Addiction Survivors

Reply
Unread 06-18-2007, 04:07 PM   #1
here to learn
Member
 
Posts: 81
Default PAWS

I am still relatively new to this forum and come from a science background. Being that science is my background, the idea of PAWS was interesting to me. Unfotunately, other than the information on this board, there is not any other source I can find that documents this disorder in an evidence based way.

Should protracted withdrawal from drugs be included in DSM-IV?
Satel SL, Kosten TR, Schuckit MA, Fischman MW.

Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.

OBJECTIVE: The authors reviewed both clinical data and selected laboratory research related to withdrawal from alcohol, opiates, and stimulants in order to draw a conclusion about whether the phenomenon of protracted withdrawal exists and should be included in DSM-IV. METHOD: Studies were located through computerized searches and reference sections of published articles. RESULTS: Symptoms extending beyond the period of acute withdrawal in alcohol and opiate dependence have been fairly consistently described; this is not the case with cocaine. Nevertheless, protracted alcohol and opiate withdrawal has not been conclusively demonstrated because of the failure of studies to do multiple time point sampling, to use standardized instruments and control groups, and to re-administer the substance in an attempt to suppress withdrawal symptoms. Further, the concept of protracted withdrawal itself is ambiguously defined. This confounds interpretation of the literature and precludes derivation of a unified concept of the term, which would be necessary for adding the diagnosis to DSM-IV. CONCLUSIONS: There is insufficient documentation to justify inclusion of protracted withdrawal in DSM-IV because of methodologic limitations of the studies and lack of consensus definition of the term itself. An outline for conceptualizing protracted withdrawal is offered in which the symptoms can be seen as: 1) a global post-use syndrome, 2) attenuated physiologic rebound, 3) toxic residuals, 4) expression of preexisting symptoms unmasked by cessation of use. Future efforts to identify signs and symptoms of protracted withdrawal should carefully define the parameters of the syndrome.

PMID: 8097618 [PubMed - indexed for MEDLINE]


This abstract is from the American Journal of Psychiatry in 1993. When doing a PubMed search using the search criteria of PAWS (spelled out) and narcotic and them combining them, I can only return 18 studies.

The people who speak most knowingly on this topic, although in an apparent adversarial way, are Jaden and Suture. Perhaps if those gentlemen can point me in the direction of their information I would appreciate it. I would love to peruse the information on my own to form my own opinion. The abstract from the journal demonstrates that the idea of PAWS is plausible but it lacks a clear definition. I tend to side with suture and think that a syndrome like this would due to any addiction, not just to narcotics.

Again, I prefer information that is from mainline, reputable journals. A reputable journal is one that is open to peer review and has criteria one must meet to publish in it. This would discount someone who just posts his/her own opinion on a web page or blog. One's own experience does not make him an expert.

Thank you in advance,

D
here to learn is offline   Reply With Quote
Unread 06-18-2007, 04:43 PM   #2
Suture
Senior Member
 
Posts: 1,628
Default

D,
I couldnÃà‚‚à‚’t find much on it either. The most info I found was in the articles that define what addiction is. They define it as long term changes to the brain and go on to describe what parts are affected. These are consistent with all addictions although manifest in slightly different ways. But it seams consistent that PAWS only exists when there is evidence of addictionÃà ‚Â‚ÃƒÂ‚Ã‚Â‚ÃƒÂƒÃ‚ÂƒÃƒÂ‚Ã ‚” as opposed to physical dependenceÃà ‚‚ÃÂà ‚Â‚ÃƒÂƒÃ‚Â‚ÃƒÂ‚Ã‚Â”. The answers might be found in the description and theories of what the exact brain changes caused by addiction are.

For sources you might find some info in the references to this article:
http://archives.drugabuse.gov/PDF/Pe...s-Neurobio.pdf
S-
Suture is offline   Reply With Quote
Unread 06-18-2007, 04:54 PM   #3
Jaden
Senior Member
 
Posts: 163
Default

Opiate addiction is much different than that of other addictions. Human brains have natural opiates that are produced regularly and everyone is born with them. They are called opioid receptors which stimulate the brain and are responsible for lifting a person's mood, helping that person feel motivated for everyday purposes, and natural pain relief. When a person starts using opiates regularly, the opiates that they are using are much stronger and more stimulating than the natural ones in their brain. As a result, the natural opiate receptors shrink and stop producing and eventually just die off within six months to one year after beginning to use the opiate.

