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- McDermott╒s Guide to Do-It-Yourself Detox
-
- (c) Peter McDermott, 1993
- (c) Lifeline Project, 1993
-
- This guide was first published by Lifeline Project, Manchester, UK.
- This electronic version may be freely distributed electronically or as
- hard copy. However, be warned that you are missing out on Mike Linnell╒s
- brilliant illustrations.
-
-
- Why should I do-it-myself?
-
- People often go along to a drugs agency in the hope of finding an easy
- solution to their drug problem. This is a mistake. There are no easy
- solutions.
-
- The majority of people stop using drugs without any help. Addiction to
- smoking is just as difficult to give up as addiction to heroin, but the
- majority of people stop smoking with out any outside help. Drugs agencies
- are thought to be in contact with between 10% and 25% of all heroin users.
- The rest stop using drugs without any help whatsoever. When the U.S. army
- was fighting in Vietnam, hundreds of thousands of soldiers became addicted
- to heroin. When they returned to the U.S.A., the vast majority gave up
- heroin without any help whatsoever.
-
- While a small number of people find that it is harder to stop using unless
- they are physically removed to a place where they cannot get drugs, i.e., a
- hospital or a rehab unit. This may be an option for you to consider, but if
- you do, remember, you still have to face the situation back in the real world
- when you do get out. Ultimately, nobody else can do your detox for you.
-
- Some people find that support from a drugs worker can be helpful during a
- detox. Other people╒s experience is that they are a bunch of know-nothing
- do-gooders who are about as much use as a blocked needle or a packet of wet
- skins. There are also other drawbacks associated with attending a drugs
- agency. They expect you to attend for regular appointments. You can
- expect to run into other drug users, possibly even dealers, and most drugs
- agencies keep records of your name, address, date of birth, etc. In some
- cases, these are passed on to the Home Office and kept on a register. If you
- decide to use a drugs agency, remember to ask about their record keeping
- and confidentiality policies.
-
- Ultimately, whether you decide that you want support from a drugs worker
- or not, the only person who can stop using drugs is YOU. However, the
- greatest obstacle to your success is fear. This booklet aims to try and remove
- some of the mysteries that surround drug detoxification, by explaining
- what will happen, we hope to make you your own expert. You take the
- credit for success, and the responsibility for your own continued use.
-
- Before you make the decision to detoxify, there are several questions that
- you should try to answer for yourself.
-
- Who are you stopping for?
-
- In order to succeed in your attempt to stop using drugs, you have to
- genuinely want to stop. Not for your parents, not for your wife, not for the
- court or the probation officer, but for yourself. Of course, all those other
- people may play a role in making you want to stop. If you are upsetting
- your parents, if your wife is about to leave you, or you stand a good chance
- of being sent to jail, that may well make you tired of using drugs. However,
- for many people, it doesn╒t.
-
- If you aren╒t really sure about it, perhaps you should think about other
- options. Some people find it is easier if they attempt to stabilize their drug
- use before giving up. If you feel that this may be a better option for you,
- then talk it over with a friend or a drugs worker. If you do attempt to stop
- using drugs before you really want to, you may be setting yourself up to
- fail. After several failures, you may lose confidence in your ability to
- succeed, which can lead you to stop trying. So try to be clear about what it
- is that you really want, and if you do want to continue using drugs, then
- focus on trying to reduce the harm associated with your drug use.
-
- Why do you want to stop?
-
- Drug use has both positive and negative aspects to it. Everybody who uses
- drugs experiences both. People usually only stop when they are aware that
- the negative aspects outweigh the positive ones. Some people are aware
- that the negative consequences of their drug use are great, but are still
- unable to make the decision to stop using drugs. This may be because the
- positive benefits that they gain from using are even greater, or it may be
- simply because they haven╒t thought clearly enough about the
- consequences. Here is a list of some of the positive and negative aspects of
- drug use.
-
-
- Positive
- Drugs make you feel good.
- Drug use helps you gain acceptance among friends
- Drugs give you something to do
- Everybody you know uses drugs
- Drugs make you feel more confident
- Drug use makes you feel free to be who you want to.
-
- Negative
- Drugs may be bad for your health
- Drug use may upset your family and friends
- Drug use can get in the way of the other things that you want to do
- Drug use is against the law
- Continued drug use can damage your self-image
- Dependence upon drugs can negatively shape the way that you see yourself
-
- Before you decide to give up, make a list of the positive and negative aspects
- of your own relationship with drugs. Then you can see whether or not you
- think stopping would be a good idea.
-
-
- What drugs are you using?
