Personal stories are really important when it comes to drug withdrawal and addiction treatment. Each individual’s circumstance is affected by and affects his or her drug use and recovery. Here’s an interview with someone who started experimenting with heroin in his teens and became an addict in his early 20s. He’s now 40 years old, a heroin-free junky on methadone. Here’s what he has to say:

What can people expect when they experience methadone withdrawal?

They can expect to be—at the very least—very, very uncomfortable for at least 30 days.

Define “uncomfortable.”

No sleep. You’re not going to sleep for 30 days. You’re not going to eat. You’re going to feel like you’re going to die. You’re going to hallucinate. You’re going to, really pretty much feel like you’re about to die at any moment.

How many times have you gone through a methadone withdrawal?

One, two, three…four…. Four times.

Have you ever done a medical detox off of methadone?

No.

So you kicked “cold turkey”?

Uh-huh. Two times. But the dose was really low. The dose was like down to 8, 8 milligrams, and even that felt like, you know, something harder than I ever did before because I didn’t sleep for like three weeks straight off of that alone, 8 mg. But I didn’t feel the, you know, the flu-like symptoms but I suffered from the insomnia and anxiety part of it, where your legs are twitching.

If you detoxed four times and twice “cold turkey,” how did you detox the other two times?

I went right back. I’m talking about, I got arrested for a parole violation, and it took six working days to get let out, and I went five of those six days off of an incredibly high dose because they don’t give you methadone in San Quentin. That happened twice. The first time I was on 220 milligrams and the second time I was on 110 milligrams.

Why do you take methadone?

I take…. Well, at that time, I took 120mg a day at the clinic, on maintenance and I have a prescription for 100mg a day from my doctor for pain. The second time I got violated, arrested for a parole violation, was only two months after the first time, and it was so bad the first time that I had started to go down on my maintenance dose at the clinic. On my own, I had cut down my pain prescription so I was already kind of sick when I got arrested.

Did you get arrested for drugs? Were you trying to buy something because you were sick?

No. I got arrested because I’m on high control parole. I had a chain on my wallet and they call that a “dangerous weapon.” Plus I tend to talk loud when I get excited about something and he [the cop] took it as I was yelling at him. He had a rookie cop with him who said, “You’re going to let him talk to you like that?” He later told me that if I hadn’t done that he would have let me go.

Bad day.

Yeah, I was sick and I didn’t feel like getting f*cked with when I was just walking to the corner store. But I mean, I’ve been in San Francisco for 20 years and the cop stopped me because he knows me. We’re not, you know, exactly friends. I wasn’t doing anything wrong but “high control” means they can come in your house, stop you anywhere, anytime, search you, whatever. Not to say I deserved it that day but being on parole, you know, your rights are limited.

Sounds like it’s a precarious situation. You could get picked up anytime.

Yeah.

Do you ever think about getting off methadone completely so that you won’t have such a hard time in withdrawal if it happens again?

No.

Why not?

Because…I don’t know. I’m more or less gambling with it.

So being on methadone is worth the risk of a nasty withdrawal?

Yeah. If the end result of the methadone is to stay out of prison, yeah. The reason I’m taking methadone is so I’m not using heroin. And if I was using heroin, I’d have to pay for it and I would more than likely be committing crimes to pay for that heroin and I’d be back in jail regardless. So by being on methadone, it’s satisfying that part of my head that needs to take something but it gives me room to function and maintain a normal, somewhat normal lifestyle.

Have you ever considered Suboxone?

I have. I have to be on a much lower dose of methadone to do that and right now I need to stay at least at a blocking dose. I’m not going to rush it. Methadone has given me a chance to get off heroin, off the street, out of prison. I’ve got a family, a wife and kid, a job. I’m not going to risk losing that by going too fast or detoxing too quickly off methadone before I’m ready. I’ve seen Suboxone work really well for some people, and maybe one day I’ll be one of those people. Getting away from the methadone clinic is a big step for someone like me. You go down there, you see all these people you know. People offer you free this and that, pills, heroin, speed, whatever. You hear about who’s doing what, you know, what’s going on. Suboxone lets you get out of that world, fully commit to making a new life. So it’s good. But one step at a time….