When a person attempts to stop using the opiate, they will go through withdrawal for about one week. Typically, that is expected but the problem gets much worse. Post acute withdrawal symptoms last much longer than that and include extreme sensitivity to pain as the natural pain receptors have vanished. The pain tolerance that a normal person has is no longer present in the opiate addict. They also experience a complete lack of motivation because the natural receptors are gone. Just getting out of bed can be a challenge. Finally, their mood is completely altered, they are sad, depressed, and feel like losers.

Jaden
Jaden is offline   Reply With Quote
Unread 06-18-2007, 04:59 PM   #4
Denista
Member
 
Posts: 96
Default

Wow Jaden
Thank you for your clear and easy to understand definition of PAWS.
I get all mixed up and confused when i try to take apart articles that are written by mds or phds or whomever. just saying thanks
Denista is offline   Reply With Quote
Unread 06-18-2007, 05:20 PM   #5
Suture
Senior Member
 
Posts: 1,628
Default

Denista,
Jaden is likely referring to tolerance and physical dependence. The causes of PAWS are independent of that and have to do with changes to the brain specific to "addiction". People with all addictions including gambling report PAWS so Jaden's explanation is off the mark.
S-
Suture is offline   Reply With Quote
Unread 06-18-2007, 07:18 PM   #6
Denista
Member
 
Posts: 96
Default

Oh.. well its all just so confusing to me. Im not taking sides or anything, I just read that and understood it. It seems there is so much analyzing of everything. I'd rather just hear that you did drugs, you have to pay a price--meaning, there is going to be bad days. Instead of all the dr. talk-- that what frustrates me i guess-- I know i sound childish-- I just like things simple
Denista is offline   Reply With Quote
Unread 06-18-2007, 09:16 PM   #7
Frozen
Senior Member
 
Posts: 674
Default

"Human brains have natural opiates that are produced regularly and everyone is born with them. They are called opioid receptors which stimulate the brain and are responsible for lifting a person's mood, helping that person feel motivated for everyday purposes, and natural pain relief."

--->Incorrect. The brain's endogenous opioids are called endorphins, dynorphins, and enkephalins. Endogenous opioids are the key... Opioid receptors are just the keyhole.

"When a person starts using opiates regularly, the opiates that they are using are much stronger and more stimulating than the natural ones in their brain. As a result, the natural opiate receptors shrink and stop producing and eventually just die off within six months to one year after beginning to use the opiate."

----> The endogenous opioids are not produced in the opioid receptors. Opiate addiction does cause your body to produce fewer endogenous opioids, but the receptors don't "shrink" at all. In fact, you grow more of them. (Which is not a good thing. The extra receptors demand to be fed with more opiates- One of the causes of tolerance buildup.)

A few years back, there was a study of the brains of suicide victims, to see how they compare to the brains of non-mentally ill cadavers. The researchers found that the brains of suicide victims contained up to nine times as many opioid receptors than the mentally healthy individuals.

I frequently use the term "Endorphin Deficiency Syndrome" for simplicity's sake, but EDS could really also mean a deficiency of the other (not endorphins) endogenous opioids, or instead- An over-abundance of opioid receptors. The EDS sufferer could have normal, sufficient endogenous opioid levels. The problem is that since he has far more receptors than mentally healthy people do, he would need double, triple, or more endogenous opioids than everyone else in order to fill them all, and feel 'normal'.
Frozen is offline   Reply With Quote
Unread 06-19-2007, 03:37 AM   #8
here to learn
Member
 
Posts: 81
Default

Quote:
quote:Originally posted by Jaden

Opiate addiction is much different than that of other addictions. Human brains have natural opiates that are produced regularly and everyone is born with them. They are called opioid receptors which stimulate the brain and are responsible for lifting a person's mood, helping that person feel motivated for everyday purposes, and natural pain relief. When a person starts using opiates regularly, the opiates that they are using are much stronger and more stimulating than the n They also experience a complete lack of motivation because the natural receptors are gone. Just getting out of bed can be a challenge. Finally, their mood is completely altered, they are sad, depressed, and feel like losers.

