Aa
What to expect after initial acute withdraws subside
Ran across this and perfectly describes what to expect:
Secondary Withdrawal (after first 24-100 hour depending on usage)
Secondary withdrawal has a number of potential symptoms. The most common are: depression, insomnia, muscle aches (especially back pain), and nausea. In addition to this, boredom can modulate the pain of all these. The secondary withdrawal syndrome is probably the cause of more re-addictions than is acute withdrawal. The reason is that the ex-addict still feels bad when he is supposedly done with withdrawal. "I went through all that for this?" he says. "I'd rather not live than live with this; where's that pager number?"
Detox Well
It helps enormously if the acute-withdrawal was managed properly. People who do a cold turkey withdrawal are perhaps at the greatest advantage here. Having been through a week of living hell, the relatively minor symptoms of secondary withdrawal may not even register. This is not a recommendation for a cold turkey withdrawal, however. It is harder to get through and I believe in quantifiable terms, it slows the process of complete physical recuperation.
Medicated Detox
The traditional clonidine detox can be helped greatly with the use of naltrexone. In this procedure, the patient is given higher clonidine and Librium® doses as increasing doses of naltrexone are given during the five-day process. Addicts find that after a five day detox, the body feels as well as it normally would after three weeks with a straight clonidine detox.. The down side is that many people find this detox very painful. The drug dosing must be exacting by the medical staff. Generall he benefits out-weight the extra care needed, however.
Methadone Detox
Methadone replacement with slowly reducing doses is probably the best heroin detox method available. The biggest problem with it is that the methadone doses are lowered too quickly. I think that the maximum rate of decrease should be 1 mg every 3 days (one week is better). This means someone maintained at 60 mg of methadone would require 6 months (180 days) to detox. Any rate faster, leaves the patient somewhat uncomfortable for the month or two after the completion of the methadone doses.
Secondary Withdrawal (after first 24-100 hour depending on usage)
Secondary withdrawal has a number of potential symptoms. The most common are: depression, insomnia, muscle aches (especially back pain), and nausea. In addition to this, boredom can modulate the pain of all these. The secondary withdrawal syndrome is probably the cause of more re-addictions than is acute withdrawal. The reason is that the ex-addict still feels bad when he is supposedly done with withdrawal. "I went through all that for this?" he says. "I'd rather not live than live with this; where's that pager number?"
Detox Well
It helps enormously if the acute-withdrawal was managed properly. People who do a cold turkey withdrawal are perhaps at the greatest advantage here. Having been through a week of living hell, the relatively minor symptoms of secondary withdrawal may not even register. This is not a recommendation for a cold turkey withdrawal, however. It is harder to get through and I believe in quantifiable terms, it slows the process of complete physical recuperation.
Medicated Detox
The traditional clonidine detox can be helped greatly with the use of naltrexone. In this procedure, the patient is given higher clonidine and Librium® doses as increasing doses of naltrexone are given during the five-day process. Addicts find that after a five day detox, the body feels as well as it normally would after three weeks with a straight clonidine detox.. The down side is that many people find this detox very painful. The drug dosing must be exacting by the medical staff. Generall he benefits out-weight the extra care needed, however.
Methadone Detox
Methadone replacement with slowly reducing doses is probably the best heroin detox method available. The biggest problem with it is that the methadone doses are lowered too quickly. I think that the maximum rate of decrease should be 1 mg every 3 days (one week is better). This means someone maintained at 60 mg of methadone would require 6 months (180 days) to detox. Any rate faster, leaves the patient somewhat uncomfortable for the month or two after the completion of the methadone doses.
For sure, those steps helped me identify the underlying causes of my addiction. Guilt, shame, anger, childhood trauma, and then I learned to deal with them. But I've also found that I am a huge adrenaline junkie. In the past 8 months I've gone cliff jumping many times, hang gliding, skydiving, etc. I'm getting a much better rush out of these things and even hiking the White Mountains and camping out than I ever had from shooting dope :) So yes, 5 meeting s a week for me plus these recreational outdoor activities (also throw in my family relationships improving and my connection to my high power/God/spirituality) and it makes for a very fufilling existance. I pray for the strength in every struggling addict to emerge and send them along a virtuous path.
