Prescription Opioid Withdrawal First Aid – And Beyond

Prescription Opioid Withdrawal First Aid – And Beyond

By Cindy Perlin, LCSW.

It’s happening more and more every day. Doctors are refusing to write opioid prescriptions, even for patients who have been taking them responsibly for decades, or drastically cutting doses. Some patients who do have prescriptions are finding their pharmacies are no longer willing to fill the prescriptions. It’s cruel and inhumane to do this to pain patients, but no one is listening. What’s a patient to do?

Abrupt discontinuation of opioids throws patients into withdrawal. After only a week or two of administration, the human body adapts to the presence of opioids by reducing its production of endorphins, the body’s natural opioids. Adrenaline production is also increased to counteract the sedative effects of the opioids.  This adaptation is called physical dependency.

Cindy Perlin

Once physical dependency has occurred, discontinuation of opioids will result in withdrawal symptoms. Severity of these symptoms will vary depending on how long the drug was used, dosage and other factors.  Physical withdrawal symptoms include: a sick flu-like feeling with runny nose, sweating, chills, nausea, diarrhea, stomach cramps, fatigue, loss of appetite, and muscle aches and cramps that can become severe.  Psychological symptoms include anxiety, irritability, insomnia, depression and difficulty concentrating.  Patients may also experience cravings for the drugs.

Withdrawal symptoms usually begin within 24 hours after the last dose of opioids.  Severe symptoms usually last for about a week, after which the patient still has to deal with the pain that the opioids were prescribed to treat.

Minimizing Withdrawal Symptoms

The experts I consulted for this article all agreed that withdrawal symptoms are time-limited and not life threatening.  But, as Dr. Stephen Grinstead, a chronic pain patient who’s been through opioid withdrawal and founder of A Healing Place – The Estates, noted, “No one’s going to die from it—they just wish they would”.

I asked the experts about medical interventions and self-care strategies that could be helpful in reducing the severity and duration of opioid withdrawal.  Dr. Denis Patterson, of Nevada Advanced Pain Specialists, recommends a medical approach, in an inpatient rehabilitation facility or outpatient addiction treatment program.  In these programs, physicians are able to prescribe medication that can ease withdrawal symptoms, including buprenorphine, which helps suppress withdrawal symptoms and cravings.  The problem with buprenorphine, however, is that it is also an opioid and withdrawal from it can also be problematic.  Some patients report that withdrawing from buprenorphine is more difficult than withdrawing from other opioids. It’s also not widely available due to legal caps on the amount of patients each physician can treat.

Dr. Grinstead prefers Suboxone as a medication to ease withdrawal.  Suboxone is a combination of buprenorphine and naloxone. Naloxone blocks the effects of opioid medication, including pain relief and feeling of well-being that can lead to opioid abuse.  Patients are usually tapered off Suboxone after 6- 8 weeks but they can be continued on the medication for up to a year.

If you can’t get to a medical program to help with withdrawal, Dr. Patterson recommends the following over the counter medications and self-help strategies that can help with the side effects of withdrawal:

  • Nausea/vomiting – Medications that contain the active ingredients bismuth subsalicylate (e.g. Pepto-Bismol) and phosphorated carbohydrate solution (e.g. Emetrol) can help.
  • Diarrhea – Medications that contain the active ingredients bismuth subsalicylate (e.g. Pepto-Bismol, Kaopectate) and loperamide (e.g. Imodium) can help.
  • Dehydration –  Water
  • Muscle cramping – Fluids that contain electrolytes (e.g. Gatorade, Pedialyte, etc)
  • Agitation – Exercise (e.g. yoga), meditation, biofeedback, and sleep.   Some people may benefit from using antihistamines such as diphenhydramine (e.g. Benadry).  Antihistamines should be used with caution because in some individuals it can have a paradoxical effect and can worsen their agitation.

Herbal and homeopathic remedies that address the same symptoms are good alternatives.  Ginger and homeopathic remedy cocculus indicus can be helpful for nausea.  Yellowroot,  bayberry, comfrey, peppermint, slippery elm, white willow, black walnut and green tea are helpful for treating diarrhea.   Homeopathic remedy ipecac treats both nausea and diarrhea.

Dr. Grinstead recommends a dietary detox cleansing protocol for 5-7 days. Stress intensifies symptoms so Dr. Grinstead also recommends relaxation and cognitive behavioral therapy. Exercise for flexibility and mobility can also ease the pain of withdrawal, according to Grinstead. Acupuncture, massage, aromatherapy and spending time in the sun have also been reported to ease withdrawal symptoms.

Many pain patients have found that marijuana helped them to reduce or eliminate their use of opioids. Some physicians are now using medical marijuana to ease withdrawal as well as for long term pain management  Dr. Gary Witman of Canna Care Docs in Massachusetts reports he has helped many patients withdraw from opioids through a one-month tapering program using marijuana.  Canna Care Docs is a network of facilities that certify patients for medical marijuana in Arizona, Delaware, Maryland, Washington D.C., Massachusetts, Maine, New Hampshire, New York and Connecticut.

CBD oil, derived from hemp, is being used by many pain patients to reduce withdrawal and manage pain over the long term. CBD is a key pain relieving ingredient in both marijuana and hemp. CBD oil is legally available in all states.

Other patients are reporting that kratom, a Southeast Asian herb, is very helpful for easing withdrawal symptoms as well as managing chronic pain. Kratom is widely available on the internet.

WARNING: Be very careful about restarting opioids if you have gone through withdrawal. Withdrawal reduces tolerance to the drugs, so patients who have just gone through withdrawal can overdose on a much smaller dose than they used to take.  A large percentage of opiate overdose deaths occur in people who have just detoxed.

The Long Haul

Once you have gotten through withdrawal, the problem of how to treat the pain remains.  Many patients are surprised that their pain levels without opioids are not as severe as they expected.  This is due to many factors.  Pain is exacerbated when opioids wear off between doses, a phenomenon known as rebound, leading the patient to believe the baseline level of pain without medication is higher than it actually is.  Pain is also exacerbated by withdrawal, as already noted. In addition, as the level of opioids introduced into the body is reduced, the body starts producing more of its own natural (endogenous) opioids.  And, lastly, some opioid users develop a condition called hyperalgesia, where use of opioids actually creates more pain and stopping opioids relieves pain.

