Rapid Opioid Detoxification

Ah what a beautiful fall day here on the East Coast. The weather is as close to perfect as one could ask for when taking into consideration the sometimes baffling New England weather. The birds are chirping, the sun shining, calm guests of wind pass by creating an almost picture-like atmosphere around me. And here I am enjoying this wonderful day demonstrating the beauty of life....sitting behind my computer screen typing away!

I recently took somewhat of a break from blogging (not intentionally however) and I must say, it feels good to be back at it. For those of you who haven't yet read my "comeback" post, check it out. It's labeled as "I'm Back" and can be found on my blog homepage. Now lets get to business.

For anyone visiting this site for the first time, I welcome you to my blog and hope you will find it both helpful and an enjoyable read. This is now my 14th post and I must say I am becoming more and more pleased with the blog as each post is thought of, written, and published for you guys to read. Over the past several months I have gotten a few comments, a solid number of page views, and even an e-mail from someone looking for a little more advice and someone to "just talk to". I have also noticed that a few people took the most recent poll as well which only adds to my satisfaction. It makes me feel like that I'm getting my blog out there to anyone who's looking for any advice and information about opiate addiction and that I'm not just typing away for nothing. I would like to take a second to thank all of you who have read my blog, commented on it, taken part of the poll, or have passed the word around. THANK YOU!

For this post I would like to talk about a treatment option for opiate addicts that is relatively new. This method of treatment is commonly referred to and known as Rapid Opioid Detoxification and has been met with both praise and criticism. To make things a little easier for myself, I will be referring to the Rapid opioid detoxification as ROD. To give you guys a quick idea of what this is, please let me explain and sum it up in a few quick sentences. ROD is a method of treatment for opiate addicts which often places the patient in a state of unconsciousness while doctors provide the patient with a variety of medications that will help speed up the detoxification process. The patient will be "asleep" for a period of time and will then awaken after the normal period of opiate withdrawal. To put it bluntly, they basically put you asleep, give you some medications to speed up the detox process, and allow the patient to awaken feeling little to no withdrawal symptoms.

When I first heard of this method of treatment, I was very enlightened and curious about the process as it seemed far too good to be true. After doing some research and asking both my addiction doctor and consoler some questions about the matter, I was left with the impression that this method of treatment has a lot of promise but is still in its early stages and needs a lot more work and research put into it. Similar to many of my other posts on this blog, I would like to take this post and divide it into a few sections that will further discuss the matter. I would like to give you guys a brief overview and history of this method of treatment, its effectiveness, the general census of it currently, and my thoughts on it. After that, I'll leave the rest to you guys provide any comments, inputs, or even experiences you have on the matter. On that note, lets begin.

A Basic Overview/History Of  Rapid Opioid Detoxification

 

The origins and history of ROD are somewhat unclear and shady from what I have been able to research and understand. After doing some of my own research on the matter, I came across a website that gave me a few answers on this question.  This website states that "rapid opiate detox was created in Israel almost 20 years ago by Dr. Andre Waismann, who still practices his craft in Barzilai Medical Center in Ashkelon, Israel," and that this method of treatment came about after a striking number of soldiers from the Israeli army were found to have been suffering from opiate addiction. The army and its doctors (or scientists, not exactly sure who?) came to the conclusion that something must be done to address this growing problem and that the traditional methods of treatment were not good enough for the situation at hand. Over time, research, and much effort, this is where Rapid Opioid Detoxification (ROD) emerged as an option.

 

There is a brief amount of information from this website that explains the origins and history of this method of treatment and its something that I feel I can't really explain to you guys without basically stating exactly what the website says so rather than to try to put it into my own words and possibly leave out any important information or to say the wrong things, I will put below this paragraph in blue front word for word what the website states (feel free to check out the website yourself if you wish by clicking on the link in the paragraph above).

 

"Rapid opiate detox was created in Israel almost 20 years ago by Dr. Andre Waismann, who still practices his craft in Barzilai Medical Center in Ashkelon, Israel.

Since the original procedure was used on addicted soldiers in Israeli army, it has been gradually perfected by new medications that have since been approved by FDA to help control the effects of the withdrawal. The detoxification drug treatment procedure involves administering intravenous medications that remove opiates from the opioid receptors while the patient is sedated. The detox is done under anesthesia to avoid extreme discomfort and pain from opioid withdrawal symptoms. Additional medications are given to counteract the withdrawal manifestations and to comfort the patient.

Rapid detox under anesthesia can get you through the worst of withdrawal with only limited amount of symptoms that we can help to manage. A small implant containing Naltrexone may be placed under the skin while the patient is still under sedation. The Naltrexone implant slowly releases medication to continually block receptors and help the patient fight the physical symptoms of drug addiction. The Naltrexone implant will entirely dissolve and disappear in approximately two months. Naltrexone implant will take the daily decision making out of your hands. Knowing that narcotics will have no effect on you, if you do slip up, will help the psychological cravings as well.

There sprung up numerous small clinics all over the country duplicating the work that Dr. Waismann began in 1994. Some are well trained and well ran clinics quietly helping patients start new lives, however a few were trying to make a fast buck and ran into trouble and unfortunately those are the ones that get into news and leave a bad taste in the mouths of all.

Internists not doing proper medical screening, not making sure the patients are well enough for the procedure; Anesthesiologists who are not ABA certified, facilities that are ill equipped to deal with emergency situations, etc. Unfortunately the list can go on and on…

The procedure became somewhat controversial, because of the spectacular stories that were heard from time to time, also because no pharmaceutical company was behind it and making a lot of profit (aka Suboxone). However for the professionals who have been involved in it, Addictionologists, Internists, Anesthesiologists – are all believers. They do it because they know it works. Patient after patient, as long as there is a will and a commitment."

While this method of treatment has been around for 20 years, it really hasn't been that well known in the U.S. until recently. Some doctors are all for it while others are very much against it, so there isn't really a final census or agreement on the matter as of now. Hopefully there will be more information about this matter as time goes on and that they can fix any of the problems with this procedure. The withdrawals experienced during this procedure are often compared to as how one would feel if they were to go into precipitated withdrawal. If you remember from my previous posts (or worse, know from experience), precipitated withdrawal occurs when you take a drug such as Suboxone, Methadone, or Vivitrol without having waited long enough after any previous use of opiates such as Oxycodone, Heroin, and the like. For those who don't know, precipitated withdrawal is said to be much worse of a feeling than the "normal" opiate withdrawals one would suffer if they were to suddenly stop using opiates after a continued period of time (going cold turkey).

Normal opiate withdrawals already suck enough as it is, so precipitated withdrawals is something you don't want to mess with. While the patient would normally feel like they were in a state of hell during the course of experiencing precipitated opiate withdrawal, the patient undergoing ROD is supposed to feel little to no discomfort or pain during ROD due to the fact that they are not conscious and are under certain medications. Basically, the procedure has you sleep though the rough part while under medical supervision.



The procedure itself differs slightly from place from place but the basic concepts behind it remain nearly the same. To give you guys a description of the procedure, I have once again provided a detailed description of the procedure from a website I found online (I promise you I'm not getting lazy, I just want everything to be as clear as possible for you guys rather than putting things in my own words) while researching this method of treatment. This information is below this paragraph and is once again in blue front.

"Naltrexone is sometimes used for rapid detoxification ("rapid detox") regimens for opioid dependence. The principle of rapid detoxification is to induce opioid-receptor blockage while the patient is in a state of impaired consciousness, so as to attenuate the withdrawal symptoms experienced by the patient. Rapid detoxification under general anesthesia (sometimes called "ultra-rapid detox") involves an unconscious patient and requires intubation and external ventilation. Rapid detoxification is also possible under lighter sedation. The rapid detoxification procedure is followed by oral naltrexone daily for up to 12 months for opioid dependence management. There are a number of practitioners who will use a naltrexone implant, usually placed in the lower abdomen, to replace the oral naltrexone."

Another website provided a brief description of the process for their particular facility and I have listed it below this paragraph as well. This information comes from a facility in New York known as New York Rapid Opioid Detoxification (NYROD).

"The process begins when NYROD is first contacted by a patient or referring source. Patients then undergo a thorough screening of their medical and drug histories, and psychological profiles. Patients will complete an extensive questionnaire which will be reviewed by Dr. Brooks and our addiction specialized therapist. Dr. Brooks and out addiction therapists will speak to each patient in person, or by phone if calling from a great distance. Patient determination to end their opiate addiction is key to acceptance for treatment. With patient consent, previous therapists will be contacted to discuss your addiction and treatment histories. All patients must undergo physical examination and testing appropriate for their age and drug history.

AAROD is an important first step toward becoming opiate addiction free, but is only a first step. Therefore, to optimize outcomes and avoid relapse, NO patient will be allowed into the program unless aftercare has been established. That is, patients must have an inpatient, or outpatient post-procedure treatment plan to help them understand any psychosocial roots of their addictions and trigger avoidance. Our staff will work with you to assure a smooth transition into an aftercare program. In addition, we will maintain contact with each patient with frequent phone calls and return follow-up appointments. Every patient will have 24-hour access numbers to reach us if needed.

