Post Acute Withdrawal Syndrome (PAWS)

Hi Guys and welcome once again to my blog about opiate addition. The topic I would like to talk about today is an aspect of addiction that usually follows the period of physical withdrawals once we stop taking opiates. What I am referring to is Post Acute Withdrawal Syndrome, commonly referred to as PAWS. Making the decision to get off opiates can often be a pretty difficult step to take, not to mention dealing with the nearly inevitable physical withdrawals that follow. When trying to quit their first time (myself included), most addicts say to themselves "ok, so I basically got to put up with a week or two of feeling like crap than voila, after that its all about keeping cravings at bay and learning to live sober." Unfortunately, it is rarely that easy.

The physical withdrawals are without a doubt one of the most challenging and painstakingly parts of overcoming addiction. However, the period that follows the initial physical withdrawals is far too often overlooked or underestimated. Remember that saying "Getting clean is easy, staying clean is the hard part?" Well, there's a reason that saying is so popular and commonly used within the addiction community. The reason being of course; PAWS.

What Exactly Is PAWS & What Causes It?

Post Acute Withdrawal Syndrome, or PAWS, is defined as a "set of traits and impairments that occur following cessation of some drug or medication". PAWS, for the most part, deal with the emotional and psychological feelings one experiences after they stop taking or abusing opiates. Some common elements of PAWS are depression, boredom, anxiety, mood swings, panic attacks, insomnia, intense cravings/urges to use again, suicidal thoughts/feelings, increased stress, tiredness, inability to concentrate, and lack motivation to get out and do things.

Just like the physical withdrawals, PAWS do eventually get better and go away but are often harder to understand and cope with than traditional physical withdrawals. It is important to note that it is important to monitor PAWS and to seek help/advice from your doctor(s), counselor(s), and members of your support network as PAWS can be just as or even more dangerous than the physical withdrawals one experiences while detoxing off opiates. Just like how the cold sweats, restless legs, or stomach cramps are very real when experiencing opiate withdrawal, so are the feelings of depression, stress, and anxiety as well.

The cause of PAWs can be best described in the passage below in the blue font (courtesy of Wikipedia):

"The syndrome may be in part due to persisting physiological adaptions in the central nervous system manifested in the form of continuing but slowly reversible tolerance, disturbances in neurotransmitters and resultant hyper-excitability of neuronal pathways. Stressful situations arise in early recovery, and the symptoms of post acute withdrawal syndrome produce further distress. It is important to avoid or to deal with the triggers that make post acute withdrawal syndrome worse. The types of symptomology and impairments in severity, frequency, and duration associated with the condition vary depending on the drug of use."

In other words, PAWS mainly occur as a result of our minds and bodies learning how to live and cope without our drug of choice. As I have covered before (click HERE), the reward system in our brains is greatly altered and affected during the time we abuse opiates. Opiates have such a powerful impact on the way our brains and bodies function, that over time it begins to rely on these opiates to produce endorphins, which are the neurotransmitters in our brains that provide us with the opportunity to experience pleasure, happiness, enjoyment, and feelings of being content. Opiates provide the brain with the ability to produce a vast arrange of strong endorphins, providing us with these feelings as a direct result of getting high. Continued use of opiates results in the mind relying on opiates to produce endorphins, eventually resulting in the brain having difficulty in creating its own naturally.

A lot of addicts state how they feel a sense of emptiness after they stop using opiates. Some express how they feel like their minds will never be satisfied or content while they are sober, which can be quite heartbreaking to hear. However, over time, it will and does get better. Unfortunately it can take several months or even years for one to feel totally normal. Recovering from months or years of opiate abuse takes much time and effort so it is important to remain positive and patient through thick and thin. Now, I'm not saying you will be hurting and depressed for months and months, but rather that one should expect that the road to once again living a life without having the thought of opiates present in the back of the one's mind will have its bumps and take time to travel. Remember, you didn't become an addict overnight so don't expect an addiction to go away overnight.

 

Some Good Information About PAWS

Here are some links to a few websites that I found particularly helpful in regards to PAWS:

http://www.addictionsandrecovery.org/post-acute-withdrawal.htm

http://whatmesober.com/personal-writing-about-addiction-and-recovery/early-recovery/paws/

http://www.arctreatment.com/post-acute-withdrawal-symptoms/

http://www.michaelshouse.com/opiate-rehab/why-are-opiates-so-addictive/

Dealing With PAWS

 

While PAWS can most defiantly be an obstacle in one's road to recovery, it is certainly an obstacle that one can overcome and learn to deal with. The most important step to take when dealing with PAWS is to identify what kind of symptom's of PAWS you are experiencing and to ask yourself why you are experiencing these symptoms. Besides the obvious answer of "I'm feeling like this because I love opiates so much and am now withdrawing", an addict must learn what led them to become an addict in the first place. 

 

Every addict has their own background, set of experiences, and reasons that can explain what lead one to use drugs in the first place and to eventually become to addicted to them. As I always say, everyone is different so don't expect your reasons to be the same as someone else's reasons. Some common reasons behind one's decision to try using a drug and to eventually become addicted to it are as follows:

 

• Stress
• Peer Pressure
• Disease or Health-Related Issues
• Mental Illness
• Pain
• Death of Loved One
• Difficult Childhood/Upbringing
• Loneliness

 

Were you using your drug of choice(s) because of stress from work, school, or simply life in general was beginning to be just too much to deal with? Or do you have a chronic disease that is sometimes painful or difficult to live with? Do you ever feel a sense of loneliness or helplessness? These are all questions an addict must address when coming to terms with their addiction and are ones that are often quite challenging to consider and answer honestly. More often than not, there is an underlying reason or root cause for why we got addicted to opiates in the first place.

 

 

The reasoning behind why it is so important to address and answer these questions is because (1) they most likely influenced one's decision to use drugs to some extent and (2) they are things that will most not likely not just disappear when one gets sober and can be difficult to handle without having drugs to ease or dull the pains of the stress and nuisances of life. If you give this an honest approach, you'll most likely find that there isn't just one, but rather a few, factors that lead to one getting involved in opiates. For example, I have to come to terms with my addiction and believe that the root cause of my addiction was a variety of factors such as:

 

1. Living with a chronic disease that can sometimes be painful and difficult to manage/live with
2. Being someone who is somewhat of a loner that enjoys being one's own company 
3. Stress from school, work, and relationships
4. Trouble sleeping
5. Difficulty of talking to others about my feelings or problems and instead just bottling them up

 

The good news is that you don't have to ask and answer these questions by yourself or all at once suddenly. Rather, try to talking about your addiction with your spouse, family members, or close friends. If you are fortunate enough to afford it, try speaking with a counselor, therapist, or psychologist. You'll be surprised just how helpful and beneficial it can be expressing yourselves and your problems with someone willing to listen rather than just keeping them inside you and trying to deal with them alone. It took me awhile to realize this myself as I was somewhat of a skeptic when it came to counseling and therapy. I always figured I became addicted to opiates because I simply loved to get high and it was an something to do with my friends (it's sad that I saw getting high as a form of entertainment and fun). Well, I wasn't looking deep and hard enough at my situation and what brought me to it until I made the decision to get sober and off opiates once and for all.

 

As most of you may already know, I decided to do something about my addiction to Oxycodone and got on Suboxone, which requires me to meet with a counselor at least twice a month for an hour each visit. I'm not going to lie, it took awhile for me to feel comfortable enough to express myself and talk about my struggle with my Oxycodone addiction to total stranger but it definitely got better and easier over time. I learned that I struggled to deal with my chronic illness, sleeping difficulties, and stress management. With therapy, I learned to better manage my time to help minimize stress and to not stress about things that are out of my hands. Rather than just complain and moan about my sleeping habits, I spoke to my doctor about my sleep difficulties and obtained a prescription to something that helps tremendously with achieving sleep. Learning to cope with my chronic disease hasn't been easy but I do feel a sense of relief being able to talk about it with someone. Flash forward to today and it has now been close to year of being on Suboxone and meeting regularly with my counselor and I feel that I have made much progress in my attempt to get and remain sober from opiates.