Long term management of chronic pain is most successful with a multidisciplinary approach that addresses the underlying causes of the pain and treats the whole person, mind, body and spirit.  There are many safe and effective pain treatments including acupuncture, biofeedback, cognitive behavioral therapy, chiropractic, physical therapy, massage, mind/body medicine, nutritional and herbal interventions, low level laser therapy, medical marijuana, neurofeedback, homeopathy and more. Learn about these treatments and find the ones that work best for you.

Although loss of access to opioids can be a devastating blow, don’t lose hope! Many formerly opioid dependent patients have found strategies that actually work better for them than opioids. Read some of their stories HERE.

Cindy Perlin is a Licensed Clinical Social Worker, chronic pain survivor, the creator of the Alternative Pain Treatment Directory and the author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free.

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Authored by: Cindy Perlin

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sandy auriene sullivan

I’ve mentioned on this site for about a year now that after my doctor’s last DEA scare [at least he’s opened] he took all patients off any schedule II. I’ve been with him nearly a decade. Location, he is a pain specialist and a primary. The two together are just easier. He had always been certified to treat patients with suboxone or similar for the last 10yrs also.

He suggested it to me. I really really doubted it would help; besides the concerns of being labeled an addict! My family and I spent a week discussing it between ourselves and the doctor. As well as research.

The opiate works on pain – there just is no euphoria. Which pain patients never received anyway. It’s not the *best* for pain but beat my 90mme dose; as I had detoxed myself down to 90mme in frustration of the slower method which seemed to draw out my agony [1-2x monthly reductions] So far *my* experience with suboxone to zubsolv has been a fairly smooth transition. Ive lost 80lbs. My left is shrinking faster than ever [nerve damage severe and lumbosacral nerve compressed in hip]; MMJ helps significantly. 6 shingles outbreaks since November – I just turned 47yrs! [started in late Sept/early october] Mine states on script it is for spinal stenosis, cervical pain etc. it also has stated opiate-dependent *no-complications. Compliant* [insurance has since relaxed on allowing it for patients in pain]

In maternity wards in Australia the use of a generic instant release ‘oxycodone/naloxone’ tablet is given to c-section patients in pain. As most women and doctors understand; the area cannot get constipated either [not my issue but a huge one in maternity wards]. It IS used because it is slower in and slower out. Which helps the c-section recover the worst 72hrs.

I’ve had better treatment and far far worse pain treatment. This beats *nothing* or something so weak that it keeps you on the edge. Doctors need to be more honest about its safety and street use/abuse [lets not have another oxycontin freakout because everyone wasn’t on the same page…] My doctor thinks it is *VERY* safe.

But an overdose still requires the naloxone epipen; as that is a HIGH dose of naloxone and intramuscular delivery with a trip to the ER.

What I’ve been trying to tell the pain community is my experience ‘coping’ with new regulations imposed on us all.

Julia Heath

Please know that suboxone can throw one into horrid rapid withdrawal. I attempted an inpatient conversion from my long acting and short acting opioid meds to suboxone. I was off all meds for 20 hrs but still had quite a bit of the long acting opioid metabolites on board. Within 20 minutes of the first suboxone dose, I knew something was very, VERY wrong. My legs started going crazy and jerking uncontrollably and I had horrid spams all over. I spent 5 hrs walking around my hospital room crying and praying and kicking my heels against the ground as hard as I could trying to get rid of the awful sensation in my legs. I was sweating so severely they couldn’t get a 12 lead to stick to me to monitor how my heart was responding. It was the worst torture of my life – and these Healthcare specialists were suppose to know how to stave off withdrawal symptoms! They had no idea what “rapid withdrawal” looked like. They thought I’d lost my mind (and I was ready to put my fist thru the window in the room so they would do something to stop what I was going thru). After 5 hrs of this nightmare I finally convinced them to put me back on my old meds – then the withdrawal slowed down enough for “normal” withdrawal symptoms to show up and the cramping and vomiting started. But I was able to stay still long enough for them to put an IV on me and get Xanax on board to knock me out. I was told my legs continued to jerk for a bit even after I was asleep. When I left the hospital, I was black and blue, and the wounds on my feet from kicking them on the ground are still healing 5 weeks later. So please know that the stronger the opioids you’re on, the more severe the withdrawal symptoms. Don’t let anyone underestimate what you might go thru… It’s not clear cut or simple to get thru withdrawal. I hope no one ever goes thru what I had to endure.

Steven

Thank you for your article Terry. I know it wasn’t the focus of your article however I really see no mention of the reason that we’re taking the medication in the first place. Big Time pain! Withdrawal is the worry of some of us. Who can face severe pain 24/7 without pain medication? A person could walk up stairs and have a heart attack. Our medical system has been set back 100 years in terms of treatment. Now the only thing you go to the hospital for is diagnosis and to die not treatment. After 5 years of the monthly threat of having our medicine taken away they finally are. The emotional disintegration alone has been devastating. Loss of any kind of quality life and now finally life itself. I would be interested to know what other severe pain patients are trying. Has anyone had success with the Medtronic stimulator? Any other realistic alternatives? Meditation and exercise are not substitutes for pain medication folks and nobody can stay stoned for 24/7.

Anne Fuqua

I would take exception to the emphasis that withdrawal is not life threatening. If a person is generally in decent health and able to avoid getting severely dehydrated the statement is true, but many pain patients ARE NOT in good general health. Patients with cardiovascular or renal problems are at higher risk as are patients with adrenal disorders. Even a relatively healthy person can die if they become severely dehydrated and don’t get treatment for dehydration. This is often the cause of withdrawal deaths that occur in correctional settings. It is likely to occur more often as patients become increasingly fearful of seeking treatment from their local ER.

