Up until this point, many of my blog posts have discussed the various psychological aspects of quitting opiates and getting through withdrawal. However, starting with my recent post on “The Art of Opiate Tapering”, I’ve decided to discuss the more pragmatic aspects of taking your first step off of opiates. After all, I can wax poetic about the virtues of being off of opiates until I’m blue in the face, but it won’t do anyone much good unless I clearly map out HOW to detox the right way.
But before I begin, I must remind you that what I’m talking about is only the “First Step”. This stage of detox is often described as “acute” and “post-acute withdrawal”. Essentially this is the time that you are cleansing your body of opiates. I’m not going to talk much about addiction or cravings or how to “fill the void” in this post. Withdrawal Ease is dedicated to helping people take the first of many steps towards detox from opiates and staying off of them. What you learn on the site or from the Survival Guide, and what you experience with the product is for one purpose and one purpose only:
To get through your withdrawal as comfortably as possible in order to increase your chances for a successful detox.
Obviously, there are millions of different tactics, tinctures, potions and strategies that people try to get off opiates. And some might argue that there is no “right way to” do it… just different ways. But there are empirical facts, published data and proven results that always point towards several key strategies that have been proven to reduce the acuity of withdrawal. I’m going to share some of those with you now. I should also point out that what I describe in this post concentrates mostly on Home Detox. I will briefly touch on other options for detox but most of you want to know how you can detox comfortably in your own home, on your schedule, privately and without having to pay an arm and a leg.
This post will include several different strategies and subsequent tactics that I will summarize below and then go into more depth later on. As I will emphasize throughout this post, YOU are the engine that drives this process. Opiate addicts are pathologically wired to expect instant results with minimal effort but that’s not reality. There is no silver bullet… there is no panacea. Even though your pills may provide almost immediate effects, getting off of them requires effort, discipline and patience. That’s why it is so hard for those of us who are dependent on opiates to quit. It takes a complete paradigm shift in our thought processes to detox successfully. It cannot be done with a single pill (regardless of what the makers of Suboxone may tell you). Unless you are engaged and committed, your chances of getting through your withdrawal diminish significantly. I’m not passing the buck here — just being honest.
Alright, let’s get to it. The following are the main tenets of detoxing the right way at home as I have defined it.
As a “memory management device,” I’ve devised this easily recalled acronym: C.P.T.P.C.R.P. (T-shirts and bumper stickers pending)
1. Commit: This is the point when you say “Help!” OR “Enough!”
2. Prepare: Getting ready for your detox process.
3. Taper: Less opiates in body = less severe withdrawal symptoms.
4. Prime Your Body (And Mind): The detox is literally a “shock to your system” but you can prepare it to handle the rigors of withdrawal.
5. Conduct your detox: It’s important to think of this process as yours. You are conducting this detox on YOUR terms. There are proven ways to make this process less agonizing!
6. Recover: Patience and acknowledging the little improvements that happen each day.
7. Plan Next Step: What to do now?
Step #1. Commit:
Obviously, this is a crucial part of the process and requires a great deal of courage. This is the point when you say “enough is enough” and decide that the “fun” is over. Too many things have happened to you and you want to get your happiness back. It’s a small step but a profound one because this when you change the direction of your life. Many of you are already at this point or perhaps almost at this point when you visit a site like withdrawal-ease.com. If you read The Top Ten Reasons To Quit page on this website and you can relate, then you’re probably ready to quit whether you like it or not. I also have a multitude of other posts dedicated to this crucial first step and I encourage you to read a few of them.
All of these posts articulate basically the same thing in different flavors. You need to quit needlessly taking opiates. Life is better when you quit. You won’t miss anything and you’ll live to a ripe old age hopefully.
I have found that just uttering the words “I Need Help” to yourself or — even better — to someone you trust can jump-start this process. You’re not helpless or hopeless or even (dare I say) powerless. You just need a little help to get your life and happiness back. If at all possible, give your friends and loved ones the benefit of the doubt and ask one of them for help. You might be very surprised at their response. Don’t worry about the bridges you’ve burned or the promises you’ve broken in the past. If you ask for help, 9 times out of 10, that person will help you. Sometime that one little act of acknowledgment of asking for help will begin to make you feel empowered. And if this is where you’ve come for help, then great!
