Sean Mosher
Member
Is there any correlation between long-term and/or heavy opiate use and low testosterone?
Studies to prove/disprove?
Studies to prove/disprove?
Low T & Opiates
- Thread starter Sean Mosher
- Start date
CoastWatcher
Moderator
Opiate use has been known to impact testosterone levels for some time. Here is just one recent study.
http://www.ncbi.nlm.nih.gov/pubmed/22786453
http://www.ncbi.nlm.nih.gov/pubmed/22786453
Nelson Vergel
Founder, ExcelMale.com
Nutpuncher
New Member
I am living proof that chronic opiate usage lowers T levels. I am no longer taking opiates. After roughly 10+ years of opiates and then 5 years after my last opiate, I t was 145, 205 & 198 (345-1197), all test taken around 8 am.
I highly suggestion TRT for anyone that wants to get off opiates. Getting off opiates is hard enough, no need to suffer from low T and withdrawls at same time....thats a recipe for failure.
I highly suggestion TRT for anyone that wants to get off opiates. Getting off opiates is hard enough, no need to suffer from low T and withdrawls at same time....thats a recipe for failure.
Nutpuncher
New Member
Just be careful that t injections don't bring on a relapse. Your friend might be better off going to a methadone clinic or go to a doc and get on suboxone to get his/her life stable and then start TRT. Too many variables will overwhelm him/her.
It took me almost 5 years to recover from my 10+ year addiction.
Jasen Bruce
Member
As stated above there is certainly negative hormonal changes which do occur with chronic opioid use. Primarily hypogonadism in men and woman, this has been clinically evident. In addition to disrupting your limbic system which controls emotions and other things.
The thought is that synthetic opiate use disrupts the neurohormones that regulate the HPTA which in turn regulates your testosterone production.
Here are the neurotransmitters that influence the release of GnRH and therefore influence your testosterone production;
GABA,neuropeptideY, opiates, dopamine, norepinephrine, adenosine monophosphate-AMP, and nitricoxide. Gonadotropin releasing hormone (GnRH) is released from the hypothalamus to stimulate the production and secretion of LH & FSH, which then stimulates the production of testosterone (and sperm) as many of you already know
NEUROTRANSMITTER: the brain chemicals that communicateinformation throughout our brain and body.
those interested, neuropeptide Y is a neurotranmitterthat increases food intake and storage of energy as fat, reduces anxiety andstress, reduces pain perception, affects the circadian rhythm, reducesvoluntary alcohol intake, lowers blood pressure, and controls epilepticseizures- all important functions.
The thought is that synthetic opiate use disrupts the neurohormones that regulate the HPTA which in turn regulates your testosterone production.
Here are the neurotransmitters that influence the release of GnRH and therefore influence your testosterone production;
GABA,neuropeptideY, opiates, dopamine, norepinephrine, adenosine monophosphate-AMP, and nitricoxide. Gonadotropin releasing hormone (GnRH) is released from the hypothalamus to stimulate the production and secretion of LH & FSH, which then stimulates the production of testosterone (and sperm) as many of you already know
NEUROTRANSMITTER: the brain chemicals that communicateinformation throughout our brain and body.
those interested, neuropeptide Y is a neurotranmitterthat increases food intake and storage of energy as fat, reduces anxiety andstress, reduces pain perception, affects the circadian rhythm, reducesvoluntary alcohol intake, lowers blood pressure, and controls epilepticseizures- all important functions.
Last edited:
Jasen Bruce
Member
Pharmaceutical Tools for Opiate Detoxification
This originally started as a short, unofficial guide for my doctor friends to use in helping patients come off opiates. I put this together myself and it should be noted that the medications outlined below require a prescription and monitoring in some cases, therefore please seek a doctors advice as I am no doctor. I was a compounding pharmaceutical rep who supported doctors, and this was during the time of the Florida opiate purge where the law enforcement started shutting down the horrible pill mills dealing prescription narcotics in volumes that would startle you. When the hammer came down there were (and are) so many patients cut off from opiates and seeking help for the agony of WD they were not prepared for. There is so much more behind this and one day I will put it all together and get the info out there. I am sharing this excerpted protocol because it will hopefully serve a better purpose for someone than being stuck on my desktop.
Here is a list of comfort medications that can assist a patient experiencing Acute Opiate Withdrawals Symptoms (initial 1-2 weeks) after discontinuing their last dose.
