When ingested, opiates incite feelings of intense pleasure and relaxation by stimulating receptors in the brain. Whether prescription medication or recreational drugs, this makes opiates highly addicting and, therefore, difficult to stop using.
For those who become addicted, dopamine slowly loses its ability to release itself in the absence of the drug—because of this, halting the use of opiates even for a little bit can cause an individual suffering from addiction to experience severe withdrawal symptoms almost immediately.
Opioids come in various forms, each with specific characteristics and uses.
Common types include:
- Natural opioids (morphine, codeine)
- Semi-synthetic opioids (oxycodone, hydrocodone)
- Synthetic opioids (fentanyl, tramadol)
These medications are prescribed for pain management, but misuse can lead to dependence and addiction. Learn about what you can expect during an opiate detox.
The Various Types Of Opioids That Could Cause Substance Use Disorders
Opioids represent a diverse class of potent analgesic drugs, each possessing unique characteristics and applications. (1) Some of the following can be prescribed by public health sectors, whereas others aren’t. Derived from the opium poppy plant or synthesized in laboratories, opioids interact with specific receptors in the brain and body to alleviate pain.
Here’s a more detailed exploration of different types of opioids and some common brand names associated with each category, as a disclaimer: (1)
1. Natural Opioids:
- Morphine (Brand Names: Avinza, Kadian, MS Contin): A powerful analgesic often used for severe pain, post-surgery, or in palliative care. (2)
- Codeine (Brand Names: Tylenol with Codeine, Capital and Codeine, Empirin with Codeine): Frequently prescribed for mild to moderate pain and cough suppression. (2)
2. Semi-Synthetic Opioids:
- Oxycodone (Brand Names: OxyContin, Percocet, Percodan): Widely prescribed for moderate to severe pain, available in various formulations. (3)
- Hydrocodone (Brand Names: Vicodin, Lortab, Norco): Commonly prescribed for pain relief, often combined with acetaminophen or ibuprofen. (3)
3. Synthetic Opioids:
- Fentanyl (Brand Names: Duragesic, Actiq): An extremely potent synthetic opioid used for severe pain management, available as patches or lozenges. (3)
- Tramadol (Brand Names: Ultram, ConZip): Acts as a synthetic opioid and analgesic, prescribed for moderate to moderately severe pain. (3)
4. Methadone:
- Methadone (Brand Names: Dolophine, Methadose): Primarily used for opioid addiction treatment (opioid maintenance therapy) and chronic pain management. (4)
5. Buprenorphine:
- Buprenorphine (Brand Names: Subutex, Suboxone): Used for opioid addiction treatment, including medication-assisted treatment (MAT). (5)
6. Hydromorphone:
- Hydromorphone (Brand Names: Dilaudid, Exalgo): Prescribed for the management of severe pain, often in postoperative or cancer-related scenarios. (6)
7. Meperidine:
- Meperidine (Brand Name: Demerol): Historically used for pain relief, but its use has decreased due to the risk of toxic metabolites. (7)
8. Tapentadol:
- Tapentadol (Brand Names: Nucynta, Palexia): An analgesic with both opioid and non-opioid activity, used for moderate to severe pain. (8)
While opioids are invaluable for pain management, it’s crucial to use them judiciously under medical supervision.
What is Opiate Withdrawal?
Opiate withdrawal is the challenging process that individuals experience when they discontinue or reduce their use of opiates after prolonged and regular consumption. (9) Opiates, including prescription painkillers and illicit substances like heroin, bind to opioid receptors in the brain, leading to the release of neurotransmitters that create a sense of pleasure and pain relief. (9)
When an individual decides to stop using opiates, the sudden absence of these substances can trigger a range of physical and psychological symptoms.
These symptoms, collectively known as withdrawal, can include:
- Muscle aches
- Nausea
- Anxiety
- Insomnia
- Intense cravings for the drug
Opiate withdrawal is a complex and uncomfortable experience, but it is a necessary step for individuals striving to overcome addiction and achieve lasting recovery. (10)
Seeking medical support and engaging in various treatment options can significantly ease the challenges associated with opiate withdrawal, enhancing the chances of a successful recovery journey.
Opiate Withdrawal: Timeline and Symptoms
Although there are many different kinds of opiates, withdrawal is generally similar across the board in terms of symptoms. The main difference is when exactly withdrawal symptoms will begin and how long they will last.
Heroin withdrawal usually starts 8–12 hours post-ingestion and lasts up to a week, whereas Buprenorphine/Naltrexone withdrawal usually begins about 36 to 48 hours post-ingestion and can last around three weeks. (10) (11)
These symptoms’ severity and duration also depend on how long the individual used and how much, on average, they ingested daily.
