Raphael (I don’t use patients' real names, so I thought this would be a fun one) came to the office recently to have his monthly Vivitrol injection. Vivitrol is the trade name for a long-acting formulation of naltrexone, which is a pure opiate antagonist or blocker. After the rapid detox, Vivitrol is often given monthly to occupy the endorphin receptors in the brain to help fight cravings and help with a successful recovery.

Raph completed a rapid opioid detox with The Coleman Institute several months ago. Prior to that, he used heroin and assorted pills for almost a decade. He has a small, but growing construction company. He used to work for someone but had to create his own business because of a felony charge for possession some years ago.

He told me that a couple of weeks before this office visit he was looking for something inside the toolbox on the back of his truck when he found a small bag of heroin. Raph said it was like time was suspended; he held the bag in his hand, staring at it as if an alien had started growing up out of his palm. He felt shock, disbelief and—interestingly—most strongly, he says he felt fierce anger.

What Happens to the Brain on Drugs

Repetitively using opioids changes the brain’s ability to function. If Raphael had found his little bag of heroin when he was still actively using, he very likely wouldn’t have hesitated to use it. The brain of the opioid user desires to repeat the behavior again and again to get the same good feelings.

Without opioids the human brain coordinates the activity of billions of neurons throughout the body, but opioids totally override this ability and functioning is altered. When a person repeatedly consumes opioids, the brain is imbalanced but is always trying to right itself.When opioid receptors are occupied with opioids the body produces excessive amounts of dopamine which trigger the reward system in the brain. This is why people are motivated to take more, and soon it becomes their only source of pleasure. When the body lacks dopamine, you can feel depressed, tired, have poor concentration, and even experience tremors. As Raph and most of our other patients could tell us, they felt as though they functioned incredibly well on their opioids.

And to a certain extent, this is true. The brain rearranges itself to try to accommodate any situation it’s in. But sadly, when the brain is able to adapt to the constant presence of opioids, opioid dependence is established. This means that without the drugs, withdrawal is inevitable.


Does Suboxone Cause Brain Fog?

Suboxone, as a partial opioid agonist itself, can have similar effects to opioids when detoxing. One of these effects is commonly referred to as “brain fog.” Brain fog can make focusing on tasks difficult. As the brain fights to heal and regain chemical and hormonal stability, it can feel like there is a slow down in regular thought processes. This can manifest in feeling tired and irritable, forgetfulness, and a wandering attention span.

Healing While Experiencing PAWS

Post-Acute Withdrawal or (PAWS) is what people can experience after they have detoxed. It is very uncomfortable for most, and its duration is individually based. As the brain recalibrates without the presence of opioids, the body experiences low impulse control, depression, anxiety, irritability, insomnia, brain fog, poor memory, and intense cravings. Working with a professional to get through these symptoms is crucial in the recovery process as they can sometimes lead to relapse.

Healing the Brain After Opioid Detox and Withdrawal

After completing the rapid opioid detox at the Coleman Institute, Raph’s brain began the healing process. Our protocols help a great deal with getting through the initial intense withdrawal. Symptoms such as anxiety, chills, diarrhea, insomnia, muscle spasms, and insomnia are largely reduced or eliminated.

And although Raphael is doing well and his Post-Acute Withdrawal (PAWS) symptoms (which are pretty standard after being on opioids for such a long time) are tolerable, he readily admits that having naltrexone on board when he found the heroin may have saved him from relapse.

His brain will likely be vulnerable for several months. This is why we strongly encourage our patients to commit to at least a year of naltrexone therapy using either implants or injections, coupled with counseling that further helps the brain learn new patterns of reacting to life’s inevitable stresses and surprises…like an argument with your spouse, a disagreement with your boss or finding a bag of heroin in your toolbox.

Please call us at 877-773-3869 if you have any questions about our rapid opioid detox. We are here to help.

Joan Shepherd, FNP