In this article, I’m going to teach you about the Top 7 Obstacles To Opiate Detox & Recovery…and you’ll be provided with extremely beneficial information and exercises that will help you conquer opioid dependence once and for all.
Thus, without further ado…here are the “Top 7 Obstacles to Opiate Recovery” and how to overcome them.
Table of Contents
- 1 1. The Hijacked Midbrain
- 2 2. Hyperbolic Discounting
- 3 3. Disempowering Neuro-Associations
- 4 4. The 3 Types of Fear
- 5 5. Acute Opiate Withdrawal
- 6 6. Post-Acute Withdrawal Syndrome (PAWS)
- 7 7. Neurotransmitter Deficiencies
1. The Hijacked Midbrain
In chemical dependency, something dreadful happens after the substance abuser has been using their drug of choice for a while. Their brain chemistry changes. They need that particular substance.
Drugs are so AMAZINGLY powerful. Our bodies weren’t meant to handle these concentrated substances, so after a period of continuous use, brain chemistry can short-circuit. It actually rewires itself in a disastrous way.
In a healthy individual, water, food, shelter, defending from predators, and sex are at the top of their survival hierarchy of needs. In a non-addict, the drug is just a drug. They can take it or leave it.
Examples of non-addicts are:
- Recreational users
- Regular users
In chemical dependency, the brain short-circuits and reorganizes this ladder of importance.
It places the drug at the top of the list. Their newly rewired brain literally makes the following powerful connection:
DRUG = SURVIVAL.
Why does the drug now equal survival? It’s because drugs act on the midbrain (unconscious), which is the primitive part that deals with survival.
The Olds Experiments of the 1960’s confirmed this.
The Olds Experiments
Researchers believed that drugs acted on the prefrontal cortex (conscious), which is the logical part that deals with personality expression, decision making, and moderating social behavior.
They injected cocaine into mice in the prefrontal cortex over and over, and the mice never became addicted. After poking all over their brains, they made an important discovery. When they injected cocaine into the midbrain, the mice would continue to press the lever to receive more of the drug, even when the ground beneath them was shocking them to death, and all they had to do to survive was stop lever pressing and move away.
Furthermore, mice would die of thirst or starvation even when they had full access to food and water. Their midbrains became totally hijacked and they linked “survival itself” to the drug, and as a result, they continued using cocaine despite extremely negative consequences (death).
Opioid Dependence is a Chronic Brain Disorder
Humans can become addicted in the same way the mice did. That’s why they keep getting arrested, overdosing, getting their children taken away, and ending up in hospitals or rehab facilities, or even dead. It’s not because they’re scumbags intrinsically.
In actuality, they’ve become a victim to their own malfunctioning brain, and the primal drive to seek out and use more drugs causes them to put everything else in their life at a distant second or lower.
Exercise: Now that you know opioid addiction can hijack your midbrain and cause you to make bad decisions despite negative consequences, have some self-compassion. It’s not like you tried to get addicted. Make sure you view yourself not as a “bad person,” but rather, as a person with a malfunctioning brain that puts a higher value on using opioids than a normal person does.
2. Hyperbolic Discounting
What if I told you that one of the main reasons it’s SO HARD to quit opioid is due to our caveman brain wiring?
Would that interest you?
Because the way our brains are wired to choose immediate rewards rather than far-off rewards is totally screwing your ability to get off opioids.
This phenomenon is called Hyperbolic Discounting.
How Hyperbolic Discounting works:
- Given two similar rewards, humans show a preference for one that arrives sooner rather than later.
- Humans are said to “discount” the value of the later reward, by a factor that increases with the length of the delay.
- Hyperbolic Discounting is a cognitive bias, where you choose smaller, immediate rewards (instant gratification) rather than larger, later rewards (delayed gratification).
Your Caveman Brain:
- A caveman did not have to contend with the same complex choices we have today.
- Cavemen and cavewomen never knew if they were even going to survive the day, so we evolved to choose the IMMEDIATE options that had the best chance of ensuring survival and procreation.