You MUST gather the courage, understand how profoundly unhappy your are, recognize that being unhappy is unacceptable, and take control. Then it’s time to put together your plan to get your contentment and your life back. Your happiness was taken from you by the pills, and you want it back, dammit!
Step #2. Prepare:
Now is the time when you map out your detox strategy. There are some options out there to help but many are unsuitable due to the cost and time required:
—In-patient detox and intensive outpatient (IOP) follow up
—In-patient detox + Rehab (30-90 days)
—Rapid detox under general anesthesia
If you have come to Withdrawal Ease and are reading this post, I have to assume that for a variety of reasons you are interested in trying a to detox from home. I have done every single one of these detox methods (minus rapid detox…too scared) and personally think that a home detox is the best way to go. But this is a very personal decision and what you decide depends on a variety of factors:
—Comfort of detox
Whatever you choose, it really comes down to what gives you the best chance to succeed based on your circumstances. I’m not going to debate the merits of one vs. the other here. Each day, thousands of people commit to quitting opiates and many do not have the time or resources to participate in a medical detox or rehab. If you simply need to get through your detox and withdrawal in the most comfortable way possible, I think that detoxing from opiates at home makes a lot of sense. Opiate withdrawal is not considered life threatening and if you go to an emergency room for opiate withdrawal symptoms they will most likely observe you, give you some Benzos and send you on your way with a big, fat bill. And NO, they will not give you a straight IV push of Dilaudid or Verset (opiates that are industrial strength and used in hospitals).
So… if you have decided to detox from opiates at home, let’s just say that you’ve come to the right place. I’m also going to assume that you have the Withdrawal Ease product and the Survival Guide. If you don’t have the product and the Guide not to worry; you’ll still find this very useful and we offer the Guide as a free download. However, if you detox at home and don’t use these two tools you are going to be more uncomfortable than you have to be. If you’re hell-bent on not buying the product, I will not leave you out in the cold. I’ll give you a link to all of the ingredients in Withdrawal Ease. There are many ingredients in our formulations but you may be able to find a lot of them sold separately in a store like GNC. But who wants to spend $300 bucks on stuff that you’ll never use again when you can buy one system for 300% less? Do you really think you’re going to need this stuff later on? Nevertheless, to be completely impartial, I’ve listed the ingredients and you can do as you wish.
Putting together your plan can be as simple or as detailed as you want. I hate all of those self help books that look like it’s going to be soooo easy to be happy again! And then you start reading it and there are all of these complicated steps and processes to follow which end up overwhelming you and ironically making you feel inadequate! So don’t kill yourself on the details here. The Withdrawal Survival Guide has a lot of that. Just remember that this will represent the framework and guard rails of your detox; so whatever your plan is, you need to be prepared to follow it closely.
Your Home Detox Plan Should Include The Following:
1. Your timetable, taper plan and detox date: I would recommend planning your detox at least 30-45 days in advance depending on your taper schedule (I will go into tapering later on). And don’t get all relieved because you have 30 more days to take pills. That “fun” is over, pal. Those people on Suboxone need to taper for at least 3 months, so keep that in mind, folks. Or, see my page on Suboxone withdrawal to get more info on what you need to do for a Sub detox.
2. Your support structure: Is there someone that you can trust that can help you through this? Even if you just tell a good friend what you are planning to do, this is a good thing. It’s always better to have a loved one to be with you (or be on-call) during this process. If you don’t have any loved ones OR friends, isn’t there some cool guy or girl at work that you can trust??? If not, then that’s okay. It’s just a good thing to have that support when you need it.
3. Your budget: Although you may be avoiding pricey detox centers and rehabs, you’re going to need to shell out some money for supplies, food, movies etc.
4. Your “to-do” list: The Withdrawal Ease Survival Guide has all of this info in it and should include things like:
—Supplies needed for detox
—Childcare needs. Do yourself (and them) a favor and find someone who can take care of the kids for a couple of days. Even if it’s just for a good portion of the day. Spend the money to get a babysitter if you have little ones because you’re NOT going to want to take care of them when you are in withdrawal.
