06/16/2011

Dear Patti,
My wife, Trish, has been addicted to opiates for four years. We don’t have a lot of money or medical insurance to pay for in-patient detoxification or rehabilitation. She has finally decided to get off this stuff once and for all rather than go through any more pain. The decision to quit is totally hers, and I’m really proud of her. She’s going to a psychotherapist, attending Narcotics Anonymous meetings and has a good support system that will work with her to stay clean throughout the long recovery process.
 
What I need from you is advice on how to get through the withdrawal process. She has already seen an outpatient detox doctor recommended by her internist, and this weekend she’s starting opiate withdrawal. Her mom and her sister will come over to help her when I’m at work. Her mom tends to minimize what Trish will be experiencing. Her sister and I don’t want to do that, but we also don’t want to be negative. The detox doctor tells us she’ll probably go through acute withdrawal symptoms for about 10 days. What can I do to support her through this process?
– Ben

Dear Ben,
Opiates are not only known as some of the strongest pain relievers, but also the most addictive substances possible. Cessation is often described as one of the hardest withdrawals to endure. Opiate abuse is becoming more widespread and, although many of the withdrawal symptoms are similar, they are influenced by the type of drug as well as the amount and duration of its use.

Typical psychological symptoms include extreme anxiety, depression and impaired judgment. Physical symptoms include nausea, vomiting, chills, extreme body aches and pain, sweating, restlessness, weakness, exhaustion and insomnia. 

Because opiate withdrawal is very dangerous and extremely painful, it should only be done under the care of a doctor and with a loved one supervising. Here are a few tips my patients and colleagues have shared.

Again, please consult with a medical professional before proceeding with any of these.
1. No work, school or domestic responsibilities. Trish’s No. 1 responsibility and focus right now should be on getting through this. 

2. Except for a small trusted circle of family, friends and professionals that she has chosen don’t tell anyone she’s quitting without asking her permission. 

3. Use over-the-counter remedies such as aspirin, ibuprofen and non-addictive pain relievers to slightly ease the symptoms of body aches and nausea. An antihistamine may help the runny nose, sneezing and eye tearing symptoms. 

4. Stock your home with green tea, a daily vitamin, lots of Vitamin C, comfort foods and sweet treats. Make sure she drinks plenty of fluids. 

5. Have music, video games, TV and funny movies available to distract her. Online support systems are good, too. 

6. Only allow people around her right now who are loving and supportive. 

7. Refrain from asking about her symptoms or how bad she’s feeling. 

8. Have lots of clean bedding, soft blankets and comfortable bed clothes available, as sweating, vomiting and diarrhea can occur. Keep the bedroom well ventilated. 

9. Encourage light exercise. 

10. Hot baths, Jacuzzis and massages are a must to lessen muscle aches and pains. 

11. If she becomes irritable and starts a fight, don’t engage and don’t take it personally. Give her space, and if in emotional pain, encourage her to make a phone session with her therapist.
 
All the strong emotions that have been suppressed by the drug will undoubtedly surface in the next three to 12 months and that’s to be expected. Support Trish to face these feelings with you and her therapist. Remind her to give herself lots of love and to be gentle with herself. I applaud and completely admire your wife’s courage.