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Opiate addiction Support for coping with Opiate addiction and Opiate addiction treatment.

 
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  #1  
Old 29-04-2013, 02:38
stormbringer stormbringer is offline
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POST-DETOXIFICATION/PAWS lethargy, energyless SYNDROME A POSSIBLE SOLUTION??

[[/Hello friends, I have been following the travails of a lot of people trying to quit and having a bad few weeks/months after detox. The information I am presenting here is more like regurgitation than a well researched and documented solution. However, the main ingredients seem to be in place, any modifications/enhancements are welcome. I was just too exited to learn that there may be a way to relieve this post detox-syndrome that forces a lot of folks to give up or do something even more dangerous to relieve themselves of this very debilitating and depressing condition. Here goes:

Here’s some information I have gathered on the post-detoxification (or PAWS, as some call it) syndrome of lethargy, lack of energy, inability or lack of enthusiasm to socialize etc. that a lot of folks face, sometimes for months. For some who are determined to quit this is the most disappointing part of the process and as such, make them prone to relapse or try some other “place-holder” or method to survive this period. While surviving this period without doing something even more dangerous like turning alcoholic or benzo dependent requires commitment and determination, I am afraid I have seen even the bravest, boldest and the stubborn-set people give in during this perplexing period of plummeting hope and rising despair.

As much as I wish that there were some safe and shiny meds to help during this period, there’s none that at least I have found. (If there be any safe meds please do tell). Though, I have found what appears to be a relatively safe alternative which can be used for a short period of time to reintroduce one to their pre-use days in relative comfort and in a much shorter time. John, a friend who was a diamorphine/heroin addict of some years, discovered it by accident after he struggled for seven months of severe post de-tox distress.

There are some caveats to it, though. Roughly, they are as follows:

1. If you are diabetic/and or suffer from resultant neuropathy, you must ensure your kidneys are fully functional (no renal damage)
2. If suffering from Hypertension/High blood pressure, might want to monitor your blood pressure and adjust meds (with your doctors’ help) to normalize BP. (Specially for diabetics)
3. Take lots, I mean lots of fluids and NO DXM, NO ALCOHOL and/or other CNS depressants.
4. Some sort of a SRI/SNRI has probably been subscribed or maybe you could ask your doctor to subscribe depending on any precondition pertaining to you. This is THE real fulcrum of the solution to come out of this zombie state. I don’t know about MAOI’s so read up, ask your doctor. Also, some folks are naturally “high” on SRIs so see if you need extras Don’t think benzos interact with MAOI but I have never looked into that.
5. You must not be allergic to Caffeine or coffee or whatever you may want to use for a much higher than usual intake of caffeine. A nice, steadily beating heart is always a good thing for this. Failing that, make sure your ER is nearby (Joking).

I am sure most have either Clonazepam (klonopin) or Alprazolam (Xanax) or some other form of benzo left over from detox-days or may be able to acquire some anyway.
Long acting benzos like Diazepam (Valium) chlorodiazopoxide (Librium) works best as you need to take smaller quantities. If not Clonazepam is good too. Not sure about Lorazepam (Ativan??). Basically the idea is to NECESSARILY keep the benzo intake as less as possible for this to work.

John takes one 0.5mg Chlonazepam and about ten minutes later, the biggest shot of coffee he can survive. I believe he requested the owner of the nearby 7-11 to give him a couple of those black coffee shots that come in little tubs. However, caffeine tabs (like NO-DOZ) work too, about two tabs or two tubs should be the max. (Depending upon individual tolerance.) The amount mentioned is for medium level caffeine consumers. Basically, John new how much coffee/caffeine he had to take to feel “wired” or “the buzz”, don’t blow your heart out. He was most surprised by the results! He was “doing things” within a week and ten days later he had eased himself back into his professional and social circles and was “partying” most satisfactorily! Clean, this time. He had eased himself out of the benzo caffeine combo by the end of two week and only takes about 300mg of Effexor which his doctor has advised him to continue for two more months. He is currently on no other meds, dope, drink except water, and soft beverages.

