Anyone who takes an opiate or opioid daily for any length of time exceeding a few weeks or so will become physically dependent upon the drug. Physical dependency, withdrawal and addiction are not the same thing. Physical dependence is a result of the effects of opioids upon the brain and body. It will happen to everyone. Addiction is a compulsive desire to use an opiate or opioid for non-medical reasons. Addiction will not happen to everyone.
What Is An Opiate?
The terms opiate and opioid are often used interchangeably. Technically, an opiate is a narcotic substance directly derived from the opium poppy. Examples would be codeine, morphine and opium. An opioid is either a semi-synthetic narcotic originally derived from opium or a totally synthetic narcotic substance with no opium source at all. Examples of semi-synthetic opioids are oxycodone, oxymorphone, hydromorphone and hydrocodone. Some totally synthetic opioids are methadone, fentanyl, meperidine, buprenorphine and propoxyphene. This article will use the term, opioid, to refer to all forms of opiates and opioids.
Once an individual has become physically dependent upon an opioid, an extremely unpleasant withdrawal syndrome will result if the drug is suddenly stopped. Fear of withdrawal is universal among all opioid addicts who have ever experienced it. It keeps many people addicted. In fact, many opioid addicts take their drug of choice just to feel normal. They no longer get much of a high; they just don’t want to be sick. Symptoms of opioid withdrawal vary in length, character and intensity, but they generally include the following:
- Feeling hot and cold
- Stomach pain
- Diarrhea and intestinal cramps
- Nausea and vomiting
- Extreme weakness
- Bone, muscle and joint pain
- Restless leg syndrome
Acute symptoms typically abate within a week to 10 days, but this depends upon the person, the drug abused, the dosage and the length of time the drug was taken. Buprenorphine and methadone have a longer withdrawal period than opioids with a shorter half-life. This means those that are shorter-acting. However, any opioid can produce withdrawal symptoms that can linger for a month and more.
It’s no wonder no one will voluntarily subject themselves to such a nightmare of symptoms. Those thinking of entering rehab may not want to because of their fear of withdrawal. However, there is no reason for this. Opioid rehabs know how to keep their patients comfortable during the withdrawal process. In fact, it’s part of their job.
Don’t let the fear of opioid withdrawal stop you from getting the help you need. You will not suffer any significant discomfort during your withdrawal. If you do, you need only to speak up. Your medication regimen can be adjusted by rehab staff. It’s their job to ensure that you’re not in pain. It may not be possible to completely abate every symptom, but you shouldn’t be in pain. You should be able to sleep and you shouldn’t be unduly uncomfortable. Modern withdrawal from opioids in a rehab facility is safe and free from undue discomfort.
Medications for Opioid Withdrawal
One way to reduce opioid withdrawal symptoms is to gradually reduce the dosage of the drug over time. However, someone addicted to opioids is powerless to control their usage. It’s part of their addiction. After all, if they could control their use, they would be unlikely to need rehab services in the first place. Therefore, patients entering drug rehab are often using very high dosages of opioids. Here are some medications used to help them get through withdrawal in relative comfort:
Clonidine is in a drug class known as beta-blockers. These drugs are normally used to control high blood pressure and for certain types of heart disease. However, clonidine has an important use in opioid withdrawal. It can reduce withdrawal symptoms by as much as 50 percent. It’s especially effective against feelings of anxiety. Clonidine is not a narcotic or a controlled substance. There are no addiction concerns with this medication.
This medication is best known as its combination form, Suboxone. Buprenorphine is an oral medication that attaches to the same brain opioid receptors that all opioids do. However, buprenorphine doesn’t affect the receptors in the same way. Its effect is only partial, but it’s longer-acting. Buprenorphine acts to both alleviate withdrawal symptoms and drug craving. In opioid rehab, the drug will typically be given in gradually reduced doses over time until the patient is totally free of all opioids.
Buprenorphine can be unpredictable in that it won’t help everyone. It may not help those patients who have been taking vast doses of opioids for long periods of time. Others just don’t respond to it that well. On the other hand, for some patients, it can eliminate all traces of withdrawal symptoms like magic. For some people, it works so well, they don’t need any other medications during their withdrawal period at all.
Methadone is a full synthetic opioid with the power to quell all withdrawal symptoms in virtually everyone. It’s best known for its use in methadone clinics, but it can be used in gradually reduced doses over time to detox a patient from other opioids. It only needs to be taken once a day. It will stop withdrawal symptoms completely. Other medications will not be necessary.
Opioid withdrawal often produces severe muscle cramps. Muscle relaxants like Robaxin can help with this annoying, sleep-robbing symptom.
Trazodone and Chlorpromazine
Both of these medications will help with some opioid withdrawal symptoms, especially anxiety and insomnia. Chlorpromazine will help the patient to relax and may help with insomnia, too. Trazodone will help the patient to get some sleep. Both are non-opioids.
These are anti-anxiety and hypnotic drugs most commonly known as Valium, Halcion, Ativan, Xanax and Tranxene. They are addictive, too, but they aren’t opioids. They are sometimes used for short periods of time for patients who are extremely anxious or unable to sleep and who haven’t responded to other medications.
If you think that you or someone you love may need help with a substance abuse problem, please call us. We’re professional counselors. We are here 24 hours a day to help guide you to the right substance abuse program for you. Just call us at 866-802-6848. We look forward to your call.