1.Suboxone or Subutex: Prelude: Suboxone (Buprenorphine) only provides any benefit when administered within the initial 24-48 hours of acute withdrawal symptoms (AWS) and used short-term. Suboxone or Buprenorphine should be administered only after the patient has started experiencing withdrawal symptoms, therefore it is recommended that the patient has completely abstained from opioid drugs for a minimum of 12 hours prior to starting buprenorphine. Do not provide buprenorphine to a patient who is already beyond 48 hours of acute WD as this will only lengthen WD. Acute WD last average 3-10 days, if the patient has been in acute WD for 48+ hours do not admin buprenorphine and skip to #2 below. Patients are recommended to receive 2mg-16mg per day, depending on degree of withdrawal symptoms. Relief of AWS will occur within 15min of initial dose. Suboxone can be a great tool when utilized correctly, but unfortunately many opiate “detox” doctors fail to recognize the danger related to improper and long-term prescribing which is only replacing one opiate dependency with another. Suboxone (Buprenorphine) should only be used for the short-term relief of acute-withdrawal-syndrome (AWS), which occurs within hours of the patient's last dose of abused/prescribed opiate (oxycodone, hydrocodone, morphine, etc). Remember, buprenorphine is also an opiate and can increase withdrawal symptoms if taken too long. The difference between buprenorphine and commonly abused opioid medications is that bupe interacts differently with opioid receptors in the brain. In simplified terms, buprenorphine can essentially be thought of as a non-selective, mixed agonist–antagonist opioid receptor modulator, acting as a partial agonist of the MOR, an antagonist of the KOR, an antagonist of the DOR, and a relatively low-affinity, weak partial agonist of the ORL-1. Many experienced opiate dependent patients report that withdrawal symptoms are more severe and last longer in duration after long term suboxone use than with commonly abused short-acting opioids like oxycodone. This may be due to the strong affinity buprenorphine has on opioid brain receptors along with its lengthy half-life. On the contrary, experienced opiate dependent patients who have experienced WD report that the severity of WD symptoms can be significantly reduced when buprenorphine is administered within 24 hrs of WD onset and titrated down over 3-10 days where it is then discontinued. The Acute Withdrawal Symptoms (AWS) are the severe physical withdrawal symptoms that occur from physical/psychological dependency and they can last from 3 days-10 days. Withdrawal from long term use of longer-acting opiates like Methadone and Buprenorphine can last 24+ days. Acute Withdrawal symptoms are described as physically and emotionally torturous- sometimes unbearable for the patient to experience without medical assistance. Here are some of the symptoms of AWD; “Diaphoresis, nausea, constant yawning, lacrimation,tremor, rhinorrhea, extreme irritability, dilated pupils, resp. rate, pulse>90 Severe Signs (begins 12-48 hrs after last dose): Insomnia, elevated T,P,R,& BP, nausea,vomiting, abdominal cramps, chills, diarrhea, muscle twitching,dilated pupilsCourse: (1) Heroin: onset in 8-12 hrs, lasting 5-10 d, untreated.(2) Methadone: onset in 24-48 hrs., lasting 2-4 wks.” Note, the AWS symptoms mentioned above were an excerpt from a medical website. In reality, many of the most uncomfortable symptoms can last for a few months to one year depending on the patients drug use, lifestyle, and underlying illnesses.
**Suboxone should ONLY be used to manage AWS for 3 days- 10 days maximum. (10 days being reserved for high tolerance patients- inpatient advised). Due to its long acting nature and ability to attach only to specific, less rewarding, opioid receptors using Suboxone can help alleviate AWS significantly, making the patient more comfortable during the AWS phase. Using Suboxine any longer than 10 days will cause a tolerance and therefore further WD syndrome caused by the long acting Buprinorphine found in Suboxone.
Suboxone dosing: Many physicians mistaketly start with a dosage that is too high and not necessary for the goals at hand. This improper dosing is probably due to the recommendations provided by the pharmaceutical companies coupled with the doctors not understanding addiction and subsequent withdrawal. The drug manufactuerer recommends 8mg-16mg daily, however this is a quick way to increase the patients tolerance very quickly and enable a dependency for the Suboxone. Rather, a lower dosage should be used for a short period of time. 2mg-4mg appears to work well for moderate cases of AWS while 6mg appears to work for more severe cases. Suboxone should be quickly titrated starting after the initial dosage.