Kratom saved my life… Literally… After being abruptly d/c ‘d from a relatively high dose of opiate for 15 years, the impending doom and hopelessness would have been the motive for my self murder! Thank God I found Kratom before the withdrawal process started. I love ALL of you who have had to face this HORRIBLE experience!

Fu hunt

1 thing your experts are wrong opiates withdrawal can and has killed people before

DBarker

Hypertension combined with the added stress of withdrawal can creat a vary dangerous life treating situation. It is irresponsible not to mention such dangers in this article. Opioid withdrawal alone may not be deadly but combined with certain cardiovascular diseases it can be deadly!

Rita KIMBEL

This is very valuable information, I have been through it and I wish I had read this a year ago. The insurance company was the cause of me detoxing in January last year then again in Feb and in April and it wasn’t a reduced dose, it was not covered and I didn’t have $2000. To fill the script the first time when my family doctor was dismissed from writing my pain prescriptions. After that I never saw 80 mgs of oxycontin. I had been taking it under the care of my family doctor for about 12 years and it worked wonderfully for my neurogenic intractable pain. I also had a neuro-stimulator implanted 12 years ago to aid the medication and was able to stay at 80 mg. all those years. The other months, the insurance Co wanted me to take Xtampza instead of oxy but refused to give it to me without prior authorization.??? I’m not getting relief to this day, my milligrams used now are much lower than what I need. My pain doctor is afraid to write it for anything more than CDC recommendation. I will start medical marijuana soon, they say it will help and I may be able to find freedom from the pain, I can’t keep going on like this, so I’m just praying.

Lisa Hess

I’ve come in late of this conversation so going back further than a couple of pages is just too much for my headache right now. But, from what I have read on this string of responses here and have not seen was the mention that once someone has used Subluxone to help remove the symptoms of withdrawal, when it comes to chronic pain patients it also blocks the brain’s pain sensors from allowing pain relieving medications from ever working again to relieve pain. I know this because I was willing to go that route to get off of Opioids just to see if I could stand the pain and the doctor gave me this warning and said “I can’t do this to you because you will need these opioids for your chronic pain due to so many chronic illnesses that cause chronic pain in my body and the pain will not magically just go away because you want to stop taking opioids.” I am one of those people whose own body is my own worst enemy. I am a head to toe pain patient with so many illnesses that there is no cure but cause excruciating pain. One more thing that I haven’t seen on these threads is about Multivitamins and some other medications and/or supplements that “block” Opioids pain relief action from working, especially if taken at the same time. I did several experiments with the different scenarios of taking my multivitamin at different times of the day including right before bed and had the same results each time. Just one more fact that I researched and brought to the attention with my PM doc and he confirmed my findings that, indeed, multivitamins will interfere with the way Opioids work for pain relief and advised I stop taking them. I asked my PCP as well and she told me that multivitamins (some do) can be more harmful and that even she stopped taking them because new studies have come out stating the same. Just my own 2 cents that I haven’t seen mentioned here.

Terry

Thank you for all of the information, very informative. There’s another way of coping with at least the pain and anxiety. I just started therapy with a pain management psychologist, the first two sessions were general questions and I had to fill out a questionnaire with 344 questions, I was to pick from five choices for each question ranging from not true to always true and everything in between, the questionnaire is sent to a third party who send the report to your therapist and then she goes over the conclusions with you. The third session, which I haven’t had yet, will be showing me new techniques for dealing with pain, meditation etc. I will keep you all informed as to my progress, if it helps or not. My pain medication was cut from 195 mgs of oxycodone daily to 90 mgs daily, and it was done very quickly, over a 3 month time period, and even though I still get meds I did go through some pretty horrible withdrawals not to mention the terrible I’m in. It took ten years to ramp up my pain meds to the point where my life was fulfilled, I participated, I was outgoing, I did yard work, I did my art work, in other words I was participating in my life, now I get just enough pain meds so I can at least move around but any extra caricular activities puts me on my butt for three days. I know it’s hard, I know we all feel like giving up some days, but we have to try every single thing that is available to help our lives to be fulfilling and happy. Like my wife always tells me, if you try ten things to help with your pain and each one is 3 % helpful, then you’re going to feel a bit better and that’s what it’s all about. Remember, you’re not alone and you haven’t tried everything yet, so keep a happy thought and grind out each day with a positive attitude and a smile on your face. I feel that my new pain management psychologist is going to help me immensely!!! Feel good everyone and keep up the good fight. There’s always one more thing you can do and I will share everything that comes my way. God bless you all.

Samantha Adcock

This article is not entirely accurate.

While as stated by many Addiction Treatment Centers “Withdrawal cannot technically cause death”, it certainly CAN.

Withdrawal can also cause seizures and send a person’s system into shock. Triggering heart failure. Especially if they are titrated down too rapidly or discontinued without any titration.

For patients with complex medical histories with comorbitites like heart disease and seizure disorder the risks of death due to Withdrawal increase.

In addition, uncontrolled pain can kill.

Very sick

Hello Reece. I pray for you even though I don’t know you. I have IC also, and I know what you are going through. 24/7 pain that is undertreated.

Alan Edwards

What happened to our courageous Doctor Mark Ibsen? And Forest Tennant? His door was flattened by the dea,fda,cdc while he was in Montana testifying for the defense. Forest helped guide Fda policy in the 70’s. The government is getting aggressive with good people. I cannot locate the article on national pain report but saw the heading. Some information is on the net and you tube. Both are top doctors and Tennant or Tenant has been possibly shut down in an attempt to intimidate other good doctors. He is an expert on centralized pain and withdrawal without an antagonist. Pray for them. And thanks to Dave Coghlan for all he does on NPR.

