Opiate Detox and Addiction
Opiate addiction is recognized as a central nervous system disorder, caused by continuous opiate intake. Using opiate for extended periods of time can cause the nerve cells in the brain to stop functioning normally and stop producing natural endorphins. Since the body is receiving opiates and is no longer producing natural endorphins the nerve cells start to degenerate and become physical dependent on opiates.
Sudden withdrawal (quitting cold turkey) leads to a syndrome called withdrawal syndrome. Withdrawal syndrome is a long and painful process and can result in permanent damage to the cardiopulmonary system and the central nervous system. Untreated and unmonitored, it can result in death for unhealthy patients. For these reasons, opiate dependency treatment requires appropriate and responsible medical care.
These symptoms have led to the growth of ultra-rapid, anesthesia-assisted opioid withdrawal procedures. Proponents state that rapid detox is a painless way to withdraw from opioid. However, studies show that the procedure can lead to risk of:
- Death
- Psychosis
- Increased stress
- Delirium
- Attempted suicide
- Abnormal heart rhythm
- Acute renal failur
- Are very expensive
There are other traditional forms of opiate detoxification including opioid agonist drugs. These include drugs like methadone, levo-alpha-acetylmethadol (LAAM), or Buprenorphine; Clonidine, which blocks some withdrawal symptoms; ultra-rapid opioid detox under anesthesia; and an experimental method using the drug lofexidine. Opioid agonist drugs acts like opiates but do not produce the same high and are administered in doses that are gradually reduced. Since these medications act like opiates there appear to be no noticeable or significantly reduced withdrawal symptoms.
Clonidine can be administered by a transdermal patch, which dispenses the drug gradually and consistently over a seven day period. Patients who choose to use the patch should also take Clonidine orally for the first two days since medications taken through the skin takes two days to reach a steady effectiveness. Monitoring of blood pressure is essential since Clonidine causes hypotension and sedation.
Rapid detox is done under general anesthesia with intubations for six to eight hours. During this time a combination of drugs, usually naltrexone and Clonidine are administered to the patient. Lofexidine, a non-addictive drug brought to the market in 1992, is a centrally acting alpha-2 adrenergic agonist targeted for relief of opiate withdrawal symptoms.
Withdrawal symptoms continue to be the greatest obstacle in heroin detoxification treatment. Studies concur that there is no proof that one detoxification treatment is better than another. Relapses continue to occur in numerous cases around the world therefore making opiate addiction very difficult to treat successfully long term. Studies show that on average addicts will stop and start detox 10-25 times in their lifetime relapsing back to opiate use each and every time.
Opiate detoxification involves:
- Admitting there is a problem
- Seeking medical help
- Staying focused on the goal
- Rehabilitation
- Treatment through a continuing program
Statistics and studies show that there is no easy cure nor is there a guarantee that a relapse will not happen. Support from family, friends and physicians along with the will to succeed are all necessary factors in successful detox regardless of the method chosen. While there are many methods to use for opiate detox, one must choose the method that looks at their general health condition, psychological state, external support and length of time addicted and making an informed decision that best meets the needs.
References
- http://www.opiates.com/opiate-addiction.html. Opiate Addiction.
- http://www.opiates.com/opiate-withdrawl.html. Opiate Withdrawal Syndrome.
- http://www.asam.org/ AMERICAN SOCIETY OF ADDICTION MEDICINE, INC. Public policy statement on rapid and ultra rapid opioid detoxification ( Formerly Public Policy Statement on Opioid Antagonist Agent Detoxification under Sedation or Anesthesia (OADUSA ))
- Rabinowitz, Jonathan, Hagit Cohen and Moshe Kotler. Outcomes of ultrarapid opiate detoxification combined with naltrexone maintenance and counseling. Psychiatr Serv 49:831-833, June 1998.
- http://www.abc.net.au/health/regions/features/heroin/links
- Health Matters, ABC, 2006.
My name is Country. I am an opiate addict who was recently on the Suboxone (Bupronephren, or however it's spelled :) program. I began taking opiates a few years back and became, like most people, physically addicted. I finally worked my way up to 320mg of Oxycontin per day when I realized I needed help. I first confronted my girlfriend who was oblivious to the fact I was spending thousands of dollars per month on drugs. Luckily she understood and was extremely supportive of my decision to tell her and try and make a change for the better. I started to see a doctor who got me on short-acting opiates, then put me on Suboxone. I started with four 8/2mg Subs per day. As time passed I was able to drop my daily dose to 2/0.5mg per day and was put on anti-anxiety medicine to help with the extra stress and anxiety that comes along with relieving yourself of the burden of addiction (which is not easy). I was doing great and now only taking 2/0.5mg ever OTHER day. In my opinion this is the best way to get yourself on the wagon with a firm grip. My doctor abruptly cut me off of Clonazepam and my Suboxone without notice and now I am fighting this on my own. I will be brutally honest, it is HELL, but I know I can do it since I was on such a low dose of Suboxone.
This is just my story for anyone to read and hopefully take something from it. I wish all who are going through the same thing the best of luck and know that you ARE NOT ALONE and DO NOT GIVE UP!
KNOW YOU CAN AND YOU WILL!
As I stated previously this is merely MY story and may not be the path for you but regardless of the method you use to rid yourself of that demon, family and friends who support you and do not judge are the best stepping stones to start your path.
These are my opinions and personal experiences and are in no way intended as medical advice.
Thank you for reading my story and once again YOU CAN DO IT!
I am a 50 year old male, I have treated for chronic Back and left leg pain for over 25 years. I was seeing a doctor who switched me to Suboxine & soma "I had always taken Soma for the spasms & sleep". I was doing well keeping the pain in check. I then tried to stop taking the Suboxone by decreasing the doses gradually as instructed, I also committed to loosing weight & getting in shape using only Tylenol & Advil for the pain. I truly tried everything, and the discipline is their but I was suffering with sever pain and withdrawal anxiety, I had to stop. I was out of everything and could not get into the Dr. so after not sleeping for almost 72 hours I found 3 50 mch/h Fentanyl patches, so I put one on today. I'm very disappointed, I thought gradually decreasing the Suboxone would be manageable. I'm really @ the end of my rope with this. After 25 years of using opiates & becoming addicted I have lost my family, my home. I'm living in a tiny 1 bedroom apartment isolated from everyone, also I have tried rehab 5 to 6 times in the past with no success. I really thought that Suboxone was the answer & still do although I'm not sure how!
Frustrated
I`d been on methadone several times for recurring back pain. Never had a problem stopping it until 8 months ago. After my last usage period of 1 1/2 months, I stopped & thought I had a bad flu. When I realized what the problem was, I thought I could go cold turkey.
After 45 days I decided to get back on it & did the taper at 1mg every two weeks (from 10mg a day). My stomach has never been the same. I have lost my sense of hunger & can only eat a few bites before feeling nauseous. I've lost a lot of weight & worry about nutrition.
Is there anyone out there with this problem? Does anyone know if this is permanent? I can`t find much about it from Google. My doctors can`t figure it out.
pain management dropped me urine test showed no Oxycodone i also take MS-Contin and Xanax i ran out of my oxys early that's why it didn't show up now none of my meds were refilled i need help had back surgery 4yrs ago have lower back pain plus nerve damage in both legs first i do not use any street drugs if i cant soon get relief I'll have to hit the street for them.