Here is how we can make a difference!

I went to a conference where virtually every public and community health agency in the area where I live was represented. There is a change in the wording of the common language being used when speaking about "addiction". I want to talk about this and explain some of the reasons why this is being changed.
When you hear the words "addict", "addiction", "drug abuse", it brings a mental image to whoever hears or reads these terms.....for example, the word abuse brings on the image of someone hurting another person. These words, which depict images when heard, influence a person towards being judgmental of that person or group of people. This could affect the quality of healthcare for that judged person. Maybe that person feels judged and won't go for help. That is a terrible thought! We need to stop judging by changing our language when speaking about or with "people with substance use disorder". Doesn't that sound like we are talking about an everyday person with a diagnosis that needs to be treated? Yes! Let's start using these terms:
substance use disorder, person in recovery, drug misuse, actively using, abstinent, not using.
NO more addiction, addict, drug abuse, former addict, clean, dirty. Let's talk about people as if they ARE people, like you, like me. When people who have a substance use disorder talk about themselves, they also should not use the old terms. Why? Because talking about themselves in a negative way presents a negative self image in their own mind. When they say it over and over again, that negative self image is reinforced over and over. That is enough to make anyone depressed, want to hide and numb those negative feelings! So let's help others talk and feel more positive about themselves. It starts with me and you. Together we can make a difference!

Let's talk about Opiate Use & Drug misuse

Takoda says, "Talk LOUD"

Takoda the rescue dog got a second chance at Life...someone you know might not if they misuse opiates, other drugs, or medications so....talk LOUD

Let's talk about
Opiate
Use &
Drug misuse

with your friends, with your kids, with your parents!

SAFE STATIONS

I am not sure about other parts of the US or world but here in the State of New Hampshire in USA, a trend started late 2016 where EVERY Fire Station in Manchester, NH and then in Nashua, NH was designated a SAFE STATION. What does that mean? It means that at ANYTIME day or night, if a person goes to the Fire Station they would be assessed by a fire fighter. If their condition warrants medical attention right away then an ambulance is called and that person is brought to the local Emergency Department for urgent medical treatment. If the person is medically stable but needs intervention for substance misuse treatment then the local treatment center on contract is called and that person is brought directly to the treatment center. NO ARRESTS. NO LEGAL IMPLICATIONS. Any drug paraphernalia, drugs or weapons are confiscated, obviously, and handed over to the local police for disposal. NO ARRESTS for amounts that do not implicate an intent to distribute. This was one way to help the opioid crisis since the Emergency Rooms were becoming overwhelmed and unable to handle the volume of people asking for help or needing intervention. Find out where the SAFE STATIONS are near you and take advantage! It is truly one of the best ways to get someone help.

WHAT IS SUBOXONE? WHAT IS SUBUTEX? WHAT IS MAT & OBOT?

Suboxone is the name of a combination medication: buprenorphine and naloxone. I comes in different strengths. It is made into "films" that get absorbed in your cheek or tablets that get absorbed under your tongue. It is confusing to hear since when you hear naloxone, one thinks of the naloxone used to reverse opioid overdose.  It is all in the properties of each medication. When in film or tablet form AND absorbed via cheek or under tongue, the buprenorphine is the stronger of the two medications, when absorbed through the GI tract. The naloxone properties are different and it is weak in the GI tract and doesn't interfere with the buprenorphine combining with the opiate receptor site, in fact it might help it stick better. But, if misused and abused, and given nasally or IV somehow, the naloxone is stronger and prevents the buprenorphine from adhering to the opiate receptor site. The naloxone takes over the site and nothing else can enter since this med is very strong when given through nose or IV. Strange, but that is how it works in a nutshell.  That is why buprenorphine is usually given as a combination medication. To minimize abuse and prevent harm.

Subutex is a brand name for buprenorphine alone without any naloxone. It used to be that pregnant women received Subutex to minimize any chance of miscarriage. But nowadays, since it is only a danger if abused, Suboxone is often given to pregnant woman with the proper education on the chance of miscarriage if abused. Subutex might also be used for those switching from methadone to Suboxone. It makes for a smoother transition. I heard Subutex is becoming a more popular med in general for treatment but I am not certain on the actual facts. If it is true, then the only reason would be to get more people into treatment.

As I said in a previous post, suboxone is good for those with short history of opioid abuse, with the daily use not too great. If you experience cravings despite all else becoming stable then you need methadone.

