7 replies to this topic

[Doktor]

Hi all,

So for the past month, I have slowly been getting clean from an opiate addiction. I have previously been addicted to heroin, but was using Poppy Seed Tea (strong unwashed seeds) for the past several months. At the moment, I am consistently going 4-5 days without using, and then using a small-moderate dose. Each time I have done this, the withdrawals become more and more managable, to the point where now I barely feel a thing between doses. As a result, I will be jumping off completely this week (hopefully!).

Here is the thing; I suffer from mild/moderate depression with some related anxiety, which opiates completely irradicate for me (thus forming the bases for my addiction). Now that I am coming off the opiates, I am feeling a moderate resurrgance in these symptoms, which likely are slightly modulated by post-acute withdrawal symptom as well.

There are two different ideas that I have currently as alternative treatments to the opiates I have abused for relief:

D-Phenylalanine - Supposed to increase the level of endorphins by slowing their degradation within the body (by blocking the enzymes responsable for this). Lots of mixed reports, but seems like a plausible treatment vector.

LDN/ULDN aka. (Ultra) Low Dose Naltrexone - Theoretically could work by blocking the MU Opioid receptors during sleep, and thus creating a rebound effect during the day. Again, sounds plausible, but lots of mixed reports.

I currently take 30mg Vyvanse everyday (which helps my focusing issues greatly without ill effect), and that is it. I have taken both Wellbutrin and Lexapro in the past, but have no interest in any further experimentation with such drugs, as I do not feel like they have significant coorelation to the symptoms which I possess.

What do you all think? I would really appreciate any responses.

[Doktor]

Well... since nobody has responded yet, here is what I've been thinking:

1. I am going to start back up on a heavy weight training routine, and incorporate 5 - 10 minute intense blasts of sprints immediately following my workouts.

2. After a week or so (when my D-Phen arrives), I will add in 500mg of D-Phen twice a day. This should slow enkephalinase down at gobbling up all of the endorphins released following my workouts, allowing them to hang around for a while longer.

3. Depending on how that all goes, I am considering adding in Ultra-Low to Low dose Naltrexone taken half an hour before bed. Based on what I'm reading about this treatment, it seems like people are overdosing extremely frequently; The entire point of this treatment is to take advantage of the rebound effect, which you won't even get if you dose too much. Many people who take 4.5mg report all the symptoms of low endorphin levels during the day (very high libido is one of these, which happens to opioid addicts during withdrawal), and then many also experience a positive rebound effect upon stopping altogether. For this reason, I will start this as low as 0.25mg and titrate up as necessary. Maybe even lower.

I am going to give the first two steps above a solid while to judge efficacy before (potentially) adding number three. My reasoning for this is because I believe the first two steps should be adequate, and also that the combination of D-Phen and Naltrexone could prove to be really fucked up despite how it looks on paper (too many endorphins can be bad as well I'm sure!).

[datrat]

You might look into Ondasetron. It is used primarily to prevent post operative/chemo induced nausea and vomiting. It's, IIRC, solely a 5HT3 antagonist and available on-line. I believe it was originally developed as an anti-depressive/anti-anxiety agent, but was so effective as an antiemetic that it was subsequently switched to that niche and they could charge $5 per pill. Off-label it has shown some positive effects for opioid withdrawal.
"Stanford scientists identify drug to treat opioid addiction". 17 FEB 2009. Retrieved 19 FEB 2009.

[nowayout]

Clonidine (not clonopin) is often prescribed for acute withdrawal (reduces restlessness, akathisia, and anxiety by reducing noradrenergic tone). It might help post-acute as well.

[Doktor]

You might look into Ondasetron. It is used primarily to prevent post operative/chemo induced nausea and vomiting. It's, IIRC, solely a 5HT3 antagonist and available on-line. I believe it was originally developed as an anti-depressive/anti-anxiety agent, but was so effective as an antiemetic that it was subsequently switched to that niche and they could charge $5 per pill. Off-label it has shown some positive effects for opioid withdrawal.
"Stanford scientists identify drug to treat opioid addiction". 17 FEB 2009. Retrieved 19 FEB 2009.

Hmm, interesting... I don't know how I feel about serotonin being an issue for me, but sounds interesting... I don't really think serotonin modulating anti-depressants do anything for depression really though (IMO)... It looks like it also affects Acyl Choline and GABA levels though, which is worth further reading.

Clonidine (not clonopin) is often prescribed for acute withdrawal (reduces restlessness, akathisia, and anxiety by reducing noradrenergic tone). It might help post-acute as well.

Clonidine is used more to treat blood pressure spikes that occur during acute withdrawal (which - luckily - was never an issue really for me).

I'm referring more to the "lower-key" psychological symptoms which lend themselves to people relapsing after the acute withdrawal period has ended... such as depression (or at times anhedonia), GAD, lethargy, hopelessness... mostly psychological phenomena. The ideal approach I would like to take would be to emulate some of the mood/psyche modulating effects of opioid drugs, as I feel that If I could hit some of those same key areas of the brain (without resorting to MOR-Binding substances), then I could form an effective stack again'st the effects of PAWS, and lower chances of relapse/cravings.

[Doktor]

I've actually found some D-Phenylalanine on sale locally (in Canada believe it or not), but it is expensive and comes bundled with Curcumin and Boswellia (in a herbal pain relief formulation). Regardless, I am thinking of buying a bottle tonight just to get this show on the road, and begin experimenting with dosages and combined exercise/diet. Even if the effects are placebo, they're still going to better my odds of getting my shit together anyway ;P

[nowayout]

Clonidine is used more to treat blood pressure spikes that occur during acute withdrawal (which - luckily - was never an issue really for me).

...also the restlessness, akathisia (can't keep still), and anxiety. Clonidine suppresses norepinephrine, among other effects, and is also prescribed for anxiety, panic disorder, attention deficit disorder, and several other psychiatric disorders.

For this reason, it could be useful for your GAD, especially since it doesn't have the risk of addiction so many other anxiety meds have, given your history. IME anxiety is a strong motivator to fall back into opiate abuse, and can contribute to the depression, so I would definitely try to treat at least the anxiety as well as you can.

Edited by nowayout, 05 June 2013 - 11:08 PM.

[Doktor]

You're right; I was short selling Clonidine. In my experience however, it has hardly proven effective for me (I get more anxiety relief from 600mg of magnesium citrate). Also, as someone who works out vigorously at the gym, clonidine is not something I would want to take medium-long term. But thanks for bringing to light what I skipped over in regards to Clonidines effects.

In other news, I have been taking this homeopathic preparation with D-Phenylalanine in it for around 5 days now, and believe I am noticing a difference; I feel more upbeat, and the general aches and pains I would normally get in my back during this time are absent. I have a bottle of Doctors Best 500mg D-Phen on its way to me right now, and I am excited for its arrival!

Edited by Doktor, 10 June 2013 - 01:25 PM.