Post acute opiate withdrawal and the introduction of alcohol

[At4r4xis]

Its been a long time coming for me to disconnect painkillers from everyday life though now that i have i find myself drinking more. id like to get some feedback regarding this situation and what might help- or rather some success stories regarding how long it takes to get out of limbo with it. its unlike me to drink and even though im not getting blackout drunk i think im getting thrown back into a depression bc of it but not sure if its from the 2 weeks of clean time from dope. furthermore im pretty sure nicotine doesnt help and has a link to the discomfort of it all.
any articles or sciencey stuff to reference are welcome

 

[Rybee]

I think I can relate to your position.

I have been using opium since January and my depression has spiralled out of control in the last 3 months (medicated with 300mg Venlafaxine). About 4 weeks ago I started drinking every night as well, it'd be a bottle of wine and 400mg of Codeine or the equivalent dose of Morphine. I wouldn't consider myself a drinker, I have the odd social drink but I started using alcohol as a drug to take me out of one state and put me into another, with that specific purpose.

I've been clean of opium for 10 days now and although I'm having withdrawal effects, my determination and mindset is keeping me going. I saw my psychiatrist on Tuesday and promised to keep off of the opium and stop drinking. I did okay until tonight where again I've found myself with a bottle of wine, but no opium yet. I am so determined to kick that habit.

The withdrawal effects have been quite bad, the worst of which by a mile is diarrhoea! It takes a fair while for your GI tract to adjust from being pounded with opium and being chronically constipated, to nothing at all. Other than that I take 10mg of diazepam daily to stop the shakes and calm me down a bit and I take paracetamol/acetaminophen and ibuprofen to deal with the aches and pains, and drink plenty of water.

You've done so well to stay clean for 2 weeks, that's a HUGE step. So a massive congratulations on that. Have you felt any w/d effects from stopping the painkillers? What were you taking, how much, and how regularly?

How long have you been drinking for?

 

[SineWaveSoldier]

Having been through this many times honestly the best thing to do is ride it out and let things take their course. Your brain chemistry is adjusting to doing without drugs.

What you're going through isn't even really post acute withdrawal. What you are experiencing are the mood swings of detoxing. Post acute withdrawal depression will be more mellow. The early more severe depression brought on by detoxing is completely normal, and adding a depressant to you're mind and body won't help in the long run in my opinion.
I'm not a doctor so all of this is a matter of opinion I just thought post acute withdrawal is something you go through a little further in the process. It will get easier though. Its nothing you can't deal with. An anti depressant will help. I'm bipolar I notice everything paw sucks and it affects me severely so I'm not sympathetic to your plight. I understand you may not want to quit drinking. So I'll just say drinking more won't help and you could end up with the monkey of alcohol replacing the monkey of opiates in which case it has its own withdrawal and post acute withdrawal hurdle as well. Its substitution but just tread carefully

 

[At4r4xis]

the story is i went to rehab then came out, started drinking after 3 days and continued to with at least 3 ounces or more of 80 proof stuff mostly. eventually i relapsed with dope although it was very modest, for about a week and some change. i abstained with little repercussion and relocated to solidify the cleanliness but still continued to drink on and off. i definitely believe i had to reset my brain once again like with what i went through when i went to rehab and can say that im making some ground with that and that i could be dragging it out with substances in general, mostly alcohol. there seems to be a strong link of depression and anything touching the GABA receptors. as for length its been about a month or more of modest chronic drinking.

im very much into the cognitive approach into getting back into the swing of things. there are so many tangents to go off of.
this being the darkside...i will say salvia seems very promising. bc it was before.

 

[SineWaveSoldier]

I've slipped back starting with alcohol a few days out of rehab a couple times. Really all I can say is there is no better time than now because if you really want to feel better and you're really an addict then steady drinking won't get you anywhere.
Straight out of rehab you need to be busy and going to meetings but if that isn't your thing whatever healthy replacement you have needs to be accompanied by something that can support you when life hits. Which it will. Don't beat yourself up over it and just try again ya know. Stay off the dope and get that alcohol under control or it may become just as hard to kick.

 

[At4r4xis]

thanks guys- i pretty much know what the right thing to do is, def. to stay busy.honestly it helps to have validation. reinforcing positive cognitive habits will push the journey forward I think it gets better every day. Im def. beginning to realize what doesnt work...and what isnt worth it.

