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Addiction to prescription pain medications and street drugs such as heroin is one of the greatest health-related problems our society faces, and one of the greatest difficulties in dealing with that problem is the withdrawal that most people experience when they abruptly stop taking opioid drugs that they have been taking for a long time, for whatever reason. Withdrawal is not just the enduring desire for the substance but involves physical and mental symptoms, some of them potentially lasting a long time. The nature and severity of withdrawal symptoms depends on the drug that has been taken, and in some cases can be severe and even life-threatening: delirium tremens from alcohol withdrawal, for example, has a mortality of around 20 per cent if not treated, while withdrawal from sedative or anxiety drugs can be attended by seizures. Withdrawal from opioid drugs is not fatal, but is very unpleasant and more than anything else prevents people from getting clean or drives them back to use.

There is sometimes no substitute for professional treatment for drug addiction, and sometimes no alternative to medical treatment for nervousness, tremor, sweating, cramps, stomach pain and diarrhea after abruptly stopping or running out of opioids. It may not be necessary to enter a rehabilitation program; Suboxone and other prescription drugs are increasingly effective for withdrawal and easy to use in an outpatient setting. As with any other addiction, involvement in a support group is often crucial to success in getting clean: Narcotics Anonymous is the best-known 12-step group dealing with this problem, and the generally more numerous meetings of Alcoholics Anonymous are also welcoming to those trying to overcome drug addiction and usually tell newcomers to simply substitute their addiction problem for alcoholism in reading about and discussing the means of recovery.

There are many things that can be done for withdrawal in addition to or instead of further drug treatment. A long period of drug use often results in a highly toxic state, and cleansing and detoxification are helpful. This is often done with juice and other fasts, but fasting is not advisable when sick from any other cause and is more complicated when people are undernourished or malnourished to begin with, as is often the case when beginning recovery. In addition, rapid swings in blood sugar are part of any addiction problem and can bring on or aggravate withdrawal symptoms, and fasting will make this worse. Vegetable juices, fruit juices with as little sugar as possible, teas made from calming herbs and as much fresh and clean water as you can manage are key to detoxifying, and this may take weeks to months.

Most people with addictions gradually withdraw from activities and cease to exercise. Exercise produces endorphins, internal chemicals that have the effects of opiates naturally, as well as increasing oxygen utilization and encouraging mental relaxation. It need not be aerobic exercise, although that is good; tai chi, yoga and deep breathing exercises are also helpful. Skin brushing has been recommended as well: the skin has been called the third lung and is important for eliminating toxins. Brushing the skin with a soft brush for 2 or 3 minutes before bathing increases skin circulation and the flow of lymph fluid, which carries off toxins. Warm baths, between 92 and 98 degrees F or 33-36 degrees C, and careful use of a sauna or steam bath can also help with detoxification.

Eating several small meals a day will prevent blood sugar swings, and refined sugar should be avoided for this reason. Calcium is calming and reduces tremors and anxiety, while protein lessens drug cravings and facilitates the replenishment of brain transmitter chemicals that have been depleted during use. Lemon or lime juice in water and cranberry juice will enhance liver and kidney removal of toxins, and sports drinks rich in electrolytes are helpful if there is vomiting or diarrhea during withdrawal that can deplete these.

Herbs have long been used to help with withdrawal and recovery. Ashwagandha helps to relieve depression, dandelion root aids in clearing drug residues, fennel seed stabilizes blood sugar, ginseng improves strength and relieves exhaustion, kava kava and lavender lessen anxiety as does oat seed or oatstraw, Reishi mushroom and skullcap are helpful for tremor, valerian aids with sleep and yellow dock root enhances kidney and liver function.

Homeopathic remedies are safe, inexpensive and widely available over the counter. Four pellets of 30c or 30x potency under the tongue twice a day are often recommended, but not combined with food or drink. Aconite is helpful for restlessness, Arsenicum for diarrhea and vomiting but also for despair and agitation, Ignatia helps with chills and thirst or with pain, Nux vomica is particularly useful and helps tremor and sensitivity to light and sound as well as lessening nausea and vomiting, Stramonium may prevent hallucinations and convulsions and Zinc helps with jitteriness, nervousness and irritability.

Many nutritional supplements have been recommended, chiefly B-complex vitamins and vitamin C. Chromium and magnesium stabilize blood sugar and reduce cravings, while the amino acids taurine and L-glutamine reduce tremor as well as cravings. Flax seed oil or DHA (docosahexanoic acid) are sources of essential fatty acids that help with depression and craving. The neurotransmitters GABA (gamma-amino-butyric acid) and 5-HTP, a precursor of the mood chemical serotonin, are calming and reduce tremor.

Smell can also be used to calm and improve brain function. Aromatherapy uses the essential oils of plants and herbs to relieve anxiety and excitability and to enhance the removal of toxins. Oils can be placed in a bath or diffused in a room with calming effect. Bergamot and geranium help to relieve anxiety, clary sage and juniper alleviate exhaustion and fatigue, basil and nutmeg are useful for cravings and helichrysum makes overwhelming stress less acute. Another use for plant essences is in flower remedies, and 2 or 3 drops of these can be placed under the tongue or in a glass of water for acute withdrawal symptoms. Rescue Remedy contains 5 calming essences, and other options include Crab Apple for those who feel unclean, Hornbeam for exhaustion, Larch for fear and self-doubt and Walnut for the pain many people feel in giving up an addiction.

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