What can patients expect after Suboxone: There is no miracle drug that will eliminate with discomfort and agony of opiate WD, Suboxone included. When used correctly Suboxone will significantly reduce the severity of AWS allowing for a more comfortable detox as your receptors self titrate down as the opiates leave the body. Nevertheless, when Suboxone is discontinued the patient will still experience withdrawal symptoms at varying degrees depending on the person. The AWS symptoms will start to resolve progressively over 2 weeks after the last dose.
Additional compounds that can safely be used during and after Acute Opiate WD
2. Clonadine: Upon interviewing numerous opiate dependent patients (and addicts) all commonly mentioned this important tool for helping reduce the severe discomfort that occurs with AWS. Here is an excerpt from an opiate detox forum, someone's explanation of what the medication called clonadine helps with physically:
Clonadine also reduces the usually very high BP in patients experiencing withdrawals. Detoxing patients have reported that clonidine saved them from much of the physical suffering associated with acute withdrawal. Patients blood pressure must be taken prior to taking clonadine, and a BP cuff should be provided to them to take home, so they may record their BP prior to taking clonidine. This is just a safety precaution as many detoxing patients use clonidine safely without monitoring, although this is not recommended. In addition one of the typical symptoms of WD includes elevated BP in which low dose clonidine can be low risk due to reduced possibility of lowering BP too low.
Excerpt from online detox forum of person describing clonidine use during acute WD from opiates:
**“Clonidine can help minimize the following WD side-effects; panic/anxiety; hole in gut; heebie-jeeebies, kicking leg sensation, sleep issues. Some have reported that it also helps with associated sweats.When taking Clonidine you may experience a dry mouth and sense of lethargy....feeling like you're walking through mud. Guard against any quick, sudden movements like picking up your head too quickly”.
1.Vistiril: An anti-histamine which helps with two things; opiate withdrawal produces a histamine response which makes the patient have runny eyes, nose, and itching. Vistiril will help treat this symptom along with reducing anxiety and assisting in sleep. It is a very potent anti-histamine similar to Benadryl but much stronger and more effective at reducing some anxiety while providing some sedation. This medication may be used a few weeks beyond the suboxone to help manage the mild withdrawals that occur after suboxone therapy. Patients cannot expect any of these medications to completely eliminate WD symptoms. This includes Vistiril. In the minimum these medications will provide comfort and reduce the severity of WD symptoms.
Other comfort Medications used during WD;
Milk of Magnesia
Imodium AD (higher dosages can relieve the stomach WD symptoms)
RX strength Motrin (for re-bound pain which will occur)
Supplements Needed: Use for 6-12 months post-acute WD-
1.Multi-Vitamin/Mineral High potency/quality- take daily
2.DL-Phenylalanine (1g-2g daily): Restores natural endorphins
3.5-HTP (100mg TID): Restores serotonin and provides calming effect (don't use with SSRIs)
4.Magnesium: Helps with muscle pain, tension, spasms, and promotes relaxation
5.Methylcobalamin injection once per week: Restores appetite, reduces nerve pain, improves energy
6.B-Complex 100mg daily: Helps with mood, energy, and CNS repair
7.Glutathione (IV would be beneficial since most pain meds have acetometaphin which causes high liver enzymes): Expedites detoxification process and restores liver health
8.Glycine (Administer 10ml IV)- Helps restore neurotransmitters in the brain. Improves mood.
A compounding pharmacy can compound 2-3 formulations combining the above nutracueticals and provide them as part of the detox program. Here is an example: •1 capsule contains:
•500mg DL-Phenylalanine
•100mg 5-HTP
•100mg magnesium
DLPA-This particular supplement would help increase levels of serotonin, dopamine, and endorphins, which are deficient in the brain after opiate use. DL-P is clinically proven to help manage pain and also reduce opiate tolerance. Patient would take 1-2 capsules 3 times per day.
The program should be divided into two phases:
Phase 1 would deal with the initial acute withdrawals which occur after stopping the opiates. This phase would last from 1-2 weeks, and up to 30 days for those discontinuing methadone. The majority of the pharmaceuticals, such as Suboxone, will be used just for this phase.
Phase 2 will deal with the recently identified Post Acute Withdrawal syndrome, which can last from 30 days to 1 year after discontinuing opiates. PAWS (see below). This phase will utilize nutrition, nutraceuticals, and alternative therapies to assist the brain as it heals from long term opiate use. Some of these supplements, such as DL Phenylalanine, will help the patient manage some physical symptoms along with helping the central-nervous-system increase its production of neuro-hormones. Many symptoms of withdrawal are caused by a deficiency of a nuero hormone caused by opiate use.