—Job responsibilities and possible comp time. Have any vacation or comp days that you can use for the detox? If you do, use them because it will be worth it.
—Financial responsibilities that you will NOT want to take care of during detox (electric bills, car payments etc.)
—Any visits or dates that you’ve scheduled. Do you really want Uncle Stanley coming over when you’re in withdrawal?
5. Your 5-7 day, daily detox schedule: I have written out a detailed day to day detox plan in the Withdrawal Survival Guide but you can take that schedule and make it your own. Try to fill your days during the acute detox period with a lot of activity and then designated sleeping/rest times.
6. Your Wish List: I think that this is a crucial part of the planning process. You need to put together a list of all the reasons why you are doing this. “Getting your happiness back” is an obvious favorite of mine but feel free to be more specific. Things like:
—Have more energy and desire to play with my kids
—Improve my marriage
—Do a better job at work
—NOT be depressed and moody all of the time
—Save Life/avoid unwittingly overdosing on my pills
—Enjoy activities that I used to enjoy but no longer do
—No more guilt
Etc. etc. etc. You get it. This list should be with you at all times. You can even dork out and get a card laminated with the reasons why you’re quitting. But whatever you do, you need to keep these at the forefront of your mind.
7. Your Plans for After Detox: You’d be really surprised at how much time you spend on your addiction/dependency. All of the doctors appointments, pharmacy visits, counting pills, counting pills again, thinking of excuses why you need your script filled 2 days earlier and counting your pills a third time. All of this time needs to be filled by something, so try and think about things you might want to do with that extra time. This could be closely related to your wish list and can be combined with it. But the fact is, you’re going to have a LOT more time to do stuff than you think. Idle minds and idle bodies lead to idle thoughts which lead to pills.
8. How are you going to STAY off of the pills?: This is the rest of your life that Withdrawal Ease cannot actively help you with. You need to figure out how you are going to stay off of your pills for good. You can never take opiates again unless you have a medical emergency. Therefore, you might need some support for cravings, triggers and any addictive behavior that you think may or may not manifest itself. We have a product called Recovery Ease that is a dedicated supplement system (Day and Nighttime formulations) which can help with post acute withdrawal symptoms and ongoing detox. Think of Recovery Ease as a multivitamin optimized for opiate dependency recovery; it also includes a version of our Nighttime sleep aid.
Don’t blow this off and say you’re gonna be fine. Assume that you are going to have some cravings and play it conservatively. I don’t care if it’s AA or NA or simply getting a therapist… there’s a multitude of good options out there for you. I know, I know… you’re “just physically dependent” but even if that’s the case, plan for the worst and make sure you have resources that can help you stay off of the pills. This is -of course- important.
Step #3. TAPER:
Tapering is critical. If you slowly reduce the concentration of opiates in your body, your withdrawals should be less acute and perhaps take less time. Many of the people that have been successful with the Withdrawal Ease plan have used some sort of tapering method. There are many people who believe they cannot taper and that is not true. If you have an adequate supply of your “meds” to ween down from, you can taper. If you can find someone to help you stay on schedule with your taper and keep you “honest”, even better! Make sure you read up on our suggestions for finding your “pharmacist” in the Survival Guide.
Bottom line: Those that taper can get a LOT of benefit from it. It’s just a matter of telling yourself, “I’m quitting now and I’m going to take as little as I need to stave off of the sickness… that’s it… the party’s over and I’m moving on.”
For a complete step-by-step process on how to build your own tapering plan, I would highly recommend that you look at my post on “The Art of Opiate Tapering”.
Step #4. Prime Your Body (And Mind):
As you taper, you also need to start doing things like exercising and preparing your body for the detox process which can be quite a shock to the system. Take the time to eat well, exercise and keep yourself well hydrated. I also highly recommend taking Withdrawal Ease Daytime and Nighttime formulations as directed about 5-7 days before your detox. You can take Withdrawal Ease with opiates during this 5-7 day period. This will allow your body to absorb some of the nutrients and adjust to the new ingredients being introduced into your body. Bodybuilders and others call this “loading up” or “saturation”, but I just call it “taking the product 5-7 days before detox”.
