Opioid withdrawal
OPIOID WITHDRAWAL
What is Opioid withdrawal? To understand opioid withdrawal, it is important to first understand what taking opioids over a long period of time does to one’s body. Taking an opioid daily for three weeks or longer leads to a change in brain chemistry which can be defined as drug tolerance. This means that over time, more of the drug is needed to achieve the same outcome (euphoria, pain control, or control or anxiety/depression). Dependence does not necessarily mean addiction however, which is characterized by constantly craving and continuously preoccupying oneself with the need to obtain more of the drug. If someone who is dependent on opioids stops suddenly, they will likely have both physical and psychological symptoms of withdrawal as the body is no longer receiving a drug that it is dependent on. The most common withdrawal symptoms are flu- like in nature and include:1. Runny nose
2. Muscle aches
3. Upset stomach, nausea, vomiting, diarrhea
4. Chills/sweats
5. Rapid heartbeat
6. Goosebumps on the skin
7. Anxiety
8. Inability to sleep
9. Fatigue
There are two main ways of going into withdrawal:
1) Suddenly stopping all opioid use without tapering down first (spontaneous withdrawal)
2) Taking an opioid antagonist like naloxone (contained in suboxone) or naltrexone too early (precipitated withdrawal)
How Long Does Opioid Withdrawal Last?
If you ask anyone who has experienced opioid withdrawal, the answer is that it is quite uncomfortable and in some circumstances, life- threatening. Withdrawals can start as early as a few hours and generally last 3-5 days. However, depending on the severity of addiction and the type of drug used, symptoms may last up to 3-6 weeks (methadone). A rough rule of thumb is an onset of symptoms occur after two to three times the half-life of the withdrawn opioid.Is There Anything to Make Withdrawals Easier?
While the mainstay of treatment for opioid withdrawal, Buprenorphine/Naloxone (Suboxone), focuses on satisfying your body’s physical dependence to opioids and reducing cravings, we also have additional treatment to help alleviate the other unpleasant symptoms of withdrawal. Below is a list of symptoms with corresponding treatment medications:1) Muscle aches, headache- acetaminophen, ibuprofen, and naproxen
2) Muscle spasm- cyclobenzaprine, baclofen, and methocarbamol
3) Nausea, vomiting- tigan, and ondansetron
4) Diarrhea- loperamide, bismuth subsalicylate
5) Abdominal cramping- dicyclomine
6) Inability to sleep (insomnia)- diphenhydramine, hydroxyzine, melatonin, trazodone, and doxepin
7) Anxiety, irritability, restlessness- diphenhydramine, hydroxyzine, and clonidine