Patients are admitted early morning. An intravenous line is started and patients are placed on cardiac and oxygen monitors. Under the care of an ICU trained RN, patients will receive clonidine and intravenous fluids. The clonidine will help stabilize blood pressure and heart rate during detoxification. The fluids will begin the “washout” of the opiates still on the patient’s receptors.
Next, under the direct and constant care of a Board Certified Anesthesiologist, patients are brought into a state of the art procedure room. After the induction of deep intravenous sedation patients are administered the opiate antagonists naloxone and naltrexone until all opiates have been displaced from the opiate receptors and the detoxification is complete. Patients have no awareness or memory of the detoxification process which would otherwise be intolerable. Depending upon the level of addiction and the drugs to which the patient is addicted, the procedure will last from 3 to 4 hours. Before awakening, and only after the patient is completely detoxified, the patient is administered depot naltrexone injection.

Patients are next brought to a comfortable recovery area where they will be continuously monitored through the night by a trained RN. Any residual restlessness or discomfort or expected gastrointestinal distress will be treated as needed. Young patients may have a parent stay with them for all or part of the recovery period.

Before discharge the next morning, every patient will be evaluated by Dr. Brooks, and visited by our therapist to discuss immediate aftercare planning. Unless ready for discharge, patients will be kept. No patient will be allowed to leave without a responsible adult escort.

The aftercare you receive will be individualized and determined by you and your therapist. Some patients will choose to immediately continue in an outpatient setting, working closely with a therapist and joining a support group such as Narcotics Anonymous. Others may feel that they must first enter a more structured program in a protected and anonymous rehabilitation setting, far from their familiar “people, places, and things"

This procedure is supposed to be nearly painless and provides the patient with the chance to achieve sobriety without having to put up with the physical withdrawals from trying to quit opiates. The withdrawals from opiates is often a factor that prevents many (myself included) from going the cold turkey route. This option may also be appealing for those who dislike Opiate Replacement Therapy drugs such as Suboxone, Methadone, or Vivitrol or who feel they would otherwise be unsuccessful with going down this route (or cold turkey). The fact that it is basically a one time procedure (unlike Suboxone/Methadone which is an every day thing) is something that may be very appealing for some addicts.

Based on what I have read, patients will often stay in the facility or hospital for a few days and will be closely monitored. After the procedure, patients will be sometimes be prescribed Naltrexone to help them remain sober. It is important to remember that Naltrexone is not addicting and is the same drug that is found in the Vivitrol shot that I talked about here. It is also recommended that after the procedure that the patient continues to see their doctor, live a drug and alcohol free life, and seek support and/or AA/NA meetings.

Effectiveness/Opinion Of Rapid Opioid Detoxification

 

As I said previously in this post, there is still much debate as to exactly how effective the ROD can be and where it ranks among the many other treatment options out there. Many feel the procedure has much promise but is still in its early stages of development and that the procedure itself carries its own risks. There are others who feel the procedure offers little to no advantage over more traditional methods of treatments besides allowing the patient to avoid the physical withdrawals that so often accompany the challenging process of quitting opiates. In other words, while the patient may be able to avoid withdrawal, he or she will still have to face the mental aspect of addiction (cravings, depression, etc.), which can be just as difficult or harder than the physical part of quitting opiates.

 

A major drawback of ROD is that it is usually expensive, in fact quite expensive, as typical procedures usually range anywhere from as low as $5,000 to as high as $30,000 as well as additional costs of having to stay in a hospital for monitoring after the procedure and any medications you may be given. Based on my own research, it appears the average price is usually between $15,000-$20,000. That's a lot of money for most of us and to make matters worse, from what I have read getting insurance to cover the procedure can be quite difficult. Again everyone and their cases are different so some might pay more or less than others or may get better (or worse) insurance coverage. However, staying at an inpatient rehabilitation center is also pretty expensive ranging from a couple hundred dollars a day to thousands of dollars a day depending upon the place and situation. Suboxone, Vivitrol, and Methadone can also burn a hole in your pockets as well but is usually cheaper than ROD or an inpatient stay at a rehabilitation center. In other words, unless you plan on going cold turkey, getting clean can often be quite expensive.

 

To give you guys a clearer picture of what I'm saying, take my situation for example. I am currently on 1 mg of Suboxone a day and usually end up paying about $300-350 a month for my prescription, appointments with my addiction doctor, and meetings with my drug addiction consular which are all mandatory to remain in the outpatient Suboxone program I am part of. And those numbers are with insurance coverage (I'm told I have pretty good insurance too). If you're looking at getting on an opiate replacement therapy program, staying in an inpatient program, or giving the ROD procedure a try, insurance is a near must unless you have the money to spend. I have never been to an inpatient rehabilitation program but to give you an idea of what a stay at a average/normal (not some shithole or some 5 star resort-like rehab), I have included a list of prices without insurance coverage for a typical inpatient stay at a rehabilitation center (Waismann Method Medical Group and Domus Retreat) below:

 

5 day program is $18,800

1 week program is $20,800

10 day program is $23,800

2 week program is $27,800

3 week program is $33,800

4 week program is $39,800

 

Another disadvantage are the risks involved with this procedure. For this procedure, the patient will sometimes be put under anesthesia to basically have them "sleep" through the entire procedure. As most of you already probably know, anesthesia does carry its own risks despite the fact that it is commonly used and well known. These risks can be intensified for those with medical issues or disease so be sure to think this over and talk both regularly and honestly with your doctor if you feel ROD is the route you wish to go. The patient will also be given a variety of drugs (I'm not sure what) so it is important you know what you're being given in case you have any allergies or bad reactions to these drugs. A final risk involved in the procedure is the same risk you take when you decide to go cold turkey. Detoxing off opiates is very rarely life-threatening but it still does take its toll on your body when/if you decide to go cold turkey off opiates. These same risks will be present if you undergo the ROD procedure. I don't want to scare anyone or to seem as though I'm trying to lead you guys in a direction but I feel it is my duty to at least mention that there has been cases of people actually dying during the procedure or a few days after it. This is something that really concerned me but we must also take into consideration that people can die or suffer from complications during any procedure that involves anesthesia as well as the fact that some addicts can be in a relatively poor state of health in the first place. Like anything in life, this procedure has its risks. The following excerpt is taken from an article which explains some of the risks involved with this procedure:

 

"Detox is tough on the body, and a rapid detox is tougher. Although you do not consciously feel the pains of this quickened detox, your body must endure an intensified and accelerated period of detox, and this can be very taxing on the body…and doubly so as many addicts do not enter into detox in the best of health.
 
There have been a number of deaths related to the procedure, where patients have died within days of a rapid detox, and one prominent clinic was closed down over concerns over health and safety.

Advocates argue that although there are risks, the risks of a lifetime of abuse and addiction are greater, and for society as a whole rapid opiate detox betters health. This may or may not be true, but it is not likely very encouraging on an individual basis and when deciding on personal options."

Rapid Opioid Detoxification does not guarantee life-long sobriety and a person who undergoes this treatment has no greater chance of remaining sober than someone who attempts to go cold turkey or use opiate replacement therapy. Someone can be cold turkey off of opiates for a month and suddenly relapse. Someone may be on Suboxone or Methadone for 2 years and relapse. Hell, there are people who have decades of sobriety who end up suddenly relapsing. The same unfortunately goes for patients who have undergone a ROD procedure. I'm not trying to sound like a jerk when I say that (there certainly are people who have undergone cold turkey, opiate replacement therapy, and  I'm sure ROD who have gotten and remained sober) but I want to be as honest as I can be with you guys. ROD will help you avoid the physical withdrawals but you'll most likely still end up having to fight off urges, struggle with the mind games of addiction, and live through the mental anguish for quite some time after you quit opiates. I bring this up because $20,000 is a lot to pay to get sober to end up relapsing later on. Like I've said before, some people get it their first time while others, their 100th try. Everyone is different so don't feel as if I'm speaking for you and every opiate addict out there. Getting sober is easier for others just as it can be harder for others.

This chart shows the percentage of patients who remained sober after a Rapid Opioid Detox procedure. This chart was obtained in the book Drug and Alcohol Dependence (Vol. 52, Issue 53-Pages 177-270). The link to this information can be found by clicking Here.

The following excerpt is from a study that was conducted in 1999 by American Society of Anesthesiologists. It discusses the success rate of the procedure in 20 individuals as well any side effects experienced by these people. The link to this study can be found by clicking here. Here it is below in blue front:

"Background: Opioid addiction therapy includes successful detoxification, rehabilitation, and sometimes methadone maintenance. However, the patient may have physical, mental, and emotional pain while trying to achieve abstinence. A new detoxification technique that incorporates general anesthesia uses a high‐dose opioid antagonist to compress detoxification to within 6 h while avoiding the withdrawal.

