Help for Post Acute Withdrawal Syndrome (PAWS) after Opiate Withdrawal

[Richard_smoker]

Many people addicted to oxys, hydro, heroin, fentayl, or other opiates are concerned about what to expect AFTER the initial WITHDRAWAL period (~3-10 days, depends on the drug).

The reality of Recovering from Opiate addiction is that there is an initial "HELL" period (immediate withdrawal) that is followed by a much longer, much milder period of time while the body is fine-tuning the nervous system, and while the body's own endogenous opiate system (endorphin) is recuperating.

There are 2 basic stages of opiate withdrawal.

1. The Short-lived, Acute, intense, immediate withdrawal which occurs directly after stopping all opiates. "clucking", shakes, profuse sweating, chills, gooseflesh, body temperature instability, autonomic instability, "revved-up," diarrhea, cramping, bone pain, mental anguish, etc. (takes ~3 to 10 days depending on the half-life of the drug)
   
2. PAWS or "Post Acute Withdrawal Syndrome." This is the more drawn-out phase of withdrawal...as the body learns to cope without the drugs. includes boredom, insomnia, self-doubt, 'restless legs,' depression.
   

I believe from my own experience, combined with reports from recovering opiate addicts and the physiology involved that the initial withdrawal is the big, feared MONSTER associated with feelings of sickness and delirium, whereas PAWS can be extremely different for different people. PAWS seems to be more akin to a "waiting game" with fears of overwhelming boredom than an acute sickness. The most important thing to remember during PAWS is AWARENESS that PAWS IS ONLY TEMPORARY!

With time, PAWS will go away!! In fact, with few exceptions, it seems that with every passing week, PAWS symptoms can be demonstrated as improving--sometimes DRAMATICALLY compared to the weeks prior.

Some Reasons why PAWS takes several months to get over:

1. Behavioral changes are necessary in order to learn new and solid pathways for the brain's reward circuit, and
2. It takes MUCH LONGER for your effective neurotransmitter levels and nerve conduction parameters to return to normal, pre-addiction levels.
   

And depending on your expectations and how you approach these critical 're-building' and 're-organizing' phases, will go far in how well you'll feel during and after withdrawal.


What can be done to HELP your nerve conduction while re-equilibrating to life without opiates? (or--"How to Maximize Your Neuronal Signaling During Post Acute Withdrawal Syndrome.")

• Boost the deficient neurotransmitters.
• Maximize electrical conduction ALONG the nerve.

1. BOOSTING THE DEFICIENT NEUROTRANSMITTERS.
First, let's talk about boosting the neurotransmitters. For the opiate addict, this means SPECIFICALLY "ENDORPHIN"---short for "Endogenously Produced Morphine" aka "Endomorphine" aka "ENDORPHIN."

There are some things you should know about endorphins. They are the body's natural opiate. Endorphin is released naturally in response to pain, orgasm, exercise, laughter, positive thoughts, secondary messengers responsible for fevers & immune responses, and there are other potential triggers including prayer.

These tips may not seem like earth-shattering phenomena by themselves, but believe me, when these steps are clustered and performed regularly, THEY REALLY DO HELP!!!

Common activities known to boost endorphin levels/satisfy cravings:

• Chocolate. Chocolate has a mild effect on endorphins.
  
• Candy. Actually any kind of sugary candy boosts natural endorphin levels. Candy helps most with early stages of withdrawal. Lab mice experiments have shown sugary sweets appease craving after abruptly cessation of morphine. Swim practically LIVED on Reese's Pieces, sour candies, M&M's, and those 'tiny' Hershey Kisses for 8 TO 10 WEEKS! Note: he did not gain or lose weight during this time.
• Exercise. This is #1. Force yourself to walk out the front door. FORCE YOURSELF to walk 2-3 blocks from your front door…then you turn around and get 2-3 additional blocks in for good measure. I CANNOT STRESS THIS ENOUGH!!! The best exercise is running/jogging/spinning/anything aerobic. Second best is walking or yoga. Somewhere in-between the two is weight lifting. Weight lifting or resistance-training can be done in a fraction of the time and there is evidence to show that this kind of exercise might benefit the MOST at the late stages of withdrawal (i.e. insomnia from 'restless legs').
  

some medical professionals believe the positive feeling you get when you meet a physical challenge, rather than the exertion itself, is what stimulates the endorphin release....(how much endorphin-release you get) is all about intensity and duration.

