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He’s Withdrawing At Home

B&W man facing wall

momoftwins' Loved One is trying to detox himself at home and clearly wants to be left alone. She knows it's going to get much harder and is afraid of what he'll turn to. How can she best support him right now?

© Nijwam Swargiary via Unsplash

Hi. My son was in an outpatient suboxone program but with COVID 19 there is no going into the office at the program and no drug testing. He had completely relapsed for about 5 weeks now. Very difficult.

He has been trying for last 2 days to detox himself. Already getting sick and agitated. I have tried to ask if he wants to go for walk etc. but he said he wants to be left alone.

Should I do so? Should I try to engage with him? It is going to get much harder in the next 3 to 4 days and I am afraid he will go back to using. Any support I can give him?

Thank you.

Detoxing from opioids at home is very hard. You are watching your son try this after a 5-week relapse on opioids. COVID is forcing treatment centers to change how they deliver services. In the case of medication for opioids (like the Suboxone your son was on), a minimum of monitoring and follow-up would typically include drug testing, face-to-face check-ins, and therapeutic support. So the situation at hand is far from ideal. Only the most motivated clients are likely to hang in there without these minimum external supports.

We wrote a post a while back that addresses your question to some extent. The member writing in was addressing the need for a more orderly withdrawal from Suboxone. But an opioid is an opioid. What we suggest in that post is worth reading given your situation.

The longest acting opioids are the ones that are the hardest to come off of because they stay in your system so much longer than opiates such as heroin. Coming off of methadone can take weeks, even months, before one feels “normal” again: sleeping, eating, and generally being in a decent mood. Suboxone, I’ve been told, takes less time. Heroin and opiated pills can take even less time: perhaps 7-10 days. But everyone is different, so these are just estimates.

My first suggestion is for your son to get back on Suboxone. It will stop the withdrawals and is simply the best way to protect him from more use and possible overdose. It can take several efforts, several treatment programs, to get any traction with abstinence.

Would your son try again? I know the conditions were not optimal this past time. The clinic isn’t testing or providing sufficient supports during this virus but will they take him back on? Can they tighten things up around him? How about home testing in coordination with the clinic?


What does the clinic recommend?

As your son’s family member, you are in a position to help him withdraw. I do suggest you keep your actions small, though. By this, I mean: you leave him alone for the most part. Withdrawals are a consequence of use. You’ll need to find a balance between fawning over him and completely ignoring him. Be as neutral as you can be. Provide him with what he needs, but don’t wait on him and try not to sugar-coat what’s going on by telling him it will all be all right. This lines up with the CRAFT approach of allowing natural consequences.

The withdrawals are typically not dangerous with opioids. You do want to watch for dehydration. A recent talk I heard suggests lots and lots of Gatorade or whatever form of electrolyte solution you can come up with. The post I referenced above gives some other tips.

I suggest you call a local detoxification center and tell them what is going on. They may have more suggestions. Ask them about bed availability as backup.


Your son may not be able to hang on. He may decide to use an opioid to stop the pain. In this case, he’d be in danger of overdosing as his tolerance is dropping quickly. You should have Naloxone in the house and be clear on how to administer it. You are not a medical professional. The minute his condition scares you, call an ambulance. You can’t be expected to know what to do in a moment of such extreme stress. I dearly hope this does not come to pass, but thinking this through now will help you take swift action in a time of crisis if it does come to that.

All in all, withdrawal is hell. You are watching your son in pain, which is not easy for anyone. COVID is reducing options for help so, though this is not an ideal scenario, you may be the best help he has right now. You can do this. Know that every day will be better than the day before.

Thank you for reaching out. This is an important question. Our thoughts are with you and all families trying to navigate an already difficult treatment system made even more challenging with COVID. Your question must be on the minds of so many families right now. Please let us know how it goes.



In your comments, please show respect for each other and do not give advice. Please consider that your choice of words has the power to reduce stigma and change opinions (ie, "person struggling with substance use" vs. "addict", "use" vs. "abuse"...)

  1. Hi there: Still off Heroin but struggling more and more daily. Says that life was easier on drugs and he is unhappy. I keep telling him that with support he will eventually feel a bit better but I think he is thinking of going out and getting drugs again. I have looked into Recovery Centers of America. They have an inpatient suboxone program for 30 days. They will also conduct an intervention at home but I don’t know if that is a good idea.

    He is angry all the time and snaps easily. I look for windows to talk about rehab and support.

    Not sure how long we can go on in this state and I fear he will break down and go back again to Heroin before I can get him in a program.