- Example – A caveman never had to choose between eating the meat of the animal he hunted and killed today, or investing the dead animal in an Animal 401k that would yield a big return decades later!
- Our brains are wired to choose immediate rewards rather than the potential of a far-off future reward.
Instant Gratification vs Delayed Gratification
When it comes to opioid addiction recovery, there is a big dilemma. Our brains are literally wired to choose instant rewards (feel good today by using opiates) instead of far-off rewards (feel like crap for a few weeks or longer with the hope that we will eventually feel better sometime down the line after quitting opiates).
How do we overcome our brain’s natural wiring of Hyperbolic Discounting and go through the very UNFUN (is that a word?) process of quitting opioids today, so that we might feel better in the future?
- Step 1 – Write a list of all the reasons you want to quit opiates.
- Step 2 – Write a list of all the ways in which using opioids is causing negative consequences in your health, finances, relationships, career, business, parenting, self-esteem, spirituality, and all other areas of life.
- Step 3 – Write out a new Target Identity of how you want to be as a person and what you want your life to look like in the future. Be very specific.
- Step 4 – Read this document every morning first thing upon waking, and every night just before bed.
A daily review of all the reasons you want to quit opioids as well as your new future Target Identity and Life will start to reprogram your brain. A strong neural connection will be made.
“When neurons fire together, they wire together.” New brain research shows us that we can literally rewire our brains with neuroplasticity.
3. Disempowering Neuro-Associations
The key to quitting opioids and staying quit is to change the way you feel about opioids and recovery. Everything we do in life is either to avoid pain or gain pleasure. Also, we will do much more to avoid pain than we will do to gain pleasure.
A fundamental concept to quitting opioids is this:
You must link up in your brain ultimate, life-ending, massive pain to using opioids, and supreme, life-enhancing pleasure to being clean.”
That’s the secret, however, most people have mixed up or disempowering neuro-associations. Most people on opioids still link pleasure to using them. Others link both pleasure and pain to using opioids.
And for the few that link only pain to using opioids, they link even more pain to being clean, and so many are stuck in this cycle because they haven’t changed the way their brain thinks.
I’ve been clean for over six years now, and the main reason I’ve been able to do this is that I no longer link pleasure to using opioids. I associate being addicted to opioids as a total failure and a horrible life ruled by fear.
Also, I link MASSIVE PLEASURE to being clean. I used to hate being clean because I never felt comfortable in my own skin. I needed opioids to feel normal, and so I linked a lot of pain to being clean since they were actually my antidepressant and anxiety medication.
Exercise: Start visualizing all of the pain that will result if you continue to use opioids over the next 1, 5, and 10 years. Then visualize what your life could be like if you quit opioids now, then stay clean for the next 1, 5, and 10 years. Figure out what you need to do or think to change your neuro-associations so you link massive pain to using opioids, and massive pleasure to a life free of opioid dependence.
4. The 3 Types of Fear
Physiological fear of physical threats such as running from a saber tooth tiger or hearing the sounds of a burglar break into your home cause serious panic and for good reason.
However, when it comes to non-physical threat fears, it’s usually due to mismanagement of the mind. There are three types of fears that interfere with opioid detox and recovery and underneath all of these is an “assumption of pain.”
The 3 Types of Fear are:
- Fear of Loss
- Fear of the Process
- Fear of the Outcome
The following writing exercises will help you uncover, dissect, and reframe any fears that you may have so that you can have an easier time moving forward toward your goal of quitting opioids and feeling great afterward.
1. Write out any Fears of Loss you may be having regarding quitting opiates. Are you afraid you’ll lose the pain relief benefits? The anxiety benefits? Or maybe you’ll lose the energy and happiness they may have been providing you with? Write out what you might be fearing you’ll lose, and then write every possible benefit you can think of regarding everything you will gain from quitting opiates.
2. Write out any Fears of the Process you may have regarding quitting opiates. Is there one or more Steps of this Process that seem too difficult or scary for you? Write these down and then commit to respecting and welcoming the process. Honor the process and even though you may be scared, write out why you’re going to go through with it anyway.
