The world of opioids can be divided into two categories: illicit opioids and prescription opioids. Illicit opioids include substances like heroin that people abuse to reach a euphoric and relaxed state. In contrast, prescription opioids are commonly used by doctors in a medical setting to treat pain. Some of these powerful painkillers include codeine, oxycodone, hydrocodone, morphine, and methadone. While these prescription medications provide pain relief for patients who are recovering from surgery or injuries, they also pose serious risks when they are misused.
In recent years, more people in the United States have been using opioids for nonmedical purposes. In fact, the National Institute on Drug Abuse found that approximately 2.1 million people in the United States and 26.4 to 36 million people worldwide are technically abuse opioids. Our country and the world are clearly facing an epidemic of opioid abuse and addiction. It’s important to remember that there is help available despite the highly addictive nature of opioids.
All opioid drugs can cause physical dependence. As a result, when you try to stop or decrease your opioid use, you may experience the symptoms of opioid withdrawal. The risk of experiencing opioid withdrawal symptoms is higher for someone who has been using these drugs at high doses for a few weeks or more. The reason why is simple. Many bodily systems are impacted and altered when someone takes large amounts of opioids for an extended period of time. When you stop taking opioids, your body has to adjust to no longer having opioids in it, and withdrawal symptoms occur.
Although the withdrawal symptoms of opioids can be uncomfortable and unpleasant, they are generally not life-threatening. However, the discomfort that they cause makes you consider giving up on getting clean and sober all together. Understanding the opioid withdrawal symptoms and timeline can increase the odds of breaking free from an addiction to opioids.
Understanding the Most Common Opioid Withdrawal Symptoms
Before discussing the withdrawal symptoms of opioids, it makes sense to take a closer look at how these substances work. Everyone’s brain and spinal cord contain opioid receptors, and the brain actually produces low levels of its own opioids. These opioids are responsible for decreasing pain, lowering respiration, and reducing anxiety. However, since the body only produces opioids in small quantities, they are never enough to mimic the effects of opioid drugs or cause problems like addiction or overdose.
Opioid drugs, both prescription and illicit, are different from naturally occurring opioids, because they produce stronger effects, including pain reduction, relaxation, and euphoria. While these effects can be helpful for patients who are struggling with serious pain, they can also drive you to use opioid when you don’t need them.
When you take opioids for a long period of time, your body becomes desensitized to the drug. As a result, your body needs more of the substance over time to achieve the same effect. This can be a slippery slope that can lead to addiction and accidental overdose.
Additionally, prolonged use of opioid drugs changes the way opioid receptors work in the brain, making the receptors dependent on the drug to function normally. This is referred to as dependency. When you are dependent on opioid drugs, you will become sick if you stop taking them. These symptoms, which can sometimes be mistaken for the flu, are known as withdrawal symptoms and they are your body’s response to no longer having the drug in it.
The symptoms of opioid withdrawal can be classified as mild, moderate, moderately severe, or severe. A physician can determine the severity of a patient’s symptoms by evaluating their opioid use history and symptoms. After diagnosing the severity of the symptoms, the doctor can begin treating them.
Multiple factors, including overall health and frequency and severity of your opioid use, determine how severe withdrawal symptoms will be and how long they will last. As a result, the process of opioid withdrawal is slightly different for everyone.
Additionally, different drugs remain in the body for different lengths of time, which can impact the onset of withdrawal symptoms. For example, heroin tends to leave the body quickly, so withdrawal symptoms can start within 12 hours of the last dose. In contrast, methadone users may not experience withdrawal symptoms for 30 hours, because the drug takes longer to leave the body.
Despite these differences, there is a general opioid withdrawal symptoms timeline that most patients experience.
The first symptoms appear 24 hours after the last dose of the drug. These symptoms include:
- Cravings for the Drug
- Muscle Aches
- Runny Nose
- Tearing Eyes
The next set of opioid withdrawal symptoms is more intense. These symptoms typically start after the first day, and they include:
- Abdominal Cramping
- Blurry Vision
- Dilated Pupils
- Goose Bumps
- High Blood Pressure
- Nausea and Vomiting
- Rapid Heartbeat
This set of cardiac, gastrointestinal, respiratory, and visual symptoms can be very unpleasant and painful. However, these symptoms often begin to improve within 72 hours of the last dose, and they should disappear within a week.
Sometimes, you may have some symptoms of withdrawal that last for six months. If you are experiencing these protracted symptoms you should talk with your physician about how to manage them.
Complications of Opioid Withdrawal Symptoms
Although opioid withdrawal symptoms are not life-threatening, they can be very uncomfortable. Some of these symptoms can also lead to medical complications. For example, if you experience severe nausea and vomiting you can accidentally inhale vomit into your lungs. This is known as aspiration, and it can result in a specific type of pneumonia called aspiration pneumonia.
If you experience both vomiting and diarrhea you can lose critical fluids and electrolytes. This can cause a heart arrhythmia, which can lead to a heart attack. As a result, it’s very important to replace fluids and electrolytes lost due to diarrhea and vomiting. Having a team of medically trained professionals by your side can help you manage potential complications with withdrawal. Doctors can also prescribe medications to reduce diarrhea, nausea, and vomiting.