**Don't forget to check hormone levels and treat deficiencies. Especially Testosterone.
**Long term. Opiate use causes hypogonadism. http://defymedical.com/resources/he...suppression-in-patients-with-opioid-addiction
**ED/Low T and opioid use: http://defymedical.com/resources/he...sfunction-may-be-tied-to-prolonged-opioid-use
Testosterone helps with pain perception: http://defymedical.com/resources/health-articles/149-testosterone-tx-may-ease-pain-perception
by Jasen Bruce
This originally started as a short, unofficial guide for my doctor friends to use in helping patients come off opiates. I put this together myself and it should be noted that the medications outlined below require a prescription and monitoring in some cases, therefore please seek a doctors advice as I am no doctor. I was a compounding pharmaceutical rep who supported doctors, and this was during the time of the Florida opiate purge where the law enforcement started shutting down the horrible pill mills dealing prescription narcotics in volumes that would startle you. When the hammer came down there were (and are) so many patients cut off from opiates and seeking help for the agony of WD they were not prepared for. There is so much more behind this and one day I will put it all together and get the info out there. I am sharing this excerpted protocol because it will hopefully serve a better purpose for someone than being stuck on my desktop.
Here is a list of comfort medications that can assist a patient experiencing Acute Opiate Withdrawals Symptoms (initial 1-2 weeks) after discontinuing their last dose.
1.Suboxone or Subutex: Prelude: Suboxone (Buprenorphine) only provides any benefit when administered within the initial 24-48 hours of acute withdrawal symptoms (AWS) and used short-term. Suboxone or Buprenorphine should be administered only after the patient has started experiencing withdrawal symptoms, therefore it is recommended that the patient has completely abstained from opioid drugs for a minimum of 12 hours prior to starting buprenorphine. Do not provide buprenorphine to a patient who is already beyond 48 hours of acute WD as this will only lengthen WD. Acute WD last average 3-10 days, if the patient has been in acute WD for 48+ hours do not admin buprenorphine and skip to #2 below. Patients are recommended to receive 2mg-16mg per day, depending on degree of withdrawal symptoms. Relief of AWS will occur within 15min of initial dose. Suboxone can be a great tool when utilized correctly, but unfortunately many opiate “detox” doctors fail to recognize the danger related to improper and long-term prescribing which is only replacing one opiate dependency with another. Suboxone (Buprenorphine) should only be used for the short-term relief of acute-withdrawal-syndrome (AWS), which occurs within hours of the patient's last dose of abused/prescribed opiate (oxycodone, hydrocodone, morphine, etc). Remember, buprenorphine is also an opiate and can increase withdrawal symptoms if taken too long. The difference between buprenorphine and commonly abused opioid medications is that bupe interacts differently with opioid receptors in the brain. In simplified terms, buprenorphine can essentially be thought of as a non-selective, mixed agonist–antagonist opioid receptor modulator, acting as a partial agonist of the MOR, an antagonist of the KOR, an antagonist of the DOR, and a relatively low-affinity, weak partial agonist of the ORL-1. Many experienced opiate dependent patients report that withdrawal symptoms are more severe and last longer in duration after long term suboxone use than with commonly abused short-acting opioids like oxycodone. This may be due to the strong affinity buprenorphine has on opioid brain receptors along with its lengthy half-life. On the contrary, experienced opiate dependent patients who have experienced WD report that the severity of WD symptoms can be significantly reduced when buprenorphine is administered within 24 hrs of WD onset and titrated down over 3-10 days where it is then discontinued. The Acute Withdrawal Symptoms (AWS) are the severe physical withdrawal symptoms that occur from physical/psychological dependency and they can last from 3 days-10 days. Withdrawal from long term use of longer-acting opiates like Methadone and Buprenorphine can last 24+ days. Acute Withdrawal symptoms are described as physically and emotionally torturous- sometimes unbearable for the patient to experience without medical assistance. Here are some of the symptoms of AWD; “Diaphoresis, nausea, constant yawning, lacrimation,tremor, rhinorrhea, extreme irritability, dilated pupils, resp. rate, pulse>90 Severe Signs (begins 12-48 hrs after last dose): Insomnia, elevated T,P,R,& BP, nausea,vomiting, abdominal cramps, chills, diarrhea, muscle twitching,dilated pupilsCourse: (1) Heroin: onset in 8-12 hrs, lasting 5-10 d, untreated.(2) Methadone: onset in 24-48 hrs., lasting 2-4 wks.” Note, the AWS symptoms mentioned above were an excerpt from a medical website. In reality, many of the most uncomfortable symptoms can last for a few months to one year depending on the patients drug use, lifestyle, and underlying illnesses.
