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Addiction: Substance Abuse Community
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Avatar universal

I'm terrified, can anyone help me ??

Hi guys, I'm in desperate need of help as I am terrified of my second detox. I've been back on codeine for a good lot of months now after detoxing in January of this year, how could I have been so stupid ??!! In January I detoxed in an outpatient detox clinic which I attended every day from 9.30am til 1pm. Everything was going OK, I was given britlofex (lofexedine) to help ease withdrawals and all was well until day 11. On day 11 I was given 25mg of naltrexone with the intention of increasing it the next day to 50mg and to stay on it for 6 months. After around 2 hours of taking the naltrexone I was back at home from the clinic and the pains,diarrhoea and vomiting started. An ambulance had to be called as I was vomiting every 60 seconds or so, the pains in my stomach were increasing rapidly and my hands had closed into a claw like shape (the paramedic said this was due to hyperventilating but I'm not sure if that's true). The pains in my stomach I can only describe as equal to labour pains, the vomiting was non stop, injections into my backside and stomach to stop it didn't work. I was hospitalised for 4 days. I honestly thought I was dying, infact my parents (who were with me during all of this) told me when I got home from hospital that they had thought that too and that they had never seen anything like it. On my second day in hospital I had to get my sister who was visiting me to rub my leg as it was going mad and I had to wear earplugs as I couldn't bear any sound and I paced the empty day room attached to a drip as I really felt like I was going mad, I couldn't sit still. I don't think I've experienced pain like this (I'm a mother of 4 children). The doctors at the addiction clinic, the doctors in the hospital and my own GP could not tell me why this happened to me, they hadn't a clue. I'm really hoping that someone here could shed some light on this. Remember I had been codeine free for 11 days when this happened. I'm terrified that it will happen again. Thankyou for any info that you have.
14 Responses
4522800 tn?1470325834
Hi madge23
Wow! I am so sorry to hear this. I have Tons of info regarding Addiction, and Addiction and the Brain and about many different drugs too.. I picked up a book here that is the National Practice Guidelines for the use of Medications in the Treatment of Addiction Involving Opioid use. It says that a person switching to Naltrexone from a short acting opiate should at least wait 6 days after the removal of there other drug. The Most common side affects in random order can include; insomnia, lack of energy/sedation, anxiety, nausea, vomiting, abdominal pain/cramps, headaches, cold symptoms, joint and muscle pain. WOW!! That sounds just like W/DS to me! Maybe it threw you into precipitated w/ds, as you had not yet got the other meds out of your system. Bummer!!! The Naltrexone can cause you to be really sick if you take another opiate with it. WE do have many ppl on here that have come of the Subs/Subutex but I have not seen them around..Maybe they will stop by and give you some more personal experience about this..Are you better now?? I sure would stay away from that one for sure. It is some powerful stuff, as I did have some experience with Buprenorphine way in the past.  Pray you are off of it now and working a program. You know we can not do it alone and it will take so many Behavior changes to stay clean..AA/NA are good for this. I am sure you have gone to a few. Wishing you the best and hope you are feeling better. So Sad! Sometimes we trust the Drs and we get even worse. Hug! Hope others with SUB experience will chime in!
PS. We have Receptors in our Brain and Body. The Stomach is one place that gets hit, as those receptors are trying to clear up.

