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Opiates are a class of drugs which are used to treat moderate to severe pain. Prescribed medications can include oxycodone, hydrocodone, morphine, dilaudid and methadone. In general, these drugs are not to be taken for long term unless there are underlying illnesses such as terminal cancer. Other opiates include heroin and opium; both of which are illegal and heavily abused. In the United States, approximately 2.1 million people abuse opioids with another 26.4 to 36 million worldwide. While it is accepted that opiates are useful for alleviating pain, they are highly addictive. Users can build a tolerance quite rapidly; thereby, requiring more of the drug to feel the same euphoric like effects. Once this happens, if the use does not discontinue, an addiction will result. From here on out, withdrawal symptoms can develop whenever opiates use is abruptly stopped. The withdrawal from opiates can be extremely challenging which makes it very difficult to quit without the assistance of an opiate detoxification and rehab.
If you are battling an opiate addiction, want to quit, but have concerns or fears about the withdrawal, this article will help you to better understand what you may experience.
Any opiate withdrawal, including the symptoms and severity, are dependent upon the usage amount, the length of use, the individual’s age, underlying disorders and whether or not there are any co-occurring addictions. In general, the longer the abuse and/or the higher the amount, the more difficult the withdrawal will be. The withdrawal can be categorized as mild, moderate, moderately severe, and severe. Everyone will start to go through the withdrawal at different times. Some people feel the first effects within a matter of hours, while others don’t experience them until the next day. At this time, there is no scientific reason for this. That being said, the following opiate withdrawal timeline is a generalized outline based upon a large group of opiate addicts and what they experienced.
These first two days are known as the acute withdrawal phase, and said to be the most difficult. This is also the period in which relapses frequently occur if the withdrawal is not safely supported by professionals. Most people say the first symptoms begin at the 12 hour mark after the last use. Muscle aches, bone pain, intense sweating, diarrhea, vomiting, loss of appetite, insomnia, anxiety, irritability and panic are all common symptoms.
The previous day’s physical pain will have likely eased; although it may not be completely gone. A loss of appetite, stomach problems and an overall lack of interest in drinking or eating may be prevalent. As difficult as it can be, it’s important to stay hydrated and eat light foods such as bananas, toast with butter, avocado, fruit or crackers. Goosebumps, trembling, shivering, stomach cramping, nausea and mood swings are common symptoms during these days.
By day 6, most people will be through the worst of the opiate withdrawal. It can still be difficult to eat food and nausea, stomach cramping or anxiety may still be an issue. At this point, for people not involved in a treatment program, it’s important to start getting active rather than lying in bed or sitting in the house. This is not conducive to recovery. People in rehab will have started therapy, counselling and group sessions to start learning how to stay sober.
A few things to consider in regarding this timeline is that people with an addiction to opiate painkillers may experience the symptoms for up to 14 days, with methadone addictions taking upwards of one month before the withdrawal symptoms cease. From there on out, the physical withdrawal from opiates will have subsided; however, the psychological symptoms can last for months or years. This is why it is so important to be equipped with the right tools, techniques and knowledge to maintain a healthy recovery.
A lot of people talk about going “cold turkey” when trying to quit opiates. This is not recommended because of the nature of the drug, its strength and its potential to put the individual into shock when coming off of the opiate.
A detoxification will help eliminate opiates from the body while being supervised by medical professionals. The detox is done in a safe and comfortable environment either on an inpatient or outpatient basis. Vital signs, respiration levels, heart rate and body temperature will be monitored to ensure there are no dangerous peaks. Medications may be utilized to regulate brain and body functions, assist in sleep and decrease the overall symptoms.
A mild opiate withdrawal may be treated with acetaminophen, aspirin or ibuprofen as well as, vitamins, minerals, fluids and plenty of rest. Anti-nausea and anti-diarrhea medication may also be given. Intense opiate withdrawals may require medications such as clonidine. This is a prescribed drug used to alleviate anxiety, cramping, muscle aches, restlessness and sweating. Naltrexone, not be confused with Naloxone (a medication to reverse opiate overdoses) is used to lessen the effects of the withdrawal and is a popular choice of doctors.
Suboxone is another drug which combines buprenorphine and naloxone. This medication works to treat the symptoms of the withdrawal by shortening the intensity and duration. Methadone is used for long term opiate dependency maintenance; it is a powerful drug which can be addictive if not controlled. A rapid detoxification from opiates is occasionally administered by doctors. This is done under anesthesia with different opiate blocking drugs. However, because vomiting can occur, there is a high risk of this type of opiate detox treatment.
For safety and long term sobriety, it is highly recommended to avoid going at an opiate withdrawal alone, but rather with the assistance of a rehab or detox centre.