Besides cravings, the biggest complaints I have heard from those who tried Suboxone Treatment is that they could not fall or stay asleep. Some complain of a constant headache. Others, it was muscle cramps in their thighs and calves. As with all narcotics constipation is the #1 complaint.

With the Opioid Crisis, Suboxone is becoming a focus point for treatment. Doctors take a course and become certified. Medication Assisted Treatment (MAT) or Office Based Opioid Treatment (OBOT) is what it is being called and you will be hearing a lot more about this. They are generally Suboxone Treatment. Some states already have many physicians participating. Physician participation does vary by state or area. All medication is given by an RN and the patient is assessed and progress monitored properly. Since it is office based, the stigma of a clinic is not there to interfere with any progress. It is a great way to help those newly addicted and a great way to get someone in treatment. As with any treatment program, there is drug testing and addiction counseling or group addiction counseling. It won't work unless you change your thinking AND your behaviors. If Suboxone doesn't work, there is methadone. Still treatment just different med for different needs. The downfall of methadone are the rules: so far, only a hospital or clinic setting may dispense methadone for addiction. I feel a change coming in the near future....

WHAT IS BUPRENORPHINE? WHAT IS METHADONE?

Buprenorphine is an "analgesic", aka pain medication, aka narcotic. It is man made from something "natural" and altered chemically to become a semi-synthetic compound. Yes it is considered a narcotic and treated as such by the DEA. It is in the "Opioid" category. When taken, this medication will merge with opioid receptor sites just as morphine, heroin or methadone does. But this med has other slightly different properties. 

Buprenorphine is a partial agonist opioid. Heroin and methadone are full agonists. I mention this since you might hear those terms, not to conduct an opioid course. Because it is a "partial agonist" Buprenorphine can give pain relief same as the other opioids but it doesn't affect your breathing as much as methadone would. It is faster and easier to get stable with this medication and when you are ready, faster and easier to detox off.  It is considered to be less addicting and with fewer side effects. It is shorter acting compared to methadone. You can't be on any benzodiazepine prescriptions (or illicit) such as xanax since it is not medically safe. You must be illicit drug free after you are stabilized or usually you get terminated. Remain illicit drug free and you get "take home" doses for several days or a week so you don't have to go everyday. Some clinics have you go every other day. Of course there is a catch: buprenorphine has what is called a "ceiling" effect. Meaning, once you reach a certain dose, taking additional doses does not give you more pain relief and it is not suppose to get you euphoric or high. Once you reach a certain level, that is it. Okay if your drug use has been 5 years or less or your daily use is not real high. For some people with substance use disorder  this works very well!  If you are taking buprenorphine and still have cravings then you need methadone. With the carfentanil, it is hard to judge if this treatment would work well with heroin users until one tries it. Doesn't hurt to try. 

Heroin users usually need methadone; WHY? Because of the large amount of daily use and recently because of the carfentanil potency. Methadone is a full agonist. It has no ceiling effect. It gives full pain relief but take too much and you will stop breathing and die. Plainly put. It affects your breathing so anyone with a respiratory disease such as asthma or COPD must be monitored and must be very careful in taking this medication. Methadone can also affect your heart rhythm. A very high dose (> 200 mg) or a dose above 80 mg in combination with certain prescribed meds such as clonidine or seroquel can be deadly. That is why methadone clinic patients are monitored so closely. For medical safety. Methadone is dispensed by nurses only (not counselors) and you are assessed before you take that daily dose, for medical safety. Methadone has a very long half life....it lasts for days in your body until it is totally out of your system. When you take it at a methadone clinic daily, as you should, it builds up in your body to a therapeutic level and then it is maintained at that level. A therapeutic level is when you have no physical withdrawal symptoms at all AND no cravings. You almost forget that you take it because you feel "normal". Not high. Not sick. No cravings. Just live and enjoy life. When I say methadone clinic, I mean methadone for addiction NOT pain. Methadone for pain is a totally different program, different approach and different rules. 