 

Many addicts probably cringe at the thought of speaking with someone about their addiction. I know I certainly did. However, it really is one of the most important aspects of recovery. After all, who are you going to go to or talk to if you feel overwhelmed or like using during your recovery when you are the only person who knows of your addiction. Believe it or not, speaking with someone about your struggles isn't as hard as it may initially seem and this is coming from someone who is quite shy and who preferred to keep their addiction in the closet next to a few other skeletons. A therapist or counselor won't force you to say anything, allowing you to say as little or as much as you would like. It is not uncommon for most patients to not begin talking about their addiction or causes of it until several meetings later. Everything that goes on in the room between you and the therapist/counselor stays in the room between the two of you. Most people who are in this kind of profession provide patients with a laid back, quiet, and easygoing atmosphere. These people can really help so please don't be afraid to use them when possible.

 

 

Another therapeutic-like session can be found at AA and NA meetings. These meetings are filled with addicts, some just a few days clean and others with decades of sobriety under their belts. AA and NA programs allow addicts to hear the stories, emotions, and experiences of other addicts that many can often relate to in one way or another. These meetings are also a great place to learn tips and coping mechanisms from other addicts who are fighting the same war as you; addiction. One can meet and befriend various people at these establishments which can aid in building one's sober support network. For more information on AA/NA meetings, check out my post about the topic by clicking HERE.

 

It is also important to discuss how you feel with your doctor(s). Some people experience conditions such as depression and anxiety after they quit opiates, making staying sober that much harder. By talking with your doctor(s), you may be able to find ways to deal with conditions such as these through things such as therapy or medication. Sometimes, these conditions may have been present before one started using drugs and are one of possibly many factors that could be a reason for a person's dependency on drugs. Discussing your situation and how you feel with your doctor is critical as conditions such as depression or anxiety can be dangerous and can get worse over time, especially after experiencing something as exhausting as detoxing from opiates.

 

By identifying and learning how to deal with the root causes of our addictions, it allows us to better ourselves and to learn how to deal with life without needing to get high. My point is, there are medications and other ways to help one cope with PAWS. Sometimes just simply talking with others about our problems is all we need. Whenever I was stressed after a long day of work and school, I would simply go out and get some Oxycodone to relieve myself and settle down. Only I wasn't dealing with my problems but was rather finding ways to mask them. It took me awhile to learn this but it is something that has played a pivotal role my recovery.

 

Most Common Types of Therapy to Deal with PAWS

 

In addition to medication, there are several kinds of therapy methods that can help one deal with PAWS and their addiction. It can be very difficult trying to overcome addiction alone so it is important to learn the available tools and people that can help one in his or her recovery. As I mentioned earlier, simply talking with someone about your personal problems, thoughts, concerns, feelings, emotions, and experiences can be extremely beneficial in one's road to sobriety. The following 3 methods are commonly used by those within the addiction community when dealing with people looking to get and stay clean. These methods, courtesy of the Authentic Recovery Center, are:

• Integrated Group Therapy (IGT): is a recent addition to the preexisting therapies designed to tackle dual diagnosed individuals. Using the group setting, this style of therapy targets people suffering from bipolar disorder and drug addiction.

 

• Exposure Therapy (ET): is a behavioral model that had proven useful in assisting addicts also suffering from phobias or anxiety disorders. Frequently with people suffering from anxiety disorders, they find themselves triggered by specific stimuli, which in turn triggers a craving for a drug. Like Cognitive Behavioral Therapy, Exposure Therapy seeks to unlearn these responses, and to establish in their place more rational, less destructive responses. This style of treatment has promise assisting individuals who experience anxiety and are also addicted to cocaine.

 

• Dialectic Behavioral Therapy (DBT):  specifically seeks to lessen behaviors that cause self-harm, such as cutting or mutilation. It is also used to treat individuals with a history of suicidal ideation or suicide attempts, and has proven helpful treating individuals who are diagnosed with borderline personality disorder.

 Conclusion

 



Well Guys, as you can see, physical withdrawals are only part of the difficult journey towards sobriety. PAWS are far too often overlooked and underestimated as everyone tends to focus on and worry about the physical withdrawals simply because it is what usually comes first when detoxing off opiates and because they are things that you can actually feel physically.

 

When dealing with PAWS, it is important to remember that it will get better over time and that recovery is a long process. This is where the skills you have learned to help cope with the physical and mental aspects of detox are critical. It is not unusual to feel depressed, fatigued, bored, or just "off" for some time after you say goodbye to opiates. Therefore, it is important to keep busy and active, seek sober support, and to truly learn and understand your addiction and what lead to it. 

I invite all of you guys to comment in the comment section about any other information you have about Post Acute Withdrawal Syndrome. Please feel free to ask any questions you have about the matter or to share your own experience(s).

As always, thanks Guys for taking the time to read my blog. Keep seeing the light!

-Seeingthelight

Clonidine for Opiate Withdrawal

Introduction

Hi Folks and welcome to my blog about opiate addiction. This is now my 18th post and I am proud to say my blog, number of followers, and topics are growing each day. This really provides a sense of success for myself and I am so happy I have the opportunity to help others while sharing my own experiences, thoughts, and stories while being to able to express myself. I can't say it enough, thank you guys!

I must admit, the ideas regarding what to write about on my blog are getting more and more challenging. I want to provide you guys with solid information, fresh topics, and things that many opiate addicts search for in their quest for sobriety. After doing some thinking, I came up with the idea to dedicate a few posts to specific drugs that may aid in opiate detox or recovery.

For this particular post, I would like to discuss the drug Clonidine. This drug is a high blood pressure medication that also has several off label uses, one being helping opiate withdrawal.  The drug is supposed to help with symptoms such as high blood pressure, sweats, cold chills, restlessness, insomnia, and anxiety.

This drug is often considered one of the top medications to prescribe for patients undergoing opiate withdrawal and has been used in the addiction community for quite some time. As far as reviews go, they're pretty mixed. Some people swear by this drug when experiencing opiate withdrawal while others say it provides little to no relief. Then of course, there are many who feel somewhere in between. I am currently on the drug myself (more on that later) and would have to say that I'm one of those people who are somewhere in the middle when it comes to judging the effectiveness of Clonidine.

 

What is Clonidine and What is it Used For?

 

According to the RX list, Clonidine is described as:

 

A centrally acting alpha-agonist hypotensive agent available as tablets for oral administration in three dosage strengths: 0.1 mg, 0.2 mg and 0.3 mg. The 0.1 mg tablet is equivalent to 0.087 mg of the free base.

The inactive ingredients are colloidal silicon dioxide, corn starch, dibasic calcium phosphate, FD&C Yellow No. 6, gelatin, glycerin, lactose, and magnesium stearate. The Catapres (clonidine) 0.1 mg tablet also contains FD&C Blue No.1 and FD&C Red No.3.

Clonidine .1 mg Pill

Clonidine is a sympatholytic medication used to treat high blood pressure, anxiety/panic disorder, ADHD, migraines, drug withdrawal, sleep disorders, and certain pain conditions. The drug is commonly used for patients experiencing opiate withdrawal as it helps with many of the common symptoms that accompany withdrawal.

Clonidine can be administered in three ways; orally, injection, and transdermal. For those of you who don't know, transdermal is when the medication is prescribed as a patch, which is worn by the patient throughout the day or night. The patch then provides dosing throughout the day. This method of administration is usually only received under doctor supervision such as in the hospital or in a rehab facility so you'll be likely be dealing with the pills if you are partaking in a rehab or detox center program. Based on what I have read, injection of Clonidine is rarely used, especially for the treatment of opiate addiction.