*

• Accomplishment. That's right. Any kind of accomplishments. Small ones, big ones. Just be sure you're PLANNING and EXECUTING daily. Anything that fosters a feeling of self-accomplishment and PRIDE will cause your brain to squirt out some Endogenous Morphine.
• Sex. Orgasms release endorphins. You've probably already figured this one out… OR--more likely, you've noticed that your sex drive has gone down to almost NOTHING while on opiates. This is normal. I can explain the hormones of it later if you're interested. The point is, you've replaced the endorphin-rush of sex with one that requires no build-up, no mess, and no chance of rejection. Do not feel embarrassed if you become a masturbation machine. This is also a normal part of recovery. Eventually, the sex act itself will be overshadowed by the LOVE aspect.
• Love. Love is a complicated emotion. It's the fuel for poets, playwrights since recorded history and the need for it traces all the way back to the first man and woman. HOWEVER!! SEXUAL LOVE IS *NOT* WHAT I'M TALKING ABOUT HERE!!!! Ultimately, your most long-lasting, gratifying experiences outside of drugs will come from the experience of giving AND RECEIVING love. Get creative with this. Love your enemies. Remember people's names. Start remembering birthdays. Surprise someone with your generosity. Next time you mow the lawn, cut your neighbor's grass…and take his trash out to the street. Donate time to feeding the homeless. There's literally TENS OF THOUSANDS of small things you can do to put forth love out into the world. *THIS* is the true secret to learning how to live without opiates! And believe it or not, the rewards are MUCH GREATER than even the best heroin you'll ever do!!! But you've got to get up and DO SOMETHING!
• Sleep. Eventually---like in 4-6 months from now--your body's autonomic nervous system will stop being 'revved-up' all the time. Eventually, you will be able to sleep again without having to knock yourself in the head with a sledgehammer! When this day comes, BE PREPARED! Start going to bed as early as possible, to allow yourself a good 7 or 8 hours of restful sleep. Your endorphin levels will naturally increase from the circadian rhythm, plus you'll allow yourself the luxury of copious dreaming--not only endorphin-releasing, but overall will make your days more relaxing and give your psyche plenty of time to play.
• Eat a hot Chili Pepper. *

  The rush you get after holding one on your tongue is likely due to your body's protective response. "Chewing a hot pepper can release endorphins centrally and on the tongue," says Dr. Hirsch. Why? To reduce pain, of course.

• Think Positive Thoughts.* Placebos, prayer and positive thinking all trigger endorphin release according to Dr. Slotnick.
• Get Emotionally Moved *
  

  Dr. Fuhrman says that viewing beautiful art, watching a touching dramatic scene or even listening to an inspiring piece of music can produce endorphins. "A person who gets pleasure in life, from whatever source, will keep endorphins at a healthy level," he says.

• Undergo Acupuncture.*

  "Putting needles into the body is a release," says Dr. Fuhrman, "and it may trigger endorphin production." Also, acupuncture patients benefit from a placebo effect -- they believe that the process is working, so it really does, says Dr. Fuhrman. Talk about the brain's power.
  Endorphin factor: 3 (NOTE: HIGHEST LEVEL). People who use acupuncture tend to be positive thinkers, which adds to the effects.

• Be Afraid.*

  Whether you're watching a horror movie... or feeling a rush of wind in your hair as you plummet down a steep incline on a roller coaster, fear causes endorphin release. Why do you think extreme sports are so popular? No one wants to get hurt; it's just fun (in a twisted kind of way) to cheat death. "The thrill of a high-speed ride induces a positive mood state that can leave you giddy," says Dr. Hirsch. And Freddy Krueger can do it for you too. Who knew he was such a heartthrob?

• Watch a Funny Movie or TV Show. More specifically, research has proven that simply the expectation of watching one's favorite funny movie releases Beta-endorphin and human growth hormone.** Go ahead and buy the Seinfeld Box DVD.
  

2. MAXIMIZING NERVE CONDUCTION. or How to Increase Electrical Conductivity WITHIN Neurons.

The portion of your body that is re-learning its own equilibrium WITHOUT OPIATES is essentially an aquatic salt-water ecosystem that runs almost entirely off electrolytes (+ and - particles called "ions" dissolved in solution) and VERY THIN membranes. These membranes are "semi-permeable" which means that with some assistance from various proteins, these membranes allow your body to separate and partition off positively-charged & negatively-charged ions. This creates VOLTAGE--the difference in charges across a membrane or "potential energy."

You can imagine the separated + and - ions as being like a battery. As long as the membranes are intact and your body is able to separate positives from negatives, then your batteries are "charged." But, if you punch a hole in one of the membranes or stop actively separating out positives from negatives, you end up with a lifeless or DEAD battery. ions from

Anytime you 'fire' off a neuron, an "ON" signal is propagated from somewhere deep inside the brain, along a LOOOONG axon, that ends by terminating into either another neuron (inside the brain) or somewhere else outside the brain (like a muscle or a salivary gland, for example).

If you were to tell yourself, "I am now Lifting my right fore-finger," then a neuron in your brain's motor cortex will first "fire" using a neurotransmitter. But the signal actually travels all the way down on a single neuron from the brain to your right arm. All the way down a discrete "wire" found in a bundle of other wires (your spinal cord) until the single nerve cell finally ends on muscles in your forearm where ANOTHER neurotransmitter is released, cause you to LIFT YOUR RIGHT FOREFINGER.

Why the description? well, the FIRST step involved in this example involves a neurotransmitter. In this case, the neurotransmitter is called acetyl-choline... but there are plenty of other neurotransmitters whose functions are to transmit various ideas, emotions, reactions, reflexes, memories, etc.

The SPECIFIC neurotransmitter you're missing is ENDORPHIN. Earlier in this post, I listed suggestions to help you SHOWER your brain with endorphin--and these will make you feel much better. If you can assimilate some or all of these activities into your daily routine, then you'll not only be back to normal very soon, BUT (swear to GOD) you'll actually FEEL MUCH BETTER THAN YOU DID ON OPIATES!!!

