How to Prepare for Buprenorphine Induction at Home

Think of it as if you had a flu, go back to the time that you had no choice but to go through it. Opioid withdrawal feels very similar to how your body reacts when fighting a flu virus.

Being well hydrated is the key to making withdrawal more tolerable. Keep a glass of water at bedside at all times and keep drinking it, more than you normally would.

Stock plenty of sports drinks or fluid replacement drinks made for children (such as Pedialyte) to replace electrolytes, as well as broth or chocolate milk for easily digestible nourishment.

Avoid eating regular food for a few days and eat several small meals. Stick with crackers and other easily digestible snacks. Bananas and rice may also help.

Medications used during withdrawal to counteract specific symptoms may not shorten withdrawal but they can make it much less severe.

Over-the-counter medications can relieve most of the symptoms and you may want to make a trip to the pharmacy to purchase some medications and have them handy. You should ask pharmacist for an advice but here are examples of products that other people found helpful to relieve symptoms of withdrawal:

  • Diarrhea: Imodium, Pepto Bismol
  • Nausea: Pepto Bismol, Emetrol
  • Abdominal cramps/heartburn: Pepcid, Tums, Milk of Magnesia
  • Fever and sweating: Advil, Tylenol, Motrin
  • Anxiety and insomnia: Benadryl, Unisom, Valerian, Melatonin
  • Muscle pain and spasms: Ibuprofen, Naproxen

Other strategies people found helpful include:

  • Try to rest as much as possible (sleep it off), reduce activity, do not exercise
  • Try to meditate or try other calming activities (to reduce increased activity of the stress system happening during the withdrawal)
  • Avoid stimulant drinks (Red Bull) and products with a lot of caffeine
  • Acupuncture or therapeutic massage can reduce symptoms of withdrawal
  • Cold showers (traditional remedy for opiate withdrawal in many countries in Asia)

A Word of Caution

Though it is rare for someone to die from opioid withdrawal itself (although you might feel as if you are going to die), if you have a preexisting illness, such as high blood pressure, asthma, or diabetes, you will want to take precautions. Likewise, if you have an active infection, flu, pneumonia, or acute hepatitis, or a serious injury, going through withdrawal should be postponed or done under medical supervision. In withdrawal, the body goes through a state of intense arousal and major stress. Already weak organs may fail when stressed.

The only reason you should go through withdrawal is if you are planning to start medications to prevent relapse such as buprenorphine or naltrexone. Detoxification is very dangerous otherwise. Going through withdrawal, or detoxing off opioids, is not by itself a treatment for opioid addiction and completing withdrawal will not “cure” your addiction. A great majority of people who finish detoxing will relapse and use opioids again. However, medication decreases the risk of relapse. People who detox and do not continue treatment with medications are vulnerable to overdose. Only a small percentage die, but there is no way to tell who will fall within that statistic. Medication reduces the risk of overdose many times over.

WRITTEN BY
Adam Bisaga, MD
Professor of Psychiatry at the Columbia University Medical Center and Research Scientist at the New York State Psychiatric Institute.

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