**Suboxone should ONLY be used to manage AWS for 3 days- 10 days maximum. (10 days being reserved for high tolerance patients- inpatient advised). Due to its long acting nature and ability to attach only to specific, less rewarding, opioid receptors using Suboxone can help alleviate AWS significantly, making the patient more comfortable during the AWS phase. Using Suboxine any longer than 10 days will cause a tolerance and therefore further WD syndrome caused by the long acting Buprinorphine found in Suboxone.
Suboxone dosing: Many physicians mistaketly start with a dosage that is too high and not necessary for the goals at hand. This improper dosing is probably due to the recommendations provided by the pharmaceutical companies coupled with the doctors not understanding addiction and subsequent withdrawal. The drug manufactuerer recommends 8mg-16mg daily, however this is a quick way to increase the patients tolerance very quickly and enable a dependency for the Suboxone. Rather, a lower dosage should be used for a short period of time. 2mg-4mg appears to work well for moderate cases of AWS while 6mg appears to work for more severe cases. Suboxone should be quickly titrated starting after the initial dosage.
What can patients expect after Suboxone: There is no miracle drug that will eliminate with discomfort and agony of opiate WD, Suboxone included. When used correctly Suboxone will significantly reduce the severity of AWS allowing for a more comfortable detox as your receptors self titrate down as the opiates leave the body. Nevertheless, when Suboxone is discontinued the patient will still experience withdrawal symptoms at varying degrees depending on the person. The AWS symptoms will start to resolve progressively over 2 weeks after the last dose.
Additional compounds that can safely be used during and after Acute Opiate WD
2. Clonadine: Upon interviewing numerous opiate dependent patients (and addicts) all commonly mentioned this important tool for helping reduce the severe discomfort that occurs with AWS. Here is an excerpt from an opiate detox forum, someone's explanation of what the medication called clonadine helps with physically:
Clonadine also reduces the usually very high BP in patients experiencing withdrawals. Detoxing patients have reported that clonidine saved them from much of the physical suffering associated with acute withdrawal. Patients blood pressure must be taken prior to taking clonadine, and a BP cuff should be provided to them to take home, so they may record their BP prior to taking clonidine. This is just a safety precaution as many detoxing patients use clonidine safely without monitoring, although this is not recommended. In addition one of the typical symptoms of WD includes elevated BP in which low dose clonidine can be low risk due to reduced possibility of lowering BP too low.
Excerpt from online detox forum of person describing clonidine use during acute WD from opiates:
**“Clonidine can help minimize the following WD side-effects; panic/anxiety; hole in gut; heebie-jeeebies, kicking leg sensation, sleep issues. Some have reported that it also helps with associated sweats.When taking Clonidine you may experience a dry mouth and sense of lethargy....feeling like you're walking through mud. Guard against any quick, sudden movements like picking up your head too quickly”.
1.Vistiril: An anti-histamine which helps with two things; opiate withdrawal produces a histamine response which makes the patient have runny eyes, nose, and itching. Vistiril will help treat this symptom along with reducing anxiety and assisting in sleep. It is a very potent anti-histamine similar to Benadryl but much stronger and more effective at reducing some anxiety while providing some sedation. This medication may be used a few weeks beyond the suboxone to help manage the mild withdrawals that occur after suboxone therapy. Patients cannot expect any of these medications to completely eliminate WD symptoms. This includes Vistiril. In the minimum these medications will provide comfort and reduce the severity of WD symptoms.
Other comfort Medications used during WD;
Milk of Magnesia
Imodium AD (higher dosages can relieve the stomach WD symptoms)
RX strength Motrin (for re-bound pain which will occur)
Supplements Needed: Use for 6-12 months post-acute WD-
1.Multi-Vitamin/Mineral High potency/quality- take daily
2.DL-Phenylalanine (1g-2g daily): Restores natural endorphins
3.5-HTP (100mg TID): Restores serotonin and provides calming effect (don't use with SSRIs)
4.Magnesium: Helps with muscle pain, tension, spasms, and promotes relaxation
5.Methylcobalamin injection once per week: Restores appetite, reduces nerve pain, improves energy
6.B-Complex 100mg daily: Helps with mood, energy, and CNS repair
7.Glutathione (IV would be beneficial since most pain meds have acetometaphin which causes high liver enzymes): Expedites detoxification process and restores liver health
8.Glycine (Administer 10ml IV)- Helps restore neurotransmitters in the brain. Improves mood.
