PAWS? Or something Else?

[abc11]

Hello, so let me start by giving you guys a little history about myself. I'm 25, I started using drugs at age 16 (Cocaine and benzos). At 17 I started using opiates daily (Oxycontin shortly, then Heroin and Methadone). I've been off opiates for a little over 1 year now, actually I have used opiates about 4 times in that year but I have not had a habit for 1 year.

Anyways, shortly after I stopped several strange things happened to me... Extreme anxiety, insomnia, no sex drive, fatigue, diarrhea, mood swings, at times the best way to describe it is as if my brain has no oil in it, like grinding gears. I've gotten off dope for periods of time in jail or prison but I have never had anything like this. I've been absolutely miserable for the last year. I will add though that this is the first time I have gotten off Methadone.

So my question is this: Can this be a manifestation of PAWS even without intense cravings? I have always had some mental illness (Social Anxiety, minor depression, and ADHD) but its so hard to tell if these problems just got really bad over the years and the drugs were masking them or if this is drug induced. Up until now I've been trying to deal with it through psychiatry, but with little success (Multiple SSRI's, SNRI's, mood stabilizers, ect.). I got ahold of the anxiety for the most part with Trilafon (An old school typical antipsychotic) but I still do not feel right. The few times I have used opiates over the last year have seem to reversed all this instantly with the exception of the sex drive. I'm at the point now where I am about to go back on MMT if I can't get a handle on it.

Any Advice or input will be appreciated. Thanks.

 

[Bob Loblaw]

~~> ODi

 

[lolwhatzdrugs]

so let me start by giving you guys a little history about myself. I'm 25, I started using drugs at age 16 (Cocaine and benzos). At 17 I started using opiates daily (Oxycontin shortly, then Heroin and Methadone).

I could have had a fugue state and written that. Unfortunately the part about cessation for a year, man I'd love to get that far.

Anyways, shortly after I stopped several strange things happened to me... Extreme anxiety, insomnia, no sex drive, fatigue, diarrhea, mood swings, at times the best way to describe it is as if my brain has no oil in it, like grinding gears. I've gotten off dope for periods of time in jail or prison but I have never had anything like this.

Consider yourself lucky you found them strange as they seem like pretty regular acute w/d symptoms (though some claim withdrawal increases their sex drive as opioids depressed it).



As to going back to mmt, if by "can't handle" you mean can't find a will to live, or suicidality, then I suppose methadone is justified. Otherwise I'd stick it out. Besides, they won't put you on methadone unless you're in acute w/d, PAWs don't count (far as I know).

 

[abc11]

I found them weird because it does sort of feel like a toned down acute withdrawal which I know is not possible. That's why I'm wondering about whether or not this sounds like it could be PAWS; because if so I would have hope that I would one day get over it. MMT is still an option (I called and checked) for me because I have a history with my local clinic, I can restart at any time apparently. That would be a last resort long term plan though.

 

[fizzymk]

DAMN, that is scary, youve been off methadone for that long and still having issues! Ive heard methadone is the hardest thing to come off of, and some say once youve taken it for so long, it changes your brain chemistry and even if you quit, your brain will always be like that...This does not give me alot of confidence that I could quit methadone one day though!!! it actually scares the crap outta me to be suddenly taken off it, or cant get it anymore...I cannot afford to do H every day! Thankfully I only pay $25 for a months supply for my methadone, problem is, it doesnt last me a full month...usually gone by the second week.

I know what you mean by lack of sex drive, when I go thru w/ds, that is the last thing I want, I used to have a strong sex drive and enjoy it quite a bit, but after beinng on opiates for years now, I could almost become a hermit! LOL That is the one thing I dont like about opiate use, its scary after that long, you still dont have your sex drive back...that is really scary actually!!

Good luck

 

[lolwhatzdrugs]

I found them weird because it does sort of feel like a toned down acute withdrawal which I know is not possible. That's why I'm wondering about whether or not this sounds like it could be PAWS; because if so I would have hope that I would one day get over it. MMT is still an option (I called and checked) for me because I have a history with my local clinic, I can restart at any time apparently. That would be a last resort long term plan though.

I would guess so, unless this is a suddenly new symptom. PAWs for methadone apparently can last a very long time.