 

Methods: After Institutional Review Board approval and detailed informed consent, 20 patients, American Society of Anesthesiologists status I–II, addicted to various opioids underwent anesthesia‐assisted rapid opioid detoxification. After baseline hemodynamics and withdrawal scores were obtained, anesthesia was induced. After testing with 0.4 mg intravenous naloxone, 4 mg nalmefene, was infused over 2 to 3 h. After emergence, severity of withdrawal was scored before and after administration of 0.4 mg intravenous naloxone. After 24 h, patients began outpatient follow‐up treatment while taking oral naltrexone.

 

Results: All 20 patients were successfully detoxified with no adverse anesthetic events. After the first post‐treatment test dose of 0.4 mg naloxone, 13 of 20 patients had no signs of withdrawal and hemodynamic changes were minimal. Withdrawal scores were always very low and similar before and after detoxification. Three of 17 patients (18%) available for follow‐up have remained abstinent from opioids since treatment (≤ 18 months). Four other patients are clean after brief relapses.

 

Conclusions: Anesthesia‐assisted opioid detoxification is an alternative to conventional detoxification."

Getting and staying clean is not an easy thing but is something we (us opiate addicts) must seek, or eventually seek. Most who continue a life of abusing opiates usually end up in jail, institutions, being homeless, or even dead. For those who don't get to any of those places, they will probably end up hurting their families/friends (in addition to themselves), ruining relationships, losing their jobs, and basically destroying their lives. Think about it,  how many happy, successful opiate addicts do you know or have you heard of? If you're like me, none. Addiction may not seem so bad at first but trust me, it will eventually bite you in the ass if you put up with it long enough. Again, I hate to appear gloomy and like a jerk on a high horse, but this is usually the case and is something I know from experience. My rock bottom wasn't jail, homelessness, or death but I did hurt some of the people I cared most about, did some things I would have never thought I would have done, and changed (negatively) as a person. I hated what I was doing and who I was becoming, eventually getting help and can honestly say I am happy the way my life is going right now. It hasn't been easy but like I've said numerous times before, it is possible. I'm still learning this myself as I continue my journey towards sobriety.

What I just mentioned in the previous paragraph is there for a reason. I want to stress to you guys that just like Suboxone, Vivitrol, or Methadone, Rapid Opioid Detoxification is not some miracle drug or procedure. After patient goes through this procedure, he/she will have to continue battling their addiction. It doesn't just go away after this procedure. This is where AA/NA meetings, counseling/therapy, and changing your surroundings and people around you are critical. Just like some Suboxone/Methadone/Vivitrol and rehabilitation centers, some clinics that offer ROD may try to lure you to give ROD a shot with statements of high success rates and an answer to your problems. These places, after all, are businesses and have a product/service they are trying to sell. Remember that. I'm not trying to knock any of these things as they can certainly help someone but you must remember that they are only a tool in your battle against addiction. Think of them a weapon on the battle field. You are battling addiction and have at your hands a variety of weapons. These weapons can include AA/NA meetings, sober networks, coping skills/mechanisms, and opiate replacement therapy drugs such as Suboxone or Methadone. However at the end of the day, it is not the weapons that are on the battlefield that wins (or loses) the war, it is people who are fighting on it that do.

There are a lot of different answers and numbers out there in regards to the effectiveness and success rate of Rapid Opioid Detoxification. Some will claim close to a 100% success while others will be as low as 20-30%. Unfortunately for addicts, most (but not all!) will fail their first (or few) times of trying to get clean. My addiction consular always told me that relapse is part of recovery but that just because it's part of it doesn't mean it has to be. Meatballs can be a part of a spaghetti diner but you don't have to eat them, you can simply eat around them or not put them on your plate and you'll still have your spaghetti. While this metaphor may sound silly at first, if you take a moment to think about it, it is a great comparison for the tools we can use to achieve sobriety.

I don't really have an answer for you guys about how effective or successful this procedure is other than what I just have stated previously. There are articles out there about this topic however, and I would like to provide you guys with them. After reading through a couple of them, you'll probably get what I'm saying about how there isn't really a clear-cut answer about how effective or successful ROD is or can be. Here are some of these articles below:

http://www.choosehelp.com/detox/problems-with-rapid-opiate-detox
http://thestatsblog.wordpress.com/2008/10/02/reporters-love-rapid-detox/
http://jama.jamanetwork.com/article.aspx?articleid=187166#
http://journals.lww.com/anesthesiology/Abstract/1999/12000/Rapid_Opioid_Detoxification_during_General.15.aspx
http://www.mdsdrugdetox.com/faq/
http://www.rapid-detox.net/2005/08/how-effective-is-rapid-detox.html
http://www.doctordeluca.com/Library/DetoxEngage/MethodsRoleOpioidDetox05.pdf

My Final Thoughts On Rapid Opioid Detoxification

 

When I first heard of the Rapid Opioid Detoxification, I was really interested and curious about the procedure. When I heard that you could simply "sleep" through the withdrawals and wake up feeling almost "normal", I simply couldn't believe what I was hearing. It seemed to good to be true. After doing my own research, I began to learn exactly what the procedure was, what it was about, how it worked, and much more information. Yet here I am today, still somewhat puzzled about it.

 

I haven't met or talked to anyone who has undergone the procedure or who knows someone who has. I have never undergone it myself and probably never will as it seems far to expensive for my case and I am a little bit concerned about the potential risks that come along with the procedure. If you asked me if I would ever consider getting this procedure, I would answer truthfully with a no. Between the costs, risks, and uncertainty of the procedure, I feel I wouldn't be comfortable enough going through with it.

 

However, I really do believe there is a lot of promise for a procedure such as this and I think it shows how far the addiction community has come in treating those who suffer from this disease.

I'm Back!

Hi Guys,

Hope everyone is doing well. I want to start this post off by apologizing to my fellow readers and friends. It's been awhile. I got a new laptop a few months ago and ended up losing my password and user name for my blog. Because of this, I have been unable to post on my blog. I plan on getting back to posting as often as I can and I hope I can continue to help some people in regards to opiate addiction.

I would also like to take a second to thank you guys for not only ready my posts but for also commenting on them. I think discussion can be really beneficial and helpful for everyone involved in this blog (myself included). I will try my best to read and reply to every one's comments. So please, keep the comments, questions, and thoughts coming!



I think the best way to write this post is to give you guys a quick update on how my recovery is going and where I am. I have some good news and some bad news...

I'll start with the bad news. I have been on Suboxone for about a year now and have been for the most part, pretty successful in my recovery. However, I have had a few bumps. I made it about 6 months of doing no drugs besides the Suboxone before I eventually caved in and messed up. I went on what I would call a "binge" and ended up getting high on my drug of choice, Oxycodone, for a couple of days. I actually had 3 periods of this. Each time lasted about 3 or 4 days before I ended up back on the sober train. I'm upset I did this after the hard work and dedication I put into my recovery but have learned to come to terms with myself and get back to a life of sobriety. I have now been clean for 45 days as I am writing this post (3/27/13).

It hasn't been easy but I'm surviving. It actually made me realize just how difficult recovery can be and how quick and easy it is for old habits to sneak up on you. I looked back on myself and the things that were going on at the time and have decided the most likely reasons for my relapse were stress, hanging out with the wrong people, boredom, and simply giving in to wanting to get high.

Despite these relapses, I have managed to continue my Suboxone treatment. I was able to avoid testing positive for Oxycodone during my drugs tests by providing myself with enough time (3-4 days) before having to take my weekly drug test at the Suboxone clinic. I want to be honest with you guys and not be someone who preaches something yet doesn't think the rules apply to his or her self. I never told my consular or doctor of my relapses and instead simply went on with the program. If you want my recommendation on what to do if you find yourself in a similar situation, I would tell you to be honest with not only your doctor, consular, and support team but with yourself as well. Once again, that's what I would recommend, not what I actually went out and did myself.

To give you guys a quick history of my story with addiction, I'll start out with what was my drug of choice. I had about a 2 year addiction with the Oxycodone 30 mg pills. I would snort/sniff these pills and was doing them daily, usually taking at least 150 mg a day but would take as much as I could afford/get my hands on. I came clean about my addiction with my girlfriend, family, and some friends and decided to seek help at a Suboxone clinic. I was initially prescribed 4 mg of Suboxone once a day. After about 4 or 5 months on 4 mg, my dose was reduced to 2 mg a day. I would take 1 mg in the morning and 1 mg at night. I was on this dose for about 3 months until my dose was lowered once again to 1 mg a day (.5mg in the morning, .5mg at night). I have been at this dose for about 2 months now.

The jump from 4mg to 2mg was actually very easy. In fact, I felt absolute no withdrawal at all or any negative side effects from my reduction in dosage. However, the jump from 2 mg to 1 mg has been somewhat of a different story. While I feel pretty good and normal most of the day, I can usually begin to feel some discomfort by the end of the day before my second dosing. These withdrawals are minor and usually consist of a runny nose, restless legs, random cold chills, and minor anxiety. I also begin feeling these withdrawals in the early morning around 5 or 6 in the morning before my next dose (usually around 10 a.m.). My best guess is I am feeling my previous dose wearing off and my body is looking for the next dose. Again, these symptoms have been pretty minor but can still suck when I have to work or go to school.