JJ Kamp

Neurontin is amazing when it comes to going through withdrawal or making the switch to suboxone…

April

To Jeanne, doctors do make patients prove they have pains by having patience bring in their MRIS , x-rays and other tests needed, to prove we pain patients indeed are in pain. It is us that are going to pain management doctor’s, to live a life without extreme pain on a daily basis 24 7!! it is not pain patients that that are causing this Hysteria opiate abuse. it is the people who buy drugs off the street and mix it with other street drugs that cause someone to OD. I have taken opiate drugs for over 25 years for health problems that doctors cause me when having surgical procedures done. we pain patients that do not abused our medications have never taken more than we should have never refilled prescriptions early should not be responsible or scolded or treated like drug addicts because people decide to get high off of street drugs and blame it on prescription medication. why should pain patients be punished because druggies OD? besides people that OD over and over and over again get the methadone and then are treated special. I know a lot of people who abused alcohol. I know a lot of people who have died by drinking too much alcohol. I know a lot of people who have died smoking tobacco also I have known a lot of people who have died from secondhand smoke. Although the government will not take alcohol and tobacco off the shelf the government gets too much money from the tobacco company and alcohol company. so we pain patients have to suffer now. It is called cruel and unusual punishment not to be able to take advantage of a prescription that takes pain away. Now marijuana is legal and they used to say marijuana was the first step towards taking heroin. So what is it? I am on able to take marijuana for pain. first it makes me more aware of my pain number two it makes me very paranoid and I have terrible panic attacks. it is also very costly and not paid by any insurance companies. we pain patients really need to all gather together and start hiring litigation attorneys as a couple of gentlemen did in the state of Maine. they started a lawsuit to sue the state of Maine so that they could have their opiate medications guess what they won that law suit! 🙂 one gentleman takes 450 MMS daily. I only take 30 mms daily and soon will not even be able to get that even though my state that I live in has a cap of 90 MMS daily. However doctors are too afraid of losing their license so they are taking everyone off of all pain management medications. God help us all.

Alan Edwards

Thank you, Cindy. You didn’t mention tapering or titrating down from opioids. It can and does work with little or no withdrawal. And some go through no withdrawal. One percent of which I was one. My father and mother also had no withdrawal symptoms after prolonged opioid treatment.

Amitriptyline withdrawal symptoms are far worse than opioids. Titration is not effective. Amitriptyline and Nortriptyline, it’s metabolite, have been used since 1961 for pain and depression and are being used to replace opioids. It takes some people like myself three years to survive the ordeal. Withdrawal symptoms of amitriptyline are so intense, painful and prolonged I thought of death but did not know it could be fatal.
Yet the government and Medical professionals aren’t seeking a ban on amitriptyline though they have known withdrawal could be the severest of any drug since at least 1962.

I advocate tapering from opioids. It’s not comparable to what I went through with amitriptyline. And my amitriptyline withdrawal not yet ended. A comprehensive medical article about amitriptyline withdrawal was evidently pulled about 2 years ago by the FDA and CDC from Wikipedia. It expertly described what I experienced coming off of 200 milligrams over 2 years of titrating down at ten percent per month to zero.
I prayed for death. Lost 60 lbs. Had insomnia, pain, vomiting, hallucinations, mind tripping, feelings of going back in time, and grand mal seizures.
Stomach pain and mild sweating was the first symptom at 50mg of titration.
Being on amitriptyline caused severe neuropathic pain of my face, skull, skin, migraines and depression.The withdrawal has been the most painful, long-term odyssey of my life. Please don’t take amitriptyline. I lost my job and nearly died. Not a day went by for 3 years that amitriptyline craving did not occur.
It was extremely addictive yet no medical professionals warned me what amitriptyline and other antidepressants can do when taken for a long period. Yet it is on the WHO’s list of essential medications. Mindblowing.

Now let’s ban opioids. How ridiculous.

It is a pity that any physician would treat a patient in this way. It is irresponsible at the very least. They have the power to do this however and I applaud this writer for caring enough to give these guidelines for anyone in this predicament.

Scott Sheryak

One extreme to another, the fentenal is the problem ! I use Tylenol 3 2 tabs 3 times a week along with Aieve so I can play golf, now I sit home and get depressed !

I took tramadol, at one time I was on 180 pills a month but now they take that away also my Klonopin that I was on for years this is just so messed up isn’t there any other pain medication other than opiates I don’t get it the Drs are so afraid of getting there license taken away but they should of thought of this way before it got out of hand,I am so glad that I’m off of narcotics but still there are people who were just cut off because they had marijuana in there body I hope Drs suffer for the pain they are causing people and I’m hoping I don’t have to deal with Drs in the future

Elizabeth

You suggest someone use kratom? I will tell you, my experience was that the withdrawal from kratom was worse than the one I went through when my prescription was denied and I went cold turkey after four years. It has been 8 months, the PAWS are unbearable and I have found myself contemplating suicide. Please don’t lead people down that path.

Ed s

God help us all are we lost to trying to find a herion dealer?

Lisa Shuman

Just to let you all know ..if you get a prescription for suboxin or methadone you will NEVER BE ABLE TO GET PERSCRIBED OPIODS AGAIN…NEVER

Adam o halstead

I cant believe its come to this

Louis Ogden

I agree with jill slovacek, below. Severe pain can cause increased blood pressure which can cause a stroke or a heart attack.

Kelley

What I dont understand is this

1. Pain patients use opiodes yo reduce pain and are not addicted to their meds, BUT, the media and FDA have stated that all patients are addicts, so they stop prescribing their meds and leave them in the state of withdrawal and no further assistance, the people who are not ODing, are the pain patients.they are also told, they cant use opiodes and anxiety meds together, again because someone can OD on the mixture, but again NOT the pain patient.
.
2. People who use opiodes to get high, and overdose from recreational use, are labeled as “victims, and so they decided to stop all prescription opiodes and then recommend more opiates with a program, intended stop the abusers from suffering withdrawal symptoms.
.
NEXT, the pain patients being labeled as addicted and opiod dependent are then FORCED to stop taking their medication and are forced into withdrawal, BUT most pain patients are NOT entitled to being prescribed the opiodes deemed safer and to stop withdrawal systems, because “technically ” they are NOT addicts, and are refused any assistance with withdrawal.
Next, the abusers are being offered care for their withdrawals with both opiodes and are informed they can continue their anxiety medication as well, if medically necessary.
So, pain patients being forced into immediate withdrawal, WITH NO medications to assist them. BUT, we have addicts being prescribed medication not only for opiod abuse but also, to help withdrawl.
How, is it that a pain patient can go to a clinic that prescribes these 2 medications, only to be told “sorry, we dont treat ” CPPs, because u were using opiates properly to control pain.
but an addict who was not using opiodes properly, is entitled to those 2 medications to help their withdrawal,
How is fair to label pain patients as “addicts” but, then claim they are not “addicts” that are entitled to assistance.
This entire thing is obsured and insane, not one thing makes sense, even allowing drug users to shoot up their illegal drugs, in a gov run facility, but NOT Allowing people suffering from a painful disease ANY medication to help them.? I even have a hard time wrighting this, because frankly it’s so backwards it’s hard to put in words. In some insane and ridiculous way, people who are abusing drugs are now “victims” and the tax payer is paying for them to continue their illegal use.

