Opiate and opioid dependence and addiction has become a significant issue recently and one of the most difficult aspects of this can be withdrawal and detox symptoms. Knowing the signs of opiate withdrawal can help you determine if opiates might be a problem for you or a loved one. Opiate withdrawal is not only a common issue for those who are abusing opiates, but they are also a common problem for those who are taking prescription opioid medication for things like pain management. Anyone who may find themselves taking opiates or opioids for a long period of time is most likely going to experience some sort of withdrawal symptoms, however these can vary in length and severity depending on the individual, what they have been taking and how long they have been taking it for.
Here are some of the most common substances that can cause opiate withdrawal which may require an opiate detox:
- Hydrocodone (Vicodin)
- Oxycodone (Percocet, Oxycontin)
There are many other forms of opioids, typically in the form of pharmaceutical medications, but there are among the most common. Taking any of these for an extended period of time, whether under the care of a doctor or not is more than likely going to cause some signs of opiate withdrawal. If these signs of opiate withdrawal do present themselves then there are medical detox facilities and substance abuse treatment programs which can help resolve the issue and return a person to their normal selves.
These withdrawal symptoms are often times the scariest aspect of attempting to recover from opioid addiction or dependence. While these fears are not unfounded, they are usually based on the experience of having to go through them without any type of medical supervision or intervention. There is no way around it, opiate withdrawal is difficult no matter what but it is much more difficult when someone attempts to do it on their own. This is why medically supervised detoxification programs are so helpful, they can do many things to help manage the uncomfortable and scare signs of opiate withdrawal and make the process much safer and more comfortable for the patient. Many times they can also significantly shorten the length of time that an individual is in discomfort from withdrawal symptoms, giving them a much better chance at a successful recovery.
Common Signs of Opiate Withdrawal
Opiate withdrawal is an extremely uncomfortable experience for many people. In fact, withdrawal symptoms can be one of the leading issues that keep people from attempting to discontinue the use, or abuse, of opioids. However, there are many different options that can help to mitigate these uncomfortable withdrawal symptoms and make the process of recovery much more manageable.
Some of the most common signs of opiate withdrawal are:
- Teary eyes
- Muscle aches
- Excessive yawning
- Runny nose
- Racing heart
- Intense cravings
These symptoms can vary in intensity from quite mild to extremely intense, depending on the amount of opiates someone has been using and how long they have been used for. Typically, symptoms will begin to emerge between 8 and 12 hours after the last administration of an opiate substance. The signs of opiate withdrawal can last anywhere from 3 days to a couple of weeks, depending on which substance is being abused.
In addition to acute withdrawal symptoms like the ones above, there are also post-acute withdrawal symptoms which can linger for weeks or even months after detox. These symptoms typically include trouble sleeping, anxiety and depression. The extended length of these opiate withdrawal symptoms are a very big reason why it is always recommended that an individual participates in an inpatient rehab facility after completing detox, in order to make sure that they continue to stay in a healthy and supportive treatment environment while they work through these post-acute withdrawal symptoms.
As an individual continues to gain more time away from these substances, their body will eventually return to its normal state where it can produce adequate amounts of neurotransmitters on its own, eliminating the post-acute withdrawal symptoms all together. Still, even after the elimination of these withdrawal symptoms there are things like mental cravings which much be taken into account. Although these are not technically withdrawal symptoms, they must be managed in order for someone to remain abstinent from opiates for the rest of their lives. The way to accomplish this is with substance abuse treatment and individual therapy sessions as well as the strong support of things like 12-step recovery communities.
What Causes Opiate Withdrawal?
Opiates work in the brain by stimulating receptors to release large amounts of the neurotransmitter dopamine which causes the euphoric effect on those who use them. While this can be beneficial for those who are using these drugs in order to do things like manage chronic pain, it does have the side-affect of making it more difficult for the body to naturally produce these neurotransmitters without the use of opiates.
When someone stops using opiates after a long period of time, they will experience a lower than normal amount of dopamine which causes most of the negative signs of opiate withdrawal that occur. Luckily the body, and the brain, is extremely resilient and is able to get itself back into homeostasis after a period of time. Unfortunately, this can take a few days to a few weeks which is why things like medical detox and inpatient substance abuse treatment are so crucial during these early stages of recovery.
