DISCLAIMER – I am a psychologist and licensed chemical dependency counselor. I am not a medical physician. This article makes recommendations on how to deal with opiate withdraw from a lay perspective and should NOT be a substitute for proper medical treatment. The person who tries these recommendations takes full responsibility for the outcome. I take no responsibility for any adverse effects that might occur from someone attempting to use these scientifically untested self-help remedies.

“I don’t know what I’m going to do. If I don’t get my pills I’ll go into withdrawal and that’ll be terrible. I can’t stand it. You just don’t know what it’s like. I won’t be able to go on. I might die!”

People with a physical dependence upon opiates commonly think this way. Sometimes these individuals find themselves in a situation where they out of their opiate medication and begin to panic knowing in a few hours they are going to start experiencing withdrawal symptoms.

Their first response is to get more of their medication from their doctor. Usually this does not work. The next response is to get opiates from someone else, even resorting to buying what they need on the street. The problem with this solution is that it is illegal and takes the opiate dependent person to a place he or she does not want to go.

Another problem with this second solution is that you increase your risk of OVERDOSE. Once the opiate dependent person has gone into withdrawal he or she quickly loses their tolerance to the drug. Consequently, if you are in withdrawal try to take your usual does of opiates it is quite possible to accidentally overdose yourself.

There is a third solution – cope with the withdrawal.

The prospect of this is bad news to most opiate dependent individuals. Opiate withdrawal can be quite unpleasant. The good news is unassisted opiate withdrawal is generally MEDICALLY SAFE. Withdrawal is NOT LETHAL. In fact, unassisted opiate withdrawal is medically safer than withdrawal from other drugs like alcohol and benzodiazepines. So the good news is that you are not going to die if you go into withdrawal. Here is some more good news, there is a lot you can do to ease your withdrawal symptoms without using more opiates.

This article provides do-it-yourself remedies to ease opiate withdrawal. These recommendations are not just folk remedies. The remedies are similar to the same treatment you would receive if you went into a hospital for opiate detox. However, none of these remedies are fool proof and results vary across people. Some people will find these remedies eliminate their withdrawal symptoms altogether. Some will find the remedies completely ineffective. Most will derive some reduction in their symptoms, hopefully to a level they find tolerable.

Typical withdrawal symptoms

At first you can expect to have watery eyes, runny nose, sneezing, yawning and sweating. This is sometimes followed by restlessness, irritability, loss of appetite, fever, tremors, depression, vomiting, diarrhea, elevated heart race, increase blood pressure, chills alternating with flushing, excessive sweating, musculoskeletal pain, and muscle spasms. Throughout this process you can expect to have intense cravings to use opiates.

These symptoms can begin within about 8 hours of the last time you took any opiates and increase in intensity, peaking over the next 48 to 72 hours. The symptoms decrease in their intensity after that but can persist up to 5 to 7 days after you last took any opiates.

Who should NOT do this on their own

The overwhelming majority of people can medically tolerate physical withdrawal from opiates. However, certain individuals should not try to detox themselves on their own. These include the following:

• Pregnant women – Try unassisted detox and you increase your risk of having a spontaneous abortion. Also, your unborn child will also go into withdrawal as well.
• Individuals with major mental health problems and/or a history of suicide attempts – During unassisted detox you might become severely depressed and possibly suicidal.
• Unstable medical conditions – If you are in poor health or have a serious medical condition you probably should not detox yourself. A lot of the over-the-counter medications and herbal remedies listed in this article could compromise your medical condition. This article presents remedies for people who are medically healthy apart from the fact they have a physical dependence upon opiates.
• Chronic pain – People often become addicted to opiates after their doctor initially prescribed pain medications to deal with intense, crippling, chronic pain. Even though you may be sick of taking these pills you still might have a problem with pain. Try to go off pain medication without assistance and you might feel a great deal of pain. This physical pain may be far worse than the withdrawal symptoms.
• Cross physical dependence to alcohol or benzodiazepines – If opiates are not the only drug you have a physical dependence upon then you should probably go into a hospital for detox rather than try to do it yourself.

Preparing for your unassisted detox

If you’re going to go through unassisted withdrawal the first thing you want to do is take a trip to your local drug store to pick up a few things. Here’s what you’ll need to get:

• Flu/cold medicine or something that has an antihistamine in it.
• Something for nausea and to reduce vomiting.
• Imodium for diarrhea
• Something for aches like aspirin or Motrin.
• Lots of Gatorade, Smart Water, or some other electrolyte replacement beverage.
• An over-the-counter sleep aide.
• Consult a physician about getting a prescription for Clonidine.

