Opiate Withdrawal

Off Topic
21

[quote]heavythrower wrote:

[quote]challer1 wrote:

[quote]tmay11 wrote:
I had to take a close family member to the hospital today who is going through Oxycodone and Imovane withdrawals. The drugs were not prescribed and were being heavily abused. The person I know quit the Oxy cold turkey 5 days ago and the Imovane 2 days ago and has not sleept since the cessation of the Oxy. Today things got bad enough that we had to go to emergency. This was one of the scarier things I have seen.

The person was violently shaking, taking shallow breaths, had a rapid heart rate, was vomiting(dry) and had diaherra. To make things worse we had to wait 3 1/2 hours like this to see a doctor. We were sitting in the middle of emergency with people all around us watching this…Finally got to see a doctor, got an IV for fluids, some gravol, phenobarbital and a few other drugs to calm the stomach.

We got home from the hospital after 2 liters of saline and the above drugs, withdrawals are still hitting in “waves” and sleep looks unlikely despite the prescribed sedatives.

Don’t know why i’m really sharing this, just wanted to get it off my chest I guess. Let this be a warning to anyone who is abusing this stuff, it’s nasty. Reading around a bit I have found that people with experience with both say it’s very much like coming off heroine.

What i’m particularly worried about is the Imovane, which, according to citations on wikipedia, can have affects that last up to a year after stopping(serious problems to - behavioral changes, chronic depression etc). Surprisingly the doctor didn’t mention this.

Has anyone gone through this personally? anyone know and watch someone who has ? Any advice ? [/quote]

I used to work at a drug and alcohol treatment center. We always had pts taper with suboxone rather than just pulling the drugs outright.

Any drug has long-standing side effects when it comes to mood. Opiates cause a lot of dopamine to be released when you take them, your brain responds by lowering the # of dopamine receptors and starts producing less dopamine on without the drug’s stimulus. This takes awhile to reset to normal… in other words it will be a very long time before the person taking the drugs gets to a “normal” emotional state.

IMO that’s not worth worrying about because if they stay sober they’ll level out eventually. The real scary thing is relapse… Relapse rates are high, to say the least. [/quote]

yes, good post, suboxone is something i see more and more. to be fair though, those people who have been in treatment and have been placed on suboxone STILL hit the ED PISSED OFF and wanting narcotics or heavy doses of benzos to ease withdrawal symptoms.

the request i hear often almost to the word from many people is: cant you just put me “out” for a few days till this is over?

they want to be heavily sedated so they literally sleep through withdrawal. hmmmm… now that wont encourage them to go out and relapse will it?
[/quote]

Of course there are people who just want to keep getting high and game the system, but it definitely is beneficial to give people suboxone in a residential treatment program as it keeps up retention.

Most people wouldn’t make it otherwise - they’re already anxious as hell for being in a drug treatment facility, so part of good treatment is making the detox more bearable - otherwise a majority would leave treatment early against medical advice to get high. Not a very productive situation.

Also, 28 days is not that much time in the grand scheme of things… can’t afford to have people non-functional for 2 weeks while detoxing; they need to get started right away.

At any rate, I hear what you are saying though about being tougher: most of our kids came from rich families and never worked a day in their lives and were enabled the entire time.

22

good points…

how often some kid (10-16 year olds) come in with a cut that needs 2-3 stitches, or a headache after getting a soccer ball to the face, whatever…and the PARENTS request a narcotic script for them? insane! you should see the look of horror on the parents faces when we tell them “no, use Tylenol or ibuprofen”!

23

what i was saying was that suboxone is not the miracle cure to opiate withdrawal. I have had many people that hit my ED who have left treatment early because they say all they got while there is suboxone, they still feel like crap and want something to sedate them through the withdrawal process. though i am sure that for every one of those people many more stay in treatment and do well with it.

