Let’s look at the opiates first. An opiate is a narcotic pain killer like Roxycodone, Oxycodone, Loratabs, Loracet, Methadone, Vicodin, Actiq, and Stadol. The action of these drugs may last varying amounts of time and has varying doses. For example, some people can be on 100mg a day of oxycontin while others may take 1000mg a day of oxycontin.
When a person goes through the detox process, problems begin soon after the initial part of the detox at and around five days. Mood problems are the most common with depression and anxiety. Occurring frequently people become lethargic, sad, anhedonia (unable to enjoy anything), unable to concentrate, feeling hopeless, helpless, worthless, despair, negative thinking, worrying, having tension, unable to relax, fearful.
Another thing that happens in recovering opiate addict is they can’t wait for anything. Everything needs to be immediate. They don’t like plans, tend to be impulsive and they just like to do it now. It’s called instant gratification. Problems with sleep last for months if not years. People may develop cravings for sugar and increased sexual drive may occur. Difficulty thinking develops; they may have apathy towards everything which is a lack of interest in all activities. They don’t want to do leisure activities or work. They have difficulty setting goals, finding motivation and have difficulty following through on tasks. They become preoccupied with using opiates.
Problems develop with irritability and low frustration tolerance. Weeks, if not months after stopping opiates people are easily frustrated and short with people. One patient ordered a whopper without cheese at the drive-thru. When it came with cheese he started screaming so much, he had foam coming out of his mouth. Another patient asked for a soy latte at Starbucks and got milk instead after he waited twenty minutes. He started banging on the counter and having a tantrum at Starbucks. I have heard countless stories from co-workers and families. Once you stop opiates, everything bothers you.
I am not sure if Opiates were their coping skills and now they have none or they are just overwhelmed with life or maybe there is some physiological explanation for it. Alterations in neurotransmitters in the brain occur after people stop using opiates.
Another big problem for recovering opiate addicts is triggers. Triggers are people, place, and things which set off a series of psychological events resulted in intense cravings for opiates. For example, one patient always got high on roxycodone 30mgs and went to 7-11 and bought a 40oz big gulp coke and skittles. Twenty years later if he sees a big gulp cup or skittles package, he feels like he wants to get high or maybe he is a little high just from the sight of it. The sight or thought of a needle, seeing a piece of tinfoil, or driving down the street where they used to buy drugs, can trigger the desire to use opiates. One patient told me shooting water into his vein got him high. One told me that just going to buy oxycontin got him high. All types of triggers make people think of getting high. One patient would go to his dealer’s house by the railroad tracks in West Palm Beach to get high. Ten years after stopping opiates, the sound of a train makes him want to get high.
Once people stop opiates, other problems develop. Certain individuals can miss the excitement of the drug addict life. Buying and selling illegal drugs, not working a job, beating the system and making quick money can be exciting. Breaking the law, lying, stealing, cheating, and manipulating is an adrenaline high. It’s hard to believe but, some people miss that. These people don’t like the routines of normality. A routine life is boring or mundane to them. These individuals who stop using opiates also have problems with their identity. They are unclear who they are, how to interact with others and what their goals are in life. Spending five or twenty years trying to get high is a job. This job requires that all your efforts go into getting high. Without this job, to occupy all your time, what do you do now? People need to form new identities, and new goals.
On the positive side, if you live through, the Hepatitis, or HIV, and the overdoses, you should have a chance at a new life. The nervous system can recover completely from opiate addiction. So can the rest of the body and mind. Recovering addicts have developed certain skills which can have benefit in the workplace and in social settings. Recovering addicts are very capable, resourceful people. They are individuals who can get things done right away. The lessons learned from getting drugs, can be applied to getting other things. These people are very effective in the workplace.
Some times recovering addicts can never find real happiness. They miss the days of using, or are so damaged psychologically from using nothing is fun for them anymore.
There is a saying “You can take the boy out of the jungle, but, you can’t take the jungle out of the boy”. You can take the addict off drugs, but, you can’t take the addiction out of the individual. The addiction may start to manifest in other areas of that individuals life. Addictive relationships are common, as are addictions to coffee, sex, food, gambling, making money, spending money, other drug addictions, and other high risk behaviors. When I say high risk behaviors, I mean skydiving, scuba diving, hang gliding, mountain climbing.
One thing I have noticed in recovering addicts is they never seem comfortable at parties anymore. I guess they have no interest in watching other people drink alcohol, and not get high themselves. For the recovering addict, watching people use drugs and get impaired is just not fun.
Some recovering addicts develop a grandiose sense of self. Because they were an addicted individual and they have recovered they feel they are superior to others. Some feel that stopping opiates is something to brag to others about. I don’t agree with this. You brag about doing things, not about overcoming a drug problem. Putting on your resume that you are a recovering addict is not something you would want to do.
Other individuals isolate and act as if they just exist, off opiates life is a burden. They just exist and nothing is fun. They are usual loners and live with other recovering addicts alone. People have told me they lived life so hard and fast that nothing is left for them. They describe themselves as being totally burnt out.
One final comment, people who stop using opiates may in some cases become wanderers always looking for something to fill that emptiness inside. They look and look for something to fill the void inside, but deep down, nothing exists, except an opiate to fill it. But that doesn’t keep them from looking indefinitely. I can’t explain it.
For the past 25 years I have detoxed people and treated people with opiate dependency. The people varied from teenagers to people in their 90’s. Rich people, poor people, all races, people in good shape, out of shape, and people from all occupations. Certain occupations seem more prone to opiate addiction than others. Occupations that are extremely hard, physically and psychologically seem to predispose these individuals to injury and need for opiates.