What are opiate cravings and why is it so hard to break an addiction and stop using drugs?
What are cravings? The phenomenon of cravings is fascinating. When you have a craving for opiates, you have an overwhelming rush of emotions and thoughts that point you back in the direction of taking opiates again. If you became addicted to opiates at some point, it was caused by your brain’s reward center becoming reprogrammed in such a way that opiates moved to the top of your list of critical necessities.
Have you ever tried to hold your breath for a long time, maybe for a full minute? As the seconds tick away, you start having thoughts about taking a breath. The thoughts just pop into your head, seemingly out of nowhere. Wouldn’t it be great to take a deep breath of air? That would fix everything and make you feel better.
What about water? Have you ever gone for hours without a drink? Thoughts of cool, refreshing water come up, along with a strong physical compulsion to find water and drink it. You know that if you could just drink some water, you would feel better and you could finally stop obsessing over it.
The feeling of having opiate cravings is not so different. It becomes the only thing you can think about. Where can you get more? How can you pay for it? How will it feel to finally use opiates again? You believe that it will sooth the craving and make it go away, like scratching a bad itch on your back with a nice, sharp back scratcher.
While all of us know how it feels to need to breath or to need water, many people have no idea what it feels like to similarly crave an opiate such as heroin. Heroin is not a basic necessity for survival that we all need. Most of us don’t ever think about heroin at all.
But, for someone who is addicted to opiates, they believe they need it as much as they need air or water. They feel intense cravings that seem like they will never go away unless they do just one thing.
When a person experiences drug cravings, they feel as if using more drugs will eliminate the cravings. It will be like scratching an itch to make it go away. Yet, just like scratching an itch, the cravings come back again shortly after using drugs again. Not only do they come back, but the cravings are now more intense than ever.
Here is how to stop opiate cravings now.
If you have recently quit opiates in the last 24 hours, you are likely feeling withdrawal sickness. As time moves on, the withdrawal symptoms intensify. You may start with cold chills and muscle aches, runny nose and sneezing.
Then, the intense cramps and nausea set in with nausea, vomiting, and diarrhea. Restless leg syndrome is an issue for many people. It may not seem like a serious issue if you have never experienced it, but it is very disturbing and uncomfortable.
Throughout the first couple of days of intensifying withdrawal symptoms, cravings gradually move in, blended with the withdrawal. Thoughts and images come up in your mind. Full formed plans of going out to get more opiates appear out of nowhere. A deep feeling of dread and helplessness sets in. You know you shouldn’t use more opiates, but its all you can think about.
The cravings reach a peak intensity at about the third day of withdrawing from opiates. While they do subside after that, they do not go away completely.
Over the next 3-6 months or so, you may notice a gradual reduction in the frequency of cravings. At first, you feel as if you think about opiates all day long. Then, over time, you notice that you have long stretches of not thinking about them at all.
If you stick with a program of not using opiates, you will have fewer and fewer cravings. Even after a year, or multiple years, you still must remain vigilant. Opiate use any time down the road may re-awaken cravings.
What if you do not want to go through the difficult and long road of abstinence-based recovery from opiate addiction? After all, the success rate is not very high. Most people, faced with the intense cravings that strike early on will give in and return to opiate use.
Fortunately, there are alternatives. The fastest way to get off of the streets and quit heroin and fentanyl use without having to go through withdrawal and opiate cravings is to show up at a local methadone clinic.
Are methadone clinics bad places? Not necessarily. Methadone is approved by the US and state governments for use in treating opiate addiction. It is a potent opioid drug itself, however, patients who take methadone are able to function in their lives without being overwhelmed by withdrawal sickness and opiate cravings.
You can show up at the clinic and get started on the same day you quit heroin or any other opiate or opioid drug. Methadone is known to have a 75% success rate, which is higher than any other form of opioid addiction treatment approved in the US.
Do you know how to fight opiate cravings effectively without going to a methadone clinic?
While methadone treatment itself is not a bad thing, there are bad clinics out there. Some of them get patients on very high dosages of methadone with no intention of ever helping them to taper down, even for the patients who are motivated to reduce or stop treatment after a year or two.
If you live in an area where you have only one clinic you can get to with no alternatives, you may find yourself at the mercy of difficult staff members, including nurses, counselors, and administrators.
Even if your methadone clinic is a pleasant place to go for treatment, as you integrate yourself back into every day life, you may start to realize that showing up every single morning for your daily dose of methadone restricts your lifestyle more than you would like.
There are alternatives to methadone to avoid cravings early in recovery.
