body for the detox period. You’re going to be thinking and worrying about all sorts of things and perhaps some of that anxiety is good but it can only benefit you so much. All of this preparation and activity will help ease your mind a bit and reinforce the fact that you are the one who is in control. You are doing everything that you can to help prepare yourself mentally and physically for your withdrawal; that’s all that you can do. In the Guide I have a few mental notes for during the detox but I don’t really talk much about the weeks proceeding your detox.
Tapering, concentrating on writing down your priority lists or needs for your supply list are all part of a process that will keep your mind out of hysterical mode. Speaking of hysterics…ready anything scary on the internet message boards lately?
For the love of all that is holy, DO NOT go onto any message boards about opiate addiction, detox, withdrawal etc. etc. Although they are meant to be “supportive” I believe strongly that they are a very toxic environment and will do absolutely nothing to help you. Internet message boards are not where you will find the facts nor are they places that welcome you with a warm embrace; they are made up of packs of needy and lonely people who have nothing else to do but act like victims and scare people like you and me. Sounds harsh doesn’t it. It’s the truth. Sometimes I will “lurk” on a message board to see what kind of “advice” people give out and its appalling. It’s shocking that a person who has 1,500 posts on a board about opiate addiction somehow gets treated with the kind of reverence and trust that an actual clinician might get. Remember, regardless of how many posts a person has, for all you know, they don’t know squat. In fact, I’d go so far as to say that the more “posts” a person has the more suspicious one should be.
Even if you’re not on a message board to get advice and you’re just lurking around to see if anything might give you some insight, you have no clue as to what you’ll find. Most likely, it will be hysterical and will only increase your anxiety. I cannot tell you how many boards I’ve gone on where people put their caps lock on and say stuff like, “IF I HAVE TO GO THROUGH ONE MORE DAY OF THIS IM GONNA DIIIIIIIEEEEEE!!” or “pleeeze tel mee when this is gunna end!!!!”
How is something like that going to help you out? That isn’t reality and you’re not going to die from opiate withdrawal. You’re going to be sick…just sick. You’ve been sick hundreds of times and this will be no different. I can tell you that I’ve personally experienced opiate withdrawal at least 5 times and it’s nowhere near as uncomfortable is a bad stomach flu or when one gets out of some type of major surgery or breaks a bone. In fact if you told me that I had a choice between a root canal and 3 days of opiate detox, I would take the detox in a heartbeat! Does it suck? Yes, it does. But if you do it the right way and take steps to control the acuity and duration of your withdrawals it’s completely bearable. I’ve had people who took 60 Percocets a DAY along with various other muscle relaxants go through tapering, read the Withdrawal Guide and take the product who have been able to go back to construction jobs after 2 days. But what’s a few days being sick compared to the weeks, months, and even years that you’ve been chasing this demon?
Your health and happiness are worth it and you need to be reminding yourself of that as you prepare…Bring it!
Step #5. Detox:
So hopefully at this point, you’ve done your preparations, you’ve tapered your meds and hopefully started taking the Withdrawal-Ease. You’re ready. Now is the time to refer to your daily schedule or perhaps the outline of the schedule that I have written in the Guide. You’ve done everything right up until this point and now is the moment of truth. At this point hopefully all responsibilities are either not applicable or delayed for a few days so that you can concentrate on yourself. If not, well then you’ll just need to make the best of it which is the case for most people.
Even though you may have your own daily schedule or perhaps are referring to the Guide, there are some main FAQ’s and strategies that I want to emphasize about the detox period. Perhaps you may not have bought the product or are trying something different so I want this to be helpful. Two of the worst aspects of opiate withdrawal are fear and not knowing so hopefully this will be helpful:

