Opioid withdrawal is perhaps the hardest part of addiction recovery. It consumes you. Both physically and mentally. In fact, I’m not sure which one is worse.
I do, however, know that you’re sick. Really sick and in pain. A lot of pain. Your joints ache. Hell, everything aches. All you want to do is sleep. So you lie down, but you can’t get comfortable.
Restless. So you get up, but you’re too weak to do anything. So you get back in bed. And it’s the same thing all over again.
For the next 72 hours, there will be a lot of nausea. More pain. Restlessness —fused with weakness and sleeplessness and just plain awfulness. People often call it the Asian flu.
Whether you’re coming off 30 milligrams or 900 milligrams, some say that doesn’t really matter. Because one of the worst parts about it, is how badly you miss your drug of choice. Because you know with just one pill, you’d feel some GD relief. So yeah, it’s quite unpleasant; there’s no doubt about it. For most, it’s exceptionally scary because you’re used to being numb all the time. Because when you stop using, all of your emotions come back.
That said, it’s fairly common to see people crying over something you wouldn’t necessarily cry about. Because you’re raw. Extremely raw and vulnerable. It’s important to remember that opioid withdrawal, like many other substances, will affect both your body and your mind; like I mentioned above. When you’re experiencing the first few stages of withdrawal, you most likely know what’s about to happen. You’ve probably been using —even though you don’t really want too anymore just to avoid feeling like shit.
And it fucking sucks.
Because drug cravings will consume you. It’s that simple. Because you know there’s a cure. You know it’s out there somewhere. And you probably can’t help but feel a little envious of the next guy out there right now who’s using the very thing you want. The very thing your body needs —that your mind is screaming for. Like with the flu, you understand there isn’t an immediate fix. You just have to rest and ride it out.
But when it comes to addiction, you’ve spent so much time using just to feel normal —to avoid these symptoms of withdrawal that when the sickness comes on, it’s hard to accept that this your reality. Because you know what you can do to feel better. If only I had saved that last little bit. If only I didn’t spend that money on that thing. Or, if I could just get my hands on something I could sell —that would fix it. Right? Wrong. Because you can’t escape the inevitable. Because eventually, you’re going to run out of pills.
And that feeling is daunting. It’s hard to really convey what that feels like. Because you feel useless. Like this could possibly be the worst thing that’s ever happened. Because you feel that awful. When you’re dependent on opioids and then suddenly stop, so much of your daily experience will change. Things that used to bring you joy simply don’t anymore. It’s very strange. Some people say, and I have to agree that they never feel entirely normal again.
And that’s because they literally change the matrix of your brain.
To understand how opioids affect the brain, we have to understand how the brain works. Based on some research, I found that the human brain (not to say that word for the fourth time but I have too; so don’t hate me) has millions of cells (I mean, duh). Those cells work without any type of conscious thought by reacting to different chemicals already in our bodies. Take breathing or walking as an example. We don’t have to speak that shit into existence (like when we sleep, we’re still breathing). It’s a process that naturally occurs within all of us because of those cells in our brain.
Anyway, those cells are called receptors.
And besides reacting to shit already in our bodies, those receptors will also respond to things we consume (i.e. food, medications, drugs). Depending on what we’re consuming will depict how our bodies respond. Get this. There are actually specific receptors that will only react to specific chemicals. The receptors, in this case, like the ones that react to heroin and all other opiates are called opioid receptors (makes sense). Opioid receptors, also known as our endogenous opioid system, affects how we feel pain and pleasure.
When our endogenous opioid system is activated, the brain will naturally produce a set of chemicals called endorphins. Endorphins will then attach to our opioid receptors and reduce feelings of pain. They also help regulate bodily functions. In short, they make us feel good. The thing is, when you smoke, inject or snort an opiate, that drug will immediately enter the bloodstream —traveling straight to the brain. Inside, it will bind itself to those natural opioid receptors —flooding the system; giving you a feeling of euphoria.
It’s a feeling people chase because it’s that good.
But because opioid receptors control important life functions, when you consume synthetic opiates, you’re disrupting that process. Because when the brain is flooded with heroin or pills, our natural opioid receptors can no longer tell our bodies how to function properly. Because now, there’s a surge of those feel-good chemicals and our body just doesn’t know what to do with it. Because your brain is now flooded with far too many chemicals —chemicals called neurotransmitters like dopamine and serotonin.
And that shit is already inside of us but they’re also inside those man-made pills. Regardless of the in-between, both of those neurotransmitters function as messengers between brain cells. In short, dopamine produces feelings of pleasure —initiating our reward pathway, telling us that we feel good. Dopamine will also boost feelings of pleasure based on certain activities, while serotonin is more of a stabilizer than a booster. When those two chemicals come into play, a hormone is released.
A hormone called endorphins.
Taking it a step further, when you hug someone, laugh, work out and/ or have sex, all three of those chemicals bind to our brain’s natural opioid receptors. They activate that reward pathway —telling us; this feels good. This makes me happy. But when opiates come into play, they overwhelm those receptors, and a large surge of happiness is initiated —just like that hug. But it’s a hug on steroids. Because you’ll feel extreme happiness and relaxation.