A compounding pharmacy can compound 2-3 formulations combining the above nutracueticals and provide them as part of the detox program. Here is an example: •1 capsule contains:
•500mg DL-Phenylalanine
•100mg 5-HTP
•100mg magnesium
DLPA-This particular supplement would help increase levels of serotonin, dopamine, and endorphins, which are deficient in the brain after opiate use. DL-P is clinically proven to help manage pain and also reduce opiate tolerance. Patient would take 1-2 capsules 3 times per day.
The program should be divided into two phases:
Phase 1 would deal with the initial acute withdrawals which occur after stopping the opiates. This phase would last from 1-2 weeks, and up to 30 days for those discontinuing methadone. The majority of the pharmaceuticals, such as Suboxone, will be used just for this phase.
Phase 2 will deal with the recently identified Post Acute Withdrawal syndrome, which can last from 30 days to 1 year after discontinuing opiates. PAWS (see below). This phase will utilize nutrition, nutraceuticals, and alternative therapies to assist the brain as it heals from long term opiate use. Some of these supplements, such as DL Phenylalanine, will help the patient manage some physical symptoms along with helping the central-nervous-system increase its production of neuro-hormones. Many symptoms of withdrawal are caused by a deficiency of a nuero hormone caused by opiate use.
**Don't forget to check hormone levels and treat deficiencies. Especially Testosterone.
**Long term. Opiate use causes hypogonadism. http://defymedical.com/resources/he...suppression-in-patients-with-opioid-addiction
**ED/Low T and opioid use: http://defymedical.com/resources/he...sfunction-may-be-tied-to-prolonged-opioid-use
Testosterone helps with pain perception: http://defymedical.com/resources/health-articles/149-testosterone-tx-may-ease-pain-perception
by Jasen Bruce
Last edited:
Jasen Bruce
Member
Post-Acute Withdrawal Syndrome
Post Acute Withdrawal syndrome can last from 30 days to 1 year after discontinuing opiates depending on the person's use. Symptoms associated with PAWS begin at some point after acute withdrawal has ceased and can last for a long time if left untreated. PAWS is rarely discussed in conventional medicine and many patients are left in the dark, not understanding why they are not feeling better, and suffering in silence. During PAWS is where the patient is at the highest risk for relapse. PAWS symptoms also often get misdiagnosed by physicians who then place patients on unnecessary medications leading to more problems.
Post-Acute-Withdrawal Syndrome (PAWS) refers to a set of impairments that can persist for weeks or months after the abstaining from a substance of abuse. PAWS may also be referred to as post-withdrawal syndrome, prolonged withdrawal syndrome, or protracted withdrawal syndrome. The condition is marked by symptoms similar to those found in mood disorders and anxiety disorders, including mood swings, insomnia, and increased levels of anxiety even without any apparent stimulus.
PAWS symptoms most commonly manifest after a withdrawal period from alcohol, benzodiazepines and opioids, but have been known to occur with (cessation of) use of other psychoactive substances. It is estimated that 90 percent of recovering opioid users experience the syndrome to some degree as do 75 percent of recovering alcohol and psychotropic abusers. The precise mechanisms behind PAWS are still being investigated, but scientists believe the physical changes to the brain that occur during substance abuse and are responsible for increased tolerance to the substance are responsible for the
Common symptoms of post acute withdrawal syndrome are: •Psychosocial dysfunction
•Anhedonia
•Depression
•Impaired interpersonal skills
•Obsessive-compulsive behavior
•Feelings of guilt
•Autonomic disturbances
•Pessimistic thoughts
•Impaired concentration
•Lack of initiative
•Craving
•Inability to think clearly
•Memory problems
•Emotional overreactions or numbness
•Sleep disturbances
•Physical coordination problems
•Stress sensitivity
•Increased sensitivity to pain
•Panic disorder
•Generalized anxiety disorder
•Sleep disturbance (dreams of using, behaviors associated with the life style)
Symptoms occur intermittently, but are not always present. They are made worse by stress or other triggers and may arise at unexpected times and for no apparent reason. They may last for a short while or longer. Any of the following may trigger a temporary return or worsening of the symptoms of post acute withdrawal syndrome:[citation needed] •Stressful and/or frustrating situations
•Multitasking
•Feelings of anxiety, fearfulness or anger
•Social Conflicts
•Unrealistic expectations of oneself
PAWS Treatment:
This phase will utilize hormones, nutrition, and therapies to assist the brain as it heals from long term opiate use. Some of these supplements, such as DL Phenylalanine, will help the patient manage some physical symptoms along with helping the central-nervous-system increase its production of neuro-hormones.
