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Addiction to prescription pain medications is one of the public health problems today, in part because there have been great advances in pain treatment that have made powerful pain medications available to many people who were previously incapacitated by pain. Unfortunately, most of these highly effective pain medications are not less addictive than the opium and morphine that has been used to treat pain for centuries, and they are sometimes more addictive. About one person in 10 is predisposed by heredity and brain chemistry to overuse pain medications and eventually to become addicted to them, and we have not made as much progress in the understanding and treatment of addiction to pain medications as we have in the development of pain medications. There is still a stigma attached to becoming addicted to alcohol or drugs, although it is not as severe as it once was, and that has led many people to fear and avoid coming to terms with drug problems even after they are recognized, and particularly in this country to laws and regulations that make the treatment of addiction more difficult and expensive than it needs to be.

Studies show that one of the greatest difficulties in getting off of pain medications and staying off is the withdrawal that most people experience when they abruptly stop taking opioid pain medications that they have been taking for a long time, for whatever reason.

Withdrawal is not just an enduring desire for the substance but involves mental and symptoms that may sometimes last for a long time.

The nature and severity of withdrawal symptoms depends on the drug that has been taken. Although withdrawal from opioid drugs is not fatal, as alcohol withdrawal for instance can sometime be, it is very unpleasant and more than anything else prevents people from getting clean or drives them back to use.

The current standard for drug addiction treatment is either inpatient or outpatient rehabilitation with the goal of getting off of the drugs entirely and remaining abstinent. Twelve-step programs like Narcotics Anonymous are also effective in supporting long-term abstinence.

Methadone is effective for keeping people clean once they have stopped using, but must be given by a federally-approved treatment center and there not enough of those, so there is often a waiting period.

Buprenorphine, an opioid that blocks withdrawal and craving but does not usually make people high, can be taken on an outpatient basis from a certified provider, and naltrexone has been approved to deal with drug cravings also.

Another option for support during recovery from opioid addiction is the generally more numerous meetings of Alcoholics Anonymous, which 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.

Natural or nonmedical means of getting off and staying off drugs are attracting increasing attention. 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 fasting will make these worse. Vegetable juices, fruit juices with as little sugar as possible, teas made from calming herbs and as much fresh and clean water as possible help with are detoxifying.

Exercise

Most people with addictions gradually withdraw from activities and cease to exercise. Exercise produces endorphins that naturally have the effects of opiates naturally. Exercise does not have to be aerobic, although that is good; deep breathing, tai chi and yoga are also useful. The skin has been called " the third lung" and is important for eliminating toxins, and brushing the skin softly for 2 or 3 minutes before bathing increases skin circulation and the flow of lymph fluid, which carries off toxins. Warm baths, between 33-36 degrees C or 92-98 F, and careful use of a steam bath or sauna can help with detoxification.

Dieting

Eating several small meals a day and trying to do without refined sugar will prevent blood sugar swings. Calcium is calming and reduces tremors and anxiety. Protein lessens drug cravings and facilitates the replenishment of brain transmitter chemicals that have been depleted during use, and calcium is calming and reduces tremors and anxiety. 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

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 oat straw, reishi mushroom and skullcap are helpful for tremor, valerian aids with sleep and yellow dock root enhances kidney and liver function.

Homeopathic remedies

Homeopathic remedies are safe, inexpensive and widely available over the counter. 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.

Nutritional supplements

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

Plants

Smell can also be used to lessen the effects of withdrawal. Aromatherapy uses the essential oils of plants and herbs to relieve anxiety and excitability and to enhance the removal of toxins. 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 crabapple 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.

Rehab can be expensive, but local mental health agencies can often help. Narcotics and Alcoholics Anonymous can also help with guidance and referrals as well as with support. The natural alternatives above are inexpensive and easy to use. This journey of a thousand miles must begin with the first step of the first phone call, but hopefully these suggestions will help.

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