LIST OF MEDS RECOMMENDED AND OK TO ***FLUSH***

Source is FDA.GOV so this is the official word on this subject! 
As you will see, narcotics of all kinds are on this list along with one benodiazepine:
DIAZEPAM OR VALIUM

WHY FLUSH?
In past the concern was all about the water. Now, with the opioid crisis, it was determined that it doesn't affect the water supply enough to make a difference compared to the lives SAVED by flushing all pain medications. You see, once you cross over from tolerance to dependence to addiction, you are willing to do anything to get your next fix. This includes dumpster diving and trash hunting. Nurses used to crush it and mix with kitty litter and detergent. But even this measure is not good enough. The addiction is stronger than any offense from detergent or garbage! To do this properly it is recommended to crush the tablets then flush them twice. Whether they are capsules or tablets, put them in a bag, put your boots on, and STOMP them to powder then flush them twice. If it is just a couple and you have a pill crusher or hammer then you can use that. **If it is a fentenyl patch then *PUT GLOVES ON*, TAKE THE PATCH APART AND CUT IN TINY PIECES THEN FLUSH MULTIPLE TIMES. A fentenyl patch is made to be absorbed through the skin over a period of time such as 24 hrs or more. If a child, pet or maybe even an adult were to ingest part of this patch by mouth then it would definitely be deadly! Here is the official list from fda.gov., A-Z

"Medicines Recommended for Disposal by Flushing Listed by Medicine and Active Ingredient  There is a small number of medicines that may be especially harmful and, in some cases, fatal with just one dose if they are used by someone other than the person for whom the medicine was prescribed. This list from FDA tells you what expired, unwanted, or unused medicines you should flush down the sink or toilet to help prevent danger to people and pets in the home. 
 [the one with]* These medicines have generic versions available or are only available in generic formulations.
FDA continually evaluates medicines for safety risks and will update the list as needed. Please visit the Disposal of Unused Medicines: What You Should Know page at www.fda.gov for more information.
Medicine Active Ingredient
Abstral (PDF - 1M), tablets (sublingual) Fentanyl
Actiq (PDF - 251KB), oral transmucosal lozenge * Fentanyl Citrate
Avinza (PDF - 51KB), capsules (extended release) Morphine Sulfate
Belbuca (PDF – 44KB), soluble film (buccal) Buprenorphine Hydrochloride
Buprenorphine Hydrochloride, tablets (sublingual) * Buprenorphine Hydrochloride
Buprenorphine Hydrochloride; Naloxone Hydrochloride, tablets (sublingual) *
Buprenorphine Hydrochloride; Naloxone Hydrochloride
Butrans (PDF - 388KB), transdermal patch system Buprenorphine
Daytrana (PDF - 281KB), transdermal patch system Methylphenidate
Demerol, tablets * Meperidine Hydrochloride
Demerol, oral solution * Meperidine Hydrochloride
Diastat/Diastat AcuDial, rectal gel [for disposal instructions: click on link, then go to "Label information" and view current label]
Diazepam
Dilaudid, tablets * Hydromorphone Hydrochloride
Dilaudid, oral liquid * Hydromorphone Hydrochloride
Dolophine Hydrochloride (PDF - 48KB), tablets * Methadone Hydrochloride
Duragesic (PDF - 179KB), patch (extended release) * Fentanyl
Embeda (PDF - 39KB), capsules (extended release) Morphine Sulfate; Naltrexone Hydrochloride
Exalgo (PDF - 83KB), tablets (extended release) Hydromorphone Hydrochloride
Fentora (PDF - 338KB), tablets (buccal) Fentanyl Citrate
Hysingla ER (PDF - 78KB), tablets (extended release) Hydrocodone Bitartrate
Kadian (PDF - 135KB), capsules (extended release) Morphine Sulfate
Methadone Hydrochloride, oral solution * Methadone Hydrochloride
Methadose, tablets * Methadone Hydrochloride
Morphabond (PDF – 162 KB), tablets (extended release) Morphine Sulfate
Morphine Sulfate, tablets (immediate release) * Morphine Sulfate
Morphine Sulfate (PDF - 282KB), oral solution * Morphine Sulfate
MS Contin (PDF - 433KB), tablets (extended release) * Morphine Sulfate
Nucynta ER (PDF - 38KB), tablets (extended release) Tapentadol
Onsolis (PDF - 297KB), soluble film (buccal) Fentanyl Citrate
Opana, tablets (immediate release) Oxymorphone Hydrochloride
Opana ER (PDF - 56KB), tablets (extended release) Oxymorphone Hydrochloride
Oxecta, tablets (immediate release) Oxycodone Hydrochloride
Oxycodone Hydrochloride, capsules Oxycodone Hydrochloride
Oxycodone Hydrochloride (PDF - 100KB), oral solution Oxycodone Hydrochloride
Oxycontin (PDF - 417KB), tablets (extended release) Oxycodone Hydrochloride
Percocet, tablets * Acetaminophen; Oxycodone Hydrochloride
Percodan, tablets * Aspirin; Oxycodone Hydrochloride
Suboxone (PDF - 83KB), film (sublingual) Buprenorphine Hydrochloride; Naloxone Hydrochloride
Targiniq ER (PDF - 48KB), tablets (extended release) Oxycodone Hydrochloride; Naloxone Hydrochloride
Xartemis XR (PDF - 113KB), tablets Oxycodone Hydrochloride; Acetaminophen
Xtampza ER (PDF – 67.6KB), capsules (extended release) Oxyccodone
Xyrem (PDF - 185KB), oral solution Sodium Oxybate
Zohydro ER (PDF - 90KB) capsules (extended release) Hydrocodone Bitartrate
Zubsolv (PDF - 354KB), tablets (sublingual) Buprenorphine Hydrochloride; Naloxone Hydrochloride"

