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drugs in tissues
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drugs in tissues

hello dr....i will be 200 days clean from opiates soon...but i been having terrible cravings lately.  i been googling everything i can about addiction and cravings.  i read an article about how the drugs are stored in our tissues after we stop and over time our tissues turn over releasing the drug in to our brain therefore causing relapse or cravings.  i have never heard of this and would like your thoughts on this.   thank you....maria
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I was just talking with a patient about this topic.  Opiate dependence is a disease of relapse, and the cravings will always be there to some extent.  In fact, addicts often say that it is better to feel the cravings-- at least then they know they are there, instead of doing some crazy 'addict behavior' that gets them in trouble.  I continue to have cravings from time to time after 9 years of sobriety-- they occur at the 'usual' times-- when I am bored, or when I am tired, sick, or lonely.

Now, as for your question... after 200 days, pretty much any traces of opiates will be gone from your system.  The only place they still might be found would be in your hair follicles or in your hair-- the hair that was coming out of your head 6 months ago and now is about a foot away from your body!  That is, by the way, why hair follicle testing is so useful for monitoring purposes-- it measures substances that have been out of your body for weeks.

Some opiates will stick around for awhile, but not for 200 days.  Fentanyl enters the fatty parts of the body, and then after stopping using it will leach back into the bloodstream for a few weeks.  Methadone binds to proteins in a number of tissues in your body and will slowly be released to enter the bloodstream, but again, after a month or two you won't find any methadone left behind.  Some of the other opiates-- morphine, oxycodone-- undergo a cycle where they are absorbed from the intestine, taken up by the liver, and excreted in the bile, into the intestine... where they are taken back up again in small amounts.  Again, this cycle will keep opiates around for an extra week or so, but that is about it.

Remember that cravings don't come from opiates-- they come from the LACK of opiates.  At some point they really are 'purely mental'-- not that it makes them any less real.  But the way to deal with them isn't by cleaning out your system or taking medications, but rather by doing some type of recovery program.  Mine is the 12 steps, and it will reduce cravings when I 'work it'.  I don't know why exactly it works, but it just does--  I think that each step does something to our thinking that reduces the need for drugs.  The first step alone relieves most of my cravings-- the knowledge that I am powerless over the substances, and that there is just no way that I can take them without it destroying me.  To illustrate how that works, say a person is allergic to strawberries-- they cause the person anaphylactic shock and death.  If the person loves strawberries, wants strawberries, is angry he can't have them, and thinks that he can probably eat them without trouble-- but that his wife doesn't think they are safe--  when he comes across a strawberry stand out by himself when he is good and hungry it will be hard for him to say no--  but let's say that same guy has been through an experience where his throat was swelled shut and he gasped for air for 120 seconds before a passer-by jabbed a fountain pen through his trachea, allowing him to breathe...  that guy is going to have no trouble saying no to strawberries, even if they have whipped cream on top!

Not the greatest analogy, but you get the idea.  Cravings will be fueled by the part of your thinking that suspects that just maybe you could use and get away with it.  If, on the other hand, you KNOW, deep inside, that using even one little time will certainly kill you...  then the cravings will go away.

Do some thinking on the consequences of your prior use.  Write down in graphic detail how you felt at your very worst, when using made you sick and ashamed.  Write down what using did to the people you love.  And if you ever catch yourself with one of those 'fantasy memories' about how good using felt, make sure to carry the memory full circle-- to how it felt when you were caught, or when you realized that once again you let yourself down.  Then think about how hard you worked to get to today, and decide that just for today you are going to treat yourself to something special-- that doesn't involve drugs.  Get a massage, or buy yourself a nice necklace with an amethyst on it-- which is the universal 'gemstone of recovery'.

Congratulations on the 200 days, and hang  in there!
thank you so much for your response...i really appreciate your words of wisdom...i feel i can never learn too much...thanks again and i am hanging in there...forever..maria :)
LOL LOL   I must have brain damage! I had to re-read this post a couple of times, because I thought you were saying that drugs were stored in ( and I was thinking you were a little off your rocker!  lol)   Oh,  I better go have some more coffee.......
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