To help combat these symptoms, I talked with my doctor and was prescribed a few medications. These include Clonidine, Requip, and Advil. The Clonidine has been great at night for sleep and does seem to help a little bit with chills and restlessness. I haven't really noticed much of a difference with the Requip, which was prescribed to help with the restless legs. Surprisingly, the Advil has actually been pretty effective with the aches and pains I sometimes get.

While I am certainly happy I am now at a relatively low dose of the Suboxone, I am somewhat fearful of how difficult it will be when I again have to lower my dose when the time comes. I am even more scared about when the time comes to make the jump off of Suboxone completely. My plan is to jump off the Suboxone at as small of a dose as possible to help avoid or limit any potential withdrawal symptoms. If things get tough after I make the jump off of the Suboxone and I am feeling overwhelmed or facing intense cravings, I think I will give the Vivitrol shot a shot (no pun intended).

That's basically where I've been over the past few months since I last posted on here. I am so glad to finally be able to once again access my account and talk with you guys. It really helps to vent, hear others share their experiences, and to have the opportunity to help others as well. My next two posts are going to be about the rapid detox method and ways to taper off of Suboxone. I would like to dedicate the rest of this blog to you guys. In the comment section, please comment about a topic you would like me to address, ask any questions or comments you have, or simply pop in to say hello.

Thanks a lot Guys for reading and it's great to be back. I haven't said this in awhile so here it goes: Through times of desperation, difficulties, and darkness, remember to keep seeing the light!

-Take Care Guys,

Seeingthelight

The Power of AA/NA Meetings

Introduction

Hello everyone and welcome back to my blog about opiate addiction. After taking some time off from posting on my blog, I am glad to once again be back at it with posting. Between work, my addiction, and just life in general, I have been quite busy and unable to post as often as I would normally like. I also thought there was enough posts already in such a short period of time that it will give everyone a chance to read through my blog without feeling overwhelmed by so many posts. Today, I would like to dedicate this post to the topic of AA/NA meetings and their role in recovering from an addiction.

Both AA and NA (especially AA) have been around for quite some time and have resulted in numerous other groups/meetings that deal with other addictions to emerge. Today, there groups/meetings that deal specifically with things such as cocaine addiction, overeating, anger management, road rage, and much more in addition to the traditional groups/meetings for dependency on drugs and alcohol. Some people have claimed that these meetings were one of the biggest reasons for them being able to achieve sobriety and that without them, they wouldn't be where they are today. For this post, I would like to go over a brief description/history of both NA/AA meetings, what these meetings are like, how successful and valuable they can be, and my own thoughts on them.

A typical AA meeting

I would like to state early on in this post that despite being almost 6 months clean off of my drug of choice (Oxycodone 30 mg pills), I have never attended an AA or NA meeting in my life. I have been part of an outpatient program which requires me to meet frequently with a drug consular and doctor. This program provides me with both support and the opportunity to get Suboxone. While Opiate Replacement Therapy isn't for everyone, I can honestly say that I would most likely not have been able to get and stay clean without it. My hope is that in a few months from now, I will begin tapering off of the Suboxone and eventually be clean off of all opiates period. I am currently prescribed 4 mg of the Suboxone strips once a day and have found this dose to work well for me. While it certainly hasn't been easy, it is possible.

I also want to state that I have nothing against AA/NA meetings and that the main reason behind me never attending one is due to a combination of fear and lack of interest. I am the type of person who shys away from trying new things and often feel uncomfortable talking about something so personal (my addiction) with strangers especially amongst a group of them. I also feel that as of right now, I do not need the meetings and that getting to them would be a bit of a hassle between work and life. Now, I know I probably sound like someone who is cocky and naive (and maybe I am) but that is how I feel. I hope to one day finally "man up" and attend a meeting but this is something I have been saying for months now.

Despite my experience of not attending meetings and feeling them to not be necessary for my particular case, I want to make clear that I have nothing against them and have nothing but the utter most respect for them. I have talked to numerous people who really enjoy going to the meetings and say how helpful/beneficial they have been in their battle against addiction. These same people talk about the friends they have made, the support networks they have developed, and the knowledge they have gained about addiction as a result of going to these meetings. My drug addiction consular and doctor have told me numerous times how helpful these meetings can be in one's battle with addiction. It may seem somewhat ironic and hypocritically of me to be writing this post as someone with virtually no experience with AA/NA meetings but my motive behind this post is to show others a tool that may help them with addiction and to provide them with as much information about meetings as I can. When I was initially considering attending an AA or NA meeting, there was a world of questions I was asking myself and I was really in need of obtaining some information about these very meetings so hopefully this post can help a few of you guys who are in a similar position. Anyways, lets get started on this topic with a brief overview of AA and NA.

About AA & NA



Alcoholics Anonymous (AA) was created in 1935 by Bill Wilson and Dr. Bob Smith in Arkon, Ohio with the primary purpose of the group being to help its members to get and stay sober from alcohol. The group would hold meetings frequently that would provide members the opportunity to gain support from other recovering alcoholics, learn more about both addiction and the members themselves, find ways to live a sober life, and the stories and struggles of other alcoholics. The basic backbone of AA is the Twelve Step Program, which is a set of steps/guidelines with the purpose of leading alcoholics to the road of recovery. The Twelve Traditions were later created in 1946 and are a set of traditions that the group strongly believes in. These Traditions recommend that "members and groups remain anonymous in public media, altruistically help other alcoholics and include all who wish to stop drinking. The Traditions also recommend that AA members acting on behalf of the fellowship steer clear of dogma, governing hierarchies and involvement in public issues." AA has also developed a book, often referred to as "the Big Book" which further illustrates the basic concepts and beliefs that AA stands for (the actual title of this book is called Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism).

Today, AA is found all over the world, in various languages and cultures, with over 2 million members. The organization has seen its fair share of both praise and criticism, managing to be as relevant as ever today even over 75 years later. AA groups are self supported, meaning they tend to not accept outside help or money and rely on its members for its existence. Despite common misconceptions, the group does not associate itself with any particular religion or political party and everyone is allowed to join with the only requirement being "the desire to stop drinking". Those wishing to join AA simply attend any meeting of their choice without having to do sign up for anything, do any paperwork, or pay any fees. Donation baskets are often passed around during meetings similar to how they are passed around in church allowing members to make any contributions if they wish. The funds from these donation baskets are what ultimately supports the organization.

The growth of AA over the years

With the growth and success of AA, another group would later emerge that would go on to be known as Narcotics Anonymous (NA). This organization holds many of the same concepts and principles of AA but focuses more addictions to Narcotics such as cocaine, meth, opiates, and the like. While alcohol is technically a drug, there is somewhat of a difference of views between alcohol and other drugs such as the ones previously mentioned. NA itself has been quite successful over the years and is continuing to grow currently holding over 58,000 meetings in 131 different countries. Like AA, the backbone of NA is also the Twelve Steps and Traditions and NA meetings are considered to be quite similar to AA meetings. Along with the "Big Book", members of NA also use the text Narcotics Anonymous which is divided into 2 parts. The first part of this text discusses the basic concepts of NA emphasizing the Twelve Steps and Traditions. The second part of this part deals mostly with stories of recovering addicts.

There is a lot more information out there about both AA and NA that I simply can't touch upon all of it. However, I will list below this paragraph the websites of Both AA and NA for you guys if you wish to know more about these organizations. I have visited both websites and there is a lot of good stuff on them for those interested and feel AA or NA may be helpful in their road to recovery.

AA Website
NA Website

The Format of AA & NA Meetings

Now that you guys have a brief understanding and history of AA and NA, I would like to take a look at the meetings themselves. Under this section, I will provide you guys with information about how to find meetings, what they are like, the topics discussed, and much more.

Finding a meeting is basically the same for both AA and NA. There are numerous pamphlets that one can find online, in churches, shelters, community centers, doctors offices, rehabilitation centers, and at meetings themselves. These pamphlets usually list the date, time, location, type, and topic of each meeting and are pretty easy to read and grasp. One can also find this information on the AA and NA websites as well as calling the AA and NA hot line. Most rehabilitation centers are up to date with meetings and can also provide information about them as well. Both AA and NA meetings are held frequently and can be found nearly everywhere (you most likely won't have to drive more than 30 minutes to find one). There are meetings held every day of the week with some meetings meeting more than once a week. Meetings take place at all hours of the day, some as early as 8 a.m. and others as late as 10 p.m.

A typical list of AA/NA Meetings

Most meetings typically last anywhere from 1-2 hours and usually have at least one break during the meeting. One can come late or leave early for meetings without having to worry about being penalized. However, if arriving late or leaving early, please be sure to do so politely and quietly. Many members arrive 15-30 minutes before a meeting begins to engage in small talk with other members, ask questions to members or meeting facilitators, and to help set up the meetings. Meetings will often have food and beverages such as coffees, doughnuts, candies, or other small snacks. During breaks, members can use the bathrooms, smoke a cigarette, talk with others, ask questions, make phones calls, or do whatever else they may need to do.

