A patient called the other evening. He finished his rapid opioid detox about a week ago. He has a very physical job and is the father of a 4-month-old baby, Noah. Noah is the reason he finally decided he had to stop using opioids once and for all. He has been using high dose opiates for over 20 years, with a few small blocks of abstinence thrown in.

He did well through his opiate detox; he was able to stay pretty comfortable getting off the equivalent of somewhere between 300-450 mg of mixed opiates. He was also using heroin. He was able to detox from opioids in 3 days. On the first day, we planned, together, for him to stop using opioids. The next day when his previously overstimulated endorphin receptors were dropping from lack of opioid use, we gave him a small dose of Naltrexone to avoid the feelings of “going cold turkey.” On day three, his endorphin receptors were free from the effects of opioids. He was amazed at how comfortable the detox and withdrawal process was. Naltrexone therapy helps to decrease cravings and allows the brain to heal. It also offers protection from slip-ups. Vivitrol injections can also help by offering sustained endorphin receptors for months after.

His call came because he is so very frustrated with his lack of energy since detoxing. from opioids. With a job installing granite counters and a tiny baby, not to mention the mother of this tiny baby who is desperate for his help, this man wants to feel energized. Now. Yesterday. He wants a magic pill and he is certain there is something I can prescribe for him to help. If there is, I haven’t found it.

The Impact of Opioid Withdrawal on Energy Levels

With over 2 million Americans abusing opioids, and the loss from overdose growing by the day, many are experiencing the difficulty that comes with dependency and withdrawal. When you stop taking opiates your body goes through withdrawal. The body's endorphin receptors take a dive and the body feels this in many unpleasant ways. For some, unpleasant symptoms may persist even after the body has detoxed. 

One of the most common complaints from those in recovery is having low energy and feeling very irritable. This lack of energy can be debilitating, making it difficult to carry out daily activities and maintain a normal routine. The feeling of constant exhaustion can also exacerbate other symptoms, such as irritability, mood swings, and depression, creating a vicious cycle that can be challenging to break.

One of the signs that your energy is low due to being in a state of post-withdrawal is exhaustion paired with trouble concentrating, memory problems, or anxiety. This combination of symptoms can significantly impact an individual's ability to function effectively at work, school, or in social settings. Difficulty concentrating and memory problems can make it hard to complete tasks or follow through with commitments, leading to frustration and a sense of inadequacy. Anxiety can further compound these issues, making it hard to relax or feel at ease in various situations.


PAWS and Low Energy After Opioid Withdrawal

In conjunction with feeling low energy post-withdrawal, he was also feeling irritable and frustrated. These feelings fed his exhaustion and he knew he had to gain some insight into managing these symptoms. He was feeling the effects of Post-acute-withdrawal-syndrome or PAWS.

PAWS is a condition that affects many individuals after they have undergone a medically supervised detoxification from opiates. Unlike the acute phase of withdrawal, which involves intense symptoms over a shorter period, PAWS can linger for weeks, months, or even years after initial detoxification. It’s characterized by a range of symptoms, including feelings of lethargy, headaches, nausea, muscle aches, irritability, anxiety, and depression. These symptoms can be quite debilitating and make the recovery process seem overwhelming.

One of the most common and persistent symptoms is a profound sense of fatigue. This isn't just typical tiredness but a deep, pervasive exhaustion that can make even simple daily tasks seem insurmountable. Individuals often experience mood swings, irritability, and frustration. These emotional fluctuations can be intense and unpredictable, contributing to a sense of instability. Many people report difficulties with concentration, memory, and decision-making. This cognitive fog can interfere with work, school, and personal relationships. Insomnia or disrupted sleep patterns are frequent issues. Poor sleep exacerbates other symptoms, creating a cycle of fatigue and irritability. Additionally, headaches, nausea, and muscle aches are common physical symptoms. These can sometimes mimic the flu, adding to the overall discomfort.

Managing PAWS requires a multi-faceted approach focusing on physical health, mental well-being, and social support. It's crucial to identify and avoid situations, people, or environments that can trigger cravings or relapse. A balanced diet is essential. Proper nutrition helps replenish depleted nutrients, stabilize blood sugar levels, and improve mood and energy. Focus on whole foods rich in vitamins and minerals, and stay hydrated. Regular exercise can be a powerful tool in managing PAWS. Physical activity releases endorphins, which are natural mood enhancers. Exercise also improves sleep quality, reduces stress, and boosts overall energy levels. Establishing a regular routine can bring a sense of normalcy and control. Regular sleep schedules, meal times, and planned activities can help stabilize daily life. Practices such as mindfulness, meditation, and yoga can help manage stress, reduce anxiety, and improve emotional regulation.

Using Natural Dopamine to Fight Low Energy After Opioid Detox

Dopamine is the neurotransmitter that allows us to feel pleasure. It is made in our brains so we can enjoy food, sex, laughing, a beautiful sunset, fishing, hunting or whatever it is that personally brings you pleasure. Unfortunately, when the brain is constantly overloaded with exceedingly high levels of dopamine from an external source like opioids, it eventually stops making its own. It can’t compete.

If external sources of dopamine are not introduced into the brain for about four months, the brain will begin to make its own again. And that’s what we tell our patients. One of the standard questions we track at the Coleman Institute when people return for their follow-up Naltrexone implants specifically addresses this: What is your energy level on a 0-100% scale?

Most people don’t have their energy levels back to 100% by four months, but almost invariably people are feeling better in 2 to 4 weeks. It is closer to two weeks for patients getting off short-acting opiates such as most painkillers and heroin; closer to four weeks for patients detoxing off methadone and Suboxone.


The Right Way to Improve Low Energy After Opioid Withdrawal

Part of my job is to help people manage their expectations about restoring energy after detox. Some patients say they have used various amino acid supplements that seem to help with a quicker recovery. Others say exercising, working hard, and avoiding naps during the day help. I believe the body wants to heal from opioid use and it will. I think it’s important to put the best "fuel" into our bodies we can, but I haven’t met a patient yet who doesn’t eventually feel and look better within a few months, even if the only change they make is stopping opiate use.

Managing Low Energy Levels After Opiate Withdrawal

When he asked us if we had any tips on how he could manage PAWS, we were happy to share with him what we have seen work well for others.

  • Be realistic. Recovery from opioids takes time and it’s important to be patient with yourself and others.
  • Get to sleep early. The body has a lot of healing to do when going through recovery after opiate detox. Make a plan to get 8 hours every night.
  • Journal your experiences. Journaling can help you pinpoint patterns in your thoughts and identify other ways of reacting.
  • Make an appointment with a mental health professional to help support you.
  • Problems with memory are a common occurrence with PAWS. Writing things down can be extremely helpful to keeping up with daily tasks.
  • Joining a 12 step program can be very helpful as you get to meet other people who are going through the same thing as you.
  • Cyclical thinking can be interrupted by listening to music, talking with friends, or getting some physical exercise.

Learn more about boosting energy after opioid withdrawal.

Take the First Step Toward Opioid Detox and Recovery

So I have great faith that Noah’s dad will regain his energy, hopefully, sooner than later. And when that little guy looks up into his dad’s face and smiles and laughs, or when he takes his first few steps, I think some genuine dopamine will be coursing through this proud daddy’s brain.

If you or someone you know is struggling to reclaim their life from the destructive power of opioids, you can also find help like Noah did at the Coleman Institute. Our Accelerated Opioid Detox program can put you on the path to freedom from addiction. All it takes is one phone call.

Contact the addiction medicine specialists in our Richmond, VA, office or in one of our nationwide clinics near you today to learn more about the Coleman Method for opiate detox, or request a callback below.