Opiate Addiction Detox: Don't Poop Your Pants
10 Tips for a Person About to Opiate Detox
By Bill Dinker
Sweat poured off my body and I lay curled in bed, shaking uncontrollably. Physically, I looked like I’d just come back from a long-term stay with Bear Gryll’s in the wild. The “unabomber” became a nickname of choice for people who knew me during that transitory period of my life. Late that night, a nurse practitioner walked into my room and said, “We haven’t seen heroin withdrawals like this in years.”
Opiate addiction is an American epidemic. Maybe you didn’t know that; maybe you did. In this article, I will try to raise awareness of the American opiate dilemma and offer some advice for those beginning the initial stages of treatment, specifically detox. I persevered through a nightmare detox from opiates and heroin, and I’ve been continuously sober from the day I checked into detox at a hospital on May 24th, 2012. The grim words uttered above by the nurse practitioner stay with me to this day. It’s a reminder of where I came from: hopeless in the bondage of opiate addiction and heroin addiction. Follow my advice and join me in a life of liberty from opiates and heroin. Your life or the life of your loved one probably depends on it.
1. Your life is not ending when you begin detox; it is just beginning – but it may feel like it is ending.
One of the most common things I hear from my friends in recovery from opiate addiction is, “I felt like I was dying when opiate withdrawals began.” Having been through it myself, this is true. But you won’t.
Withdrawals will be incredibly uncomfortable. Detox medications like Suboxone®, Subutex®, and clonidine can alleviate some discomfort; however, you’ll eventually have to “pay the piper.” Some in the treatment industry argue that detox from long-term use of medications like Suboxone or methadone is more painful than detox from oxycodone or heroin.
Few treatment centers and recovery centers recommend long-term use of Suboxone®. It can be a very effective detox medication, but no medical professional I know who operates in addiction treatment recommends Suboxone “maintenance.” It is swapping one addiction for another. Many active addicts I knew would sell their Suboxone® medication too. Opiate addicts favor Suboxone® because it is cheap to buy on the streets when opiates and heroin are in short supply.
Anxiety, perspiration, restless legs, insomnia, feeling like I had the flu, vomiting and diarrhea were some of the primary symptoms I battled during my heroin/opiate detox. More information on heroin/opiate withdrawals.
2. If the resources are available, detox at an inpatient medical facility or a qualified treatment/recovery center.
My drug dealer used to tell me that, “no one gets off (clean and sober) opiates or heroin because they can’t get through the dope sickness (withdrawals).” I attempted, several times, to get off opiates by myself, trying a variety of methods I found on the internet. First, I tried to taper from heroin to prescription opiates (mainly oxycodone).
Result: I was using both heroin and oxycodone. Fail.
Next, I tried to taper off of heroin with a benzodiazepine called Xanax® – a psychoactive prescription drug usually prescribed for anxiety.
Result: I was using heroin, oxycodone, and Xanax. Fail.
Every time the withdrawals, or dopesickness, started I used some form of opiate to alleviate my symptoms.
By entering a medical setting, I was monitored closely until I got through the worst of it (3-4 days). From there, it was straight to treatment at Discovery Place. Some facilities, like Discovery Place, offer those seeking help for opiate addiction detox a more affordable option: you can detox from opiates on a Suboxone taper while receiving treatment. This method is also called a "walking" detox. It is more affordable than detox in an inpatient medical facility, and it allows you or your loved one to begin participation in the recovery process.
3. Be careful not to poop your pants.
Humorous as this may sound, it was a legitimate concern for me. Let’s just say I’d heard some stories. Consistent abuse of opiate narcotics not only results in addiction, it also causes epic constipation. When you begin detox, make sure a restroom or toilet is close. Like… no more than 30 feet away close.
If you are in a medical facility, be advised that your first dose of Suboxone or Subutex may get the bowels moving unexpectedly. Make sure, when taking your first dose, that a restroom is 10-20 feet away.
If you’re at home and trying to "cold turkey" (quitting with no medication), make sure the restroom is super close. The immediate urge to use the restroom could hit hard within 1-7 days, sometimes longer depending on the severity of abuse.
4. While we are on the subject of pooping, request a laxative.
You are constipated. Depending on the frequency of use (how many opiates you ingested per day), strength of the opiate (see figure 1.1) and duration of use (how long you abused opiates), there’s a good chance you’re going to have an "incident."
This incident will hopefully take place on a toilet. It will be extraordinarily uncomfortable. Take the worst stomach ache you’ve experienced, plus the feeling of a powerful fever, and you’ll have an idea of what this will be like. The bad news is that you will never forget it. The good news is that, once it’s over, you’ll feel much better. I don’t even like calling it diarrhea because an incident like this deserves a special term. But diarrhea may or may not continue for a few days to one week afterwards.
5. Sleep is going to be a luxury, consider requesting some sleep aid from a medical professional for a minimum of two weeks.
I took Seroquel® for sleep for about 1.5 months. Other guests I knew took Trazodone. Your sleep medication should be non-narcotic, as an opiate addict will almost certainly abuse narcotic sleep medication.