He discovered this method accidentally when one day, feeling unbearably lethargic and fuzzy, unable to ‘latch’ on to a single subject/action, he talked to his doctor. He was taking 0.5mgX5 Clonazepam and 1mgX2 clonodine at the time. The doctor asked him to drop (taper off) Clonodine (Clonodine, as we know is extremely helpful during the de-tox/withdrawl period) but also an established body clogger and mind fogger and practically useless a week or so after the de-tox pains have subsided, especially for folks with normal BP. John did not find that stopping Clonodine made much of a difference and did not suspect that clonazepam may be a cause for the symptoms he was experiencing. Frustrated, with lethargy and lack of interest in anything, he decided to take a big shot of caffeine and it was one of those “eureka” moments in his life. At that time, he was being prescribed almost 2.5mg of clonazepam. By a process of ‘titration’ and eliminating excess clonazepam He cut his dosage to about 0.5mgX2 to take one tab before the coffee and one for later in case he felt the jitters/anxiety etc. He has the following observations to offer, though, which might be pertinent:

1. After years of abuse and subsequent detoxification, you are bound to feel fatigue and pain that the drug/opioid had been masking. Lots of drugs effect anabolism and even the endocrine system effecting efficient distribution of energy (or food) throughout the body. Case in point, diabetics on heroin has a much lowered ability to feel the effects of Hypoglycemia and in some cases there have been fatalities. That is because the pseudo energetics of narcotics masks the brains ability to correctly trigger the response to the hypoglycemic crisis (higher heart rate, activating adrenaline mechanism, anxiety etc.). This happens over months and years of usage. If not reciprocal, the body does need time to reverse these changes. Patience is a prerequisite and must be taken into account by anyone trying to successfully drop the habit. Plan it, there’s so much information in these forums.
2. One must consider the circadian rhythm. There will be at least eight to twelve hours of low energy states that you would face if you had not used drugs of any kind and were a teetotaler, anyway. Low energy states are common in normal life. The timing of these depends on whether you are a “lark” (day timer) or an “owl” (nocturnal). During WW-II Winston Churchill used to take a midday nap (around 12-1PM or so) even if London was being bombed. Some corporations provide “nap time” for their employees to enhance productivity. Generally speaking, the hours between 12:00hrs to 15:00 hrs are accepted “low productivity” hours as are a few other blocks of time in a 24 hour cycle. These cycles are also effected by the state of your mind and health and regularize with time.
3. John says that he started cutting down on clonazepam as soon as he discovered that it was not serving any therapeutic purpose. One time, he recollects, he took a particularly high dose of clonazepam but, besides feeling “comfortably numb” for a few hours he discovered that the “hangover” was one of the worst experiences of his life. To each his own trip, he says, but rigorously warns against the misuse of benzodiazepines. He started tapering before he developed tolerance.

He also adds that using Amphetamines and any other stimulant will not only not work but add a new dimension to whatever hell one is facing. Amphetamines (dex/Meth or Benzedrine) work fast to bring about dependence and destruction of those very brain stem cells essential for opioid dependence recovery.

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  #2  
Old 29-04-2013, 03:04
ld1980 ld1980 is offline
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Re: POST-DETOXIFICATION/PAWS lethargy, energyless SYNDROME A POSSIBLE SOLUTION??

Excellent advice. Unfortunately I was one of those that succumbed to Benzo addiction in attempt to quit opiates. Thankfully those come from the doctor though, and also help with anxiety I have dealt with my entire adult life.

Good point about Meth - at one point I took an adderall and it made withdrawal symptoms disappear. Then the comedown. I never wanted a pill so bad in my life!

