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  • BDD Moderators: Keif’ Richards | negrogesic

Opioid Withdrawal and How to Survive

cloudz

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Joined
Jun 3, 2013
Messages
8
OPIOID FACTS AND WITHDRAWAL MECHANISM

Endogenous opioids include Enkephalin, Beta-endorphin, Dynorphin, Endomorphin, Nociceptin, opiorphin, and morphine. Enkephalin is the ligand for delta receptors and also has a high affinity for Mu-opioid receptors. Dynorphin is the ligand for kappa receptors. Beta-endorphin has an affinity for mostly Mu, but also delta and kappa. Endomorphin is the ligand for Mu. Nociceptin for ORL receptors. Opiorphin is found in saliva and inhibits the enzyme that breaks down Enkephalin and B-Endorphin called Enkephalinase. Opiates inhibit the firing of locus ceruleus neurons which is involved with physiological responses to stress and panic. The highest concentration of opioid receptors are found in the sensory, limbic and hypothalamic regions of the brain.
When exogenous opioid consumption is stopped, the increased activity of the locus coeruleus contributes to the symptoms of opiate withdrawal. The alpha2 adrenoceptor agonist clonidine is used to counteract this withdrawal effect by decreasing adrenergic neurotransmission from the locus coeruleus. Excessive cortisol secretion is seen in 40-60% of depressed patients, associated with diminished noradrenergic inhibition of corticotropin-releasing hormone secretion in the hypothalamus. Corticotropin-releasing hormone induces anxiety in experimental animals. Cortisol stimulation of the locus coeruleus due to chronic stress exacerbates norepinephrine stimulation of the amygdala. Healthy humans fed fish oil rich in the omega-3 fatty acids EPA and DHA show reduced plasma levels of the stress-associated hormone norepinephrine

(1)Drastic reduction in dopaminergic activity during opioid withdrawal likely accounts for the intense dysphoric state of the user. Therefore increased dopamine activity attenuates withdrawal
(2)Substance P is involved with expression of some symptoms of opiate withdrawal
(3)Acetylcholine outflow is increased and GABA decreased during opioid withdrawal.
(4)Anti-opioid peptides may contribute to tolerance and possibly dependence of chronically administered opioids.
(5)Lower doses of opioids are easier to come off, tapering is effective at reducing the severity of withdrawal.
(6)Nicotine withdrawal causes desensitation of the delta opioid receptors.

GOAL—HOMEOSTATIS (BALANCE)

Gamma-aminobutyric acid (GABA) is the second most abundant neurotransmitter in the brain and the primary inhibitory neurotransmitter that acts through a negative feedback system to block the transmission of a signal from one cell to another. It is important for balancing the excitation in the brain. Benzodiazepines (anti-anxiety drugs) work on the GABA receptors of the brain, inducing a state of relaxation.

Glutamate is an excitatory neurotransmitter and is the most abundant chemical messenger in the brain. It is believed to be involved in learning and memory. Certain diseases (such as Alzheimer’s disease) or brain injury (such as stroke) can cause too much glutamate to accumulate. This can set the stage for excitotoxicity, a process that can lead to damage or death of the affected brain cells.

It is important that GABA and glutamate are carefully orchestrated to balance each other. Dysfunction of one of these amino acid neurotransmitters affects the function of the other. Some experts believe that their excitatory and inhibitory balance influences all brain cells.

[SOURCES]
(1)http://www.ncbi.nlm.nih.gov/pubmed/7853194
(2)http://www.ncbi.nlm.nih.gov/pubmed/2482512
(2)http://www.ncbi.nlm.nih.gov/pubmed/12576096
(3)http://www.ncbi.nlm.nih.gov/pubmed/3814913
(4)http://www.ncbi.nlm.nih.gov/pubmed/8545244
(5)http://www.ncbi.nlm.nih.gov/pubmed/17952010
(6)http://www.ncbi.nlm.nih.gov/pubmed/20941594