The reason I went thru the whole explanation of the + and - ions, the function of cell membranes to partition off these charged particles, and how that nerves & thus your entire brain FUNCTIONS by using a continuous flow of ions in and out of various partitions is because I want you to really REALLY UNDERSTAND something about how our bodies work.

You see, all this fine detail about nerve transmission can ONLY take place under ONE condition. And this is one of the most convincing arguments for evolution that I've ever heard… The ONLY PERFECT ENVIRONMENT for the proper flow of electricity and nerve conduction is found---IN THE OCEAN!

Fortunately, our body's have a "waxy coat" of skin that traps the ocean INSIDE US!

So, whenever you hear someone say "SALT IS BAD FOR YOU", you can tell them they would be DEAD if it weren't for the salt they eat!

Without getting too involved in this, just know that your body has exquisite mechanisms for hanging onto precious minerals and filtering out 'excess' ions. This is mostly done by the kidneys. HOWEVER, your body has NO WAY of either DILUTING or CREATING electrolytes. (i.e. sodium, potassium, calcium, magnesium, & trace minerals)


So, HOW CAN YOU ASSIST YOUR BODY IN ACHIEVING THIS OPTIMUM AQUEOUS ENVIRONMENT???

Simple. Drink plenty of water. Plain water. Not colas, not coffee, not beer. Your body will utilize pure water to form the MOST PERFECT, EXACT ion levels in the various partitioned areas. Unlike what many people believe, drinking extra water does NOT go straight into your piss!! Rather, the water goes from your GI tract, into your bloodstream where it is then dispersed EVENLY throughout every single cell in your body!

That's right…when you drink a glass of pure water, that water becomes almost instantly available to EACH AND EVERY CELL IN YOUR BODY, in order beginning with those cells which NEED WATER THE MOST! So, those cells which urgently need this pure water will get 'first dibs', and so on until the water has been evenly dispersed.

What do the cells DO WITH this pure water??

• Rejuvenate Cell Processes/Restore Cellular Health. First off, the new water allows overly-concentrated, sluggish, toxic (dehydrated) cells to return to their original healthy size, shape, & texture. You may recall from biology that a single water (H2O) molecule is generated in cellular energy generation (called respiration). Glucose and Oxygen are transformed into energy, releasing CO2, and H2O. Well, if your teachers were like mine, they neglected to teach how important pre-EXISTING H2O was for this energy to be produced in the first place! Without a surplus of pure H2O, NONE of this energy can be produced!!
• Eliminate Toxins. This pure water is necessary for your muscles (and other cells) to mobilize their toxic byproducts for excretion in to the urine. Plus, the additional water will optimize sub-cellular activities that have become erratic or sub-optimal from dehydration, built-up waste materials, and are living in an overall unbalanced, unhealthy state. These molecular-level processes will be cleansed by way of excessive hydration, dilution of toxins, and toxic elimination when these toxins are absorbed along with excess water into the bloodstream and almost immediately filtered into the urine. This 'flooding' leads to a "clean slate" on a sub-cellular level, which then allows the cell's energy production to normalize, which translates into higher energy, more energy efficiency on the tissue & organ level which affects the energy and health that we "FEEL" as organisms!!
• Enhance Normal Nerve Conduction Velocity. Remember all that talk about positive and negative ions being separated by membranes to form a 'biological battery'?? Well, one of the most vitally important pieces of the nerve-conduction puzzle is adequate hydration! Adequate hydration allows nerves to conduct their signals FASTER and also allows each nerve to 'reset itself' FASTER as well! So, in essence, adding pure water into your body will make your brain and muscles faster and more efficient--as though your neurotransmitter levels were actually HIGHER--when in reality, you haven't done anything to change your neurotransmitter levels!

When your urine has any yellow coloration or smells, this signifies waste products and toxins that your body must ELIMINATE in order to create this perfect aqueous environment for your nerve cells, muscles, and every tissue.

HOW MUCH WATER SHOULD YOU DRINK? honestly, everyone is different. People going through drug withdrawal require more water than someone whose tissues are already in equilibrium. Your need for 'extra' water during times of stress or drug detoxification will be obvious by the color and smell of your urine.

RULE OF THUMB REGARDING PURE WATER CONSUMPTION: Your urine should be clear and have no smell. This signifies optimal hydration.

Vitamins and Minerals. For fastest re-equalization, you should take ONE daily vitamin with minerals. These days, most every daily vitamin includes minerals as well as folate (aka folic acid). Don't waste your money on expensive vitamins or supplements. All you need are the basic RDA. The *REAL* secret to maximizing the absorption of vitamins is to simply take them WITH FOOD. Taking excess or "mega-dose" vitamins is just a waste of vitamins. 250mg to 500mg of Vitamin C per day is also encouraged, especially in the first few months of withdrawal.

The basic message is to take care of the things that you probably never even THOUGHT ABOUT while on the junk. Things like making sure to take vitamins, eat balanced meals to provide sustenance, exercising and drinking PLENTY OF WATER!