How to Treat Opiate Withdrawal
Treating opiate withdrawal in order to make it more bearable for the patient is extremely possible and medical techniques and medications are now able to make the process safe and comfortable for everyone. The first step in this process is best done at an inpatient detox facility, where the patient can be supervised by a medical staff 24-7. While outpatient detox programs are also available, they tend to be les than ideal as they do not allow a person to undergo continually managed care. If they are in an outpatient detox program and they experience any breakthrough withdrawal symptoms, managing these in a timely manner can be difficult.
It is also much more difficult to avoid the temptation and cravings that come along with detox as these are one of the most common signs of opiate withdrawal. While someone in an inpatient detox facility is under 24-hour supervision, they may have cravings, but they have support staff and counselors there at all times to help them through this. Unfortunately, this level of care is not available while undergoing an outpatient detox program which is another reason why inpatient medical detox is so strongly recommended.
While the exact forms of treatment will vary from patient to patient, there are many common forms of treatment and medications which are used in order to help manage the discomfort during the opiate detox process. Typically, a person will be evaluated by a doctor upon entering a medical detox facility at which time the doctor will order some, or all, of the following medical techniques or medications to help with detox.
- Buprenorphine – This drug is found in medications such as Suboxone and Subutex and is used to alleviate severe opiate withdrawal symptoms. While this medication is also used in a long-term maintenance fashion, most substance abuse detox facilities will administer the drug in a taper which lasts between 3 and 7 days. These medications are able to drastically reduce the severity of most opiate withdrawal symptoms, but it is extremely important that they are taken under the care of a doctor.
- Other medications – Sometimes the doctors at a medical detox may utilize other, non-narcotic medications to confront specific withdrawal symptoms such as insomnia, anxiety or general discomfort. These medications can vary from person to person depending on their needs.
- Nutrition and Vitamins – Another big contributor to the severity of the signs of opiate withdrawal can be poor nutrition. While it may seem like a small thing, proper nutrition and vitamins can have a significant impact on the severity and length of withdrawal symptoms. Things like meals that are designed by a nutritionist, individualized vitamin supplements can be a big help when it comes to managing detox symptoms.
- Hydration – Lack of fluids can also be a big contributor to the aggravation of opiate detox and withdrawal symptoms. Proper hydration is another big help to mitigate these symptoms.
- Emotional support – When you mention medical detox some people may not think about the emotional state that someone is in during this process. However, this is a huge component to a successful process. Things like anxiety and depression are extremely common during opiate detox and emotional and mental support from licensed therapists and knowledgeable support staff go a long way towards helping patients get through these symptoms.
Treatment for Opiate Addiction
While medical detox for opiates is the first step in the process of recovery, it is always best to follow it up with a longer term stay in a residential substance abuse rehab. This is not only because the post-acute withdrawal symptoms from opiates can linger for weeks or even months, but also because many people suffer from severe cravings and triggers for opiates well after their stay in a detox facility. Residential rehab programs are designed to address these emotional, mental and behavioral aspects of both substance abuse and substance dependence by allowing the person intensive emotional support during their most vulnerable period after detox.
Residential treatment is usually made up of a combination of treatments like group therapy, individual therapy and support groups, such as 12-step meetings. All of these combined allow a person to take an internal look at the reasons why they feel the need to use substances in the first place and allow them to come to terms with them and gain a solution to their problems with the hope that they never have to return to a life of substance abuse again. These residential programs typically last anywhere from 30 to 90 days and can occasionally last even longer, depending on the individual’s needs.
The time while in residential rehab is also when the patient will be able to structure their life after treatment by participating in family therapy, developing a strong aftercare program and even setting up things like outpatient treatment or outside individual counseling sessions. Recovering from any form of opioid abuse or dependence is a long process which requires regular maintenance in order to remain successful.
There are many options for substance abuse treatment including traditional residential programs, dual-diagnosis programs as well as outpatient options such as partial hospitalization and intensive outpatient programs. While it is usually best to choose the highest, most intensive level of care the most important thing is that someone is receiving some sort of continued care after medical detox.