24

[quote]heavythrower wrote:
i am a nurse in a regional trauma center/ed. see this shit all the time. thing is, alcohol withdrawal can kill you, so can withdrawal from benzodiazapines. NOT opiate withdrawal. we see people come in to the ED all the time begging for help because they ran out of there supply and cant get anymore, so they flop down at the ED screaming for help. fact is, opiate withdrawal will make you feel like hammered dog shit for a few days, but it will not kill you.

trying to make two points here…first, you seemed incensed that you had to wait so long, on a busy friday night at our trauma center you would have waited longer. we would have put the gunshots, car accidents, heart attacks, strokes, heart failures, acute exacerbation of restrictive airway diseases(people who cant breath), little kids with high fevers, seizures, just about everything cept maybe a cut on the finger or toe ahead of you guys.

second, there has a been a big “push-back” recently for aggressive treatment of opiate withdrawal recently. Not sure what the underlying reason is, but I see it happening. answer this, if all the people who were abusing opiates got aggressive palliative treatment of their withdrawal symptoms, eg, we calm the insomnia, nausea, agitation, etc, would not a less harsh experience be less of a deterrent to go out and make the same bad choices?

why not start your habit again, when you hit bottom, and start going through the hell of withdrawal, just run to the ED and get some meds and treatments to make it less of a horrible experience?

[/quote]

hey heavythrower i was recently talking to one of the medics at my work about withdrawals and death and such. and they said that alcohol is the only drug that when in withdrawal CAN NOT be combated with another drug? I was curious due to things ive seen and figured an RN would have a pretty good answer on this one?

not saying that combating withdrawals with other drugs is the way to go, just the convo we were having.

25

[quote]heavythrower wrote:
what i was saying was that suboxone is not the miracle cure to opiate withdrawal. I have had many people that hit my ED who have left treatment early because they say all they got while there is suboxone, they still feel like crap and want something to sedate them through the withdrawal process. though i am sure that for every one of those people many more stay in treatment and do well with it. [/quote]

oh no I’m right with ya, just giving a different perspective. We know people try to work the system.

Case in point: we had a kid sprain his ankle and they sent him to the ER for x-rays (weren’t sure if it was broken) - he told the workers in the ER that he needed an ativan because hospitals make him nervous due to a previous malpractice case (complete lie). They gave it to him, lol.

26

ETOH withdrawal can be combated with benzodiazipines, (valium, ativan, xanax, versed) with ativan being the standard at this time.

our protocol has us rate withdrawal symptoms on a number scale, agitation, sweats, confusion, hallucinations, tremors, etc., and that gives us a numeric score which we use to gauge how much ativan we give and how often. the doses can sometimes get so high it is almost comical, and you probably would not believe it.

the severity of symptoms depends on how much how often and for how long a person has been drinking.

hell, i have seen “good ol boys” who just have a few beers every night while watching tv after work go through pretty significant withdrawal when they are put in the hospital for a few days for some other reason like a bad case of pneumonia, knee surgery, whatever.

27

[quote]fighting_fires wrote:

[quote]heavythrower wrote:
i am a nurse in a regional trauma center/ed. see this shit all the time. thing is, alcohol withdrawal can kill you, so can withdrawal from benzodiazapines. NOT opiate withdrawal. we see people come in to the ED all the time begging for help because they ran out of there supply and cant get anymore, so they flop down at the ED screaming for help. fact is, opiate withdrawal will make you feel like hammered dog shit for a few days, but it will not kill you.

trying to make two points here…first, you seemed incensed that you had to wait so long, on a busy friday night at our trauma center you would have waited longer. we would have put the gunshots, car accidents, heart attacks, strokes, heart failures, acute exacerbation of restrictive airway diseases(people who cant breath), little kids with high fevers, seizures, just about everything cept maybe a cut on the finger or toe ahead of you guys.

second, there has a been a big “push-back” recently for aggressive treatment of opiate withdrawal recently. Not sure what the underlying reason is, but I see it happening. answer this, if all the people who were abusing opiates got aggressive palliative treatment of their withdrawal symptoms, eg, we calm the insomnia, nausea, agitation, etc, would not a less harsh experience be less of a deterrent to go out and make the same bad choices?

why not start your habit again, when you hit bottom, and start going through the hell of withdrawal, just run to the ED and get some meds and treatments to make it less of a horrible experience?