Will I be able to work?: Do not plan on going to work between days #2-#4 as those are the most acute days. Click here for a graph on a typical withdrawal duration and acuity
Will I die?: Yes; at some point. But, it’s very, very rare for people to die from opiate withdrawal. Your chances of mistakenly killing yourself due to opiates are FAR greater if you actually keep taking them as opposed to quitting them. If something is obviously wrong like your heart stops or you cannot breathe, get yourself to a hospital! But the fact of the matter is that the medical community does not consider opiate withdrawal to be a life threatening event. I’m assuming a certain level of common sense be applied to every situation but I would not worry about dying from opiate withdrawal.
Can the withdrawals last forever?: No. It may seem like it but opiate withdrawal symptoms usually last a few days and then slowly dissipate.
Some Good Detox Strategies To Follow (During the Acute Detox Period)
1. Stay busy and active as much as you can
2. Eat well and hydrate a LOT
3. Get some moderate exercise each day. Don’t enter a triathlon, just walk briskly for a bit each day.
4. Take hot showers multiple times a day
5. Read over the reasons why you are quitting if you ever get discouraged
6. Restless Legs?: At night I would take some Ben-Gay cream and rub it on my thighs and calves. then right before bed I would wrap both legs firmly (but not too tight) around each leg. It’s an olf growing pain trick that I found to be very useful for those night time RLS bouts
7. If you can take things like Advil and Immodium (as directed) they will help
8. Things like funny movies and books on tape (I use my iPod and dowload books from iTunes or audible) to make the time pass
9. Get out of the house at least once a day and run an errand. “Sheesh…I HAVE to be the only one in this grocery store withdrawing from opiates…wait, why is that guy sweating so much?!”
10. Understand that the depression that comes along with the withdrawal is exactly that. Everyone get’s very very depressed when they are in withdrawal. Keep telling yourself that and keep reminding yourself that the depression is a chemical reaction caused by your detox…its a symptom that will go away just like the other ones.
Step #6. Recover:
After the initial/acute detox phase which can last up to 7 days (it’s usually 3-5), you’ll need to prepare yourself for recovery. The technical term for it is P.A.W.S. (Post Acute Withdrawal Syndrome). The one thing that I emphasize to all of my customers during the recovery phase is PATIENCE. I know hate hate hate that word as I dd so maybe I could substitute the word perspective instead? Remember, we are all used to the instant gratification of taking opiates but your detox doesn’t follow those rules. Most people turn back to their pills at this point because they get discouraged about not feeling immediately better. Don’t do this! You’ve come tooooo far and it’s too late to turn back. The keys to a successful recovery are all rooted in resolve and patience but I’ll give you a few tips to make sure that you get through this period without doing something stupid like start taking your pills again:
1. Did I say patience? I meant to say perspective. Most people go back to their pills after the worst part is over…don’t make the same mistake. Each day that you are in recovery, you will experience slight improvements in how you feel most physically and mentally. It’s your job to recognize those improvements and refer back to the reasons why you are quitting. Notice any similarities?
2. Keep following the eating and exercise regimen from the Survival Guide. In fact, consider eating right and exercising for the rest of your life. Evidence suggests that this is good for you and will shorten the recovery period.
3. Make sure that you keep taking the Withdrawal-Ease. there should be plenty of product left to take and most customers take it for the full month and then stop. there are no withdrawals when you stop using it….of course.
4. Remember to stay off of the internet boards/message boards. Misery loves company and you are no longer very good company to some of those folks. I know, I know…many of those people may give you a virtual high five or use some sort of congratulatory emoticon but let’s face it; that part of your life is over. You need to train your mind to think about other things other than opiates. If you want to help others that’s fine but remember that the message boards didn’t detox for you and they won’t recover for you either….move on.