There are other threads which discuss supplements which can be taken to boost other neurotransmitters like norepinephrine, dopamine, and serotonin. Feel free to ask me if you have any questions...this is just WAY TOO HUGE of a topic to answer in a single post! good luck future smack quitters, and to all the Ex-Junkies--PEACE!

-DICK

* Endorphins 101: Your Guide to Natural Euphoria, Slotnick, MD David & Walke, Melissa. YourTotalHealth.ivillage.com

**Just Expectation Of A Mirthful Laughter Experience Boosts Endorphins. American Physiological Society session at Experimental Biology 2006, Lee S. Berk of Loma Linda University, 07 Apr 2006

Reputation Comments on this post:

	great useful information
	Nice post dick, hope for all of us
	thanks for sharing
	Good PAWS info i am gonna need.
	Very helpful and informative
	Incredible post! Would love to know this much detail about benzodiazepine withdrawal.
	thanks again for posting this
	His attention to detail requires being honest.
	This is amazing, great job
	This is such greAt info. TY.
	thank you so much. i thought PAWS was going to last forever. very helpful post
	great post! a section about ADs would be nice as well.. and just "more". maybe also supplements (fatty acids, ...
	Excellent pot. Tons of usefull info for the recovering addict!
	very helpful information for SWIM, currently experienceing PAWS
	thanks so much, swim really needs this right now
	Very important for so many to see this...thanks!
	what a wonderful topic and a good source of support for people who fear the worst.

[rokman nash]

Great thread Dick KUDOS To anyone new to this site I can tell you this gentelman has provided me with more good info and answered any and all questions I had. He's also one of the main reasons i'm about to begin day 16 clean.


ROC
do the day or the day will do you

[Richard_smoker]

hey man, i'm glad to hear that anything i've said has benefited you in any way...but none of that changes the fact that YOU DID IT! and YOU'RE DOING IT NOW!!!!

oh--and while you're dishing out complements, it wasn't really *ME* who found you Rockman, i got a message from jon-q that i opened early one morning telling me that he 'found somebody' who sounded like they needed some encouragement.

that's what i love so much about this place... it's just SO DIFFERENT than a traditional 'rehab' community. hell, i don't even know if you could FIND this site if you searched for "opiate addiction online rehab group." no, this is the kind of site that you have to find while delving on the 'other side.'

--and the people here are much much smarter than your average "AOL Community." -DICK

[rokman nash]

Well you have my utmost respect so suck it up bro. To be honest i found this site several months ago while researching for dave how to abuse fentanyl without killing yourself. When dave decided it was time he remembered the site. Without which I truly dont believe Dave would be where he is now. I had NO idea there was a resource like this available for us hardheads who have to do things on thier own terms.
so thanks dick and jon q



ROC do the day or the day will do you

[Richard_smoker]

lol, there's so much truth in that ^^^!!

I have no idea WHAT to say in reply, only that I believe my pet was first introduced to this very same site after searching for either a way to get the goods out of a fentanyl patch or something else VERY SIMILAR!

never thought about it in terms of being hard-headed, but i am definitely thick! but yeah, i guess it's true--not being one of those people who could 'fall for' someone else's ideas... whatever those ideas might be--scientology, rehab, NA/AA, whatever.

too funny!

[rokman nash]

I am a firm believer in cleaning up my own messes. Its nice to recieve support without the sanctimonius bullshit.Just knew i had to do this my way.

ROC
do the or the day will do you

[Richard_smoker]

The following quotes are extracted from a Scientific Literature Review of Endogenous Opioids, published in the scientific journal Peptides (2004), reported by Lorrie Klosterman in Endorphins: The Gift You Give Yourself. Chronogram. Nov 2005.

Mark Wilson...president of the Hudson Valley Triathlon Club and a triathlon coach. "It doesn't take much to enjoy the benefits of endorphins via exercise," he says. "Literally 10 to 20 minutes of activity can release the natural drugs into your system, which creates a sense of well-being and joy that cannot be felt by sedentary folks. Brief, quick efforts up stairways or down the block can trigger the release of endorphins and possibly keep you from buying that cup of joe on the way to work, not to mention the doughnut! Bottom line, keep moving your body; it likes that!"

Still, some of the best things in life are endorphin-friendly and generate many health and social benefits....Plus, as a drug of choice, endorphins are very safe, and you'll never run out.

The most well-known scientific association is that Endorphins are released when there is a perceived physical injury--notably PAIN.

But endorphins are released within the brain by more than overt injury. Vigorous exercise, childbirth, bodywork, and acupuncture also tweak brain endorphins. For some, like childbirth, the physical stress is obvious. But even something as simple as eating hot chili peppers has been shown (in rats, by direct application of a chemical extracted from peppers to nerve cells) to trigger brain endorphins, and is assumed to do the same for chili-pepper lovers who crave the afterglow.