Any medicine you get for yourself should be the “over-the-counter” type. Avoid taking any prescription sleeping pills (e.g., Ambien) or other prescription sedatives (like Xanax) to help calm anxiety. These medicines are potentially habit forming and will definitely turn up in a urine drug screen.

It is a good idea to talk to your primary care doctor before going ahead with this. Say what you want to do and ask your doctor if he or she thinks it is a good idea for you to do this. Ask if your doctor would be willing to write you prescriptions for medications like Clonidine, Atarax, or Trazodone.

The Proper Mental Attitude

A key to successfully detoxing yourself is to have the proper mental attitude. How you talk to yourself during the withdrawal can make or break your attempt. Saying things to yourself like “I can’t stand this!” “I can’t take it!” and “This is dangerous!” are self-defeating attitudes that will make you feel even more discomfort and panic.

Instead, you need to tell yourself things like:

• “I can handle this.”
• “It’s uncomfortable but not life threatening.”
• “I can do this.”
• “This sucks, but it makes me stronger.”
• “Persevere!”
• “This is just a bad cold.”
• “I have no choice but to get through this.”
• “There’s light at the end of the tunnel.”
• “Be tough.”
• “It gets better.”
• “Just make through today.”
• “Find something to distract yourself.”
• “Stay calm.”

These statements encourage and affirm what you are trying to do. They are also realistic statements not just platitudes or palliatives.

The Setting

Where you do your detox is also important. Ideally you should be home around people who support what you are trying to do. If someone cannot be with you, at least have a friend or family member call to check up on you throughout the day. Some people in withdrawal find they are sensitive to light so you might want to darken the room. As stated earlier, take some sick days off work.

Runny nose, tearfulness, and aches.

This is where you want to take you cold-and-flu medicine. These formulations have an antihistamine that will help dry you up. This will take care of the sneezing, runny nose, and watery eyes. Be sure to get the non-alcoholic cold and flu medicine.

Muscle Skeletal Aches

Over-the-counter analgesics like acetaminophen, aspirin, or one of the NSAIDS (ibuprofen, ketoprofen, or naproxen) will ease the body aches and pains. Often the cold and flu medicine includes a pain reliever as well.

Muscle Spasms, Cramps & leg twitches

A muscle spasm or cramp is a painful, involuntary muscle contraction people in opiate withdrawal might experience. Opiate withdrawal can cause “jerky” tic-like twitches in the extremities, especially the legs.

Most skeletal muscle spasms are associated with dehydration and electrolyte disturbances. If you are experiencing muscle spasms during opiate withdrawal you might reduce these by drinking lots of fluids, especially “sports” drinks that replace potassium, like Gatorade. Drinking orange juice and eating bananas also replace potassium. Doing stretching exercises or massaging the affected area could help too. Curiously, engaging in exercise can help the leg twitches. Taking a high potency multi-vitamin with iron, vitamin A, vitamin C, vitamin E, and folic acid (vitamin B) can help reduce leg twitching. Taking magnesium citrate (250-800mg) at bed time may decrease leg twitching and might also help you get to sleep.

Nausea and Vomiting

If you start to feel sick to your stomach you will want to take something to calm your stomach and vomiting. One over-the-counter remedy is QueaseX, which will help you calm your stomach.

Vomiting can upset your electrolytes so that is why you want to drink lots of Gatorade or some other “sports” drink that replenishes electrolytes too.

Other over-the-counter medications can help with nausea. These include sedating antihistamines like diphenhydramine (Benadryl), dimenthydrinate (Dramamine, Gravol) meclizine (Dramamine II), or prochlorperazine (Stemetil)

Diarrhea

Expect to have the “runs” while you are detoxing. To reduce this get yourself some Imodium (Loperamide hydrochloride). Diarrhea also dehydrates you and upsets your electrolytes. So again, you want to drink lots of fluids and drink Gatorade (or some similar product) that will replace your electrolytes.

Curiously, Imodium is structurally similar to opiates, but does not enter your brain. Imodium acts on opiate receptors throughout the body, including the intestines. It stops the spasm and therefore the diarrhea.

Imodium will be your best friend during withdrawal. Some opiate-dependent people have reported that Imodium works so well it actually completely eliminated their withdrawal symptoms. However, don’t expect such a successful result. Only expect the Imodium to get rid of the runs.

One other thing, be sure to double the suggested dose since your colon has a tolerance to opiates. You may need to continue taking Imodium and wean yourself off of it over a two-week period.

