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Opioids Long term abstinence and cognitive restoration

achey node

Greenlighter
Joined
Jan 24, 2014
Messages
6
This is addressed to those who have been abstinent for over a year from ALL Opioids. How would you compare your cognitive function while addicted to your functioning post addiction? Is the difference pronounced or more subtle? Can you outline the primary areas of improvement/impairment:

  • Learning
  • Memory
  • Attention Span
  • Decision Making
  • Verbal Fluency
  • Creativity
 
Last edited:
Let me preface by saying I have never been addicted to any opioids, but I can however provide certain physiological explanations for the above question through research colleagues and I have conducted. As you may guess, during early abstinence from opioids, physical signs of withdrawal are very apparent (tachycardia, hypertension, etc) but seem to diminish as time progresses. In our study, we noted that individuals who have recently come off of specific opioids almost always complain of fatigue and poor concentration, both of which can be attributed to the sudden down regulation of opiate receptor activity and the up regulation of GABA. As homeostasis tries to bring the body back down to a state of equilibrium, brain stress systems are activated and large amounts of the hormone cortisol start to be released. In a study by Guerra et al. individuals with current Heroin abuse showed deficits in all categories you listed above. However, after 7-14 days, a retest was done and their scores reached the level of control. Another study carried out by the same group concerning cognition during late opioid abstinence concluded that normal cognition was apparent, expect for in the area concerning executive function. I took these findings into consideration and started doing more research on recovering addicts who have abstained from using heroin for longer periods of time ( >14 months) and concluded the same findings as the Guerra study. It seems as though executive function seems to be impaired the most by heavy opiate use, while other cognitive functions (memory, verbal ability, etc) appear to return to that of the control groups. If you have anymore questions I would be happy to pm you more research concerning your question.
 
Id be interested in that research captain cook (breaking bad is awesome.lol).
Im a longtime opiate user due to chronic pain. I know im far from abstinence but id be interested in finding out how much of my cognitive ability ive lost (i scored high on every test during school).
 
I am off opiates for over a year and a half and although I had impairment initially due to the PAWS it has disappeared and I am as bright, creative, and mentally apt as I have ever been. I also abused many other drugs including coke, alcohol.. used LSD, mushrooms,, and used marijuana very heavily. The brain is like a muscle if you dont use it it get weak.. so I suggest that anyone who is experiencing these symptoms after the PAWS have seemed to go away needs to begin to work their brains out with something like puzzles or course work. Exercise and good natural sleep can do wonders for the brain as well. There is some good nutritional and supplement discussion in this thread Hey I thought the grey matter of ADD could chew on this....


PAWS- Post Acute Withdrawal Syndrome

PAWS is the name given, collectively, to all possible symptoms that clean addicts commonly experience after detoxification. PAWS is the main force that drives use once an addict has broken away from physical dependence. PAWS is commonly referred to as the "psychological addiction" and is also the force that drives chronic use of substances that do not cause physical dependence. PAWS also drives compulsive performance of actions, associated with addictive behaviors, such as sex, work, shopping. It is the real power of addiction. PAWS symptoms usually begin to occur between seven and fourteen days after the acute period of withdrawal, and usually peak between three and six months after the start of abstinence. The symptoms of paws can however resurface at any point in an addict's life and have been seen to be a consistent life long battle for an unfortunate few.


Also referred to as:
  • The protracted withdrawal syndrome,
  • Chronic brain toxicity,
  • Long-term neuropsychological impairment
  • Long-term neurocognitive impairment


The most common post-acute withdrawal symptoms are:
  • Mood swings
  • Anxiety
  • Irritability
  • Tiredness
  • Variable energy
  • Low enthusiasm
  • Variable concentration
  • Disturbed sleep
  • Anhedonia (an inability to experience joy).
  • Depression.
  • Behaviors associated with OCD.
  • Difficulty focusing.
  • Disturbances in autonomic functioning.
  • Lapses in memory.
  • Hyper arousal with regards to stressful situations.
  • Agitation.
  • Inability to solve simple problems
  • Disorganized thought patterns
  • Difficulty sleeping or staying asleep
  • Sexual dysfunction
  • Mood swings
  • Depression
  • Drug or alcohol cravings
  • Self imposed isolation
  • Exhaustion
  • Poor physical coordination (dry drunk)
  • Memory troubles
  • Lack of emotional response or inability to feel emotions
  • Fibromyalgia like pain
  • Change or changes in appetite
  • Fatigue
  • Thoughts of suicide
  • Homicidal Ideation
  • Racing thoughts

PAWS LINKS
Why We Don’t Get Better Immediately: Post-acute Withdrawal Syndrome (PAWS)
Post Acute Withdrawal (PAW) Excerpted From “Staying Sober” By: Terence T. Gorski
Post-acute-withdrawal syndrome Wiki
http://www.clairedorotik.com/NLWC-EXERCISE_AND_MOOD.htm
 
Yikes. Nobody is going to like my story lol. I hope it doesn't discourage anyone.


