Drug Detox & Opiate Detox

Habitual opiate use, while turning on the pain-suppression pathway, causes the normal endogenous opiate system to decrease production of endorphin and enkephalin. This diminishing of the normal pain-suppression system leaves the person with substantially reduced pain regulation and little tolerance of discomfort, increasing the compulsion to continue opiate use in order to decrease subjective discomfort.

Repetitive use of exogenous opiates also produces adaptation of the opiate receptors, rendering them less sensitive to agonist actions. This "down regulation" of the receptor requires larger amounts of the drug to produce similar effects, a phenomenon known as tolerance, and produces withdrawal symptoms when the receptors are not under agonist effect.

While not considered life threatening, the withdrawal symptoms characteristic of opiate dependency are notorious for how subjectively distressful they can be, producing dramatic and desperate attempts of the user to avoid withdrawal. Ranging from agonizing chills, nausea and vomiting, excruciating stomach cramps, fever, insomnia, irritability, dysphoria, crawling skin sensation, and piloerection ("goose bumps," which led to the term cold turkey), the symptoms of opiate withdrawal are among the most feared and subjectively distressful syndromes.

The compelling and distressful nature of withdrawal is one of the largest barriers to successful detox treatment from opiate dependency. Treatment of opiate addiction entails either controlled cold-turkey detox, with adjunctive drugs such as antiemetics used to mediate withdrawal discomfort, or attempts at detox using a traditional pharmacological-substitution approach, where a drug with similar pharmacologic effects but with less subjective euphoric "rush" is used instead. In the case of opiate dependency, methadone is the substitute drug of choice. Methadone, an opiate, is potentially psychologically addicting but does not produce the subjective euphoric state characteristic of other opiate drugs, making it easier for a patient to adapt lifestyles and to adjust to a less cognitively impaired state. Once these lifestyle changes occur, the patient still faces eventual detox off methadone, a process that often takes months to years to accomplish.

Rapid Opiate Detox Treatment

The discomfort of opiate withdrawal, which can last up to 14 days with heroin, has led to many addicts avoiding treatment in order to avoid the extreme subjective discomfort. Until recently, avoidance of withdrawal left patients with only two options: continue to use, or substitute with methadone. Acknowledgment of this reality led researchers to attempt to accelerate the detox process and decrease the discomfort, using new understanding of the opiate receptor regulation system by treating the addiction at the neuroreceptor level.

Rapid opiate detox procedures, the outgrowth of these attempts, employs two novel approaches. First, general anesthesia is administered to ensure no subjective distress is felt, which allows the second approach: the use of large dosages of opiate antagonists in order to rapidly and completely remove the exogenous opiate drugs from the opiate receptors in the brain. Because the patient feels no subjective distress from withdrawal, detox can be accomplished rapidly, usually within 4 to 6 hours, rather than 5 to 15 days with traditional detox procedures.

While rapid opiate detox is the most common and most generic of labels used to describe this new approach to opiate dependency treatment, a few authors (Albanese et al., 2000; Legarda, 1998; O'Connor & Kosten, 1998) make a distinction between rapid detox and ultra-rapid detox:

Rapid opiate detox: Similar to traditional detox strategies, but the patient receives more sedation than usually used during withdrawal. This sedation is most commonly accomplished through the use of benzodiazepines and can decrease the time for withdrawal by a day or two. The sedation is done to minimize the subjective distress of withdrawal symptoms, allowing detox to progress more rapidly.

Ultra-rapid opiate detox: An approach using general anesthesia to induce complete unconsciousness, thus ensuring complete comfort during detox.

Ultra-Rapid Opiate Detox is seen as an outgrowth and logical extension of rapid detox procedures, and has become a patent-protected treatment name (UROD). This has led to rapid detox becoming an inclusive and interchangeable term with ultra-rapid detox, with rapid detox being the term most frequently appearing in the literature. "Rapid detox" as used in this article refers to this broader use, when opiate detoxification is attempted with the use of general anesthesia.

Detox: one-size detox doesn't fit all.

Customize your plan with supplements that work best for the liver, digestive system, or arteries

MANY PEOPLE ARE LIVING LONGER than ever: In 1929, life expectancy of the average north American was 57 years; today, it's 77. Yet those extra two decades are spent in a world filled with pollution, pesticides, and the internal toll (especially on the liver) taken by medications.

"Toxicity and detox is of much greater concern than ever before," explains Elson M. Haas, M.D., founder and director of the Preventive Medical Center of Marin in San Rafael, Calif.

To detox or not to detox is no longer the question; instead, people have to decide what to detox first. Do you need to decontaminate your liver, clean out your gut, or clear away cholesterol? Each worthy goal can be accomplished using herbs and supplements. Here's a brief guide to some of the best natural detox or body cleansers.
PEOPLE SEEM MORE pharmaceutically oriented than ever. In the last decade, U.S. prescription expenditures increased about 200 percent, while the population rose less than 15 percent.