    1. Your son is on-again, off-again with Suboxone. He is home and is off all opioids at the moment, but his irritation is growing. You are concerned he will turn back to heroin before you are able to engage him into a 30-day Suboxone inpatient program. Your own nerves must be frayed. Your poor family.

      Life has indeed become small for your son. You’ve certainly gone through these steps before, but write down every last detail about the inpatient program in order to facilitate his admission: the phone number, the person to speak to, what documents are needed, how it is paid for, transportation, what about COVID?

      Read Dominique Simon-Levine’s full response to momoftwins here:

    1. Dear Sunny, Welcome to this community. We are so glad you’re here. Thanks for your comment and for letting us know that this post was helpful. Sending you our best.

      You are not alone.


  2. Thank you for your advice. Spot on in so many ways. He has pulled through on the detoxification and is back on Suboxone which helps with his cravings. I am proud that he was able to detox at home and I know he wants this. Now that he is somewhat detoxed from Heroin, he seems a bit moody and gets agitated very easily. Now that he is not using I am trying to follow the CRAFT method. I am also looking for windows of opportunity to discuss getting support such as meetings etc. The suboxone clinic is not opened yet but they do reach out to him I believe. I don’t think he was truly engaging with them but I have said that if he wants to stay on Suboxone he needs to converse with them.

    He feels he needs no help and this has been the problem since day 1. I swear when he was using he was much more tolerant of conversations with me and expressed how he wanted to get off the heroin. Now that he is off heroin, he is shutting us out more and more. Very confusing at times and of course I am worried that he will use again.

    He fought with his twin brother last night over something silly and he stated that things like that make him want to use. He said that if I didn’t support him and side with him he might use again. I did say that I am not responsible for whether he uses or not.

    One day at a time . . .

    Thank you.

    1. Hello Momoftwins. Glad to hear things are going a bit more smoothly. Your son’s nervous system has been through a lot lately: the suboxone, the heroin, the withdrawals, and now back on the Suboxone. He is likely to be irritable for a while. He is also likely to get more edgy without emotional supports. You can’t be his emotional support.

      So more CRAFT: same approach, new treatment goal (module 8): self help, early recovery group, peer supported programs at a recovery center? If the irritation is getting to him, perhaps you help him look for a psychiatrist.

      I love that you told him your were not responsible for his use. Yes, there will be irritations like twin brothers all his life.

      You are in shutdown with someone in very early recovery who is not getting much help for his moods or thoughts, or the prevention of relapse.

      Take small steps. Don’t expect much from him. I hope you can find a place or a way to stop the action and go to a place of peace, even if it’s just for 10 minutes.

      All our best to you. BTW: people do get abstinent with little or no help. it is called spontaneous recovery in the literature. I don’t recommend waiting around for it though.

  3. Thank you for responding. He is on day 2 and the suboxone helps with the withdrawal from Heroin/Fentanyl. I do leave him alone for the most part and when I ask how he is doing he does get agitated. I pray he will continue to try. I know he hates the control that drugs have on him. Taking it one day at a time and thank you for your support and advice.

    1. Hello Momoftwins,
      I’m a new member and I’m also prescribed Suboxone. I came off of heroin at my parents house many years ago and I recall it like it was yesterday. I didn’t want to be touched, I didn’t want to eat, talk, move, shower, or anything. But it helped just knowing my mom was there. She would ask if I wanted any food, and left fresh water, and a bucket with a rag next to my bed. She’d wipe the puke off my face while I was sleeping, but it took her a couple days to understand that cleaning myself up and going outside wasn’t going to happen. So she would check on me every so often to make sure I was ok.
      It’s going to get harder for your son in the upcoming days, so I also suggest following the advice given and trying to find a Suboxone clinic (a different one) that’s open and accepting patients. Hang in there and I wish you well!

      1. Thank you HelloRebel. Words of encouragement. Unfortunately on day 3 he went back onto Heroin/Fentnyl. Says he is going to stop and wants sobriety. I am trying to figure out what next? I think he needs a detox program. He has suboxone but not taking now because of the Heroin. Keeps saying he will stop. He did it before but the suboxone program he is with has him call in for prescription because of CoronaVirus.

        I don’t know what to do but feel encouraged hearing your story. Thank you so much.

        1. Your son is wrestling with opioids in the middle of a Pandemic. Suboxone was designed for motivated individuals. This is certainly the case when they take away drug testing and therapy. It sounds like your son knows the score. Please do call a detox to see what else can be done. Young people, especially, look better than they are as they detox from opioids. Jail medical teams have learned dearly from mistakes. The dehydration is dangerous. Gatorade, Gatorade.