The Thomas Recipe – What Is It and Can It Really Help Opiate Withdrawal?

 

Dear Thomas: It is alleged that you passed away in 2008: R.I.P. With one simple post on a message board, the Thomas Recipe was born and you made an impact on countless lives (and no doubt saved a bunch of them). If it is true that you passed away in July of 2008, it was one month before I started Withdrawal Ease. To be honest, it was not until after I started Withdrawal Ease that I actually found the original Thomas Recipe post and I was awestruck at how many people had searched for it, read it and shared it. That one post alone gave you an express ticket to Heaven.

Thanks Thomas! 

-George

I recently read on a message board that Thomas had died of an overdose in 2008. Based on the accuracy of message boards, there’s a 50% chance that Thomas is alive and well. Nevertheless, the Thomas Recipe has achieved legendary status among those looking for help with opiate withdrawal and detox symptoms. For those that were forced to detox at home due to finances, time, children or other facts of life that prohibit most people from checking into a posh rehab with cooking classes, yoga etc., the Thomas Recipe was invaluable because it was free.

In this respect, Thomas certainly achieved grace and a heavy dose of good karma. He probably could have made a LOT of money off of his intellectual property. I know some would suggest that money is not the issue but perhaps Thomas needed some; if so, it would have been richly deserved.

I know that this post is coming perilously close to being a eulogy…I simply want to pay my respects before I suggest that the Thomas Recipe is -in many ways- flawed. To be fair, we’ve learned a lot about opiate withdrawal and detox since the Thomas Recipe first appeared in that famous blog post. In the following blog entry, I will list the full recipe for those of you who are simply curious about what it is. I do not think the Thomas Recipe post itself is under “copyright” but I have noted the source of the current post below. The recipe is verbatim…typos and all!

As you will see, the Thomas Recipe itself is generally organized by line item. After each line item of the plan, I have added my thoughts (“Note:” followed by blue text) which include suggestions, warnings and other opinions on how to improve upon the strategies and “ingredients” in the recipe.

THE THOMAS RECIPE FOR COLD TURKEY DETOX OFF OPIATES

-by Thomas,

If you can’t take time off to detox, I recommend you follow a taper regimen using your drug of choice or suitable alternate — the slower the taper, the better.

Note: I could not agree more. Tapering is a slam-dunk way to reduce the intensity of opiate withdrawal. I’ve inserted a link above to our blog post called The Art of Tapering which will give you a good overview of the tapering process and how to put together your own tapering schedule

For the Recipe, You’ll need:

1. Valium (or another benzodiazepine such as Klonopin, Librium, Ativan or Xanax). Of these, Valium and Klonopin are best suited for tapering since they come in tablet form. Librium is also an excellent detox benzo, but comes in capsules, making it hard to taper the dose. Ativan or Xanax should only be used if you can’t get one of the others.

Note: I’m not crazy about this unless unless a doctor is involved and the prescription is for no more than 2 weeks. Since benzos are highly addictive (and can cause their own withdrawal symptoms), I would only take these meds if prescribed specifically for your detox. Having said all of this, they can be beneficial if you suffer from a lot of anxiety during withdrawal. Some people struggle with anxiety more than others during the withdrawal process. When I was in opiate detox, lack of energy was a bigger issue for me than anxiety, so benzos were not worth it for me.  

2. Imodium (over the counter, any drug or grocery store).

Note: Huge! Imodium is a big one and I’ll give you some background. The active ingredient in Imodium (or most generic anti-diarrheal medications) is called loperamide. Loperamide is the secret sauce because it is an “opioid receptor agonist” that binds to the opiate receptors in the lining of your large intestine. Even though it has a similar “mechanism of action” as morphine et. al. Loperamide is non-narcotic because it does not cross the blood-brain barrier which is what is necessary to produce narcotic effects and dependence.

Loperamide works by slowing down the activity of your gut and therefore reducing cramping and diarrhea. In many respects, it is for this very reason why many opiates can cause constipation. I know that this must be riveting for many of you! Ultimately, that is why Imodium is so effective at reducing the intensity of withdrawal. However, I take issue with Thomas (and others) about how much Imodium is necessary and/or safe.   

3. L-Tyrosine (500 mg caps) from the health food store.

L-Tyrosine is one of the key ingredients in Withdrawal Ease. It is a great non-essential, amino acid that is converted to L-DOPA by an enzyme called tyrosine hydroxylase which is involved in the production of dopamine. Dopamine is a neurotransmitter that works in the pleasure centers of the brain to reduce stress and fatigue. Dopamine and serotonin production are essentially shut down during opiate withdrawal so L-Tyrosine can help for those suffering from opiate withdrawal symptoms

4. Strong wide-spectrum mineral supplement with at least 100% RDA of Zinc, Phosphorus, Copper, Magnesium and Potassium (you may not find the potassium in the same supplement).

