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Many people struggle with withdrawal symptoms even after their initial 90 days, which is the typical period of time to expect withdrawal symptoms. As a person's substance use moves further into the past, they may not initially notice that they still have some issues. However, many people struggle with PAWS in their first few years of recovery, especially if their drug of choice is an opioid. Without understanding the cause of their symptoms, it can be very frustrating and even detrimental.
Post-acute withdrawal syndrome (PAWS) is a term used to describe persistent withdrawal symptoms that occur after the acute withdrawal period has ended. While people who use any substance may struggle with PAWS, it's commonly associated with opioid use. It can last for months or even years after an individual has stopped using opioids. PAWS can significantly hinder recovery and long-term sobriety without education and treatment. It can be incredibly frustrating for a newcomer to recovery to cope with PAWs for months or even years into sobriety.
Opioids are highly addictive substances that can cause physical dependence. People who use opioids regularly have a body that has adapted to the presence of the drug. When they don't have it regularly, they can experience intense withdrawal symptoms. The acute withdrawal period typically begins within a few hours of the last dose. It can last for several days to a week. Symptoms of opioid withdrawal can include muscle aches, agitation, anxiety, insomnia, and abdominal cramps.
PAWS occurs after the acute withdrawal period. It is diagnosed by persistent symptoms such as fatigue, irritability, anxiety, depression, and sleep disturbances. These symptoms can persist for weeks, months, or even years and can be challenging to manage. Additionally, PAWS can increase the risk of relapse, as some individuals may turn back to using opioids to relieve their symptoms.
Effective management of PAWS is crucial for long-term recovery from opioid addiction. Treatment options for PAWS may include medication-assisted treatment (MAT), behavioral therapies, and holistic approaches such as nutrition and exercise. Individuals in recovery need a healthcare professional or addiction specialist to help develop a personalized treatment plan that addresses their specific needs and helps to support their journey to long-term sobriety.
Many treatment centers provide a holistic approach to treatment and recovery. However, nutrition can be essential in post-acute withdrawal syndrome (PAWS) and recovery from substance abuse. Here are some ways that nutrition can help:
1. Replenishing nutrients: Substance abuse can deplete the body of essential nutrients, and a healthy diet can help to replenish these stores.
2. Stabilizing blood sugar: Substance abuse can cause fluctuations in blood sugar levels, contributing to cravings and mood swings. A balanced diet that includes complex carbohydrates, healthy fats, and lean proteins can help to regulate blood sugar and improve mood stability.
3. Supporting the brain and nervous system: The brain and nervous system are particularly vulnerable during recovery, and adequate nutrition is necessary for their proper function. Consuming foods rich in vitamins and minerals such as B vitamins, omega-3 fatty acids, and magnesium can help to support the brain and nervous system during recovery.
4. Boosting energy: PAWS can cause fatigue and lack of energy. Proper nutrition can help increase energy levels and support overall physical health.
It is important to note that everyone's nutritional needs are different. Therefore, consult a healthcare professional or registered dietitian for personalized recommendations if you suffer from any health condition.
A healthy lifestyle is essential for sobriety. Living with PAWS means taking care of yourself and learning to cope with life, even when you experience symptoms of it.
Many people experience PAWs and find relief with assistance. If you or somebody you love is experiencing longer-term anxiety, cravings, sleep issues, or other symptoms, it's essential to seek help. A medical professional can help rule out other disorders as well.
Many people in recovery also live with mental health disorders, which may have previously been masked due to substance use. Both of these disorders can cause challenges for people in recovery. You deserve to be treated for all your illnesses and live your best life.
Therapy and treatment groups can also help you work through the challenges of PAWS in daily life.
If you're looking for a sober housing situation that offers support, structure and community, our houses may be for you! We offer a safe environment in a vibrant, thriving recovery community. Call us to learn more about your options.
Xylazine, a drug called “Tranq dope”, is being found more frequently in drug seizures in San Diego. For the people who use this drug, there are new dangers. It’s often found in fentanyl and is also used as an additive in other opioids like heroin. It’s a disturbing new challenge for people trying to overcome opioid use disorder.
