textfiles/drugs/diy.det

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