Keep in mind that some people may experience other opioid withdrawal symptoms that are not listed. For this reason, you should remain under the close care and supervision of a medical professional during the withdrawal process.
There is one more complication of opioid withdrawal, which is relapse. Unlike the other complications, this one can be deadly. Most of the opioid overdose deaths that occur happen when someone has just gone through the withdrawal process. Since this process reduces a person’s tolerance to opioids, people can overdose on a much smaller dose than they used to take. It is a tragic situation, and the best way to prevent it is with medical intervention and caring support during the process of recovering from opioid use.
Diagnosing and Treating Opioid Withdrawal
A doctor can formally diagnose opioid withdrawal by performing a physical exam and asking questions about a patient’s symptoms, medical history, and past drug use. They can also order blood and urine tests to assess the levels of opioids in the body.
Symptoms of opioid withdrawal can be very uncomfortable, which can make you want to keep taking opioid drugs as a way to avoid the side effects. Other people may believe that they can successfully go through the withdrawal process on their own at home, but this is very difficult.
To increase the likelihood of a successful recovery, it is best to undergo the withdrawal process in a controlled, medical environment. Some examples of these environments include hospitals and inpatient drug and alcohol treatment centers. In these locations, doctors and medical specialists can provide 24/7 monitoring and treat the symptoms of opioid withdrawal during the medical detoxification, or detox process.
The way that doctors treat withdrawal symptoms of opioids depends on the severity of the symptoms. For milder withdrawal symptoms, doctors can give patients acetaminophen, aspirin, or ibuprofen for aches and pains. Doctors will often give patients Imodium for diarrhea and Atarax or Vistaril for nausea. Medical professionals will also encourage patients to get plenty of rest and drink extra fluids.
For more intense withdrawal symptoms, doctors may prescribe clonidine. Research shows that clonidine can reduce the intensity of withdrawal symptoms by 50% to 75% for many patients. Specifically, clonidine can reduce the following symptoms:
- Muscle Aches
- Runny Nose
- Tearing Eyes
There are also other drugs available that some physicians will prescribe to manage their patients’ opioid withdrawal symptoms. One is suboxone, which contains a mild opioid (buprenorphine) and an opioid blocker (naloxone). This substance is much less addictive than other opioids. When taken by mouth, this drug can reduce the intensity and length of detox from other opioids.
Treatment for Opioid Addiction
When you are ready to receive treatment for an opioid addiction, the first step is going through the detox process. As mentioned above, you should consider attending a residential treatment program for detox, since the symptoms of opioid withdrawal can make the process of detoxing difficult. In a medical detox program, you can slowly reduce your dose of opioids until they are no longer taking the drug. This form of detox tends to be the most effective, and it can reduce the severity of withdrawal symptoms.
After completing detox, you may need to receive psychological counseling and ongoing support. These services can be provided on an inpatient or outpatient basis, and they should continue as a part of your long-term treatment plan to maintain your sobriety.
During psychological counseling, a mental health professional works with you one-on-one to help you determine the cause of your addiction. From there you work to develop new coping strategies, life skills, and stress management techniques. You can also attend counseling in a group setting, with other patients who are in recovery or with members of their family. Both of these forms of counseling can be beneficial during the recovery process.
Counseling is also a useful tool, because mental health professionals can diagnose and treat co-existing mental disorders, like anxiety and depression. Patients who receive treatment for mental health conditions tend to experience higher rates of success in recovering from an opioid addiction.
In addition to counseling, when you are in recovery you should have short-term and long-term support. This support should ideally come from a number of sources, including medical professionals, friends, family members, and support groups. However, not everyone is lucky enough to have all of these sources of support. If you don’t have a strong community around you that supports your sobriety, having supportive doctors and attending a support group can help.
There is one support group that is specifically designed to help people who are recovering from an opioid addiction, Narcotics Anonymous. This group works with people who are recovering from a wide variety of substances, including opioid drugs. Another group is Heroin Anonymous which helps support people in their sobriety with local meetings taking place around the world. Attending one of these groups can help you learn from other people in recovery and feel less alone during the recovery process.
By seeking help for an opioid addiction, you can improve your mental and physical health and the quality of your life. Although the symptoms of opioid withdrawal can be uncomfortable, they can be managed. Long-term sobriety is worth the pain and discomfort of opioid withdrawal symptoms.
Withdrawal from opioids can be difficult, but The River Source can help. Our treatment center takes a holistic approach to treating opioid addiction. In a supportive and professional environment, we provide behavioral and pharmacological therapies to help patients detox from opioids. After completing detox and inpatient treatment, you will leave The River Source with a long-term care plan to help you maintain your sobriety.
If you or someone you love is suffering from an addiction to opioids, The River Source can help. Contact us today to learn more about our approach to treating opioid addiction and how we help patients overcome the symptoms of opioid withdrawal.