3. Write out any Fear of Outcome you may have. Are you afraid that you will go for it and then ultimately fail? Or are you afraid that you’ll succeed in the short-term, only to relapse a few weeks or months down the line? Write these down and then commit to not worrying about it and instead, link “Personal Fulfillment” and perhaps even “Contribution” simply to the act of trying.
5. Acute Opiate Withdrawal
When a dependent individual abruptly stops taking opioids (leading opioid-blood concentration to fall below the required level), the now opioid-tolerant central nervous system (CNS) goes haywire. With no inhibitive stimulation to satisfy receptors, the pathways of the CNS fire signals strenuously, performing at a level much higher than pre-dependence levels.
Now the locus coeruleus responds by triggering the autonomic fight or flight response. What results is known as the acute opiate withdrawal syndrome, and it’s one of the most horrific experiences an individual could even go through.
Opiate Withdrawal Symptoms
Now that you have a good overview of how the whole process starts, we can now review the physical, mental, and emotional opiate withdrawal symptoms that result from the abrupt cessation of opiate drugs.
Physical opiate withdrawal symptoms include:
- Achy Muscles and Limbs
- Gastrointestinal (GI) Distress
- Hot and Cold Sweats and Chills
- Teary Eyes
- A Runny Nose
- Restless Leg Syndrome (RLS)
Mental/Emotional opiate withdrawal symptoms include:
- Panic Attacks
- Social Anxiety
- Anhedonia (Inability to Feel Pleasure)
- Suicidal Thoughts
- Inability to Relax
- Lack of Motivation
As you can see, there are plenty of unpleasant acute withdrawal symptoms that can afflict you while you’re coming off opiates. The really awful aspect of acute withdrawal is that you get hit with a ton of different physical and psychological withdrawal symptoms.
If it were just one or the other, it wouldn’t be near as horrific of an experience.
But alas this isn’t the case.
Acute opiate withdrawal symptoms are both physical and psychological, and most of the time these symptoms are very severe.
You can reduce or even eliminate the severity and duration of acute symptoms by using the following:
6. Post-Acute Withdrawal Syndrome (PAWS)
Many opiate users have successfully managed to get past the acute withdrawal symptoms phase, only to realize that the struggle was far from being over. Though the symptoms, duration, and severity vary, an estimated 90% of all individuals quitting opioids experience Post-Acute Withdrawal Syndrome (PAWS) to some degree after the acute withdrawal is over.
To accurately and simply define PAWS, let’s break down the meaning of each individual word:
- Post – “After”
- Acute – “Very serious or dangerous; requiring serious attention or action”
- Withdrawal – “The discontinuance of administration or use of a drug”
- Syndrome – “A group of symptoms”
Simply put, PAWS is a group of symptoms that occur after an individual has gone through the serious withdrawal phase induced by the discontinuation of drugs.
In his popular book, Staying Sober: A Guide for Relapse Prevention, Terence Gorski states the following:
Post-acute withdrawal is a group of symptoms of addictive disease that occur as a result of abstinence from addictive chemicals. In the alcoholic/addict these symptoms appear seven to fourteen days into abstinence, after stabilization from the acute withdrawal. Post-acute withdrawal is a bio/psycho/social syndrome. It results from a combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.”
There is a wide range of symptoms an individual might experience from PAWS. Post-acute opiate withdrawal symptoms will vary from person to person. Post-acute symptoms will also vary in severity from person to person.
Some common post-acute opioid withdrawal symptoms include:
- Inability to think clearly
- Memory problems
- Emotional overreactions or numbness
- Physical coordination problems
- Stress sensitivity
- Increased susceptibility to emotional and physical pain
- Gastrointestinal (GI) issues
- Intense cravings to use opiates
- Drug dreams
- Inability to experience pleasure (“pleasure deafness”)
I strongly believe that the last two symptom (“pleasure deafness” and fatigue) is the #1 reason why most individuals going through PAWS relapse within the first 90 days of getting sober.
Going weeks to months without feeling any pleasure in life, and on top of that having no energy or motivation, is in my opinion more detrimental to recovery than any of the other post-acute withdrawal symptoms.