Unfortunately coffee for some reason doesn't affect me. I can drink 5 cups and go straight to bed. So....on .5 mg of suboxone I will stay! I wish there were an easier way, but I got myself into this mess.
  #3  
Old 29-04-2013, 18:29
stormbringer stormbringer is offline
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Re: POST-DETOXIFICATION/PAWS lethargy, energyless SYNDROME A POSSIBLE SOLUTION??

Quote:
Originally Posted by ld1980 View Post
Excellent advice. Unfortunately I was one of those that succumbed to Benzo addiction in attempt to quit opiates. Thankfully those come from the doctor though, and also help with anxiety I have dealt with my entire adult life.

Good point about Meth - at one point I took an adderall and it made withdrawal symptoms disappear. Then the comedown. I never wanted a pill so bad in my life!

Unfortunately coffee for some reason doesn't affect me. I can drink 5 cups and go straight to bed. So....on .5 mg of suboxone I will stay! I wish there were an easier way, but I got myself into this mess.
"Comorbidity", I believe is the old term for it. Looks like your main issue is/was Anxiety. Only under very strange and unusual condition would a doctor subscribe benzos for more than a week or two. A psychiatrist can evaluate and subscribe it indefinitely. There are a number of non-habit forming drugs like Mirtazapine. a whole class of SRI/SNRIs available for treatment. Meds like Hydroxyzine. buspar (Buspirone) are not only very viable for short/long/very-very-long treatment of Anxiety Disorders (GAD-mild to severe). These drugs are as effective as benzodiazepines BUT are non habit forming (Like Tylenol for anxiety

I am sure you may have tried some of these, what was the result (if you can share) most people I know suffering from mild anxiety to panic disorder have greatly benefited from these.

Yes, some people get that way with coffee, as tolerance build rapidly to caffeine. Therefore the key to relief from post detox pain is either to drink 5 tsp of Instant coffee or wait through few"dry" days to bring down your tolerance.I remember "eating" coffee (chase it down with water and sugar) during my engineering school days.

My biggest concern is that more than half the people who end up recreational drug dependent do so for relief from anxiety and depression. Which, then turns into a self-sustaining problem. I also feel the best way to quit Opioids is to just stop. Three or four days of discomfort is worth it. Also folks on Methadone/suboxone may be tempted to OD as soon as possible and if they do get beck to their old drug of choice, sometimes Over dosing themselves.

My best wishes to you, I hope you make it thru your issues successfully
  #4  
Old 29-04-2013, 19:59
OnTheStrength OnTheStrength is offline
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Re: POST-DETOXIFICATION/PAWS lethargy, energyless SYNDROME A POSSIBLE SOLUTION??

Very interesting topic, seeing how it completely relates to me.

I also made the mistake of substituting something to make the w/d or paws go away. I was prescribed Gabapentin, and have been using it for a short time now. I can't tell at this point how much it will hinder me in my recovery because it really does help with all my symptoms including bad back and bad mood. But I am also aware of the dependency issues.

Patience is a big part of getting over the mountain that is sobriety. We all cannot expect to much to soon. I sure had that feeling and still do yet im not even 2 months clean. In addition to the Gabapentin, from the advice I was given from a knowledgable person with expirience with the medication, Magnesium-Calcium and L-Theanine supplements. It seems to be working for me so far.

I never had access to benzo's nor do I want it. Im pretty sure at this point in my recovery, if I had benzos id be abusing them. Im sure everyone can honestly relate to that. But sometimes, life gets really tough especially when detoxing. I was on methadone for 6 years and clean 5 weeks. The first two were unbearable. Even now, I admit I have abused the gabapentin because it lifts that vale of helplessness.
You just get so tired of feeling, looking and thinking like crap.