Ellen

No patient should go through opiate withdrawal without 24 hr medical supervision and let’s face it public rehab facilities are difficult to get a spot month long waiting lists and private ones rarely affordable by patients especially patients disabled on disability do to their underlying disease
Alcohol withdrawal is life threatening but as some commented comorbities and individual situations may make any withdrawal life threatening
Why are doctors allowed to do cut offs or pharmacies ( how is that different from Catholic pharmacist denying morning after pills) Most importantly why should dosasse that are making people functional even have to change a pain regimen with opiates after highest safe OTC doses of Tylenol and Nsaids did not work
We deserve treatment that works and doctors are morally and legally bound to do provide it Guarantee if a VIP needed opiates they would get them
I have been on opiates for more 10 years one hospitalization for difficulty waking up but even Narcan did not do the trick doctor said my eyes were not typically the exam of overdose no one had a neurologist see me in the hospital because for anyone who has seen Awakenings knows longstanding dopamine defiency can make you frozen and sleepy remember seen at end when Robert DeNero played the part of an awakened on levodopa for a newly seen Parkinson like illness caused by
a virus that led to a encephalopathy with degenerative loss Dopamine and pre medications now known keep levodopa and side effects lower – carbidopa so when he developed severe dyskinesias ( not stop moving) he
Quit taking it and went physically immobile and back to sleep I had not been able to take my levodopa/carbodopa regularly for almost a year due to severe migraines and vomiting because my peripheral dopamine seniors get stimulated in addition to It centrally turning into dopamine
As for physical tests “objective proof” Dopamine Response Dystonia which UCL A diagnosed is atypical they thought almost 100% it was and the attending told me this was one type the non approved “experimental” L-Dopa pet scan helped and I also later had two of the genetic tests both negative and doctor said he was not surprised because new mutations of this illness they do not have all the variants in a
found genetic mutation which
Can be tested for
I have no side effects from opiates except constipation
IM Benadryl helps relief leg rigidity ,vomiting but I need surgery #2 now from damaged
tissue

Angela C Holbert

This is the government’s way of hurting everybody into their Suboxone and methadone clinics. That way they have everyone under their thumb. The reason there is “supposedly” an opioid problem lies completely into those on the streets or elsewhere that are not prescribed opioids. The people that have legitimate pain like myself that has gone to their pain doctor Faithfully for years that have constantly passed every test every pill count jump through every hoop went through everything that causes embarrassment and belittling because you have PAIN!! I’m just wondering will the government be taking insulin away because you’re diabetic. Will the government be taking away heart medications what about oxygen for people who need it to live because trust me if you do not think that suffering in pain is life threatening you are either ignorant or blind, deaf & dumb! This issue is only coming from the mouths of those who are against it. Those who have no idea about anything when it comes to Medicine. It is time that those of us who suffer in pain it makes them listen to us. This is wrong and we all know it. If my doctor is doing everything he is supposed to do such as giving test Etc and if he has been educated to be a pain doctor why the hell does the government have any business bothering these legitimate tax paying pain suffering people??? BIG BROTHER!!

Pauline L Fravel

Finish story:
1st surgery done by different person, place. Nurses, Pshychiatrists, confirmed my question read on of 5yr life expectancy from 1 spine reconstruction.answer is yes. Its true. gasps I hear from xray techs when see instruments in my back. They ask how do I live, how am I alive, how do I sleep? Brings tears and fears to my eyes. I wonder if I will survive next 2 to 3 yrs left expectancy of last surgery in 2015. Pshychiatrists have said reason survived is my will. But my will’s weakning. 9 yrs of 24-7 god damn pain, struggles to just get out of bed like others get to live, go, do almost like others, to have it ripped away, restarting from beginning again is wearing on me. The laws are killing those wanting life
find myself wondering if I never took suboxone, would outcome turned out different. If my back would been found sooner, surgeries avoided all together. No metal back I’ll never know. For now I sit. Struggle to get around 800 sq ft house.takes me hrs to get done. drs act like if I get more than 1 soma a day, I’ll be out in a rehab. Its so ridiculous. Something so not terrible being kept away from me. The 1 thing I tried to be the only thing that helped me move forward along with diazepam,(ive tried other anxiety meds. Buspiron, lorazepam only helped sleep. Didn’t touch my anxiety issues. Xanax, i took but didnt help plus it’s a bad med for people. I don’t want to take it. Klonopin helped with sleep. Again didn’t address my issue’s. I’ve been on many anti depressants threw decades. had side effects, only few helped depression, yes many other muscle relaxants. They didn’t work. I have to have one that sedates slightly enough for those crushing feelings in my back daily. feels like my bones in upper back are breaking.it’s horrible pain. My arms can’t lift milk. lost function of left foot, toes never recovered, intestines don’t function properly from nerve damage. Its laxative city nightly ,can’t tell I have to urinate.be 6 to 8 hrs before I go, I can’t feel it. My life has turned to hell. Yet my spirit is still young at heart. I remember my life before. I mourn for it. I exhist. Not live. Don’t want opioids. Soma ONLY WORK)be almost like anyone else that walks threw a store, visit grandbabes, done sooner to join in on family get togethers.
Its not my fault. Stop punishing me.I’m trying to live. Not dope. live. Pshycologist told me last summer, “suboxone yes changed brain.wont accept opioids ever again”. Only soma got threw. Not an opioid!