The word endorphin is short for "endogenous morphine," referring to self-made chemicals (endogenous) that have morphine-like effects....In 1973, Candace Pert and Sol Snyder published findings that morphine avidly attaches to specific proteins (receptors) on brain cells, thereby influencing the brain's activity, especially in regions allied with mood and pain. Those proteins were dubbed opioid receptors because they bind opiates...Researchers then reasoned that opiate receptors ought to have naturally occurring neurochemicals that attached to them and induced morphine-like responses. The hunt began, and eventually enkephalins, endorphins, beta-lipoprotein, and other endogenous opioids were detected in brain tissue—in extremely minute amounts, but exquisitely powerful. Beta-endorphin is one of the best studied in the endogenous opioid family. It is a peptide, meaning a short chain of amino acids (30 of them), which is especially prevalent in the brain but also shows up in the nervous system outside the body and in immune cells.


Other similar but shorter molecules, like enkephalins and endomorphins, are potent neurotransmitters as well, and their diverse actions are being elucidated. Together, the endogenous opioid family of today includes dozens of chemicals that modulate mood, block perception of pain, influence hunger, regulate reproduction, and perform many other functions.

"It feels so peaceful," says Dorothy Hamburg, an exercise physiologist and certified exercise trainer who owns Personal Strength and Training in Rhinebeck. "The runner's high, being in the zone, is real. I've been in races where I find myself struggling, then all of a sudden it just becomes easy, fun. Instead of 'oh, no, I've got to run another hour,' it becomes effortless. There is no struggle."

Hamburg, who has enjoyed endurance athletics and marathons for years, explains that endorphins are released when exercise level is moderate to high," at the point when you are going from aerobic to anaerobic exercise." A clue as to when that's happening is "when you wouldn't be able to have a comfortable conversation while exercising." Short bursts of activity like weight-lifting or sprinting, don't trigger endorphins enough to be measured in the bloodstream, but might boost brain levels, and they help condition the body for more exertional activities.

Also, studies do show that an hour or more of even modest exercise can elevate endorphins. Most of Hamburg's personal training clients are women wanting to get exercise back into their lives as their bodies change in middle life. The endorphins are not a goal, but a perk, and the exercise can be just plain enjoyable for many reasons. "The most important thing is to find what you like doing. If you don't like it, you won't do it." It could include a combination of things, like gardening, walking, and yoga, for a total of half an hour a day. "Start with gentle effort. Learn the movement patterns, see how you feel, then increase in duration, intensity, and frequency."

Chiropractic adjustment releases endorphins through its impact on the nervous system

From my memory, I want to say that this has statement has actually been proven on animal and human models--on animals for sure--that the 'popping' of the vertebral joints actually induces small regional bursts of endorphin--hence the immediate pain-relief and sometimes-referred to as mildly-'addictive' nature of chiropractic adjustments.

Bruce Pomeranz, PhD, at the University of Toronto, was the first to propose that acupuncture, commonly undertaken to relieve pain, does so through endorphins. After attending a 1975 conference at which the discovery of endorphins was announced, he theorized that acupuncture needles inserted at key locations in the body (which correspond to points on the meridian) stimulate nerves that trigger endorphin release within the brain (d'ai chi, meaning twisting the needles, is key to the effect, he says). There, the endorphins block the brain from registering the sensation of pain.
He then spent 20 years collecting data to disprove that (as proper science is meant to proceed). But diverse studies of his and other researchers indeed support this "westernized" medical explanation of why acupuncture is analgesic (versus that of traditional Chinese medicine, which explains it in terms of chi energy flowing through meridians). Bottom line: Acupuncture works and endorphins help make it happen.

Richard_smoker added 223 Minutes and 38 Seconds later...

Originally Posted by rokman nash

Its nice to recieve support without the sanctimonius bullshit.

Man, that's awesome. I thought i had a way with words.

Thanks ROC, this statement has given me permagrin that will no doubt last into next week!

beautiful! Keep yer head up ROC--DICK

Reputation Comments on this post:

Great quotes from this literature

[AvidFan]

Great thread - even Patient X learned a thing or two, and he is pretty knowledgeable

He just wishes he didn't have a chest infection so he could take a run, in fact as ill as he feels with this damn flu, he wants to get out there and experience that pure runners' high.

But he just went for a walk today, managed a few achievable things (like paying a bill, getting in some fresh bread), then came back and ate some chocolate.

He is not feeling as talkative today, it's day 10 (he's needing to use his diary to make sure which day he's on now - a good sign!)

Time will tell. Each day is a mixture of fear and hope, sadness and joy just now.

[teddybearpicnics]

This is such an great post, Swim hopes that everyone reading this doesn't just read it, but tried to use it as a guideline. Swim thinks it would be nearly impossible to follow EVERY bullet fired, but that it would be foolish not to take this advice to heart, and do it. That's what it all comes down to. Swim has realized in the past few weeks that there is no half-assed way to get clean. Swim has been trying hard to stay off the smack, And in almost a month exactly, he has used 5 times, and most of those days were a 3 day stint where swim was very upset and used drugs to cope. But to stay on topic...

Swim thinks the most important aspect of this thread is keeping yourself happy, and finding ways to please that reward center. If a swimmer is always just down and thinking about how bad he wants to use, it seems that that user is destined to use, because if you want to be getting high, you don't really want to get clean. Anyway, This thread should be stickied. Way to go bro!
.teddy

[twoofus2]

this is great info... thank you so much for posting this... You always post wonderful stuff...I hope you are well and I wish you thbest. Good, good stuff. Two thumbs up!