EFFECTIVE METHODS TO EASE OPIOID WITHDRAWAL

{TENS}

(a) Cerebral Electrotherapy (CES/NET)
(k) EA Acupuncture
(k)*Binaural Beat Frequencies (Utilizing headphones) @ 2hz, 100hz, 111hz


{DRUGS}

(b) Baclofen
(c) THC/Marijuana
(d) Gabapentin/ Pregabalin (Lyrica)
Phenibut
(p) Gamma-Hydroxybutyric acid (GHB)
Chlordiazepoxide
(e) Clonidine
Tricyclic Anti-Depressants
-Amitriptyline
(f) Benzodiazapines
-Alprazolam
-Diazepam
Loperamide (Immodium)
(o) Cobrotoxin (Cobroxin/Nyloxin)
*Propoxyphene
*Codeine
*Ibogaine


{HERBS}

Kratom
Passion Flower
(h) Weinicom
(i) St.John’s Wort (NOTE: Do not use while tapering)


{VITAMINS}

(j) Vitamin C
Vitamin D
Vitamin E
B-Complex
Calcium
Magnesium
(NOTE: Multivitamin Suggested)


{AMINO ACIDS & NUTRIENTS}

(m) D/DL-Phenylalanine (DPA)
(l) L-Tryptophan
L-Tyrosine
Omega-3
DHA


{DRUGS TO STAY AWAY FROM}

(g) Caffiene
(NOTE: Adenosine A2 antagonists increase dopamine release and slightly reduce withdrawal, while adenosine A1 agonists inhibit excitatory amino acid release and significantly reduce withdrawal. Caffeine has been found to antagonize both A1 and A2A receptors in the brain, therefore potentiating opioid withdrawal. It also inhibits GABA and neutralizes any benzodiazepines.)
(n) Cocaine
(n) Amphetamine


{Other helpful activities to help reduce withdrawal severity and distract the mind}
Exercise
Massage
Sexual Activity
Hot Shower or Bath
Cool Mattress or Pillow
Use a Fan to Keep Cool
Watch Favorite TV series


My Personal experience: As I’ve tried nearly everything under the sun, nothing has worked as effectively for me in regards to reducing acute withdrawal as mega dose Vitamin-C supplementation (as sodium ascorbate a more bioavailable form). A daily dosage of 40-60 grams of Vitamin-C in split doses throughout the day had taken care of 80-90% of all symptoms of withdrawal. ( See cited source (j) ) This is knowledge I wish I had years ago. Another very effective method for me was listening to 2 hz binaural beat frequencies with headphones for a minimum of 20 minutes, this causes the brain to release enkephalin. Gabapentin and alprazolam were the most effective drugs and Kratom the best herb that I've used to relieve withdrawal. If you want to quit but have chronic pain in your way, Cobroxin/Nyloxin is the only over the counter pain reliever that can take the place of a high dose opiate when it comes to alleviating chronic pain. I recommend at least using the gabapentin and alprazolam along with the mega-dose sodium ascorbate if you plan to stop opioid use with as little withdrawal as possible. A good back massage, and a hot shower always takes the edge off too. I have not yet tried baclofen but I've heard and read many good things about it, I also have yet to try the Electro-Acupuncture (EA) or other TENS treatments as well but I’ve seen amazing results on video. Check them out in the links below.
http://www.netdevice.net/aboutvideojournal_2.php
http://www.netdevice.net/aboutvideojournal_1.php
http://www.netdevice.net/aboutvideojournal_3.php