Note: Opiate dependence can leave the body nutritionally compromised so nutritional supplementation can be very beneficial. Withdrawal Ease and Recovery Ease have many of these ingredients but there is certainly no harm in taking a wider spectrum multi-vitamin as directed. 

5. Vitamin B6 caps.

Note: Agreed. We include B6 in Withdrawal Ease because its active form Pyroxidine or Pyroxidal 5 Phosphate are co-factors in neurotransmitters such as serotonin, dopamine, epinephrine and GABA.  

6. Access to hot baths or a Jacuzzi (or hot showers if that’s all that’s available).

Note: Hot showers are a staple for opiate withdrawal and we recommend taking several a day during the acute portion of withdrawal.  It stands to reason that if you have a jacuzzi, you have a shower. We recommend showers just because of the water pressure. 

How to use the recipe:

Start the vitamin/mineral supplement right away (or the first day you can keep it down), preferably with food. Potassium early in the detox is important to help relieve RLS (Restless Leg Syndrome). Bananas are a good source of potassium if you can’t find a supplement for it.

Note: We recommend taking Withdrawal Ease 5-7 days prior to detox because the ingredients need to load-up in the body. Starting nutritional supplements during the detox will deprive you of many potential benefits. 

Begin your detox with regular doses of Valium (or alternate benzo). Start with a dose high enough to produce sleep. Before you use any benzo, make sure you’re aware of how often it can be safely taken. Different benzos have different dosing schedules. Taper your Valium dosage down after each day. The goal is to get through day 4, after which the worst WD symptoms will subside.

Note: As I mentioned in the beginning, taking benzos is a slippery slope. The Thomas recipe recommends using drugs like Xanax, Valium etc. but it can cause dependency which is why we highly recommend seeking the advice of a doctor prior to taking any benzodiazepines for opiate withdrawal. On a personal note, I never found benzos to be that effective for withdrawal symptoms. In fact, there were times that it made me feel worse. The use of benzos is one of my chief complaints with respect to the Thomas Recipe both from a health perspective as well as a treatment for withdrawal.   

During detox, hit the hot bath or Jacuzzi as often as you need to for muscle aches. Don’t underestimate the effectiveness of hot soaks. Spend the entire time, if necessary, in a hot bath. This simple method will alleviate what is for many the worst opiate WD symptom.

Note: Agreed although I prefer showers…certainly not worthy of a big debate; do what works best. It’s also important to note that you do not want to take a both that is too hot; although sweat is good, you want to soak for a while and an extremely hot bathtub will increase your blood pressure. Your blood pressure is already elevated during withdrawal so make sure the temperature is not too hot…or you could just take a shower:)

Use the Imodium aggressively to stop the runs. Take as much as you need, as often as you need it. Don’t take it, however, if you don’t need it.

Note: Disagree. You don’t know how much you “need” and for most people who have taken opiates, we are the absolute worst judge of what we need or don’t need! Did you really need to take that 5th vicodin? The fact of the matter is that chugging Imodium to your heart’s content is not necessary or advisable. I’ve seen some people on YouTube suggesting that taking 10x or 15x the recommended dose is “optimal” to reduce withdrawal symptoms. Your body and gut can only take so much before any additional becomes ineffective and/or unhealthy. In fact, slowing down the gut too much can cause an impaction (bad) or even a syndrome called toxic mega-colon (worse).

Ultimately, take as directed and if you want to take more doses in between go for it but I’ve never had any success using massive amounts of Imodium… believe me when I say that I’ve tried.   

At the end of the fourth day, you should be waking up from the Valium and experiencing the beginnings of the opiate WD malaise. Upon rising (empty stomach), take the L-Tyrosine. Try 2000 mgs, and scale up or down, depending on how you feel. You can take up to 4,000 mgs. Take the L-Tyrosine with B6 to help absorption. Wait about one hour before eating breakfast. The L-Tyrosine will give you a surge of physical and mental energy that will help counteract the malaise. You may continue to take it each morning for as long as it helps. If you find it gives you the ‘coffee jitters,’ consider lowering the dosage or discontinuing it altogether. Occasionally, L-Tyrosine can cause the runs. Unlike the runs from opiate WD, however, this effect of L-Tyrosine is mild and normally does not return after the first hour. Lowering the dosage may help.