Many symptoms of withdrawal are caused by the reduction of sex hormones and neurotransmitters resulting from long term opiate use. It is important to perform a complete hormone and metabolic blood test to determine and treat any deficiencies. Take special notice to the patients testosterone level and thyroid (T3) function, typically altered in long term opiate users. Restoring testosterone which will subsequently improve neuroendocrine balance will help improve quality of life for the patient in addition to possibly reducing the duration of PAWS.
The patient must refrain from ANY chemical that negatively interacts with receptors especially those that are affected by opiates. For the best and more effective recovery, patients should refrain from using:
•Alcohol
•Opiates of any kind
•Benzodiazepines
•Stimulants including OTC, prescription, and illicit
• ***
cannabis medications have shown to be safe and to provide comfort for patients experiencing PAWS.
Post Acute Withdrawal syndrome can last from 30 days to 1 year after discontinuing opiates depending on the person's use. Symptoms associated with PAWS begin at some point after acute withdrawal has ceased and can last for a long time if left untreated. PAWS is rarely discussed in conventional medicine and many patients are left in the dark, not understanding why they are not feeling better, and suffering in silence. During PAWS is where the patient is at the highest risk for relapse. PAWS symptoms also often get misdiagnosed by physicians who then place patients on unnecessary medications leading to more problems.
Post-Acute-Withdrawal Syndrome (PAWS) refers to a set of impairments that can persist for weeks or months after the abstaining from a substance of abuse. PAWS may also be referred to as post-withdrawal syndrome, prolonged withdrawal syndrome, or protracted withdrawal syndrome. The condition is marked by symptoms similar to those found in mood disorders and anxiety disorders, including mood swings, insomnia, and increased levels of anxiety even without any apparent stimulus.
PAWS symptoms most commonly manifest after a withdrawal period from alcohol, benzodiazepines and opioids, but have been known to occur with (cessation of) use of other psychoactive substances. It is estimated that 90 percent of recovering opioid users experience the syndrome to some degree as do 75 percent of recovering alcohol and psychotropic abusers. The precise mechanisms behind PAWS are still being investigated, but scientists believe the physical changes to the brain that occur during substance abuse and are responsible for increased tolerance to the substance are responsible for the
Common symptoms of post acute withdrawal syndrome are: •Psychosocial dysfunction
•Anhedonia
•Depression
•Impaired interpersonal skills
•Obsessive-compulsive behavior
•Feelings of guilt
•Autonomic disturbances
•Pessimistic thoughts
•Impaired concentration
•Lack of initiative
•Craving
•Inability to think clearly
•Memory problems
•Emotional overreactions or numbness
•Sleep disturbances
•Physical coordination problems
•Stress sensitivity
•Increased sensitivity to pain
•Panic disorder
•Generalized anxiety disorder
•Sleep disturbance (dreams of using, behaviors associated with the life style)
Symptoms occur intermittently, but are not always present. They are made worse by stress or other triggers and may arise at unexpected times and for no apparent reason. They may last for a short while or longer. Any of the following may trigger a temporary return or worsening of the symptoms of post acute withdrawal syndrome:[citation needed] •Stressful and/or frustrating situations
•Multitasking
•Feelings of anxiety, fearfulness or anger
•Social Conflicts
•Unrealistic expectations of oneself
PAWS Treatment:
This phase will utilize hormones, nutrition, and therapies to assist the brain as it heals from long term opiate use. Some of these supplements, such as DL Phenylalanine, will help the patient manage some physical symptoms along with helping the central-nervous-system increase its production of neuro-hormones.
Many symptoms of withdrawal are caused by the reduction of sex hormones and neurotransmitters resulting from long term opiate use. It is important to perform a complete hormone and metabolic blood test to determine and treat any deficiencies. Take special notice to the patients testosterone level and thyroid (T3) function, typically altered in long term opiate users. Restoring testosterone which will subsequently improve neuroendocrine balance will help improve quality of life for the patient in addition to possibly reducing the duration of PAWS.