PAWS typically lasts for several weeks or months. Luckily, there are many things you can do to shorten the healing time and feel better FAST.
The following can help you prevent or at least minimize post-acute symptoms:
7. Neurotransmitter Deficiencies
After using opioids daily for around a month and especially longer, once you come off the drugs you’ll have neurotransmitter deficiencies that can lead to a multitude of psychological and even physical health issues.
Opioid daily use leads to a minimum of a deficiency in the following neurotransmitters:
Endorphins and dopamine are neurotransmitters, which are substances that transmit nerve impulses across a synapse. The brain uses neurotransmitters to tell your heart to beat, your lungs to breath, and your stomach to digest.
They also play a HUGE role in mood, concentration, sleep and weight, and can cause a number of negative consequences when they become out of balance.
Endorphins are our natural painkillers (endogenous opioids). Our bodies release endorphins when we exercise. Perhaps you’ve heard of “runners high,” which describes a euphoric feeling produced by the massive production of endorphins after running long distances.
Endorphins promote joy, euphoria, and contentment; and that leads us to why opioids make you feel so good…
Different drugs mimic different neurotransmitters. Opioid specifically mimic endorphins. That’s why opioids are so beneficial for relieving pain and producing euphoria. When an opioid is taken, the body produces massive amounts of endorphins in quantities our bodies weren’t designed to handle.
If you use opioids consistently over a period of time, the body starts making more opioid receptors, and that’s how tolerance is developed. Now the brain has become dependent on opioids to produce endorphins, and it stops making them naturally.
The problem arises when someone on opioids lowers their dosage considerably or comes off completely. You are now supplying your body with fewer endorphins from the drugs, but your brain doesn’t supply you with the rest.
Your brain short circuits, and therein lies the problem. What results is a massive endorphin deficiency leading to increased sensitivity to physical and emotional pain, among other problems.
Dopamine is our main focus neurotransmitter. Dopamine is also responsible for our drive or desire to get things done…our motivation. Dopamine lifts the dark clouds of depression, is responsible for feelings of pleasure, and plays a role in the “reward system” in the brain. Prolonged use of opioids leads to continuous spikes in dopamine levels.
Over time, the brain eventually adjusts natural production of the neurotransmitter to compensate for the presence of drugs.
Due to both the over-activation of dopamine during periods of opioid intoxication and long-term changes in brain chemistry, natural dopamine levels become lowered and depleted. Once your dopamine levels are depleted, it’s virtually impossible to experience pleasure without using the drug.
Things that used to provide you with pleasure no longer do so, such as a job promotion, your kid scoring the winning goal at a soccer game, or listening to your favorite music.
You no longer derive enjoyment from these activities. It now takes a huge spike in dopamine (drugs, sex, gambling etc.) to feel pleasure. This is one of the top reasons why individuals often relapse within a few months of getting off opioids…they have anhedonia (pleasure deafness), life basically sucks, and they are also sensitive to physical and emotional pain due to the endorphin deficiency.
Enough is enough…they feel like they can’t go on feeling so bad every day, so they use…thus, the cycle continues.
Below is a list of the most important neurotransmitters for mental health:
- Endorphins/Enkephalins – Our natural painkillers; they promote feelings of physical relaxation, joy, and produce a natural high.
- Serotonin – Responsible for feelings of being emotionally relaxed and happy.
- GABA – Mentally relaxing, your brain’s natural Valium.
- Catecholamines – Dopamine is in this class of neurotransmitters; responsible for concentration and euphoria.
Amino Acid Therapy
The best way to restore healthy neurotransmission after getting off opioids is to use “Amino Acid Therapy.” Amino acid supplements are amazing because they help you produce neurotransmitters naturally and quickly, thus repairing your drug-damaged brain.
The following amino acids can help you restore healthy neurotransmission the most:
As you can see, there are a lot of pretty big obstacles to recovering from opiate addiction. Luckily, now you know what the main ones are and how to overcome them.
I wish you the absolute best of luck on your journey now that you know what you’re really up against and what to do about each of these seven potential barriers to progress.
If you have any comments or questions please post them in the comment box below.