Jaden
I have not quoted the entirety of Jaden's post. He presents a very smooth and simple to understand argument. My only problem with that is if the disorder were truly that well understood, then there would be much more research, or at least some research, on the disorder. Let alone a diagnosis and some form of treatment. Jaden appears to understand the disorder, and be some sort of expert, so I pose the question to him: Where is the official diagnosis? Where are the treatment options? Medication regimes? Support groups? Why is there not any better understanding of the disease other than you?

I do not mean to be critical and mean spirited. I guess my biggest concern is a person one. I am an ex-user and a Suboxone user now and I am honestly afraid to suffer in the way Jaden describes. But, when I look for treatment options I can use when I make the jump off Suboxone, I cannot find any. This leads me to think that either the disorder does not officially exist. Is poorly understood (then Jaden must be the expert which begs the question: why is he here on this board. If he is the PAWS expert he should be touring the country teaching medical schools and doctors about this disorder? If he understands the disorder this well, why does he not develop a treatment plan?)

Anyway, Jaden, as I asked before, please point me in the direction of the evidence based research that led you to your apparent wonderful understanding of PAWS?

D
here to learn is offline   Reply With Quote
Unread 06-19-2007, 05:39 AM   #9
hockeynut
Senior Member
 
Posts: 117
Default

Hi Here to Learn,
I work in a rehab and I just want to let you know that PAWS Post Acute Withdrawal is real.

Do a google search on Post Acute Withdrawal if you are looking for information on PAWS, you will find alot on this topic.

H
hockeynut is offline   Reply With Quote
Unread 06-19-2007, 01:27 PM   #10
CK1976
Guest
 
Posts: n/a
Default

hockernut,
Here_to_learn is asking for scientific evidence. That would be papers written by doctors or scientists and reviewed by peers. They are hard to find because I don't think we know all of what is happening in the brain when someone gets addicted, and PAWS appears to be symptoms of these brain changes.

The changes associated with "physical dependence" have been studied well, but that probably isn't what causes PAWS since people with non-chemical addictions report some kind of PAWS too.
chris
  Reply With Quote
Unread 06-19-2007, 06:52 PM   #11
here to learn
Member
 
Posts: 81
Default

Thank you Chris, that is exactly what I want. I don't doubt that it exists, but I am wanting to try and find some sort of scientific evidence regarding the disorder. Typically with scientific evidence comes some sort of treatment option. One day I will be off Sub, and I don't want to get caught up again. If PAWS is more related to the addiction behaviours, and sub does not do anything with addictive behaviours, just helps us try to learn new methods of coping, then other treatment options must exist. Like Suture, I too think that PAWS would be more related to ANY addiction. All addictions, whether they be to porn, sex, drugs, gambling or alcohol, share some common themes. I would like to think that with addictions to various things being so prevalent, we would have some sort of desire to investigate and learn. Perhaps not though .....

D
here to learn is offline   Reply With Quote
Unread 06-20-2007, 12:13 AM   #12
Frozen
Senior Member
 
Posts: 674
Default

[quote]quote:Originally posted by here to learn

Quote:
Originally posted by Jaden

I am an ex-user and a Suboxone user now and I am honestly afraid to suffer in the way Jaden describes. But, when I look for treatment options I can use when I make the jump off Suboxone, I cannot find any.
Sure you can! You've already been told about LDN.
In addition, you may have seen my frequently mentioned list of things one can do to boost endogenous opioid levels: LDN, acupuncture, D-Phenylalanine (DLPA), Capsaicin (tabasco sauce), and the only medically recognized antidepressant that's a quasi-opioid: Effexor.
Frozen is offline   Reply With Quote
Unread 06-20-2007, 12:16 PM   #13
Sub-Zero
Senior Member
 