Meetings usually start off with a welcoming statement that is often followed with a facilitator (sometimes referred to as "trusted servants") who reads passages from the Big Book. Sometimes members are allowed to volunteer to read these passages. After that, meetings can involve a speaker(s) who shares their stories or knowledge of addiction with other members. Members who have been involved with a particular meeting for an extended period of time can volunteer to become a speaker, who are assigned with going to meetings to talk about their experiences and knowledge of addiction with others. These speakers usually rotate and attend different meetings to help keep things "fresh" and to provide them the opportunity to have their stories heard by different meetings and members. After a speaker is finished speaking or if there is no speaker for the particular meeting, the facilitator will often allow members the opportunity to volunteer to speak about their experiences, knowledge, thoughts, or questions with others in the meeting. There is no minimum or maximum time limit for those speaking as one can simply say a few words or say as much as they want. However, members are usually urged to not speak for no more than 15 minutes at once (unless otherwise directed) to allow others the opportunity to speak.

The "Big Book"

Sometimes in meetings, members will take part in a prayer. These prayers are not religious prayers like "Our Father" or "Hail Mary" but rather prayers that focus more on addiction than religious matters. Perhaps the most well known and used prayer is the Prayer of Serenity. Another topic often touched upon at meetings are the Twelve Steps and Traditions. These Steps and Traditions require time to truly understand and grasp, thus resulting in a single Step or Tradition being discussed for an entire meeting or even multiple meetings. Another part of meetings that can occur is when a facilitator asks the audience if there are any new members to the particular meeting or if there is anyone in the crowd who is attending their very first meeting. If you are one of these people and don't wish to draw attention upon yourself, you can simply keep quiet and members will not say or push anything on you. If you do decide to announce you are a newcomer or that this is your first meeting, members will usually allow you introduce yourself while also taking the time to introduce themselves to you. Sometimes, when a new member or someone attending their first meeting is there, the members will switch the topic of day to focus on introducing the newcomer to the meeting and what the group stands for. I have been told more times than I count by others that AA/NA members are very welcoming and kind to newcomers in hopes of making them feel comfortable and accepted.

Meetings for AA and NA tend to be on the more informal side and usually like to emphasize group discussion. Members are encouraged to participate in discussion by sharing their own stories, providing what works for them, and asking any questions they may have. If your someone like me who is on the shyer side and likes to just listen, you're free to just sit back and listen. Members of AA and NA will not push you to speak up and should have no problem with you just being there and listening. Sometimes a group will go around and allow members to introduce themselves and speak of anything that is on their mind. This is what you usually see in movies and on television when everyone sits in a circle and each member goes "Hi my name is...I am alcoholic (or addict)." If this does happen and it is your turn to speak, you can simply say "pass" or "I think I'll just listen today." You can also say something along the lines of "Hi my name is...I am an addict and I'll like to just listen today." Again, you should feel no pressure to have to talk a lot and very rarely do they have it so you have to get up on stage or in front of a lot of people. AA and NA groups try their best to make the atmosphere as laid back and easy going as possible. However if you do feel like opening up about yourselves and talking, then by all means go for it. Some of the better AA and NA meetings consist of active group discussion but again, NO PRESSURE!

I want to stress the no pressure part and not having to get up and give a lecture because this is one of the things that I feared most. My original idea of a AA/NA meeting was that it took place in a church with each member having to get up behind a podium and talk. This is totally not true. Despite me never actually attending a meeting, I have been told this more times than I can count as well as reading this on various websites including the AA and NA websites. Some people love to talk and are great at public speaking. Others (like myself) absolutely hate speaking in front of people and prefer to just sit back and enjoy the show.

 

Types of AA & NA Meetings

I would also like to talk about how certain meetings are labeled under different categories. Some meetings are for men only or women only while others are aimed at other demographics such as the gay community, African Americans, young people, veterans ,single parents, newcomers, among others. Meetings are also labeled based on the format of meeting itself. There are meetings labeled as open discussion meetings where the meeting focuses mainly on, you guessed it, group discussion. There are also meetings labeled as speaker meetings where most of the meeting will revolve around a speaker or group of speakers visiting the meeting. These people who speak at meetings such as these are often members of another group looking to share their stories. Another kind of format are 12 step meetings which emphasize the 12 steps and will often dedicate the particular meeting to one of the twelve steps. There are also handicap and nonsmoking meetings as well along with a variety of others. The most common labeled meetings are probably open and closed meetings. Open meetings are open to everyone, meaning alcoholic/addicts and those who do not suffer from addiction while closed meetings are usually meant for just alcoholic/addicts. However, based on what I have heard, most meetings will not discriminate between the two and will usually welcome all.

A final kind of meeting I would like to talk about are Al-Anon meetings which are meetings that welcome alcoholics/addicts and their families/friends. I have heard these meetings are becoming more and more popular and are great for not only the person suffering from addiction themselves, but also for their families and friends. These meetings allow the friends and family members of alcoholics/addicts the opportunity to learn more about addiction and how to aid their friend or family member in battling addiction.

A popular question asked by those who are unfamiliar with AA and NA is what exactly is the difference between the two and is someone who is addicted to drugs allowed to attend AA or vice versa. Based on what I have read and been told, there isn't really that much of a difference between the two and that most groups do not discriminate between addicts and alcoholics. After all, it is addiction we are all looking to beat, meaning we're all basically in the same, shitty boat. If for whatever reason a group shows some discrimination or resistance to accepting someone based on their type of addiction, you can do a couple of things. The first thing you can do is to simply stop going to that particular meeting and find another one. Like I said before, there are literally thousands of meetings worldwide that meet throughout the week. Another option is for you to simply say I am an alcoholic at AA even if you suffer from an addiction to drugs or vice versa. From what I am told, there is little difference between the groups and that attending an AA meeting if you're an addict or attending an NA meeting if your an alcoholic is better than not attending a meeting at all. If you do feel you are really being discriminated against or treated poorly, don't hesitate to speak to the group leader or to call AA/NA to report any problems. Like I said before, AA/NA usually try their best to be laid back and welcoming so hopefully you shouldn't have any problems.

One final thing I would like to touch upon about AA/NA meetings is the common misconception that these groups focus heavily on religion. I believed in this at first and can see how many others would too. After all, most of these meetings take place in churches, involve prayers, and talk of a higher power. Well, I couldn't have been more wrong. The higher power these groups talk about can be anything you wish it to be. It can be god, the group itself, your mother, your dog, or hell even a doorknob. The purpose of the higher power is for the alcoholic/addict to admit that there is something more powerful than themselves. It took me awhile to really understand this until my drug addiction consular explained it to me. He said that I was overpowered by my drug of choice (the Oxycodone 30 mg pills) and that I was unable to quit on my own without seeking help. He said if this wasn't true, I wouldn't be where I was in the first place and wouldn't even be having this conversation with him. For me anyways, that really hit home and gave me a better understanding of what the group meant by a "higher power" so once again, please don't think these groups are just a bunch of religious fanatics because they certainly aren't. AA/NA groups have a wide variety of members who come from different cultures, races, religions, and backgrounds so you'll most likely meet and see a lot of different people. I have even heard of atheists attending AA/NA meetings so if that doesn't prove my point, I don't know what will.

I really hope to attend a meeting soon (unfortunately I have been saying that for awhile now) as I would like to really give the experience a chance. At meetings you'll hear a lot of stories and tips from people of all backgrounds. Like I always say, addiction doesn't discriminate. You'll hear the good, the bad, and the ugly meaning you'll hear stories of someone who has been clean for decades and is living a wonderful, enjoyable life. You'll also hear stories of people who have lost everything (sometimes their homes, money, and even family) to their addiction. Most people tell me the experience can be both quite inspiring and humbling but most importantly, helpful. I know I had a lot of questions about meetings (I still do) so I'm going provide a couple links below this paragraph that might be able to answer some of your questions. They talk about a variety of things and can probably answer a lot of the questions you may currently have. Here they are:

http://www.bma-wellness.com/papers/First_AA_Meeting.html
http://alcoholism.about.com/cs/meetings/a/blclosed.htm
http://www.na.org/?ID=bulletins-bull15-r
http://alcoholism.about.com/cs/meetings/a/aa040208a.htm
http://video.about.com/alcoholism/What-to-Expect-at-AA-Meetings.htm
http://www.new-life-in-recovery.com/aameeting.html
http://www.thefix.com/content/meeting-minds
http://www.azcentral.com/health/news/articles/0131dayofAA0131.html?&wired
http://www.na.org/?ID=NAMeetings-WhatHappensAtAnNAMeeting
http://www.nzna.org/drugproblem/firstmeeting.shtml
http://www.peninsulana.org/02%20New%20To%20NA/New_To_NA.html
http://www.healthboards.com/boards/addiction-recovery/9667-what-na-meetings-really-like.html
http://www.soberrecovery.com/forums/newcomers-recovery/85520-questions-about-na-aa-meetings.html
http://www.aa.org/lang/en/subpage.cfm?page=287

The Effectiveness of AA & NA Meetings

This next section I would like to talk about exactly how effective AA and NA meetings are for those who attend them. Based on what I have heard from other addicts, my drug addiction doctor, and my drug addiction consular, they are supposed to be really helpful. In fact, to this day I haven't heard of anyone who said they walked away from a meeting not learning something or having a bad experience. The one thing I have been told is that you may have to check out a few different meetings before you find one that you really like or feel comfortable in so if your first meeting doesn't go as you had planned, don't give up and give another one a shot. Just like everything else in life, there are great meetings, average meetings, and crappy meetings but my gut feeling is that most tend to fall on the good side. These people don't judge, know what it is like to be addicted to something, and share a goal with you (getting and staying clean). This is quite different than when all you have to talk to is a friend, family member, doctor, or consular who has never suffered from addiction themselves. I think I can speak for most of us when I say it takes another addict to know what an addict is going through and feeling.