In recent years, xylazine has been found in large drug seizures across the US. Usually, it is added to drugs such as heroin or Oxy. While few overdoses on the West Coast have detected the drug, San Diego authorities say xylazine has been found in seized drugs 23 times in the last two fiscal years between San Diego and Imperial counties. While this isn’t indicative of widespread use, it’s a growing pattern that concerns authorities.
On the East Coast, including Pennsylvania and Rhode Island, xylazine has quickly established itself as a drug of concern, added to drugs like fentanyl to create a more substantial buzz. Just like fentanyl, it’s being added to other drugs without people knowing. More than 40% of street drug samples tested in Rhode Island contained xylazine, according to recent research.
Xylazine is a drug that has never been approved for human use. Its main purpose is the sedation of large animals such as horses. It is technically a muscle relaxant for horses. In the past few years, the drug has been making major headway on the East Coast, where it is added to other drugs. It has been found in heroin, fentanyl, and cocaine.
The sedation caused by it can lead to an overdose death. If a person who has taken fentanyl also has taken xylazine, it may be much harder to reverse the overdose. Naloxone, an opioid-overdose reversal drug, does not work in reversing xylazine toxicity. The person who overdoses may have the opioids reversed but not wake up. It can cause coma and death when a person overdoses on it.
Xylazine is a drug that is still being understood in the medical community. There are a few things that the DEA has told medical providers about it, such as the fact that the “high” starts within minutes and lasts for hours.
Inside a person’s body, it relaxes muscles by decreasing the release of norepinephrine and dopamine in the central nervous system. It has a profoundly sedating effect.
People high on xylazine may experience blurred vision, low blood pressure, and sleepiness/drowsiness/nodding out. It can cause hyperglycemia (high blood sugar) and can be dangerous for people with medical conditions affected by blood sugar.
Xylazine can cause skin disease. People often end up with painful, easily infected skin ulcers when they’ve taken a drug containing it. The wound usually isn’t in the same place they injected it and can still occur if they didn’t inject it, making it a hazard for all accidental users.
On the East Coast, especially in places like Pennsylvania, where xylazine use has become endemic, users have become addicted to the drug. This means they only seek out opioids containing it. When they decide to get sober, this adds an extra challenge because they will typically experience withdrawal symptoms that Medication-Assisted Treatment can’t suppress. Treatment centers are still learning to cope with the challenge but are ready to help anyone who wants to get sober, regardless of the challenges. Medications still exist to help minimize withdrawal symptoms.
If you or somebody you love is looking for a sober living situation, we're here to help! Our sober homes feature community, safety, and structure as you learn to live life on its terms. Everyone deserves the opportunity to stay sober. Give yourself a chance and learn about our programs by calling 760-216-2077.
Coping with the youth fentanyl overdose crisis has been scary. California has experienced a flurry of fentanyl-related overdoses within high schools. The dangers are real enough tschoolshool are going to be required to keep Naloxone, the opioid reversal drug, on hand by law. This new law aims to tackle the epidemic of fentanyl overdoses.
California recently passed Assembly Bill 19, requiring schools to keep the lifesaving drug naloxone on hand in case of accidental fentanyl overdoses. Unfortunately, high schools around the country have been experiencing this. In October, a student overdosed at a Los Angeles school during regular class hours. A few weeks later, Prince George's County, across the US, Maryland suffered a string of overdoses in public high schools.
California, in its quest to slow and end the opioid epidemic, is trying to tackle every angle. The new law would require schools in California to have at least two doses of emergency drugs such as a naloxone inhaler or canister. However, two doses may not be enough if a student overdoses on pure fentanyl. Most students who have overdosed don't even realize that their drug could be tainted, and their bodies can't handle
Fentanyl has been found in all street drugs, from cocaine and meth to Oxy and heroin. However, prevention of overdoses starts with education, and there seems to be a deficit when it comes to kids understanding the dangers of tainted street drugs.
No one wants to think of schools as a place where young possessing drugs. But that has always been the reality, regardless of the measures schools and local law enforcement take to prevent it. Many students who overdose don't know what they are taking- California is flush with fentanyl and counterfeit pills.
Schools are a place where drug education and mitigation can take place. But they are also where kids sell and swap drugs in their spare time. Adding naloxone to schools to prevent overdoses was a bipartisan measure with little opposition. The issue will come down to funding and costs. Fentanyl can be costly to keep in stock.