Some of these medications, along with alcohol and high doses of over-the-counter drugs like acetaminophen (Tylenol), place substantial stress on the liver.

It's important to support the liver's filtration activity, which is your body's best defense against any number of poisons. Fortunately, there are several herbs that may detoxify your detoxifier.

GI assistants

MANY PEOPLE EAT a diet low in whole grains, fruits, and vegetables--and therefore low in fiber. This may result in constipation and hemorrhoids, both of which are common in the U.S.

Considerable evidence also indicates that chronic constipation increases the risk of colon cancer. In response, formulas for detoxing the digestive system contain xatives to empty the colon.

Heart and cell mates

LDL CHOLESTEROL IS, to some degree, a lifestyle toxin, the result of unhealthy living (fatty foods, inadequate exercise) that increases the risk for heart attack and stroke. Severe cases generally require powerful detox drugs, but people with mildly elevated cholesterol can try natural options to detox their arteries. These three supplements may help reduce harmful cholesterol; garlic and tea are accomplished cancer fighters as well.

MILK THISTLE (Silybum marianum)

Milk thistle seeds contain three components, collectively known as silymarin, that have a remarkable ability to protect and heal the liver. European studies, including a Swiss report in the journal Drugs and an investigation at the University of Vienna, have shown that the herb aids the treatment of alcoholic cirrhosis, extends the survival rates of alcoholics, and speeds recovery from hepatitis.

Plus, milk thistle works better than mainstream medicine against amanita ("death cap") mushroom poisoning; analyzing 452 cases, Swiss 0000ff researchers found that 18 percent of those who received standard treatment died, compared with only 10 percent of patients given silymarin.

"Anyone who drinks alcohol and takes medication regularly might benefit from milk thistle," declares James Duke, Ph.D., retired botanist for the United States Department of Agriculture. The typical recommended dose is 140 milligrams of silymarin three times a day during periods when the liver is stressed from the use of drugs or alcohol or when liver enzymes are elevated.

Side effects are rare, but headache, stomach distress, nausea, hives, itching, and joint pain are possible.

ARTICHOKE (Cynara scolymus)

Because artichoke is closely related botanically to milk thistle, its leaves offer similar protection. "Artichokes are not as beneficial to the liver as milk thistle," Duke says. "But if you enjoy eating them, some liver benefits are an added bonus." As well as being a source of folic acid, fiber, potassium, and vitamin C, artichokes contain cynarin, an acid that aids hepatic function, plus a cleansing compound called inulin, could be the right detox food. The detox herbes may also reduce cholesterol synthesis in the liver.

Artichoke leaf extract is found in some liver-detox formulas. Renew Life Liver Detox (renewlife.com), for example, combines artichoke leaf with milk thistle seed, selenium, dandelion root, green tea leaf, and other purifying ingredients. (It's taken in conjunction with a formula of ayurvedic herbs to support liver function.) Nature's Secret Ultimate Liver Cleanse (naturessecret.com) also provides artichoke leaf, along with milk thistle, dandelion, and other herbs.

ELEUTHERO (Eleutherococcus senticosus)

Also known as Siberian ginseng, this adaptogen stimulates the immune system and increases energy levels. It has a long tradition of use in China as a general tonic and detox with a protective effect against toxins. According to a Korean study, the polysaccharides in the stems of eleuthero enhance liver detox function and reduce levels of enzymes and other detox factors linked to liver disease. In animal studies reported in the British Journal of Phytotherapy, eleuthero tempered the effects of a number of toxins, including ethanol and tetanus. And research in Russia indicates that the detox herb may help the body withstand the effects of chemotherapy.

Eleuthero can be taken for detox following the use of liver-stressing medications like statins or when liver enzymes are high. The typical dose is up to 3 grams of dry root per day for up to a month or up to 16 milliliters of extract one to three times daily for up to two months. Eleuthero is also available in formulas; for example, Now Liver Caps (nowfoods.com) blends it with silymarin (milk thistle), vitamins [B.sub.2] and [B.sub.12], and iron-rich protein.

Side effects, while uncommon, may include drowsiness, anxiety, irritability, headache, and depression. Those who are pregnant, nursing, feverish, or hypertensive should avoid eleuthero.

PSYLLIUM (Plantago psyllium)

This supplement, from the seed of the plantago or plantain plant, is safe for GI cleansing. The word psyllium is from the Greek for flea, referring to the seed's tiny size. But when placed in water, psyllium's outer coat swells like a sponge into a thick, gelatinous material called mucilage, which is a form of soluble fiber.

In the colon, psyllium adds ska scientists showed that the herb provides significant relief from constipation and reduces pain during defecation, while a report from Procter & Gamble researchers found that psyllium works better than docusate sodium, the active ingredient in Colace, an OTC stool softener.

Because bulk-forming laxatives most closely approximate the body's own mechanisms, psyllium is a "recommended choice for most forms of constipation," according to the American Pharmaceutical Association. The usual dose is about 7-5 grams per day. To avoid blockage, it's important to take psyllium with 8 to 12 ounces of water followed by more water throughout the day, says Linda B. White, M.D., co-author of The Herbal Drugstore. Psyllium, which is safe to use long term, is available as a powder or capsules under numerous labels; it's also the active ingredient in Metamucil.