What is Naloxone?

This is an excerpt from SAMHSA's Opioid Prevention Toolkit,

*I underlined and did bold on pertinent info. After the SAMHSA paragraphs I summarize it all...

      " Opioid overdose-related deaths can be prevented when naloxone is administered in a timely manner. As a narcotic antagonist, naloxone displaces opiates from receptor sites in the brain and reverses respiratory depression that usually is the cause of overdose deaths.7 On the other hand, naloxone is not effective in treating overdoses of benzodiazepines (such as Valium®, Xanax®, or Klonopin®), barbiturates (Seconal® or Fiorinal®), clonidine, Elavil®, GHB, ketamine, or synthetics. It is also not effective in overdoses with stimulants, such as cocaine and amphetamines (including methamphetamine and Ecstasy). However, if opioids are taken in combination with other sedatives or stimulants, naloxone may be helpful. Naloxone injection has been approved by the United States Food and Drug Administration (FDA) and used for more than 40 years by emergency medical services (EMS) personnel to reverse opioid overdose and resuscitate persons who otherwise might have died in the absence of treatment.8

FACTS FOR COMMUNITY MEMBERS
Naloxone does not have the potential for abuse. It reverses the effects of opioid overdose.9 Injectable naloxone is relatively inexpensive. It typically is supplied as a kit with two syringes10 These kits require training on how to administer naloxone using a syringe. The FDA has also approved an intranasal naloxone product, called Narcan® Nasal Spray, and a naloxone auto-injector, called Evzio®. The intranasal spray is a pre-filled, needle-free device that requires no assembly. The auto-injector can deliver a dose of naloxone through clothing, if necessary, when placed on the outer thigh.  Prior to 2012, just six states had any laws that expanded access to naloxone or limited criminal liability.11 Today, 42 states and the District of Columbia have statutes that provide criminal liability protections to laypersons or first responders who administer naloxone. Thirty-nine states and the District of Columbia have statutes that provide civil liability protections to laypersons or first responders who administer naloxone. Thirty-eight states have statutes that offer criminal liability protections for prescribing or distributing naloxone. Thirty-three states have statutes that offer civil liability protections for prescribing or distributing naloxone. And 42 states have statutes that allow naloxone distribution to third parties or first responders via direct prescription or standing order.

https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA16-4742

___________________

**What it means:  Naloxone is a medication that is prescribed by a doctor. This medication has been used for many years in hospitals when needed for patients post surgery if having an unfavorable reaction to anesthesia and pain medication. These medications slow down breathing. If your breathing is not providing enough oxygen to your brain and your heart, your brain will be damaged and your heart will stop. Naloxone is a special medication that can instantly reverse this situation! Miracle med!! Before the opioid crisis, this medication was given IV in hospitals. Now, you can get a prescription for naloxone that can be given by spraying in one nostril (close the other one) or by injection *thru the clothes* eliminating precious time unclothing the person (it will even tell you what to do). 42 states allow "third parties" (such as clinics) to give out naloxone by a "standing order", which means you don't need to personally see a doctor to get it. Just show up at the appropriate clinic and ask for it. No questions. 39 states have a law in effect that protects whoever calls 911...no arrests, no searches, if you call 911 to save a life. So please, call 911 for anyone in need. Don't drop someone off at an Emergency Room! Parents, friends, get a prescription for naloxone and carry it with you. No incrimination when asking for a prescription. You CANNOT harm someone if you give it and they don't need it. It just won't do anything. No side effects. But, if they need it...you saved a life and there is no better feeling than making a difference! One thing to remember, once given during an overdose, the person might need a second dose after a 30-60 seconds if no response. Why? It is because of the super duped drugs out there....carfentanil......making the drugs more potent and deadly. That is why naloxone always comes in packages of 2. Like  I said, it can't hurt and if needed will save a life. After receiving naloxone the person will start breathing and then will be in withdrawals. So, give the spray or injection then call 911 right away! Don't wait to see how it works. They will need intervention for their drug use and this is the perfect opportunity. Plus they need a medical evaluation to ensure they do not need any other medical care. 

