Category Archives: Opiate Detox

Opioid Craving Similar to Food Hunger

Clients tell me that their loved one does not understand why stopping opiate use is so hard. Most non-users think that it is simply a matter of "willpower". While determination is very important in overcoming active addiction, "willpower" alone is usually not enough to overcome one's physical opioid dependence once it has taken hold.

There is a page here on Methadone.US that is dedicated to explaining opioid addiction and the overwhelming compulsion that addicted people feel to keep using these drugs. If you are suffering with an opioid addiction, I recommend that you have your family or friends read this page. It helps to explain (using easily relatable examples) how and why addicted people have such a hard time avoiding opioid use when their withdrawal symptoms and cravings begin to build.

Opioid addicted people are no more able to "just not use" than most people are able to "just not eat". The need to satisfy hunger and the need to avoid opioid withdrawal are similar physiological drives. Both are powerful needs that a person cannot ignore.

Opioid addiction causes profound biochemical changes in the brain. The potential for becoming addicted is always present. Thus, this risk of addiction is something that all physicians should discuss with their patients when they prescribe them opiates for whatever reason.

Methadone Used With Newborn Babies

methadone-babyThere is a fascinating article in The New York Times which explores the use of methadone and buprenorphine in treating babies born addicted to opioids. While this is often an emotionally-charged subject, it is a very important topic and points to the benefit of methadone in relieving suffering and in stabilizing one’s health through the elimination of painful opioid withdrawal.

The article explains the dilemma that hospitals face when an opioid addicted woman is pregnant. Depending on the type and length of her opioid use, her baby may be born with an opioid dependence. And the newborn could begin experiencing painful withdrawal symptoms within 1 to 5 days.

The Times article addresses the use of methadone (or buprenorphine) in alleviating a baby’s suffering. Prior to birth, methadone has also been used to reduce the chance of miscarriage and the probability of in utero seizures. Many doctors have little to no experience with this type of treatment, and are consequently apprehensive about taking on the risk of treating an opioid addicted mother-to-be.

As of yet, there is no single universal protocol which has been established for treating newborns with methadone. However, several medical centers have been working in this area using a combination of medications such as methadone, phenobarbital, clonidine, and buprenorphine.

Early indications suggest that it is hard to predict which infants will need opioid replacement medication. To determine which babies may be experiencing withdrawal, nurses use a checklist of symptoms and assess each baby every few hours … if the baby has been identified as “at risk” due to the mother’s opioid addiction.

The Times article goes on to speak about the growing opioid addiction in America and the need for medical professionals to further educate themselves on available treatment options. We all need to remain solution-oriented, and to address this problem straight on in a constructive fashion. Thankfully, opioid addiction is a treatable illness, and opioid replacement therapy is a viable option for coping with this growing epidemic.

Methadone and buprenorphine are the best interventions we have at present for treating opioid addiction. Without them, many addicted persons would remain lost in their addiction for years on end. And babies born to addicted mothers would needlessly suffer. With time and good public education on opioid replacement, more people will find their way into a life of recovery.

Why Self Administered Home Detox Rarely Works

methadone-patientMany opioid addicted people have discovered that trying to detox off of opioids “at home” does not work and leaves them feeling miserable. There are some individuals that have “kicked the habit” without medication-assistance or a medically supervised detoxification. However, these success stories are somewhat rare, and usually pertain to people with a comparatively milder opioid addiction or an addiction of relatively shorter duration.

Somewhat compounding the challenge of addiction recovery are outspoken critics who wrongly assume that every drug addiction is the same, and that an addict should just pull themselves up by their bootstraps and tough it out. Individuals who hold such views are typically uneducated on the physiological characteristics of opioid addiction and the underlying brain neurochemistry that has been radically altered once opioid addiction sets in.

I have spoken to many suffering opioid addicts who have attempted home-based detoxes. The story is almost always the same: “It didn’t work. I just couldn’t make it. It was a horrible experience.” And they return to active drug use in order to cope with a myriad of sudden & protracted withdrawal symptoms, and to regain some momentary ability to function again.

Unfortunately, even some addiction professionals are poorly schooled on opioid addiction, and consequently may hold a bias against opioid replacement therapy (methadone, buprenorphine) until someone comes along to properly educate them.

Acute withdrawal from opioids results in a plethora of extremely uncomfortable physical symptoms and psychological stress that builds for days. With a home based detox, users try to self-administer decreasing amounts of opioids only to find the process overwhelming. Even a seven day detox in a medically-supervised setting using suboxone (and other medications) often leaves users with discomfort and protracted symptoms that are difficult to deal with.

In either scenario (home or hospital detox), individuals typically must deal with PAW (Post Acute Withdrawal). PAW for opioid addiction can last for months and results in lingering feelings of depression, tiredness, physical ache/pain, powerful cravings, inability to concentrate, insomnia, etc. Scientists have suggested that chronic opioid use/abuse affects the body’s metabolism and may temporarily (possibly even permanently) shut down the body’s ability to manufacture natural endorphins. This leaves the person feeling not normal. Obviously, the possibility of opioid relapse is greatly increased as a result of this post acute withdrawal process.

PAW (Post Acute Withdrawal) is greatly magnified as opioid addicts go from using daily fast-acting opiates to nothing at all. Alternatively, tapering down gradually off of methadone or suboxone introduces much less stress and allows a patient’s neurochemistry to adapt slowly to medication reduction. It also allows for much better preparation, planning, stability, and support-building as patients pursue a gradual medication taper. Tapering gradually off of an opioid replacement (methadone, suboxone) is often a much more comfortable experience than a short-term detox at home or in a hospital. Importantly, it must be said that a “social setting” or hospital-based detox is far superior to attempting a detox at home.

My final point is this. Don’t judge individuals struggling with an opioid addiction. And do not condemn them when they fail to successfully detox at home, or even in a hospital setting. Getting well, and succeeding in recovery, is a process that takes time and which may vary in procedure from one individual to the next.

We like to think that “all addicts are the same.” But, they are not. And treating them all the same is antiquated, and a failure in approach. Let’s stop to consider that medicine, science, and recovery are evolving through the years. Medication-assistance is not a cop-out or some negative compromise. It is today’s best practice approach in helping people live much improved lives. Medication-assistance is evidenced-based, and has been proven (not just theorized), but proven … to be effective.

Thanks for visiting Methadone.US, today! For more on opioid dependency, click here.