GOLDENSEAL (Hydrastis canadensis)

Used medicinally by Native Americans, goldenseal has an active compound called berberine, which has demonstrated powerful antimicrobial action in lab studies (though it's not easily absorbed). University of Illinois researchers found that goldenseal inhibits the growth of H. pylori, the bacterium behind most ulcers.

Other studies indicate its value in treating giardiasis and infectious diarrhea.

Goldenseal causes no significant side effects, though long-term use for detox can be expensive, it's not a cheap detox or detox product. Many herbalists recommend it only for symptoms of persistent intestinal distress. Take 2 to 4 mL tincture or o.3 to 1 mL fluid extract. The detox herb is also included in formulas such as Amazing Herbs Detox/Flush (amazing herbs.com), which combines goldenseal with milk thistle and other detox and body cleansers like burdock root and beet powder; it's taken for seven days in a range of doses, based on desired results, with additional dosage for daily maintenance.

ALOE (ET AL) (Aloe barbadensis, A. Africana, et al)

Many herbs have laxative action. Aloe, buckthorn, cascara, and senna all contain anthraquinones, compounds that chemically stimulate the colon. But they can also cause abdominal distress, cramps, and diarrhea. In addition, extended use may result in "laxative dependency syndrome," an inability to without them.

In 2002 the FDA banned laxative drug claims for over-the-counter products containing aloe and cascara. "But these herbs may still be found in supplements that do not claim laxative action," explains Mark Blumenthal, executive director of the American Botanical Council, in Austin, Texas. "They are labeled as intestinal cleansers or detoxifiers for promotion of bowel health."

To try these herbs, buy a commercial preparation and follow the label directions. Use only occasionally for relief of constipation that does not respond to other approaches, such as psyllium or exercise.

FYI, the laxative portion of aloe is the solid residue that resides beneath the skin, not the leaf-derived gel commonly used to treat minor burns.

GARLIC (Allium sativum)

In an investigation at Penn State University, garlic lowered total cholesterol in subjects with high cholesterol by 7 percent. (Additional research has shown that every 1 percent drop in total cholesterol results in a 2 percent drop in coronary-disease risk.) Other studies have generated less impressive results, but there are still significant indications that garlic may have a positive impact on cholesterol levels and heart health,

Many studies have used the equivalent of one-half to one clove a day. "Garlic works best if you chew the cloves raw," Duke explains. If that's a turnoff, take a supplement--one clove equals about 4 grams. Kwai and Kyolic (at drugstores) are two popular brands--the former also offers a "Heart Fit" variation that combines garlic with antioxidant vitamins A, C, and E--and manufacturer trials found that Nature's Way Garlicin (naturesway.com) was consistently potent.

Impaired blood clotting is the one notable side effect, so if you notice increased bruising, consult your physician; if this is not an issue for you, garlic may be used daily. To avoid "garlic breath," chew on parsley or opt for "deodorized" supplements.

PSYLLIUM (Plantagon psyllium)

In addition to aiding the digestive tract, the soluble fiber in psyllium is similar to oat bran in its ability to reduce cholesterol. In a study published in the American Journal of Clinical Nutrition, University of Kentucky researchers gave people with high cholesterol a placebo or 5.1 grams of psyllium twice a day along with a modified diet. After 26 weeks, serum total and LDL cholesterol was 4.7 and 6.7 percent lower, respectively, in the psyllium group. An added bonus: A study in Spain found that psyllium lowers blood sugar absorption in type 2 diabetics.

"Psyllium doesn't lower cholesterol as much as the statin drugs," Blumenthal notes, "but it's clearly useful in any cholesterol-reduction program." Take psyllium with plenty of water; check labels for details.

TEA (Camellia sinensis)

In the West, tea is a beverage; in China, it is medicine. "The Chinese consider tea a grease-cutter," says San Francisco-based Efrem Korngold, LAc., O.M.D. "It protects against harm from fatty meals."

Western science seems to be catching up to this idea. In a study conducted by the USDA, volunteers received five servings of tea daily or a placebo; after three weeks, the tea group's cholesterol dropped 6.5 percent. And a Dutch study found that people who drank one or two cups of tea daily had significantly lower risk of heart disease than non-tea drinkers.

"Tea is high in antioxidants -could be a real ditox diet- , which help prevent both heart disease and cancer," Duke observes. Drink one to four cups a day, or as much as you enjoy. A cup of tea has approximately half the caffeine of a cup of instant coffee, and one-fifth the caffeine of brewed coffee; however, jitters and insomnia are still possible.

By the way, green tea and black tea come from the leaves of the same plant--steaming the leaves produces green tea, while fermenting them yields black--and both may help ward off heart disease.

Natural Health Author Michael Castleman - COPYRIGHT Weider Publications & Gale Group