Note: There’s a lot of experimentation here that concerns me. I would not recommend taking 4,000mg’s of L-Tyrosine. Don’t get me wrong, I’m a huge fan of L-Tyrosine but it can make people really, really jittery even at nominal doses. Furthermore, taking that much on an empty stomach will very likely lead to re-introducing yourself to them on the way back up. If you are lucky enough to keep 4,000mg of L-Tyrosine down, you do run the risk of having some serious anxiety or even a panic attack. If you decide to supplement the L-Tyrosine in Withdrawal Ease with more, I recommend following the dose on the L-Tyrosine label first and wait for 24 hours to see how you respond.    

Continue to take the vitamin/mineral supplement with breakfast.

Note: I believe that nutritional supplements should always be taken with food but perhaps there are those of you who have an easier time keeping them down on an empty stomach. I’m not aware of any data that suggests that taking nutritional supplements on empty stomachs increases efficacy. 

As soon as you can force yourself to, get some mild exercise such as walking, cycling, swimming, etc. This will be hard at first, but will make you feel considerably better.

Note: This line highlights one of the most significant differences between the Thomas Recipe and our program. I realize that the Thomas Recipe is simply that…a “recipe.” It’s a grocery list of some key components that can be beneficial during withdrawal but it is by no means comprehensive. Unless you are physically incapable of doing so, exercise is an essential part of any detox recovery plan. It’s hard to overstate the importance of regular exercise; it will improve your physical as well as emotional well-being during and after withdrawal. We make a concerted effort to provide many of the tools that can help you reduce the discomfort of opiate withdrawal and the vast majority of this information is free. The Withdrawal Ease Survival Guide is a 65-page book and the Thomas Recipe is a list…it would be unfair to compare the two. Ultimately, it is critical to realize how much more information is available to you now; take advantage of it! 

——–

Yes, it’s my recipe, though many addicts contributed their wd/detox experiences to its development. While there has been some clinical research into L-Tyrosine, and some rehabs now use amino acids such as L-Tyro for opiate and cocaine detox, because it is a naturally occurring amino acid, pharmaceutical companies can’t patent it. Therefore, no meaningful research is or probably will be done (in the US, anyway).

Note: Thomas was right on this one. Non-essential amino acids (such as L-Tyrosine) have not been at the forefront of research when it comes to opiate withdrawal relief and it’s a shame. But as long as nutritional supplements such as medicinal herbs, vitamins, minerals and amino acids are exempt from any intellectual property protection, it is unlikely that any private company would spend the money to research the benefits. Nevertheless, there are many that are satisfied with empirical evidence; if it has worked for them or someone they know then that’s good enough. Regardless of what the media, pharmaceutical companies or others might suggest, there’s a reason why millions of people over the years have used these ingredients for opiate withdrawal…they work. 

I’ve tried to keep the recipe text as simple and non-technical as possible, but I need to provide more info for all the addicts like me who consider following directions optional, including two caveats:

1) If L-Tyro is started too soon in the wd/detox process, it can make the detox impossible to continue. Like the pill-ravenous beasts that we all are, many addicts start gulping the L-Tyro on the first day of wd — an appallingly bad idea, considering that sedation (from the benzo), muscle relaxation (from the benzo/hot bath/potassium combination) and inhibition of bowel motility (from the Imodium) are critical at that point and L-Tyro acts to defeat all of them.

L-Tyrosine therapy should NOT be started until you’re no longer feeling the acute opiate wd symptoms (you know what they are — sweats, cramps, runs, vomiting, insomnia, RLS, etc.) and are now dealing with the aftermath — total lack of mental, emotional or physical energy.

Note: I strongly disagree. Although Thomas categorizes L-Tyrosine as a stimulant, it is not. By acting as a pre-curser to the neurotransmitter norepinephrine, L-Tyrosine helps the body recover from stress. Many of the clinical trials on L-Tyrosine focus on its ability to help the brain recover from stressful situations and sleep deprivation by improving mood and cognitive function. Substances that improve cognitive function and mood are often associated with stimulants (Adderall etc.) but in the case of tyrosine, the data suggests that it merely reduces the impact of stress on the body and enables faster recuperation. This may translate into increased energy or enhanced mood but it should not be considered a stimulant per se. This is an important distinction.

Opiate Withdrawal and detox is an extremely stressful process so it makes sense that any stimulant could potentially increase anxiety which is not what we’re looking for. Opiate withdrawal can make us feel uneasy and skittish which is why hot showers and other soothing remedies are so popular. However, lethargy and flu-like sluggishness caused by lack of sleep is also agonizing (which is why I was never a big fan of the benzos during the day). Treating stress and lethargy do not have to be mutually exclusive which is why I believe that Tyrosine and some of the other “soothing” remedies/tactics can work together during the acute withdrawal phase. I don’t think it’s realistic to think that you can knock yourself out for 5 days with benzos. 

I think L-Tyrosine can be extremely beneficial for those few days in the acute withdrawal AND post acute withdrawal. Perhaps consider taking things slowly and see how your body responds but I believe you are profoundly shortchanging yourself if you decide not to take L-tyrosine for your withdrawals. 