=D

[SOURCES]
(a) http://www.ncbi.nlm.nih.gov/pubmed/760910
(b) http://www.ncbi.nlm.nih.gov/pubmed/1324986
(c) http://www.ncbi.nlm.nih.gov/pubmed/11359533
(d) http://www.ncbi.nlm.nih.gov/pubmed/15093968
(e) http://www.ncbi.nlm.nih.gov/pubmed/3048954
(f) http://www.ncbi.nlm.nih.gov/pubmed/8905331
(g) http://www.ncbi.nlm.nih.gov/pubmed/12879207
(h) http://www.ncbi.nlm.nih.gov/pubmed/11061678
(i) http://www.ncbi.nlm.nih.gov/pubmed/19370548
(i) http://www.ncbi.nlm.nih.gov/pubmed/19067385
(i) http://www.ncbi.nlm.nih.gov/pubmed/12649774
(j) http://www.ncbi.nlm.nih.gov/pubmed/10836211
(j) http://www.tandfonline.com/doi/abs/10.1080/02791072.1979.10472107
(k) http://www.ncbi.nlm.nih.gov/pubmed/15135942
(l) http://www.ncbi.nlm.nih.gov/pubmed/7454382
(m) http://www.moodcure.com/restoring-natural-opioid-system.html
(n) http://www.ncbi.nlm.nih.gov/pubmed/16191669
(o) http://www.aseanbiodiversity.info/Abstract/51010802.pdf
(o) https://www.nyloxin.com/media/nyloxin_drug_insert.pdf
(p) http://www.ncbi.nlm.nih.gov/pubmed/8397726
 
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damn, nice work. Can your body really utilize that much vit c though? wouldn't u just end up pissing most of it out?

binaural beats and acupuncture have not helped me at all.

Acute withdrawal isn't so bad though, how can one better survive post acute withdrawals is really my issue.

amphetamine is actually pretty effective in getting through opiate withdrawal for some people, gets the old dopamine going and if you add a benzo in there, you have the GABA effectively eliminating much of the worst aspects of the withdrawal.

yeah codeine, kratom and loperamide are what i use but then you also have to quit them afterwards and still face the PAWS. Anyway, great post especially citing your sources.
 
By using sodium ascorbate instead of ascorbic acid, your body can utilize very large amounts. If you take that much ascorbic acid, say even 10 grams at once, it will likely exceed anyone's bowel tolerance and you and the toilet will spend some quality time together.

And yes, I have heard of people who would rather take amphetamines for withdrawal than not, however in many cases, it increases akathisia, anxiety and agitation ( see source (n) ). Will likely reduce some symptoms such as restless legs because of the dopamine uplift and exacerbate others.

Normal acupuncture has been proven relatively ineffective for managing withdrawal, but there has been great success with electro acupuncture using the 2hz and 100hz frequencies ( source (k) ), I applied that concept to binaural beats and had good results, much more so with the 2hz. To use this method, its ideal to have an mp3 of the frequency on a mobile audio player or phone that you can set to repeat but check the link below for an example. It's one of the samples I've used while sick at work.
http://www.youtube.com/watch?v=luIaWKDBslQ
 
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How do you keep from crapping your pants on a Vit C dose a 6 grams?
 
Using sodium ascorbate you don't have to worry about reaching a bowel tolerance, I take 6-10 grams at a time easily with some orange juice.

^ Thanks Chromo, I figured after years of being on bluelight forums I might as well take 3 minutes and sign up to contribute.
 
with binaural beats, doesn't your brain effectively subtract one frequency from the other? so you run 100 hz in one ear and 2 hz in the other and the brain perceives 98 hz? it's been a while since i've played around with them but like to put really low frequencies in music for fun based on my experience with binaural beats lol. I find they help with meditation but in withdrawal i'd probably be in too much pain, agony, anxiety to actual do anything to help myself other than garble pills down.

electro acupuncture sounds interesting.
 
^Yes that's how binaural beats work.

Other drugs I left out of the list because of many conflicting reports include Alcohol, Quetiapine (Seroquel), Cyclobezaprine (Flexeril), Carisoprodol (Soma). I have experience with Soma by itself when I was in withdrawal and it had no signficant benefit and in high doses is said to exacerbate akathisia. I also have used seroquel as a weapon to combat withdrawal also ineffectively, but I'm sure it may have some knockout value for those who are only in mild withdrawal. Alcohol has made it worse for me when I started drinking while I was far along into withdrawal, but on the other hand, it seemed to diminish the severity of withdrawal if I drank with my last few doses of opiates possibly due to it's activity at the NMDA receptor... perhaps lowering my physical dependence.
 
^what about NMDA antagonists? MXE and DXM seem to help people quite a bit, even if they are just so fucked up they are numb and can't feel anything for the acute stage.
 
