Q about Opioid Relapse/Withdrawal Timeline

[Asparagus_Prince]

If a clean but experienced opioid user relapses how long does the relapse have to carry on before he/she is faced with eventual withdrawal symptoms? For example, suppose you slip up just one day but you immediately return to sobriety. I'm assuming you won't be facing withdrawal symptoms, right? But how many days of use does it take?

And a related follow-up question: How long until withdrawals kick in for a first time opioid/heroin user? I'm assuming it takes a little longer compared to an experienced user. But let me know if I'm wrong about that.

I know everyone is different, but feel free to share your experiences.

 

[pixies+]

3 years ago I had been clean from opioids for 2 years. I was on 16mg subs at the time.

I relapsed for I think it was a total of 5 days? I think. It wasn’t long. My withdrawals were severe. That shit hit me like a ton of bricks.it was fucking awful.

I had been using the IV route… so I’m sure that didn’t help the situation.

As for your question about a first time user… umm I feel like that depends on a lot of factors. Age, weight, metabolism, diet, exercise, mental health, etc.
it took me about 2 weeks of consecutive use (far above what would be prescribed) before I realized I was in over my head.

I know some people that never seem to really get addicted as such… they may feel lousy for a couple days after they stop, but me? Whole other realm. It grabbed me, sunk its teeth in and never let go.

Hope that helps in some way?

 

[Asparagus_Prince]

but me? Whole other realm. It grabbed me, sunk its teeth in and never let go.

That's powerfully written.

Thanks for the response.

 

[Asparagus_Prince]

I relapsed for I think it was a total of 5 days? I think.

If you would have relapsed for 2 days instead of 5 do you assume you would not have had withdrawals?

And I'm assuming you stopped the subs when you were relapsing right?

 

[Them Witches]

The rule of thumb is using opioids for 3 days in a row will start the withdrawals. On a relapse, Experienced users will start to feel them at 2-3 days in a row. I want to pre-apologize for the length of this reply post and if my intent comes across as too serious for the original question towards the group. Please digest this with an open-mind and try to accept my words as extending the beneficial value of one addict helping another addict(s). From taking prescription opiates/opioids for legit medical reasons to taking them for a "reward feeling & euphoria", I did not not understand the rip current, the depth of the water, the strength of the tide, and how far away from shore I actually was. !5 years ago degenerative bone disease & my heart disorders started, chronic pain turned into "chronic pain syndrome", many surgeries later, being disabled took hold, still requiring more surgeries, and the prognosis for degenerative bone disease & 3 heart disorders equals "poor."

If you have completely removed the drug from your system it is smart to put it in the past. I have lost count how many times I set boundaries of not going back then used one time and the cycle started over again. One of the many truths to relapse is an addict will pick up right where they left off and the disease of addiction always wants to make up for lost time. Anytime I went back to using, the horror show became worse. The bus to hell was on time, had a full tank of 11ct race gas, and the engine & transmission was freshly rebuilt. Guilt and shame became worse and feelings of worthlessness became greater. I knew I clearly crossed the boundaries I set for myself.

Rock bottom has a trap door. There is a passage below the dungeon. A whipping post is always vacant. Everyday I get smarter in recovery, my disease gets another day smarter. I am accustom to chaos in my life, it feels most familiar, and order through chaos is how I made changes. It is very easy to hit "dry spells" in recovery unfamiliar to the next step required to stay on task. When this happens, many times subconsciously a blind default decision is made that seems rational at that moment. The "fresh recovering brain" remembers & acknowledges that a positive change happened as a result from chaos. Enduring a short stint of chaos or perhaps just one night of chaos will result in a refocused determined effort to continue the same drive. Sometimes a relapse is the driving force needed to dig deeper into a recovery program and it expected most of the time. It still doesn't make it the best option or decision.

I have been clean for 9 weeks before and got a new job. The exact moment I got my first paycheck the flood of compulsive using thoughts hit so hard that I ended up using that day. Just like the statement goes about the "lion behind the tree" waiting for me to wonder off course, waiting for me to not pay attention, and/or waiting for me to pull the surrender flag back down quickly.