Possible Side Effects of Clonidine

 

Possible side effects (courtesy of drugs.com) of Clonidine include any of the following:

 

• Fast or pounding heartbeats

• A very slow heart rate (fewer than 60 beats per minute)

• Feeling short of breath, even with mild exertion

• Swelling, rapid weight gain

• Confusion, hallucinations

• Fever, pale skin

• Urinating less than usual or not at all

• Numbness or cold feeling in your hands or feet

• Feeling like you might pass out

• Severe skin irritation, redness, swelling, burning, or blistering where the patch is worn.

Less serious clonidine side effects may include:

• feeling dizzy, drowsy, tired, or nervous
• dry mouth
• dry or burning eyes, blurred vision
• headache, muscle or joint pain
• nausea, vomiting, constipation, loss of appetite
• sleep problems (insomnia)
• urinating more at night
• mild skin rash or itching
• decreased sex drive, impotence
• skin rash, discoloration, or mild irritation where the patch is worn

"Clonidine is classed by the FDA as pregnancy category C. It is not known whether clonidine is harmful to an unborn baby. Additionally, clonidine can pass into breast milk and may harm a nursing baby. Therefore, caution is warranted in women who are pregnant, planning to become pregnant, or are breastfeeding." -Physicians Total Care, Inc.

Suddenly stopping Clonidine after continued use can lead to rebound hypertension, meaning that your blood pressure may spike if you stop taking the Clonidine. Therefore, you should taper off of the Clonidine to avoid rebound hypertension. The following is from Wikipedia:

"Clonidine suppresses sympathetic outflow resulting in lower blood pressure, but sudden discontinuation can cause rebound hypertension due to a rebound in sympathetic outflow.
Clonidine therapy should generally be gradually tapered off when discontinuing therapy to avoid rebound effects from occurring. Treatment of clonidine withdrawal hypertension depends on the severity of the condition."

Clonidine for Opiate Withdrawal

 

Most of you reading this post about Clonidine are probably here because you currently are taking Clonidine for opiate withdrawal or are considering it. Therefore, lets start talking about how the drug is used in opiate withdrawal.

 

Everyone here probably has experienced or are aware of the symptoms that accompany opiate withdrawal and how they can make quitting opiates seem impossible. Drugs like Methadone and Suboxone are great in that they help you avoid opiate withdrawal for the time being, allowing one to get his or her life together and decide their plan for recovery but they also come with their disadvantages as well. Unfortunately, these drugs do result in a dependence for the user and one will most likely experience some withdrawal when they come off of a drug like Suboxone or Methadone. The good thing about Clonidine is that it is not as addicting as drugs such as Methadone or Suboxone and withdrawal, if any, will be relatively painless compared to the withdrawal from most opiates.

 

Clonidine isn't a drug you would want to abuse to get high as it has little recreational value so that's a plus for addicts really looking to get clean and turn their lives around. The drug also doesn't have the withdrawal symptoms that come with opiate withdrawal besides rebound hypertension. In other words, when you stop taking Clonidine, you won't be sitting there experiencing the cold sweats, aches, restless legs, the runs, and an overall feeling of crap. Once again, a plus.

 

In a study conducted by PubMed involving 30 patients, the following information was found regarding the effectiveness of Clonidine for opiate withdrawal:

 

"In a placebo-controlled, double-blind crossover trial, clonidine caused a marked and significant reduction of objective signs and subjective symptoms of opiate withdrawal in thirty hospitalized opiate addicts. In an open trial of clonidine in opiate withdrawal, clonidine was found to suppress opiate withdrawal signs and symptoms, allowing all of the patients to detoxify successfully from chronic opiate addiction. Clonidine was demonstrated to reverse and suppress the signs, symptoms, and effects associated with opiate withdrawal."

 

To obtain Clonidine, you will need a doctor's prescription. Based on my experiences and what I have read, there are a few ways to do this. The first is going to your primary care doctor and explaining to him or her your situation. Tell them about your addiction and how you are looking to get clean but feel as through you need something to help get you over the hump and keep withdrawals at bay. Most doctors will be willing to prescribe Clonidine as it is often highly recommended and well known for its ability to aid with opiate withdrawal. This technique also works if you go to the ER and explain to them your situation. The final way that I know of to obtain a prescription for Clonidine concerns those of you who are currently in a Suboxone or Methadone treatment program. I have been able to obtain a prescription by telling my Suboxone doctor during my taper that I am having trouble sleeping at night and experience random chills and restlessness throughout the day and night. Without hesitation, my Suboxone doctor prescribed me Clonidine. Overall, it shouldn't be too difficult to get a prescription for Clonidine. However, everyone's doctor is different and has different views/methods so take a careful look at your options.

 

 

Clonidine typically comes in pills that contain .1 mg each. Please note that this is .1 mg not 1 mg. There is a big difference right there so it is important you are careful with your dosing and are aware of what and how much you are putting in your body. The typical dosing protocol is usually .1-.3 mg 2-3 times per day or as needed. Higher doses are also prescribed depending upon the patient and situation at hand but these doses are usually the most common. I currently take .2 mg once at night and find this dose to be sufficient but again, everyone is different.

 

The use of Clonidine for opiate withdrawal is quite common in rehab facilities and outpatient detox as the drug is seen as both an effective and relatively safe drug in combating opiate withdrawal. The following link provides a typical protocol when it comes to dealing with opiate withdrawal and medications that can help provide relief for patients.

 

http://www.quadrant.net/cpss/pdf/Opioid_Withdrawal_Protocol.pdf

 

 

Some Good Links Regarding Clonidine for Opiate Withdrawal

 

Like most of my previous posts, I'll leave you guys with some links to websites that discuss the use of Clonidine for opiate withdrawal. These links are found below this paragraph.

 

http://www.drugs-forum.com/forum/showthread.php?t=46291

This link provides experiences and thoughts about Clonidine for opiate withdrawal by several people who have used the drug.

 

http://www.soberrecovery.com/forums/substance-abuse/108952-anyone-taken-clonidine-opiate-w-d.html

This is another forum that provides stories and experiences by people who have used Clonidine.

 

http://drugsdb.eu/drug.php?d=Clonidine&m=Physicians%20Total%20Care,%20Inc.&id=b65742b7-5db5-41cf-bf69-41700cdd2c59.xml

This link provides an in depth look the drug Clonidine including dosing protocol.

 

http://www.drugs.com/clonidine.html

This link also provides a brief description of Clonidine as well as commonly asked questions about the medication.

 

How Effective Is Clonidine for Opiate Withdrawal?

 

I don't know about you guys, but whenever I come across a new drug that can help minimize, avoid, or aid withdrawals from opiates, I instantly become extremely interested and curious about the drug. I begin to hope and pray that I have finally found something that will make opiate withdrawal a hell of a lot easier. Sometimes the drug ends up being a great tool while others don't quite seem to live up to expectations. Well, Clonidine is one that falls somewhere in between.

 

The following excerpt is from the book, Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy regarding the effectiveness of Clonidine in opiate withdrawal:

 

"Studies in animals and humans have demonstrated that clonidine hydrochloride, an alpha-2-nor-adrenergic agonist, significantly attenuates the opiate withdrawal syndrome. Inpatient and outpatient clinical studies have shown that clonidine is a reasonably safe, specific, and effective agent for detoxifying opiate addicts. Clonidine seems best suited for use as a transitional treatment between opiate dependence and induction onto the opiate antagonist naltrexone. Dosage regimens of clonidine must be individualized according to symptoms and side effects and closely supervised because of varying sensitivity to clonidine's sedative, hypotensive, and withdrawal-suppressing effects. Clonidine is an important new treatment option for selected opiate addicts and may be the treatment of choice when detoxification using methadone is inappropriate, unsuccessful, or unavailable. Lofexidine, a structural analogue of clonidine, may be safer and more effective as an opiate detoxification treatment. It has similar withdrawal-suppressing actions but causes little hypotension and sedation. Although clonidine and lofexidine may be highly effective in helping opiate addicts achieve initial abstinence, a multi-modality aftercare treatment approach including naltrexone and psychotherapy may be necessary to maintain an abstinent state."