There is no way I could drink anything when I am in serious wd. I cant even drink a sip of water without throwing up never mind alcohol, but everyones different I guess.
 
This thread is very intresting. Im acutally in WD I stopped using AH-7921 2 days ago and I have severe body symptom such as weird sensation that lead to spasm. It is actually the worst WD I ever had in my life. Previous WD was more mental than physic but that one is very physic, I dont feel much mental effect yet, I bet its gonna kick off in a few days.

What is really helping me now is reading bluelight, even if I read about WD, it keep my mind busy and I feel less body sensation.

I tried Loperamide 24mg, it doesnt seem to help at all, I also took 60mg DXM and grape fruit juice. All that mix made me sick and I puked.

Im listening to your youtube 2Hz link right now cloudz. It help a little too.

I use Quetiapine (Seroquel) for sleep for a few months now and yesterday I could fall asleep even with 6X the dose I use to take which is 25mg. Finally at about 3h30 am I fell a sleep for a short time then woke up about 30minutes later, I fell asleep again later and woke up at 8h00 am. So I slept about 4hours.

I didnt know WD could be that bad. Everytime I used a drug and had to WD it was bad but I could get over it easily but now every seconds feels like hours.

Multi-vitamins doesnt seems to do much for me. St-johns wort neither.

I which I had acces to other stuff like Benzodiazepine, Codeine or Clonidine. Kratom would help alot but I do not have acces to it right now.
 
EDIT: I've been reading bluelight while listening to 2Hz binaural beats for 1hours, most of the symptom are gone, it really helps for me.

another EDIT: Since I dont have acces to Clonidine, I had the idea to put some clear eyes in a glass mixed with water and drink it. Clear eyes contain Naphazoline which as alpha-a activity so it should work in a similar way Clonidine do. For me it helped with the bad body sensation.
 
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Solid post. Even a very basic and limited understanding of neurochemistry/neuropsychopharmacology can work wonders when facing opioid withdrawl. If people who are suffering understood why rather than simply focusing on masking symptoms through methods which are often counterproductive and marginally effective, and which fail to actually address the imbalance which is responsible.

I pretty much agree with your approach. For me- alprazolam, l-tyrosine (to boost catecholamine concentration), any and all essential [daily] vitamins/minerals coupled with an extremely nutritious ideal diet, and the most important in my opinion and experience- Exercise. Vigorous exercise- weightlifting, running sprints, cross-fit- intense physical activity stimulates the production and release of incomparable levels of all endogenous opioid ligands to a degree which nothing else can, and can have a profound impact on the severity and duration of acute w/d, which ultimately results in a substantial and rapid reduction in symptom severity, duration, and overall healing time. I preferred pregabalin to gabapentin though. Cleaner and generally more effective IME.
 
EDIT: I've been reading bluelight while listening to 2Hz binaural beats for 1hours, most of the symptom are gone, it really helps for me.

another EDIT: Since I dont have acces to Clonidine, I had the idea to put some clear eyes in a glass mixed with water and drink it. Clear eyes contain Naphazoline which as alpha-a activity so it should work in a similar way Clonidine do. For me it helped with the bad body sensation.

I actually can't believe that nobody has called him out on deliberately ingesting Clear Eyes...this is an absolutely horrible idea. Whatever "help with the bad body sensation" you felt was either placebo effect or the effect of something else you had taken. Naphazoline is a partial α1-agonist, and Clonidine is a a partial α2-agonist. The effects of those two things are essentially opposite - α1 agonists have sympathomimetic effects (including vasoconstriction as it is a vasopressor, meaning it makes your BP and HR go UP), and α2 agonists (like Clonidine) have sympatholytic effects (including lowering blood pressure, heart rate, etc.).

Do some research before you just start throwing chemicals down the hatch. Thinking you know what you're doing and actually knowing what you're doing are (obviously) two very different things. You're lucky that the active ingredients in eye drops are incredibly dilute and the total dose you received from your concoction was likely minimal, or you would probably have ended up having a hypertensive crisis (or a adrenergic storm).

