Introduction

What Are Opiate Withdrawals and Why Do We Get Them?

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

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

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

Stomach Aches/Pains

Diarrhea

Restlessness

Restless Legs/Limbs

Cold Chills/Goosebumps

Cold Sweats

Joint and Muscle Aches/Pains

Runny Nose

Watery Eyes

Difficulty Sleeping

Anxiety

Depression

Frequent Yawning

Agitation

Lack of Appetite

Tremors

Flu-Like Symptoms

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

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

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



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



Addiction and Our Bodies



Why We Got Addicted To Opiates



The Power of AA/NA Meetings



The Dreaded Withdrawals

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

The List

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

Over the Counter (OTC) and Easily Accessible Products:

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

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



Dramamine Tablets

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

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

Imodium (Loperamide) Tablets

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

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

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

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



Valerian Root Extract Capsules

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



Ensure Supplemental Drink

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

Melatonin Capsules

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

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



St. John's Wort Extract Capsules

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



Hylands Restful Legs Sublingual Tablets

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

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

Prescription Medications:

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

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

Man, I love Restless Legs...

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

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

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

Other Tips/Tools:

Hot Baths/Jacuzzi/Hot Tub

Reading Material

Movies or Video Games

Computer/Laptop with Internet

Heated Blanket

Comfy Bed or Couch

Comfy, Loose Clothing

Fan or Air Conditioner

Music

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

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

Go For Short Walks or Jogs

Exercise Lightly Whenever Possible

Drink Plenty of Fluids and Eat as Healthy as Possible

Conclusion

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

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

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

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

How most of us feel during opiate withdrawal

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

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

Take Care Guys and remember to keep seeing that light.

-Seeingthelight

Hi Guys, hope all is well on the other side of the computer screen. I welcome both new and returning visitors to my blog about opiate addiction. For this post, I would like to provide you guys with a list of items that can help provide some relief for those experiencing opiate withdrawal. As most of you already know, opiate withdrawal can be a true pain in the ass and is for many, one of the hardest and most difficult times of one's life. I call this list the ultimate survival kit for opiate withdrawal and hope that it can help you guys during such a challenging time.For this list, I will provide you guys with a list of over the counter medications, prescription medications, coping techniques, and other tips or activities that can help make withdrawal a little more bearable. With the exception of Loperamide, a relatively weak opioid, I will be excluding any opiates or opioids from my list as well as any drugs that can be used for opiate replacement therapy (ex. Suboxone or Methadone). In other words, the items on this list are things that will not simply mask or prolong opiate withdrawal but rather help provide relief for withdrawal without the aid of opiates through other means.