 

Study on 21 people on the effectiveness of Clonidine

 

 

Dr. Janaburson writes about Clonidine in her blog (I highly recommend checking it out) stating: 

 

Since clonidine works by calming the locus ceruleus, clonidine reduces many of these unpleasant opioid withdrawal symptoms. So how effective is clonidine? Most patients say that it helps somewhat, but they still feel withdrawal symptoms. My impression from what patients have described is that clonidine is mildly to moderately effective.

The following link provides several cases of patients who were prescribed Clonidine for opiate withdrawal. These cases are interesting as they deal with a variety of patients ranging from what the researchers describe as hardcore addicts, casual users, and everyone in between. When you click on the link, you will see three little pages near the top of the website. Each page comes from a study provided by PubMed. Simply click on any of these pages to read these cases about Clonidine. The link is below.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1862300/

So, exactly how effective is Clonidine when it comes to going head to head with opiate withdrawal. There is no universal and definite answer to this question and it appears that the effectiveness of the drug varies based upon several factors such as the patient involved, his or her tolerance, their general health, the dose they are taking, the length of time they have been taking the medication, and more. I have read probably close to a hundred forums about the effectiveness of Clonidine and have talked to some addicts who have used Clonidine and still have no clear-cut answer for you guys. Some people swear by it while others find it little help. At the end of the day, I think it comes down to what does and doesn't work for the person using the medication. Some people may find this medication to do wonders for their withdrawals while others may notice little to no difference.

Conclusion

 

I am currently prescribed and am taking Clonidine once a day at night. My dose is .2 mg (2 .1 mg pills) and I have found this dose to be quite helpful. I have been on Suboxone for just under a year now and am currently going through a taper regime. I recently went from 2 mg to 1 mg of Suboxone per day and have experienced some withdrawal since my drop in dose. These withdrawals usually start to arise right before bedtime (around 8 p.m.), which I believe is a result of my morning dose wearing off. This is where the Clonidine has come in handy as it really has helped me with sleep, restless legs, and minor anxiety.

 

As I mentioned earlier in this post, getting a prescription was easy and painless and it was actually something that both my Suboxone and primary care doctor recommended. I haven't had any negative side effects from taking the mediation either which is always a good sign in my book. However, please be careful with taking this medication and to talk honestly and openly with your support network. Some people say they get dizzy on the medication or feel as if they are about to fall over when they get up after sitting for a long period of time. Make sure you are cautious if you must drive or work on this medication.

 

I have no experience taking the drug in full blown withdrawal so I can't say much as to how effective it is in a situation such as this. I have read and can imagine that Clonidine probably only provides minor relief to one who is full blown opiate withdrawal (what drug besides Suboxone or Methadone truly takes away or masks all the withdrawal) but I could be wrong. Again, I think it all depends on the person taking the medication as everyone and their reactions to certain medications is different. At the end of the day, I don't think having a prescription for Clonidine can hurt provided that the patient has talked it over with their doctor and has no health conditions that could interfere with the drug.

 

I would love to hear from you guys about what you think about Clonidine. If you have taken it before for opiate withdrawal, please tell us how effective it was for you and would you recommend it? I will be making the jump off of Suboxone in the near future and see Clonidine as one of a few tools I have in battling the dreaded opiate withdrawals.

 

As always, thanks for reading my blog and remember to continue seeing the light!

 

Take Care Friends,

 

Seeingthelight

The Ultimate Surival Kite For Opiate Withdrawal

Introduction

Hi Guys, hope all is well on the other side of the computer screen. I welcome both new and returning visitors to my blog about opiate addiction. For this post,  I would like to provide you guys with a list of items that can help provide some relief for those experiencing opiate withdrawal. As most of you already know, opiate withdrawal can be a true pain in the ass and is for many, one of the hardest and most difficult times of one's life. I call this list the ultimate survival kit for opiate withdrawal and hope that it can help you guys during such a challenging time.

For this list, I will provide you guys with a list of over the counter medications, prescription medications, coping techniques, and other tips or activities that can help make withdrawal a little more bearable. With the exception of Loperamide, a relatively weak opioid, I will be excluding any opiates or opioids from my list as well as any drugs that can be used for opiate replacement therapy (ex. Suboxone or Methadone). In other words, the items on this list are things that will not simply mask or prolong opiate withdrawal but rather help provide relief for withdrawal without the aid of opiates through other means.

What Are Opiate Withdrawals and Why Do We Get Them?

 

Opiate withdrawal occurs when a person continues to use an opiate(s) over a prolonged period of time and than suddenly stops taking the opiate(s). The amount of time it takes for one to become addicted to or dependent upon an opiate varies from person to person and also depends on a variety of factors such as the amount of the drug taken, the length of time the drug is taken, the kind of drug being taken, along with other factors. These factors can also determine the severity of the withdrawals as well. Some people may become addicted to a drug after a few weeks of continued use while for others, it may take longer to develop a dependency or addiction. The general rule of thumb for most opiates is that anything over 2 weeks of continued use greatly increases the risk of developing a dependency or addiction to the drug. Everyone experiences their own set of withdrawal symptoms with some feeling worse than others. Misusing, taking more than prescribed, and abusing opiates in comparison to taking them as prescribed by a doctor under their supervision can also increase the chances of becoming addicted or dependent upon the opiate. 

 

It is also important to note the difference between being physically addicted to something and physiologically addicted to something. Being addicted physically means you will actually feel a variety of symptoms if you stop taking the drug after continued use. These symptoms include things such as aches, chills, cold sweats, restless legs, and such. The physiological aspects deals with the cravings and urges to use the drug you may begin to develop after continued use of the drug. While it may take several weeks to become physically addicted to something, becoming addicted to something physiologically may happen much quicker. Again this varies from person to person along with other factors so there really isn't a definite answer as to how much of or how long we must take something to become addicted to it.

 

Some common symptoms of opiate withdrawal include any of the following:

 

• Stomach Aches/Pains
• Diarrhea
• Restlessness
• Restless Legs/Limbs
• Cold Chills/Goosebumps
• Cold Sweats
• Joint and Muscle Aches/Pains
• Runny Nose
• Watery Eyes
• Difficulty Sleeping
• Anxiety
• Depression
• Frequent Yawning
• Agitation
• Lack of Appetite
• Tremors
• Flu-Like Symptoms

As you can see and may already know from experience, opiate withdrawal can be one hell of a time. Most people who experience opiate withdrawal will experience several of these symptoms while their bodies withdraw, detox, adjust, and heal from the continued use of a opiate(s). The length of time one experiences these symptoms also varies depending upon the drug, person, and other factors. Some drugs like Oxycodone and heroin usually result in about 7-10 days of physical withdrawal symptoms. Others like Suboxone and Methadone result in physical withdrawal symptoms lasting between 10-30 days, sometimes longer (especially in the case of Methadone withdrawal). These physical withdrawal symptoms are usually accompanied with and/or followed by physiological symptoms such as anxiety, depression, boredom, and dysphoria. A common term used to describe these physiological symptoms is the term PAWS, which stands for Post Acute Withdrawal Symptoms. PAWS can often be the most difficult part of opiate withdrawal and recovery as these symptoms can last several months or even years in some extreme cases. This is where the saying "Getting clean is easy. Staying clean is the hard part."