There’s also some psychological benefits to priming your body before the detox period. You’re going to be thinking and worrying about all sorts of things and perhaps some of that anxiety is good but it can only benefit you so much. All of this preparation and activity will help ease your mind and reinforce the fact that you are the one who is in control. You are doing everything that you can to help prepare yourself mentally and physically for your withdrawal. That’s all that you can do.
Writing down your priority lists and/or your supply list will also help keep your mind out of hysterical mode. Speaking of hysterics… read anything scary on the Internet message boards lately??!
For the love of all that is holy, DO NOT go onto any message boards about opiate addiction, detox, withdrawal etc. Although they are meant to be “supportive”, I feel strongly that they are very toxic environments and will do absolutely nothing to help you. Internet message boards are not where you will find facts nor are they places that will soothe your anxiety; quite the opposite. They are made up of packs of needy and lonely people who have nothing else to do but act like victims and scare people like you and me. Sounds harsh doesn’t it? It’s the truth. Sometimes I will “lurk” on a message board to see what kind of “advice” people give out and it’s appalling. It’s shocking that a person who has 1,500 posts on a board about opiate addiction somehow gets treated with the kind of reverence and trust that an actual clinician might get. Remember, regardless of how many posts a person has, for all you know they don’t know squat. In fact, I’d go so far as to say that the more “posts” a person has the more suspicious you should be.
Even if you’re not on a message board to get advice and you’re just lurking around to see if anything might give you some insight, you have no clue as to what you’ll find. Most likely, it will be hysterical and will only increase your anxiety. I cannot tell you how many boards I’ve gone on where people say stuff like, “IF I HAVE TO GO THROUGH ONE MORE DAY OF THIS I’M GONNA DIIIIIIIEEEEEE!!” or “pleeeze tel mee when this is gunna end!!!!”
How is something like that going to help you out? That isn’t reality and you’re not going to die from opiate withdrawal. You’re going to be sick… just sick. You’ve been sick hundreds of times and this will be no different. I can tell you that I’ve personally experienced opiate withdrawal at least 5 times and it’s nowhere near as uncomfortable is a bad stomach flu recovering from surgery or breaking a bone. In fact, if you told me that I had a choice between wisdom tooth extraction and 3 days of opiate detox, I would take the detox in a heartbeat! Does it suck? Yes it does. But if you do it the right way and take steps to control the acuity and duration of your withdrawals, it’s completely bearable.
I’ve had people who took up to 60 Percocets a DAY along with various other muscle relaxants who have been able to go back to construction jobs after 2 days of detox. They tapered, followed the Withdrawal Guide, took the product and got through it. For some, it may take a little longer to recover but if those people could get through it, it’s safe to say that you can too. Ultimately, you must remind yourself of this one thought: What’s a few days being sick compared to the weeks, months, and even years that you’ve been chasing this demon?
Your health and happiness are worth it and you need to remind yourself of that as you prepare…Bring it!
Step #5. Detox:
So hopefully at this point, you’ve done your preparations, you’ve tapered your meds and hopefully started taking the Withdrawal Ease. You’re ready. Now is the time to refer to your daily schedule or perhaps the outline of the schedule that I have written in the Guide. You’ve done everything right up until this point and now is the moment of truth. At this point, hopefully all responsibilities are either not applicable or delayed for a few days so that you can concentrate on yourself. If not, well then you’ll just need to make the best of it, which is the case for many people.
Even though you may have your own daily schedule or perhaps are referring to the Guide, there are some main FAQ’s and strategies that I want to emphasize about the detox period. Perhaps you may not have bought the product or are trying something different so I want this to be helpful. Two of the worst aspects of opiate withdrawal are fear and not knowing so hopefully this will be useful:
5 Most Common Opiate Detox FAQ’s From withdrawal-ease.com (Caution: some drugs have longer half-lives than others so withdrawal periods will vary. The figures below are for the usual offenders like Vicodin/Hydrocodone, Percocet etc.):
How long is it going to last? Typically an acute opiate detox lasts 3-5 days with some residual symptoms hanging around for a week or so after that. After 3-5 days, your symptoms will dissipate a bit more each day and you’ll start to get more and more sleep.
What are the symptoms? Here are the most common symptoms of opiate withdrawal.