I agree with you. In the beginning we do need to surround ourselves with others going through the same thing we are going through. In time we need to find other things to improve our quality of life. I think the point was that it shouldn't be the only activity you are doing to improve the quality of your life. One needs to find other fulfilling activities in life to be completely rounded. SI do believe that some people need more meetings than others. And even if one doesn't go as often as they used to in the beginning, it's always good to be working the steps.
Deffinitely an informative post and thank you. However, I can't entirely agree with the opinion on 12 step meetings. I agree they shouldn't become the central focus of someones life forever. However living a life based on not doing drugs is not just a minor improvement but a HUGE improvement from living a life based on doing drugs lol. The first few months I hit 2 meetings a day and it was my life. But I needed this at least to get started and guess what? I stopped lying to people, feeling dopesick, stealing, hating myself. It's about the results and quality of life regardless of how you get there. But yes, along with meetings a person needs to create an additional purpose, hobby, enthusiasm for other aspects of their life. "AA isn't my entire life, but it's given me a life worth living". Idk, I'm not trying to start a debate, just saying if it needs to be someones main focus to get them started on the right path so be it you know?
This helps put things in perspective for not only short term, but long term as well. Its easy to focus o detox and forget about the big picture. Im glad others foune it helpful too! :)
Some tips on how to deal with side and after effects:
Back Pain and Muscle Aches
There are many over the counter (OTC) drugs for relieving back and muscle pain.
Take a Soak
If you know someone with one, or there are public ones near you (look in the yellow pages), hot tubs are really helpful to relieve pain. In addition it can improve mood and help sleep. Even without a hot tub, just a hot bath can do wonders.
Nausea
Unfortunately, there are no OTC medications that work well to relieve nausea. There is an effective anti-nausea drug, however. It is also commonly available. Unfortunately, it is illegal. Of all the people in federal prisons, 60% are there for non-violent drug offenses. Of these people, roughly 30% are there for possessing this anti-nausea drug. The drug is cannabis. It is an excellent medication with many uses. Despite what the federal government will tell you, it was found in over 30 prescribed drugs when the U.S. outlawed it. And despite what the state government might tell you, you can still go to jail for a very long time for possessing it.
Acupuncture and "Alternative" Medicine
There are some remedies that "alternative" medicine has to offer for nausea. Goldenseal, for example. It can be found at health-food and vitamin stores.In addition, a couple of acupuncture points are effective: P.6 and St-36. You would have to see a license acupuncturist regarding this however. The acupuncturist could apply "beads" or "seeds" on these points. These are basically tiny steel balls that are taped on the skin. Once they are placed, the patient can perform his own acu-pressure simple by pressing on them. Thus, when the nausea comes on, you can treat yourself.
Insomnia
Other than things like Valium®, everything available for insomnia is either ineffective or has so many nasty side-effects that it isn't worth using. In addition, a lot of things that are supposed to produce sleep are idiosyncratic. For example, antihistamines produce sleep in some and hyperactivity in others.
Acupuncture and "Alternative" Medicine
Acupuncture can be helpful for insomnia. So can some herbal formulae. Two that are pretty easy to find are "An Shen" and "An Mien Pian". If you go to a Chinese pharmacy, they may have other remedies for sleep. If you live near a "Chinatown", it is worth looking around.
Jin Bu Huan
There are also herbal pills called "Jin Bu Huan". These little pills are amazing. Unfortunately, they are no longer sold in the United States because they are made by one family in China that will not list the contents. The Pure Food and Drug Act requires the listing of contents, so people in the United States are not allowed access to these pills.
From the packaging, "Jin Bu Huan is a kind of Herb Medicine which is, in history, used by the people as an important medicine good for the relief of pain with conspicuous result. [sic.]"They don't make the patient "high". He simply takes it and in a half hour he is quite suddenly asleep. The chemistry of the pills have been analyzed, of course; they do not contain any opioids; but we don't know exact what the stuff in it is.
Although these pills are illegal in the United States,they are still around and you might find them. I warn you, however: don't go around asking for them because you will scare people. They'll think you are a government agent.
Relax
The main thing to remember about the insomnia is that it will gradually go away. The way to deal with it is to simply accept it. Insomnia is at its worst when the sufferer fights it, thinking that he must sleep. While you are suffering from it, you will find that your body really doesn't need that much sleep. It's hard to deal with, of course--your body wants to sleep--but just stay calm. It is a real pleasure when you start sleeping normally--and eventually, you will.