Have a Merry Christmas!
Vickie
Avatar universal
Hi Vickie, thankyou so so much for your reply. Do you mean that I should have been off britlofex for 6 days before starting naltrexone ?? On the day I became I'll I had been clean of codeine for 11 days. I went to the clinic that day as usual and was given my last dose of britlofex (I had been reducing the britlofex after having increased it over the first week of the detox) and was also given my first dose of naltrexone at the same time. I still can't understand what happened to me, I'd been led to believe that the worst withdrawals from codeine were experienced in the first 3 days, not after 11 !!!! I'm having to detox on my own this time so will not have britlofex to help ease withdrawal symptoms, I'm just terrified that I will experience the same horrific symptoms and end up back in hospital as I know my body couldn't cope with that amount of pain/vomiting, as I said in my post, I'm a mother of 4 and what I experienced in January was the most painful thing I have ever had to endure, I was sure I was going to have a heart attack or stroke due to the intensity of the vomiting and the pain. If it turns out that what I experienced is normal codeine withdrawal symptoms, I really know that I couldn't do it again. Thanks again for your answer  .xx.
Avatar universal
Hi
If you were off codeine for 11 days I really doubt these were withdrawals. I think you had a bad reaction to the naltrexone to be honest. I was addicted to codeine and then dihydrocodeine for give or take 10 years+. I got put on subutex (not suboxone as that contains naloxone - similar to naltrexone) and unfortunately after a few months on the subs (buprenorohine) I got very sick and had to taper and get off. I believe some people can handle that drug with no problems (at low dose I.e 4mg or less...or you're asking for trouble or a new addiction to the sub), and iv just had to deal with just the mental part of the addiction because some of these meds they give to stop you from taking opiates can have a great impact on the body. For a heroin addict then yeah subs are a good idea. But for this type of addiction, if you try subs and they make you sick like they did for me (as well as feeling like a zombie and no energy - very depressing) it's best to just taper off your codeine and just restrain from them as much as you can. Buprenorphine (subutex) is incredibly strong and many many many doctors who prescribe this have their patients start at 8mg which is sooooooo much stronger than what I was even addicted to (30x30mg daily of codeine/dihydrocodeine) SO it's not the best idea to touch that stuff (which I personally call poison). Example - even with the doses I was taking but tapered down before I took the subs, at 2mg I found it hard to breathe!!! That's how strong these are. So yes there's a chance you may not react like I did, but there's a chance you will. Because codeine is strong enough to make you a full blown addict, but not as strong as heroin or oxycodone etc etc. you need to see a therapist or someone who can help you without resorting to these drugs that stop u craving opiates. One day you'll have to taper of those too (the subs) and it will be hard. It was for me. I was in bed for a month! Let me know what you think
Avatar universal
P.s britlofex is a hypotensive  drug. There will not have been any clash with the naltrexone to give you that reaction. You are just having a bad reaction to naltrexone which is possible occurance in people. Hence why I chose subutex and not suboxone (with the naltrexone in it). It's known to give bad side effects as you describe. Xx
Avatar universal
Thankyou for your reply. While I was in hospital the doctors kept saying about codeine withdrawals and I kept telling them that I hadn't had any codeine for 11 days. I had to go back to the addiction clinic when I was let home from hospital as they wanted to discuss whether or not I wanted to continue with the naltrexone. I said I didn't after what had happened, they too said they didn't know why I'd gotten so desperately I'll. I've always wondered why no doctor could explain it, I've googled naltrexone so many times too and have never been able to find anything out about unusual reactions to it.I'm just scared of it happening again, it was terrifying    .xx.
Avatar universal
May I ask how much codeine you were taking before your 11 days clean? And did u taper? X
Avatar universal
What naltrexone does is, after you are clean for a while off the opiates (never mind the hypotensive drug u were put on - that was just for codeine withdrawals at the time), if you take naltrexone, it will aggressively rip away any remaining opiates in the system from the body which is why you may have felt very sick. It's like fast forwarding the process and also stops you from getting any effects from an opiate. Some people can handle it long term, but not all. Some can get very ill, even after taking it for some time. Hope that helps a bit :-) best bet is to stay away from all these drugs, and get external help for yourself. And if you have children then you will find the will power for them and especially for yourself. I think subs, naltrexone, etc - all these drugs are short cuts to getting clean. They do help many life and death situations, but for codeine (exactly like my story with dihydrocodeine) it's best to tackle the psychological bit with (as posters above mentioned...) meetings, therapist, distractions etc and just try not to take anything unless you HAVE to (as in an injury and still then, there are other ways other than opiates to fix the pain). Check out calm support from youtube - a very nice man who posts info on these situations - you will learn a lot and it will help with the will power issue :-) xx
4522800 tn?1470325834
Hi Madge.

