Opioid withdrawal: facts, issues, and expectations

Opioid addiction has become a challenging health care issue in recent years. While the popular image of opioid addiction is the 70’s style needle using junkie, opioid addiction has made its way to the suburbs. Contrary to popular belief, opioid addiction is not an issue that just afflicts minority communities. Instead, many people have now become addicted to opioids through prescription pain medications, all over the US. The effects of opioid abuse now range up and down all levels and sectors of society.

Knowing how opioid withdrawal works is of vital importance to health care workers, clinicians, law enforcement personnel and family members of those who suffer from opioid dependence. In this article, we will aim to provide you with the facts that surround opioid withdrawal.

What is opioid withdrawal?

Opioid drug withdrawal is the set of symptoms and complications associated with ceasing to use opioid medications. This is where opioids have been used enough and in large enough dosage to cause physical dependence. If opioid medications have been used for longer than a period of two weeks, there can be symptoms associated with sudden opioid withdrawal that can be harmful, or even life threatening.

What are opioid withdrawal symptoms?

Withdrawal symptoms can range from mild to severe, depending on the drug used, the dosage involved and the length of time of use. Early symptoms can include:

• Lessened pain relief, aka tolerance
• Agitation, anxiety, and depression
• Muscle aches
• Insomnia
• Sweating
• Yawning, fatigue, and bodily malaise

Late symptoms of withdrawal can include:

• Abdominal cramps
• Diarrhea
• Pupil dilation
• Nausea and vomiting

How do opioids affect the body?

Opioids bind to centers in the reward system of the brain, suppressing neurotransmitters such as noradrenaline and flooding the system with dopamine and serotonin. When opioids are no longer present, pain transmitting neurotransmitters reactivate and dopamine and serotonin supplies are diminished, helping to create withdrawal symptoms. Further, long term use of opioids can cause long term damage to the brain, kidneys, liver, and the nervous system. First time users of opioids who overdose can even suffer cardiac arrest. Oxycodone withdrawal and hydrocodone withdrawal symptoms work in an identical manner, as these are both opioid drugs. 

If used correctly, opioids can be valuable tools to manage chronic and acute pain. However, they should only be used under the guidance and care of a trained medical professional. In recent years, more emphasis has been placed upon providing medical professionals with the proper training to manage pain care with patients, so that patients can have their pain managed correctly without exposing them to the risk of opiate addiction.

Treatment available for withdrawal symptoms

Fortunately, there are both short term and long-term options to help opioid users deal with the symptoms of addiction.

In the short term, a detox and opioid taper is designed to help a patient clear their system of opioids while lessening withdrawal symptoms. These include:

• Methadone, which is a management medication that alleviates opioid withdrawal symptoms. Methadone dosage is slowly reduced until the system is cleaned of opioids.
• Naltrexone is also called an opiate antagonist. It reduces the desire to take opiates, but it must not be taken while opioids are still in a patient’s system.
• Clonidine is used to treat anxiety symptoms, muscle aches, fatigue, runny nose, and cramping.

Usually, these short-term treatments are administered during a detox, which can occur in an inpatient or outpatient setting, over the course of two to three weeks. Physical withdrawal usually completes itself after 5 to 7 days. However, long term addiction issues can take years to address.

During long term treatment, a patient is supported with long term professional care, counseling, and a program that involves Methadone and Buprenorphine as support medications. Buprenorphine is a medication that treats long term opiate withdrawal symptoms and cravings. This is used along with Naltrexone to dissuade opiate consumption, usually as  part of a long term addiction treatment program.

Potential complications with opiate withdrawal

It can’t be understated that withdrawing from opioids should be done under professional care – “cold turkey” approaches can throw the body into a state of shock, resulting in cardiac arrest and other life-threatening events. Unsupported withdrawal is also usually intensely uncomfortable, which may drive the patient into opiate use again. This can lead to an overdose, which can result in death.

Other complications can result from mixing other drugs with opiates. In particular, using alcohol, stimulants and other drugs while withdrawing from opiates can result in cardiac arrest, seizures, and death.

Opiate withdrawal may take several weeks. The best way to avoid complications is to engage in a controlled opioid taper under the guidance of a trained physician or other medical professional, who can monitor the patient’s vitals and take blood panels as needed while providing proper support for pharmaceutical symptomatic relief as the opioid dosage is slowly reduced. Then, after the detox, the professional can direct the patient into appropriate long-term addiction treatment and support.

Countrywide Testing - services and support for opioid withdrawal management

Countrywide Testing has worked with treatment professionals, law enforcement and patients for years. Countrywide Testing provides drug testing services and products and that help those struggling with the impact of opioid withdrawal and addiction serve their patients and communities. Contact us about these options.