Prior to my love affair with opiates, I wasn't doing too well. Once I hit puberty, I started noticing symptoms in myself. I had chronic headaches, pretty much daily, I was depressed (from mild to severe), I had severe menstrual pain, sleep issues, restless leg syndrome, I had little motivation or joy in life. I had brain fog, I never experienced a "runner's high". It seemed the only time I felt ok was after a bout of intense pain that would last 20 minutes to a half hour, presumably from the endorphin rush. Of course it never lasted long and I would crash back down again. I was taking horse doses of ibuprofen, which worked only some of the time.


When I was 24, I moved away from my home country (the US) and to the UK. Since my headaches were so common, it wasn't long before I needed to buy something there to treat it. I bought some ibuprofen, but weirdly I didn't take my usual dose, something I subconsciously avoided. I just took two. Before I knew it, the headache was gone, I actually felt happy, motivated and relaxed - something very foreign to me. That night I slept like a baby. I took a couple more doses in the days that followed that had the same effect. I looked at the box out of pure boredom and saw 12.8mg of codeine phosphate. No wonder they worked so well! I was naive, I assumed because you couldn't buy it in the US over the counter, you couldn't buy it that way anywhere.

For 3 years, I took approx 50mg per day of codeine 4-5 days out of the week. I did not build a tolerance. I stayed on the same dose and if I abstained, I did not have withdrawals. Then I had a severe pain issue that couldn't be rectified for 2 months. I was then prescribed dihydrocodeine, 8 tabs at 30mg a day to stay on top of it. I went from 50mg of codeine, to 240mg of dihydrocodeine per day and I felt even better. Once I didn't need them for that specific pain, I talked my doctor into continuing to prescribe them for my headaches. 6 months after that, I had to take them daily or I didn't feel well. I found it too hard to taper down short acting opiates. I was given methadone to taper. I felt great, until I began tapering.


The lower my doses, the more those old symptoms were back. I went to 0, then went on Tramadol because I just didn't feel right. I moved back home to the US and my doctor refused to keep me on opiates. So I detoxed. The first year was hell, with it only slightly getting better. This was almost 6 years ago and I've never felt back to normal. All my symptoms are back ten fold. I thought you're supposed to feel better after a certain amount of time. It however never happened for me.


I honestly hope others have had better experiences than I have. Since my dependency days, I've had opiates for acute pain just a couple times and they still had their magic with me feeling a thousand times better. I don't know what to do. It's not easy to get help for something like this. I'm scared I will never feel happy, never have the quality of life I once had before. I eat a lot of hot sauce to trigger endorphin production and I feel ok, but then comes the crash an hour later.


I do really envy those who end up feeling loads better because it sure didn't happen for me.
 
Let me preface by saying I have never been addicted to any opioids, but I can however provide certain physiological explanations for the above question through research colleagues and I have conducted. As you may guess, during early abstinence from opioids, physical signs of withdrawal are very apparent (tachycardia, hypertension, etc) but seem to diminish as time progresses. In our study, we noted that individuals who have recently come off of specific opioids almost always complain of fatigue and poor concentration, both of which can be attributed to the sudden down regulation of opiate receptor activity and the up regulation of GABA. As homeostasis tries to bring the body back down to a state of equilibrium, brain stress systems are activated and large amounts of the hormone cortisol start to be released. In a study by Guerra et al. individuals with current Heroin abuse showed deficits in all categories you listed above. However, after 7-14 days, a retest was done and their scores reached the level of control. Another study carried out by the same group concerning cognition during late opioid abstinence concluded that normal cognition was apparent, expect for in the area concerning executive function. I took these findings into consideration and started doing more research on recovering addicts who have abstained from using heroin for longer periods of time ( >14 months) and concluded the same findings as the Guerra study. It seems as though executive function seems to be impaired the most by heavy opiate use, while other cognitive functions (memory, verbal ability, etc) appear to return to that of the control groups. If you have anymore questions I would be happy to pm you more research concerning your question.

Please identify your sources when responding with information like that.
 
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