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  1. #1
    PENCILNECK
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    Default Opioid addiction/withdrawal and the Adrenal glands/Adrenal fatigue

    Opioid addiction/withdrawal and the Adrenal glands/Adrenal fatigue

    I read that having no power during opiate withdrawal should be related to adrenal fatigue and problems with the adrenal glands.
    I started a research and it seems that opiate addiction causes really a change in adrenal gland hormone production.
    A couple of websites mention that opiates could deplete your adrenal glands. I cannot really believe this because it is also said that opioids shall reduce cortisol production. And it seems that cortisol levels rise during opioid withdrawal. But I am not sure if it rises because it was depressed during the long time of opioid abuse or if it rises because withdrawal means so much stress to the body.

    Todd T. Brown, Amy B. Wisniewski, and Adrian S. Dobs. Gonadal and Adrenal Abnormalities in Drug Users: Cause or Consequence of Drug Use Behavior and Poor Health Outcomes. Am J Infect Dis. 2006; 2(3): 130–135.
    Opiates and cocaine both have effects on adrenal and gonadal function. Opiates suppress the hypothalamic-pituitary adrenal (HPA) axis, whereas cocaine leads to HPA activation. Opiates also cause gonadal dysfunction in both men and women. During withdrawal from opiates and cocaine, the HPA axis is activated which may reinforce relapse behavior. This review describes these hormonal effects and explores the potential consequences, including the effects on mood cognition and cardiovascular risk. Modification of the drug-induced hormonal dysfunction may represent a treatment strategy for drug rehabilitation.
    When the body is in stress (and opiate withdrawal surely means a lot of stress for the body) it will produce/release more cortisol.
    So during withdrawal there is probably more cortisol than I want...

    Adrenal fatigue means being tired all the time, having no energy, no motivaton to do something, mild depression, anxiety, ...
    This is what I feel during opiate withdrawal.
    But I think, a doctor will prescribe cortisol for adrenal fatigue. And during withdrawal there shouldn't be too less cortisol, should it? Shouldn't the body produce much cortisol during the stress of withdrawal?
    Why do I often read advices to take an adrenal supplement for opiate withdrawal? Wouldn't it be logical to take something cortisol reducing?
    Is "adrenal fatigue" really occuring during opioid withdrawal or is it something else?


    It seems that cortisol levels are decreased during the time of opioid addiction
    Fabio Facchinetti, Annibale Volpe, Giulia Farci, Felice Petraglia, Carlo A. Porro, Giancarlo Barbieri, Anna Cioni, Angelo Balestrieri, Andrea R. Genazzani. Hypothalamus-pituitary-adrenal axis of heroin addicts. Drug and Alcohol Dependence Volume 15, Issue 4, August 1985, Pages 361–366
    The hypothalamus-pituitary-adrenal axis of heroin addicts was investigated by evaluating plasma cortisol levels throughout the day in 37 heroin abusers.
    All heroin abusers showed lower cortisol levels in basal condition compared to the control group.
    Moreover all heroin abusers, and in particular those taking heroin during the study, show a reduced cortisol decrease in the evening, which was significantly lower than in controls. [...] These data indicate that chronic opiate abuse leads to a hypoadrenalism which could be the result of morphine-induced changes at the hypothalamic level.
    and it seems that cortisol levels rise during withdrawal:
    Bearn J, Buntwal N, Papadopoulos A, Checkley S. Salivary cortisol during opiate dependence and withdrawal. Addict Biol. 2001 Apr;6(2):157-162.
    Salivary cortisol concentration correlated significantly with withdrawal symptom severity. [...]Salivary cortisol levels remained significantly higher than controls for the duration of the study. The study supports a role for hypothalamo-pituitary-adrenal (HPA) activation in opiate withdrawal. The contribution of persistant dysregulation of the HPA, found in this study, to the vulnerability for relapse after abstinence has been achieved, is discussed.
    Camí J, Gilabert M, San L, de la Torre R. Hypercortisolism after opioid discontinuation in rapid detoxification of heroin addicts. Br J Addict. 1992 Aug;87(8):1145-51.
    Nava F, Caldiroli E, Premi S, Lucchini A. Relationship between plasma cortisol levels, withdrawal symptoms and craving in abstinent and treated heroin addicts. J Addict Dis. 2006;25(2):9-16.
    Li SX, Li J, Epstein DH, Zhang XY, Kosten TR, Lu L. Serum cortisol secretion during heroin abstinence is elevated only nocturnally. Am J Drug Alcohol Abuse. 2008;34(3):321-8.


    The second cited study said that
    Salivary cortisol concentration correlated significantly with withdrawal symptom severity.
    What does this correlation mean? Does it just mean that cortisol levels rise the more severe the withdrawal is? Or does it also mean that withdrawal could be alleviated when cortisol levels would be decreased.
    I is said that phosphatidylserine shall be able to lower cortisol levels. In Germany it is sold as body building supplement that shall be able to lower cortisol levels. I don't know if it really works but when it could lower cortisol levels then maybe it could help during opioid withdrawal?


    Some of these adrenal supplements that are adviced during withdrawal contain herbs like ashwagandha, (siberian) ginseng, rhodiola and/or schizandra. But others also contain "Freeze dried Adrenal Cortex Extract", "Raw Tissue concentrates from toxin-free lyophilized glands", "Adrenal and spleen concentrate".
    I don't know too much about these extracts. But I think they will contain cortisol. In Germany it is not allowed to play with hormones without prescription and when someone needs more cortisol (or any other hormone), he will get an injection (or pills) by a doctor. I never heard of anyone who ever got those extracts. It is nearly impossible to find german texts about that. No doctor prescribes that stuff and it's not allowed as dietary supplement (in Germany).
    I think, I would not dare to try those preparations. But could this really help during opioid withdrawal?
    For me it seems that this would make it worse.

    But what with those herbal supplements? Could this maybe help during opioid withdrawal?

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