-
- Just as different drugs have different effects, so the attempt to stop using
- different drugs has very different results. Make a list of the drugs that you
- are currently using and try to think about which ones might be causing
- you a problem. Remember, you can lie to parents, employers, teachers,
- partners and friends, you can even lie to yourself ╤ but given that you are
- only doing this detox because you want to, what would be the point?
-
- Some drugs are not regarded as addictive, but that does not mean that you
- cannot become habituated to their use, or that their use is not a problem.
- Cannabis, L.S.D., Solvents, Amphetamine and Ecstasy may all fall
- into this category. Some people may experience mental craving if they try
- to stop using these drugs, but they should not experience any physical
- discomfort.
-
- Other drugs are quite definitely addictive. This means that when you
- attempt to stop using them, you might experience physical withdrawal
- symptoms as well as psychological craving. The drugs that fall into this
- category include Opiates like Heroin and Methadone,
- Benzodiazapines like Valium, Temazepam, Ativan or Nitrazepam,
- Barbiturates like Seconal or Tuinal, and Alcohol.
-
- For a long time, people thought that Cocaine fell into the first category of
- just being psychologically addictive. However, more recently, scientists
- have identified changes in the brain chemistry that occur after regular
- use of coke, and so the severe craving experienced by people with a
- cocaine problem may well have a physical component as well. Whether it
- does, or whether it doesn╒t, cocaine provides us with an example of a drug
- that produces chaotic and compulsive use patterns prompted by
- psychological craving rather than fear of withdrawal.
-
- Make a list of the drugs that you currently use regularly. If all the drugs
- that you use fall into the non-addictive category, then you will not need to
- detoxify gradually. You can stop using immediately without experiencing
- any physical symptoms whatsoever.
-
- If you find that you use more than two types of addictive drugs regularly,
- then you will probably find it easier if you seek professional help with
- your detox.
-
- If you are just using one of the addictive drugs or one addictive drug and
- one or more of the non-addictive drugs, then you may well be a good
- category for a do-it-yourself detox.
-
-
- What is your source of supply?
-
- If you are dependent on drugs that are prescribed by a doctor, then you
- have an ally in your detoxification project. Talk over your plans with the
- doctor and tell him or her what you are planning to do.
-
- If you feel that you are dependent upon Benzodiazapines or Barbiturates,
- and are on high doses, or have been using them for a long time, then it
- may be unwise to attempt to stop without medical supervision. Both drugs
- can cause severe fitting when they are withdrawn, and deaths have been
- caused by barbiturate withdrawal so it is not a good idea to attempt to stop
- immediately. With the Barbiturates, it is usual to change over to
- Phenobarbitone before attempting a gradual reduction, whereas with the
- Benzodiazapines, it is usually best if the prescription is changed to
- Diazepam.
-
- If you are dependent upon an Opiate, then many people find it helpful to
- change over to either Methadone or Dihydrocodine (DHC or DF118) for
- detoxification. Again, if you are receiving your supplies from a doctor or a
- clinic, talk your plans over with them. They can help you by rationing
- your supplies for you. during the course of your detox, and by offering
- more flexible options should you experience difficulty with your plans.
-
- If you are dependent on black-market drugs such as heroin or cocaine, you
- may find it difficult to persuade a doctor to prescribe for you. This can be a
- good thing, as if you go on a script, it can make it too easy to continue using
- for a long time. Once again, it is crucial to stress that you need to know
- what you want. If you want to stop using, then it may be easiest to attempt a
- home detox. Should you find it too difficult, then you can always seek help
- from a doctor or drugs agency afterwards. If you wish to continue using,
- then you may well benefit from a visit to a drugs agency in order to discuss
- ways of stabilizing your drug use or reducing the risks that you run.
-
-
- What will the withdrawals be like?
-
- Withdrawal symptoms will differ with the drugs that you use. Cocaine users
- will not experience physical withdrawals, but they may experience intense
- craving, irritability, inability to sleep, mood swings and panic attacks.
-
- Heroin users, on the other hand, will experience all of the psychological
- symptoms, accompanied by physical withdrawal symptoms. Some clever-
- dick drugs workers claim that withdrawal is no worse than a dose of bad flu.
- That might be true, except when did anybody suffer a dose of flu that
- stopped you from sleeping or even getting comfortable for more than a
- minute at a time? A dose of flu that can be cured in minutes by the
- consumption of a little bag of powder?
-
- With opiate withdrawal, although the symptoms are the same for
- everybody, everyone seems to focus on one particular aspect as the thing
- that they experience as the worst. For one person it may be pains in the
- muscles or joints, for others it could be the inability to get comfortable.