California has had trouble funding other programs that help with opioid use disorder. There have been wait lists for supplies of naloxone, an opioid-overdose reversal drug that can help save lives. It's recommended that anyone who uses opioids or takes them regularly should keep a supply of Naloxone on hand in case of accidental overdose. This means that schools will havesavekeep a steady supply and money will be needed.
Fentanyl is a threat to all high schools and junior high schools. Young people frequently experiment with drugs without knowing the hazards. Naloxone will be required on all of the more than 10,000 K-12 campuses in California once the bill is signed into law. Implementation would begin with middle and high schools.
Some larger school districts in Los Angeles, Sacramento, and Fresno already stock naloxone, but for the plan to succeed, the state must fund the initiative. Naloxone can be expensive, especially when it needs restocking.
Legislators also want to be able to offer schools naloxone training, opioid abuse education, and fentanyl education. Many young people don't know about the dangers of street drugs when it comes to fentanyl. Adding education to student health classes can help save lives.
If you or somebody you love is interested in sober housing, we're here to help. We offer a safe, tight-knit community focused on recovery and moving forward in life. Give us a call to learn more about our sober living programs at 760-216-2077.
Months ago, California was part of a historic lawsuit win against pharmaceutical companies and their distributors. A large payout was allocated to the state after four companies - Allergan, Endo, Johnson & Johnson, and Teva – were ruled to have used false and misleading marketing to push massive amounts of the addictive drug, Oxycontin onto the public.
Early this month, the results were reversed. A state judge in California ruled that the companies cannot be held liable for the raging opioid epidemic; it was simply too much of a reach to hold them responsible using a public nuisance law.
Many Californian counties needed the lawsuit money; they had already planned on how they would spend it. For example, San Diego County would use it to invest in more treatment centers and other public health initiatives.
Much of the money was also slated for opioid addiction training and prevention initiatives. Now, there may not be an expansion of treatment opportunities for people who need them.
Many people are still able to get treatment, even if it’s not what they envisioned. Medical can help people get on waiting lists and get coverage when a bed is available. People with private insurance companies tend to have better options.
Addiction treatment is an integral part of healthcare, but there will still be limitations without new funds. The pandemic also has brought new challenges as well as healthcare delivery options. Some people find that therapy and groups online make treatment available almost everywhere.
Many people find that a sixty or ninety-day inpatient program benefits them, but they’re not ready to return to everyday life right away.
Sober housing options are still available for people who need aftercare and support as they live life on its own terms daily. Sober housing provides an intimate, recovery-focused environment where you can focus on your wellbeing.
If you or somebody you love needs structure and support in their living environment, recovery housing is an option. Call us to learn more about how it works at 760-216-2077.
The addiction crisis is raging in San Diego during the times of the COVID-19 pandemic. Like many parts of the country, addiction rates have seen an uptick due to isolation and other stressors of the pandemic. San Diego has lost an average of three people a day to overdoses.
In 2020, the County reported 457 fentanyl-related overdose deaths, but not all opioid deaths are from fentanyl, and not all opioid deaths have yet been counted. A total of 722 meth users were lost to an overdose last year, up from 546 the previous year. A large number of prescription drug users – 576 – were lost to overdose as well.
All of these numbers are startling. In recovery, there have been many anecdotes of people with long-term sobriety relapsing. Relapse doesn't have to be a part of your story, even if you're struggling. And even if you DO relapse, you are welcome back to recovery with open arms.
Of course, life has been difficult for people of all walks of life during the pandemic. And for most of us, it’s not over. People who live with addiction especially need support during these times. Staying connected to other people in recovery can help you stay sober and sane.
San Diego offers many opportunities for recovery for those who embrace them. 12-step meetings, therapy online, and even peer support groups are incredibly valuable for people in recovery.
The Harm Reduction Coalition of San Diego County is one example of an organization that uses state grant money to help reduce the harmful dangers of addiction. They offer needle exchange services and the opioid-reversal drug, Narcan, to drug users to help them stay safe.
Harm Reduction Coalition of San Diego also offers fentanyl test strips, wound care, education, and referrals for healthcare.