C. Laws

There’s a lot wrong with this article but I’ll only address a couple of things. True homeopathic concoctions contain NO active ingredients so if the container lists ANY active ingredients it’s not homeopathic. Zicam is the the most notable example of this as it actually had an active ingredient that was causing people to permanently lose their sense of smell, zinc gluconate The makers of that specific Zicam product paid out over 12 million dollars in a class action lawsuit in 2006 and the specific product was pulled from the market due to FDA intervention.
The link to the of the “study” in India was originally posted in a homeopathic magazine and not an accredited medical journal. NO homeopathic studies have and there is a very good reason for this. It’s bunk. Homeopathy will be happy to take your money and will work no better than a placebo.

Withdrawal from a number of drugs including opiates or opioids can contribute to or cause and number of adverse physiological effect including seizures and death. Withdrawal symptoms can and probably last for FAR longer than a week.

Marijuana can cause psychosis or can contribute to psychosis surfacing.

I find this article irresponsible in several areas.

kbh

Thank you Jennifer & Jill for pointing out the lie that withdrawal can’t kill us.

In my first forced taper, which happened with no warning in August 2016, after 36 hours I became profoundly nauseated. Before I could think of downing Pepto Bismol, much less running to the store to get some, my eyes and nose began watering as saliva pooled in and poured from my mouth. I made it to the bathroom and threw up until there was nothing left in my system. Then I began dry-heaving so violently my back and ribs ached for days. Weak and in pain, I crawled into my glass-enclosed shower, sat on the floor, and rinsed off. That, at least, washed away the smelly, sticky sweat and the odor and taste of vomit on my body and in my mouth. I stood up to step out and felt like I was going to pass out. I stumbled out of the shower knowing if I fell I would hit the glass and suffer potentially severe, life-threatening injuries. I got myself clear of the glass, then collapsed, unconscious on my bathroom floor. The last thing I remember is reaching for a bath towel.

I don’t remember hitting my head. I don’t remember anything at all until I woke up 22 hours later. I was in my bed, thank God; but as I looked around my house, it was apparent that after my fall, on autopilot, I went straight to my bed. Lights I’d normally turn off at night were on, including my bedside lamp— curtains and shades I’d normally open in the day time were closed. I had a shrieking migraine headache and a huge two inch wide, one inch high black and blue knot on my forehead.

I live alone. Nobody checks on me day to day. Had I fallen through the glass or cracked my head open on whatever I hit that caused the lump and bruising on my forehead, I may well have bled to death long before anyone would have found me. Had the fall caused a severe concussion or some other type of brain trauma, I could have died in my sleep.

I am terrified of ever having to go through that again, although I suspect I probably will, sooner or later. This injury should never have happened. It was caused by being forced into withdrawal with no medical support or advice— my PM doc of over 10 years dismissed my concerns about withdrawal, waving his hand at me like I was an annoying housefly and saying “You won’t have any.”

Death is death, as they say. If I’d died that night, it would have been a direct consequence of withdrawal. So please quit perpetuating the lie that withdrawal can’t and won’t kill us.

Debbie P

2 1/2 times more people die from drinking too much alcohol each year. Yet people who truly need pain meds are the ones who are suffering because of the FAKE “opioid crisis”! This hog wash needs to stop.

Pauline L Fravel

After the laws changed on soma, my physical and emotional health has diminished a great deal. I have taken soma, plus other muscle relaxants for over 40 yrs for strains, ect…. Never had a addiction issue with soma. Its ludacris that it is considered to be an opioid. Its not. Because of a little something called suboxon, it has blocked any opioid from working on pain. Vicodin, Tylenol 3, percocet, morphine, i.v. meds. Non worked. So why did soma i wondered. Its because my brain accepted it to work. If my brain accepted this, then its not a narcotic. It couldn’t possibly be. So the government doesnt want people getting better? Population control? People are going underground either running away from a life they hate, or pain they can’t take living with anymore. Shooting up cocktails of god knows what to escape. But anything getting shot into blood stream like whats happening is certain death. It goes directly to the heart. Bam. Your dead. I blame the government for these deaths. Not narcs. For it put people in desperate situations. They dont care. Threatened drs license for even terrible chrinic pain sufferers. That’s just messed up. Because your article mentions theres other ways if pain control. Maybe for the not so severe cases, or non cancer cases, the non bone cases, your other ways still don’t help. These drs know who need it. But to turn their backs on us is just absolutely cruelty. To make us feel bad like were drug addicts for conditions we didn’t ask for us messed up. Theirs a group called “the mighty”, its all chronic pain sufferers of all kinds left to be prisoners of iyr suffering alone. To not get to live. Check it out. thousands of us. Left hanging. Shoved aside. We don’t matter. We aren’t valued. I hate this government and country. Think marijuana will help us? Maybe some. Not all. Im so angry at what effects suboxone has had on me. For ive suffered dearly because of it. Medical fields to this day when im checked over, xrayed, are flabbergasted by what’s discovered in me. My whole spine has screws, splints, a cage un upper mid back for some flexibility. 2 rods each size of my spine(total 4), 2 v -shaped rods attachment to my hips then those are attached to my spine. Because of discs shattered that caused my body to bend in half. I was stuck this way for 9 months. My husband ignored me. I was so ill i wasnt capable of finding help. My daughter got involved and called Rush in Chicago. Took them 3 more spine reconstructions after my 1st done

Debra

You say Withdrawals cause a lot of pain and that sometimes it’s unbearable now how many people do you think will commit suicide from the unbearable pain they rather not live with the pain then take the medication cuz you’re going to take it away from people with chronic pain how many of those do you think are going to die from the withdrawals because of the the pain the the people that are on diabetic medicine the people that are on heart medicine how many are they going how many of them are going to die from withdrawals you say withdrawals don’t kill people but it’s what withdrawals causes that person to go through

Reece

This article portrays a lack of understanding of bad chronic pain. Maybe it works for some people, but for those suffering from daily chronic pain at an unbearable level, it is not doable. Doctors don’t care what happens. They only care about their practice and not getting investigated. I have had a Doctor say that personally to me. I have never abused my meds. Yet, today I can’t get what I need. The medical community makes me feel like a criminal. They show no compassion when they hear Chronic Pain. It’s hopeless.