I think it would be wiser to give the body the nutrients it is lacking compared to more mind and body altering chemicles.
  #5  
Old 29-04-2013, 20:26
rosielee rosielee is offline
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Re: POST-DETOXIFICATION/PAWS lethargy, energyless SYNDROME A POSSIBLE SOLUTION??

we feel anxious and miserable because we have messed with our brain chemistry....so what do we do? mess with it some more....a little tweak here....a tweak there.....when i got down to four methadone tablets (20mls) a big depression hit me....and low self esteem and i was in darkness....i just dragged myself around until in a few weeks a few things happened.....a couple of good things and then it was enough to lift me. depression isnt a permanent thing it will pass....its a natural come down...a natural withdrawal.....what can comfort you is knowing in the back of your mind that you are on the mend and you have to go through this to get better.
  #6  
Old 29-04-2013, 21:27
ld1980 ld1980 is offline
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Re: Re: POST-DETOXIFICATION/PAWS lethargy, energyless SYNDROME A POSSIBLE SOLUTION??

Quote:
Originally Posted by stormbringer View Post
"Comorbidity", I believe is the old term for it. Looks like your main issue is/was Anxiety. Only under very strange and unusual condition would a doctor subscribe benzos for more than a week or two. A psychiatrist can evaluate and subscribe it indefinitely. There are a number of non-habit forming drugs like Mirtazapine. a whole class of SRI/SNRIs available for treatment. Meds like Hydroxyzine. buspar (Buspirone) are not only very viable for short/long/very-very-long treatment of Anxiety Disorders (GAD-mild to severe). These drugs are as effective as benzodiazepines BUT are non habit forming (Like Tylenol for anxiety

I am sure you may have tried some of these, what was the result (if you can share) most people I know suffering from mild anxiety to panic disorder have greatly benefited from these.

Yes, some people get that way with coffee, as tolerance build rapidly to caffeine. Therefore the key to relief from post detox pain is either to drink 5 tsp of Instant coffee or wait through few"dry" days to bring down your tolerance.I remember "eating" coffee (chase it down with water and sugar) during my engineering school days.

My biggest concern is that more than half the people who end up recreational drug dependent do so for relief from anxiety and depression. Which, then turns into a self-sustaining problem. I also feel the best way to quit Opioids is to just stop. Three or four days of discomfort is worth it. Also folks on Methadone/suboxone may be tempted to OD as soon as possible and if they do get beck to their old drug of choice, sometimes Over dosing themselves.

My best wishes to you, I hope you make it thru your issues successfully
Yes sir/ma'am, you hit the nail right on the head. Anxiety has always been my problem and that's the reason why I probably started taking opiates to begin with. No excuses though. I'm not sure where you live but in my area they prescribe benzos like candy. It's actually quite a shame. If I would have known what I was getting myself into I would have never picked up the Rx. But too late now.

I have actually been taking different types of SSRI my entire adult life however they really didn't start working until I begin taking the benzos. Right now I am taking celexa and klonopin. It definitely works very well for controlling my anxiety but when I run out early that's a different story.

I wish I would've been smart enough when I started taking Suboxone to only take it for a few weeks. But again hindsight is always 20/20. Sometimes I feel like the doctors that prescribe medicines are simply out to make a buck and really don't care about the patients. It's a sad state our medical world is in, at least around here in SE US.

Thanks for the well wishes and same to you. One thing I have noticed but I never actually believed in before is faith does help. I'm not sure if you believe in God or not but he truly does help things. God bless you, and if you have any questions please let me know. Take care.
  #7  
Old 04-05-2013, 20:11
yellowmellow yellowmellow is offline
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Re: POST-DETOXIFICATION/PAWS lethargy, energyless SYNDROME A POSSIBLE SOLUTION??

Quote:
Originally Posted by ld1980 View Post
I wish I would've been smart enough when I started taking Suboxone to only take it for a few weeks. But again hindsight is always 20/20. Sometimes I feel like the doctors that prescribe medicines are simply out to make a buck and really don't care about the patients. It's a sad state our medical world is in, at least around here in SE US.

Thanks for the well wishes and same to you. One thing I have noticed but I never actually believed in before is faith does help. I'm not sure if you believe in God or not but he truly does help things. God bless you, and if you have any questions please let me know. Take care.
I'm from Florida and I totally agree with your statement about doctors and faith.

