Endure Acute Withdrawal from Opiates (Narcotics)

Stay strong. Remember: if you are going to overcome an opiate addiction, you'll need to start by enduring the acute symptoms of withdrawal. Ease your suffering with over-the-counter medications: analgesics to manage the body aches, antihistamines to beat the nausea, and Ioperamide to cope with diarrhea. Ask your doctor about prescription meds: blood pressure medication like Clonidine, and partial opioids like Suboxone. Make yourself comfortable, read up on the symptoms, and consider finding a support group or rehab clinic to help you ride out the worst of the withdrawal.

Steps

Using Over-the-Counter Medications

1. Purchase over-the-counter analgesics. These medications include acetaminophen, ibuprofen or naproxen, and they will help you to manage the body aches that you are going to feel during withdrawal. The small aches that you've been handling easily with narcotics are going to feel magnified as the drugs leave your system. Ibuprofen and naproxen are both NSAIDs which work very similarly and if you mix them, remember each contributes towards the maximum dose of any NSAID (dosing for acetaminophen would be independent).
2. Buy an antihistamine with sedating effects. Sedating antihistamines such as diphenhydramine (Benadryl), dimenhydrinate (Dramamine) or meclizine (Dramamine II) will help you to conquer the nausea and sleep through a lot of the queasiness.
3. Get medication to treat diarrhea. Your best choice is loperamide hydrochloride (Imodium AD). While this medication is structurally similar to the opioid meperidine (Demerol), loperamide doesn't cross the blood/brain barrier.
   • By acting on the opioid receptors in your intestines, loperamide will stop intestinal spasms and the diarrhea that comes with them. The medication moves food more slowly through your gut and increases water absorption. Many people report that this medication is the most important key to easing withdrawal symptoms.
   • Only take loperamide if you need it, but take double the suggested dose on the package. Remember, your intestines are used to a barrage of narcotics. A normal dose simply isn't going to be as effective.
   • Skip loperamide if you are pregnant, if you have colitis or if you have a high fever of F 100.4 (38 C) or more. Also, don't take it if you start to notice blood or mucus in your stools.
4. Buy 2-week supplies of your over-the-counter medications. You definitely don't want to run out of medication and have to walk or drive yourself to the store in full withdrawal mode.

Using Prescription Medications

1. Ask your doctor about Clonidine. Clonidine a non-opiate, non-addictive blood pressure medication not to be confused with the addictive anti-anxiety medication Klonopin. Clonidine inhibits your body's sympathetic response and helps decrease the sweating, chills, anxiety and restlessness that you may feel during withdrawal.
   • Side effects include dry mouth, sleepiness and, for some, insomnia. Your blood pressure will drop, so if you already have low blood pressure or fainting spells, you should definitely talk to your doctor. Also, be careful when you stand up quickly. Many people who take blood pressure medication "see spots" and feel dizzy when they suddenly change positions.
   • Clonidine does have the potential for physical addiction even though it doesn't remotely provide the euphoria you can get from narcotics. Try to maintain a low dosage: Take between 0.1 to 0.3 mg of Clonidine, 2 to 3 times daily.
2. Try Subutex/Suboxone (buprenorphine) if you've been on narcotics for a long time. Suboxone is a long-lasting partial opioid agonist that blocks withdrawal symptoms.
   • "'Advantages':'"., Suboxone is available by prescription, which means that you won't have to go to the methadone clinic., You may find it's easier to kick than methadone, and if you quit using other drugs, suboxone can help you feel normal pretty quickly. You can take it once in the morning, and you'll feel fine until the next morning.
   • Disadvantages: You will have withdrawals from suboxone, although for some people they will be less severe and of shorter duration. Suboxone can also be expensive as doctors must have special training to prescribe it, and they can only have so many patients who take suboxone at one time. Also, no generic version of suboxone is available in the US
   • Buprenorphine has both agonist, and antagonistic properties. Because of the antagonistic properties, as opposed to a pure agonist like methadone, approximately 10 percent of patients do not respond well to this medication.
   • Wait until the half-life of your opioid of choice has passed before you take suboxone. If you do not, you will have withdrawal symptoms which can be more severe and of much longer duration than opiate withdrawal, so be very careful with these.
3. Take diazepam (Valium) or clonazepam (Klonopin). These drugs can have physically addictive properties, and they can cause you to experience withdrawal.
   • Stick to small doses. Five mg of diazepam 2 to 3 times daily, or 0.5 to 1.0 mg of clonazepam 2 to 3 times daily, will get the job done. Don't take them long-term, and taper them off when you decide to stop using them.
   • If you abuse Valium or Klonopin and don't properly detox, you could experience symptoms including tonic clonic seizures and even death.
4. Think about using some lower-level controlled substances if they're legal in your country or state.
   • Share your narcotic addiction with your doctor
   • You may also consider using kratom to take the edge off of your symptoms, though be very cautious since kratom has been known to cause addiction as well. Order kratom online in the US or Europe. It's illegal in Australia.
   • Avoid alcohol. Alcohol is a depressant, and while the buzz may distract you for a while, alcohol can cause your mood to plummet and can interfere with your ability to sleep.