Lola gave you some great info..NO I do not think it was the codeine but the naltrexon that threw you into w/ds. Maybe it did not mix with the codeine that could of still been hanging on a bit??? I am going to the Drs today and he knows some about these meds. I will ask him his opinion. It does take awhile to physically w/ds meds out and the Mental goes on for awhile as those Brain Chems have to adjust back. YOU will be Fine in Time. Maybe search the web for some info about this too! Be Safe!

Bless
Avatar universal
Hi again, thankyou for keeping talking to me. When I was at my worst I was taking 16 cocodamol 30/500 twice a day. I managed to reduce and at lunchtime the day before I first went to the clinic I took 8 of these tablets, this was at the direction of the doctor in the clinic. So I took them and that was my last. I was doing OK the whole time I went until the 11th day when I was given the naltrexone. Within half an hour of taking it I'd started getting uncomfortable pains in my stomach, which as I described above intensified to pains that I can only describe as painful as contractions. I've been reading up on this all day and have discovered that naltrexone should only be given after the patient has been opiate free for at least 7-10 days due to the risk of precipitated withdrawals, I had been given it in the morning of my 11th day of being opiate free, do you think that what I experienced was a result of being given the naltrexone too soon in my detox ?? Surely what I experienced and described in my first post is too severe to be just codeine withdrawal symptoms ?? Thankyou so much for your help   .xx.
Avatar universal
Thankyou so much. I would really appreciate it if you could mention to your doctor about me. In a nutshell, I detoxed through an outpatient clinic. They gave me britlofex to help ease withdrawals. On day 11 of being codeine free (I was tested in the clinic regularly to be sure I was) I was given 25mg of naltrexone. Within around an hour and a half I could barely move with pains so severe in my stomach, I was projectile vomiting every minute or so. I was hospitalised and it was 4 days before I was allowed home. Thankyou so much    .xx.
3197167 tn?1348968606
When you detoxed in January 2014 at the outpatient clinic, the protocol they followed was a very good one...and one that is commonly used in the UK.  The "standard" waiting period before introducing the naltrexone is 7-10 days after you ingested any codeine and you hadn't had any for 11 days.  It is also "standard" protocol to begin with 25 mg and then increase it to 50 mg.  It IS possible that it was too soon for YOUR body chemistry and you had a negative reaction to the naltrexone.  It is also possible that other medications you were taking at that time could have affected your reaction.
This is what I read about the method of detox they used for you:

"Britlofex (Lofexidine) is commonly used in conjunction with the opioid receptor antagonist naltrexone in rapid detoxification cases.  When these two drugs are paired, naltrexone is administered to induce an opioid-receptor blockade sending the subject into immediate withdrawal and accelerating the detoxification process, while Lofexidine is given to relieve the symptoms associated with the withdrawal including chills, sweating, stomach cramps, muscle pain, and runny nose.  Lofexidine inhibits the release of norepinephrine in the central and peripheral nervous system, thereby reducing some of the withdrawal symptoms, but it has no documented effect on drug craving and endogenous opioid levels."

Since you had such a negative reaction once they administered the naltrexone, it could be that it was just too soon for YOU.  But as you said, they did do tests to check for the presence of opioids before they gave it to you.  You may also just be a person that is allergic to naltrexone.

For the sake of clarification in this thread, it is important to understand that naltrexone and naloxone ARE similar drugs (one lasting longer).  But that suboxone (buprenorphine AND naloxone) is NOT the same as naltrexone.

Madge, since you are withdrawing this time on your own w/o the aid of britlofex and naltrexone, what are your plans this time around?  Are you not able to return to the outpatient clinic or do you not want to?