 

The body withdraws from opiates after continued use due to the fact that the brain and body eventually begins looking for and craving the drug. When we put opiates in our bodies, the reward system in our brains receive and send positive signals throughout the body. I have used this example before so please excuse me if you have already heard it before in my blog. Take for example, a dog owner trying to train his dog how to sit on command. The owner will command the dog to sit and will reward the animal with praise, encouragement, or treats each time it successfully sits on command. The dog eventually learns that each time it sits on command, it will be rewarded with something positive such as a treat or words of praise. This is the reward system in the dog's brain working, which we as humans have as well. Well, when we put opiates in our bodies, our brains over time begin to see these drugs as something that will lead to a positive reward. This results in the brain releasing endorphins, which are neurotransmitters in our bodies that lead to feelings of wellness, happiness, success, and the like. To make matters worse, opiates have a very powerful effect and impact on the human brain and its reward system, which can eventually result in the brain depending upon opiates to create and provide the body with endorphins instead of creating them naturally. Rather than creating natural endorphins through say, running or exercising (a "runner's high"), our brain sees opiates as a more powerful and easier means of creating endorphins, albeit unnatural ones.

 

When we use opiates for a long period of time and become dependent upon or addicted to them, our brain then struggles to know how to make its own endorphins naturally without the presence of opiates. Our minds and bodies now depend on the opiates to create endorphins that lead to a sense of wellbeing, enjoyment, happiness, and a feeling of being content and satisfied. Once we stop taking the opiates, our brains become confused as to why it is no longer being rewarding and struggles to remember how to make endorphins naturally, leading the mind and body to go into a state of confusion. Our bodies then react negatively ultimately resulting in opiate withdrawal. Learning how to once again create endorphins naturally is often one of the hardest parts of recovering from opiate addiction, which is why it is not uncommon for former addicts to feel depressed, tired, or anxious for a period of time after they stop taking opiates. This is where the saying "It gets better over time" comes into play and why many in the addiction community recommend finding new hobbies, exercising, and talking with people such as family, friends, counselors, doctors, psychologists, therapists, and other addicts in recovery.  

I have previously written a few posts that discuss these matters in a little more detail that some may find to be beneficial to read in addition to this article. For those who are interested in reading these posts, feel free to click on any of the links below to check them out.

Addiction and Our Bodies

Why We Got Addicted To Opiates

The Power of AA/NA Meetings

The Dreaded Withdrawals
 

The List

 

I have developed and created this list through my own personal experiences, talking with other opiate addicts along with my addiction counselor and doctor, and through researching the matter and talking with others about it online. There are a lot of helpful websites out there filled with hundreds of other opiate addicts and specialists helping one another. Try doing a quick Google search with a topic your interested in and you'll be surprised by how many results that will come up and how many others are in the same boat as yourself. Some of the items on this list actually come from the Thomas Recipe, which is list of items and tips that can help provide relief during opiate withdrawal. The link to the Thomas Recipe can be found by clicking Here.

 

 

Over the Counter (OTC) and Easily Accessible Products:

 



Benadryl, Unisom, Sominex, Tylenol PM (Diphenhydramine): Benadryl or any other OTC product containing Diphenhydramine can be helpful during opiate withdrawal as it can provide relief for a runny nose, teary eyes, and for some, sleep. Diphenhydramine is known for having a sedative effect which is why it can help some with sleep. However, beware that Diphenhydramine can cause restlessness in some people (myself included) possibly resulting in you tossing and turning all night from restless legs and an overall sense of restlessness rather than being able to fall asleep. I personally prefer Tylenol PM as it has a sedative effect and can also help with the sore joints and muscle aches. Be careful not to overdo it and take too much of any of these brands as too much can lead to restlessness, hallucinations, and even death.

 

Dramamine, Driminate, Gravol, Gravamin (Dimenhydrinate): Dramamine is a medication I prefer to use during opiate withdrawal as it helps with a few things. First, the Dimenhydrinate in Dramamine has a sedative effect similar to Diphenhydramine which can help with insomnia that so often accompanies opiate withdrawal. However beware that like Diphenhydramine, Dimenhydrinate can also cause a sense of restlessness for some and in larger doses can lead to hallucinations, illness, or death. This drug also helps with stomach cramps/pains and nausea although it provides little relief for diarrhea.

Dramamine Tablets

 

Tylenol (Acetaminophen), Aleve (Naproxen), Advil (Ibuprofen): These medications are useful for providing relief with the body and muscle aches/pains that are often present during opiate withdrawal. Some of these brand name medications can also reduce fevers that can sometimes occur during opiate withdrawal. Every person reacts differently to these drugs and have their own opinions/favorite so there really isn't a universal one to chose from this group. I have actually found Advil and Tylenol to be quite helpful with the muscle and body aches/pains during opiate withdrawal. Again use caution with dosing as too much can lead to organ damage or death and be sure to use only one of these products rather than a combination of them.

 

Imodium, Lopex, Fortasec, Lopedium, Pepto Diarrhea Control  (Loperamide): These medications will help with diarrhea and stomach cramping/pains. I have no experience with any of these medications but it appears Imodium is a favorite among opiate addicts as I have heard from others and read this numerous times. Loperamide is actually an opioid drug and some claim that when taken in higher doses, it can help with some of the other symptoms of opiate withdrawals due to it being an opioid. Please be cautious with this medication like any other and talk it over with your doctor as it can be just as dangerous as the others when taken in high enough doses. Because Loperamide is an opioid, there is also a risk for dependency and the drug can cause minor withdrawal symptoms when discontinued after being taken regularly for a period of time so please keep this in mind and to try to use this medication only when needed. It seems that this is a great medication to use during opiate withdrawal if used cautiously and correctly as it has garnered much praise and recommendation from other addicts and members of the addiction community.  

 

Imodium (Loperamide) Tablets

 

L-Tyrosine: L-Tyrosine is amino acid that is said to help provide relief for stress and for helping with mood swings during opiate withdrawal. I have no experience with this drug but it is commonly recommended by addicts with many saying it helps with mood and energy. This drug can be found at most pharmacies, food stores, and vitamin/supplement stores.

 

Vitamin B6: This vitamin is said to help with mood, fatigue, diarrhea, and stomach cramping. Once again, I have no experience with this vitamin but it is often recommended by other addicts or members of the addiction community for providing relief during opiate withdrawal.

 

Multivitamin: A multivitamin is important to take during opiate withdrawal for several reasons. The first reason being that most of us have little to no appetite during withdrawal so it is important we find some way to get our needed vitamins and nutrition. A multivitamin is something good to take not only during withdrawal but on an everyday basis before, during, and after withdrawal as well. In addition to providing nutritional value, some vitamins and minerals are said to help with a variety of symptoms during opiate withdrawal so it certainly can't hurt to take. It is important to remember that with vitamins and minerals, taking more does not result in better results as once the required amount is ingested by the body, the extra or leftover vitamins and minerals are simply passed through the body. In my experience, I have noticed virtually no difference from taking a multivitamin during withdrawal but I was also taking one daily before and after my experiences with withdrawal. I believe the benefits of taking a multivitamin can be difficult to physically see and determine despite doing the multivitamin doing its job. I prefer using the Men's One A Day multivitamin chewable tablets.

 

Valerian Root: Valerian Root is a herbal medicine that can be found at most pharmacies and vitamin/supplement stores. This herb can be found in capsules that can be taken orally or as powder-like substance that can be made into a tea. It is said to help with anxiety, restlessness and sleep as it has a sedative and calming effect on some. I have taken Valerian root capsules before and can say it did help a little bit but was nothing too dramatic or extreme. Everyone is different though so it might do wonders for some and absolutely nothing for others. These capsules can run on the expensive side as well and people with heart problems should use caution when taking Valerian Root. I decided to include this herbal medicine on my list as it is something that often comes up on several similar lists for dealing with opiate withdrawal but in my opinion, it is probably something you could get away with not taking.