5. If you can, start up an old activity and/or hobby as soon as you can. you’ll be amazed at how much time you have now that you don’t think about pills. You need to fill that time with something else or your mind will start to default back into that pill mentality. Do something/anything to fill this time with something that gives you pleasure and distracts you from your recovery.
6. Although I mention eating right above, I have to emphasize the importance of hydration during this time. Your body has gone through the ringer and it needs as much replenishment as it can get. If you are peeing more than you would like to, that’s probably a good indication that you’re well hydrated…keep on peeing!
7. Call a friend or relative and tell them that you’ve kicked pills and are in recovery. Obviously this needs to be someone you trust but if you have someone that you can talk to, you’ll be amazed at how good it makes you feel and how proud that are of your accomplishment.
8. IMPORTANT: Call your doctor(s), dealers, pharmacists etc. and tell them that you have just recovered from an opiate addiction. Whether you like it or not, these are all people who financially benefit from your addiction and they need to know that you are no longer a target. Of course, many people like your pharmacist and doctors may have had no idea that you were addicted but you need to take the first step and tell them about your issue. This will be hard to do but it’s a necessary step to insure that you will no longer get pills from them. Under HIPPA patient privacy laws, your doctor and your pharmacist are not allowed to discuss your situation with anyone else and if they do, you can sue their asses. So don’t worry about people calling the police or anything; you don’t need to give out many details. The goal here is to make sure that your “suppliers” know that you are no longer interested. If you choose not to do this then you will be welcomed back with open arms if you decide to start taking pills again…you don’t want that.
9. Buy yourself something. You deserve a selfish, needless present for what you’ve accomplished. Many of your will now be saving a lot more money since you will not have to feed your habit. You don’t have to go and buy yourself a Maserati (2010 Spyder, dark blue with cream interior…) or anything like that; just something that makes you smile and that you’ll enjoy.
10. Read your reasons for quitting when you wake up and before you go to bed. You are going to be happier when you have fully recovered. Honestly and truly happier…I promise.
Step #7. Plan Next Step: What to do now?:
After a full month, you should be totally detoxed and feeling much better in every way imaginable. Some of you will be happy to forget about your pills and just be glad to get off of them. You’ll go on with your life and hopefully move on from this whole episode. You may have been just physically dependent on your pills and are extremely happy that this whole nightmare is now over. Well good for you and consider yourself lucky to have this over with. However, there may be some fences to mend with friends and loved ones about your mood swings, poor performance at work etc. I urge you to dedicate the next few months to patching up all of the things that may have gone by the wayside. Your friends and family will forgive but you need to make sure that you make it clear that they are your priority since they have not been since you have been on the pills.
Of course, life will still have it’s good days and it’s bad days. In the past, you may have “hid” from those bad days by using pills but by and large, you’ll be happier and healthier now that you’re off of the pills.
For those of you who were both physically and psychologically addicted to opiates, your road to recovery may be a lot longer. As I mentioned at the beginning of this blog, Withdrawal-Ease is not meant to help with cravings and addictive impulses…just detox. Nevertheless, there are tons and tons of people and organizations out there that can help you. A.A., N.A., group therapy, individual therapy with an addictionologist are all good avenues to take if you continue to have cravings. I don’t have any bias towards any one of these support systems other than the fact that A.A. seems to think they have all of the answers. They don’t. For some people AA is great but it doesn’t work for everyone and there are plenty of other viable options to help you cope.
For some, the thought of not being able to take pills ever again is a scary one. That’s why it is so important that you reach out to people who are either in your situation or are trained to deal with ongoing addictive personalities. There are also a lot of good intensive outpatient programs (IOP’s) that provide ongoing services to people on an outpatient basis and those might be helpful as well. “Whatever works” is my motto and it’s a motto that seems to work quite well.