I don't mean to revive a somewhat-old thread, but what he did was downright dangerous, and as someone who is looking for things to help cope with opiate withdrawal, I thought it prudent to give a heads up to anyone else who may find this post thinking it was a good idea to start downing eyedrops. Newsflash: it's not. Do your research, or better yet, ask a doctor.
 
{Other helpful activities to help reduce withdrawal severity and distract the mind}
Exercise
Massage
Sexual Activity
Hot Shower or Bath
Cool Mattress or Pillow
Use a Fan to Keep Cool
Watch Favorite TV series

Ok, one by one I'll take these on.

Exercise when you're coming down is impossible.
Massage is painful as fuck, unless of course you can have a shot beforehand, then it's great.
Sexual activity after abruptly ceasing prolonged use of opioids... well, I'm sure you could do it, if your partner doesn't mind, well, what's a euphemism for being a completely useless sack of shit in the bedroom?
Hot shower or bath, hot, cold, in between. It doesn't matter. It all hurts, then there's the actual energy required to get into a bath or shower.
Cool mattress or pillow. Right, it will be covered in sweat and fucking too hot one minute, fucking too cold the next, but wet the entire time from sweat.
Using a fan to keep cool. Yeah, nah. That doesn't work when you're sweating so much that you feel like you've been swimming, and the alternating hot and cold will not be helped by a fan.
Watching TV. Ok, here's one that does help. Except for the fact that once you've been unable to sleep for a few days, and you've watched every show/movie/youtube video that you have ever liked, it starts to get a little boring.

You will survive opiate withdrawal, but it will not be helped much by these remedies, I'm afraid to say. The best thing is to not get addicted in the first place.
 
ok, one by one i'll take these on.

Exercise when you're coming down is impossible.
Massage is painful as fuck, unless of course you can have a shot beforehand, then it's great.
Sexual activity after abruptly ceasing prolonged use of opioids... Well, i'm sure you could do it, if your partner doesn't mind, well, what's a euphemism for being a completely useless sack of shit in the bedroom?
Hot shower or bath, hot, cold, in between. It doesn't matter. It all hurts, then there's the actual energy required to get into a bath or shower.
Cool mattress or pillow. Right, it will be covered in sweat and fucking too hot one minute, fucking too cold the next, but wet the entire time from sweat.
Using a fan to keep cool. Yeah, nah. That doesn't work when you're sweating so much that you feel like you've been swimming, and the alternating hot and cold will not be helped by a fan.
Watching tv. Ok, here's one that does help. Except for the fact that once you've been unable to sleep for a few days, and you've watched every show/movie/youtube video that you have ever liked, it starts to get a little boring.

You will survive opiate withdrawal, but it will not be helped much by these remedies, i'm afraid to say. The best thing is to not get addicted in the first place.
=d ^^^
 
The best thing is to not get addicted in the first place.

Hindsight seem to always be 20/20, doesn't it?

Sigh...it would be foolish to disagree with most of your points though. I have found that in WD, although my libido is through the god damned roof, I have no desire (or rather, physical motivation) to even masturbate, let alone have sex. I'm not sure having sex is even such a great idea, especially for myself since I have high BP and HR without being in WD. I will say though, that keeping my mind occupied by something, anything that gets me up and moving to some extent seems to help a bit, probably because using the muscle groups that are so restless from WD takes my mind off of them. No deliberate exercise for the first few days though, that shit would be impossible from the fatigue and malaise.

I've really never understood the whole hot bath thing, either. I'm already fucking burning up, that's not going to make me feel any better. Maybe during a spell of the chills? I don't know. I always thought that was one of the less useful pieces of advice I'd seen.

Not that it bears repeating, but...clonidine for heart rate/blood pressure/sweats/chills, loperamide for shits/possible slight overall relief, a benzo (preferably clonazepam as it has muscle-relaxing properties) for restlessness/sleep/anxiety, drink gatorade and water like it's your job to replenish fluids, and eat foods that are high in fiber to help put your poop back together.

Oh, and don't, whatever you do, ingest any eyedrops. Ever. Under any circumstances.
 
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