[rhudson]

Great post, it is very nice to see someone empathetic who clearly wants to help others through difficult times. Your advice about exercise is spot on and the supplements you mention at the end (5-HTP, etc.) really do help. The only thing I might say is that antidepressants (even St. John's Wort) and mild stimulants (Adrafinil and Modafinil are easily acquired) do work too, but obviously one wants to be careful not to substitute one addiction for another.

Keep posting; many users suffer needlessly out of ignorance because there isn't much effort made on the part of the "establishment" to actually provide practical advise about opioid addiction.

[testingthewaters]

Really stellar article. I may be new to this forum but I've been working on my dope addiction for a while now.

I managed to get into sub maintenence, which has really helped me not do dope. But as I continually push forward (I will very soon be on 2mg bupe (from 16-20), which is a heartbeat away from abstinence for me), I find myself using the tactics from this post to get beyond the bupe. I didn't even realize it until I read this thread, but for the first couple weeks or months after I started dropping my bupe dose, I was craving sugary foods and carbs. I always felt like it was a response to wanting dope, but little did I know it could be a physical response to wanting dope!

Now my exercise level is up, I have been eating much better, trying to stay positive, and ready to kick the sub out of my life. So cool. Thank you.

[bodymore]

Perfect post for me... I'm on day 4 but SWIM has only been on the dope for a month or so. It's usually the stuff called scramble that they sell in Baltimore. SWIM figured it to be fairly easy to kick... wrong!

I've already noticed that when I go to work and get into something it helps and that when I do things to keep busy and occupy my time it helps but SWIM doesn't really want that! SWIM wants dope, tried yesterday and got ripped off... don't want to, but have to take that as a sign.

Plus, there IS the doctor appointment thursday. I have to get treatment for hepatitis C so it's too late to take 'the ride' now. It is funny that pain is what brought this on and why I need to treat the hep C. I hate feeling helpless and being in pain.

Sorry to keep overusing the acro and just moan on about nothing but again, occupy time... not taking 'the ride'. So here I go drinking water, eating sugar and trying to ramp up to some walking.

Thanks guys, right on post!

[Chica35]

Well this is Swims second week of being off buprenorphine and what swims read about PAWS is sooooo true!!
Swims still having trouble sleeping (even with sleep meds) but that is also physcological ...i think....but the legs....damn .....swim is getting really tired of those restless legs.....espescially when she has to walk 70 flights of stairs to walk her dog ....(about 3-4 times a day)
Swims legs feel like Jello.....is that normal??
Swim also quit a Pot-smoking addiction (here the weed is MUCh stronger) and maybe that feels a little uncomfertable as well.....
Swim smoked for more than 15 years.,..;
Well thanx for reading this.....

[Dr. Amapola]

to swi-Richard_Smoker,

Thank You for posting this wonderful thread! From both a biological (SWIM is a life-long science lover) and from an ex heroin addict's perspective, your thread was extremely interesting and helpful. It gives SWIM some hope, inspiration and motivation to do things the right way.

SWIM totally agrees with excercise as the #1 remedy for opiate withdrawal. Even though sometimes it's so difficult to do something as simple as climbing the stairs, one has to push oneself to MOVE!

SWIM wanted to share some details of his current situation with you...

SWIM has been on a methadone maintenance for almost 3 years now, and was maintained at 160mg for the majority of that time. Over the past six months SWIM's come down to 75mg, decreasing 5mg every other week. The first two months of decreasing weren't bad at all, but now SWIM is really starting to feel the methadone leaving his body, and at times it's very painful. Also because the dose is wearing off earlier and earlier each day, when swim gets his dose in the morning he gets a real buzz from it. It sucks because he's obviously trying to curb his affinity for that feeling and it doesn't help when one is "high" every morning. So swim is now in an unfortunate cycle of being loaded and being sick.

Before methadone, swim tried just about everything to get off of heroin. Three trips to rehab, two different runs on suboxone perscribed by a doctor, and a handful of DIY-style remedies, none of which had any significant effect on SWIM's habit or urges to use. Finally SWIM got on a methadone clinic, and even though it's shunned by a lot of folks, for people like SWIM who just can't kick heroin, methadone really worked to stop cravings and allowed SWIM to lead a semi-normal lifestyle.

SWIM has tried tons of hollistic and old-fashioned remedies. SWIM tried drinking Kratom tea, not only did not work but left SWIM with a speedy cocaine feeling and an upset stomach. Kava tea worked a little better, mainly just for sleeping, but again was nasty on the digestive tract. Also lavender tea worked to help sleep. All these things had a very minimal effect on the overall feeling, and much of it is psychological, as swi-you said, if one thinks it will work, then it will often make one feel better.

Finally, SWIM would just like to ask if swi-you or anyone else out there has any suggestions for a methadone-specific detoxing patient here.