Valerian Root Extract Capsules 

 

Supplemental Drinks such as Ensure: These drinks often provide a variety of vitamins, minerals, amino acids, proteins, fats, carbs, and calories that we usually struggle to obtain during opiate withdrawal. It is not uncommon for someone to lose some weight during opiate withdrawal so it is important we make sure we are getting good nutrition during this difficult time. Plus, providing your body with the right nutrients will only help with the recovery process as withdrawal can certainly take its toll on the mind and body. Your body will most likely feel weak and tired at times during withdrawal so it is important you are eating and drinking the right things during this time. The combination of a lack of appetite, ability to keep foods down, and possible bouts of  diarrhea can lead to weakness and dehydration.

Ensure Supplemental Drink

 

Melatonin: Melatonin is a naturally occurring compound in our bodies that help regulate sleep. It is hormone that regulates our sleep schedule and cycle. This compound also comes in the form of a supplement that is taken a few hours before bedtime each night. It is important to note that this supplement takes time to work and build up in the body (usually a couple of weeks) so it is important you begin taking it before you start your detox if you do decide to use a Melatonin supplement. I have tried Melatonin before and it did little to help with achieving sleep but there are many people, including my own family and friends, who swear by it. Melatonin is a relatively safe and cost effective supplement which is an added plus.

 

Melatonin Capsules

 

Kava/Kava-Kava: Kava, sometimes called Kava-Kava, is a plant that is said to have a sedative and calming effect that can help with anxiety. There are a lot of herbal supplements and such that are said to provide relief for insomnia and anxiety with varying degrees of success and effectiveness so keep in mind that what works for one person might not work for another. I have no experience with Kava myself.

 

St. Johns Wort: St. Johns Wort is a herbal medicine that is said to be helpful in treating insomnia, restlessness, anxiety, and depression. I have no experience with this herbal medicine but have seen it mentioned several times on online forums regarding medications or products that provide relief for opiate withdrawal. You'll most likely have to experiment a little bit with herbal medicines such as St. Johns Wort, Kava, and Valerian Root before you find one that works for you. It might be a good idea to give these herbal remedies a try before you actually go head to head with opiate withdrawal to see what works and what doesn't work. Be sure to talk with your doctor before trying any of these herbal medicines and make sure to not mix them with one another or other drugs without your doctor's approval. Remember, just because they are natural remedies doesn't necessary mean they are any safer or more effective than other medications.

St. John's Wort Extract Capsules

 

Hylands Restful Legs: Hylands Restful Legs is an over the counter medication that is said to provide relief for restless legs, tingling feelings in the legs, and minor aches/pains in the legs. It comes in two different forms of a pill; one that can be taken orally and another that is taken sublingually (dissolved under the tongue). I have tried this medication myself and found it to be ineffective but there are numerous positive reviews about the product online. So many in fact, that I was shocked by how ineffective it was for me. Like I always say, to each his own.

Hylands Restful Legs Sublingual Tablets

 

Potassium and Zinc Supplements: Potassium is a chemical element while Zinc is mineral. Both of these are said to help with restless legs, which for many is one of the worst symptoms imaginable of opiate withdrawal. I have used a Potassium supplement before and found it to be only moderately effective. Restless legs can sometimes be caused, among other things, by neurological damage or low potassium, zinc, or iron levels so if you are someone who regularly experiences bouts of restless legs regardless of whether you are in withdrawal or not, a visit to your doctor and a blood test at the lab might prove beneficial in determining the cause of the restless legs.

 

Caffeine/Energy Supplement: I have found that having a cup of coffee in the morning helps warm me up a little bit from the chills while providing me with a little jolt of energy to make it out of bed. Getting out of bed in the morning during opiate withdrawal can sadly be a painstakingly and difficult task so doing something simple yet motivating like making a cup of coffee and watching the news, surfing the web, or reading the newspaper can make getting up and out of bed a little easier. I wouldn't recommend drinking or ingesting any caffeine or energy drinks/supplements past noon and to try to take as little as possible as it may affect your sleep and lead to restlessness. Decaffeinated tea might be a good choice to drink throughout the day and night to help provide one with sense of warmth and something that is easy to get down.

 

Prescription Medications:

 

Clonidine: Clonidine is a medication that is used to treat high blood pressure but has also found its niche in the addiction community. This medication is used to help treat not only the high blood pressure that can appear during opiate withdrawal but also with other symptoms such as cold sweats, chills, anxiety, restlessness, and sleep. This medication can have a sedative effect so be careful driving on, working on, or taking it during the daytime. I have used this medication (.2 mg at night) and have found it to help with sleep, anxiety, and restlessness. It isn't a miracle drug but it does help in my opinion and there is a reason that it is often the first line of defense for a medication during detoxes and rehabs. It is usually pretty easy to obtain a prescription for Clonidine if you are honest with your doctor about your addiction or if you go to an ER explaining to them you are in opiate withdrawal. Clonidine should be tapered off of as it can lead to rebound hypertension (high blood pressure) when stopped suddenly after continued use. It is important that whomever is prescribing you this medication is aware of any health issues you may have, especially those concerning the heart.

 

Requip, Ropark, Adartrel (Ropinirole): Ropinirole is a dopamine agonist medication that was originally used to treat Parkinson's Disease. More recently, it has been used to treat Restless Leg Syndrome (RLS) and has been met with mostly positive reviews. I am currently using this medication for treatment of RLS and have experienced only moderate success. In my experience, it defiantly helps if you have RLS regardless of your addiction to opiates but when your going through RLS as a result of opiate withdrawal, it seems to only provide moderate relief. Experiencing restless legs is for many one of the most dreaded and uncomfortable symptoms of opiate withdrawal so having a prescription to Ropinirole isn't a bad idea.  

 

Man, I love Restless Legs...

 

Valium (Diazepam), Xanax (Alprazolam), Ativan (Lorazepam), Klonopin (Clonazepam): These drugs are all classified as Benzodiazepines. Benzodiazepines are used to help provide relief from insomnia, anxiety, restlessness, and muscle spasms/cramping. Benzodiazepines can be extremely helpful during opiate withdrawal but there are also several risks one must be aware of and consider before taking any of these medications. These medications can be dangerous if abused or used with any other medications/drugs that can result in illness or even death, so please be careful and talk with your doctor about your plan and any other medications, supplements, vitamins, or drugs you are using. Benzodiazepines can also be habit forming so it is important to plan on taking these medications for only a short period with the possibility of having to taper off them. Withdrawal from Benzodiazepines is said to be even worse and more dangerous than withdrawal from opiates so again, use caution. I  have no experience with Benzodiazepines but have talked with several addicts as well as reading online that Benzodiazepines can really make withdrawal more bearable especially with the anxiety and sleep issues. At the end of the day, remember these are a pretty powerful classification of drugs so it is critical you speak often and honestly with your doctor if you plan on using any kind of Benzodiazepine. Your best bet is probably to try to avoid these medications if possible but I know that is easier said than done when you have been up for 48 hours straight, freezing and sweating at the same time, and have been unable to sit, lay, or stand in a comfortable position for more than 30 seconds.

 

Trazodone: Trazodone is an antidepressant that can be helpful in providing relief for depression, anxiety, and insomnia from opiate withdrawal. This medication is usually safer in comparison to a Benzodiazepine as it is less habit forming and has less negative side effects. It is however weaker than most Benzodiazepines so don't expect to have anywhere near the same results. However, I currently take Trazodone and must say it does help with getting to sleep although I have never taken it during opiate withdrawal, instead taking it as needed for sleep during my time on Suboxone.

 

Ambien (Zolpidem): Ambien is a medication that is used to help treat insomnia. I have some experience with this medication and have found it to be effective in getting one to fall asleep, more so than Trazodone. While taking Ambien for a prolonged period of time won't lead to the same withdrawal symptoms one would normally feel from an opiate or Benzodiazepine, it does still carry the risk of dependency as some users have stated they experience anxiety, restlessness, and difficulty in falling or staying asleep after discontinuing Ambien suddenly, thus a taper may be necessary to come off this medication. Some people experience hallucinations, vivid dreams or nightmares, and sleepwalking on Ambien so it is important that you, if possible, have someone with you during your first couple of nights on this medication in addition to speaking with your doctor about the risks and benefits of Ambien.