- Others have difficulty coping with the lack of sleep. The range of symptoms
- for opiate withdrawal includes sweating, restlessness, nausea, diarrhoea,
- stomach cramps, muscle pains, sleep disturbance, hot and cold flushes. It is
- undoubtedly unpleasant. However, fear of withdrawals makes them seem
- worse than they actually are. Almost everybody can cope with the severity
- of their withdrawal, regardless of how much they have been using.
-
- Some people do really stupid things and claim the fact that they were in
- withdrawal is an excuse. It isn╒t that they can╒t deal with the sickness
- though ╤ the real reason that they do these things is because they aren╒t
- really committed to stopping. It╒s hard to sit and suffer if you know that as
- soon as you get money, you are going to get sorted, and therefore you╒ll
- have to go through the whole thing again. You, on the other hand, are
- different. If you have decided to stop using drugs, this will be the last time
- that you suffer this way. Not only will you feel the pain, you will embrace it
- as you kiss it goodbye, safe in the knowledge that after you have finished
- your detox all that will be behind you.
-
-
- How do I go about it?
-
- Once you have decided to stop using, don╒t just say ╥that╒s it, no more╙ as
- you are bound to fail. You need to plan your detox properly. Decide a time
- when you are going to do it. It could be relatively soon, or it could be some
- time in the future. Whenever it is, put aside at least two weeks when you
- don╒t need to do anything stressful and you don╒t have any responsibilities.
- If you have children, send them to their grandparents or to a friend for a
- holiday. They won╒t enjoy spending this time with you, and you╒ll be glad
- not to have to worry about them.
-
- Tell everybody about your decision to stop using. People who love and care
- about you will give you support through this period. Other users may
- resent your ability to break the habit and try to tempt you into using. If
- you suspect that this is the case, explain what you are doing, and tell them
- that you would rather they didn╒t come around during this period. You can
- decide later whether you still want to see them, but if they insist on trying
- to tempt you, you can be certain that they don╒t really care about you, so
- don╒t feel guilty about excluding them from your life.
-
- Try to put some money aside. You need to be able to pamper yourself with
- rewards during this period. Giving up drugs is a very brave and difficult
- decision, so you shouldn╒t feel guilty about indulging yourself in other, less
- destructive ways. If you are unemployed, perhaps you could avoid paying
- the rent for a week and make up the arrears a bit at a time later on.
-
- Finally, find a comfortable place in which to do your detox. One of the main
- reasons for doing a detox as an in-patient is that some people don╒t have
- anywhere comfortable that they can detox. For most people though,
- detoxification is much easier if you can make a drink in your own kitchen,
- watch your own T.V., read your own books and listen to your own stereo. If
- the place where you live isn╒t very nice, see if you can go back home to
- your parents, or if you can stay with non-addicted friends for a couple of
- weeks.
-
- Personally, I think you should regard a detox as being like a prison
- sentence. Rather than focussing how long you have felt lousy, focus on
- how much closer you are to feeling better. Make a calendar and tick off the
- days, or keep a diary and write down how you feel. Identify landmark
- points so that you can look back over it and see how much progress you
- have made. Stopping using drugs is one of the major decisions in your life
- ╤ it will be nice to look back and see how you managed to overcome each of
- the obstacles, or even just how much you suffered without quitting.
-
- Every time you complete a certain period, congratulate yourself for having
- made it. Give yourself a reward. For each day you complete it could be
- something small, like something special to eat or drink. For each week that
- passes, do something really nice for yourself. Buy yourself something to
- wear or go out for a meal. Think about both the detoxification and the
- rewards as investments in the new you ╤ the person that you want to
- become rather than the person that you were.
-
- One of the most difficult aspects of opiate withdrawal is the lack of sleep.
- Some people might be tempted to use sleeping tablets in a desperate attempt
- to get some respite. Personally, I find that they don╒t really help, they just
- dope you up so that rather than lying around withdrawing, you are lying
- around feeling doped-up and withdrawing. You still won╒t sleep and
- benzodiazapines are addictive too, so you could end up replacing one habit
- with another. Remember, there are no easy solutions, you╒ve just got to bite
- the bullet and ride it out.
-
- Finally, don╒t get hung up thinking about the length of time that a detox is
- going to take. Like they say in Alcoholics Anonymous, just try to get
- through one day at a time. It╒s difficult trying to imagine a life without
- drugs, but far easier to make it through to the end of a day. Then you can
- again start afresh tomorrow. Remember, every day that you manage to stay
- clean is an investment in your own future ╤ and if you can╒t be bothered to
- invest in yourself, you can be pretty damn certain that nobody else will.
-
-
- How long does it take?
-
- How long is a piece of string? It all depends what drugs you use, how much
- you╒ve been using, how long you╒ve been using for and what your own
- particular metabolism is like. Somebody who has been using
- benzodiazapines might take months to feel normal. Heroin usually takes
- anywhere between three days and two weeks. Methadone seems to take
- much longer than heroin. It can last anywhere from two weeks to a month
- before you start to feel normal again.