Another important piece of advice I have been given is that after attending a particular meeting that you enjoy for awhile, try to look and find a sponsor. A sponsor is someone who is also battling an addiction and is willing to help you in your road to recovery. Your sponsor is someone you can ask questions to, obtain advice/tips from, and call or talk to if you feel the urge to use again. The one thing I was told about getting a sponsor is to make sure it is someone you feel comfortable around and to try to pick someone who at least a year of sobriety under their belt. Again, I have no experience myself with these meetings, let alone asking someone to be my sponsor, but I am told it is quite simple. After introducing yourself to someone at a meeting and once you feel comfortable enough around them, simply ask them if they would mind being your sponsor and if you could exchange numbers and/or e-mails. Most people will have no problem doing this and many will even feel flattered that you asked them. It takes a little courage but is something that I feel can go a long way. I just want to state again, make sure it is someone you feel comfortable around, has been sober for quite some time, and is someone who won't lead you down the wrong path in the future. I say this because, remember, at some point this person was an alcoholic or addict themself so be careful. You want to end up with someone who can help you, not someone that you can get drunk or high with.

There is a lot of information out there about how effective AA and NA meetings truly are yet there really isn't a final answer. In fact, the topic is very debatable. I wish I could tell you guys that going to AA and NA will solve all your problems, but like I have said before about there being no miracle drug to accomplish this, AA/NA meetings aren't the perfect solution. Some studies and programs have claimed these meetings to be extremely beneficial while others have shown little to no improvement for those suffering from addiction. I can throw a bunch of studies and figures at you guys but in the end, it's just a bunch of numbers to look at. In my opinion, I think AA/NA meetings can really help someone suffering from addiction but just like Suboxone or Methadone, they are simply a tool in helping one achieve sobriety. At the end of day, it is the person who must chose between a life of addiction or a life of sobriety. It is defiantly not an easy choice despite the fact that we all know which path is the better way to go. If you asked me my thoughts on the topic, I'd tell you to give a meeting a shot as I think it will certainly do more good than harm and probably won't hurt.

I'm not going to lie to guys, I have never been to a meeting and don't want to sugarcoat things so take this post in whatever fashion as you wish. I hope to provide you guys with the best information that I can provide and answer some of the questions you may have about AA and NA meetings. I know I had a lot of questions myself when I first begun my road to recovery. Anyhow, I will provide you guys with some links below that talk about how effective AA/NA meetings can be. These links provide studies, charts, graphs, and other numbers that might paint a better picture of the effectiveness of AA/NA than I can over a computer screen. Here are these links below:

http://hamsnetwork.org/effective.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140338/
http://www.addictioninfo.org/articles/1587/1/Estimates-of-AAs-Effectiveness/Page1.html
http://www.thefix.com/content/the-real-statistics-of-aa7301

 Conclusion

 

 

Well guys, I hope you found this post helpful and that I was maybe even able to make you think about attending an AA/NA meeting in the near future. Despite never being to one before, I get a sense of how helpful and even enjoyable these meetings can really be. Being on the Suboxone (4mg once a day) and remaining clean for almost 6 months has really helped me in being able to get my life back together. I feel great and most importantly, am happy. I know one day I will have to come off of the Suboxone and face the withdrawals, mental agony, and life without opiates sooner or later. I think this where AA/NA may come in handy for me (although I must say, attending a meeting now while on the Suboxone would probably do me world of good as well) as I will no longer have a drug (an opiate itself) in Suboxone to turn to instead of my drug of choice. I will be forced to travel this road to recovery naturally and will have to find other tools to help me remain clean. Maybe a meeting is one of these tools. Scratch that, it will probably have to be...I'll end this post like my others by wishing you all nothing but good fortune, luck, and happiness in your battle against addiction and your road to sobriety. It's been awhile since I've gotten to say this so hear it goes....Keep seeing the light my friends, it's out there.

 

Best wishes,

 

Seeingthelight

P.S.

If this is your first time reading my blog and you would like to read some of my other posts about opiate addiction, feel free to click on any of the below links. Each post has its own topic that I focus on with topics such as Suboxone, Methadone, Opiate Withdrawals, Sleep During Opiate Withdrawal, Quotes About Addiction, and much more.

Welcome Post (1st Post)
My Experience With Suboxone
The Dreaded Opiate Withdrawals
Why We Got Addicted To Opiates
Suboxone Vs Methadone
The Vivitrol Shot
Addiction And Our Bodies
A Soldier's Addiction
Cold Turkey Or Opiate Replacement Therapy
Some Good Quotes About Addiction
Getting Some Sleep During Opiate Withdrawal











 



Getting Some Sleep During Opiate Withdrawal

Introduction

Hello everyone and welcome to what is now my 11th post on my blog about opiate addiction. I would like to use this post to discuss something we so often take for granted; sleep. For someone who hasn't had a problem with opiate addiction and has no sleeping problems/conditions, sleep is often a natural occurrence that comes with relative ease. Sleep is what allows our mind and body to rest, heal, and rejuvenate itself and is something we all need in order to survive. Well for someone who suffers from opiate addiction, getting and staying asleep can be quite difficult. It is not uncommon for opiate addicts to have restless nights of sleeping, trouble going to sleep, or to have to wake up early as withdrawals begin to creep their way in. It gets even worse for opiate addicts when they decide to quit opiates cold turkey or to discontinue their use of opiates after tapering or treatment (Suboxone or Methadone). I've been there before and can vouch that it is one of the worst parts of opiate withdrawals. Therefore, I would like to dedicate this particular post to talk about sleep when the time comes for us to quit opiates.

If you are interested in reading other posts in my blog about opiate addiction, click on any of the following links (in order from 1st post to most latest post).

Welcome Post (1st Post)
My Experience With Suboxone
The Dreaded Withdrawals
Why We Got Addicted To Opiates
Suboxone Vs Methadone
The Vivitrol Shot
Addiction And Our Bodies
A Soldier's Addiction
Cold Turkey Or Opiate Replacement Therapy
Some Good Quotes About Opiate Addiction


When one stops using opiates, a variety of withdrawals will begin to come into play and can leave the person involved feeling like they are in a state of absolute hell. For this post, I will be referring to those who have either quit opiates cold turkey or who have stopped using all opiates after their tapering or treatment is completed. Basically, this post is for people who are no longer taking any forms of opiates (be it Oxycodone, Methadone, Suboxone, Morphine, ect...). When one quits opiates, they often have difficulty in getting and staying asleep due to a variety of factors. Restless legs (the withdrawal I hate the most), a racing mind, the chills, cold sweats, anxiety, and aches/pains are some of the more common withdrawals that affect our sleep patterns the most when going through withdrawals. I can remember a few times in which I attempted to quit opiates cold turkey and couldn't get more than a couple hours (if I was lucky) of sleep in a night. During the day, we are faced with withdrawals such as lack of energy, chills, cold sweats, diarrhea, and aches/pain. One basically feels like they have a really, really bad case of the flu. Come nighttime, our bodies are often tired and hurting after a long day (minutes seem like hours) of experiencing withdrawals, only to face even more agony at night. When the sun finally rises the next day, we have to experience this cycle all over again until withdrawals begin to calm after a period of time.

How many of us feel during Opiate Withdrawal at night.

I want this post to talk about a few things in regards to sleep and opiate withdrawal and I think the best way to do this is to break down this post into a few sections. I would like to touch upon the importance/role of sleep, the process of sleep for an opiate addict, and finally some methods that may help one get a good night's sleep (or at least a few hours) when experiencing opiate withdrawal. On that note, lets begin.

The Role & Importance of Sleep

 

Sleep is defined as a natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is a decrease in bodily movement and responsiveness to external stimuli (Free Dictionary by Farlex). Sleep is what allows our mind and body to have the opportunity to rest and perform several important tasks. Without sleep, one will not survive for very long and unhealthy sleeping patterns can result in both physical and mental health conditions. Sleep helps restore and strengthen our immune system, which is critical to our bodies as it helps heal or prevent wounds/injuries, infections, diseases, viruses, and much more. Sleep also aids in the brain and development of it. Despite there still being a lack of total understanding of the roles sleep has in living organisms, one thing is clear, sleep is essential for our survival.