My old sponsor taught me about creating plan's to help combat the compulsive desires to use. These are some of the changes I made in my life to help avoid
the "lion behind the tree" :

-- Allow a trusted family member hold on to my cash, debit & credit cards. Only giving me just enough money per week or daily to survive on.
-- Have a family member help out with paying my bills. This way I could not swindle extra cash for using.
-- Never leave the house with cash in my pocket exceeding $10. If I left with more cash, I would have an exact plan of what I was going to spend the money on.
-- Have a family member or friend tag along for shopping events to help stay on task.
-- Delete all previous contacts relating to using or linked to using. Create a different route of movement to avoid the areas I used to use in or score in.
-- Allow a family member to hold onto the car keys once I returned home. No sneaking out to score.
-- If I have the desire to use do not keep it bottled up inside. Secrets kept me sick and turned into reservations to use later down the road.
-- If I have prescription drugs that are controlled substances, let a family member hold on to them and provide the minimum daily dosage each day.
-- If I have prescription drugs that are controlled substances, have a family member pick them up from the pharmacy or have a family member ride along.
-- Do not hold onto tools to use drugs, throw them away. No burying a crack pipe in the backyard or stashing needles and spoons.
-- Start each day with a gratitude list and write down the daily goals creating a checklist to adhere to. No daydreaming, no idle hands, no idle thoughts.
-- If I work with using buddies, admit to them about the desire to make changes. Tell them to not talk about drugs around me.
-- At work completely avoid any old using buddies before payday, on payday, and the day after pay day.
-- At work make any contact with old using buddies very short. Do not get caught in boredom discussions with them or passing time discussions.

My old sponsor used to say "work the steps or die muthafucker"... He also used to say "when the pain of remaining the same is greater than the pain of change, then an addict will change. Who am I to stand in the way of me getting all the pain I need in order to change..?" When I first asked him to be my sponsor he replied, " Yes. 95% of your thinking is fucked up and the other 5% you need to run by me." I miss him and lost contact over the years. No one is sure what happened to him but we concluded that life happens after we were sure there was discord in his marriage.

 

[Helpmeescapethis]

I had four years clean when I returned. It took two days of using less than 0.1g of street “fent” to feel significant withdrawals.

It literally gets worse than before, every single time.

 

[helpingout]

I have profound insight on this.

Just used for about a two and a half week period of daily use.

Prior to that I started lapsing in periods of two days use spaced out five days between.

The first time I lapsed I used two days in a row. I got violent withdrawals for five days. Very distressing. But I wasn’t ready to give up yet. I wanted to see if being sick for five days had helped. So I got more and used for just one night instead of two days and I found that I didn’t get sick that second time around.

Third and fourth times followed this one day one dose rule with five days between and I found I wasn’t getting sick like the first time.

I think what happens is that your body still recognizes exogenous endorphins and when you stop giving them after two days of lapse for the first time since sobriety is that you end up withdrawing as if from the opiate drug you quit to get off opiates. But if you suffer through that sick and then after five days when homeostasis returns to your body you in the future only use a single dosage at a single time, I think you can keep from getting sick like that every time.

I think the kindling effect only manifests if you don’t return to homeostasis after a lapse.

I got injured though and I ended up deciding to relapse completely.

Relapsed for two or three weeks. And what do you know i had been sick for about five days with days six and seven being almost recovered.

I’m definitely not dying to go out and use tho. Because five days of withdrawal is absolute hell. My coworkers make fun of me for being all sick and sad at work. It’s a ok tho. They don’t know I’m dopesick. They just think I’m bummed.

Anyways. I think the kindling effect diminishes if you reinforce the bodies ability to restore homeostasis by going through periods of abstinence five times more than you through periods of lapse while only lapsing one dose at one time. When you do this, I found that after the second period I stopped getting sick after every dose.
For what it’s worth though I did completely relapse once I suffered an injury around the time I normally went to pick up. So picking up just changed into lapse because I was in real pain and the doctor prescribed nsaids which pissed me off and the relapse became a way to regain control.

Now I’m clean on my own terms again because I faced the sickness and got back under control. But what if I had been more injured. What if things were more severe.

It’s just a very dangerous position to put yourself in.

I kinda would have preferred seeking out the resources I need to get some help. Than the relapse.

 

[thurston]

If a clean but experienced opioid user relapses how long does the relapse have to carry on before he/she is faced with eventual withdrawal symptoms? For example, suppose you slip up just one day but you immediately return to sobriety. I'm assuming you won't be facing withdrawal symptoms, right? But how many days of use does it take before you'll be faced with withdrawals?

And I suppose I have a related follow-up question: How long until withdrawals kick in for a first time opioid/heroin user? I'm assuming it takes a little longer compared to an experienced user. But let me know if I'm wrong about that.

I know everyone is different, but feel free to share your experiences.

I feel sick after using something for 2 days.

 

[Asparagus_Prince]

Thanks for the thoughtful response

I have lost count how many times I set boundaries of not going back then used one time and the cycle started over again.

