Opiate Detox and Addiction

Opiate Detox and Addiction drug rehabilitation and alcohol rehabilitation

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

  1. http://www.opiates.com/opiate-addiction.html. Opiate Addiction.
  2. http://www.opiates.com/opiate-withdrawl.html. Opiate Withdrawal Syndrome.
  3. 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 ))
  4. 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.
  5. http://www.abc.net.au/health/regions/features/heroin/links
  6. Health Matters, ABC, 2006.

Topic Discussion

  1. Addict

    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!

  2. Addict

    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

  3. Addict

    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.

  4. Addict

    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.

  5. Addict

    Thank you for the great information. It has been interesting to hear what treatment options are out there. I will definitely be coming back here.

  6. Addict

    I want to warn all those people who consider detox using Suboxone. If you have depression, anxiety, personality disorders and other mental problems in addition to pain, and especially if you are in a crisis, you might not be a good candidate for the Suboxone detox in a doctor's office. The better way is to be in a clinic where they have the ways to pull you out of the extreme withdrawals that can happen if you are not in enough withdrawal stage to allow Suboxone to work. That is what happened with my son, who went to an ethical doctor who was more interested in money then my son's well-being. My son shot himself 5 minutes after the procedure with Suboxone put him in the horrific withdrawals. He was on Fentanyl patch for pain. He is at peace, but I have been in grief and depression for 5 years. Please be careful, for yourself and your loved ones. Not all doctors are trustworthy. Any doctor who does not have a chat with your mental health professional and has not done the testing of your blood, and does not have a recovery and support plan for after the detox is not doing his job and your life is on line. I hope I have helped somebody with my comments. I wish you all the best success in your fight for your well-being. A grieving mother Mira

  7. Addict

    I have been taking Lortab for about 4years and it no longer helps me Lortab 10.im on my 2nd day without them and I'm trying to stay home and do it by myself. It's VERY painful. I have bulging discs, torn rotator cup and it hurts so bad. I can't see my doctor until july16th. I'm in so much pain and becoming disoriented a little. I don't know what to do.

  8. Addict

    None of you need any of this. Fight through it! I was taking 200 mg of morphine a day and one day I decided to flush the 50 remaining pills down the toilet. I was fed up and angry that I even allowed something like that to run my life! Don't let an inanimate object run your life. Don't let anything run your life. Grow some damn balls and put up with the withdrawals. If you don't go through it the hard way, you will never appreciate how strong you are. i have gone through withdrawals about 15 times and it's just not worth it. Save your money, save your family, save your life!

    Some good things to get through withdrawals:
    1. Hot showers
    2. Massage your joints and muscles frequently
    3. Drink lots of water
    4. Have some anti-diarrhea stuff on hand
    5. (And my favorite) play lots of video games, or do something that will take your mind off of it for a few days. Just veg out in front of a TV screen or something.

    Once you get through your withdrawals you will need some sort of physical/emotional staple as a replacement for the addiction. For myself, I went to the gun range at least two times a week. Now I do competition pistol shooting. Every time I think of the pills I drown it with the love for shooting things. Find your love of something, whether it's taking your kids to the park, or running marathons. Do something that will better yourself and ultimately make your life better. If you think about it in the grand scale of things, 5-6 days of withdrawals is NOTHING! God made us for a reason, because we have the ability to overcome and conquer.

    I'm not a doctor, and this is based off of my encounters with this problem. I do not give medical advice nor should anyone believe that this is medical advice. Find your own path, and take control of your own life. There is no easy way out of anything.

    • Addict

      Hi Mark, we are of the same name. Cool. But not of the same opinion. Where are all the people who took your advice and their sponsors advice and their suboxone doctors' advice and God knows who else's advice and are now dead from withdrawals. Would any of you like to have a dollar for every person who goes into shock, gets cancer 6 months later, or contracts some "mysterious disease" that could "never be from drugs, Mrs. widow". Why do I say this...I am 54 yrs. old. I came within 1 hair of killing myself after getting out of a professional private detox before going back on opiates and saving my life. How many people can't make it thru the detox...but don't go back on drugs either? There's only one other alternative!!!!