Lortab, a combo of hydrocodone and acetaminophen like Lorcet, Norco and Vicodin, seems to be a supplemental drug of choice for those addicted to OxyContin and other oxycodone derivatives. Note: I have met a handful or two that somehow stumbled onto Lortab without realizing the addictive effects and ended up “strung out,” but more often I hear people say that they are addicted to other drugs and then couldn’t keep up with their body’s tolerance and so supplemented with Lortab.

Either way, this stuff is scary. A look at HealthBoards.com shows just how many people are struggling with their Lortab addiction. The side effects alone are devastating—blurred vision, nausea and vomiting, constipation, dizziness, fatigue—but on the other hand, withdrawal is so much worse. Constipation turns into stomach cramps and explosive diarrhea. Fatigue becomes overwhelming weariness but combined with involuntary leg movements and restlessness that amount to insomnia that is miserable. The intense craving for the drug combined with the irritability and vomiting, profuse sweating and overall achiness make this and every opiate withdrawal an absolutely miserable experience, one that makes the side effects look good.

A fear of withdrawal keeps a lot of people away from attempting to get clean, and it doesn’t have to be that way. While it’s uncommon for methadone or LAAM maintenance treatment to be prescribed for prescription painkiller addiction, it may be a possibility depending on where you live and what the regulations are. However, a more convenient option might be Suboxone and Subutex, the two pill forms of buprenorphine, a drug that is also an opiate but is reported to have fewer and less severe side effects.

The way it works is this: you stop taking the Lortab immediately and take Subutex for the first couple of days. After that, you take the Suboxone. You may choose it as a maintenance measure, taking as long as you need to detox. Or you may opt to slowly cut back on the drug at a measured rate so that you can be drug-free, sometimes in as few as six weeks.

Why take lower and lower doses of Suboxone instead of Lortab? Suboxone is reported to shorten the length of the detox and mitigate the withdrawal symptoms. Also, though getting high is rarely even a possibility for those who are using the drug to supplement another pain pill addiction, Suboxone definitely doesn’t have as much of an effect in that area, especially if you have a high opiate tolerance.

If you’d like more information on the effects of Lortab, why it’s prescribed and what to expect while you’re taking it, check out MedHelp.com.

I was reading the Diary of a Quitter the other day and I was struck by her honesty. Now a great many of her posts pass along the inspiration that she has come across in her reading, through other blogs, from therapy, friends and other sources of support and these are great and helpful in her own way. But when she admits as she does in her posts “Hard to Fight It” and “The Honeymoon is Over” that recovery is not all pink clouds and happy reclamations of life, love and happiness.

She says: “Those first few months after I started Suboxone treatment were filled with the excitement of doing something new, plus the motivation of desperation. Now, the newness has worn off and I’m left here with myself and my habits and no easy way out.

“So it is time for me to recommit myself to this process of healing. This point, right here, is the point where I usually quit. Where the inspiration has run out and the goal is still out of sight, I give up. I start in with the self-sabotage, craftily stirring up some kind of drama so that when I do quit, it looks like events have conspired to foil me, once again.”

Even though Suboxone promises the instant gratification of renewed mental clarity (that you may not have even realized that you lost during your prescription painkiller addiction), it has no cure for that plateau that happens to all of us a few months or, for some, a few weeks into a new venture. Call it boredom, call it depression, call it fatigue. There are so many reasons why we give up. It’s being honest with ourselves and recognizing our patterns, our triggers and the emotions that preclude a relapse that help us to fight them. By not giving in, by distracting ourselves until the feeling passes, by recognizing the seriousness of the situation and choosing not to use right now, today, and making the same decision when tomorrow comes, we can get through these feeling when they come and go to sleep each night knowing that this is ongoing process and that it doesn’t have to overwhelm us, that we have the choice to get through it the best way we can, no matter how that is.