Other Strategies for Going Through Withdrawal

1. Know what symptoms to expect so that nothing catches you by surprise. You may experience some or all of the following:
   • Agitation and anxiety
   • Muscle aches
   • Tearing
   • Sweating
   • Insomnia
   • Runny nose
   • Abdominal cramping
   • Diarrhea
   • Vomiting
   • Dilated pupils
   • Chill bumps
2. Prepare a comfortable environment.
   • Keep your tablet or TV and DVD player nearby so that you can watch some lighthearted movies.
   • Make sure that your room is at a comfortable temperature, and make sure that you have some soft blankets and maybe a fan. Prepare to change your sheets often because of sweating.
   • Wear loose and comfortable clothing. Again, you'll probably have to change clothes a lot because of the sweating.
3. Avoid going through withdrawal alone. If you don't plan to check yourself into a rehab facility, then stay with someone who can support you during the withdrawal period.
4. Take some time off from your usual activities. Withdrawal may take up to 2 weeks, so try to take some time off of work. If you have a family, then check yourself into a rehab facility or go somewhere where your children won't have to see you going through withdrawals.
5. Slowly taper off your narcotics. Reduce your doses of opioids or medications by about 20 to 25 percent every 2 or 3 days to minimize withdrawals.
6. Try community detox. Check out your local methadone clinic so that you can gradually wean yourself off of narcotics by taking gradually decreasing doses of methadone. Community detox will allow you to go on with your daily life without checking in to an in-patient facility.
7. Go to a psychiatric ward or other inpatient psychiatric facility if you've had episodes of suicidal thoughts or hurting yourself in the past. Withdrawal can bring out these negative behaviors, which could put you in real danger. If you have a history of depression or other psychiatric problems, then do your detox under medical supervision.
8. Check yourself into a rehabilitation facility. Rehab will give you a variety of in-patient treatment options:
   • Detox under anesthesia. With this kind of detox, you are placed under anesthesia and given substantial doses of opiate-blocking drugs. Use caution with this method because opiate withdrawal often causes vomiting, and you can aspirate or choke on vomit when you are under anesthesia.
   • In-patient therapy and support groups. While you stay in a rehabilitation facility, you can talk to counselors about your addiction or you can spend time in support groups with other addicts.
9. Give yourself a lot of positive reinforcement. Try some of these strategies:
   • Tell yourself that your withdrawal pains are like labor pains. You're giving birth to a new you.
   • Write a notice to yourself that says, "I'm a fantastic person, and I'm doing something amazing." Post the notice where you can see it.
   • Give yourself a non-drug reward for every day that you make it through withdrawal.
10. Remember to eat food and drink water. You may not feel like eating or drinking fluids, but your body needs nourishment and hydration. Eat saltines or yogurt or other foods that are easy on your stomach. Also, be sure to drink water or fruit juice to replace any fluids that you lose from vomiting or diarrhea.
11. Get some light exercise. Don't overdo it, but take a short walk around your neighborhood or do some light housework. Exercise will keep your spirits up and will help to distract you from your symptoms.
12. Believe in yourself. As corny as it sounds, you'll feel much better about the experience of quitting if you truly believe you can do it successfully. Tell yourself repeatedly that you can do this, that you're strong and motivated and capable. Try to be consistent in your positivity. Come up with a mantra or something similar if that helps you!

Beating Addiction Once and For All

1. Quit for yourself and no one else. You won't maintain your resolve if you're trying to quit for your parents, your kids or even your spouse. Make up your mind that you're done getting high and you're done with the lifestyle.
2. Join Narcotics Anonymous or SMART Recovery. Narcotics Anonymous follows a 12-step program similar to Alcoholics Anonymous to help you to navigate life after opiates. In addition to following the 12 steps, you can go to meetings to talk to people who share your experience, and you'll be connected with a sponsor who you can talk to at any time as you fight to beat your addiction.
3. Associate with the right people. Steer clear of people who will enable your lifestyle and friends from your druggie days. Also, avoid dealers or anyone else who used to give you access to drugs.
4. Prepare for the process of overcoming addiction to take a long time. The acute withdrawal may take anywhere from 3 days to 2 weeks. However, you can also experience something called Post-Acute Withdrawal Syndrome, or PAWS.
   • PAWS often mimics other psychological disorders like depression, anxiety disorder and psychosis. People often experience lethargy, fuzzy thinking, memory problems, sleep disturbances and emotional swings. At the far end of the spectrum, people have thoughts of suicide.
   • Get some support if you find yourself going through the symptoms of PAWS. If left untreated, the symptoms can lead you directly into relapse.
5. Take life one small moment at a time. You may find out that every part of your daily routine reminds you of the times that you took narcotics, but this will only be temporary. Also, it would be very beneficial to your sobriety to try to find new activities and new sober friends to add to your new life. These can help you down the right path. Of course, only start new things once you're starting to feel well enough and think you're up to it.