 

[manboychef]

Dude just steer clear of any mind altering substances. They are just different paths to the same destination: fucked up.

 

[GenericName12]

Definitely stay away from alcohol, for good. It's hard because it's so socially accepted but it's just something you have to do.

It will just lead you back to where you started.

Congrats on being clean from your DOC for 2 weeks!

 

[bennyZA]

I gotta chime in here. I used to be addicted to alcohol and opiates and to this day ALCOHOL has been the harder of the two to kick. It was also the one with the more awful withdrawal. Don't trade one addiction for another. As ubiquitous as alcohol is, it doesn't mean it's any less of a bitch to get off of.

 

[beengerman]

^im realizing that now.

 

[manboychef]

:Sucks when you realize there is no escape from your own mind

 

[monstanoodle]

I wouldn't consider myself a drinker, I have the odd social drink but I started using alcohol as a drug to take me out of one state and put me into another, with that specific purpose.

This is exactly what happened to me: (Rant ahead, so I'm going to put a spoiler action on it incase you don't want to read)

Spoiler: My Tale

I wasn't drinking much at all - even before I got into Opiates - Then I got into Opiates and ended up going down the spiral staircase and landed up with a H habit.
I tried to come off it with Buprenorphine but the sedation that Buprenorphine doesn't provide just made me relapse after 2 weeks on it. If I'd have been given a good dose of some form of Benzodiazepine then I may have been more successful - And there was no fucking way I was going to touch Methadone!
What's the point of kicking H with another Opioid that's even more difficult to kick? Methadone's a fucking piss-take of a "solution for addiction"

So I started drinking heavily, put my Pancreas in hospital and thank the Invisible Invented Entity that my GP was so clued up and cares about me:
We both decided that it was either going to be me using H and drinking shit loads, or try a combination of Codeine and Diazepam (with Temazepam or Zolpidem at night), because it was the lesser of two evils and it was managed and constant, instead of still using H one week then without and in WDs the next.
Plus drinking loads and taking myself closer to hospital (and very likely in an ICU).

It took a while to completely get off H and give Ethanol a very good break. But as is bolded in Rybee's quote up there:
I was drinking lots to replace H. I wasn't in WDs because of the Codeine, but every user knows that there's very little like good H.
So yeah, Ethanol took over where Diamorphine stopped for quite a while, and - in large enough doses - Ethanol does act as a µ-Opioid Receptor Agonist, infact it's fucking mess of a psychoactive substance is Ethanol - Hits so many receptors, it's a "Dirty Drug".

Anyway, right now I'm not using H, drinking nowhere near the amount I was drinking back then (maybe a couple of cans at most a week) and I'm stable on my Codeine and Diazepam script.

But it seems that the major replacement substance for H or other heavy Opioids keeps popping up as Ethanol
And which is safer and less damaging to the body?

 

[Vaya]

Thank you for sharing all that you have been going through with us. "Wherever there's hope, there's a trial." The Recovery Forums are decidedly my all personal favorite resources and community. Bluelight has persisted with me for a whole decade, now. That in and of itself is testament to its strength, fueled by love and respect. Thanks for joining as a member

And now, then...

any articles or sciencey stuff to reference are welcome

...let's get all scholarly up in this house

Alcohol absolutely is correlated with depression. So intimately, in fact, that chronic depression is almost a symptom itself of heavy, sustained drinking.

Depression and alcohol.

Specifically:

Comorbidity between depression and alcoholism
Depression and alcoholism are associated with considerable morbidity, disability, and mortality, and co-occur more commonly than expected by chance.3–,8 The extent of comorbidity between depression and alcoholism was demonstrated by the results of several large epidemiological studies.3–,7 The National Comorbidity Survey (NCS), a nationally representative survey in the US, found that compared with non-depressed respondents in the NCS, the lifetime odds of alcohol dependence were significantly elevated for both men (2.95) and women (4.05) with major depression.7 Conversely, NCS data demonstrated a two-fold increase in the lifetime odds of depression among subjects with alcohol dependence.6 Spaner et al.3 examined the comorbidity between major depression and alcohol dependence in Edmonton, Canada, and found that 30.5% of individuals with an affective disorder also met criteria for alcohol dependence, compared with only 16.8% of those who did not have an affective disorder. Similarly, the National Longitudinal Alcohol Epidemiology Study demonstrated that amongst those with major depression, 32.5% met criteria for a lifetime diagnosis of alcohol dependence, compared with only 11.2% of those who did not meet criteria for major depression.4 Rates of depression are more elevated among people who seek treatment for alcoholism.8 Possibly, some of this elevated comorbidity may be due to increased treatment-seeking among people with alcoholism who also experience symptoms of depression.

