What Will My Doctor Do if I Tell Him I Am Addicted to Opiates and Want to Quit?

There are a number of options to help people stop opioid use and your doctor can certainly help you. Most doctors are very supportive and are willing to provide medication to reduce withdrawal symptoms and provide references for chemical dependency treatment. Remember getting off the drugs with minimal withdrawal does not really fix the addiction, it is just a stop gap measure. Therapy, support groups, and in some cases medication are effective in helping a person remain clean.

I can’t guess exactly what your doctor will do, there are a lot of options and depending on your situation certain drugs may be better than others.

Also you really are not taking a huge amount of opioids. It does not look like you are a candidate for withdrawal with drugs like Dolophine (methadone), Suboxone (buprenorphine/naloxone), or Subutex (buprenorphine). Also people typically do NOT have any significant withdrawal from taking up to 40 mg of oxycodone/day for up to a month.

When you wake up do you experience withdrawal? Most people who are opioid-dependent go into withdrawal 4-8 hours after using a drug like oxycodone or Heroin. Do you think your problem is more an issue of craving rather than withdrawal?

Typically “ancillary medications” are used for symptomatic relief of opioid withdrawal. The medications clonidine and benzodiazepine class drugs are, in general, the most effective, most studied, and provide relief for a wide range of symptoms.

Ancillary medications include-

For anxiety, agitation, hypertension, nausea, abdominal pain, muscle aches/pains
*Valium (diazepam) 5-10 mg every 4-6 hrs, maximum 40 mg/day)
*Ativan (lorazepam) 1-2 mg every 6 hours as needed, maximum 10 mg/day
*Klonopin, Rivotril (clonazepam) 0.5-2 mg every 8-12 hrs as needed, maximum 10 mg/day
*Librium (chlordiazepoxide) 10-25 mg every 4-6 hrs as needed, maximum 100 mg/day
*Luminal (phenobarbital) 30-60 mg every 8 hours as needed, maximum 180 mg/day

For diarrhoea
Imodium (loperamide) 4 mg initially, followed by 2 mg after each loose bowel motion as needed, maximum 16 mg/day

For nausea/vomiting, cramping/abdominal pain, anxiety, and in some cases insomnia
Phenergan (promethazine) 12.5 to 25 mg every 4-6 hours as needed
Atarax, Vistaril (hydroxyzine) 25-100 mg every 4-6 hours as needed, maximum 400 mg/day

For pain, muscle aches
Advil, Motrin (ibuprofen) 400-800 mg every 4-6 hours as needed, maximum 3200 mg/day
Tylenol (acetaminophen) 1,000 mg every 4-6 hours as needed, maximum 4,000 mg/day
Norflex (orphenidrine) 100 mg twice daily

For nausea/vomiting, cramping/abdominal pain, and (not for Bentyl) muscle aches and pains, excessive sweating, and anxiety
Bentyl (dicyclomine) : 20-40 mg four times as needed
**Donnatal (belladonna alkaloids/phenobarbital) 1-2 tablets every 4-6 hours as needed, maximum 8 tablets/day
**Donnatal Extentabs (belladonna alkaloids/phenobarbital extended-release) 1 tab every 8-12 hours as needed.

For overall reduction in withdrawal symptoms including anxiety, restlessness/agitation, insomnia, tachycardia, hypertension, and muscle aches and pains.
Catapres (clonidine) 0.1-0.2 mg every 4-6 hours as needed, maximum 0.8 mg/day

For insomnia
*Ambien (zolpidem) 10 mg at night as needed
*Ambien CR (zolpidem extended-release) 12.5 mg at night as needed
*Lunesta (eszopiclone) 3 mg at night as needed
*Restoril (temazepam) 15-30 mg at night as needed
*Dalmane (flurazepam) 15-30 mg at night as needed
Desyrel (trazodone) 50-150 mg at night as needed

For anxiety, restlessness/agitation, insomnia, and nausea/vomiting
Haldol (haloperidol) 0.5-2 mg every 8 hours as needed
Thorazine, Largactil (chlorpromazine) 10-25 mg every 4-6 hours as needed
Stelazine (trifluoperazine) 1-2 mg every 12 hours as needed

For anxiety, restlessness/agitation, and insomnia
Seroquel (quetiapine) 25-50 mg every 6-8 hours as needed (100 mg at night as needed)
Zyprexa (olanzapine) 5-10 mg daily as needed

Note: drugs with a “*” are controlled substances and, especially in people with a history of substance abuse, should be used for the shortest time and at the lowest dose due to risk of abuse.

Drugs with “**” are not controlled substances under American law however they do contain a modest dose of the barbiturate Luminal (phenobarbital), which alone is a controlled substance. These drugs should also only be used, if possible, short-term due to the phenobarbital in the drugs.