Unfortunately PAWS is a major cause of relapse after opiate detoxification.
Heroin and opiates attach themselves to various brain receptors, serotonin, dopamine, mu/kappa etc
They interrupt and replace the brains natural production of these hormones which provides the lovely, warm, happy feeling you can only get from opiates.
This is where the length of abuse comes into play, someone with a short term (less than a year) habit will hardly suffer at all, the brain will quite quickly recover and start naturally producing the hormones again, usually within six months. Whereas a heavy long term users brain can take years to recover!
PAWS is long term, low grade withdrawals, sneezing, sweating and chills, restless legs, goosebumps, stomach cramps and general anxiety.
Because opiate withdrawal is in my opinion quite largely psychosomatic these low grade withdrawals can quite easily in your head be turned into unbearable pain... and knowing that a tiny bit of heroin will not only take it all away but also give that lovely warm feeling is sometimes too much to deal with!
Some OTC remedies and medications that can help with PAWS and acute withdrawal symptoms include...
Quinine - For cramps and RLS
Imodium - Cramps and diorreah
Paracetamol/acetaminophen - For keeping temperature regulated and aches and pains
Herbal supplements that can help (especially when recovering from ibogaine) are...
High Dose Vitamin C - 1000mg Plus Daily
Vitamin B complex
Omega 3-6-9 Complex
Fish oils help the body repair the synapses in the bran damaged by opiate abuse, zinc will also aid cell renewal
St John's Wort for depression, although be aware there are some contra-inications with SSRI's
And Rhodelia Rosea is really good for fatigue and lethargy post detox/ibogaine
Valerian can aid sleep (better than benzo's where possible)
When I was really struggling with 'kicky' and achey legs I would walk up and down the stairs in my flat..
I would take a bath whenever it got unbearable, this often meant 5-6 hot baths a day! Adding Epsom Salts helps too!
After that I'd rub deep heat all over my legs and use a hot water bottle...
If you have an understanding friend that will massage your legs its orgasmic :)
I had an acupressure treatment on my feet in rehab once and it was bloody fantastic!
It's really all about nursing your body back to health, eating well, meaning plenty of green vegetables, nuts, pulses, fruit, oily fish etc...
As I've mentioned before, a small daily dose of Ibogaine is great for PAWS and cravings.. start with 600mg (root bark) and work up if more is required, it's best to take it in the morning as it can cause insomnia.
If your using TA or HCL use titrate the dose up from 200mg and 100mg respectively.
A lot of people grind it down and mix it with a chocolate milkshake or something similar every morning.
Other than medication, post ibogaine therapies that have been shown to be beneficial include, talking therapies, acupuncture, exercise and sex (always good for an endorphin release after opiate WD, plus exercise will help with RLS and cramps)
If you are really worried about relapsing then a Naltrexone implant could be a good idea, although quite expensive and only available privately, Naltrexone is a full opiate antagonist, it completely blocks any opiates ingested rendering the drug useless..
As mentioned above, counselling has been shown to be an important part of recovery and most people that achieve long term abstinence employ some kind of talking therapy.
Saying all this though, the daily battle with your brain and body screaming out for heroin is one of the hardest things anyone can go through, and anyone that does has my full respect.
Ibogaine can definately help, the liver converts it into noribogaine whichis stored in fat cells and slowly releases, this in most people, stave's off cravings for up to six months!
So my best advice for PAWS would be to micro-dose with Iboga rootbark.
The trick is to find how much you can take before you notice any psychoactive effects.
For me this is around the 1000mg a day mark.
Get some gel caps and weigh (with mini scales) 300mg Iboga rootbark into each of them.
You need to always take any Iboga in the mornings as its a stimulant in low doses.
Start with 300mg (1cap) one day and titrate up by one more cap daily, until you reach a level where you can feel any psychoactive effect. This is your limit.
Usually between 600-1500mg first thing in the morning is enough.
You want to take enough to relieve any withdrawal symptoms but not trip or notice any stimulating effect.
For the large majority of people, rootbark will relieve PAWS almost completely or entirely.
It really is the best thing for it.
Rootbark in low doses isnt dangerous and has some really beneficial effects.
You can buy it ready powdered or as actual bark.
I buy the 20 gram sachets from Iboga World and it costs around £75-80 usually.
This is enough for about a month though.
Ignore any rumours of it being addictive or habit forming. Trust me, Iboga is not something you would want to take daily if you didn't need to. Iboga wouldn't let you get addicted to it!
A lot of ex-ibogainers still use weekly or monthly top up (boosters) of rootbark.
A common and effective dosing regieme seems to be: a quarter teaspoon weekly and a half teaspoon monthly.
You can also put the powder into a smoothie of you prefer.
People have said things like 'I've heard of people becoming dependant on bark' or 'I don't want to swap one thing for another and still depend on taking something every day' ....
Well, as far as I'm concerned, I'd much rather take some Iboga when I need to than be dependant on heroin or methadone!
I think Iboga is safer and better al round than an opiate addiction!