Will I be able to work? Do not plan on going to work between days #2-#3 as those are the most acute days. Click here for a graph on a typical withdrawal duration and acuity. As I mentioned, this may vary and many folks feel ok to work sooner… but plan for 3-5 days
Will I die? Yes, eventually you will die but probably not from opiate withdrawal. It’s very, very rare for people to die from opiate withdrawal. If you keep taking opiates, your chances of mistakenly killing yourself due to an overdose are FAR greater. If something is obviously wrong… like your heart stops or you cannot breathe… get yourself to a hospital! But the fact of the matter is that the medical community does not consider opiate withdrawal to be a life-threatening event. I’m assuming a certain level of common sense is applied to every situation but I would not worry about dying from opiate withdrawal.
Can the withdrawals last forever? No. It may seem like it but opiate withdrawal symptoms usually last a few days and then slowly dissipate.
Some Good Detox Strategies To Follow (During the Acute Detox Period)
1. Stay busy and active as much as you can.
2. Eat well and hydrate a LOT.
3. Get some moderate exercise each day. Don’t enter a triathlon, just walk briskly for a bit each day.
4. Take hot showers multiple times a day.
5. Read over the reasons why you are quitting if you ever get discouraged.
6. Restless Legs? At night, right before you slip into bed, I would take some Ben-Gay cream and rub it onto your thighs and calves. After applying the Ben Gay, take two towels and wrap them around each leg firmly (but not too tight). You can take the corners of each towel and tuck them in to make sure that the towels don’t unravel. Then slowly and carefully, slide your legs into bed. It’s an old “growing pain” trick that I found to be very useful for those night time RLS bouts. By applying pressure and heat you can help reduce the muscle spasms and twitching. A customer of mine named Jim also told me that compression socks can work well too. Thanks Jim!
7. If you can take things like Advil and Immodium (as directed), they will help.
8. Things like funny movies and books on tape (I use my iPod and download books from iTunes or audible.com) can help make the time pass.
9. Get out of the house at least once a day and run an errand. “Sheesh…I HAVE to be the only one in this grocery store withdrawing from opiates. Wait, why is that guy sweating so much?!”
10. Understand that the depression that comes along with the withdrawal is exactly that. Everyone gets depressed when they are in withdrawal. Keep telling yourself that and keep reminding yourself that the depression is a chemical reaction caused by your detox. It’s a symptom that will go away just like the other ones.
Step #6. Recover:
After the initial/acute detox phase which can last up to 7 days (it’s usually 3-5), you’ll need to prepare yourself for recovery. The technical term for it is PAWS. (Post Acute Withdrawal Syndrome). The one thing that I emphasize to all of my customers during the recovery phase is PATIENCE. I know… you hate that word as much as I did so maybe I could substitute the word “perspective” instead? Remember, we are all used to the instant gratification of taking opiates, but your detox doesn’t follow those rules. Most people turn back to their pills at this point because they get discouraged about not feeling immediately better. Don’t do this! You’ve come tooooo far and it’s too late to turn back. The keys to a successful recovery are all rooted in resolve and patience, but I’ll give you a few tips to make sure that you get through this period without doing something stupid like starting to take your pills again:
1. Did I say patience? I meant to say perspective. Most people go back to their pills after the worst part is over. Don’t make the same mistake! Each day after the acute detox period, you will experience slight improvements in how you feel both physically and mentally. It’s your job to recognize those improvements and refer back to the reasons why you are quitting. Notice any similarities?
2. Keep following the eating and exercise regimen from the Survival Guide. In fact, consider eating right and exercising for the rest of your life. Evidence suggests that this is good for you and will shorten the recovery period.
3. Make sure that you keep taking the Withdrawal Ease. There should be plenty of product left to take and most customers take it for the full month and then stop. There are no withdrawals when you stop using it.
4. Remember to stay off of the Internet boards/message boards. Misery loves company and you are no longer very good company to some of those folks. I know, I know… many of those people may give you a virtual high five or use some sort of congratulatory emoticon, but let’s face it… that part of your life is over. You need to train your mind to think about other things other than opiates. If you want to help others that’s fine. But remember that the message boards didn’t detox for you and they won’t recover for you either. Move on.