I suggest reading the whole article - that journal was kind enough to provide it online full-text/PDF for free(!!!!!).
I, too, fit the nicotine bill, despite the fact that I use electronic cigarettes, now. It's quite a predictor for situations like yours (just like mine), according to the following study:
Depressive Symptoms and Cigarette Smoking Among Teens

I, myself, am at no loss for words after having read the article. I'd always been aware that the 'friends' I had in High School and College almost all uniformly smoked as much as I did. I find the same thing outside of a lot of the recovery meetings I attend for myself these days.

Clinical Observations in Manic-Depressive Disease

Here's another link suggesting a strong, positive correlate between alcohol and, this time, a particular type of depression. Of note:

Increase in alcoholic ingestion was common in the manic-depressive patient. Family history showed significantly more "alcoholic" fathers. At least part of the problem called "alcoholism" seems related to manic-depressive disease.

If you continue the Google Search I began, you'll find fields of substantiating evidence that would strongly suggest your recent drinking patterns certainly haven't been making you any happier!!

Believe me my friend, I have been there. Every thing echoes - for that state of being can feel and be the absolute epicenter of loneliness

A song by an electronic artist called Hybrid *just* came on as I type this. Here are the lyrics:

You drink your health,
And remember to forget about your self...
Sit on a roof,
In the everlasting moments of your youth...
You look surprised,
As it all went up in smoke before your eyes,
Beneath the cloak of a different kind of Sunday morning...

Until tomorrow,
On a different kind of Sunday morning,
Until tomorrow...

Gave me the chills. 8(
Don't stay isolated. You've done a wonder thing for yourself, kicking the opiate habit.
My instincts tell me that you did so with the impression that life would get better if you quit (it does!!).

Keep this in mind: In the beginning, recovery is painful for each and every one of us. You are not, nor ever will be, alone. But by replacing opiates with alcohol...
with each successive sip, you kill yourself further.

Peace, love unity, respect,
~ Vaya

 

[Vaya]

Some more relevant links from the recovering-from-opiates-so-shortly-ago aspect of it:



Guilt, Shame, and Depression in Clients in Recovery from Addiction

(Something to keep in mind for this next one: Dopamine is the body's most prolific pleasure-transmitting neurotransmitter)
Depression of Mesolimbic Dopamine Transmission and Sensitization to Morphine During Abstinence

Withdrawal from morphine resulted in a marked reduction of extracellular DA concentrations from control values at 1, 2, 3, and 5 days of withdrawal. After 7 days of withdrawal, DA output was less, but still significantly, reduced.

This will take time to heal. After all, it took time to get to where you're at now, did it not? (Tough reality we addicts simply must own up to )

Relationship of Depression to Psychosocial Stressors in Heroin Addicts


Some very interesting food-for-thought in that one, I thought...

Again... Be well. Pace your recovery so that you do not lose this. you can... And you must.

~ Vaya

 

[beengerman]

very interesting vaya

 

[buffalobillygoat]

Hi OP, I came off fentanyl mid june, through a treatment centre that uses a naltrexone implant. Although I have over a month off opiates, tonight is only my second night since treatment when I haven't been drunk. I was drinking a bottle of wine/ or a half of whiskey on week nights after work, then more at the weekend. Yesterday morning I woke up in a bed covered in vomit. So I obviously don't have a success story yet, but I did choose not to drink yesterday and today. And I feel much better.

 

[herbavore]

^buffalobillygoat, I'm glad that you woke up. Though the bed may have been a hell of a mess to deal with, you survived what many do not. I'm also glad you made the choice you did yesterday and today--may that choice become easier and easier to make. ((((()))))