Because opioids release 10 times as much dopamine as the chemicals naturally in our bodies. Think of the difference between the two as listening to a specific song at a normal level versus hearing it live at a concert. You love the excitement of hearing it so loud and so intense that your brain starts telling itself, “I can’t listen to the song on the radio anymore. I need that intense feeling.” So bringing it back to pills, those pills start training your brain —telling itself, “I am superior to any natural process.”
That right there reinforces your brain to seek that chemical more and more.
It’s telling your body, I need that to be happy. As a result, slowly, your brain will prefer those intense effects to anything else. And if you give your brain what it wants over extended periods of time, more of the drug is needed to feel the effects you felt when you first started. This is a little something known as tolerance. When someone builds a tolerance, your brain will signal, once again, that it needs more of that drug to feel good. Consequently, your brain starts producing more and more opioid receptors, which will demand more and more of the drug in order to feel good.
And when you suddenly stop, it’s a shock to your system. Like without those drugs, your body doesn’t know what to do anymore. It’s screaming for its daily dose of whatever you were taking. This happens because when you do drugs for a while, those neurotransmitters in your brain eventually stop producing dopamine (or they’ll make less). When there’s not enough dopamine —and because drugs are toxic —some neurons (or all; depending on your dosage) may die.
As a result, your ability to feel any type of pleasure —without opioids is significantly reduced. The addict feels flat, lifeless, and depressed. For me, I was unable to enjoy things that once brought me joy. Because now I needed my drug of choice just to make my dopamine levels normal. Or as I like to say, back to zero. So every morning when I woke up (during my addiction like before detox and rehab), I’d have to snort 60 milligrams just to feel OK; because it had been hours since my body got its medicine.
BUT WHAT IF I WANTED TO GET HIGH AND NOT JUST FEEL NORMAL?
Like what if I wanted to feel that euphoria, listen to that song at a concert or be happy and relaxed? That’s usually the goal but overtime priorities change. I say that because, in the beginning, I was, in fact, using to get high. But after a while, I built that tolerance; so I needed more of the drug to create that initial dopamine flood. Because as my addiction grew, so did my tolerance. And without my pills, I was below zero. Negative.
That’s how the withdrawal process starts.
That’s why addicts experience withdrawal when they go without. Like every morning, you’d snort some oxy in an attempt to get a small buzz but overall the goal is to not feel sick. And that’s the thing. Most of the time, people who use hit a wall where they no longer feel any pleasurable effect but continue because of the painful withdrawal that is experienced when you stop. Imagine profusely sweating; like you’re hot AF but at the same time, you’re freezing fucking cold. Like goosebumps and shivering.
Here’s what you else can expect.
- Drug cravings
- Anxiety and agitation
- Panic attacks
- Muscle and joint pain
- Increased blood pressure and heart rate
- Sleep disruption and insomnia
- Mood swings
- Nausea, vomiting or diarrhea
- Stomach cramps
- Loss of appetite
That said, you’d think most people in this world wouldn’t want to do drugs merely because of those awful symptoms. But the alternative, like that feeling of euphoria, is just that good. Addicts are OK with the extreme lows because of the extreme highs, which is why most of us will relapse within the first 24 to 48 hours of cessation. That right there is what keeps most addicts (like myself) trapped in the vicious cycle of addiction. Because these drugs are expensive.
So it’s hard to keep up.
And unfortunately, symptoms like the ones I mentioned above can actually start as soon as 6 hours after your last dose. But it’s important to remember that this phase will not last forever. It’s temporary and you can overcome its awfulness (here’s how). Because the first stage tends to peak within 72 hours. So after five to seven days, you most likely will start to feel some relief. You’re not done yet though. Because this is when secondary withdrawal begins. At this point, you can expect to experience most of the shit I wrote above.
But a lot milder.
Along with a runny nose, teary eyes, uncontrollable yawning, and the inability to concentrate. On a happier note, a few days after that, from a physical standpoint, recovery is well underway. However, psychological symptoms can linger, while drug cravings persist —sometimes, for weeks, months or even years. That is a lot of something called “Post-Acute Withdrawal” (PAWS). During this stage, you’d feel intense drug cravings, body aches, insomnia, depression, anxiety and just an overwhelming feeling of now what.
Seriously, what now?
Because I’ve been there. And it’s awful. But it’s not a life sentence. I will say, having support is incredibly important throughout this process. So remember, it’s OK to ask for help. Whether it’s a friend, a family member, a doctor or even a support group, leaning on those around us can help you through this tough time. Because when you have someone to talk to about how you’re feeling, you can mitigate the anxiety and internal struggles that might lead to a relapse.
So I finally accepted it. And after taking a leap of faith (quite literally), I finally ascended from the depths of my own personal hell a.k.a. rock bottom and traveled my way back to the top. It was hard and far from pretty (as I’m sure you can now see). It didn’t get easier but I did get stronger. And along the way, I learned that the worst thing that happens to you, the thing you think you can’t survive, well —it’s the thing that makes you better than you ever used to be. So hurt now.
And then, live the rest of your life as the recovered champion you were always meant to be.