Ask The Doctor: Questions and Answers from Addiction Medicine Experts
2. How Long Do Opioids Stay In Your System?
3. How Can I Get Energy Back After Opioid Withdrawal?
4. How Long Does It Take To Get Energy Back After Opioid Withdrawal?
5. Can a Doctor Refuse to Prescribe Medication?
6. Can I Use Kratom To Detox Off Heroin?
7. What If I Never Stop Taking Suboxone?
8. Does Naltrexone Really Help With Cravings?
9. Why Is Naltrexone Therapy So Important for Opioid Addiction?
10. What Does It Mean To Drink Alcohol in Moderation?
11. How Do You Detox Safely from Kratom and Poppy?
12. When Does Energy Come Back After Opioid Pain Medication Withdrawal?
13. What Is Dopamine and How Does It Keep Me Using Opioids?
14. Is Recovery Possible for Fentanyl Addiction?
15. Why is it So Hard to Detox Off of Suboxone and Other Forms of Buprenorphine?
16. What Is to Blame for Low Energy After Opioids?
17. How Do I Know It Is Safe to Stop Drinking Alcohol?
18. What Does It Mean to Hit Rock Bottom?
19. Who Should You Surround Yourself With in Recovery?
20. Can I Really Be Addicted To Tramadol?
21. Should I Date in Early Recovery?
22. What Are the Effects of THC Exposure on the Brain?
23. Is Artificial Pot Dangerous?
24. What Is The New Buprenorphine Injection?
25. Why Is It So Hard To Detox Off Opioids?
26. Can I Have Surgery Without Opioid Pain Meds?
27. What is CBD?
1. What Is Lean?
An opioid-based drink called “lean” has skyrocketed in popularity among teens and young adults in recent years, with one study suggesting that nearly seven percent of college-aged students have tried the concoction. Also known as “purple drank,” “sizzurp,” or “dirty Sprite,” lean has raised concerns among parents, doctors, and lawmakers due to its potential risks and the negative impact it can have on a person’s health.
2. How Long Do Opioids Stay In Your System?
Opioids encompass a wide range of substances, including powerful prescription medications like fentanyl, oxycodone and hydrocodone, as well as illicit drugs such as heroin or street fentanyl. Each opioid has unique characteristics, including varying half-lives and rates of metabolism, which affect the duration of its presence in the body.
3. How Can I Get Energy Back After Opioid Withdrawal?
Long-term opioid use can have life threatening side effects that range far beyond the difficulty of withdrawal. Such long term consequences include increased risk of cardiovascular complications, hyperalgesia, increased risk of infections, and even psychological and cognitive deficits. After extended use of opioid pain medications, stopping is no easy matter. Neither is the first several weeks afterward. Cessation of these opioid medications leaves the brain with a deficit of dopamine, the neurotransmitter associated with pleasure and reward. Not only is there a lack of dopamine to contend with, but many patients who have been using opioids for an extended time have not focused on other important aspects of their health. Eating, sleeping, and moving have often been compromised and impaired.
4. How Long Does It Take To Get Energy Back After Opioid Withdrawal?
With over 2 million Americans abusing opioids, and the loss from overdose growing by the day, many are experiencing the difficulty that comes with dependency and withdrawal. When you stop taking opiates your body goes through withdrawal. The body’s endorphin receptors take a dive and the body feels this in many unpleasant ways. For some, unpleasant symptoms may persist even after the body has detoxed. Having low energy and feeling very irritable are common complaints from those in recovery.
5. Can a Doctor Refuse to Prescribe Medication?
Medical providers find themselves in an increasingly difficult position when treating pain. Doctors are responsible for prescribing pain medication. However, they can also face serious legal issues for inappropriate prescribing, including malpractice liability, medical board discipline, and criminal convictions. A fascinating article in the American Journal of Law and Medicine describes why physicians are turning away from prescribing pain medications, even for “legitimate” patients. According to a report by The American Medical Association (AMA), there has been a nationwide decrease in opioid prescriptions of over 44%.
