Ana was concerned about “feeling normal” after her Fentanyl Detox. Therefore, the Coleman Network for Addiction Medicine gave her tips that helped with Post-Acute Withdrawal Symptoms (PAWS), and she started sleeping again.
Ana’s Fentanyl and Heroin Detox Story
Ana and her fiance, Dylan, showed up at our clinic without an appointment. They were worried.
She didn’t have the most straightforward detox I’ve been involved with. However, Ana powered through and, on day 6, received her naltrexone implant. Remarkably, she felt well enough to show up at her court date scheduled only 48 hours after the completion of her detox.
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Ana’s Support Person, Dylan
During her Fentanyl Detox, Dylan was Audrey’s detox support person. For 5 years, Dylan has been sober from pain medication following a series of surgeries and treatment with various prescription opioids.
Many patients who come to the Coleman Network for Addiction Medicine have been prescribed pain medication. Such as Percocet®, Roxicetv, Oxycontin®, morphine, tramadol, hydrocodone, etc., and inquire about Pain Medication Detox treatments.
Dylan knew addiction well and could relate to what Ana was now experiencing. But he never experienced an opioid as potent as fentanyl. Most drugs or pills people now buy on the street contain fentanyl. And it is much harder to detox off since it is 50 to 100 times stronger than morphine.
Fentanyl Is Causing Longer Detoxes
When I first started at the Coleman Network for Addiction Medicine 14 years ago, we could complete detox for those taking 150mg to 200mg of pain medication in 3 days. Today, with the addition of fentanyl, 5 days is the minimum amount of time for an Accelerated Detox.
We also find that sometimes patients respond better with a 6 to 7 detox program. We find ourselves basing the treatment length on how well our patient is doing for fentanyl is hard to quantify. But, I don’t remember patients taking longer than 8 days to complete a detox involving fentanyl.
Post-Acute Withdrawal Symptoms (PAWS) for Fentanyl Detox
The most significant short-term challenge Ana was facing was that she could not sleep. Dylan told me that she hadn’t slept more than an hour since completing our outpatient detox program. It was affecting her job and wedding planning. Not to mention the legal case she had against her former employer.
Something we go over with our patients is how to be prepared for Post-Acute Withdrawal Symptoms (PAWS) and what they can expect. In some cases, we prescribe our comfort medications at the beginning of their detox and add extra, expecting them to need extra help when they go home.
Presumably, during and after detoxes, 2 of the most challenging things someone deals with are lack of energy and trouble sleeping.
In my experience, when a patient stops taking a drug, they may encounter the opposite effects. Opioids increase the brain’s dopamine levels more than the brain can produce, which results in bursts of energy. Therefore, patients will likely experience lethargy, fatigue, and insomnia as the opposite effect.
I heard a podcast interview recently with a Stanford Addiction Psychiatrist, Dr. Anna Lembke. In her book, Dopamine Nation: Finding Balance in the Age of Indulgence, she reinforces everything that we tell our patients: You will get through this. Promise.
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Feeling Normal After Fentanyl Detox
Based on the type of drug, medical or psychological conditions, and the amount and length of time a person has been taking it, I cannot give a precise detox timeframe for everyone. However, within 2 weeks to a month, most patients start to feel normal again. Complete dopamine restoration can take several months during the most challenging cases.
The most important thing we tell our patients is that they can commit to being abstinent. So their brain can return to homeostasis or its baseline.
More like this: Is Recovery Possible For Fentanyl Addiction?
Post Detox Support with the Coleman Network
At the Coleman Institute for Addiction Medicine, we understand that the brain may take several months to achieve normal dopamine levels, but it will happen. Therefore, we regularly prescribe medication to help patients who complete our Fentanyl Detox programs navigate this trying period.
Initial post-acute withdrawal symptoms (PAWS) occurring after a Fentanyl Detox can be difficult. And we believe that it’s beneficial for our patients to acknowledge this going into a detox program. Fortunately, they shouldn’t experience the painful symptoms of a cold-turkey withdrawal similar to having the flu. Instead, with PAWS, someone may experience anxiety, insomnia, restlessness, and possible stomach irritation.
We believe that this is an opportunity to practice self-discipline and push through it.
Help from friends and family, support groups, and counseling during this time is highly beneficial.
More like this: Taking the First Step in Your Recovery Journey
Helping Ana Sleep
When I spoke to Ana and Dylan, they let me know that she was not taking the additional comfort meds that we had given to her since she went home. She told us that she didn’t like to take pills even though she sought treatments for using fentanyl and heroin. I spoke with her about how if she took a sleeping aid on a short-term basis, it would help her get more than an hour or 2 at a time. After our conversation, she felt hopeful.
Ana had a follow-up phone call in a few days to see how she was sleeping and ensure she didn’t have any other issues. During her follow-up call, Ana let me know that her PAW symptoms were getting better, but she still couldn’t sleep more than 4-5 hours at a time.
I asked her a list of questions to try and get to the bottom of her sleeping issue and prescribed her an alternative sleep medication:
- How close to bedtime was she eating?
- Was Ana getting any physical exercise?
- Was she completely blackening her room at rest?
- How much caffeine was Ana consuming?
- How much was screen time happening before bed?
I gave her some non-pharmaceutical tips to assist Ana in getting longer and more restful sleep.
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Treating Fentanyl Addiction at the Coleman Institute
Situations like Ana’s often remind me of the quote, “To create one’s world takes courage,” by Georgia O’Keefe.
Ana dared to break the cycle and live a life free from fentanyl and is continuing to improve with her new life.
At the Coleman Network for Addiction Medicine, we provide a more comfortable, safe, and affordable outpatient Fentanyl detox. To help people detox off fentanyl or opioids, we have specialized in using long-acting naltrexone for over 25 years.
Contact the Coleman Network for Addiction Medicine today if you are ready to ‘create your world’ and remove fentanyl from your life. Let’s take the first step together.
In the meantime, stay safe.
Joan R. Shepherd, FNP