Depression
Without a doubt, the best thing that can be done about depression is exercise. It helps the whole body to get working normally. This is very important. Daily exercise will help in endless ways.
It is also a very good idea to start taking vitamins. In short, the path to physical health is the path from addiction. The new ex-addict needs to take care of his body. It is surprising how dramatic and quick it is paid back.
A Life Worth Living
Once a person detoxes, he needs something to live for. Work, school, hobbies, it doesn't matter. Commonly, ex-addicts fill up their new free time with 12-step meetings. This is okay, but the time could be better spent. When 12-step meetings become the focus of an ex-addict's life, he has simply changed his focus from doing heroin to not doing heroin. A life that is preoccupied with not doing drugs is a minor improvement over a life preoccupied with doing drugs.
Gathering Information
Going to meetings of model-makers or Java-programmers is more healthy than going to 12-step meetings. For one thing, the ex-addict won't be spending all his time with drug addicts. He'll see regular people getting pleasure from regular, legal activities. It is part of gathering information for building the new life he wants to lead.
Detoxing is extremely difficult. What follows is at least as difficult. The first month is particularly hard. It's not that there is great pain--there just won't be anything that is all that pleasant. The whole world seems like a black and white movie. The life worth living--the one the addict detoxed to get to--only exists in the future. But there is a wonderful life waiting just up ahead. It isn't an illusion. Once a person has been a junkie, it is easy to appreciate the any joy in life.
Finding a Purpose
What is the pay-off for kicking dope? A great life. A life worth waking up to each day. How does one get one of those? The ex-addict can start by supporting himself: encouraging his dreams, abilities, pleasures, loves. A junkie's life has a clear purpose: junk. Without junk, he must find a new purpose. An ex-addict is lucky in this regard. He really can follow his dreams, because compared to being a heroin addict, almost everything is easy. He can re-invent himself. He can become one of the most exotic people on the earth. Or he can just enjoy living a quiet, simple life. All he has to do is choose because he no longer has his heroin addiction defining how to live.
Deciding what kind of life you want to lead can be difficult. Fortunately, there is a lot of help out there in the world. Instead of going to a 12-step meeting, an ex-addict might go to see a career counselor. He could talk to people he admires about what their goals our, what their ideal life is, what give their lives purpose. There is an excellent book that helps determine one's life goals: High Performance Goal Setting - Using Intuition to Conceive & Achieve Your Goals by Beverly "Doc" Potter.
Remember: You're Lucky
After you kick dope, you're like Dorothy opening that door from Kansas into Oz. But it takes a long time to get that door open. Be patient. You have time--all the time in the world. And things will be better, regardless. You're lucky. Remember that.
Back Pain and Muscle Aches
There are many over the counter (OTC) drugs for relieving back and muscle pain.
Take a Soak
If you know someone with one, or there are public ones near you (look in the yellow pages), hot tubs are really helpful to relieve pain. In addition it can improve mood and help sleep. Even without a hot tub, just a hot bath can do wonders.
Nausea
Unfortunately, there are no OTC medications that work well to relieve nausea. There is an effective anti-nausea drug, however. It is also commonly available. Unfortunately, it is illegal. Of all the people in federal prisons, 60% are there for non-violent drug offenses. Of these people, roughly 30% are there for possessing this anti-nausea drug. The drug is cannabis. It is an excellent medication with many uses. Despite what the federal government will tell you, it was found in over 30 prescribed drugs when the U.S. outlawed it. And despite what the state government might tell you, you can still go to jail for a very long time for possessing it.
Acupuncture and "Alternative" Medicine
There are some remedies that "alternative" medicine has to offer for nausea. Goldenseal, for example. It can be found at health-food and vitamin stores.In addition, a couple of acupuncture points are effective: P.6 and St-36. You would have to see a license acupuncturist regarding this however. The acupuncturist could apply "beads" or "seeds" on these points. These are basically tiny steel balls that are taped on the skin. Once they are placed, the patient can perform his own acu-pressure simple by pressing on them. Thus, when the nausea comes on, you can treat yourself.
Insomnia
Other than things like Valium®, everything available for insomnia is either ineffective or has so many nasty side-effects that it isn't worth using. In addition, a lot of things that are supposed to produce sleep are idiosyncratic. For example, antihistamines produce sleep in some and hyperactivity in others.