6. Can I Use Kratom To Detox Off Heroin?
At one time, researchers thought it would make sense that Kratom would help with opioid withdrawal. But, if you think about it, for a person withdrawing from heroin, heroin will “help” with the opioid withdrawal. So will oxycodone, fentanyl, Percocet, etc. The problem is that you are simply perpetuating the situation.
7. What If I Never Stop Taking Suboxone?
Many individuals are prescribed opioid pain medication for their pain conditions. When their specialist stops prescribing their medication, they might need additional treatment for their physical dependence on these medications. In many cases, addiction specialists will treat this with Suboxone. However, this medication (along with other Buprenorphine medications) can lead to an entirely new dependency.
8. Does Naltrexone Really Help With Cravings?
We often get asked whether long-acting naltrexone really does eliminate cravings for opioids. And that has been pretty much our experience, where, of course, eliminates a strong word where there’s no cravings at all. But almost all of our patients are amazed at how low their cravings are when they’re taking either Vivitrol, the one-month injection, or the implants that we use, the naltrexone implants that last two months.
9. Why Is Naltrexone Therapy So Important for Opioid Addiction?
Naltrexone’s really important for opioid addiction for the main reason that it works. Because without naltrexone, people just don’t do very well. Patients really need some form of medication-assisted treatment (MAT); and the options, of course, are buprenorphine or methadone. But for 20 years, we’ve been specializing in naltrexone because it’s a long-acting version of the drug, and it’s completely non addictive.
10. What Does It Mean To Drink Alcohol in Moderation?
Moderation is difficult to achieve for most people with moderate to severe Alcohol Use Disorder (AUD). However, some can achieve moderate drinking without it resulting in a full-blown relapse. Without any work or intervention, the chances of success in moderating drinking are much lower.
11. How Do You Detox Safely from Kratom and Poppy?
Kratom, a tropical evergreen plant from Southeast Asia, and the residue in unwashed poppy seeds contain opioid compounds with strong binding affinity, like scheduled pain medications. Both substances, if taken in high enough amounts for a long enough time will create physical dependency. Both can cause a person to experience withdrawal if the substance is not available.
12. When Does Energy Come Back After Opioid Pain Medication Withdrawal?
Many people express frustration with the lack of energy that ensues following an opioid detox. Working with our counselors, support groups, and other reliable resources can help people get through this tough period. This is a time when patients are particularly vulnerable to cravings and triggers and why working with experts trained in helping people with Substance Use Disorders is so valuable.
13. What Is Dopamine and How Does It Keep Me Using Opioids?
Dopamine is known as a pleasure molecule that is released in the nucleus accumbens area of the brain when we do pleasurable things—like eat food, have sex, or even take prescription opioids (drugs). When dopamine releases in the brain, we experience a strong sensation of pleasure and, of course, we will want to repeat that experience.
14. Is Recovery Possible for Fentanyl Addiction?
Relapses can occur because fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. It also has to do with the way the brain adapts to the drug. Naltrexone, which is a pure opiate/opioid blocker (or antagonist) and therefore does not create physical dependence or tolerance, resides on the opiate receptors, thus blocking the drug from occupying these receptors.
15. Why is it So Hard to Detox Off of Suboxone and Other Forms of Buprenorphine?
Detoxing off of Suboxone can be quite difficult. Suboxone can be a great option for use disorders as it binds to the same opiate receptors in the brain and turns on the same “switch” an opioid would. Suboxone is slow acting and doesn’t cause the patient to feel high. Because of this, there are low cravings and it’s relatively safe. Interestingly, the more Suboxone in the body the more it becomes an even bigger blocker to the opioid receptors in the brain. This prevents overdose as receptors are kept extremely full, but it’s also why it’s so hard to detox off of.
16. What Is to Blame for Low Energy After Opioids?
Because opioids flood our brain with more dopamine than it was ever meant to have, most people who stop opioids, whether prescription medication from a doctor or drugs bought off the street, will feel a great loss of energy, especially in the early part of the brain’s recovery.
17. How Do I Know It Is Safe to Stop Drinking Alcohol?
Not everyone needs a medical detox off alcohol, but it can be dangerous to stop drinking abruptly if your body has developed a strong tolerance. Some people have mild to moderate tremors or sweating until they get a drink in their system. It’s important to check with your doctor if you are concerned or unsure.
