Wednesday, August 24, 2011

Fruity pebbles for twelve, please

Busy week working with people who are getting off methadone, suboxone and various combinations of oxycontin, percocet and vicodin.

Behind Door Number One, the patient’s mother, asked, “Is it normal that he’s eaten 2 boxes of Fruity Pebbles since he started this detox?

Behind Door Number Two, the puzzled wife of the detoxifying patient states with incredulity, “He ate the whole pan of banana pudding and an entire crumb cake in the last 12 hours….is that OK?”

And behind Door Number Three, an amused best friend and former patient, laughs and says his buddy has gone through three bags of pork rinds, 2 cheeseburgers and a gallon of ice cream, wondering if he’d done the same thing during his own detox.

According to Dr. David A. Kessler, author of The End of Overeating: Taking Control of the Insatiable American appetite, “The neurons in the brain that are stimulated by taste and other properties of highly palatable food are part of the opioid circuitry, which is the body’s primary pleasure system. The “opioids,” also known as endorphins, are chemicals produced in the brain that have rewarding effects similar to drugs such as morphine and heroin. Stimulating the opioid circuitry with food drives us to eat.”

So, it is not a bit surprising that the abrupt cessation of opiates would trigger this craving for whatever happens to be one’s own comfort food.

Not to worry. We can always talk about diet and exercise at the follow up visits. Just remember to brush your teeth.

Joan R. Shepherd, NP

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