Speaking as someone who went through it, with an addiction to painkillers and poppy pod tea, you're mostly accurate, but I would say you're underselling the longer-term psychological damage.
There's acute withdrawal, which is the hellish stage of symptoms that feel like the worst flu imaginable times a thousand, cold sweats, hot sweats, constant diarrhea, crushing depression, restless leg syndrome, the inability to sleep, and of course mind-shattering cravings.
That can last anywhere from two days (for someone whose habit was very small and short term), to several weeks for people who have been abusing for years.
But after that comes the post-acute phase, which is actually more dangerous in some ways. That's when the brain, accustomed to having its receptors flooded with opioids but no longer getting them, goes haywire and ushers in unfathomably deep depression.
During this stage, people get suicidal. If they're not in a treatment program, they are almost guaranteed to relapse. Likewise, a person in that stage of withdrawal is not going to be useful, a clear thinker, or very motivated to do things like Nick's been doing.
So no...FTWD has not been accurate at all in its portrayal of addiction. First of all, it didn't even hint at the incredibly pain of withdrawal. Secondly, it ignored the post-acute withdrawal phase.
But more than that, the show makes it look like someone can go through withdrawal and be cured of the issues that led them to become an addict in the first place. It doesn't work like that. You have to put in the work to address those issues, which is why any legitimate recovery program has a therapeutic component -- group meetings, one on one counseling with psychologists, etc.
I've been clean for more than six years and I still see my psychologist once a month. He is an addiction specialist. Maintenance is important, and I've found that groups like AA are not good places to be, at least for me, because 1) Not everyone is their of their own will. The people who are court-mandated, or attending because a family member or spouse gave them an ultimatum, are not serious about stopping their drug habit, and that's not something I want to be exposed to at this point in my recovery. 2) AA meetings and other drug counseling groups are, unsurprisingly, among the easiest places to score drugs.
Breaking Bad didn't make that storyline up involving Jesse -- drug dealers can and do take advantage of those meetings by selling afterward to the people involved.
This is why its always best to gradually taper down and/or use an opiate replacement drug such as methadone or suboxone. Over the years I have visited numerous clients recently arrested and sometimes their withdraw is so severe that their court date had to be postponed a week or two just so they can sit through their preliminary exam without puking.
The only incarcerated defendants who will receive methadone in my state are pregnant women who were on a methadone/suboxone regiment legally prescribed and under the care of a license physician prior to being arrested. Even then the amount they receive is the bare minimum and for the sake of the baby not the addict.
The worst place in the world to kick a serious opiate habit is in the holding tank or even a one man infirmary cell and I wouldn't wish that on anyone other than a terrorist who are usually smart enough not to commit a felony while they have a severe habit.
No joke, it can take years to properly taper down with Suboxone or methadone. I don't even know why methadone is still a treatment option when Suboxone is so much better.
The crucial thing about Suboxone is that it does not get people high. All it does is flood the receptors without triggering any of the euphoric effects of "regular" opioids.
That means an addict immediately starts to feel normal, the way they felt before they were an addict, and THAT is why it's so good at helping people get their lives back together. The cravings are gone, the worries about scoring are gone, it allows addicts to cut off "friendships" with drug buddies and dealers, and it helps them reintegrate into the real world.
Within a month of induction on Suboxone more than six years ago, I got a very good full-time job, started dating a good girl who was not in any way involved with drugs, started doing the fun things in life again, and was well on my way to repairing my relationships with family and friends.
The only advice I'd give to people looking at Suboxone is to look at a good opioid equivalency chart, preferably with the help of a knowledgeable physician, and make sure your induction dose is appropriate for your habit.
In other words, if your habit was 400mg of oxy daily, then it makes sense to induct on 4mg of Suboxone. But if your habit was 100mg of oxy or morphine, or even Vicodin, your induction should be 1mg or 2mg at most.
The reason is that it's a lot easier to taper down from 1mg than it is to taper down from the insane 16mg or 8mg that people are given to start with.
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sevenlilxenos
8 years ago
xy, In your opinion are the doctors and clinics intentionally over prescribing methadone/suboxone just to string the patient along and keep him (and his health insurance money) around as long as possible?
I've heard this complainant more than once.
Also, I've tried to find a conversion chart for methadone vs suboxone without much luck. The nearest I can figure as a starting dose 40mg methadone = 4 mg suboxone. Does that sound about right?
Would you agree if a patient wants to switch from methadone to suboxone, as you seem to suggest is better, they should detox as much as comfortably possible before they go cold turkey from the methadone for 72 hours pre-induction of suboxone?
Again, I've heard, but don't personally know that you must be clean of all opiates, even methadone, before starting suboxone or you will get very sick.
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