 

[Numb19]

Hello, so let me start by giving you guys a little history about myself. I'm 25, I started using drugs at age 16 (Cocaine and benzos). At 17 I started using opiates daily (Oxycontin shortly, then Heroin and Methadone). I've been off opiates for a little over 1 year now, actually I have used opiates about 4 times in that year but I have not had a habit for 1 year.

Anyways, shortly after I stopped several strange things happened to me... Extreme anxiety, insomnia, no sex drive, fatigue, diarrhea, mood swings, at times the best way to describe it is as if my brain has no oil in it, like grinding gears. I've gotten off dope for periods of time in jail or prison but I have never had anything like this. I've been absolutely miserable for the last year. I will add though that this is the first time I have gotten off Methadone.

So my question is this: Can this be a manifestation of PAWS even without intense cravings? I have always had some mental illness (Social Anxiety, minor depression, and ADHD) but its so hard to tell if these problems just got really bad over the years and the drugs were masking them or if this is drug induced. Up until now I've been trying to deal with it through psychiatry, but with little success (Multiple SSRI's, SNRI's, mood stabilizers, ect.). I got ahold of the anxiety for the most part with Trilafon (An old school typical antipsychotic) but I still do not feel right. The few times I have used opiates over the last year have seem to reversed all this instantly with the exception of the sex drive. I'm at the point now where I am about to go back on MMT if I can't get a handle on it.

Any Advice or input will be appreciated. Thanks.

Here's the thing, everyone is different and everyone reacts differently to opiates, tolerance and withdrawal as well as what happens after. I've heard Methadone eventually just puts your receptors to sleep, especially if taking it daily.

You've had a daily opiate habit for 8 years and last I would assume was methadone, which is a long-acting opioid that saturates your receptors and stays in your system longer than short-acting opiates/opioids (heroin, oxy etc.). The detox for methadone is more than twice as long as short-acting opioids and this also means that the threat of PAWS is greater and will last longer. This could explain why this is different from when you were in jail, assuming that you were using different, short-acting opiates at that time?

And keep in mind...PAWS is not just about cravings. You might get strong cravings but PAWS can present itself with a number of different symptoms that may eventually lead you back to using again just to cope because your brain still remembers. So I wouldn't necessarily assume that cravings, intense or otherwise, must accompany PAWS at all times (by the way, in my opinion, saying you want to go back on MMT to cope is a type of craving).

Part of what causes PAWS is the psychosocial stress of having to cope with life without the pharmaceutical or chemical crutch that was glued to your side for many years.

I'm no medical expert but what you are describing seem to be some classic PAWS symptoms. From the depression, anxiety, pessimistic thoughts, anhedonia (assuming you usually like to have sex of course hehe), cognitive impairments, wanting to go back on methadone after a year etc.

I also respectfully disagree with the above post in that if you are having suicidal thoughts, then a return to opiates after one year could be a recipe for complete disaster. If you are having suicidal thoughts or tendencies, seek professional help right away and deal with it the right way. Also, remember that MMT is meant for people who are physically dependent on opiates to manage their substance abuse but you have long passed this stage. Does your psychiatrist know about your history and does he know anything about PAWS? I would bring this up with him (or her) specifically. If your psychiatrist is not suited for this then you might want to ask for a referral to an addiction counselor who fully understands what you are going through.

My personal opinion is to not revert to opiates if you have been off them for a year now. Methadone is not a treatment for what you are enduring. Think about why you got off it in the first place and also keep in mind that many, many people do not make it nearly as far as you have. You've actually done very well man. You have actually already beat the odds. Realize this, recognize this and keep it up!

 

[lolwhatzdrugs]

Here's the thing, everyone is different and everyone reacts differently to opiates, tolerance and withdrawal as well as what happens after. I've heard Methadone eventually just puts your receptors to sleep, especially if taking it daily.

You've had a daily opiate habit for 8 years and last I would assume was methadone, which is a long-acting opioid that saturates your receptors and stays in your system longer than short-acting opiates/opioids (heroin, oxy etc.). The detox for methadone is more than twice as long as short-acting opioids and this also means that the threat of PAWS is greater and will last longer. This could explain why this is different from when you were in jail, assuming that you were using different, short-acting opiates at that time?