Tips

• Definitely take hot showers or hot salt and baking soda baths. Seems crazy but it helps draw out the toxins. Especially helps during sweats.
• Read as much information on this topic as you can!
• Keep a laptop handy so you can talk to people in online forums while you go through withdrawal. Talking to people who are going through what you're experiencing or to people who have made it through to the other side can give you the strength that you need to quit.
• Building the will power to stay away will come easier when you have support around you. People will gladly help you through the trying times if they really care about you.
• Buy snacks of all kinds. The comfort found in delicious junk foods is invaluable. Meals or healthy foods will probably be off the menu. Overwhelming the taste buds with chocolates and the like takes your mind off of the physical discomfort. Period. Worry about the calories later.
• If you have a hobby like playing an instrument, art, crafts or any other non strenuous activity to keep you busy and help pass the time get the needed supplies and set everything up before you feel sick.
• Make sure you tell your spouse exactly what's going on so they can help and not blame themselves.
• Read a good book.
• Use Subutex rather than Suboxone for your taper. Much better on your body.
• Get an HIV test if you used to inject narcotics. Thinking about having HIV can be terrifying, but the sooner you know, the better your chances of managing the disease long-term.
• Never mix Suboxone and Valium/Ativan. It can be deadly!
• If you can get a single suboxone (8mgs), taper your use down as far as you can. However much you are using cut it in half every three days. Do it over a couple of weeks. After you have taken your last opiate dose, wait between 12-48 hours before taking the sub. The longer you go in the detox without it the better off you will be. The first dose of suboxone should be only 4mgs. All of the pain you have been going through will stop within 30 minutes and you will not feel it for 24 hrs. The next day around the same time take 2 or 3 milligrams and the next day take what you have left. This is how you might be able to avoid any of the physical pain of getting clean.
• Getting checked for the Hepatitis virus is very important. Long term use of IV drugs will bring easier contraction of the Hepatitis virus. You also can spread it easier too. You can have Hepatitis viruses on top of other Hepatitis viruses which then will put even more strain on your health. Hepatitis is only diagnosed with blood tests. The side effects of this disease usually arent noticed until your liver starts showing signs of damage, which then the jaundice will be quite noticeable along with other problems the virus causes. Talk to your doctor or most health departments will give free testing, for HIV and Hepatitis, if you have ever used infected syringes from shared IV use or participating in risky activities, if you think there is a chance you have been exposed to the virus some way, and/or have participated in unprotected or solicited sex.
• Ask your Dr for some Lyrica or Gabapentin. They both will help take away withdrawal symptoms and aren't narcotics or benzodiazepines.
• AVOID SUBOXONE if at all possible. Very hard to get off of & just prolongs the inevitable withdrawal. After several painful detoxes I went that way & its 4+ yrs later, still with the chain around my ankle. I can't have more children now & can't travel anywhere with the one I've got because you can't get more than 2 weeks at a time. Only difference is $ goes in pharmas pocket as opposed to the dealers. And if you DO actually need pain relief like I do, or in the case of surgery etc, SOL.
• Honestly, just go through the pain. At least once it's over, you're free and stronger.
• Clonidine works well for withdrawals & restless legs.
• Passion flower herb and kava kava help with insomnia and anxiety.
• Milk thistle, dandelion root and grape seed extract with lots of water help with detoxing. *There's also herbs that can help with diarrhea, vomiting, appetite stimulation, mood, cravings, lethargy, low energy, etc. but I can't post em all here because you should always consult a licensed herbal practitioner before using herbs like this (coming from a professional in this field).

Warnings

• Don't give in and start using opiates during low points after you've gone through withdrawal. You'll just end up back in the same place you started.
• Avoid jumping on a methadone regimen unless you've used drugs for a long time. If you are on methadone, consider reducing your dose slowly to 30 mg. Then, switch to Subutex and slowly taper off of that.
• Do not mix! Mixing opiates with alcohol or benzodiazepines can be deadly.

Things You'll Need

• Analgesics (acetaminophen, ibuprofen, naproxen)
• Antihistamines that will make you drowsy
• Loperamide for diarrhea
• Clonidine
• Subutex/Suboxone
• Valium or Klonopin
• Tablet or DVD player with lighthearted movies
• Fan, comfortable blanket
• Multiple sets of sheets and clothing
• Good positive music

Related Articles

• Withdraw from Methadone
• Teach Your Child to Avoid Drugs
• Say No to Drugs and Alcohol
• Taper off from a Drug or Alcohol Addiction
• Cope With Vicodin Addiction

References

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