5. If you can, start up an old activity and/or hobby as soon as possible. You’ll be amazed at how much time you have now that you don’t think about pills. You need to fill that time with something else or your mind will start to default back into that pill mentality. Do something/anything to fill this time with something that gives you pleasure and distracts you from your recovery.
6. Although I mention eating right above, I have to emphasize the importance of hydration during this time. Your body has gone through the ringer and it needs as much replenishment as it can get. If you are peeing more than you would like to, that’s probably a good indication that you’re well hydrated. Keep on peeing!
7. Call a friend or relative and tell them that you’ve kicked pills and are in recovery. Obviously this needs to be someone you trust but if you have someone that you can talk to, you’ll be amazed at how good it makes you feel and how proud you are of your accomplishment.
8. IMPORTANT: Call your doctor(s), dealers, pharmacists etc. and tell them that you have become dependent on opiates and no longer wish to take any now that you have detoxed. Whether you like it or not, these are all people who financially benefit from your dependency or addiction and they need to know that you are no longer in the market. Of course, many people like your pharmacist and doctors may have had no idea that you were dependent or addicted but you need to take the first step and tell them about your issue. Under HIPPA patient privacy laws, your doctor and your pharmacist are not allowed to discuss your situation with anyone else, and if they do, you can sue their asses. So don’t worry about people calling the police or anything. You don’t need to give out many details. The goal here is to make sure that your “suppliers” know that you are no longer interested. If you choose not to do this then you will be welcomed back with open arms if you decide to start taking pills again. You don’t want that.
9. Buy yourself something. You deserve a selfish, needless present for what you’ve accomplished. Many of you will now be saving a lot more money since you will not have to feed your habit. You don’t have to go and buy yourself a Maserati (2014 GT Spyder, dark blue with cream interior) or anything like that… just something that makes you smile and that you’ll enjoy.
10. Read your reasons for quitting when you wake up and before you go to bed. You are going to be happier when you have fully recovered. Honestly and truly happier… I promise.
Step #7. Plan Next Step: What to do now?
After a full month, you should be totally detoxed and feeling much better in every way imaginable. Some of you will be happy to forget about your pills and just be glad to get off of them. You’ll go on with your life and hopefully move on from this whole episode. Perhaps you were simply physically dependent on your pills and are extremely happy that this whole nightmare is now over. Well good for you and consider yourself lucky to have this over with. However, there may be some fences to mend with friends and loved ones about your mood swings, poor performance at work etc. I urge you to dedicate the next few months to patching up all of the things that may have gone by the wayside. Your friends and family will forgive but you need to make sure that you make it clear that they are your priority now. They weren’t your priority when you were taking opiates…the opiates were.
Of course, life will still have it’s good days and it’s bad days. In the past, you may have “hid” from those bad days by using pills, but by and large, you’ll be happier and healthier now that you’re off of the pills.
For those of you who were both physically and psychologically addicted to opiates, your road to recovery may be longer and more complicated. As I mentioned at the beginning of this blog, Withdrawal Ease is not meant to help with cravings and addictive impulses— just detox. Nevertheless, there are tons of people and organizations out there that can help you. AA, NA, group therapy, individual therapy with an addictionologist — these are all good avenues to take if you continue to have cravings. I don’t have any bias towards any one of these support systems other than the fact that AA seems to think they have all of the answers. They don’t. For some people AA is great but it doesn’t work for everyone and there are plenty of other viable options to help you cope. “Whatever works” is my motto and it’s a motto that seems to work quite well.
For some, the thought of not being able to take pills ever again is a scary one. Just remember that the only thing that you’ll be giving up is loneliness, guilt, poor health and repeatedly putting your life in danger…it’s not worth it anymore.
Thanks! And good luck!
Disclaimer: I am not a licensed clinician or addictionologist. The post above is for reference purposes only and should not be considered “medical fact” or “standard of care”. It assumes that you are of sound mind and have the ability to make common sense decisions about your specific circumstances and your health. I have gathered this information from a variety of sources including but not limited to: clinical literature, speaking with clinicians, addictionologists and other recovery specialists, personal experience, first hand accounts of detox and Withdrawal Ease customers. As always, all detox plans are best explored with your primary care doctor, prescribing physician or psychotherapist.