Detox Is Not Necessarily a Nightmare
In movies like The Man with the Golden Arm, detox is presented (accurately) as a nightmarish experience. Fear of the experience is what keeps many addicts using, even when they want to quit. I remember when I was an addict, I so envied speed and cocaine addicts who could just walk away from their drug without being terribly sick. Today, I'm much more sympathetic to their plight; but there is no doubt that the path to a "clean life" is made far more difficult by the painful withdrawal symptoms experienced by opioid addicts.
Many Kinds of Pain
Due to the justifiable fear that junkies have about withdrawal, most seek some kind of help to ease the pain of the experience. In many cases, however, these addicts end up spending a lot of money on "treatment" that does not work. It is one thing to live through the nightmare of cold turkey withdrawal when you aren't paying for it. But going through much the same experience and paying $5,000 for the pleasure can make you crazy.
This issue's feature focuses on two such experiences. One was an ibogaine detox and the other was a rapid antagonist detox. In presenting these stories, we are not claiming that these forms of detox do not work. It is just that detox is a very personal thing. A regime that works perfectly for one person may not work at all for another.
No Such Thing as "Miracle Cure"
One thing I hope this feature does do, however, is dispel the idea of miracle cures for addiction. There may be perfect detox regimes for particular people, but even this I doubt. When I hear that someone detoxed from heroin without any discomfort, the first thing I think is that he wasn't actually addicted to heroin. It has been well demonstrated that one-third of those people applying for methadone maintenance turn out not to be addicted to any opioids at all.
This statistic is somewhat bothersome when looking at reports of the efficacy of any kind of withdrawal treatment. One has to wonder what the people in the study are detoxing from. Even if all the people were addicted, there is a big difference between detoxing from 10 Vicodin swallowed every day and two grams of heroin injected each day. The first person is going to have a short and relatively painless detox, regardless of the regime. The second person is going to have a tough time of it--period.
"Preparing for Failure"
"Just Protecting Yourself"?
Although the entire drug "treatment" industry would disagree with me, I believe that anyone trying to detox should have a back up--a small dose that can be used if the detox goes wrong. The truth is that there are simply too many things that can go wrong when trying to detox.
Things Go Wrong: Examples
A young woman is on the second day of a medicated detox. She begins having chest pains. She tells her roommate who is a nursing student. The roommates checks her vital signs and finds that her heart rate is 150 beats per minute. This is so fast that the heart chambers do not have time to fill with blood completely. Her roommate takes her to the hospital emergency room--she might have died otherwise.
A young man shows up to a methadone clinic with a money order to begin a 21 day detox. Unfortunately, the date is October 12, 2001. The doctor for the clinic is stuck in Denver because all flights have been canceled. No one can be allowed into the program without the doctor's okay. So the young man is out of luck. And to make matters worse, he is from out of town. So it isn't just a matter of getting money; he must also find a connection in a new town where he is already (in keeping with clinic demands) dope sick.
A middle aged woman is on day 19 of a 21 day methadone detox. As is usual for such a detox, she has begun to experience mild withdrawal symptoms. To counteract her diarrhea, she takes what she thinks is an imodium tablet; it is really naltrexone (from a previous detox attempt). This may seem unlikely, but naltreoxe pills have a similar shape and size to imodium tablets. Within a half hour, she is experiencing the most intense withdrawal symptoms of her life--the methadone still on her receptor sites has been ripped off and blocked from re-attaching. She can't take any medication (such as clonidine) because she vomits everything she ingests.
It is not a good idea to prepare for failure when starting a detox. But it is better to be strung out and alive than clean and dead. When an addict is detoxing using a method he has not tried before, he should definitely take precautions. Even when a detox regime has been used before, care should be taken. One addict told me, for example, that the first time he withdrew using ibogaine, he had no problems. The second time he used ibogaine to withdraw, he experienced intense symptoms, just as if he were doing a cold turkey withdrawal.
We present detox nightmares in the hope of adding a little restraint to any discussion about detox modalities. Also, since the two nightmares we publish here involve very expensive procedures, we hope to encourage a great deal of thought before someone opens his wallet. The price of a detox is no assurance of its efficacy.