Suboxone is another alternative that can help you to recover from opiate use without having to go through intense cravings. Suboxone is a combination drug that contains buprenorphine and naloxone. Buprenorphine is the main ingredient that does all the work to help prevent withdrawal sickness and cravings.
While buprenorphine is technically an opioid, just like methadone, it is unique in the way that it works. It is more of an opioid receptor blocker than anything. While it blocks the receptors, it partially activates them, making it a partial agonist/antagonist. Because of this, Suboxone is much milder and safer than methadone.
Doctors can prescribe Suboxone for up to a month at a time. Suboxone treatment gives you lifestyle freedom and flexibility. There are other brands as well that are similar to Suboxone, including ZubSolv and Bunavail. So if Suboxone is so much safer and easier to get than methadone, why do methadone clinics exist?
Because of the unique nature of how Suboxone works, you must wait for a period of time from your last opiate use before you can take your first Suboxone. The time is usually about 24 hours. In some cases, you will have to wait longer.
If you start too soon, the buprenorphine in Suboxone will cause precipitated withdrawal. This means that you will feel much more sick with withdrawal symptoms, caused by the Suboxone itself.
Suboxone doctors try to avoid their patients going through precipitated withdrawal. While it is not dangerous, it is unpleasant enough that it might discourage the patient from sticking with treatment or even being willing to come back to try again in the future.
Because of this limitation of Suboxone, there are patients who may still do best by starting out at a methadone clinic. There is little or no concern of precipitated withdrawal with methadone treatment.
Is it possible to go from methadone to Suboxone?
Going from treatment with methadone to buprenorphine is possible, but not easy. As a rule of thumb, you should plan to taper down to 30 mg of methadone daily or less. Talk to your doctor and counselor at your clinic to help you reach this goal.
When you do get to this milestone of a relatively low dosage of methadone, you will have to stop taking it and wait for at least a day and a half before starting buprenorphine. In most cases, you will have to wait longer to avoid the risk of precipitated withdrawal.
During the waiting period of transitioning from methadone to Suboxone, your doctor may prescribe medications to help with any withdrawal symptoms you experience. The transition from methadone to buprenorphine should always be performed under the close supervision of a doctor.
What are some anti-craving tips and things to help with withdrawal if I choose the abstinence route?
There is no one-size-fits-all solution to treating opiate addiction. Not everyone will choose to go to a medication-assisted treatment (MAT) program, such as a methadone clinic or private Suboxone doctor.
If you choose to stop opiates cold turkey and work through the withdrawal syndrome and opiate cravings, there are still some things that can help make it more tolerable. By doing whatever you can to help reduce cravings, you will increase your chances for success.
Getting enough sleep will help to keep cravings away.
Sleep seems almost too easy a solution, but it is surprising how many of us do not allow ourselves to get adequate sleep. We binge-watch television late into the night, play with our smartphones and tablets, and scroll endlessly through social media.
When it’s 3 am and you justify that you will be fine with 5 hours of sleep, you may not realize the stress you put on your body and mind. If you are already dealing with opiate cravings, even 6 months to a year out from your last opiate use, you will only make things worse with sleep deprivation.
If you pay close attention to sleep hygiene, keeping your sleeping area free of distractions, you will find that you can get more sleep than you ever thought possible. Even if you do wake up early at 5 am and you don’t have to be up until 8, imagine how great it will feel to be able to go back to sleep for another few hours.
Sleep is important to allow the brain to reset and error correct itself. Memories are sorted out in addition to other brain housekeeping activities. If you do not allow for enough sleep, you will likely experience ongoing opiate cravings that might have subsided in frequency and intensity otherwise.
Prayer can help you to reduce opiate cravings.
I realize that prayer can be a sensitive subject for people who are atheists or who are uncomfortable with religious and spiritual practices. If the word “prayer” makes you uncomfortable, you may think of prayers as affirmations.
In fact, it is not important at all to know the mechanism of how prayer works. If you believe that you are asking for help from the higher power of your faith, or, if you are sending out a message to the universe, or universal mind, that is fine. You may even want to think of prayer as sending messages to your own subconscious.
I once recommended prayer to a patient, and they agreed to try it out. When the patient returned for a follow-up visit, she said that it definitely helped. Cravings seemed to subside after praying for help. However, she had a question about prescribed prayer. How often was she allowed to pray for help.
While I am not aware of any specific restrictions in certain religions, there is not medical contraindication to frequent prayer. I advised the patient that she was allowed to pray for help in removing her opiate cravings as often as she wanted. I also recommended praying for help sleeping if she was having trouble with sleep since other patients have reported that this can be helpful.
Here is how to stop opiate cravings with nutrition and supplements.