Personal Power

We all have personal power. Yes, we are made of energy particles therefore we are energy and energy is power. We all have the ability to use our power in amazing ways. We also have Free Will to do what we want with our energy. Have you ever "willed" yourself sick before an event you really did not want to go to...focused intensely on how happy you would feel after passing an exam...visualized yourself excelling in a sports game and actually have these happen, just as you expected? You used your personal power. What would happen if you focused on how to steal some money for the next fix....constantly lied to cover your habit...always thought about your "bad luck"? Your power would start becoming negative and sickly. Once you cross over that line and become addicted to some type of opioid, you give your personal power away to the drug 100%. The drug now controls you. You have allowed the drug to take your personal power. It starts affecting every aspect of your life because you are now the puppet. The drug has taken over your personality. You are negative, irritable and don't care about anything except your next drug use. It ruins your family life, social life, your school and/or your work. On the outside you are the same person, but on the inside you lack personal power because you gave it away. So, TAKE IT BACK! Step 1 in the 12 Steps talks about admitting you are powerless. Any disagreement there? If you are an addict then you are powerless at this time. But you CAN start heading the the direction of getting your power back 100%. It is never too late to begin this process. In order to do this you must begin at a basic level and admit that drugs have your personal power.... temporarily. At the very least, start Addiction Counseling. Maybe you need inpatient or maybe an outpatient clinic fits your needs. See an Addiction professional. They can get your input then tell you which one is best for you. Don't rely strictly on your friends and family unless they have experience and education in Addiction. There are too many myths out there. Family and friends however, can be a great support system if they are interested in becoming educated and involved with your recovery. With the right treatment, with the right professionals, with the right attitude, you CAN take back your personal power 100%. Read about "The Next Step: The Phone Call" and read about being "...nervous about going to a 12 Step Meeting" for more insight.

Talk LOUD; Don't Die

                                      Takoda the Rescue Dog Says:  Talk LOUD; Don't Die

Let's talk about
Opiate
Use and
Drug abuse

Takoda the Rescue Dog got a second chance at LIFE......YOU Might NOT......Your KIDS MIGHT NOT.......talk LOUD !!!
     with your kids, your parents and your friends!

Kids and Overdose. Alert to Parents and Kids!

Tragically, in the news, you may hear about a child getting hold of an opioid and overdosing (stopped breathing). If the child was very young, then the drug was probably was hanging around, and like kids do, they put it in their mouth or mimic what they see the adults do. If was a preteen or teenager, then most likely they overdosed because they chose to use an opioid of some kind. Once you reach a certain age, it's all about choices. Why would a preteen or teenager decide to use an opiate? The first thing that comes to mind is Peer Pressure. Their friends are doing it and they want to be part of the gang and fit in. OK for maybe one time, but there are root causes for continued opioid use. The one that comes to mind is physical pain: a football injury, cheerleader injury or a sports injury of some kind. Or it could be pain from an accident such as a car accident. So what is the other reason? Emotional pain. Any type of chronic emotional pain such as teasing at school for any reason, poor relationship with parents/siblings, childhood trauma of any kind, ....anything that a kid would consider hurtful that continues on. The kid wouldn't know what to do about it and that could lead to hopelessness. To stop the emotional pain, a kid might drink alcohol or use drugs to temporarily feel better. Dangerous, yes, but kids don't think that far into the future, especially if they are hurting in some way. Now we all have had some childhood issues at one time, but I am talking about months to maybe even years of emotional pain. To a kid that is forever. Parents, what can you do to help prevent your child from falling into this death trap? I call it LOUD. Tell your kids you want to talk LOUD. It stands for:

Let's talk about
Opiate
Use and
Drug abuse

You see, kids like to think they are fooling their parents when taking certain risks. Let your kids and teenagers know that you are AWARE and KNOWLEDGEABLE. It opens the door to drug talk. It is at that time that a kid might say how they are feeling hurt over something in their life or even alert you to the behavior of another kid or teenager. There is a 2017 phrase, "Take 5 to save lives". It is about kids supporting each other to prevent suicide. Well, the same can be done for drug abuse to help prevent overdoses! Parents, tell your kids you want to talk LOUD! Kids, band together and help each other prevent drug use and overdoses. Stay alive, Don't Die! Talk LOUD to your parents! Talk LOUD to your friends! 

