This is a recent YouTube comment I received, and I thought it was so good that I had to post it on my website for more people to see.
It was written by an Australian doctor that has addicts as patients.
You’re going to love this…
Here is what he wrote:
“I have counselled many addicts. Amphetamine, benzo, alcohol, food and opioid addiction. I come to realize that I needed more specific information on opioid dependence.
This has brought me here.
The training on addiction counselling is not specific, or I missed an important lecture…
I am mid 40s, I’ve been taking opioids for an injury I received when I was 16. I never considered myself an addict though I’ve been well aware of my substance dependence.
The difference is subtle!
I’ve never had trouble getting the medication I felt I needed, Morphine, codeine, methadone, all produced unpleasant side-effects, so I settled on oxycodone.
My dose increased over time to avg 180mg/day!
A ted talk waked me to the severity of that, so I went to see a good shrink who counselled aggressive reduction, I revisited pain-management clinic who counselled cautious reduction.
Over the last year I’ve reduced to avg 75mg.
Initially it wasn’t difficult.
Lately it’s been a struggle.
My target is avg 60mg/daily – MR 20mg mane/nocte, IR 20mg PRN.
This is a far more reasonable regime for my condition, the experts agree.
Truly I would like to be off daily opioids, but this may be unrealistic. Ibuprofen alone does not control my pain, interestingly neither does oxycodone, it is the combination of those two things that works best for me.
Anyway we’re here for opioids…
Lately as my avg dose as shrunk to a significantly lesser consumption relative to the previous 20 years, I’ve been feeling dreadful.
I’ve had my pharmacist dispense to me weekly webster-packs which allow me to track my consumption more closely.
And, either in great wisdom or great folly, I had him promise to give me no extra until I have reached my target.
You see recently I have been taking all my PRN IR capsules before the week is complete, and to my horror, discovered that my MR mane/nocte doses alone are wholly inadequate.
Withdrawal has kicked in.
For the first time in my life I have been feeling what my own patients have been telling me about.
My sympathy is now replaced with empathy.
I now understand that cold-turkey means dread-nightmare.
Running nose with uncontrollable sneezing, eye watering blindness, aching legs too painful to move – or keep still, a gripping pain between the hips, a tightly panicked chest and thumping heart of extraordinary anxiety, dreams of drug-taking, and a fatigue of unendurable weakness.
Quite simply, HELL.
Indeed I confess that it has become so unbearable, I have chewed up my MR tablets, just to get a few hours relief…
All this, and more, I have experienced now first hand, and I have never had to endure the symptoms of a complete cold-turkey detox.
Now I consider myself a willful individual.
I am disciplined and tough.
But I do believe that if I were suddenly unable to obtain these oxycodone tablets at all, that I would surely die within but a few days of my last dose.
I do not feel it hyperbole to say so either.
I have suffered hardships unimaginable in my life, but never have I felt like my entire existence was being so mercilessly torn to pieces and twisted into a writhing agony of such endless ruin.
So, at least for the acute withdrawal stage, I would recommend not even a coffee, let alone a stimulant like methylphenidate or dextroamphetamine.
Though I would be curious to discuss the benefits of those things for my patients beyond it.
I cannot prescribe them but a shrink might my suggestion on referral.
I usually prescribe diazepam, buscopan and ondansetron for the acute withdrawal, with a good liquid B12 suppliment.
I found these do indeed help, but not enough.
I don’t like clonidine, though some do respond well to it if hypertension becomes an issue – however, if a patient has a relapse whilst taking it, the consequences could be fatal.
Now kratom is not legally available here in Australia so I cannot prescribe it nor recommend it, though I may be willing to get it for myself if it truly does what you all say it does.
Anyway I am wide open to any and all suggestions on how to manage acute withdrawal and will hear all arguments on how best to manage the miserable state that seems to frequently follow, including the short-term use of low dose amphetamine stimulants.
The biggest hurdle however will always be the acute stage in my view, as you will never have to worry about what comes after if you can never clear it.
Forgive my weak effort at brevity here.
I have only recently discovered for myself the true magnitude of what it means to quit opioid drugs, and I’ve only seen a few chapters of that book for myself.
Bless you for doing this, I’m beginning to think that only those who have experienced opioid withdrawal for themselves should be counselling for it.”