Debra

In the first place it’s the Doctor Who prescribes this it’s the doctor that got these people hooked on this opioids there are people who really need this medicine I for one if I don’t have it I have degenerative back disease I have fibromyalgia I have rheumatoid arthritis arthritis I also have stenosis of the back I’ve had two back surgeries I have arthritis high blood pressure when the pain gets intense my blood pressure goes up I don’t know if my Sugar goes up or down if never really checked it never really had to because I take them daily as I’m supposed to so I asked what is a person to do who has chronic pain as I do

Barrow

“Why doesn’t the government just offer assistance with assisted suicide?” Good question, Sue. They actually already are, by doing what they’re doing to us. Let’s just call it what it is: slow, torturous, cruel, inhumane “assisted” suicide— for people who don’t even want to die, no less, but only want to continue receiving and using the meds that have made our lives livable and functional for years, decades.

nana

On top of “withdrawal” no one considers that THE PAIN FOR WHICH IT WAS WRITTEN returns with a vengeance. There are SOME pain causing issues that NEVER GO AWAY.

BKH

“I think more articles of protest, reasoning, education on opioids should be written, NOT, what to do for withdrawals…” M. Billeaudeaux, I agree. With all due respect, Ms. Perlin, “This article is directed to a very specific group of patients & it’s a small group,” as Jennifer Reed says. Otherwise, all it is doing is attempting to normalize an outrage. What is being done to now tens of millions of not only chronic pain patients but acute sufferers as well (post-op patients, trauma victims, etc etc etc) is a humanitarian crisis with far-reaching effects that eventually will touch the lives of every American. Many will die— many others will have to live with the untimely and unnecessary deaths of their loved ones. Attempting to normalize cruelty, inhumanity, torture, the violation of human rights, and genocide is never the answer to a humanitarian crisis.

I went through withdrawal of Methadone that was prescribed to me for pain for about 10 yrs. It lasted almost a month, I have never been so sick, the cramping and muscle pain was the worst, and not even the hospital would touch me!
It is beyond cruel to make Chronic Pain patients go through this and I still curse my previous doctor because no one offered any help whatsoever!

Pauline L Fravel

Sub of one is HIGHLY WORSE than OPIOIDS. UTS A DANGEROUS DRUG. IT HIDES PAIN. YOU WILL NOT KNOW IF ANYTHING is going WRONG IN YOUR BODY UNTIL YOU STOP THIS TERRIBLE MED. ITS GOT A NARCOTIC PAIN KILLER IN IT. DRS HAVE LIED ABOUT. IRS THE WORST WITHDRAWAL EVER EXPERIENCED. ALSO BLOCKS PART OF BRAINS RECEPTERS TO ACCEPTING PAIN MEDS FOREVER. END RESULT? OPIOIDS WILL NEVER WORK IN THE BODY AGAIN. I TOOK SUBOXONE FOR A TIME IN MY OWN ACCORD. IMMEDIATELY STOPPED MY WITHDRAW FROM VICODIN. I WAS HAVING ODD PAIN FOR YEARS. TO WHERE I WAS TAKING UP TO ALMOST 8 PILLS A DAY. I DIDN’T WANT TO BE ADDICTED SO I TALKED to my FAMILY DR. HE PUT ME ON THIS MED. PRIOR to SPEAKING WITH HIM I WAS PUT IN THE HOSPITAL TO BE KEPT EYE IN. I WAS TALKED TO BY A PSHYCHIATRIST DETERMINING IF I WERE AN ADDICT. RESULTS CAME BACK NO. THEY BELIEVED I WAS NOT AN ADDICT. THEY BELIEVED I WAS HAVING ABUSE ISSUES THAT NEEDED FURTHER ADDRESSED. THEN I started feeling dibilitating pain after getting off suboxone. My spine had bent to the point of no return. Ended up in a total of 4 spine reconstructions in a 6 year period. 2009, 2011, 2013, 2015. Had to go on disability. My life has turned from a active woman to my bed. Because I can’t get soma 3 times a day to ease up the pain enough to go out my door to drive and go to a store. Kills me to shop. Haven’t been able to go to Christmas, thanksgiving, or birthdays for 8 years. Missed out on my 1st granddaughters first 2 years of birthdays and life. It was 20091
st surgery. Its may 2018 and I’m still struggling. I’m sitting in my bed. Beautiful day out. In an abusive marriage that im afraid to leave because of how im to be on my own without help. I have a right to not live in dibilitating pain. If I were to be given back soma i could get pain managed. Start working out, and move on with my life. I refuse suboxon. For it too dangerous in covering up pain to the point of disability. Plus try to get off that shit is pure hell. I think its cruel to lie to the public about this narcotic. The severe consequences of being on it. The other severe issue is any surgery in a persons future will be a living hell. Because suboxon blocks that area of the brain permanently from any opioid from working. Pain meds needed for during hospital stay and post pain meds used will not work. My pain meds after each spine reconstruction had to be bumped up beyond my weight. Because post recovery i.v. meds didn’t work. The surgical team couldn’t understand why. But upped the

Daily Pain

I quit going to doctors when they quit treating my pain. I had breast cancer, double mastectomy, estrogen driven, and given Arimedex to slow down the estrogen. Arimedex is very hard on joints and muscles. Nothing over the counter helps but an opioid. I have two herniated disc in low back, double carpal tunnel, prosthetic knee, and a painful left foot. Benefited me from taking a pain med. Now I have a hard time getting around and in pain daily. The doctors prescribe when it benefits $$$ them not the patient. Have a few irresponsible people OD and people like myself suffer. The doctors run with their tail between their legs.