Sub-Zero's Avatar
 
Posts: 1,563
Default

D- posted ..."If PAWS is more related to the addiction behaviours, and sub does not do anything with addictive behaviours, just helps us try to learn new methods of coping,"

Once sub treatment begins usually addictive behaviors stop. If not right away then soon with counseling. This affects the brain. If you are not in the repeating cycle of addiction everyday, the brain begins to adapt back. If it adapts back enough it will no longer cause the symptoms of PAWS. At least that's the way I understand it.
sub
Sub-Zero is offline   Reply With Quote
Unread 06-20-2007, 03:53 PM   #14
Denista
Member
 
Posts: 96
Default

Im sorry, what is LDN?
Denista is offline   Reply With Quote
Unread 06-20-2007, 03:58 PM   #15
NancyB
Administrator
 
Posts: 22,389
Default

Hi Denista, LDN is Low Dose Naltrexone.
Here's a thread on this.
http://www.naabt.org/forum/topic.asp?TOPIC_ID=889
Nancy
(BTW I tried to email you back a bit ago, and it got bounced to me.)
NancyB is offline   Reply With Quote
Unread 06-20-2007, 04:04 PM   #16
Brett
Senior Member
 
Posts: 2,766
Default

LDN is what most if not all sub or other opiate patients need after they stop using the opiate.

here's why- our endorphine producing factory has been shut down for a long time, things like exercise for some can help boost our natural endorphins.
LDN has been proven to help our brain produces 200-300% more endorphins, this would make our moods better and give us more energy. I feel this should be standard procedure after a jump off any opiate.

Brett
Brett is offline   Reply With Quote
Unread 06-20-2007, 04:15 PM   #17
Denista
Member
 
Posts: 96
Default

Oh ok, thanks for the info. Makes sense. Nancy, I will email you again and fix my computer so you can write back-- been having all sorts of problems with this thing. Is the naltrexone in suboxone or is that something different? Thanks everyone
Denista is offline   Reply With Quote
Unread 06-24-2007, 05:43 AM   #18
here to learn
Member
 
Posts: 81
Default

Quote:
quote:Originally posted by Frozen

Sure you can! You've already been told about LDN.
In addition, you may have seen my frequently mentioned list of things one can do to boost endogenous opioid levels: LDN, acupuncture, D-Phenylalanine (DLPA), Capsaicin (tabasco sauce), and the only medically recognized antidepressant that's a quasi-opioid: Effexor.
As I mentioned Frozen, I have not found any scientifically supported evidence published in a credible and peer reviewed journal justifying the use of LDN. I am not doubting the efficacy of that treatment modality, but am looking for as much information as possible regarding treatment for PAWS. So, if you have any references from where you got your LDN treatment information from, I am all ears to hear it.

Thanks,


D
here to learn is offline   Reply With Quote
Unread 06-24-2007, 05:48 AM   #19
here to learn
Member
 
Posts: 81
Default

Quote:
quote:Originally posted by Sub-Zero

D- posted ..."If PAWS is more related to the addiction behaviours, and sub does not do anything with addictive behaviours, just helps us try to learn new methods of coping,"

Once sub treatment begins usually addictive behaviors stop. If not right away then soon with counseling. This affects the brain. If you are not in the repeating cycle of addiction everyday, the brain begins to adapt back. If it adapts back enough it will no longer cause the symptoms of PAWS. At least that's the way I understand it.
sub
True that once one starts the treatment with Sub a person will usually stop using drugs. The stopping of drug usage does not mean a person will stop the addictive behaviour though. Addictive behaviours include such things as not telling the truth, hiding parts of your life from you loved ones, stealing and so forth. The behaviours are not treated by Suboxone. Those behaviours are the behaviours that help to define what an addiction is. Someone may use drugs and if that drug usage is not interfering in their life, such as impacting work, family and other facets of their life, then that person is not a true addict as they do not meet the needed parts of the definition, does that make sense? Anyway, I will post more later.