Not because the one time itself led to immediate withdrawal, right? But because you continued to use more after the initial relapse?

Sometimes a relapse is the driving force needed to dig deeper into a recovery program and it expected most of the time. It still doesn't make it the best option or decision.

I've never had a heroin or opioid problem exactly. But I can imagine a scenario where an addict might "lie" to themselves if they know they could reward themselves on one single day, or perhaps two, and then stop before withdrawals kick in. But then I can also imagine an "easier said than done" scenario when trying to actually stick to that plan.

But I can also imagine a scenario, a sort of reverse scenario from before, where the fear of withdrawal might stop a user from going beyond a day or two. Maybe you have a moment of weakness, use, but then are motivated to stop because you know withdrawal hell is eventual. It doesn't really seem to happen that way with the addicts I've known. But maybe that's because it's easier to notice someone else's trainwreck and/or disappearance. As opposed to someone that has a brief slip-up but then gets it back together.

 

[Asparagus_Prince]

I think the kindling effect diminishes if you reinforce the bodies ability to restore homeostasis by going through periods of abstinence five times more than you through periods of lapse while only lapsing one dose at one time. When you do this, I found that after the second period I stopped getting sick after every dose.

Interesting.

 

[Them Witches]

First and foremost, I am not an current active addict. Though many things have changed, I cannot forget where I came from and how easily it can be to return there.
I am dependent on prescribed drugs from a doctor. I take my medications as prescribed and carry honest relations with my doctor. Any NA member or otherwise that disapproves of what works for me, well they can either kick rocks or at anytime go for a walk in my shoes... Since they will not walk in my shoes, one option is left. There are many good high quality people that were either boycotted from NA or AA because of choosing MAT or taking prescription drugs by a doctor's prescription. Many of these people are no longer with us today and many people & family members endured unneeded pain due to boycotting. Someone seeking help is someone seeking help.

Not because the one time itself led to immediate withdrawal, right? But because you continued to use more after the initial relapse?

Yes and No. Relapsing is like leaving one's post of guarding against addiction like leaving a gorilla to watch over and guard bananas.

Maybe you have a moment of weakness, use, but then are motivated to stop because you know withdrawal hell is eventual

Having a harbored reservation will harvest into a moment of weakness.

I do not want to copy & paste the entire chapter of "Relapse and Recover" from the N.A. big book. These three inserts cover the message well :

Many people think that recovery is simply a matter of not using drugs. They consider a relapse a sign of complete failure, and long periods of abstinence a sign of complete success. We in the recovery program of Narcotics Anonymous have found that this perception is too simplistic. After a member has had some involvement in our Fellowship, a relapse may be the jarring experience that brings about a more rigorous application of the program. By the same token we have observed some members who remain abstinent for long periods of time whose dishonesty and self-deceit still prevent them from enjoying complete recovery and acceptance within society. Complete and continuous abstinence, however, in close association and identification with others in N.A. groups, is still the best ground for growth.
Although all addicts are basically the same in kind, we do, as individuals, differ in degree of sickness and rate of recovery. There may be times when a relapse lays the groundwork for complete freedom. At other times that freedom can only be achieved by a grim and obstinate willfulness to hang on to abstinence come hell or high water until a crisis passes. An addict, who by any means can lose, even for a time, the need or desire to use, and has free choice over impulsive thinking and compulsive action, has reached a turning point that may be the decisive factor in his recovery. The feeling of true independence and freedom hangs here at times in the balance. To step out alone and run our own lives again draws us, yet we seem to know that what we have has come from dependence on a Power greater than ourselves and from the giving and receiving of help from others in acts of empathy.

Many times in our recovery the old bugaboos will haunt us. Life may again become meaningless, monotonous and boring. We may tire mentally in repeating our new ideas and tire physically in our new activities, yet we know that if we fail to repeat them we will surely take up our old practices. We suspect that if we do not use what we have, we will lose what we have. These times are often the periods of our greatest growth. Our minds and bodies seem tired of it all, yet the dynamic forces of change or true conversion, deep within, may be working to give us the answers that alter our inner motivations and change our lives.

 

[Coffeeshroom]

Sidenote: I haven't read all replies so this is based on my own exp to OT.

If you were a heavy addict I would say 3-4days before you hooked and back on the normal off railing train, sorry to say... if you wanna stay clean then rather avoid all together. No matter the will power and circumstances, there will always be something that will trigger a continuous use all over again.

