Opiate Withdrawal

Opiate withdrawal is a medical term that refers to the range of symptoms that manifest after stopping or suddenly reducing the use of opiate drugs. Sometimes, these symptoms present themselves after chronic use over a period of time, usually after a few weeks or so. To understand the effects of this withdrawal, it is important to know what opiate drugs are and how they affect the body. Opiate drugs are a class of strong narcotic drugs prescribed for pain relief.

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Due to their potency, these drugs are only meant for prescriptions. In many cases however, these drugs have been used for non-medical reasons, resulting in drug abuse. Examples of opiate drugs include codeine, heroin, morphine, methadone, fentanyl and oxycodone.

How Exactly Do Opiate Drugs Work?

These drugs, once in blood circulation, are able to attach themselves to the opioid receptors. These receptors are present in different parts of the body, but mainly the brain and the spinal cord.

Once attached, the drugs reduce the relaying of pain signals from the brain, and this in turn provides relief from pain. In a medical setting, the drugs are prescribed for moderate and severe pain especially that which does not respond well to conventional pain medication.

In addition to this mode of action, opiate drugs alter the way the brain responds, producing a ‘high’ that narcotic drug users typically experience. These feeling changes the reward and pleasure centers located in the brain.

Alongside the emotional effects, opiate drugs also have an effect on the physical body. Typically, one’s heart rate, body temperature and blood pressure levels become low as the emotionally pleasant feelings take center stage.

With this understanding, it is easy to see why chronic use of opiate drugs can easily change the functioning of the brain’s chemical pathways, eventually leading to dependence. In this state, abruptly stop in the use of the opiate drugs results in withdrawal symptoms.

Simply put, withdrawal symptoms occur when the body does not have time to recover in the absence of the drug. Withdrawal symptoms may occur in between doses or may start to show when an individual stops using the opiate drugs.

What are the Symptoms of Opiate Withdrawal?

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The symptoms of opiate withdrawal may be categorized into two groups: early withdrawal symptoms and late withdrawal symptoms. Early withdrawal symptoms typically start anywhere between 6 and 30 hours depending on whether the opiates were short-acting or long acting. These symptoms include:

Late withdrawal symptoms on the other hand, tend to set in about 72 hours later and will often last a week or so. As expected, these are more intense than the aforementioned symptoms. They include:

  • Nausea and vomiting
  • Diarrhea
  • Abdominal cramping
  • Depressive episodes
  • Intense cravings for the drug
  • Intrusive (suicidal) thoughts

It is important to mention that some of the psychological side effects of opiate withdrawal cause great discomfort for the individual. The symptom, which include irritability, agitation, insomnia anxiety and intrusive thoughts are the result of a chemical imbalance in the brain.

The reason for this is that the centers associated with positive emotions are usually affected by the ‘high’ of the opiates, and may require some time to make a full recovery to their previous levels.

For this reason, therapy and psychological support availed by mental health professionals helps decrease the symptoms of opiate withdrawal.

Treatment Options Available for Opiate Withdrawal

Opiate withdrawal, as mentioned above, can be very uncomfortable, and depending on the circumstances, may even pose danger to the individual.

This is why treatment is key in managing the symptoms of withdrawal. It is important that the treatment options outlined below are carried out in a medical setting to reduce the chances of a medical emergency. The options available include medical detox and a strong support system as part of the treatment plan.

Medical detox, just as the name suggests, is the process through which opiate drugs are removed from the body under close medical supervision.

Ideally, mental health professionals are also on standby to evaluate progress and ensure that an individual remains stable enough during the process. Medical detox lasts around seven days, although this time may vary from one individual to another.

At the core of this treatment plan is the use of the tapering method. Tapering involves gradually lowering the amount of opioids administered over a set period of time until the drug is completely eliminated from the body.

This works because it not only ensures that the opioid receptors are occupied, it also prevents the sudden onset of severe withdrawal symptoms.

Medicines Available for Detox Treatment.

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There are different medicines that are available for use in the detox plan. These include methadone, buprenorphine as well as clonidine. Naltrexone is also available for this purpose. Below are the exact mode of actions in which the drugs act.

Methadone

Methadone helps manage withdrawal symptoms, and is an excellent choice for opioid dependence. It typically works to replace a short-acting opioid, heroin for example. As a long-term maintenance drug, methadone’s dosage may be decreased over a period of time in order to reduce the intensity of the withdrawal symptoms.

Buprenorphine

Also known as Subutex, this drug is a partial opioid that is preferred for its ability to remain active in the body for long periods of time as well as the fact that only a low dosage is required.

What’s more, as a partial opioid buprenorphine does not create the same ‘high’ feeling that full agonist opiate drugs create. This in turn, reduces the likelihood of drug abuse.

Research also shows that this opioid’s effectiveness is eliminated after a certain period of time, thus managing detox fairly well.

Clonidine

This drug is recommended for treating opiate withdrawal symptoms because it reduces their intensity. Clonidine helps reduce muscle aches, sweating, abdominal cramping and agitation. Note however, that it does not help manage cravings, so it may be important to combine its action with another for an effective treatment plan.

Naltrexone

This is an opioid antagonist that works by binding to the opioid receptors in the body, effectively preventing other opioids from attaching to the receptors.

What this simply means is that if one tries taking a drug such as heroin, while taking an antagonist, heroin’s effects will not be produced. Often, the results are a phenomenon known as precipitated withdrawal syndrome.

This syndrome makes reference to the quick onset of withdrawal symptoms whose intensity serves to keep a drug user away from drug abuse. Naltrexone is also used to help prevent a relapse after medical detox and the complete removal of the opioid drug from the system.

What Happens After a Detox Treatment Plan?

After a detox treatment plan, most individuals will require long term treatment to keep them in check as well as to monitor the progress made. These may include:

  • Support groups
  • Intensive outpatient treatment which may involve a day of hospitalization
  • Inpatient treatment
  • Counseling

What are the Possible Complications of Opiate Withdrawal?

Following the sudden stopping of opioid use, some of the complications that may arise include vomiting that causes the affected individual to inhale the expelled stomach contents into the lungs.

The medical term for this is aspiration, and it may easily lead to infections of the lung. Vomiting is also known to cause dehydration and disturb the electrolyte balance in the body.

Another complication that often arises from opiate withdrawal is return to drug use. In fact, studies indicate that most deaths resulting from opiate overdose occur in people who had just managed the detox treatment plan.

The underlying reason for this is that the process of withdrawal and detox significantly decrease an individual’s tolerance to the drug. Consequently, anyone who has undergone withdrawal is at a higher risk of overdose because all that is required is a smaller dosage than what was previously taken.

The medical term for this is relapse. This is why, after a medical detox, follow up should be made using any of the aforementioned channels. Simply put, comprehensive care is required to care for an individual going through opiate withdrawal, right from detox, into the process of recovery and beyond.

Helpful Tips to Use Following Opiate Withdrawal

  1. Make sure that a family member or friend is aware as you carry through the withdrawal process as this forms a solid support system.
  2. Keep a positive mindset that you can overcome the dependence on opiates as this carries a lot of weight in the journey of recovery.
  3. Take some time to unwind outdoors, even if it is something as small as taking a walk around the apartment or watching the sun set. Research confirms that spending time in the outdoors helps with recovery.
  4. Keep your mind engaged and indulge in all those things you used to love. This helps the body reset the levels of chemical compounds in the body and increases the release of endorphins, commonly referred to as ‘feel good’ hormones.
  5. Lastly, let your doctor know if you start to experience any vomiting and/or dehydration as this could cause complications.

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