 

There is a lot of information out there about sleep and of course not all of it has to do with opiate addiction or withdrawal in regards to sleep. This blog is meant to focus on opiate addiction so I don't want to be throwing a total lecture about sleep at you guys when that's probably not what you're looking for here. I just wanted to provide everyone with a brief understanding about sleep to get things started and to show how important it is to our survival. If you guys are interested in knowing more about sleep, I have included a few links below this paragraph that discuss the topic.

http://healthysleep.med.harvard.edu/healthy/science
http://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm
http://www.nhlbi.nih.gov/health/public/sleep/index.htm
http://www.helpguide.org/life/sleeping.htm

 

The Sleeping Patterns of an Opiate Addict

 

As most of you probably know already, opiate addicts tend to live a life quite different from those who do not suffer from addiction. The old saying "don't judge a person until you walk a mile in their shoes" is perfect for this scenario. As I said before, for someone who doesn't suffer from opiate addiction and has no sleeping problems/conditions, sleep is something that comes natural and takes little challenge to accomplish. However, for someone who does suffer from addiction and is currently going through opiate withdrawal, sleep can seem almost impossible at times. The withdrawals from opiates affect not only our bodies, but our minds as well resulting in our bodies being somewhat different than that of your average Joe who isn't addicted to opiates. Now I'm certainly no doctor (I can't count how many times I've said that before) but I believe the reason an opiate addict's sleep patterns become so disturbed are a near direct result of the effects opiates have the brain. I know it isn't rocket science that the physical withdrawals can keep one awake but I also believe that the mental aspect of opiate withdrawal is far too often overlooked. My guess is that the opiates play some kind of role in messing around with our brain chemistry resulting in some kind of imbalance or in something up there being "off". I mentioned before in my previous posts about the effect opiate addiction can have on not only our bodies but our minds as well, if you wish to check that post out simply click HERE.

 

Having an addiction to opiates can have quite an impact on our brain receptors whose purpose is release endorphins. Endorphins are basically opioid peptides that function as neurotransmitters. In other words, Endorphins are released in the brain as result of doing something we enjoy or find pleasure in such as exercising, having sex, or spending time with someone who we enjoy being with. Unfortunately, these same endorphins can be created and released each time we use opiates which ultimately result in one's mind and body enjoying the presence of opiates in the body. By continuing to use opiates over a period of time, the brain will begin to crave the presence of these endorphins eventually resulting in the person feeling the constant need to please the brain with the use of opiates. This is why it can sometimes be difficult for former opiate addicts to find enjoyment in things they once enjoyed as well as also resulting in depression or anxiety among other things. After reading all that, you can probably imagine the true effect opiates have on the mind and body which are what can ultimately control your sleeping patterns.

 

Once again, there's a lot of information out there about endorphins, the reward system in our brains, and the effects opiate addiction can have on these matters. I'll leave you guys with a few more links that address these topics in more detail below this paragraph.

http://www.allaboutaddiction.com/addiction/addiction-brain-effects-opiate-addiction-heroin-oxycontin
http://neuro.psychiatryonline.org/article.aspx?articleid=103089
http://www.canadianmedicaljournal.ca/content/164/6/817.full
http://en.wikipedia.org/wiki/Pleasure_center
http://curiosity.discovery.com/question/reward-center-in-brain-work
http://learn.genetics.utah.edu/content/addiction/reward/

 

Some Methods To Help With Sleep During Opiate Withdrawal

 

Getting some sleep during opiate withdrawal is something that nearly each and every one of us desires and wishes for when we choose to stop using opiates. Some people may be able to get some sleep during opiate withdrawals while others may feel as though they've been wide awake for what seems like a week straight. Like I always say, everyone is different. Some people experience certain withdrawals more or less than others and there is no universal law out there that will tell how good or bad your withdrawals will be. Unfortunately, there is no miracle drug or method out there that will prevent withdrawals but there are some methods that can help ease them. For this section of the post, I am going to talk about a few of these very methods which may help one who is suffering from opiate withdrawals and can't achieve sleep.

 

Over The Counter Medications- There are a few over the counter (OTC) medications out there that might be able to help you find sleep when going through opiate withdrawal. A common one is the drug Diphenhydramine, which is found in the OTC medication Benadryl. For some people this works great for in achieving sleep but for others (myself included) it has little to no effect. It is important to note that Benadryl when taken in high enough doses can result in restless legs and a jittery feeling similar to if one were take some caffeine. In even higher doses, Benadryl can result in hallucinations or even death so be smart when using this medication as a sleep aid. Basically, if you're not feeling much of an effect after taking the recommended dose, quit while you're ahead and don't look to take more in hopes of achieving sleep.

Another OTC medication that can be used to help with sleep is Doxylamine, which is most commonly found in the OTC drug Unisom. I have used Unisom and from my own personal experience feel that it works better than Benadryl. Tylenol PM is also another alternative to help with sleep as well as the aches/pain that often come with opiate withdrawals. Tylenol PM contains both Diphenydramine and Acetaminophen. The Diphenydramine in Tylenol PM is the same ingredient found in Benadryl and is what will help with the sleep. The Acetaminophen helps with aches, pains, and fever. All of these OTC medications should be used with caution as most are meant for short term use only. Ingesting to much of these medications can have severe consequences so be sure to be smart and talk with your doctor before doing anything drastic.

A final OTC medication that I feel is worth mentioning is Melatonin. Melatonin is a natural ingredient and works by replicating what the naturally occurring compound N-acetyl-5-methoxytryptamine does in our bodies. This compound is basically what aids our brain in determining when to sleep and has been getting more and more attention as of late. It is important to note that this medication takes time to work (usually at least a couple weeks) and that the dose needed to help aid with sleep varies from person to person. The good thing about Melatonin is that it is not addicting which is a huge plus for the addiction community. I gave Melatonin a shot before and didn't find it to help much with getting to sleep but I have seen other people praising how well it works. Like always, everyone is different so be sure to talk with your doctor if you do decide to give Melatonin (or any of these medications) a try.

Prescription Medications - Prescription sleep aids are usually more powerful and effective in helping one achieve sleep but do come with their risks. Many of these medications can be habit forming and addictive so anyone who has suffered from addiction in the past should be cautious with these medications. I have given a few prescription medications a try before and to no surprise would have to agree that they are far more effective than OTC drugs. A common prescription sleep aid is the drug Zolpidem, which is found in the medication Ambien. Ambien is a pretty powerful medication that has a pretty high success rate in terms of achieving sleep. I have tried Ambien before and found that it works great for getting some sleep but eventually canceled my prescription to it as I felt there was to great of a chance I would develop an addiction to it. There are also some side effects with Ambien such as sleepwalking, nightmares, and hallucinations so once again be careful my friends with these medications.

The drug Eszopiclone is another option and can be found in the medication Lunesta. I have no experience with this drug but have been told it is similar to Ambien but slightly stronger. Lorazepam is a option as well that is found in the medication Ativan, which works by slowing activity in the brain to allow for relaxation. Ativan also helps with anxiety which is something that can certainly arise during opiate withdrawal. Clonazepam, found in Klonopin, is yet another option as a sleep remedy. This drug is commonly prescribed for seizures, anxiety, and insomnia and based on what I have heard is quite powerful. I have no experience with Ativan or Klonopin so be sure to do your research and talk with your doctor if you think either of these may be an option.

Benzodiazepines are a class of drugs that are commonly used to treat sleeping problems and conditions. These are usually the more powerful sleep aid medications but carry the risk of developing an addiction. Withdrawal from Benzodiazepines is said to be quite severe, long, and painful with many saying the withdrawals from Benzodiazepines are far more dangerous and worse than those of opiate withdrawals. Some examples of Benzodiazepines include Klonopin (see above), Estazolam (ProSom), Flurazepam (Dalmane), Quazepam (Doral), Temazepam (Restoril), and Triazolam (Halcion). If you feel these drugs are capable of causing you to develop an addiction to them, your best bet is to stay away from these medications and look elsewhere. Another option is to use these drugs short-term (under 2 weeks) to help with the early stages of opiate withdrawal. These are powerful drugs guys, so be sure to be safe and to use these only under your doctor's supervision.

Another medication that may help with finding sleep is the drug Trazodone. I have used Trazodone before in the past and found it to work pretty well. While the Trazodone did help me, it was no where near as effective or powerful as the Ambien. Trazodone isn't as addictive as Ambien or some of the other drugs mentioned but it can still be considered somewhat habit forming. One will most likely not get too many physical withdrawals when stopping Trazodone, there is the chance of having trouble getting to sleep, having nightmares, and a sense of restlessness if suddenly stopped. The dosages prescribed for Trazodone vary greatly (any where from 25 mg to as high as 600 mg) so you and your doctor may have to slowly work your way up to a dose that works well for you.

