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Is “detox” even a thing? Or are we thinking about addiction treatment wrong?

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  • Why did Z go out of his way to look at Tom when mentioning marijuana withdrawal?

  • Why go off narcotics cold turkey? If you’re concerned about severe withdrawal symptoms, try a slow taper instead. Of course, check with your personal physician first.

    Narcotics are also called opioids. I’m talking about oxycodone, hydrocodone, hydromorphone (Dilaudid), morphine, fentanyl, heroin, etc. Not Xanax, Ativan, or Valium.

    On average, it takes three weeks of daily narcotic use to get physically dependent on it. This means that when you stop the drug completely and suddenly, your body may crave it and you could have withdrawal symptoms. The severity of withdrawal symptoms varies from person to person. Possible symptoms include anxiety, sweating, nausea, vomiting, diarrhea, hyperactivity, restless legs, weakness, easy fatigue, shaking, suicidal thoughts, insomnia, and muscle pain or cramps.

    Good and bad news, bad news first: Narcotic withdrawal can be very uncomfortable but rarely causes medically serious complications. The serious complications are usually in folks with pre-existing heart disease, high blood pressure, low blood pressure, or heart rhythm disturbances. (Reference: UpToDate.com.)

    Here’s how you stop your chronic daily narcotic habit without suffering a withdrawal syndrome (if needed, see the postscript for an example):

    Total up your current total daily dose in milligrams

    Determine 10% of the amount by dividing the milligrams by 10

    Reduce your daily milligram intake by that 10% every week

    Nine weeks later you’ll be off narcotics

    Congratulations! You’ve done your part to solve America’s opioid use epidemic. You’ve reduced your drug bill, avoided Opiate Use Disorder, and reduced your risk of narcotic overdose death by 100%. And you did it without political meddling or an expensive stay at a detox center.

    Be aware that as you taper off your narcotic, you may have a flare of an underlying psychiatric condition such as depression, anxiety, PTSD, bipolar disorder, panic attacks, or psychosis. If so, see a mental health professional posthaste.

    -Steve

    PS: Take Percocet 10/325 for example. It’s 10 mg of oxycodone and 325 mg of acetaminophen. Say you’re taking Percocet 10/325, four pills at at time, four times a day. That’s a total daily oxydocodone dose of 160 mg (16 pills x 10 mg). 160 mg divided by 10 = 16 mg. We have to round off 16 mg to 15 mg due to the availability of various strengths of Percocet. So starting today, you reduce your daily oxycontin dose by 15 g, which is one-and-a-half pills. After one week, you reduce your daily pill count by another one-and-a-half pills. Etc.

    PPS: Let you’re doctor know what you’re doing beforehand. He’ll be overjoyed and ensure it’s safe for you to do this taper.

  • lynn

    Hi! I have been a retail pharmacist in the northeast us for about one year now, and was placed in a store in an area with lots of addiction (lots of OTC syringe sales, shooting up in the store bathroom etc). The pharmacist before me filled lots of non-terminal chronic opioid scripts from internists/family med docs in the area and I have inherited those patients. Of course pharmacists can deny filling blatantly inappropriate scripts when new patients come, but I don’t just want to cut off these long time patients without a professional discussion with their doctor about their treatment plan and suggesting long acting opioids instead/in addition, non-narcotic options, referral to pain management etc. (in a pain management clinic, I assume the ultimate goal is to get them off of these and not “maintain” them on opioids if that is even possible!) How do you suggest approaching doctors who write for monthly, q4-6h dosing of short acting narcotics? I would love feedback from any doctors out there especially internists/family docs!!

  • Kinoons

    Remember that Nancy Regan is like Santa Claus, she’s always watching. Lame joke aside; I have/had three uncles who deeply suffer/suffered from addiction to drugs and alcohol. One overdosed on heroin and died, an second hung himself in the 3rd’s front yard from a tree after a fight between then when drunk. The third has been fighting addiction to drugs and alcohol with multiple various relapses over the last 30 years to include multiple hospital stays and brushes with death. I wish it was just as simple to say stop and it happened. My elephant wants to say these people make a choice to take drugs or alcohol but he truth is that it’s just not that simple. While there is some element of choice making the right choice when every fiber of you being says otherwise must me epicly difficult. Hell I feel crappy about myself when I choose bacon over oatmeal for breakfast and that’s a decision I actually have control over. Just imagine how difficult it must be to just choose to not drink or do heroin. Hell it took my mother something like ten different tries to stop smoking. On the other hand my father simply stopped smoking one day because he wanted to. We have talked about it and figured that he was never psychologically dependent where as my mother was and given the evidence of her brothers I’d agree.

    I also watched the other video on YouTube. Am I the only one having MST3K flashbacks with zdogg as Joel, tom is tom servo, and Logan is crow?