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Withdrawal from opioid pain medications or illicit drugs is an unpleasant and frightening experience, and is particularly upsetting for family members and friends who are often called upon to help the addicted person through this crisis and who very much want him to get and stay clean, but who may understandably conclude that the state of acute withdrawal is worse than the addicted but stable condition he was in before. Methadone is an appropriate drug for this problem, but it is not easy to use for either pain or addiction, and is increasingly used for long-term treatment of people who cannot get or stay entirely clean despite repeated attempts. Buprenorphine, either by itself or in combination with naloxone, is another opioid alternative that is not ideal but more often allows people to transition completely from active use to recovery. The rehabilitation and 12-step model is often harder to apply in opioid addiction than in alcoholism, and it does not always work well for alcoholism, but is sometimes importantly helpful in turning addictions around. There are a variety of safe, inexpensive natural treatment options that people can try for addiction and withdrawal, and that friends and family can help with.

Methadone was a major advance in addiction treatment in its day, but it is essentially substituting addiction to methadone for addiction to pain medications or heroin. The methadone addiction is safer and more easily controlled, but there is worry about the long duration of a methadone dose, its half-life, and worry that it can accumulate in tissue and may have more cardiovascular side effects than had been thought. The greatest drawback of methadone is that its availability is limited, there is often a long waiting list and it is necessary to go daily or at least regularly to an accredited treatment center to receive it.

Buprenorphine is also an opioid drug, but unlike methadone binds only partially to the opiate receptor sites that are involved in addiction and overdose. This reduces the change of getting high or of experiencing respiratory depression with an overdose, but is usually sufficient to block withdrawal symptoms. Buprenorphine is taken by dissolving it under the tongue because it is poorly absorbed by the usual oral route, but the drug can be snorted or injected by people who are really determined to do so, and has the potential for inducing a high or causing an overdose by those routes. To get around this, buprenorphine is usually combined with the opioid antagonist naloxone in the form of Suboxone; the main use for buprenorphine by itself (Subutex) is during pregnancy, when naloxone is not safe, or in people who are allergic to naloxone. Whereas methadone must be given at a treatment center, Suboxone can be prescribed to outpatients by any physician who has taken a course and received certification from the National Institutes of Health and obtained a special registration number from the Drug Enforcement Administration. Physicians who obtain these can then treat up to one hundred patients each with Suboxone through regular office visits.

Inpatient drug treatment or an intensive outpatient program, often abbreviated IOP, is not always agreeable to people with addictions and can be expensive, but this may sometimes be the only way to stop repeated cycles of treatment, short-term abstinence, relapse and withdrawal. This may also offer an opportunity for friends and family members to become involved in the recovery process. There are many facilities offering partial treatment which allow people to go on with their lives for at least part of the time, and many people's lives have turned around while living for a time in a residential program or a recovery community, and there is often assistance with the costs of these from public agencies or private organizations. Narcotics Anonymous, which applies the 12 steps of alcohol recovery to problems of drug addiction, may not work for everyone but is a source of information about these programs and facilities and a source of support for the addicted person from people who have themselves been there; it also provides families with opportunities for healing and help through the related spiritual program of NarcAnon for spouses and families.

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.

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.

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. 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, 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. Lemon juice 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 for depression and dandelion root for clearing drug residues, fennel seed stabilizes blood sugar, ginseng improves strength, 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 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 for restlessness, Arsenicum for diarrhea and vomiting but also for despair and agitation, Ignatia for chills and thirst or with pain, Nux vomica for tremor and sensitivity to light and sound as well as nausea and vomiting, Stramonium for hallucinations and convulsions and Zinc for 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 and cravings. Flax seed oil or DHA (docosahexanoic acid) are sources of essential fatty acids for depression and craving. The neurotransmitters GABA (gamma-aminobutyric acid) and 5-HTP, a precursor of the mood chemical serotonin, are calming and reduce tremor.

The last step of stopping and the first step of recovery can only be taken by the addict.

The family can support and encourage the decision to start one or the other of these treatment options, and can help with the natural recovery tools described above, which are safe and simple and can be tried at home.

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