[/quote]

hey heavythrower i was recently talking to one of the medics at my work about withdrawals and death and such. and they said that alcohol is the only drug that when in withdrawal CAN NOT be combated with another drug? I was curious due to things ive seen and figured an RN would have a pretty good answer on this one?

not saying that combating withdrawals with other drugs is the way to go, just the convo we were having. [/quote]

I’m no doctor but as I understand it alcohol withdrawals can be combated with barbituates. IF and only if the person has not already gone into delirium tremens (characterised by lucid and vivid halucinations). If they have your only option is to watch and hope. The death rate during severe alcohol withdrawals is surprisingly high and any long term heavy user would be well advised to undergo withdrawal under medical supervision.

Opiate withdrawals are not likely to kill you hence are not an acute medical emergency.

28

[quote]heavythrower wrote:
i will read up on that.

i am wary of drugs that supposedly help with withdrawal/addiction by binding to the same receptors.

for example, methadone was used to help with heroine addiction/withdrawal, but methadone and the “oxys” are the biggest problem with people O.D.ing and also coming in needing a fix because they have overused there scripts or supply and are now withdrawing.

I think, think, that heroin was originally developed and used to help people with morphine addiction, no?[/quote]

On an svu they talked about a drug that basically cures heroin addiction in a day… and I read up on it but forgot its name. I know its illegal in the US… any ideas what its called… I think if I see it i’ll remember it.

29

[quote]heavythrower wrote:

hell, i have seen “good ol boys” who just have a few beers every night while watching tv after work go through pretty significant withdrawal when they are put in the hospital for a few days for some other reason like a bad case of pneumonia, knee surgery, whatever. [/quote]

It’s amazing how quickly a chemical dependance upon alcohol can creep up on people who think they are functunal members of society! I am constantly shocked by how little the general public know about the drug of choice of the western world. I’m not saying people shouldn’t ever drink but that people should understand where their ‘social’ half bottle of wine in the evenings combined with a heavy binge every weekend can very quickly lead.

30

[quote]Amiright wrote:

[quote]heavythrower wrote:
i will read up on that.

i am wary of drugs that supposedly help with withdrawal/addiction by binding to the same receptors.

for example, methadone was used to help with heroine addiction/withdrawal, but methadone and the “oxys” are the biggest problem with people O.D.ing and also coming in needing a fix because they have overused there scripts or supply and are now withdrawing.

I think, think, that heroin was originally developed and used to help people with morphine addiction, no?[/quote]

On an svu they talked about a drug that basically cures heroin addiction in a day… and I read up on it but forgot its name. I know its illegal in the US… any ideas what its called… I think if I see it i’ll remember it.
[/quote]

It’s South American and a potent hallucinagen- I forget the name but it’s not San Pedro. It’s great fun and if you’re ever in the jungle and get the chance I would try it out. However it does not break addiction.

31

[quote]lou21 wrote:

[quote]Amiright wrote:

[quote]heavythrower wrote:
i will read up on that.

i am wary of drugs that supposedly help with withdrawal/addiction by binding to the same receptors.

for example, methadone was used to help with heroine addiction/withdrawal, but methadone and the “oxys” are the biggest problem with people O.D.ing and also coming in needing a fix because they have overused there scripts or supply and are now withdrawing.

I think, think, that heroin was originally developed and used to help people with morphine addiction, no?[/quote]

On an svu they talked about a drug that basically cures heroin addiction in a day… and I read up on it but forgot its name. I know its illegal in the US… any ideas what its called… I think if I see it i’ll remember it.
[/quote]

It’s South American and a potent hallucinagen- I forget the name but it’s not San Pedro. It’s great fun and if you’re ever in the jungle and get the chance I would try it out. However it does not break addiction.[/quote]

I mentioned it in an earlier post and it is Ibogaine derived from the inner rootbark of the Iboga tree.