Even with Seroquel, a powerful medication sometimes prescribed for insomnia, I didn’t sleep much. The first 48 hours were sleepless. Many opiate addicts report difficulty sleeping months after sobriety begins. Some experience sleep problems three years into sobriety, but most of the sober opiate addicts I know sleep pretty well after six months clean and sober.
6. Let family and friends know what you are trying to do. Reach out to them for help; there’s a good chance they already know you have a problem with drugs.
Virtually everyone in recovery will tell you not to "go it alone." Talk to family and friends; let them know you genuinely wish to be free from opiate addiction. Inpatient medical detox can be costly if you are uninsured, and chances are you don’t have any money. Don’t let fear conspire with pride to prevent you from getting the help you need.
As an admissions coordinator, family and friends are usually understanding as a rule. If you reach out to a family member or friend who reacts angrily, do not get discouraged. Most people are uneducated when it comes to drug and opiate addiction. Most people, however, are relieved and encouraged you are trying to change your life for the better.
7. Do everything possible to coordinate treatment prior to or during detox.
If you detox without treatment or thorough involvement in 12-step recovery, you set yourself up for failure. The best results, or outcomes, occur when people with opiate addiction complement detox with treatment and 12-step recovery programs. Virtually every piece of medical research affirms this model for giving an opiate addict the best chance for sustained sobriety.
Harvard University had the following to say on this topic, "For some addicts, the beginning of treatment is detoxification — controlled and medically supervised withdrawal from the drug. (By itself, this is not a solution, because most addicts will eventually resume taking the drug unless they get further help.)" It is vital to seek out further help once you complete an opiate detox. Discovery Place's 30-day residential program and long-term program have had phenomenal success with helping opiate addicts find sustained sobriety.
8. If you detox in a medical facility, go straight to treatment. Do not pass go. Don’t worry about collecting $200 because you probably don’t have it.
There’s a very good chance you will use again or talk yourself out of going to treatment altogether if you delay in the transition from detox to a treatment/recovery center. Make sure you arrange transportation prior to leaving detox, or do the smart thing and secure admission to a treatment center prior to detoxification.
People who don’t follow this advice supply all kinds of crazy excuses to me when I am trying to get them admitted to a facility like Discovery Place. I’ve heard:
- "I just need to take care of a few things…"
- "I’ve got to make sure I still have a job…"
- "I need to see someone and say goodbye before I come in…"
- "I’m afraid I won’t have any money left…"
…and the list goes on.
There’s a good chance your mind will supply all sorts of attractive, convincing (but self-deluding) reasons why you shouldn’t go to treatment or detox.
That’s why addiction is commonly called a "mind-powered" illness. Don’t listen to thoughts like these that so often prevent addicts from turning their life around. The transition from detoxification to treatment demands Nike treatment: Just do it.
At this point, you have probably exhausted all the money family and friends have been willing to lend you. If you are actively seeking help for opiate addiction, there’s a good chance you’re at the end of the road financially, emotionally, and physically. If you no longer have money, a job, a social life, or a desire to live, then life can look pretty grim.
Ironically, these difficult circumstances usually inspire an opiate addict to seek help. So in a sense, your bleak station in life is a good thing. Of course, you don’t have to travel too far down life’s ladder before making the decision to move toward sobriety. A "bottom" only occurs when you decide you’ve had enough.
9. Family and friends may have some very direct, difficult things to say to you. Listen to them anyway.
When I was leaving inpatient medical detox, my Dad looked me in the eye and said, "Either do this (sobriety) or don’t bother calling us (the family)." Those words really hurt because guilt, shame, and remorse were familiar feelings at this stage of the recovery process. But my Dad’s warning stuck with me. He was right, and his words were true.
No family should continue to choose participation in active exposure to addiction, especially opiate addiction. My Mom, Dad, and two little brothers experienced an incredible amount of emotional turbulence due to my active opiate addiction. Sometimes the truth hurts. In this case, that pain provided more motivation to stay the sober course. Today, I credit my Dad for being direct and honest with me. I wish more families demonstrated this form of "tough love."
10. If you have no insurance, no resources, and no family and/or friends willing to financially assist with this process, do a Google search for state-funded facilities in your area.
Many opiate addicts are at the end of the road financially. Family wants nothing to do with them. Friends have stopped answering the phone. In these cases, the only option is a state-funded treatment center. You can find such centers by going to the SAMHSA website and searching by state, or simply enter the keyword "state-funded treatment centers" + state name (example: Tennessee) in the Google search bar.
If you are still struggling with opiate addiction and heroin addiction despite repeat attempts at detox and treatment, ask your medical professional about ibogaine. Ibogaine may represent the next generation of opiate addiction treatment. New Scientist recently featured an article about an opiate addict’s struggle to find sobriety and his triumph with the assistance of ibogaine.
Why Heroin Withdrawals Are Deadly via Discovery Place
Mind-altering Drug Could Offer Life Free of Heroin via New Scientist
Opioid Dependence via Wikipedia
Long-Term Effects of Drugs on the Brain via National Institutes of Health
Substance Abuse Treatment Facility Locator via SAMHSA
Drugs, Brains, and Behavior: The Science of Addiction via National Institute on Drug Abuse
Treating Opiate Addiction, Part I: Detoxification and Maintenance via Harvard Health Publications