-
- However long it takes, don╒t let it get to you. Three days without sleep will
- begin to feel like a week. A week without sleep will feel like a month. A
- month without sleep and you start to feel as though you╒re going mad. You
- aren╒t. Your mind and body will snatch some sleep as you need it. It might
- only be the odd five minutes here and there, but it╒s better than none.
- Remember, the longer you╒ve been clean, the more you╒ve actually got
- invested in your detox, so when the going gets tough just congratulate
- yourself for the success that you╒ve achieved so far, and try to make it
- through to the next morning. And then start again, doing it one day at a
- time.
-
-
- When will it all be over?
-
- A detox is never over. After a few weeks, your mind and body will be free of
- the drugs that you╒ve been taking, but your problems are only just
- beginning. Ask any veteran junkie, they╒ll all tell you the same thing ╤
- getting off drugs is easier, staying off is far harder. Detoxification lasts a
- couple of weeks, staying drug free takes a lifetime of effort.
-
- There are a number of points that you should bear in mind:-
-
- 1. Stay busy.
-
- Boredom is one of the main reasons why people go back to gear. If you
- can╒t get a job, take up some voluntary work, or a hobby. Go back to school
- and train for a new career. Do anything that will stop yourself sliding back
- into your old patterns of behaviour.
-
- 2. Avoid other drugs.
-
- Some people think that because they were addicted to say, heroin, they
- won╒t have a problem with other drugs. A number of things happens
- frequently with ex-users if they use other drugs. Some of them simply
- transfer their dependency to a different drug, such as alcohol or cocaine
- that can be just as damaging. Those who use the non-addictive drugs such
- as amphetamine, LSD or Ecstasy often find that it acts as a spur that allows
- their resolve to slip. If you must use other drugs, cannabis is probably the
- safest, but that can also lead you to slip into using other drugs. The safest
- strategy is to avoid all drugs completely.
-
- 3. Find some support.
-
- Seek out friends that you can talk to when things are getting heavy. Some
- people find that organizations like Narcotics Anonymous are useful in
- helping them stay away from drug use, because people in the organization
- understand what you are going through. Others feel that the quasi-
- religious content of the twelve step programmes like A.A. and N.A. is too
- much to take, or they dislike the way that programme members continually
- define themselves as addicts rather than moving forward and getting on
- with the rest of their lives. Good friends, who may or may not be ex-users,
- can fulfil the same functions. Giving support when you feel low or when
- you╒ve slipped up and used again. If you don╒t have any non-drug using
- friends, go back to point 1, and find something to do with your time.
- Chances are, you╒ll make new friends through your new activities.
-
- 4. Avoid drug-using situations.
-
- Many people find that certain cues make them think about using drugs. It
- may be a certain person ╤ a friend or a relative. It may be a certain place ╤
- a particular pub or an estate, somewhere that you used to score, or it may be
- something less concrete like the sight of a Jif lemon or a bottle of vinegar.
- When you can recognize them, avoid them like the plague until you are
- certain that you have enough strength to deal with them.
-
- 5. Use the money you would have spent on drugs to do something you really
- want to do.
-
- If you do stop using, make sure that you get some benefit from having done
- so. Put the money towards buying something you really wanted, or doing
- something that you really want to do. Try to avoid having large amounts of
- surplus cash just lying around putting temptation in your way. Instead,
- plan a holiday in that country that you╒ve always wanted to go to. (Avoid
- places like Thailand or Holland.) Take driving lessons, or save for a car. You
- have already had your first taste of success when you stopped using drugs.
- Now, anything is possible.
-
-
- Summary for action
-
- 1. Re-read this booklet.
- 2. Make a list of the reasons for and against your continued drug use.
- 3. Decide whether you genuinely want to stop using drugs or not.
- 4. If you don╒t want to stop, put this booklet away until you do.
- 5. Make a list of all the drugs that you currently use. Is a D-I-Y detox viable?
- 6. If so, plan a time to stop using. Remember to leave at least two weeks
- clear with no responsibilities.
- 7. Tell your family and friends about your plans.
- 8. Accumulate money to pamper yourself with rewards after each stage.
- 9. Arrange to have a comfortable place to do it.
- 10. Make a detoxification time-table/calendar/diary
- 11. Plan activities to fill up your time after you have completed your
- detoxification programme
- 12. Begin the detoxification programme
- 13. Don╒t use any more drugs.
- 14. (I couldn╒t end on 13, could I?) Wish yourself good luck ╤ you╒ll need it!
-
-
- (c) Peter McDermott, Lifeline, 1993
-
-