withdrawals

[mother09]

Hi
My son is withdrawing from subloxone and meth which he took to help with the withdrawls of heroine...he has been using and abusing and detoxing for about 5 years, his last relapse sent him to th emeregnecy rooom, then he went into treatment for a few months and then a sober house where he relapsed again and went back into detox, he has been out of setox for  a little over a month and has relapsed for abolut a week with heropine and then the sub/meth...he was off of it for about 5 days and then went out and got a meth to deal witht he leg pains and not being able to sleep (that was 2 days ago) what can he do to deal with the leg pain, inability to sleep and feeling weak

[J T Junig, MD PhD]

My greater concern is how he is going to keep from using again, as he has used over and over without showing any sign of meaningful change.  This is not unusual, but rather the rule with opiate addiction;  the problem is that each relapse tends to become more impulsive and less controlled, and progressive relapses tend to have greater and greater consequences.  Pills lead to snorting, and snorting leads to smoking, and smoking to injecting.  Doses get higher, and ways to find money that once seemed daring start to become routine.

Suboxone has stirred arguments here, but it shouldn't-- as I wrote last night, we didn't have good treatment options for opiate dependence before Suboxone, and anyone who has worked for more than a couple years in the addiction world will have a stack of obituaries in a drawer, describing the tragic deaths of former patients.  And while it is hard for some people to taper off Suboxone, it keeps people alive, perhaps until better treatments come along-- although frankly, most patients I treat using Suboxone are pretty grateful for the job it does already.  

Yes, clonidine is the best thing out there;  recent reports about Zofran were a disappointment for the few people I prescribed it to.  The cramping and spasm of 'long muscles' is simply a miserable experience that does not have a solution that I am aware of, unfortunately.

I don't know from your post if he used on Suboxone;  if he did, his options might be limited.  But if he didn't, I would consider getting him enrolled in a Suboxone program.  It is an expensive medication, but far cheaper than using-- and far safer.

[noobfarm]

Clonidine was a HUGE help for me regarding the sweats and aches.  I also bought some
ltyrosine but I never got around to using it.  I have read it works really well for energy.  As for the sleep, I haven't really found anything to work for the first few nights.  I end up taking something to sleep and never actually falling asleep and I personally hate that feeling so I just tried to find things to keep me my mind off things.  Good luck and god bless.