 

Other Tips/Tools:

 

Hot Baths/Jacuzzi/Hot Tub

Reading Material

Movies or Video Games

Computer/Laptop with Internet

Heated Blanket

Comfy Bed or Couch

Comfy, Loose Clothing

Fan or Air Conditioner

Music

Time Off From School, Work, or Other Duties/Responsibilities If Possible

Strong Support Network of Doctors, Counselors, Friends, and Family

Go For Short Walks or Jogs
Exercise Lightly Whenever Possible

Drink Plenty of Fluids and Eat as Healthy as Possible

 

Conclusion

 

Alright Guys, that's everything I could think of for my list of things that can make opiate withdrawal a little more bearable. One thing that I cannot stress enough is to please talk openly and honestly with your doctor and support network before using or combing any of these medications (even the OTC ones). Some of these medications can have negative consequences when mixed with one another or with drugs. The Benzodiazepines can especially be habit forming or addicting so please use caution with these as you don't want to switch one addiction for another. Ask yourself if you think you can take a medication such as a Benzodiazepine responsibly for a short period of time without becoming addicted to it or abusing it. Benzodiazepines can be extremely dangerous to mix with other drugs, especially opiates so again, please, please, please talk all this over with your doctor. Better to be safe than sorry!

 

I also want to note that I am not encouraging you guys to use all these drugs. Some of these medications accomplish and provide relief for the same symptoms so you DO NOT need to use them all. I wanted to give you guys a few options as I know some medications work better than others for some people or that some may have allergies or bad reactions to certain medications. Once again, talk with your doctor(s) and support network in addition to doing your own research before putting any of these medications into your body.

 

 

At the end of the day, I think withdrawal for most will still suck to some degree with or without these medications. They may, however, be able to provide some relief or minimize some withdrawals. Just don't go into it expecting everything will be fine and dandy because this period of our lives will most likely be one of the most difficult. I'm not trying to scare anyone, I just want to be real with you guys. Some people feel worse during withdrawal than others while some feel as if they just have a nagging cold. If your like me, withdrawal feels like Hell on Earth. Its the price we must pay in the end for abusing these opiates to get high I guess. May god have mercy on us!

 

Based on what I have read and heard, a lot of people seem to say that it is important to remain active and busy during withdrawal. Now, I'm not suggesting you go out and work a 40 hour week or run a marathon. Rather, I'm saying you should do things such as going for walks/jogs, seeing a movie, doing some easy yard or house work, spending a day at the beach, and things like that. In other words, don't just sit in bed all day thinking about how bad you currently feel. It may seem like the easiest thing to do but in reality, it probably just makes things worse as all you will think about is how bad you feel and how easy it would be to use again to feel "normal". I would defiantly recommend taking some time off from work or school if possible as I think it will be really difficult to concentrate and have the energy during this difficult time but everyone is different. Some people may find school or work keeps them busy and their minds off withdrawal so you guys know your bodies and yourselves better than me.

 

How most of us feel during opiate withdrawal

 

As I mentioned in my previous posts, I will soon be coming face to face with Suboxone withdrawal in the near future. I am currently taking .75 mg a day and know I will one day have to experience life without Suboxone or any opiate for that matter. To be honest with you guys, it is something I am truly scared of. I absolutely hate and fear withdrawals! But that's just part of life and something I have to deal with and accept. I have experienced withdrawal several times going cold turkey from Oxycodone and know it isn't fun. Hopefully, the combination of some of these medications, the skills and coping mechanisms I have learned over the past year, and the help of my support network will be enough for me to reach my goal of sobriety and life without pills.

 

I would like to thank you guys for reading my post and I hope this list is helpful to some of you guys. If any of you guys have any questions, comments, or suggestions please feel free to put them in the comment section. I always enjoy and appreciate the advice of other opiate addicts.

 

Take Care Guys and remember to keep seeing that light.

 

-Seeingthelight

  

Cravings & Triggers

Hi everyone and welcome to my blog about opiate addiction. All is well my way and I hope everyone reading this is doing well as well. Whether you're here because you have or are currently battling an addiction to opiates, know someone who is, or are simply interested in the matter, I welcome you with open arms to my blog. I am trying to post often right now to get the word out there that I'm back to blogging as I have noticed a limited number of page views and comments since I've come back. As many of you may already know, I lost my password to my Google account several months back and was unable to log onto my account until recently. I really hope I can create a solid following in addition to getting back some of my readers who may have thought I quit blogging or went missing.

Alright, so now lets get down to the topic of this particular post. This post will be about the cravings we so often get when trying to quit opiates in addition to the triggers that can lead to these cravings and sometimes ultimately relapse. For those of you don't who know, cravings can best be described as sudden urges that make us want to use again or think about using again. Triggers, on the other hand, are what usually lead to cravings. Triggers are the people, places, sights, smells, feelings, and other things that can give us the urge to use again. A trigger could be seeing or hearing someone mention your drug of choice on television, driving by your dealer's house, hearing someone shake a bottle of pills, suffering physical or emotional trauma that can seem too overwhelming and difficult to deal with, and so on.

Like I have said so many times in the past, everyone is different. Thus, it is important to realize that everyone has different cravings and triggers. Some stronger than others. For instance, someone who is 6 months clean off of Oxycodone may be able to watch a documentary about opiate abuse and feel no urge to use. They may simply find the documentary interesting and may even feel less inclined to want to use again. This same documentary might make someone else watching it feel the strong urge to use again as it reminds them of something they once loved to do; get high. My point is, everyone and their situation is different.

Some Quick Information About Cravings & Triggers

An article found online on the website Everyday Health called Understanding Addiction Relapse discusses how identifying triggers and finding ways to prevent/manage them are critical in one's recovery. Dr. Stephen Gilman states how "a powerful need to stimulate reward centers within the brain can be the trigger point for an addict who is used to getting a certain drug. Both external and internal factors can create the urge to use drugs or alcohol again." This article provides some quick information about triggers and can be found by clicking on the link below.

http://www.everydayhealth.com/addiction/understanding-addiction-relapse.aspx

As many of you already know, getting off of opiates is quite a challenge. Staying off of opiates for good is even harder. The saying "Getting clean is easy. Staying clean is the hard part," couldn't be more true. One who quits opiates (or any drug for that matter) can most likely expect that they will experience cravings or triggers during at least some point in their recovery. In other words, it is normal for any addict to feel the urge to use again. Therefore, we must learn how to cope with these urges, cravings, and triggers. Learning coping mechanisms, talking with your support network, building sober support, and attending AA/NA are just a few ways to help combat these sudden urges.

It is also important to find ways to prevent and avoid these triggers. For example, if driving past your dealer's house/area brings upon an urge to use, try taking another route to get to where you need to go. Another example and one that is often very tough to overcome for addicts are the people you surround yourself around. Most of us addicts have friends or know people who also like to get high on our drug of choice. These people can simply be people you know or they can even be some of your best friends. It's very difficult avoiding or telling someone that you can no longer be around them if they are continuing to get high. Trust me, I know from experience. I handled this by being honest with my some of my best friends who used, telling them that being around the whole "getting high and using" scene will only make me want to use again. I was fortunate enough that they understood but will be honest with you guys, it was difficult. These are people who I grew up with for years that I rarely, if ever, see anymore since I got on Suboxone due to my addiction to Oxycodone. It was a tough and somewhat disheartening move, but you have to remember that at the end of the day, your health, reputation, and sobriety is what is most important. If these people are your true friends, they'll understand.