      Why isn't this topic discussed more often? Why when we hear an old lady being told by her doctor NOT to give up smoking we inherently understand why. It could shock her system......to death! I'm 54, you think after getting so sick last time I went cold turkey for 10 days in a rehab and lasted 5 days more out of one, I had to go back to pills as I ran out of food and had no energy to get into my car and buy food. Besides, if I came close to death, how many people who "man up" as their friends tell them and stick it out....die in the process. I believe that when we go to an AA or NA meeting and they all go "You're not alone. We know exactly how you feel because we've been there. I say horse-shit! If they are still alive, they have never been thru what a guy who has either committed suicide while going cold turkey or what someone like me who couldn't bathe for a week or stand up to go buy food and would have certainly died had I not gone back to the pills. Of course I'm not saying people shouldn't get off drugs. I'm just saying, every person has a different tolerance and experience and the best we can do is have some idea of what they went thru. Have any of you gone into a rehab and found out while you were there or when you get out that your mom passed away or your fiance left you for another mate? If you haven't,(I haven't.) than you can't say that person was or wasn't strong enough if they go back to drugs...or stay clean but die of "complications."

      All I know is I'm over 50 yrs. old and even my detox doctor told me...."This journey to recovery is going to be harder for you because of your age." So, unless you are anywhere near a 50 or 55 yr. old person's age, don't say you know how it feels. Just like even a pro boxer CANNOT KNOW WHAT ITS LIKE TO GET MUGGED AND BEATEN UP when you are 50 or 60 or 80!...because even his body has never taken punishment and blows like that with an old body. As an aside....why can't I find any stats on relapse rates, deaths from drugs or "other causes", cancer, heart attacks, suicide, etc. from people who got and stayed clean....................over age 50. Is there something they don't want us to know? Or..........do they just not really have the data as most people over 50 just live with it or die?

  9. Addict

    I'm over 50, can't get off of tramadol after 3 yrs. Every time I go cold turkey or taper with suboxone, the physical pain and depression go out of control, I don't even want to live any more after a few days. Once I made it 10 days in a detox center and after 5 days home (15 days clean) I wanted to off myself. I had nothing that made me smile, and worse I had no support system and NA was making me more depressed, not less. I am 54 yrs. old and I cannot find one guy who has gotten clean after 3 yrs. or more at my age. If anyone know please let me know. Right now I am just thinking I have to live with it. Last time I went cold t for 15 days I developed 5 bleeding sores on my body and 1 has not healed to this day! This tells me that a person's immune system can be blown out if 1-not done the right way 2-maybe if you are too old. Raven my regular doctor and dermatologist is still dumbfounded. None of them think it could be from withdrawals. I say they are both dead wrong! Btw...WITHDRAWALS FROM TRAMADOL is said to be worse than heroin and maybe even all the other opiates and people laugh at that because it is mild "acting." Well...it's NOT an opiate, it mimics one and I definitely came as close to death as possible without dying. No Percocet user can tell me they 1-had blood pressure sings from 92 to 142 and back in 24 hrs. were too weak to get in your car and drive to a supermarket for 15 days and had to live in canned beans before finally going off the detox and getting my energy back and going to the market. WOULD I HAVE EVER GOTTEN STRONG ENOUGH TO BUY FOOD IF I DIDN'T GO BACK ON OR WOULD I BE DEAD? Even now if I go close to 20 hrs. with no pills I start losing my will to live. That's often how I know it's time to take my meds! I've been to 2 suboxone docs and I would never use suboxone again. Why IS THERE NOTHING ELSE OUT THERE FOR OUT PATIENT OPIATE DETOX other than suboxone? I think all the all-natural products are criminal and don't work at all! I tried the amino acids, the GABA, even testosterone cream which is a drug and none of it took any symptoms away at all. I'd love to speak to someone around my age who is in the same boat. Opiates or tramadol. Thank you.

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