The patient must refrain from ANY chemical that negatively interacts with receptors especially those that are affected by opiates. For the best and more effective recovery, patients should refrain from using:
•Alcohol
•Opiates of any kind
•Benzodiazepines
•Stimulants including OTC, prescription, and illicit
• ***
cannabis medications have shown to be safe and to provide comfort for patients experiencing PAWS.
Nutpuncher
New Member
PAWs is a bitch that keeps on biting and stayed with me for close to 2 years after last opiate.
Jasen Bruce
Member
Right on point Nutpuncher. Recovery is long, and dosnt really end for someone who has experienced an addiction. Treating testosterone levels prior to WD would have some benefit, but you bring up a solid point in that first and foremost the person MUST be committed to coming off. Not because someone makes them, not because they are court ordered, but because they really want off the drugs. It will take discipline, commitment, and will be painful...but he/she will survive as many many people successfully recover from all kinds of opiate addictions.
Vince, email me at [email protected] if you would like to discuss this. Anyone can email me if they need help with this subject.
Vince, email me at [email protected] if you would like to discuss this. Anyone can email me if they need help with this subject.
Jasen Bruce
Member
Congrats Nutpuncher for punching that addiction right in the nuts!
Thank you for sharing your story, as you know it will provide motivation for many who are scared to make the jump as you did.
Thank you for sharing your story, as you know it will provide motivation for many who are scared to make the jump as you did.
Nutpuncher
New Member
I wish I started TRT a LONG time ago, especially when I was ready to stop taking suboxone. Getting off opiates can be done, but will only be sucessfully if the person is ready to start a new life. Luckily I never hit rock bottom. I was just tired of living hour to hour, not knowing when I can get more pain killers.
I am more happy know than the highest/most euphoric times I had while using.
Jasen Bruce
Member
One of the best and most important statements:
"I am more happy now than the highest/most euphoric times I had while using. "
"I am more happy now than the highest/most euphoric times I had while using. "
mikeb
New Member
I was on prescription pain medicine for 13 years because of a back injury. Mostly oxycodone, but also fentynil and oxycontin. Last 7 or 8 years was at 180mg a day. Gets to the point that it doesn't do anything for you and you have to take it just to keep from getting sick.
Got off of it on my own about 16 months ago. Went through 2 weeks of a living hell. 4 weeks before I could go back to work part time. Still not right, but trt has helped.
I think most of the docs out there prescribing this stuff don't even realize what it does to a person.
I remember years ago when they came out with oxycontin, and the drug companies were promoting it as a non addictive pain killer. Turns out that's one of the most addictive of them all.
Got off of it on my own about 16 months ago. Went through 2 weeks of a living hell. 4 weeks before I could go back to work part time. Still not right, but trt has helped.
I think most of the docs out there prescribing this stuff don't even realize what it does to a person.
I remember years ago when they came out with oxycontin, and the drug companies were promoting it as a non addictive pain killer. Turns out that's one of the most addictive of them all.
Nutpuncher
New Member
I am happy to hear that you made it out of the dungeon alive. 180mg a day is pretty high dose. You are correct, the more you take it, the less that it actually works. I used to consume 80OC to even get out of bed.
Time is your best friend. Maintain a healthy lifestyle and you will feel "normal" before you even know it.
Dr. John Crisler
Physician
I disagree. Hypogonadism makes EVERYTHING more difficult.
TRT also decreases inflammation, and increases pain threshold. Important parts of recovery.
And congrats on your success!!!!
Nutpuncher
New Member
Thank you. Change is not easy.
What I meant to say is that a heroin user has a strange but to them a special relationship with syringes and needles. A testosterone injection may cause a relapse even though its test and not herion. I feel strange whenever I see opiate pain killer in front of me. I almost have an anxiety attach because I don't want anything to do with it, but part of my (recovering addicted) mind would suggest that if I take it, I will feel so much better. I should have worded it better.
Its an honor to chat with you.
Last edited:
Dr. John Crisler
Physician
Oh...I know....sometimes when I take that bottle of test cyp out, to give a patient a shot, it catches me "just right'. LOL
Former smokers who restart will almost always say they were somewhere (used to be bars) and they smelled a cigarette, and it caught them "just right".
Jasen Bruce
Member
Mikeb, congrats on your recovery and thank you for sharing your story
Like NP stated, time will be your friend. 16 months is still fresh after 13 years. You will get even better, there is no doubt about it. I observe the biggest progress in emotion-control, mood, and well-being between the 2-3 year mark of being clean after long term use.
Share this page
Sponsors
Online statistics
- Members online
- 2
- Guests online
- 6
- Total visitors
- 8