My Friends Keep Calling and Stopping By Even Though They Know I Started Recovery!

You will hear about how "friends don't tempt friends when they start a recovery program". Just think about it.....those friends are addicts too! Don't get angry. Addiction likes company. No matter how much a friend wishes you the best in recovery, the addict in them can't leave you alone. If you truly believe that your addiction is a disease then you must believe the friends knocking at your door have a disease also. But, the fact is, you must do what is best for YOURSELF, or recovery will not work for you. You can offer support while they seek treatment but don't put yourself in the position where they are using in your presence. Even if you don't participate in the drug use, the temptation will seep into your brain. You might start dreaming of using or have severe cravings when you are really stressed about something in your life. It will spiral down from there. So don't go there. If a friend is not ready to seek treatment then just let them know that you will be there when they decide to take that first step. Tell your friend that until that happens, they must stay away from you, out of respect of the friendship. No phone calls, no visits. This is the best approach with friends. Anyone else who is not a friend you can just say no and go away! If a person continues to bother you despite your request, say what you must to discourage them. This is your life and you want to live!

Can I die from withdrawal symptoms if they are bad enough? What can I do for withdrawals?

You will not die from the symptoms of opioid withdrawal, no matter how bad they are. You will feel like you are dying and others looking at you might agree. You will not die, but there is no doubt you are suffering :(     What can happen medically is severe dehydration from the sweating, vomiting and diarrhea. Being badly dehydrated is a feeling of extreme weakness, pale skin, sunken eyes, cracked dry lips, possibly even dizziness. If the person cannot drink a large amount of water and Gatorade or Powerade, then go to an Urgent Care for IV fluids to rehydrate. In a dehydrated state you are at risk for injury from a fall due to weakness. How many of us had a real bad flu and nearly fell in the bathroom from feeling weak and dizzy? Be safe.....getting hydrated is necessary whether it is from drinking lots of fluids or getting IV fluids. Always have some Gatorade or Powerade in addition to water and IV fluids to replenish your electrolytes. It will help bring back your strength. Over the counter products can help with other withdrawal symptoms such as Immodium for diarrhea, I would avoid Kaopectate and Pepto Bismol since it contains a substance similar to aspirin and anyone ages 12-18 should not take aspirin since there is a chance it can cause a disease called Reyes Syndrome (serious/ fatal disease) if conditions are right. Imodium takes a little time to work so take it at the first signs of diarrhea. If you are pregnant, go to the Emergency Room since you don't want to risk taking any medication, and dehydration when pregnant is much more serious! For muscle cramps take ibuprofen or naproxen but don't exceed the max dose recommended or you can damage your kidneys. I would avoid acetaminophen unless you are absolutely sure you do not have Hepatitis C Antibody; it might overload your liver. Over the counter magnesium supplements also may help muscle cramping if taken according to directions and you do not exceed the recommended dose. Need some sleep? Only at night, use generic benadryl (diphenhydramine) 2 caps and try some melantonin: anywhere from 3mg - 5 mg any brand, or a 10 mg time release tab by Natrol. Melantonin is a hormone your own body makes which regulates the wake-sleep cycle. Taking a supplement helps some people with sleep disturbances get a decent night's sleep. If you end up going to Urgent Care it is best to have someone with you who knows about why you are in this condition. If ER staff suspect you are in withdrawals then whoever is with you might find out. If the Emergency Room takes blood...if they draw any blood they might do some drug testing......if they get a urine sample they might do some drug testing.....that is all I will say on that. If you are drug tested in any way and you are on probation then your probation officer might find out and have concrete evidence against you. Be wise. Go for IV fluids and don't ask for any narcotics or benzodiazepines (like xanax or ativan) and you should be treated well, be rehydrated, & released. Simple as that.