I have read through your past posts and am wondering if the other medications that you were on may have affected your past experience.
At one time you mentioned you were on Seroquel, amitriptyline, ambien (zolpidem), and an antidepressant as well as drinking alcohol.  All of these drugs may have played a part it how you reacted to the naltrexone.

The BEST thing is... you have returned and are wanting to get clean again!
It always helps us to review what we learned before and what we can do different this time.  Eliminating ANY access is one of the most important things we can do.  The outpatient clinic you went to before sounded like an excellent clinic!  They had someone for you to talk to on a daily basis, a program to participate in, urine testing to hold you accountable, and a support group to attend one you were abstinent.  You made it almost 4 months last time....did you not go to the support group that was offered that you talked about?  If we can figure out where we went wrong the last time and talk about it with someone, then we can do it differently THIS time and get all the support you can imagine.
Keep talking to us....I wouldn't worry about an ambulance ride this time around if you aren't going to take an opiate blocker.  We are all here to answer any questions and help you along the way.  So glad you decided to commit yourself to getting clean again.  Welcome back and Merry Christmas Madge☼
Avatar universal
Thankyou so much for your reply. I'm detoxing on my own this time as last time going through the process of being referred to the clinic took months. What I am afraid is ending up so ill in hospital again, that experience was truly horrific. I ended up back here again as I started using the tablets again to simply cope with everyday life. I suffer badly with depression and always feel so anxious and overwhelmed, codeine seems to help me cope and motivates me. I no longer drink, I can't get a beer down anymore, I can't stomach it (which I'm actually happy about). It's not nice to imagine that I'll always have this addiction but I know that I will and will just have to learn to cope with temptation when I get off them again. The last time when I went for counselling I was seen for 14 weeks (it was only meant to be 12 as this is what they offer). I was told at the addiction clinic to avoid groups such as NA as that would be a place where I would only hear about different drugs etc from the other members. I have a supportive family although they really don't "understand" what it feels like to be in this position. I swear if I'm successful in quitting again that I'm going to do something to raise awareness about the addictiveness of codeine. Thanks again for replyin      .xx.
4522800 tn?1470325834
Wow!! This is why I just love my Soul Sister Clean_in_ks...That is just what the Dr had explained to me..However, I just told him you took the Naltrexon but he asked if you had taken the Lofexidine. I had NO clue that was the other name for that drug..Way Go CIK as always!!!

He said that Everybody Metabolizes there meds out different. Some can detox them out fast and others it is slow go..He felt that the Naltrexon did throw you into Precipitated w/ds..however..he rolled his eyes back and said after 11 days that does not usually happen. I think he thought that you were not being honest and had taken some other opiate..ha! I told him NO...He did ask if you had them both and was one given in a shot or both.

I agree with CIK you could of just been one of those that could handle that med or you still have some codeine in you that had not yet came completely free from you system..NOW it is time to get out and get into some aftercare.AA/NA is a great place to vent and let your deep feeling out. I NEVER get tempted to use. In fact it is the complete opposite...Addiction is a very serious Disease and WE can not stay clean without some kind of Support. YOU are using this for ONE out of many reason that is explained in the "Nature of Addiction" I put up in my Journal a few yrs back. PLZ be careful, come clean and just try to taper any other drug you get hooked on. Stay away from those heavy detox meds.
Be Safe, Be Good..Reach out for Support..The detox is the easy part (uncomfortable) but working on staying clean takes the cake..It is a day to day process!!! Dig Deep inside and let the ghost out. There is NO magic wond..Surrender to your God!!
Bless
Vickie
Avatar universal
Thankyou so much for mentioning me to your doctor. So, it would seem that it was the naltrexone that caused everything. Have you ever heard of what I experienced as just being codeine withdrawals at their worst, or is what I experienced too severe  ??  Thanks again and Merry Christmas  !!!!  
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