Opioid withdrawal and lasting hypertension

[yb62338]

Hello all
Not sure if this the right place for this thread so if I'm mistaken, please move it for me.

A little background: I am a 22 year old former IV crack/heroin user. When I was 18, I developed a very small hydrocodone/oxycodone habit. This quickly became a mild addiction, with me snorting roughly 80-160 mgs at least two-three times a week (often more). I used in this manner (with occasional breaks of several months) for about 3-4 years.

Between January and March, I heavily abused Adderall and Xanax because my Suboxone doctor was a crook who had a loose hand.

Earlier this year (around March), I found a source for heroin and quickly made the switch to IVing. Since around here heroin and crack go hand in hand, I started shooting them together (Speedballs) at least once daily for about 6-8 weeks.

I've now been clean for over a month. Absolutely clean, no alcohol, pot, cigarettes, nothing. I went to detox twice this year, and both times had my blood pressure measured in the morning or evening. As of late, my b/p has been through the fucking roof. I'm talking ~ 140/90 range with a pulse of 80-130. When I checked into rehab earlier this year, my b/p and pulse had been relatively normal (115-125 / 68-80). The second time (3 months later and many drugs later), it was discovered that my blood pressure and heart rate had become significantly elevated.

I understand elevated b/p is a symptom of opioid withdrawal, but does it generally carry on for this length of time? Nobody in my family has had b/p problems at such a young age. I'm feeling real blue and I'm really hoping this is a temporary of sign of sympathetic nervous system hyperactivity in a rebound effect from having b/p artificially repressed for so long. The more serious implications of high b/p at this age could be focal segmental glomerulosclerosis, heart/kidney damage, etc.

I am a pre-med student so I completely understand the association of high b/p with morbidity/mortality.

Anybody else have any experience with similar symptoms?

 

[addictivepersona]

How is your diet? Exercise level? Both of those if "shitty" and "low" respectively can elevate blood pressure.

When you say you went to rehab twice "this year," do you mean within the past 12 months, or within the year 2011?

 

[amapola]

Hmmm I'm going to move this over to Other Drugs for you OP. It might be more of a Healthy Living concept but you'll get a lot more people with withdrawal experience over in OD. I can leave a redirect for you as well.

Personally I think that although the abuse was over a fairly solid period of time, the fact that you are young and have been clean from a relatively short acting opioid for a month means BP and heart rate shouldn't be that high. You can definitely still be within PAWs which accounts for more of the mental and emotional issues and stress and anxiety can play a part in effectin these stats as well. Either way I think an ekg and echocardiogram would be the wise course of action just to make sure everything is okay. I'm sure you're more well read on the possible effects of regular IV administration than you wish you were so stop scaring yourself with the possibilities and just go get checked out.

 

[yb62338]

How is your diet? Exercise level? Both of those if "shitty" and "low" respectively can elevate blood pressure.

When you say you went to rehab twice "this year," do you mean within the past 12 months, or within the year 2011?

I am a former distance runner and swimmer. Fairly athletic throughout my life, spent about 2-3 years lifting weights on a regular basis. I am slim, athletic build with a relatively low body fat percentage.

I meant twice in 2011, but I was mistaken. I went to detox in late December 2010 (got out new years eve) and once in mid-April 2011.

Personally I think that although the abuse was over a fairly solid period of time, the fact that you are young and have been clean from a relatively short acting opioid for a month means BP and heart rate shouldn't be that high. You can definitely still be within PAWs which accounts for more of the mental and emotional issues and stress and anxiety can play a part in effectin these stats as well. Either way I think an ekg and echocardiogram would be the wise course of action just to make sure everything is okay. I'm sure you're more well read on the possible effects of regular IV administration than you wish you were so stop scaring yourself with the possibilities and just go get checked out.

Thanks for the reply. Actually, my father is a physician and as a pre-med student, I have been working part-time at his office to build up a reputation for medical school. The scary thing is, I immediately went to go see an excellent and thorough doctor following the high readings in the hospital. He is concerned about renal damage, but I will suggest an EKG as well.

I'm certainly praying that it is only PAWS. In the past, I have heard of PAWS closely associated with benzodiazepine withdrawal but after UTFSE I see it effects those using heroin as well. As autonomic disturbances are characteristic of PAWS, this is certainly (and hopefully) a possibility.

I used Suboxone for maintenance for a couple of weeks following my detox; does bupe withdrawal typically cause rebound hypertension? It's my understanding that the long half-life of bupe really drags out the withdrawal symptoms.

 

[suessmayr]

Between January and March, I heavily abused Adderall and Xanax because my Suboxone doctor was a crook who had a loose hand.

I love how you completely just surrender all responsibility for the fact of your addiction. I think if your abuse was because of anything, it was assuredly you.

Apart from that, massive congratulations on getting clean. I don't know much about blood pressure but I know how hard it is to do what you've done. Emphatically, well done!

S

 

[TheLostBoys]

I think you have high blood pressure because of your stimulant usage & not the opiates, I could be wrong tho.

 

[ActiqAnnie]

Can you get your hands on a Clonidine script? I use the 0.2mg/day transdermal (patches) for withdrawal and it works wonders. Hypertension is a common immediate side effect but can last for months.

Overall, given your age and history of good BP and rate, I'd say this is not a huge problem. Tachycardia/elevated BP can last 3-4 months fairly commonly. If you can get your hands on the Clonidine (Catapres is the non-generic), try that out.

 

[amapola]

I used Suboxone for maintenance for a couple of weeks following my detox; does bupe withdrawal typically cause rebound hypertension? It's my understanding that the long half-life of bupe really drags out the withdrawal symptoms.

The long half life can indeed really mess with you and mean you are still within withdrawal which could account for the continued symptoms. Furthermore bupe is a delta agonist (delta opioid receptors having some effect on one of the beat adregenic receptors) and a kappa antagonist (kappa agonism believed to be involved with the feeling of stress meaning rebound would trigger it) so its much much more complicated.