Carolina Girl

Please excuse my long rant, but I try to tell my story every chance I get, because there is no one else out there trying to help those of us who are legally disabled. I just recently had to leave my primary care doctor that I have been with for more than 15 years because she can no longer prescribe my pain medicines. I had to go to a pain clinic. The doctor there is nice and all, but she doesn’t know me like my primary care doctor knows me. I suffer mainly with spinal stenosis along with the ‘fake’ disease known as fibromyalgia and some other things. I have gained a lot of weight because I can’t exercise or walk like I used to love to do. And yes, I take oxycodone/acetaminophen tablets and I also use fentanyl patches. My pain never goes away, but these meds help dull it a little bit. The pain management doctor told me that I will never be pain-free again. Besides, these people that are abusing these medicines are always going to find a way to get them. It’s the same as it is with guns. You can’t stop these people. And in the meantime, you want to punish me WHY?? Because I am a 64 year old, disabled, law abiding citizen? I have never hurt anyone in my life. Heck, I’ve never even had a speeding ticket. So it just baffles me as to why these ‘opioid crusaders’ want to take away what little relief I get from these medicines. But for the life of me, I just can’t figure out why they are so hell bent determined to make my life, and others who are disabled, unbearable. Will these ‘opioid crusaders’ take care of my final expenses when I no longer have my medicine and can no longer endure2 the pain? How do they sleep at night? They, obviously, don’t know anyone who suffers with pain 24 hours a day, 7 days a week. I wonder how they would feel if, God forbid, they became disabled and were told that they can’t have the pain medicine that would alleviate some of their pain. And all because of some people who have no willpower and who let drugs control their lives. Because they have no willpower, I get punished. I say this because these people who have no willpower will aways find a way to get drugs, one way or another. But not me, I have always done everything by the book and look where it has gotten me. Thanks for letting me rant.

Cindy, I think you have good intentions but you don’t understand the severity of the problem. Hyperalagesia has been debunked. You can die from withdrawal. Ordering any drug on the internet is dangerous. It’s obvious you have been speaking to Drs with there own agenda and mindset. For many of us because of our gutless Drs and a government who is bent on killing us, suicide is now a legitimate treatment option. Investigate what Purdue Pharma did to us. Help us get back on a treatment option that is the only option that works.

Barbara Thurman

There is know reason why someone should have to go through this. I did nothing wrong have always been responsible like many others. Like being punish. Just want small quality of life. I’m older have lived many years with chronic illness. Guess last part of my life will be far from peaceful. Opioid was last choice for me did many different treatment before opioid. Finally did and was right answer for me.

TABITHA

Forget Suboxone Its an extremely strong opioid and will ease withdrawal but you are postponing the inevitable. use Kratom . It will completely relive withdrawal symptoms and is completely safe although the DEA is trying to get its hands on that as well. What is happening to people is a crime against humanity , forgot the withdrawal thya are being sentenced to disability and eventual death from suicide or other issues related to those in chronic pain who will no longer be treated . CHRONIC PAIN PATIENTS PROTECTION ACT NOW

I have not yet met a Pain patient that has access or can afford the constant use of All the modalities mentioned in the article. Yes it would help us but it’s not realistic or affordable.

The CDC Overdose numbers caused by only pain medication is now less than the number of people killed by cars while walking & using their iPhone.

Medical Marijuana is not covered by insurance & the cost could be as much as $800 per month.

We are no longer a Civilized society.

Heather

The issue is that we’ve been orphaned. Chronic pain is isolating to begin with, and now doctors are pulling the rug out from under patients who have been on a steady treatment regimen. Most doctors are not making decisions based on their medical expertise (or they wouldn’t have prescribed in the first place or maintained dosages) and many have said they fear that they’ll lose their license if they prescribe. Much of this is JUST NOT MEDICALLY JUSTIFIABLE!

Frankly, much of it is PATIENT NEGLECT.

The doctor who says, “Sorry, I can’t help you. I might lose my medical license and tells their patient they are going to go cold turkey” knows he/she is doing harm. They know.

These patients who often lack family and social support because of the stigma of chronic pain are now having treatments discontinued for reasons that don’t make sense AND by doctors who shuffle them through to get to the next patient. The medical system does NOT support these patients as it is. Sometimes doctors are DOWNRIGHT ABUSIVE to their patients.

And those are the patients who are told, “Sorry, Charlie.”

I’ll be darned if I can’t think of a more perfect storm for a patient to either commit suicide or resort to decisions that put their health and/or lives at risk. Does any medical professional still have an ounce of sense? Who went into their field because they wanted to help patients? Who took a pledge to “Do No Harm?”

When the patient is now addicted to heroin or has committed suicide, then does that count as “Do No Harm?”

Physicians and professional medical organizations need to stand for what the pledged in and push back against politicians who are trying to play doctor.

Sue

Krantom is already considered a class I drug in some states. Try googling the FDA War on Krantom. They go after everything they dot have control over or benefit from.

Heather

Jeannie, there are causes of chronic pain that do not show up on x-rays/scans. I really think it has to be a case-by-case basis. No, opioids should not be prescribed lightly or the first line of treatment but there is no objective test available that can tell a doctor “the patient is in pain” or “the patient is not in pain.”

As for this article, it’s disheartening. I do believe withdrawal can be life-threatening. I think it’s irresponsible for doctors to not monitor the taper process, and an article like this lets them off the hook.

This is an “ideal world” article. Things just aren’t so simple. Others have pointed out that the treatments recommended are often out of reach due to expense and/or lack of insurance reimbursement.

I’ve been in touch with people who have been on a forced taper or cut cold-turkey. They’re scrambling for other options instead of saying, “Oh, I feel better than I thought now that I’m off my meds.” Some folks are turning to Kratom, others have mentioned street drugs, but the reality is that most have mentioned or hinted at suicide.

B. Gould

People have died from withdrawals. It is very dangerous and if you absolutely have to you need professional help because you must be monitored. Let’s hope the this is not the case because we still have to deal with the pain and I know when I’m in a lot of pain my blood pressure is dangerously high and there’s so much to deal with this whole thing is just wrong it feels like a war and we have to fight for our survival. Also doctors have a duty of care and for them to let the patients go without the medication or to prescribe what’s needed to safely wean off is absolutely wrong and the pharmacies too that would be just be an injustice. This is absolutely wrong don’t give up fight for your rights!