[Mister Ray]

hey Dr Amapola,

SWIM did a Meth maintenance program for about 5 years and yes, it saved him, so if someone is intent on using meth to heal the phych part while not having to yet worry about the physical, and then slowly deal with the physical, it's perfect. just don't get complacent and scared only to remain on it too long.

so as for coming off, SWIM did 10mg every 3 weeks. started on 120mg. didn't even feel much until 60mg. but when SWIM would try to go too fast he would be reminded that 3 weeks is optimum and 2 is too soon. after 40mg he started to decrease 5mg, and after 20mg he would decrease 2mg at a time. always three weeks in between.

never used benzos or sleeping aids, just did it slow enough to not feel it too much. as for PAWS, yea, it does exist. in fact SWIM's not sure he ever fully recovered to tell you the truth.

it's been a few years off now, and SWIM is messing around again. not too bad, but he's getting sick. determined to put an end to it though, before it gets out of hand. SWIM thinks the key to recovery is loosing touch with a means to get some, and people around you who know your situation who can be watch dogs. a purpose is nice too, like falling in love, and a future. SWIM is just realizing that his use ended when he got married, and has just picked up again after his divorce. damn.

[Richard_smoker]

Regretably, I've been MIA now for the last few months, but i did want to stop by and tell everyone how my life is doing...

my life has become much more structured as result of securing an engaging, time- and mind-consuming job.

Is it perfect? nah... do i love every minute of it? of course not.

it's fucking WORK...

but, at the end of the day, it feels good to come home and relax. I've picked up jogging and it's the one thing i look forward to almost every afternoon/night.

i don't come here to gloat about my "successes" and "accomplishments" being a current non-opiate-user. trust me when i say that this took many years of heart-ache and depression and failed attempts to live clean before it finally 'took.'

and as always, there's never any total freedom from the junk... you NEVER know what tomorrow has in store. But i will say that it just keeps getting easier and easier (to NOT live in junky-addiction) and life keeps getting more and more 'normal' as more time passes.

the toughest part is learning how to cope with the unpredictable roller-coasters of life..the emotional ups and downs...the unexpected...and worst of all--the lack of self-confidence that you can handle whatever life throws at you WITHOUT DRUGS!!

as always, live it 1 day at a time... -DICK

[0utrider]

SWIM wonders what he should do if he did all this well before he was withdrawin. imagine someone who is addited, but his drinks a ton of green tea everyday, takes healthy supplements in healthy doses, eats good, does sports.. what shall he do? in SWIMs opinion its not automatically implied in cases like these that they are better from the start, as they dont actually feel better. they might have started out bettter from the beginning, but no feeling of "ahh this helps".. if SWIY knows what i wanna say here..

apart from that, swim can recommend the following. there are cheap chili-candy thingies. they also burn a lot but last longer and are easier to dose as one only has to figure out the strenght once. its good for a quick improvement, and with a little milk drinking after it its surely bearable, and it immediatley takes the mind off of negative thoughts, not only because its enorphine-releasing, but also because it can be quite intense.

are there any endorphine precoursers, amino acids or so btw?

also SWIM finds it important to mention that one should try to not bring the neuro-chemical system out of balance. SWIM experienced, and tried & prooved this many times for himself. it might not be the same for everybody, but swim is sure that many are affected, especially if anxiety & depression are involved. try to avoid strong triggers and more imporantly avoid drugs/substances that work on the brain the way drugs to. so that means: no kratom (as it works the same receptors), no single-dose opiates, no benzodiazepnes if possible, swim found alcohol to be quite good at disturbing the chemical balance, no cocaine, no "drugs" in that direction (apartion from maybe psychedelics), maybe even no thc, also avoid caffeine in the form of coffe (tea is good though).

Reputation Comments on this post:

Excellent, excellent advice

[weeddream]

Thanks for the article lots of helpful information.. just a couple questions from a friend of a friend read an article about (PAWS) saying it can last anywhere from a few months to 2 years. ?

A friend of a friend has been off opiates and extacy for a year now and is still feeling sick in the stomach daily. She uses weed daily to keep from feeling sick, but eventually wants to quit. She has used weed for 10 years this year. Her history-
She was doing a couple kinds of opiates for 2-3 months off and on, using extacy inbetween, some cocain. Her boyfriend at the time was extremely addicted to oxys and made her addiction worse. Went through the withdrawls at the early stage of pregnancy. 3 months hell of feeling so sick to the point of not being able to eat or stand in the first 2 weeks.
After 3 months she was beginining to feel better. Doctor reffered to the mental health clinic, where her psychiatrist prescribed her chlorpromazine. She didnt tell her doctor about the opiate use, just the cocain and extacy. She gave the baby who was healthy up for adoption 5 months ago because she already has one child. Chlorpormazine helps her alot for stress, staying calm and muscle tension. But the sick feeling is still lingering.. her doctor has now lessened her dosage because he is worried about side effects. She feels like she needs more than 25mg twice daily but does not want to feel sedated.

Before use of opiates and extacy she never felt stomach aches. Was addicted to meth during teenage years but quit for at least 3 before doing extacy and 5 years before doing opiates.

What can she do to get rid of the weak stomach??? Is it because of liver and kidney damage? or high levels of toxins still within the body? Do you think its the weed thats making PAWS last longer?

weeddream added 3 Minutes and 58 Seconds later...