Anxiety and Restlessness

While some of the symptoms of anxiety and restlessness are due to the actual physical withdrawal, most of it is psychological. Telling yourself and believing that you are going through a horrible experience will cause you to feel anxious, afraid, and restless. Having the proper mental attitude discussed earlier will help put your mind at ease. Viewing what you are going through as being like having a bad cold will also put you at ease. After all, do you ever worry about dying when you have a cold? No, it’s unpleasant but you just go through it. Having someone around or someone who can call you during the day and give you reassurance will help you feel more at ease. Finally, get your mind off of the physical sensations you are experiencing by focusing onto something else. Watch TV, read a book, play a videogame, or do some chores around the home.

Take a shower or hot bath can help to relax. If you can afford it, try a massage or go to the gym and soak in the hot tub or go into the sauna. These too can help you relax.

If you feel like you do need some medication to help deal with the anxiety you will have to call your doctor and get a prescription for Hydroxyzine (Atarax). This is a non-addictive sedative that is an antihistamine.

If you cannot get any Hydroxyzine you might try going to the health food store and buy some Valerian Root. This herbal remedy helps reduce anxiety and some people going through opiate withdrawal find Valerian Root helpful in easing their anxiety. Another herbal remedy is Passionflower. It is similar to Valerian Root but reportedly has the added benefit of reducing muscle spasms associated with withdrawal.

Insomnia

You probably will not be able to get a restful sleep. This is just something you will just have to tell yourself is going to happen and that you can handle it. Again, it is just like having a cold or flu.

Your cold and flu medicine (especially the “nighttime” formulations) might have an ingredient that might help you sleep a bit. If not, get an over-the-counter sleep aid. Cold medicine often contains alcohol. Therefore find a non-alcohol based cold formulation.

An herbal remedy that can help insomnia is melatonin. You might also try calling to your doctor to see if he or she will prescribe you a medication like Trazodone or Vistaril. These medications are non-addictive sleep aides. Trazodone is a type of antidepressant medication that helps insomnia. Vistaril is another antihistamine that helps you sleep, and can also help reduce the watery eyes and runny nose.

Herbal remedies for insomnia include Melatonin, Valerian Root, and Passionflower.

Sweating and Chills

A prescription medication your doctor could write for you to help ease your withdrawal is Clonidine (not to be confused with the tranquilizer Klonopin). Clonidine is a non-opiate, non-addictive blood pressure medication that helps decrease the sweating, chills, anxiety, and restlessness. Be sure to tell your physician what you want this medication for and use it only as directed.

Side-effects of Clonidine include dry mouth, sedation/tiredness, and occasionally insomnia. Since it decreases blood pressure you might experience a few moments of dizziness if you get up from a chair.

Cravings

Expect to have strong cravings for opiates. These urges are physiological and psychological. Having the proper mental attitude will help you through the psychological cravings. Here are some other things you can do:

• Distract yourself from the craving but doing something active, like chores or playing videogames.
• Having someone with you to give you encouragement and support.
• Get rid of the phone numbers of dealers and other suppliers.
• Get rid of any opiates that happen to be around the house.
• Keep reassuring yourself you “can stand it” and the cravings “will go away.”
• Have someone take charge of your money and give your debit card to a trusted person.
• Remove access to a car or phone.
• Get to a 12-Step meeting like Narcotics Anonymous or Alcoholics Anonymous.

When to go to the hospital

• As stated before, although you might feel miserable during opiate withdrawal it is not life threatening. However, there are four instances when your unassisted withdrawal might not be working and you should take a trip to the emergency room.
• High blood pressure – If you have high blood pressure to begin with opiate withdrawal will only increase your blood pressure. It’s a good idea to have someone take your blood pressure during the withdrawal process. If you have high blood pressure to begin with it is likely you already have blood pressure medication. Keep taking it during the withdrawal process. Nevertheless, if your blood pressure does get very high, then go to the emergency room.
• You are having suicidal thoughts – Going through withdrawal is unpleasant and you might begin having thoughts of hurting yourself. If you start thinking seriously about suicide go to the emergency room.
• You are feeling very sick and worried about your medical symptoms – More than likely you will survive but to be on the safe side go to the emergency ward if you are really worried about your health.
• The cravings are too intense – Finally, if the home remedies are not working and you have decided that only going back to using opiates is your only solution, go to a hospital that can detox you, rather than go back to using.

Conclusion

After reading this I hope will consider going through withdrawal through the help and support of a medical physician. Your withdrawal experience will be less harsh with the assistance of such an individual.

However, sometimes individuals have no choice but to detox themselves and go “cold turkey.” Hopefully, persons in that situation may find these recommendations helpful in getting them through the process.