You are confusing it with Ayahuasca which is a South American combination of a couple ingredients. There is a place called Takiwasi in Peru I believe where they are using Ayahuasca in combination with therapy and whatever else for substance abuse disorders as well.

http://www.maps.org/news-letters/v06n3/06324aya.html

32

[quote]lou21 wrote:

[quote]fighting_fires wrote:

[quote]heavythrower wrote:
i am a nurse in a regional trauma center/ed. see this shit all the time. thing is, alcohol withdrawal can kill you, so can withdrawal from benzodiazapines. NOT opiate withdrawal. we see people come in to the ED all the time begging for help because they ran out of there supply and cant get anymore, so they flop down at the ED screaming for help. fact is, opiate withdrawal will make you feel like hammered dog shit for a few days, but it will not kill you.

trying to make two points here…first, you seemed incensed that you had to wait so long, on a busy friday night at our trauma center you would have waited longer. we would have put the gunshots, car accidents, heart attacks, strokes, heart failures, acute exacerbation of restrictive airway diseases(people who cant breath), little kids with high fevers, seizures, just about everything cept maybe a cut on the finger or toe ahead of you guys.

second, there has a been a big “push-back” recently for aggressive treatment of opiate withdrawal recently. Not sure what the underlying reason is, but I see it happening. answer this, if all the people who were abusing opiates got aggressive palliative treatment of their withdrawal symptoms, eg, we calm the insomnia, nausea, agitation, etc, would not a less harsh experience be less of a deterrent to go out and make the same bad choices?

why not start your habit again, when you hit bottom, and start going through the hell of withdrawal, just run to the ED and get some meds and treatments to make it less of a horrible experience?

[/quote]

hey heavythrower i was recently talking to one of the medics at my work about withdrawals and death and such. and they said that alcohol is the only drug that when in withdrawal CAN NOT be combated with another drug? I was curious due to things ive seen and figured an RN would have a pretty good answer on this one?

not saying that combating withdrawals with other drugs is the way to go, just the convo we were having. [/quote]

I’m no doctor but as I understand it alcohol withdrawals can be combated with barbituates. IF and only if the person has not already gone into delirium tremens (characterised by lucid and vivid halucinations). If they have your only option is to watch and hope. The death rate during severe alcohol withdrawals is surprisingly high and any long term heavy user would be well advised to undergo withdrawal under medical supervision.

Opiate withdrawals are not likely to kill you hence are not an acute medical emergency.[/quote]

Librium can be used to reduce cravings, phenobarbital too, but that one (phenobarb) is rarely used nowadays because most who use it continue to drink and the added sedative effect is very dangerous. Librium too but not as severe.

but as i said earlier the standard now is ativan, which will keep the withdrawal from killing you, and basically sedate you through the process, but now you have a chance to trade one addition for another.

33

[quote]heavythrower wrote:
i am a nurse in a regional trauma center/ed. see this shit all the time.[/quote]

I bet you kill at parties. No better job for stories. It’s amazing all the stuff that is happening ALL THE TIME that most people never experience.

I met a girl at a party once who told me that they were having big problems with a new “legal drug”. ICE COLD I think it was was called. I said I’d taken it, and didn’t see what the big deal was. She looked at me like I was a fucking kid and said “yeah luv, but you’ve always got a group of guys that are going to take it, and a group that are going to inject it into their cock.”

34

[quote]heavythrower wrote:

second, there has a been a big “push-back” recently for aggressive treatment of opiate withdrawal recently. Not sure what the underlying reason is, but I see it happening. answer this, if all the people who were abusing opiates got aggressive palliative treatment of their withdrawal symptoms, eg, we calm the insomnia, nausea, agitation, etc, would not a less harsh experience be less of a deterrent to go out and make the same bad choices?

[/quote]

I agree with this. I detoxed a few times from a variety of substances, and it took every twich, puke, and drop of sweat that I experienced to finally drive the point home.

I’ve also seen the product of a lot of the soft serve medical detox treatments come and go. One thing common to the vast majority of them is that they just don’t get it. It’s just another exercise in delusion that any good self absorbed addict is fully willing and able to take complete advantage of.