Post to above. She exercises regulary, eats healthy, still feels sick during the day, at night it seems to fade.

[Dickon]

It would be very hard to tell if what you are experiencing is PAWS, or something else. Were I, as a completely layman to hazard a guess, I'd say the chances are your stomach issue is nothing to do with PAWS. I'd be tempted to say that stomach problems are often stress or anxiety related (ulcers, butterflies in the stomach), and I wonder if there might not be some unaddressed psychological issue that is underlying the physical symptoms.

You are on chlorpromazine (aka Thorazine, Largactil) which I would be loath to see prescribed for "stress, staying calm, and muscle tension" [you do mean chlorpromazine not chlordiazepoxide (aka Librium) which might also be prescribed for these things?]. Do a quick google or use the search engine on here (I know there is info on this site) for the side effects of this drug, especially the extra-pyramidal ones. This is not a drug to be trifled with.

As for the weed, I am not sure how it would affect PAWS. It seems to bring it's own problems to some, especially those with addictive personalities who can use it excessively when they quit opiates. It would be very unlikely to be a bad thing to try giving it up for a month or several and see how you find it. Cannabis certainly affects appetite, so may have at least an indirect affect on the stomach.

It might be worth starting a separate thread on the subject as it's a complicated and personal issue, and quite possibly is not PAWS related. It is a relevant subject for the R&A section of this site, and there are many here who might be able to provide insight. Bear in mind an on-line forum is never going to be a substitute for a face-to-face consultation with a medical professional, and if you suspect something organically wrong you would be well advised to see someone.

All the best

Dickon

Reputation Comments on this post:

Good advice as always D

[dyingtomorrow]

Here's an interesting question: How long of daily use before you will suffer from PAWS?

A month? 6 months? A year?

In SWIM's experience and from what he's seen, people who at least bail by the 3 month mark don't seem to get it.

[missparkles]

These are just more insane musings from a chaotic mind...and just Sparkles own personal ideas... remember that...
Addiction has two aspects, the physical and the psychological. Physical W/D is the acute phase when the body goes through real pain as the drug is expelled from the users system. Psychological W/D is the PAWS phase, when the mind/emotions struggle to expel the negative/unhealthy thoughts, and replace them with positive, healthier ones.
So Sparkles would say if a person has been using for long enough to develop a psychological addiction, they will experience PAWS. She's met people who have used for quite a time who never experience PAWS, and addicts who have used for six weeks who really struggle with it.
Another thing to consider is the reason some use heroin.
If a person uses for the buzz and becomes addicted Sparkles would imagine they will struggle less than someone who takes heroin because of emotional problems they find difficult to deal with. The first is using heroin to enhance their life, the second it using heroin to fix it...the problem is still there when they stop using. Both types usually experience real difficulties.
Sparkles thinks that sounds too damn simple and straightforward...perhaps it is.
Take care.
Sparkles.

[0utrider]

Originally Posted by Dickon

As for the weed, I am not sure how it would affect PAWS. It seems to bring it's own problems to some, especially those with addictive personalities who can use it excessively when they quit opiates. It would be very unlikely to be a bad thing to try giving it up for a month or several and see how you find it. Cannabis certainly affects appetite, so may have at least an indirect affect on the stomach.

Dickon

as said before, if anxiety and depression is involved in the withdrawal, especially anxiety, do not smoke weed. thats SWIMs advise. it will take longer to recover and surely does not improve things.

[marlavas]

Thank you Richard for your well researched and informed posting. SWIM will try all of your recommedations to raise her endorphin levels. Her shrink was telling her that her depression was due to the cocooning effect of the opiates protecting her from feeling her true emotions. Your advice was much better. She will send your post to other friends who will find it useful.
Blessings always,
M

[cnajob]

great thread. lurking around and reading richard smoker's material is one of the reasons why swim joined the drugs-forum. swim has a bad problem and can't stop due to work. swim went through wd and couldn't hack it. swim took a week off the job to go through withdrawal. swim was doing okay---just bored and foggy headed around the 8th or 9th day and went back to work. swim's job is physically hard and mentally draining; so swim broke down and started using fent. swim uses fent because it won't show up on a U/A. swim feels like a fucking loser and wants to be clean and happy; like a long time ago. swim is moving up in the career department and can only function on junk. not one person knows...swim wears colored contacts for camouflaging pupil size, and functions quite well. swim would never be able to take suboxone or anything b/c of swim's work...most people think all junkies are irresponsible and can't hold down jobs (not true). there's not enough endorphins in swim's body naturally, to make swim feel good at work (swim loves the job and will not get another). swim will not be able to quit junk at all b/c of the responsibility swim has and performance expectations. swim can't fucking function w/o opiates; and strong ones at that. someday swim wants to be completely clean...this shit kills people and swim knows first hand. when swim's boyfriend died in the bathroom, slumped over, face smashed up against the wall, smelling like shit; with blue veins all over his arm like creeping death--swim vowed to never fuck around with any shit again. swim moved away from the city and started a new life after that. you know, the junk found swim. shit happens...swim can't go to work w/o it. someday swim will get her shit together...