I've been battling addiction from opioids for 4 years. I never got into more than 60 mg of roxicodone probably because they are expensive, even more expensive now than when I first got into them. After 2 years my family forced me to go to rehab so I chose an outpatient detox program that put me on suboxone. I chose this program because at the time I truly didnt want to clean up so if I had to "get clean" I'd rather be high on suboxone. The doctor had me on a taper system for 12 weeks. I still suffered from depression and needed counseling, they kept mentioning how great the doctor was with treating bipolar 2 disorder, which I later learned that 80% of opiate addicts have. However they never scheduled me an appointment to get help with my depression, they in turn just kept prescribing me 15X8mg suboxone a week. By the time I graduated (they only pissed tested me twice, both were in the first week of the program, not even tested on graduation) I had 3 prescriptions of suboxone that I continued to use post graduation. It was clearly obvious that they didnt care about my sobriety, they only cared about money. Suboxone is legal and doesn't have a bad reputation therefore lets get the addicts off the streets and using their drug money towards another drug that is a pain in the ass to withdraw from.

After that I relapsed and hit several rock bottoms. I cleaned up 6 months afterwards and spent 6 months depressed, then relapsed again once I started to feel alive again. Every time I cleaned up I fantasized my next high, how incredibly high I would get for being clean for X amount of days/months.

I tried everything and after years of spending more time withdrawing than feeling "good" 9 months ago I decided to try God. I prayed and prayed and read the bible, watched sermons and didnt understand why I was still using. My good friend chose God and immediately he became sober snd happy. I didn't get the same results. But they say God's timing is perfect.

I had a lot of issues that needed attention and tweaking. Over the months I faced hardships and everytime I felt bad I had to program myself to give my burdens to God. I was independent for so long and so lonely. It seemed wrong for me to give all my worries and burdens to God, but I had to become humble and realize that that aas what God wanted from me so that he could change me. Slowly I became comfortable with being alone. I was a hermit those months, always getting ragged on for being a ghost. But I trusted God. Slowly as I learned about myself and my needs I started to see change.

Now, I have been off of suboxone for 4 weeks now and reverted back to roxicodone but this time I controlled myself, something I have never been able to do. I right now have been taking as little as possi le. Never have I ever been satisfied to be on 7.5 mg of roxicodone let alone feel it. But it feels the same as taking a whole 30mg. I learned to not feel ashamed and turn my back on God when I slipped. I reverted to roxies after suboxone because suboxone withdrawal is a weakened roxicodone withdrawal drawn out for months. I must add that I wss taking .5mg or less of suboxone for a couple months before kicking it. Withdrawals still sucked but what I've learned is that 80% of withdrawals are as bad as your mind makes them out to be.

Going through 100s of withdrawals your mind is always prepared for the worst. I understand that my relationship with God is a bit taboo, however I'm still HAPPY even if I'm without. Last week I went 5 days totally clean and only suffered from lethargy hence why I got a couple more roxies to use as a taper process. I work as a server in a busy restaurant so I needed energy to make money. Every time I felt bad I prayed to God to help me get through my ordeal. I now have a newfound confidence in myself that I once had before I became an addict. Slowly God has been changing me to revert back to the girl I once was but in a better place, wise and grown. I no longer fear what ifs and how I will learn to live again because even though I haven't been clean these past months that I chose to follow God, God has changed me mentally, emotionally ans spiritually so that when my time comes to stay sober I will already be living the life I always dreamt to have when I was an adddict and even before the days of addiction hell.

God bless you and stay positive. Its all about your mentality. Thank you for this post.

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clonazepam, diamorphine, fentanyl, hydrocodone, hydromorphone, lack of libido, lack of sleep, oxycodone, post acute withdrawal syndrome, post-addiction life, post-addiction recovery, recovery advice

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