QUESTION: Could you share some of your experience concerning how to detox patients from opiates?
ANSWER: Rapid detox from opiates is tough and I’ve seen it take a year for the symptoms to abate in chronic users. The first to clinical step is to stabilize the dysautonomia caused by the S-P shift from the opiates. During opiate use the parasympatholytic effect is strong and when the drug is gone it rebounds heavily and the sympathetics can’t regulate. Treat symptomatically, if necessary, but support the adrenals and nervous system. Then there is the receptor rebound at the kappa-mu level, which is tough to treat. Low dose naltrexone can help, high dose melatonin (a-la cancer treatment levels (20mg) is good, and QID dosing of l-Theanine (200-600 per dose then ramp down). Neurosteroid support (Progesterone or pregnenolone ) is a big deal too.
IV therapy to consider:
Opiate support is tough, but what I have found is neuro-stabilization is most helpful as well as high antioxidant Tx. Alternating 25-50 G IVC one time with a Vit-Min followed by GSH then some PTC are quite useful for people trying to decrease their oxycodone intake, for example.
They should be on bowel tolerance oral C [the observation in Heroin w/d is that doses can reach 20 gm a day] and lots of B-Vits but especially B-5 at 1 Gm BID-TID and P5P at 100 MG TID for a while. Niacinamide with each meal (1-3 gm) is a good help. Then time, and keeping them from re-using.