I'm not here to judge as I use to like juggling my h and bupre habit but overall health wise it was fucking me up and financially, realistically I just could afford to maintain a normal habit. Fuck my current monthly methadone dose last me about 6-7 weeks. So comparing that to what I use to spend on H, it's worlds apart.

For exp 1 bottle of methadone gives me 50 servings divided by 2, so one bottle lasts me a month. Wherew with dope I would spending 12k a month where methadone is 1k a month. Like wtf, so the math. Come on ppl we can do this and get clean.

Anyhow big up to everyone and total fuckness to all

 

[Keif' Richards]

If we are talking about consistent, near-daily usage or more:

1 - 2 months - First twinge of "maybe I'm sick?" but no big deal. You put it down as a cold perhaps
3 months - First experience with symptoms resembling Flu, though more mild
6 months - First experience with full-blown withdrawal (unable to function normally due to vomiting, diarrhea and malaise)

As the person continues to use, the withdrawal syndrome will get worse each time. If a person experiments with abstinence, they will experience increasingly more extreme syndromes requiring fewer days of use to trigger said episodes. You might be abstinent, then be able to use Opioids for 5-7 days before withdrawal is triggered again. With each sucessive abstinence, the Opioid usage required to trigger severe withdrawal will decrease.

The end stage for most of us is, no matter how long we are abstinent for, it will only ever require 2-3 days of usage for us to return to that same full-blown syndrome that at one point had taken 6 months of more to achieve. This is not a phenomenon that can be reversed as far as I'm aware. You eventually are left with two choices, complete abstinence or full-blown addiction/dependence.

Many non-addicts are unaware of this "Kindling Phenomenon" and are thus disappointed when they see their loved ones go from total sobriety to back on the street seemingly overnight. They mark it down as a severe moral failure, not knowing that the dependence and addiction has created permanent changes in their person. I hope this helps.

 

[Asparagus_Prince]

they can either kick rocks or at anytime go for a walk in my shoes

Rather than 'kick rocks' I've always preferred: "They can grab a giant unlubricated dildo that's dangerously too big for their asshole and go fuck themselves for 2 solid hours"

I do not want to copy & paste the entire chapter of "Relapse and Recover" from the N.A. big book.

My original question wasn't really about recovery, per se. It was circumstantial in nature and more about approaches to a hypothetical situation. But nevertheless I get the bigger picture stuff and I enjoyed your post and paste.

 

[pnillyg]

If we are talking about consistent, near-daily usage or more:

1 - 2 months - First twinge of "maybe I'm sick?" but no big deal. You put it down as a cold perhaps
3 months - First experience with symptoms resembling Flu, though more mild
6 months - First experience with full-blown withdrawal (unable to function normally due to vomiting, diarrhea and malaise)

As the person continues to use, the withdrawal syndrome will get worse each time. If a person experiments with abstinence, they will experience increasingly more extreme syndromes requiring fewer days of use to trigger said episodes. You might be abstinent, then be able to use Opioids for 5-7 days before withdrawal is triggered again. With each sucessive abstinence, the Opioid usage required to trigger severe withdrawal will decrease.

The end stage for most of us is, no matter how long we are abstinent for, it will only ever require 2-3 days of usage for us to return to that same full-blown syndrome that at one point had taken 6 months of more to achieve. This is not a phenomenon that can be reversed as far as I'm aware. You eventually are left with two choices, complete abstinence or full-blown addiction/dependence.

Many non-addicts are unaware of this "Kindling Phenomenon" and are thus disappointed when they see their loved ones go from total sobriety to back on the street seemingly overnight. They mark it down as a severe moral failure, not knowing that the dependence and addiction has created permanent changes in their person. I hope this helps.

I second this

 

[Them Witches]

"They can grab a giant unlubricated dildo that's dangerously too big for their asshole and go fuck themselves for 2 solid hours"

ouch... There is no topping that.

 

[Them Witches]

1 - 2 months - First twinge of "maybe I'm sick?" but no big deal. You put it down as a cold perhaps
3 months - First experience with symptoms resembling Flu, though more mild
6 months - First experience with full-blown withdrawal (unable to function normally due to vomiting, diarrhea and malaise)

I am 40 years dependent on opioids. Regardless of how much Roxi and Methadone I take daily, I wake every morning at 4am with a hot neck, restless legs, sneezing, irritable, watering eyes, etc. I have to dissolve 60mg of Roxi under my tongue and dissolve 20mg of Methadone with coffee immediately.

Cold turkey at this point is not possible without medical tapering and intervention. My doctor said I would have PAWS for over a year at least and there is a strong chance my life will not return to normal.