Are you a recovering addict or alcohol looking for a sober living situation that offers recovery and stability? Sober living situations offer structure and independence as you learn to live life on its terms, without substances.
Living with others who have the same goals and similar challenges can help you continue to grow in recovery. Structured support will help you stay centered. You’ll also find community and camaraderie in daily living activities such as cooking, doing chores, or even taking time together to go bike riding or strolling on the beach.
Many people who are looking for aftercare choose sober living as their next step.
Learn more about sober living opportunities by giving us a call at 760-216-2077.
For the past several years, there has been a lot of interest in the wellness community about an herb sold online called Kratom. Kratom is a drug that has been used for centuries in Southeast Asian countries for various reasons. The most notable of reasoning has been as a "substitute" for opiates. Because of this, many people who are desperate to quit opioids turn to this drug to help them ease their withdrawal symptoms. Unfortunately, this quick fix isn't a fix at all; the Food and Drug Administration has received reports of similar withdrawal symptoms when a user tries to quit taking Kratom.
Kratom is a green powder supplement that has been sold as a sort of snake oil online. People have claimed it can boost their energy and moods, kill pain, and even fix their opioid withdrawal symptoms. All of these short-term effects are possible, but that doesn't make the supplement safe. Kratom is an unregulated drug that has been outlawed, in fact, in some Asian countries due to its similarity to opium.
Kratom is a quasi-legal substance, according to the FDA. They have already halted the drug's importations due to a lack of evidence that it has value as holistic medicine. People usually administer Kratom by drinking it as a tea or putting the powder into capsules they can swallow.
Long-term users anecdotally will describe the need for more Kratom to get a similar effect as before. This is evidence that people who use Kratom build a tolerance to the drug similar to opioids. Some people who try to quit Kratom have what is described as a "rebound effect." They feel much worse when they are off of it than on it. If they took Kratom for anxiety, for example, they might discover that without Kratom, they feel worse than they did before when they're anxious.
People also have reported that they have gone through withdrawal when ceasing the use of the substance. According to Poison control centers in the United States, seven infants were exposed to Kratom and were hospitalized. Five of these children experienced withdrawal effects when the Kratom left their system, suggesting that it is powerfully addictive.
Other side effects from Kratom include liver damage, trouble breathing, muscle pain, chills, vomiting, nausea, and constipation. All of these symptoms are similar to opioid withdrawal symptoms. More troubling effects reported by Kratom users included dizziness, hallucinations, paranoia, and delusions during use or withdrawal.
Due to these issues, Kratom use is not recommended by medical professionals or the addiction recovery community. If you or a loved one need help to get clean from opioids, there are safer, more recovery-affirming options available. Don't trade one addiction for another.
Staying sober can be difficult during these times. A sober living home can help you stay focused and grounded as you start your new life in sobriety. Make friends and learn to live life on its terms. Learn more about your options by calling us at 760-216-2077 to learn more about our residence, amenities, and recovery activities. We're happy to answer any questions you may have.
A recent letter to the Acting Director of Health and Human Services in the Biden administration urged action for expanding the availability of Medication-Assisted Treatment through the Office of National Drug Control Policy. This comes on the heels of Biden suspending the former administration's OUD (opioid use disorder) guidelines.
In response to a recent retraction of Trump guidelines, the letter announced on January 27, 2021, was written by the American Academy of Addiction Psychiatry (AAAP) and signed by representatives from seven representatives with over 150,000 members and 2200 treatment centers. The Biden administration recently decided to withdraw the previous administration's Practicing Guidelines for Administration of Buprenorphine for Treating Opioid Use Disorder to update them and provide better access.
The letter from AAAP implored the Biden administration to expand access to science-based medication. Buprenorphine, methadone and naltrexone are all medications that have been proven to help people get and stay sober.
Medications that help people addicted to opioids are crucial in assisting them to avoid the compulsion to use. Buprenorphine and methadone help people prevent painful and challenging withdrawal symptoms.
For many treatment programs, the idea of medication carries a stigma. Because of this, it's vitally important that more doctors are educated about how MAT works and how it should be administered. Many medical professionals have felt uncomfortable prescribing it because of a lack of education.
Opioids are notoriously tricky to cease using due to the problematic withdrawal symptoms they cause when a person quits using.