D
here to learn is offline   Reply With Quote
Unread 06-24-2007, 10:38 AM   #20
oceanlove
Junior Member
 
Posts: 17
Default

HELLO EVERYONE.......

frozen your brilliant.

jaden...i get you.

God bless you all.

ocean
oceanlove is offline   Reply With Quote
Unread 06-24-2007, 11:21 AM   #21
Brett
Senior Member
 
Posts: 2,766
Default

Heretolearn,

If you take the time to look around and do some shearching on LDN you will find proof that is does work and has cured many people from numberous diseases, thru boosting the immune system and endorphin production. All the proof you need is out there, all you have to do is look for it. Ive read Tons of literature about LDN, My sub doctor uses it for his patients after the jump, it does work for paws. check this out

Brett
Brett is offline   Reply With Quote
Unread 06-24-2007, 03:49 PM   #22
Sub-Zero
Senior Member
 
Sub-Zero's Avatar
 
Posts: 1,563
Default

Quote:
quote:Originally posted by here to learn

True that once one starts the treatment with Sub a person will usually stop using drugs. The stopping of drug usage does not mean a person will stop the addictive behaviour though. Addictive behaviours include such things as not telling the truth, hiding parts of your life from you loved ones, stealing and so forth. The behaviours are not treated by Suboxone. Those behaviours are the behaviours that help to define what an addiction is. Someone may use drugs and if that drug usage is not interfering in their life, such as impacting work, family and other facets of their life, then that person is not a true addict as they do not meet the needed parts of the definition, does that make sense? Anyway, I will post more later.

D
That makes perfect sense and that is what I was trying to say, although not as well as you did. When people start Suboxone their addictive behavior seems to end. Maybe because they can pay attention to counseling now that they donÃà‚ ƒÂƒÃ‚‚’t have cravings, I donÃà‚ ƒÂƒÃ‚‚’t know, but I see it all the time. They start treatment and the addictive behavior ends. Not with everyone and not right away with everyone, but most people IàƒÂ‚‚Âà ƒÂ‚’ve known. ThatÃà‚‚Â ’s why I donÃà‚ ƒÂƒÃ‚‚’t think Suboxone treatment is trading one addiction for another. If anything they are trading an addiction for a physical dependence (which they already had anyways)
Sub
Sub-Zero is offline   Reply With Quote
Unread 06-24-2007, 11:08 PM   #23
gabagool
Member
 
Posts: 52
Default

In my search to not feel "sad for no reason, happy sad, happy sad, happy sad, on and off every hour or so, no ambition, no energy, no hope, no ambition etc, etc e f cking tc," i went thru my "science proven celexa etc route. NOTHING. NOTTA TING. ZILCH. So much for "science backed treatment. I went to poppy tea- THE BEST. PERIOD. NONE BETTER. Trying to make my treatment legal, easier and cheaper, I am now on Subutex. Not as good. No other way to say it. For me, opioids are far superior to sub. But I will try to give sub a bit more time.

Frozen (and others) are the first to put the seed in my mind that "mainstream" science be damned. You feel good, no high, but good on opioids for a reason. A legitimate reason. You see I only care about FEELING GOOD, NORMAL, LIKE A PERSON SHOULD. I could care less if others deem me addicted to poppy or subutex or nostril hair or whatever. There is a reason I get no high from excersise. This reason means that I might be heading in the right direction in finally beating or even living with this thing.

I just cut my subutex in half, on day two and the depression KICKED MY BUTT today. Back to the drawing board. With info from the people on this board I am pretty sure I will find the solution. I had just better find it soon.
gabagool is offline   Reply With Quote
Unread 06-24-2007, 11:36 PM   #24
cat1
Senior Member
 
Posts: 349
Default

Gabagool, Your not alone in how you feel, i feel exactley the same way you do so don't feel alone not everybody gets an amazing feeling from sub,but im starting to think it works better on people that got addicted to pills cause of pain,maybe cause it helps with pain thats why certain people feel happy on it.
cat1 is offline   Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off




All times are GMT -4. The time now is 08:50 PM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
© 2014 Addiction Survivors