Patients who have stopped using opiates and gone through the withdrawal process often wonder why their energy is so low and want to find ways to boost it.
After extended use of opioid pain medications such as Oxycontin, Percocet®, Opana®, Dilaudid®, Vicodin®, etc., stopping is no easy matter. Neither are the first several weeks afterward.
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. Cessation of the opioid medications that have been supplying your brain with dopamine leaves the brain with a deficit of dopamine.
In addition to a lack of dopamine to contend with, many patients who have been using opioids for an extended time have not focused on other important aspects of their health. Eating, sleeping, and moving have often been compromised and impaired.
There are no magic pills or shortcuts, but you absolutely can restore your brain and body, leading to optimal energy. This healing process requires intention and compassion. It helps to have a solid plan.
My suggestion? Get a blank book and create a personalized habit-tracking plan. Start with these 5 ways to boost energy after opioid withdrawal.
1. DO NOTHING
In the early days following an opiate detox, patients routinely plague themselves with energy draining thoughts such as:
- I had more energy on pills
- I’ll never feel better
- I can’t function like this
- I always relapse, this time will be no different
- I can’t bear the physical sensations
- I can handle a lower dose of opioid medications
The recovery community refers to such thoughts as Stinkin’ Thinkin’. Fighting or trying to resist or suppress these thoughts saps unnecessary energy.
In The Joy Diet, Martha Beck, Ph.D., talks about the importance of starting your day with “doing nothing.”
“Doing nothing” means do nothing but with intention. Pick an “activity” to do at a designated time for a certain duration every day. These “activities” can be:
- Practice mindfulness
- Contemplative prayer
- Pranayama breathing exercises
Without awareness of the recurring patterns of thoughts, it becomes all too easy to believe one’s own thoughts—even if an alternative thought might be as true and bring peace rather than stress.
Remember, the brain has developed neural pathways reinforcing thoughts and behaviors supporting the drug use. The goal now is to create new pathways of thinking and action. This can only happen when we become quiet enough to notice the thoughts.
Enormous amounts of energy can be harnessed by decreasing resistance while dialing up awareness to such repetitive, harmful thoughts.
This step is essential for learning that we are people who have thoughts, but we are not our thoughts. Any long-term recovery and rebuilding energy after opioid withdrawal require the skill of separating ourselves from our thoughts.
2. SLEEP WELL
Trouble sleeping may be the most frequent concern we hear from patients who have been treated at Coleman Addiction Medicine. When it comes to restoring energy, you just can’t overrate the importance of sleep, especially after going through the process of stopping Percocet, Roxicodone, Oxycontin, etc. It’s important to create daily habits that support sleep, whether using medications to help with this in the short term following detox or not.
There are many resources available online that detail proper sleep hygiene. Across resources, we saw a few commonalities to restore sleep include:
- Avoid caffeine. Caffeine and its energy boosting effects may provide a temporary “buzz,” but this may come back to bite at bedtime. Some people are more susceptible to the effects of caffeine than others. Try weaning slowly for a week, then turn to caffeine-free beverages.
- Go dark. When it’s time to sleep, turn off any gadget that makes light. The light wavelengths that our smart devices and computers emit interfere with “melatonin production and stimulates the alert centers in the brain as a survival benefit to keep us awake and aware in daylight.”* Using a lightweight eye mask can be incredibly helpful to filter out light in a room that is difficult to darken.
- Limit napping. The National Sleep Foundation suggests limiting daytime naps to 30 minutes. Napping can’t replace inadequate nighttime sleep, but a short nap of 20-30 minutes can help to improve mood, alertness and performance.
- Exercise and activity. Even as few as 10 minutes of aerobic exercise, such as walking or cycling, can improve nighttime sleep quality. While the effect of intense nighttime exercise on sleep differs from person to person, most people should avoid strenuous workouts close to bedtime.
- Keep a consistent bedtime. Figure out a good 7-8 hour chunk of time for sleep that works with your life, and try to honor these hours—even on the weekends. Many smartphones have settings to remind when it’s bedtime and when it’s time to rise and shine.
- Eating at bedtime. Allow 3 hours between your last meal and bedtime; if you need a bedtime snack, Dr. Kelly Brogan, MD, author of A Mind of Your Own, suggests a handful of raw nuts.
3. BE INTENTIONAL WITH YOUR EATING
People who have been on long-term pain medications such as Opana®, Percocet®, Dilaudid®, and Vicodin® often experience compromised eating habits. They have likely forgotten the feeling of energy that comes with a healthy appetite and a healthy diet.
There are so many recommendations for the best diet out there, it can be mind-boggling. Vegan? Vegetarian? Pescatarian? Paleo? Mediterranean?
Although all of these diets differ in some way, there seems to be agreement about a few things:
- Avoid processed food as much as is possible. These are foods that generally come in a box or a package and have a long list of ingredients. If a product has a shelf life that allows food to stay intact long after it’s made, that’s probably a great thing for the food manufacturer, but not a great thing for the body. Especially a body that has just gone through opioid detoxification. Why put more toxins in?
- Eat food that looks as much like it did when it came out of the ground or dropped off a tree. Think about it—our bodies are not so different now than hundreds of years ago. But the foods that are so readily available for consumption often look nothing like the original fruit, grain, vegetable or nut that was its origin.
- Eat heart-healthy fats. As the science of nutrition continues to evolve, it seems the trend continues to go back to basics. Healthy fats, such as found in olive oil, coconut oil, nuts, avocados, certain types of fish, are believed to be heart-healthy and non-inflammatory. As much as possible, stick to these fats.
- Watch out for hidden sugars. Sugar causes a quick insulin release from the pancreas, which can then drop sugar levels so low that energy plummets. This low energy causes people to eat more sugary products to try to get their energy up again, and a vicious cycle ensues.
Patients getting off Percocet®, Dilaudid®, Opana®, etc. are ‘returning to their bodies’. Without these medications, they may be intimidated by physical sensations they haven’t felt for some time, and be guarded about making any moves that could potentially cause pain.
Start slowly. Gentle stretching and walking is one of the best formulas out there. The majority of our patients who have been treated with long-term morphine products are stunned at the minimal discomfort they experience when the meds are gone and they start to move again.
While it is important to clear any vigorous exercise program with their doctor, it is also true there may be nothing that generates more energy after an opioid detox than moving one’s body.
There are plenty of psychological benefits to movement, too. Walking and being out in nature have been shown to reduce depression.
5. DOCUMENT YOUR PROGRESS
Patients who come to Coleman Addiction Medicine to get off fentanyl, Roxicodone®, Oxycontin®, or other opioids typically have scheduled follow up appointments every one to two months. Therefore, it is easy for us to see the progress patients have made in energy levels, sleep, relationships, and mood.
One of the most beneficial practices for our patients is to keep a journal documenting their progress. A daily entry, whether long or short, is a powerful motivator because it shows how far you’ve come. There is nothing as satisfying as reading back on the first low-energy, foggy days post-detox, and realizing how far you have come.
Realistically, it may take the body several weeks to begin to rebuild dopamine. During this time period, you have an opportunity to start to incorporate energy-building life-long practices.
The first step, of course, is to get off the pain medications. Coleman Addiction Medicine is dedicated to making this process safe, gentle, and effective. We’ve been the leaders in medication-assisted treatment using the opiate blocker, Naltrexone, for Opioid Use Disorder for over 20 years. Please call us with your questions and take back your life.
Joan R. Shepherd, FNP
*Kelly Brogan, MD, A Mind of Your Own; page 186