At the intersection of spirituality and science is the importance of nutrition and supplementation. By feeding our bodies the proper fuel to keep our brains and bodies healthy, we also feed our minds and souls. Proper neurotransmitter precursors and cofactors help our brains by filling the buckets with the building blocks that our neurons need on a regular basis.
This means taking in enough protein throughout the day and also taking supplements that may include tyrosine, glutamine, magnesium, calcium, vitamins A, B, C, or a combination of these and several others. Speak with your doctor or nutritionist about what supplements they recommend. They may even recommend a multivitamin that contains everything you need, in addition to a healthy, well-rounded diet.
Another important recommendation regarding diet is to avoid harmful foods that may possibly stimulate cravings. Sugar and refined carbohydrates are the main culprits here.
Refined sugar is known to be an inflammatory substance that is unhealthy for your body and brain in many ways. It is also addictive, having many of the same effects on the brain as do highly addictive drugs, including opiates.
In addition to avoiding sugar, you may want to consider choosing carbohydrates in your diet with a low glycemic index. Low glycemic index foods tend to take longer for your body to absorb, so, even though they are broken down to sugars, as are all carbohydrates, there is not a sudden rush of sugars into the blood stream. Most fruits and vegetables are low glycemic foods. Potatoes are an exception, having a high glycemic index, similar to foods such as white bread and rice.
Here is how to deal with opiate cravings with a little help from your friends.
When patients ask what else they can do to improve their chances of success in remaining in recovery successfully, I typically recommend that they build and maintain a support network. What is a recovery support network?
A recovery support network is a form of social support network made up of people. These people may be family, friends, professionals, and people whom you meet in the setting of recovery support meetings.
Examples of such meetings are Alcoholics Anonymous meetings or Narcotics Anonymous meetings. Other groups, which are not 12-step programs, include Celebrate Recovery, SMART Recovery, and LifeRing.
At meetings of these groups, you may meet people before, during, or after the meeting. If you feel comfortable speaking with a particular person and you feel that they may be a positive addition to your support network, you may decide to exchange phone numbers.
Afterwards, for best results, it is advisable that you make phone calls to the people on your support network list on a regular basis. What should you talk about? There is no need to worry about having nothing to say.
You can talk about common issues relating to recovering from addiction. Let the person know how you are feeling today and how things are going. You can ask how they are feeling. Over time, you will get more comfortable with these phone calls and conversations. Practice makes perfect.
Having a strong network of support will help you to reduce cravings because sharing how you feel and the cravings you are having helps to get these feelings out in the open. Shining a light on opiate cravings by sharing with a friend in recovery helps to dissolve the cravings away.
To paraphrase a saying in NA, the therapeutic benefit of one person in recovery helping another is without parallel. So, along with the other recommendations made here to help reduce opiate cravings, building and maintaining your addiction recovery support network will greatly improve your recovery experience.
Protect your recovery and treat it as your most valuable possession.
There is nothing more important in your life than protecting your recovery and maintaining your state of being opioid and opiate free. You must take all reasonable measures to avoid returning to the dangerous state of active addiction.
While having friends in recovery who understand what it means to quit taking opiates and staying opiate free, you must be careful in sharing information about your medical treatment. For example, if you see a Suboxone doctor, this is not information that you should share with anyone, other than possibly your closest family members.
Sometimes, well-meaning friends have their own opinions about medication-assisted treatment and they may start making strong recommendations involving stopping your medication or changing how you take it. Taking medical advice from friends or people on the streets, you are putting yourself in danger.
When it comes to medical treatment, it is critical that you only make changes to your treatment regimen after having a talk with your doctor. Between you and your doctor, you can come to an agreement about what changes are reasonable.
Otherwise, take care to avoid allowing friends, family members, and coworkers to influence your behavior in ways that may put you at risk. For example, avoid the use of any alcohol or drugs that you know may trigger opiate cravings. If you are at an office party and your coworkers pressure you to drink alcohol, do not give in to this peer pressure.
You have a right to refuse alcohol and drugs, no matter who is pressuring you to take them. You also have a right to stay on your own path to recovery that is working for you without feeling that you should give in to the advice of people around you. You should not make changes to your program if it is working well for you simply because of the whim of the opinions of people around you.
Regardless of withdrawal symptoms and opiate cravings, you can definitely overcome opiate addiction. I recommend that you start by making an appointment to see your doctor. If you are concerned about the risk of overdose or other risks of continuing opiate use, you may go to the nearest hospital ER. Medication-assisted treatment is the gold standard of care for opioid use disorder. Even if you choose to take another path, starting with a medical evaluation is the best way to start off your journey of recovery from opiate addiction.