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Heroin/Methadone Withdrawal: Help, Please...

 
 
Abigail Blue
13:33 / 25.09.02
Okay, so here's the deal:

The good friend of a very good friend of mine has been using heroin for 10-11 years. She kicked it just over a year ago, and started on methadone. Her MD, worker, and everyone else in a position to make these kinds of decisions had her on quite high doses for almost a year, and didn't seem to be listening to her when she asked them to reduce the dosage 'cause it was screwing with her body, making her crazy tired all the time, etc. They finally listened a few months ago, and reduced the dosage. She made the decision to get off of methadone entirely, and try to live clean.

Unfortunately, this is all happening in Connecticut, where Health care isn't free. So she tried to quit methadone without checking herself into a clinic (due to no $), and she could only get herself to hospital so many times when the withdrawal was bad (again, due to no $). Anyhow, to make a long story short, she's used a few times since then, and is (I believe) back on methadone.

Here's where advice is needed. My very good friend would like to help her get clean, and is willing to do whatever it takes during the week or so that the physical withdrawal is the worst. (We, obviously, know that a lot of many kinds of support are needed, before, during and after the physical withdrawal). What I need from you all is practical help about what to expect, the health risks she's going to be facing during withdrawal, suggestions for what she should eat, everything everything everything.

Any help is greatly appreciated!
 
 
grant
16:41 / 25.09.02
I've heard good things about a drug called ibogaine, but all hearsay.
 
 
STOATIE LIEKS CHOCOLATE MILK
16:45 / 25.09.02
(Un)fortunately, I have little personal experience- the few times I tried smack, I didn't like it too much. However, I know it CAN be done the methadone route... a friend of mine who was WAY gone is now totally clean. (I also know people for whom it didn't work at all, but let's not go into that.)

Ibogaine? The name rings a bell... what was that stuff Burroughs went on about... although I seem to remember a lot of his ranting was due to it not being provided by doctors, so that may not be too much help...

Good luck to your friend, though.
 
 
Abigail Blue
16:54 / 25.09.02
Thanks grant, Chairman.

I think her issue is that she wants to be entirely clean, ie no methadone or other maintenance drugs. The more I look into this, the less realistic that route seems. But, for the sake of argument, does anyone know anything about detoxing with juices, teas, etc? I'll gratefully accept any and all suggestions...
 
 
grant
18:17 / 25.09.02
Ibogaine is a rather little-known psychedelic; not exactly a maintenance drug.

You'd find information on that (and probably a warehouse of stuff on heroin & withdrawal) at Erowid.

Detoxing is a rather big field: I've heard good things about milk thistle, red clover, parsley juice, fasting and, oh, sweat lodges.
Not that experienced with that either.

Here's one person's experience using ibogaine to kick.
 
 
grant
18:20 / 25.09.02
From one of the (many) articles in the Heroin Vault on Erowid:

Once you have decided to stop using, donÕt just say ÒthatÕs it, no moreÓ as
you are bound to fail. You need to plan your detox properly. Decide a time
when you are going to do it. It could be relatively soon, or it could be some
time in the future. Whenever it is, put aside at least two weeks when you
donÕt need to do anything stressful and you donÕt have any responsibilities.
If you have children, send them to their grandparents or to a friend for a
holiday. They wonÕt enjoy spending this time with you, and youÕll be glad
not to have to worry about them.

Tell everybody about your decision to stop using. People who love and care
about you will give you support through this period. Other users may
resent your ability to break the habit and try to tempt you into using. If
you suspect that this is the case, explain what you are doing, and tell them
that you would rather they didnÕt come around during this period. You can
decide later whether you still want to see them, but if they insist on trying
to tempt you, you can be certain that they donÕt really care about you, so
donÕt feel guilty about excluding them from your life.

Try to put some money aside. You need to be able to pamper yourself with
rewards during this period. Giving up drugs is a very brave and difficult
decision, so you shouldnÕt feel guilty about indulging yourself in other, less
destructive ways. If you are unemployed, perhaps you could avoid paying
the rent for a week and make up the arrears a bit at a time later on.

Finally, find a comfortable place in which to do your detox. One of the main
reasons for doing a detox as an in-patient is that some people donÕt have
anywhere comfortable that they can detox. For most people though,
detoxification is much easier if you can make a drink in your own kitchen,
watch your own T.V., read your own books and listen to your own stereo. If
the place where you live isnÕt very nice, see if you can go back home to
your parents, or if you can stay with non-addicted friends for a couple of
weeks.