I want to stress this last part as it is not uncommon for people to get clean for awhile only to relapse because they started hanging out with the wrong crowd again. Being around people who use and your drug of choice makes it extremely difficult to remain clean. Some might be able to do it, but I'm guessing for most, it will be the ultimate challenge. I also want to stress that just because these people use, it doesn't make them bad people. After all, most of us were right there with them doing the same thing at some point. It's just that being around these people only makes things more difficult in your recovery and recovery is already hard enough!

How Cravings and Triggers Work

 

You'll have to excuse me on this section of the article as I will be giving you guys a quick and simple explanation as to how cravings and triggers work without sounding like a scientist or doctor. Triggers work by altering how one's mind thinks and reacts to what it sees, hears, smells, feels, and remembers. Everyone has an reward system in their brain which allows us to learn how to survive. For example, we know not to touch a hot stove as we will get burnt, thus injured. When we go to touch the hot stove, our hand is burned thus sending a signal to our brain telling us not to do this. Touching a hot stove results in a negative reward or consequence, giving us experience and knowledge that touching a hot stove will cause harm. A young child may not yet be aware of and know this, resulting in them touching the hot stove whereas an adult will know from experience, knowledge, and observation that touching a hot stove will only lead to pain and injury. This is simple example of how our reward system works and is just one of the many tools the mind has.

 

To give you guys another example, think about a dog learning a new trick. At first, a dog may not know how to sit on command. But when you practice enough with your dog and provide them with treats or encouragement for every time they are successful in sitting on command, they will eventually learn to sit every time they are instructed to do so. It is the reward system in the dog's brain telling them that if they sit, they will receive a positive reward or something they like. The dog will eventually learn that sitting on command will result in something positive for it.

 

 

This is basically how addiction works in our minds and bodies. Every time we put opiates in our bodies to achieve a high, our reward system in our brain is pleased. Over time, we begin to see opiates as something that will lead to pleasure and satisfaction. Once we stop using opiates, our brain and the reward system begins to wonder what happened and why it is no longer being rewarded. To make matters worse, opiates have a very powerful impact on our reward systems and our brain chemistry. Someone saying "good job" to us for some work we accomplished may be like our brain getting a pat on the back while putting opiates in our bodies is like being rewarded a $1,000 for our work. This is why quitting opiates can be so difficult as over time, our mind and body begins to crave, expect, and look for opiates due to their powerful effect on the mind and body.

 

To give you guys another comparison, think about how difficult starting and staying on a diet can be. Each of us has a food or beverage we love to have that is probably unhealthy to be having. For this example, I'll use regular (not diet) soda pop. If you were to be someone who drank a lot of soda and were to suddenly stop drinking it due to a new diet you went on, you'll most likely find that at some point later you will crave the soda. Now imagine that it was your daily routine and tradition to have a can of soda with your dinner while you watched your favorite television show. After a few days or weeks of being off the soda, you may one day sit down to eat your dinner while watching your favorite show on T.V.. This experience may make you suddenly begin craving the soda as drinking the soda was something you used to commonly do and enjoy. The time of day, the meal you are eating, and the television show you are watching all bring back memories, feelings, and emotions that you relate to the soda. This is an example of a trigger.

 

   

 

A real good video that explains triggers can be found below. The video is pretty short and to the point but is very informative. Check it out by clicking the link below.

 

http://www.youtube.com/watch?v=FIxD7Cq2s7c

 

 

The Difference Between Internal and External Triggers

 

Triggers are identified and spilt into two different types; Internal Triggers and External Triggers. Internal triggers are triggers that occur within our mind and body. These include emotions, thoughts, and feelings. Some examples of Internal triggers are boredom, depression, helplessness, and anger. Internal triggers can also include how one feels physically as well. For example, many of us often feel tired and overwhelmed after getting off of opiates making us believe that if we use again, we'll suddenly feel better or "normal". External triggers, on the other hand, are the people, places, things, and locations that can lead one to want to use or think about using. Some examples of external triggers are being around friends or family who use drugs, driving in a neighborhood known for drugs or that you used to get your drugs from, seeing someone taking drugs on television, seeing straws or dollar bills that remind you of snorting your drug of choice, and so on.

 

Below I have included a questionnaire that can help determine what triggers you are having and how likely they are to result in one using again. I think this questionnaire is more helpful for one finding which triggers they have and what kind of triggers these are than actually determining how likely we are to use again. Someone might have several triggers or get triggers often but know how to deal with them and remain sober while someone who has just one trigger may relapse. At the end of the day, it is you who decides whether or not you get or remain sober. The link to the questionnaire is below.

 

http://www.unodc.org/ddt-training/treatment/VOLUME%20B/Volume%20B%20-%20Module%203/3.Clinical%20Forms/2.External_and_Internal_Triggers_forms.pdf

 



Some Good Articles About Cravings and Triggers

 

Like I do with most of my posts, I want to leave you guys with some helpful websites and articles that talk about cravings and triggers. The links to these sites are listed below.

 

 

http://www.psychologytoday.com/blog/all-about-addiction/201003/triggers-and-relapse-craving-connection-addicts



http://www.rightstep.com/services/intensive-outpatient/class-5/addiction-triggers-for-drugs-and-alcohol/

http://www.everydayhealth.com/addiction/helping-loved-one-avoid-relapse.aspx

http://www.huffingtonpost.com/carole-bennett/the-road-to-addiction-14_b_221160.html

http://www.drchadcoren.com/drchadcoren/Dr._Chad_Corens_Blog__Bucks_County_Therapist,_Mental_Health_%26_Addiction/Entries/2010/6/23_Triggers_of_Addiction.html

http://www.spiritlodge.com/programs/living-in-balance/internal-addiction-triggers/

Conclusion

 

Cravings and triggers are a major part of recovery and are something we must all as addicts learn to understand, acknowledge, prepare for, and learn to cope with. These triggers and cravings can be easy and quick to pass while others may feel like they are there for an eternity and are difficult to overcome. It's part of addiction unfortunately. At the end of the day, we must remember that cravings and triggers are normal and are obstacles to overcome, not reasons or excuses to use again. 

 

I have several reoccurring triggers myself that I have been able to identify, avoid/prevent, and learn to cope with. The most common ones are boredom, stress, having a bad day, seeing or having a lot of money on hand, and being around people who use. A few months ago I made the mistake of being around people who use and who were using in my presence. Well, to no surprise, I ended up relapsing and went on a binge for a few days. I managed to get back on the sober train but am upset with myself for putting in so much hard work, effort, and even pain to get clean only to screw up. The important thing is I learned from my mistake and got back to being sober pretty quickly. For others, a relapse after being clean for a long period of time can lead them to go straight back to their old ways and habits. It is important to remember that relapse is part of recovery but is not something that is necessary and that if you do relapse, to get back on the sober train as quickly as possible.

 

 

I have learned a few ways to deal with, avoid/prevent, or cope with these triggers and cravings as well. One of my triggers is having a lot of money on hand. It makes me think that because I have all this money that I have managed to save up from not using that I can cheat just one day and buy a lot of Oxycodone. To help prevent this, I have opened up a bank account where most of money goes too rather than keeping a bunch of money on hand or in my wallet. I try to stay busy to prevent boredom and have a few methods to keep myself and my mind occupied if I do experience a trigger or craving. For example, I'll throw on a movie, write on this blog, jump on the computer, play with my pets, or go for a run when I feel the urge to use. In other words, I keep myself distracted and my mind occupied.

 

I would like to hear from you guys about some of the triggers or cravings you may experience during your recovery and some of the things you do to combat these triggers or cravings. Feel free to comment in the comment section below about this topic or to ask any questions you may have about the topic or opiate addiction as a whole.

 

Thanks again as always for reading my blog and I hope this post, along with the others, is helpful, beneficial, and enjoyable for you guys to read. As always, remember to stay strong and keep seeing the light!

 

Take Care,

 

Seeingthelight