2) It’s already in the text, but people forget that the recipe is formulated for cold-turkey (total cessation of opiates) home detox using the minimum of prescription-only drugs (Valium or other benzo), since most addicts going through this are by then out of money, drugs, doctors and most if not all family support. I don’t recommend L-Tyrosine for controlled tapers. It might help when the taper dose gets very, very low, but I’ll never know personally because I can’t taper.

Note: Ahhh, remember WAY back in 2006 when remedies for opiate withdrawal were just for addicts???! Obviously, there are a lot of elements in The Thomas Recipe that are dated due to the fact that in 2006 the opiate epidemic was still in its infancy. I was going to name this post “The Thomas Recipe – Not Just For Junkies Anymore!” but thought better of it. But it is pretty amazing to think about how different the readership must have been in 2006 compared to 2016. Most of the people looking for the Thomas Recipe nowadays are people who became physically dependent after a surgery or because they were unlucky enough to visit a pain management specialist. Thomas’ comments about running out of money, drugs, doctors etc. may ring true for many; but not for most, I can assure you. The whole landscape has changed.

I just think “Can’t taper” is a cop-out and I believe everyone should try their best to do so because…it works. Tapering is one of the most effective ways to reduce the severity of opiate withdrawal symptoms.   

A significant part of what you’re probably all feeling is caused by a depletion of neurotransmitters, principally dopamine and norepinephrine. L-Tyrosine with B-6 (for absorption) stimulates the production of dopamine. It also raises norepinephrine (adrenaline in the brain) levels quite rapidly, giving you a dramatic bump 20 or 30 minutes after the once-in-the-morning dose. It feels good to addicts just out of the detox period trying to get going again!

You take it upon rising on an empty stomach along with 100mgs of B6. You first feel it in your gut — that good tug in your guts like speed kicking in — then, also like speed, a mind-clearing rush and a speed-like exhilaration and optimism. You’ll want to take another dose — DON’T! Once a day does it for the better part of the day, the part where you have to think, move and respond at work (all the things you can’t do right now). Taking a second dose in the same day almost always results in a nasty tension and, I suspect, vascular headache. Take my word for it and skip that experience!

The one dose of L-Tyrosine wears off in the evening, letting you sleep normally. I urge most people to fore-go their morning caffeine until they see how they do on the L-Tyrosine. Coffee is merely a nuisance compared to the kick from the right dose of L-Tyrosine.

When I would begin the course of L-Tyrosine, I was finishing five, sometimes six days of cold turkey detox off my extravagant hydrocodone habit. My brain was so scraped clean, I found a 4000 mg dose of L-Tyrosine to be just what the “doctah” ordered. I consider that to be the high end on the dosage chart.

I don’t know if the effect is proportional to body weight or not. I’d say start the first morning with three 500mg L-Tyrosine capsules. Use only pure L-Tyrosine caps, no compounds.

Since opiate wd leaves one’s bowels a little sensitive, always start the L-Tyrosine course in surroundings where you can deal with the temporary runs that it can give you. It’s the tradeoff for getting the benefit of the good L-Tyrosine absorption first thing in the morning. It doesn’t happen to everyone. I normally doesn’t last beyond the first hour. My system adjusted to it on the third day or so. Until it did, I just kept the Imodium handy.

I’d describe post opiate wd L-Tyrosine therapy as feeling much like speed does after opiate detox (good) without causing the daily depletion that leads to getting hooked on the speed. Almost everyone gets an immediate boost from L-Tyrosine. Most people use it for a few weeks after opiate detox.

While the Thomas Recipe may be a good summary of certain home remedies for opiate withdrawal, it’s not a comprehensive program. After all, there is only so much one can say in a post on a message board. It’s certainly not fair to compare one post on a message board to a 65-page document like our Withdrawal Survival Guide but it should give you a good idea of the depth of essential information that is missing in the Thomas Recipe. As I’ve said many times before, Withdrawal Ease is a program, not a product. The content in the Survival guide and on the site is just as important as the nutritional supplement system that we sell.

Kudos to Thomas for breaking new ground way back on 2006; he certainly helped a lot of people. For those of you out there who are looking for ways to reduce the pain of opiate detox and withdrawal, I think you could do a LOT worse. I also think you can do lot better by taking advantage of some of the much more comprehensive content found on our site and in our guide…all of which is free.

 

Updated: 4/2016

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1 Comment

  1. I have been cold turkey for over 5 days I have had only one really good day. That being said, I seem with every passing day I feel better. Was doing 15 mg a day for about 8 mos. Its not easy but anyone who uses this drug will have to face the music sooner or later.

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