The letter for AAAP also says that the Biden administration needs to begin a focus on opioid addiction prevention. They say that this means requiring all prescribers of opioids to be taught about opioids dependence, addiction, and withdrawal.
Preventing opioid addiction is the best long-term strategy for ending the opioid epidemic. It's unclear what path the Biden administration will decide to take regarding new addiction recovery health policies.
Sober Living San Diego
Do you or somebody you love need a space to get back on your feet now that you're sober? Our homes are bright, cheerful, friendly homes with both community and structure to help you stay on your path to recovery. We have a lot to offer our residents! Give us a call at 760-216-2077 to learn more.
- By Philip, Milgram, MD
Worry, fear, boredom, anxiety, loneliness, escapism, insomnia; these are the emotions that plague our society. The plague that is COVID is making these human imperfections more frequent and more pronounced. There are healthy effective ways we can not only deal with these feelings and situations. But it is human tendency to take an immediate and effective way to escape: The Devil’s Drugs. They are readily (too readily) available. There is easy access to someone who can promise you the gates of heaven. You are invincible. And you want it now. From a friend or family member who has some. Or from a prescriber who will prescribe, sometimes inadvertently but often as a legitimate dealer. Hey, maybe it‘s even covered by your insurance. Maybe you know somebody who knows someone who can get it for you in a park or a parking lot. Trust me. You are not invincible. These are not your grandparent’s drugs. These synthetic drugs have a high addiction potential. I don’t think they should have ever been released to the public, like Quaaludes. You give these drugs to a thousand white mice…and a thousand whit mice will be pushing that button for more. Physiologically, we are not dissimilar from a white mouse. They use these same white mice to test the drugs and extrapolate to human consumption. WE WANT MORE OF THAT!!
These drugs cause what is known as hyperalgesia. Let’s say you stroke the hairs on your arm with a feather. These drugs make a stimulus that would be a tickle or an unpleasurable event and convert it to pain. What do you do? I WANT MORE OF THAT!!
Then you develop tolerance to the drug. Until you rapidly, sometimes within days, need more to get you to that place where you want to be. And you then know. I NEED MORE OF THAT!!
We have been very successful treating alcoholism and drug addiction to heroin, opiates with our innovative and experienced team and the magical molecule of NAD+ (Nicotinamide Adenine Dinucleotide), which detoxifies and fixes your brain, relieving withdrawal symptoms and cravings with much greater regularity than your neighborhood rehab center. But these are The Devil’s Drugs. And they require an all out and effective therapeutic approach to avoid the gates of hell; loss of you job, your family, your money, your home. And finally you lose yourself and then you lose hope. Benzodiazepines (Xanax, Klonipen, Ativan, Ambien and the sort) are not a good solution. You solve a problem by creating another problem. But prescribers too readily whip out their prescription pads to give you a stopgap that may be as bad or worse than the original problem. Please don’t take Kratom either. Often the addiction to Kratom is worse than heroin. Unfortunately, it is readily available and touted as “natural”. When you are addicted to Kratom, you may be suffering such terrible withdrawals that you have to use through the night every two hours.
The best way to avoid this whole situation is to not allow these drugs into your body. Avoid them all-knowingly because I have here told you of their power, their danger, and the high percentage for your physiologic tendency as a normal human being to succumb to the power of these drugs. But it is human tendency to think you are different, stronger, better, even invincible. I WANT TO FEEL IT, NOW!!
We have an alternative therapy here in Carlsbad, with the magic molecule (NAD+) that is already present in every living animal and plant cell. And that the body naturally uses to detoxify, heal, pump up immunity, and create new neural pathways that results in less cravings, less withdrawal symptoms and a high degree of long-lasting sobriety, health, longevity and wellness. We help restore restful sleep, use additional therapies, and get you on the road to a new life free from the influence of these drugs.
NAD+ is the magic. There is an art to the administration of it—starting with the best NAD+. Then there are therapies that enhance and propagate the NAD+ effect. Then, once off the drugs, you need to deal with the emotional, physical, depression, anxiety, any underlying mental disease, situation, and establish an ongoing program of healthy nurturing lifestyle.
There is such a thing as recovery, let us show you.
Phillip Milgram MD