Acupuncture and "Alternative" Medicine
Acupuncture can be helpful for insomnia. So can some herbal formulae. Two that are pretty easy to find are "An Shen" and "An Mien Pian". If you go to a Chinese pharmacy, they may have other remedies for sleep. If you live near a "Chinatown", it is worth looking around.
Jin Bu Huan
There are also herbal pills called "Jin Bu Huan". These little pills are amazing. Unfortunately, they are no longer sold in the United States because they are made by one family in China that will not list the contents. The Pure Food and Drug Act requires the listing of contents, so people in the United States are not allowed access to these pills.
From the packaging, "Jin Bu Huan is a kind of Herb Medicine which is, in history, used by the people as an important medicine good for the relief of pain with conspicuous result. [sic.]"They don't make the patient "high". He simply takes it and in a half hour he is quite suddenly asleep. The chemistry of the pills have been analyzed, of course; they do not contain any opioids; but we don't know exact what the stuff in it is.
Although these pills are illegal in the United States,they are still around and you might find them. I warn you, however: don't go around asking for them because you will scare people. They'll think you are a government agent.
Relax
The main thing to remember about the insomnia is that it will gradually go away. The way to deal with it is to simply accept it. Insomnia is at its worst when the sufferer fights it, thinking that he must sleep. While you are suffering from it, you will find that your body really doesn't need that much sleep. It's hard to deal with, of course--your body wants to sleep--but just stay calm. It is a real pleasure when you start sleeping normally--and eventually, you will.
Depression
Without a doubt, the best thing that can be done about depression is exercise. It helps the whole body to get working normally. This is very important. Daily exercise will help in endless ways.
It is also a very good idea to start taking vitamins. In short, the path to physical health is the path from addiction. The new ex-addict needs to take care of his body. It is surprising how dramatic and quick it is paid back.
A Life Worth Living
Once a person detoxes, he needs something to live for. Work, school, hobbies, it doesn't matter. Commonly, ex-addicts fill up their new free time with 12-step meetings. This is okay, but the time could be better spent. When 12-step meetings become the focus of an ex-addict's life, he has simply changed his focus from doing heroin to not doing heroin. A life that is preoccupied with not doing drugs is a minor improvement over a life preoccupied with doing drugs.
Gathering Information
Going to meetings of model-makers or Java-programmers is more healthy than going to 12-step meetings. For one thing, the ex-addict won't be spending all his time with drug addicts. He'll see regular people getting pleasure from regular, legal activities. It is part of gathering information for building the new life he wants to lead.
Detoxing is extremely difficult. What follows is at least as difficult. The first month is particularly hard. It's not that there is great pain--there just won't be anything that is all that pleasant. The whole world seems like a black and white movie. The life worth living--the one the addict detoxed to get to--only exists in the future. But there is a wonderful life waiting just up ahead. It isn't an illusion. Once a person has been a junkie, it is easy to appreciate the any joy in life.
Finding a Purpose
What is the pay-off for kicking dope? A great life. A life worth waking up to each day. How does one get one of those? The ex-addict can start by supporting himself: encouraging his dreams, abilities, pleasures, loves. A junkie's life has a clear purpose: junk. Without junk, he must find a new purpose. An ex-addict is lucky in this regard. He really can follow his dreams, because compared to being a heroin addict, almost everything is easy. He can re-invent himself. He can become one of the most exotic people on the earth. Or he can just enjoy living a quiet, simple life. All he has to do is choose because he no longer has his heroin addiction defining how to live.
Deciding what kind of life you want to lead can be difficult. Fortunately, there is a lot of help out there in the world. Instead of going to a 12-step meeting, an ex-addict might go to see a career counselor. He could talk to people he admires about what their goals our, what their ideal life is, what give their lives purpose. There is an excellent book that helps determine one's life goals: High Performance Goal Setting - Using Intuition to Conceive & Achieve Your Goals by Beverly "Doc" Potter.
Remember: You're Lucky
After you kick dope, you're like Dorothy opening that door from Kansas into Oz. But it takes a long time to get that door open. Be patient. You have time--all the time in the world. And things will be better, regardless. You're lucky. Remember that.
Have an Answer?
You are reading content posted in the Addiction: Substance Abuse Community
Is treating glaucoma with marijuana all hype, or can hemp actually help?
If you think marijuana has no ill effects on your health, this article from Missouri Medicine may make you think again.
Julia Aharonov, DO, reveals the quickest way to beat drug withdrawal.
Tricks to help you quit for good.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