And keep in mind...PAWS is not just about cravings. You might get strong cravings but PAWS can present itself with a number of different symptoms that may eventually lead you back to using again just to cope because your brain still remembers. So I wouldn't necessarily assume that cravings, intense or otherwise, must accompany PAWS at all times (by the way, in my opinion, saying you want to go back on MMT to cope is a type of craving).

Part of what causes PAWS is the psychosocial stress of having to cope with life without the pharmaceutical or chemical crutch that was glued to your side for many years.

I'm no medical expert but what you are describing seem to be some classic PAWS symptoms. From the depression, anxiety, pessimistic thoughts, anhedonia (assuming you usually like to have sex of course hehe), cognitive impairments, wanting to go back on methadone after a year etc.

I also respectfully disagree with the above post in that if you are having suicidal thoughts, then a return to opiates after one year could be a recipe for complete disaster. If you are having suicidal thoughts or tendencies, seek professional help right away and deal with it the right way. Also, remember that MMT is meant for people who are physically dependent on opiates to manage their substance abuse but you have long passed this stage. Does your psychiatrist know about your history and does he know anything about PAWS? I would bring this up with him (or her) specifically. If your psychiatrist is not suited for this then you might want to ask for a referral to an addiction counselor who fully understands what you are going through.

My personal opinion is to not revert to opiates if you have been off them for a year now. Methadone is not a treatment for what you are enduring. Think about why you got off it in the first place and also keep in mind that many, many people do not make it nearly as far as you have. You've actually done very well man. You have actually already beat the odds. Realize this, recognize this and keep it up!

I agree with this post fully.

I should have clarified - it really isn't a viable option for the reasons we both mentioned - a last resort to ending your life would be the only consideration, but then, really, there are still MANY other options.

It will get better. One day you'll realize how silly getting back on methadone after a year sounds.

I remember reading a post where a desperate guy suggested cutting out his naltrexone implant (that is it is a parenteral implant) - life was unbearable any other way. It was the most rational thing ever!
His next post a month later mentioned how glad he was he waited, and it was the best he'd felt in awhile.

I don't think your opioid use made your problems that much worse (but really can't know for sure). I believe the opioids were masking them (self medication) what seems to happen is they're intensified by PAWs, making comorbid psychiatric illness with opioid addiction even more painful to quite, but will fade with time back to how they were and as you will be a stronger person in dealing with them, they may fade to be barely noticeable, can't promise that though. Think about this as merely rebound mental illness and it shall stop or diminish.

 

[abc11]

I have also heard that, I even tried Low Dose Naltrexone to try and fix my receptors but with no benefit. It's just so difficult to continue living in misery when there seems to be a simple solution. I need to consider whether or not its worth to live like this, and for how many more years? Its definitely not a decision to take lightly considering that I would probably be a lifer if I did go back on. I want to try an MAOI or dopamine agonist (Or even CBT if I can get better insurance.) before I do anything though. My psych knows my history but I go to a county funded mental health facility so the doctors are sort of subpar. Thank you for the words of encouragement guys.

 

[belfort]

OP-yes it very much sounds like Paws..i also was on methadone for several years and then got off, 6 months went by, i felt like shit and thought surely the brain fog, zero energy or enthusiasm, low sex drive would lessen or go away soon...nope, a year goes by, i still have the low quality of life, just you basically feel like shit, no pep or passion, you feel soulless basically..keep in mind i didnt use any drugs in this period off methadone...finally a year and a half went by and i still felt that basic crappy overall feeling and i had major thoughts of going back to methadone or subuxone, something to feel normal..i didnt though but did start drinking alcohol occasionally and doing other things which has both helped and hurt..i offer no solutions but what you are going through is exactly what i went through after methadone..nasty nasty stuff..

i exercised hard after coming off methadone and that gave me a tiny window of time where i felt decent but the back to the fog..plus, i was very anhedonic as well, still suffer from it...ive tried ssris and welbutrin with little to no results..

 

[belfort]

abc-although i think you are going through Paws symptoms you might also want to get some blood tests done, see where your testosterone levels are at..many of the symptoms you are describing go hand in hand with low test levels and opiates are notorious for lowering test levels..what can it hurt?