Opiate withdrawal is unpleasant and difficult, but there are some things you can do to make it easier. First, make plans to leave town to quit in a place devoid of environmental cues like needles or pill bottles. (Your body responds to these cues by anticipating a dose of "poison", making withdrawal worse.) Enroll in a treatment program or leave town, if possible, or take a "mini-staycation" in a place not associated with using, such as the house of a family member. Also, avoid people you've taken the drugs with-- it may seem like a good idea to quit together, but the very presence of your previous drug buddy may trigger your body's addiction response. Second, prepare by maximizing your general health before quitting, through regular exercise, meditation, and good nutrition-- the healthier you are when you quit, the better you'll be able to face the struggle of withdrawal. A daily multivitamin can help you cover your nutrition bases. In addition, while vitamins are not going to make withdrawal easy, certain vitamins and supplements, as well as herbs, might be able to help lessen the severity of withdrawal symptoms.

Vitamin C

While no studies have been done in humans, preliminary studies in guinea pigs and rats indicate that ascorbic acid, more commonly known as vitamin C, may be able to decrease withdrawal symptoms, especially at high doses.  Vitamin C also decreased rats' attempts to press a lever to obtain a dose of morphine, indicating that vitamin C may ease craving as well as ameliorating withdrawal symptoms.  While there is no evidence yet that vitamin C helps with withdrawal in humans, it is a very safe supplement-- daily doses as high as 2,000 mg/day or more in certain individuals are considered safe-- so it won't hurt to take it.  

Alpha-Lipoic Acid

Alpha-lipoic acid, or ALA, is an anti-oxidant like vitamin C, but whereas Vitamin C is water-soluble, ALA is both water- and fat-soluble, passing into the brain easily. ALA is generally considered safe for most people, but it has not been studied in pregnant or breastfeeding women, and it could be dangerous if you have a thiamin (vitamin B1) deficiency. Taking a multivitamin with thiamin before you quit will help you get enough, as will eating thiamine-rich foods. Sunflower seeds and peanuts are good sources of vitamin B1 that are easy to obtain and require no preparation.  In addition, ALA can lower blood sugar level, and interact with diabetes medications and chemotherapy medications. If you fall into any of these categories, you should consult your doctor before taking ALA for any reason.

Other supplements and drugs

Several traditional Chinese medicines have been approved by the Chinese Food and Drug Administration for use in opiate detoxification, including Fukang, Lingyi, Yian, Jitai, Fuzhengkang, Anjunning, Kangfuxin, Xuanxia, Shifusheng, and Zhengtongning. These and other traditional Chinese medicines should be used under the supervision of a trained Traditional Chinese Medicine practitioner.  Western medicine doctors can also prescribe a number of drugs known to mediate withdrawal symptoms, including the non-opiates clonidine and lofexidine and the opioid buprenorphine, as well as drugs to treat specific symptoms, such as antispasmodics for gut cramps.  Finally, herbal medicine practitioners can recommend herbs to help calm anxiety, facilitate sleep, and ease digestive symptoms.

From detox to recovery

One you've made it through withdrawal, your journey to lifelong recovery has just begun. To avoid relapse, keep your body healthy through good nutrition and exercise.  A daily multivitamin supplement can help make sure your nutritional bases are covered.  In parallel with keeping your body healthy, it is vitally important that you both avoid bad influences and develop good ones.  Narcotics Anonymous is a tried-and-true group of former addicts helping recovering addicts to stay clean through support and the wisdom gained through their own experience.  Detox is step one; step two is total lifestyle change-- a change to the happier and healthier person you will become when you've left addiction behind.

Further reading and references:

The Road to Recovery: part 2 of a 2-part series on heroin. Healthcare Journal of Baton Rouge.

PubMed Health: Pharmacological and Physical Interventions in Opioid Detoxification (NICE Clinical Guidelines, No. 52)

Talkhooncheh et al. The effect of vitamin C on morphine self-administration in rats. Adv Biomed Res 2014;3:178

Johnston and Chahl. Chronic treatment with ascorbic acid inhibits the morphine withdrawal response in guinea pigs. Neurosci Lett. 1992 Jan 20;135(1):23-7.

Kulkarni et al. Ascorbic acid inhibits development of tolerance and dependence to opiates in mice: Possible glutamatergic or dopaminergic modulation. Indian J Pharm Sci 2008;70:56-60

Linus Pauling Institute: new recommendations for antioxidant dosing

University of Maryland Medical Center

Pinelli et al. Plasma malondialdehyde levels and opiate withdrawal signs observed in rats treated with morphine plus naloxone: effects of alpha-lipoic acid administration. Fundam Clin Pharmacol. 2008 Aug;22(4):439-45.

Shay et al. Alpha-lipoic acid as a dietary supplement: Molecular mechanisms and therapeutic potential. Biochimica et biophysica acta 2009;1790(10):1149-1160.

Linus Pauling Institute, Oregon State University

Shi et al. Traditional Chinese medicine in treatment of opiate addiction

Narcotics Anonymous Basic Text



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