18. What Does It Mean to Hit Rock Bottom?
We have been led to believe that someone can only change their substance use patterns when they hit “rock bottom.” Maybe this black and white thinking was helpful back in the day when 12 Step recovery programs were relatively new. It provided context to know when enough was enough. Don’t wait until you hit this imaginary “rock bottom.”
19. Who Should You Surround Yourself With in Recovery?
People in recovery from drug or alcohol addiction need to take steps to protect their sobriety every single day. This often involves severing ties with people who drink or use drugs—even if they’re longtime friends. Staying friends with active substance users could put you in difficult situations that trigger cravings and lead to relapse.
20. Can I Really Be Addicted To Tramadol?
Tramadol is used to treat pain in adults that is severe enough to require an opioid analgesic and for which other treatments do not work. It is sold under brand names including Ultram, Conzip, and Rybix. In addition to acting as the opioid pain receptor, tramadol also inhibits the uptake of two neurotransmitters, norepinephrine and serotonin, which may add to its pain-relief effects. What others tend to not realize is that Tramadol, similar to opiates such as morphine, fentanyl, or oxycodone, has many of the same effects as an opioid and can result in just the same dangerous dependencies.
21. Should I Date in Early Recovery?
With recovery and sobriety comes vulnerability, especially in the early stages. The feelings and bad past experiences that you have been self-medicating away are coming to the surface. It can be very painful and it would be easy to focus on love rather than your difficult feelings. But that is the really worst thing you can do. A relationship gone badly can completely derail you. You have one main goal in early recovery—to remain sober.
22. What Are the Effects of THC Exposure on the Brain?
Medical cannabis and recreational marijuana have now become available in many states across the United States. This change has led to the widespread perception that marijuana is very safe and, that it is even safer than alcohol. While this may be true in some ways, the fact is that alcohol is extremely toxic to unborn babies. Even in low doses, alcohol causes severe brain damage to unborn babies – Fetal Alcohol Syndrome (FAS). Unfortunately, it turns out that marijuana is also toxic to unborn babies and many people are unaware of this. It is particularly a problem with the high potency cannabis products that are now more available.
23. Is Artificial Pot Dangerous?
Beware of artificial pot. A lot of people believe marijuana is a very safe drug. And to a certain extent, it can be safer than cocaine and many other street drugs. As a result, many people believe that artificial marijuana should also be safe. Simply put, nothing could be further from the truth. Natural marijuana gains its mind-altering effects from a chemical known as THC. Synthetic marijuana on the other hand, called Spice or K2, is coated with synthetic cannabinoids – a family that includes over 700 research chemicals.
24. What Is The New Buprenorphine Injection?
Recently, the FDA gave its approval to a new treatment for patients with an opioid substance use disorder. It is a monthly injection of an old medicine – buprenorphine. The new treatment is called Sublocade® and it reliably gives a steady dose of the buprenorphine for a whole month.
25. Why Is It So Hard To Detox Off Opioids?
The symptoms of detoxing off of any drug are always the exact opposite of the effects that the drug delivers when it is used properly and as prescribed. For example, a drug like alcohol is a sedative that makes people calm and relaxed and will even put them into a coma if enough is taken. Withdrawal off of alcohol is the exact opposite of this: it is characterized by anxiety, tremors, shakes, agitation, rapid pulse rate, sweating, high blood pressure, and insomnia.
26. Can I Have Surgery Without Opioid Pain Meds?
We recently had a patient who had been off of opiates and in recovery for around 12 months. He was receiving regular naltrexone treatment and feeling very good. Unfortunately, he hurt his back and needed surgery with a lumbar laminectomy – a very painful procedure. He was terrified that if he was exposed opiates, he would relapse, so he requested that he continue on his naltrexone treatment and go through the surgery without any opioid pain medicines at all.
27. What is CBD?
There are two main active ingredients in marijuana plants. Actually, there are a total of over 100 active ingredients, called cannabinoids, but there are two that are the most important. Everyone has heard of Tetrahydrocannabinol – THC, which is the drug that gets people high. Cannabidiol, or CBD, is the other main ingredient.
