I heard from Ken (not his real name) yesterday. Ken completed an Accelerated Opiate Detox with us about 5 weeks ago. The burden lifted from his shoulders is immense, he told me. He wakes up with the freedom of knowing he can be like a “normal” human: drink coffee, take a shower, snuggle his kids, read his mail…with absolutely no need to compromise his integrity or his wallet by buying pills.

Ken was using high dose opiates. He admitted to taking as much as 24mg-36mg of dilaudid (hydromorphone) plus 25-50 mcg of fentanyl together on most days. It all depended on what his dealer could find. Ken could afford to purchase pretty much whatever he wanted.

His opiate use a few years ago was very occasional.

Until it wasn’t.

When he found that he experienced withdrawal on the days he didn’t have pills, he began to justify his daily use.

“The energy it gives me is unparalleled,” Ken told me. “I could get twelve hours of work done in six. I ran circles around the younger and even more experienced employees.” Ken works in the financial industry.

But every day he woke with the sickening reality that if anything at all happened to disrupt his relationship with his dealer, if anyone at work got wind of what was going on, and –perhaps worst of all—if his beautiful wife of fourteen years, mother of his two children—found out she was married to a lying junkie—he could lose everything. He was sick of lying to himself and everyone in his world.

Ken took the courageous step to contact our office and he successfully completed his detox, opting to receive a naltrexone implant.

Five weeks later, he continues to struggle with low energy and a little anxiety, although he sees both conditions slowly improving.

When the brain has had an extended taste of dopamine at the level provided by strong opiates (and the two Ken was using are some of the strongest), the full recovery time to restored energy will depend on several things. Important variables include the quantity, potency, and duration of opiate use, as well as a person’s general health and co-morbidities-- that is, other health conditions that might impede healing.

It is extremely important for our patients to understand that an accelerated or rapid detox is not a ‘magic wand’ that will restore them immediately to the functioning they enjoyed prior to using opiates, but healing happens!

Some of the most successful strategies our patients have found to help them through the first few weeks include:

  • Sleeping. We provide our patients with medications to help with sleep after a detox, and many others seek the same help from their own health care providers. Usually within a month, sleep is restored to normal.
  • Eat well. Providing our bodies with high quality ‘fuel’, eating foods that supply the amino acids our brains need to make neurotransmitters is common sense. And although we do not promote any particular product, many patients tell me that they use amino acid supplements to promote this process and it seems to help.
  • Exercise. Again, this is common sense. Exercise increases endorphins. Some people have told me they don’t have enough energy to exercise. I am not advocating training for a marathon after an opioid detox, but moving the body with walking or gentle yoga is an excellent beginning to self-care.
  • Talk. I can’t overestimate how powerful it is for our patients to work with a counselor or find a recovery group. It is all too easy to be trapped by the mind’s constant messages of fear, discontent, and angst, or uncomfortable physical sensations to justify a return to the quick ‘fix’ of an opiate high.
  • Follow up with your health care provider. It is possible that low energy may be caused by other health conditions, compounding the post detox recovery. Some doctors may supplement men’s testosterone, which invariably declines with extended opiate use. Patients with continued low energy may be checked for anemia or thyroid conditions.

Despite Ken’s low energy, he is filled with gratitude to have his life back. Learning about the natural progression of the brain’s healing process after an opioid detox enables him to manage his expectations realistically. Our staff warmly looks forward to his two month follow up visit. We fully expect that Ken’s energy trajectory-as well as his sleep, anxiety, depression and focus—will continue to improve, based on our experience with hundreds of patients who have been treated at The Coleman Institute.

Joan Shepherd, FNP