Personally, I think you should regard a detox as being like a prison
sentence. Rather than focussing how long you have felt lousy, focus on
how much closer you are to feeling better. Make a calendar and tick off the
days, or keep a diary and write down how you feel. Identify landmark
points so that you can look back over it and see how much progress you
have made. Stopping using drugs is one of the major decisions in your life
Ñ it will be nice to look back and see how you managed to overcome each of
the obstacles, or even just how much you suffered without quitting.

Every time you complete a certain period, congratulate yourself for having
made it. Give yourself a reward. For each day you complete it could be
something small, like something special to eat or drink. For each week that
passes, do something really nice for yourself. Buy yourself something to
wear or go out for a meal. Think about both the detoxification and the
rewards as investments in the new you Ñ the person that you want to
become rather than the person that you were.

One of the most difficult aspects of opiate withdrawal is the lack of sleep.
Some people might be tempted to use sleeping tablets in a desperate attempt
to get some respite. Personally, I find that they donÕt really help, they just
dope you up so that rather than lying around withdrawing, you are lying
around feeling doped-up and withdrawing. You still wonÕt sleep and
benzodiazapines are addictive too, so you could end up replacing one habit
with another. Remember, there are no easy solutions, youÕve just got to bite
the bullet and ride it out.

Finally, donÕt get hung up thinking about the length of time that a detox is
going to take. Like they say in Alcoholics Anonymous, just try to get
through one day at a time. ItÕs difficult trying to imagine a life without
drugs, but far easier to make it through to the end of a day. Then you can
again start afresh tomorrow. Remember, every day that you manage to stay
clean is an investment in your own future Ñ and if you canÕt be bothered to
invest in yourself, you can be pretty damn certain that nobody else will.

 
 
grant
18:30 / 25.09.02
Here's more clinical info about Ibogaine
 
 
Goodness Gracious Meme
22:40 / 25.09.02
Re-emphasising something implicit in Grant's article, peer support can be vital in all sorts of ways.

The people I know who are successfully clean have done it via Narcotics Anonymous, and while some of them have reservations about individual steps (eg a couple are very vocal on the 'put your trust in a higher power/god' step), they all agree that having a peer group encouraging and providing a replacement social/support network has been the difference between staying clean and relapsing at times. Encourages holistic change in lifestyle and personality... Will ask about and try and come back to this..
 
 
Mr Tricks
23:25 / 25.09.02
I've also heard gret thing of Ibogaine...

My $.o2
 
 
kitschbitch
10:05 / 27.09.02
I take a drug called dihydrocodeine as a painkiller, but I believe that it's sometimes used as a substitute for methadone in cases of heroin withdrawal. It *is* an opiate and it can in fact give more of a high than methadone - but it's a shorter acting opiate so withdrawal is more intense but doesn't last as long. though, obviously, psychologically, this doesn't make the withdrawal process any easier.

See here for more info
 
 
Ma'at
14:23 / 27.09.02
My four pennorth worth:

I worked in a needle exchange in London during my uni years and have had some experience working with heroin addicts.

If your friend is determined to get clean I would say they have done the right thing by coming off methadone which in my experience is more addictive then heroin and not actually much help in the long run.

They need to be somewhere safe secure and warm surrounded by people who will be supportive without being bossy. They will need someone to make simple food for them, hot drinks and to hold their hands and provide quiet moral support. Your friend will dehydrate quickly and so try and get lots of fluids into them, its unlikely they will be able to stomach much so drinks with high vitamin/nutrition value are helpful. Those bodybuilding milkshake type drinks are good. You will find your friend vomits and shakes and sweats quite a bit this is normal and nothing to be alarmed about.

Distractions are good, television/videos etc are easy and don't require too much thought. Pampering and care are basically what your friend will need and something to keep their minds off how they feel. Talk to them if they want to talk, discuss why they are doing this and be relentlessly positive. Try and steer clear of preaching or disapproval of any kind. People in this state tend to be very fragile emotionally. Equally have someone to be there for you as well as this is not an easy job and there will be times when you need someone to listen to you.

You may find that your friend has problems sleeping when the withdrawal is at its worst. Some form of sleeping pill might be helpful if you can acquire them. Massages are good and I found worked very well as providing comfort as well as relief from muscle cramps. Mint tea is very good if their stomach is very upset and they are very nauseous.

Hope that helps some. Am happy to discuss in greater detail if you want to message me privately.

One thing I would stress however is that overcoming the physical withdrawal is only the first step. You will need to be there for your friend every step of the nest year or so to help them remain clean. Often its the psychological addiction whereby you have to change your habits your lifestyle and your way of thinking which actually prove the hardest habits to break.

Good luck! I'll light a candle for you
 
  
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