35

[quote]SkyzykS wrote:

[quote]heavythrower wrote:

second, there has a been a big “push-back” recently for aggressive treatment of opiate withdrawal recently. Not sure what the underlying reason is, but I see it happening. answer this, if all the people who were abusing opiates got aggressive palliative treatment of their withdrawal symptoms, eg, we calm the insomnia, nausea, agitation, etc, would not a less harsh experience be less of a deterrent to go out and make the same bad choices?

[/quote]

I agree with this. I detoxed a few times from a variety of substances, and it took every twich, puke, and drop of sweat that I experienced to finally drive the point home.

I’ve also seen the product of a lot of the soft serve medical detox treatments come and go. One thing common to the vast majority of them is that they just don’t get it. It’s just another exercise in delusion that any good self absorbed addict is fully willing and able to take complete advantage of.
[/quote]

well said.

36

[quote]heavythrower wrote:

[quote]lou21 wrote:

[quote]fighting_fires wrote:

[quote]heavythrower wrote:
i am a nurse in a regional trauma center/ed. see this shit all the time. thing is, alcohol withdrawal can kill you, so can withdrawal from benzodiazapines. NOT opiate withdrawal. we see people come in to the ED all the time begging for help because they ran out of there supply and cant get anymore, so they flop down at the ED screaming for help. fact is, opiate withdrawal will make you feel like hammered dog shit for a few days, but it will not kill you.

trying to make two points here…first, you seemed incensed that you had to wait so long, on a busy friday night at our trauma center you would have waited longer. we would have put the gunshots, car accidents, heart attacks, strokes, heart failures, acute exacerbation of restrictive airway diseases(people who cant breath), little kids with high fevers, seizures, just about everything cept maybe a cut on the finger or toe ahead of you guys.

second, there has a been a big “push-back” recently for aggressive treatment of opiate withdrawal recently. Not sure what the underlying reason is, but I see it happening. answer this, if all the people who were abusing opiates got aggressive palliative treatment of their withdrawal symptoms, eg, we calm the insomnia, nausea, agitation, etc, would not a less harsh experience be less of a deterrent to go out and make the same bad choices?

why not start your habit again, when you hit bottom, and start going through the hell of withdrawal, just run to the ED and get some meds and treatments to make it less of a horrible experience?

[/quote]

hey heavythrower i was recently talking to one of the medics at my work about withdrawals and death and such. and they said that alcohol is the only drug that when in withdrawal CAN NOT be combated with another drug? I was curious due to things ive seen and figured an RN would have a pretty good answer on this one?

not saying that combating withdrawals with other drugs is the way to go, just the convo we were having. [/quote]

I’m no doctor but as I understand it alcohol withdrawals can be combated with barbituates. IF and only if the person has not already gone into delirium tremens (characterised by lucid and vivid halucinations). If they have your only option is to watch and hope. The death rate during severe alcohol withdrawals is surprisingly high and any long term heavy user would be well advised to undergo withdrawal under medical supervision.

Opiate withdrawals are not likely to kill you hence are not an acute medical emergency.[/quote]

Librium can be used to reduce cravings, phenobarbital too, but that one (phenobarb) is rarely used nowadays because most who use it continue to drink and the added sedative effect is very dangerous. Librium too but not as severe.

but as i said earlier the standard now is ativan, which will keep the withdrawal from killing you, and basically sedate you through the process, but now you have a chance to trade one addition for another. [/quote]

thanks for the answers guys. I had no idea they were using ativan, actually I wouldnt have even guessed it. I suppose, i understand it, but at the same time i dont lol.

Im not asking for an explanation because i feel like it still wont make sense to me, yes i understand what ativan is just something isnt clicking in my head about it. If you are willing to try and make my little brain understand this, im all ears…er eyes on this one.

37

Great thread, but Im kinda of surprised that Alcohol withdrawal is more deadly than the others? Im curious why is that. I would figure that it would be hard core drugs.

38

A lot of times the severity is due to the speed at which the substance is metabolized and leaves your body. Alcohol and benzos are pretty fast and more severe. Another component may be the parts of the brain which are most affected by the drug, or something to that effect, which I am not familiar enough to speak on with any authority.

39

edited for personal reasons

40

what is a benzo drug?