During days 1-2 (and possibly day 3)
Most detoxers say it is best if you can try to sleep as much as you can during the first couple of days at least. Nyquil, Benadryl (not w/Benzodiazepine Detox!), Valerian Root, 5HTP (do not exceed 300mg daily) are types of things that may help you to sleep. Select other things from the OTC Options list as needed use other things from the list.

Days 3-5
You will likely start to stabilize. When you feel that you are starting to level off begin the L-Tyrosine/B6/D-Phenylalanine/Sublingual B-Complex w/B-12 to help w/pain and energy.

THINGS THAT MAY HELP

-HOT baths several times a day to help with aches; add Epsom Salts or vingear

-Heating Pad & warm blankets to keep muscles warm and relaxed.

-Hot Rice Socks for muscle warmers. Fill cotton socks w/rice, stretch and leave room on ends to loop and self tie sock end. Heat rice socks in microwave for approximately 2 min. Heat check & apply to achey areas.

-Keep nourished; drink lots of water: Add 1 tablespoon of Apple Cider Vinegar for body PH rebalancing & pain; and if you can, add 1 tablespoon Honey for energy

-Relaxation Exercise to help lessen muscle cramping ,pain, & restless legs syndrome, EASY exercise regimine to activate your own natural endorphins & dopamine to help w/pain, While in bed work your muscles-tighten the muscles in your entire body all at once as hard as you can---hold it for several seconds(hold breath)---slowly release muscles and breath. Do entire body 5 times and then repeat doing one area at time--both legs then both arms-then low back/abdomen area; repeat cycle/one leg-one arm, etc.

SHOPPING LIST OPTIONS TO HAVE ON HAND DURING DETOX
Print out list to shop and to use as a tool to track what you take & its effectiveness.

Soup & Frozen Meals- enough for a few days

Liquid Nutritionally Balanced Meals; e.g., Slim Fast or Ensure

Gatorade (replaces electrolytes)

Benadryl (50mg w/hydro; taper ease aide)

Robitussin DXM-helps WDs; taper ease aide

Tagamet-taper ease aide; slows absorption of Hydro

Tylenol PM(but not w/Benzodiazepine Detox!)- during WDs you can take this during the day w/o it making you sleepy

Imodium (4-6 hours after onset; first few hours let body purge toxin concentrates) [detoxers have posted that 4-6 tablets x3 daily substantially helped them not only control diahhreah, but also lessened WDs]

Salonpas Patches For Muscle Pain

Aspercreme For Joint Pain (does NOT have Aspirin in it)

Airborne-3 boxes= (4 day supply @double doses3xdaily)
 
Jive, it took me a while to find the time to read all of this but I've read it now and I appreciate you posting your compilation. This is a very thorough list and I think it is something people in immediate withdrawals would appreciate reading through to help find relief. I'm going to make note of this thread for future work as I think it's probably the most extensive guide to opiate withdrawal I've seen.

Thank you so much for posting this.
 
Jive--thank you!! On Day 11. Psychological symptoms aplenty. Keeping myself nourished. The list here is extensive and very useful.
 
this was very helpfull with allot more info than some of the other more popular withdrawal threadz
 
i have been off methadone for 3 months now after 6 years of using.. i am 100% free of opiates .. I have not physical effects but I dont get the joy out of life anymore.. i wonder if this is depression or if its still part of the effects of coming off the methadone.. anyone here been where i am? does it clear up in time? a year? two?
 
I am on and off heroin/bupe when I am just stable on bupe I feel that way you get. Maybe think of anti-dps, they do seem snarfed at but my mate ina similer boat is doing great.
 
I am on and off heroin/bupe when I am just stable on bupe I feel that way you get. Maybe think of anti-dps, they do seem snarfed at but my mate ina similer boat is doing great.


because of the anti deps. ? now how long before he went on the antis?
 
im printing this out. I've had a lapse of about 3 months both benzos and opiates and whatever else I could find. I found that cannabis has helped immensely for slowing down but i'm currently still on taper. I think the psychological part will be the toughest and that remembering day 1 is the most important thing. I think its time to be honest with myself- I've been out of rehab 2 years... and I thought I had it under control... the first day I decided to think "it's okay I'm sober now. this isn't even my Drug of Choice." That was when I already relapsed. I hit rockbottom while withdrawing on a friends floor, needing to vomit at 3 am during daylight savings. I'm back on bluelight to share my experiences with people who relate to me as well as vice versa. I think this is what keeps me going.
 
I am still clean.. it took about 6 months to get over the PAWS.. come to find out i had depression too.. i am now on a SSRI (zoloft) .. life is good. I have been doing great at work and i got back into video games..
 
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