Natural Remedy's - There are also other alternatives to sleep aid medications that can help during opiate withdrawal. One thing that works well for a lot of people is the use of hot baths, hot tubs, and trips to the sauna. These methods help relax the body and can be great for dealing with the chills and aches/pains. Exercising is another option but is something that can be quite difficult to do when going through withdrawals. When one exercises, their body releases endorphins just like how our bodies do when we use our drug of choice. Not only is exercise healthy for you, it will also often leave you feeling tired at the end of the day. Some decaffeinated tea, warm milk, or hot coco before bed can be soothing for some as well and is great for helping with the chills. Coffee isn't a bad idea during the day to get you up and going while withdrawing but should be avoided close to bedtime. The great thing about these methods are that they are not addicting or habit forming.

There are also several relaxation techniques that can be beneficial as well. When I first heard of these, I thought they were just a bunch of B.S. but must admit they did actually help a little after finally giving them a chance. Relaxation techniques include breathing exercises, mediating, and listening to those audio tapes that play peaceful sounds or music. Lets face it, when you're withdrawing you're basically willing to try anything to help yourself get through those rough times. I also find creating and sticking to a going to sleep and waking up schedule helps a lot to with sleep. What I mean by this is to not have nights were you're up until 3 A.M. and wake up the next day at 11 A.M. then following the previous day by going to bed early and waking up early. Make a schedule and stick to it.

 

A breathing exercise that I have found to help with not only getting to sleep but relaxing works by lowering your pulse and clearing your mind. For some people, this works well while others may not notice much of a difference. It takes a little practice to get used to as well. It can also help when you have a panic attack or are frustrated. This breathing exercise is called the 4-7-4 technique and works as follows:

 

1. Sit down in a chair with your back straight and hands together meeting at your stomach.
2. Your fingers should interlock at your stomach with the backside (opposite of your palm side) of your hands facing out.
3. Inhale and take a 4 second continuous breath of fresh air and hold it in for 7 seconds.
4. After holding your breath for 7 seconds, release your breath for 4 seconds continuously
5. Continue this 3-5 times

Another thing that may help is simply reading a book, surfing the web, or watching a little television before bed. It will help keep your mind busy while giving you some entertainment to pass the time and relax. However, don't just sit there for a few hours watching television, surfing the web, or playing video games as this can have the opposite effect. Try doing something that you really enjoy that doesn't take up a lot of your energy. Having a good environment around you before you go to sleep can make quite the difference so make sure you're in a relaxed, quiet, and comfortable environment each night.

Herbal Methods - There are also some natural herbs out there that are said to help with sleep. While I have never tried any of these herbs, the ones I most commonly hear about are Valerian Root and St. John’s Wort, which can usually be found at stores like GNC or Vitamin World. There are other herbal remedy's out there as well. I have also heard Lavender can help. Don't look at these herbs as something you shouldn't talk to your doctor about as some of them carry side effects or can have adverse effects with other medications. As always, be smart and talk with your doctor!

Other - A final thing that may help some of you guys may come across as somewhat controversial so please note that it is not my purpose or intent to offend anyone or to seem contradicting. When some people look to quit their addiction to opiates, they also look to end their use of all drugs and alcohol, which I think is probably the best route to go. This includes drugs such as tobacco and marijuana. In my opinion, I believe that marijuana is without a doubt a drug and can also serve as a gateway drug meaning that it's use can eventually lead to the user moving on to other harder drugs. However, I think for the most part, marijuana is quite harmless and agree that it is not addicting. It might become a habit but you won't see anyone having chills, cold sweats, extreme anxiety, diarrhea, and the other classic symptoms of opiate withdrawal when they stop using marijuana. As someone who enjoyed smoking marijuana and did so often in the past, I would often use the drug as a way to help control the anxiety that would so often accompany opiate withdrawal. It would sometimes also help me get to sleep which can seem close to impossible during opiate withdrawal. I no longer smoke marijuana due to the rules of the Suboxone program I am now in as well as just trying to make drugs a past part of my life but I still personally have no ill feelings towards the drug. I'll leave this one up to you guys. If you think it may help, give it a shot. However, if you think it might do more harm than good, then by all means stay away from it (and other drugs).

After debating with myself whether or not I should have included the use of marijuana to help with sleep during opiate withdrawal, I came to the conclusion that I want to be able to provide you guys with whatever I think can help you guys without causing any harm or bad consequences. That's why I often write about medications but never recommend dosages or regimes besides telling you guys to talk with your doctor and to never take more than told/recommended. The biggest reason I had debated on whether or not to include marijuana as an option in this post is that for some people, when they use marijuana, the high they get from it brings on too much of a temptation to get back to using the opiates again. Sometimes the high from marijuana is just to much for a person and it can begin to bring out our inner demons with addiction. While I personally believe marijuana can have its benefits, I would have to say that the best route to take is to probably just avoid it along with any other drugs or alcohol.

I also want to state that I defiantly wouldn't advise anyone to use alcohol as a means of getting to sleep. Not only is that an unhealthy and potentially dangerous thing to do, but that alcohol itself can become an addiction. This is especially true for any addict as we tend to develop addictions quicker and easier than most people. In addition, while the use of alcohol may make one feel good and able to get to sleep, it will most likely leave the person feeling even worse the next day. It is already shitty enough having to deal with opiate withdrawals so why add a nasty hangover to the mix. Both alcohol and marijuana can impair the way we think and act, which could result in one making some poor decisions such as deciding to use opiates adding yet another reason to avoid any drugs or alcohol during opiate withdrawal.

I know I might sound somewhat contradicting to some about what I have just said but I just want to add what I found has worked for me in the past. If you asked me what to do in regards to the marijuana, I would say to defiantly stay away from any drugs/alcohol and to only use the marijuana if you feel confident enough it won't have any negative impacts and as a last resort if possible. Remember, the whole point of getting off the opiates is to live a sober life. Like I've said more times than I can count, everyone is different with some people being able to handle things differently or better than others. You shouldn't even consider looking to drugs such as cocaine, heroin, meth, hallucinates, and the like to help ease withdrawals. Believe me, drugs like those will do much more harm than good and can lead you into a whole another world of problems.

Some Other Quick Tips For Finding Sleep

 

• If you can't get to sleep within a half hour or so, don't just stay in bed tossing and turning! Get up and go to a lightly lit room and do something that requires little energy and is relatively boring/dull. Some examples include reading the newspaper or a book, writing in a journal, going for a short walk, ect. You must train your body and mind that your bed is a place for sleep so that when you enter your bed in the future, your mind and body will know it's time for sleep. Or the other thing...

 

• Try to limit television, video games, or exercise right before bed as both can tend to get your mind and body up, focused, and ready to go.

 

• Limit any caffeine, high Carb, or sugary foods at night. Eat right during the day and limit (or even quit if you can) any tobacco products. Too much of these things can keep you up at night.

 

• If you're religious, calm yourself by spending a few minutes saying your prays before bed. If religion isn't your cup of tea, give mediation a shot and try relaxing and meditating for about 15 minutes before bed.

 

• Try to keep your mind occupied on something calming and something you enjoy. Don't worry about your addiction, bills you have to pay, work, or any other things that can get you worked up and worrying while you are in bed at night.

 

• As I mentioned before, make sure to set up a sleep schedule where you wake up and go to bed around the same time each day. Try to limit long naps during the day by either not napping at all or limiting your naps to less than 45 minutes (cat naps). It can be tough for some people (myself included) but try not to sleep in late on weekends or days off from work/school as this can further disrupt your sleeping patterns.

 

• Make your sleeping environment comfortable by having a nice, comfortable bed, a room temperature that's comfortable for you, and keeping noise to a minimal.

 

• If you continue having trouble in getting and staying asleep, don't continue to just put it off! Make a visit to your doctor and discuss with him or her what the two of you think is the best route of action to take in getting some sleep.  

Conclusion

 

Well guys, that's all I got for you and I really hope this post was helpful for you. In my opinion, the lack of sleep that comes with opiate withdrawals is one of the worst symptoms. You end up feeling so tired after not getting any sleep from the night before but still cannot fall asleep the next night, it really sucks. For some people, these methods may work great for while others may have mixed results. I'm sure there's a lot more information out there and I would love to hear some feedback from you guys about this matter. Comment below in the comment section if you have any thoughts, experiences, or recommendations that can help with achieving sleep during opiate withdrawals. I have also put up a new poll which can be found at the bottom of this page and would love to hear what you guys think. I'll end this post by wishing everyone nothing but the best and ask that each and every one of you guys to continue seeing that light! I have also included yet another a link for you guys below this paragraph that has some good information about some of the methods to achieve sleep. Some of the stuff on this website we have talked about already in this post but there is also much more. Here is the link below.

 

http://www.helpguide.org/life/sleep_aids_medication_insomnia_treatment.htm#otc

 

Until next time, take care guys.

 

-Seeingthelight