Overall, severe opiate withdrawal can last from one to three weeks, and some symptoms can also pop back up irregularly. (10)
According to the Substance Abuse and Mental Health Services Administration, the most common signs and symptoms of opioid withdrawal are as follows: (12)
- Quickened pulse
- High blood pressure
- High body temperature
- Insomnia
- Enlarged pupils
- Heightened reflexes
- Sweating
- Gooseflesh
- Increased respiratory rate
- Teary eyes
- Yawning
- Runny nose
- Muscle spasms
- Abdominal cramps
- Nausea and vomiting
- Diarrhea
- Bone and muscle pain
- Anxiety
Although none of these signs or symptoms are life-threatening in general, it is important to note that, without proper medical supervision, they will increase in severity throughout withdrawal.
Those who suffer from conditions such as cardiac issues, infection, anxiety disorders, and generally anything involving pain are likely to also experience an intensification in those symptoms. This makes it important to have proper management of opioid withdrawal.
Therefore, it is essential that users, especially those suffering from extreme opioid addiction for an extended period, seek medical detoxification treatment either in an inpatient or outpatient program.
This way, opiate withdrawal can be appropriately managed with or without medication under the guidance of a trained professional.
Challenges of Withdrawing from Opiates
Withdrawal from opiates presents individuals with a daunting range of challenges, encompassing not only the physical display but also the psychological and social factors.
Navigating the complex landscape of opiate withdrawal requires a solid understanding of the difficulties that arise during this process. Let’s take a closer look at the following challenges:
Physical Symptoms
Withdrawal from opiates is associated with various physical symptoms, including:
- Muscle aches
- Joint pain
- Nausea
- Vomiting
- Diarrhea
- Flu-like symptoms
- Sweating
- Chills
- Gastrointestinal disturbances
These physical discomforts can be challenging to endure, contributing to the overall difficulty of the withdrawal process. (13)
Psychological Symptoms
Opiate withdrawal can also manifest in psychological symptoms such as anxiety, depression, irritability, and mood swings. (12) These emotional challenges can make the withdrawal period emotionally taxing for individuals, requiring mental resilience and support.
Cognitive symptoms may include difficulty concentrating, foggy thinking, and mood instability, creating a complex interplay between physical and psychological well-being. (12)
Cravings and Urges
The strong cravings and urges for opiates during withdrawal pose a significant challenge. Overcoming these intense desires for the drug is key to successful withdrawal and long-term recovery, often necessitating a combination of behavioral strategies and support. (12)
Developing coping mechanisms to manage cravings becomes a key aspect of the recovery journey.
Sleep Disturbances
Disturbed sleep patterns are common during opiate withdrawal, with symptoms ranging from insomnia to restless sleep. Sleep disturbances can exacerbate the overall discomfort of withdrawal and contribute to fatigue and irritability.
Adequate sleep hygiene practices and supportive interventions may be essential to address these challenges.
Cognitive Impacts
Opiate withdrawal can affect cognitive functions, leading to difficulties with concentration and memory. Cognitive challenges may persist throughout the withdrawal process, requiring patience and support as individuals navigate these temporary impairments. (12)
Cognitive-behavioral strategies and mental exercises can assist in managing these impacts.
Emotional Toll
The emotional toll of opiate withdrawal extends beyond immediate symptoms. Feelings of vulnerability, shame, and frustration are common, and individuals may need emotional support to navigate these complex emotions during the withdrawal process. (12) Providing a supportive and non-judgmental environment is crucial for addressing the emotional aspects of withdrawal.
Duration of Withdrawal
The duration of opiate withdrawal varies from person to person but typically includes an acute phase followed by a more extended period of post-acute withdrawal symptoms (PAWS). (14) The prolonged nature of withdrawal can be challenging, requiring individuals to stay committed to the recovery process.
Risk of Relapse
The risk of relapse is a significant challenge during opiate withdrawal. The intense cravings and the desire to alleviate withdrawal symptoms may tempt individuals to return to opiate use. Building a robust relapse prevention plan and having ongoing support are crucial aspects of overcoming this challenge.
Engaging in therapy, support groups, and developing healthy coping mechanisms can strengthen an individual’s resilience against relapse or potential future opioid overdose.
Co-occurring Mental Health Issues
Individuals withdrawing from opiates may also grapple with co-occurring mental health issues, such as depression or anxiety disorders. (15) Addressing both substance use and mental health concerns concurrently is essential for comprehensive treatment and sustained recovery.
What Effects Do Opiates Have On the Body?
Opiates profoundly impact the body’s central nervous system, primarily by binding to specific receptors in the brain known as opioid receptors. These receptors are integral to the body’s natural pain management system. When opiates bind to these receptors, they diminish the perception of pain, leading to powerful pain relief. (16)
However, this interaction also triggers a series of other effects. Opiates induce a sense of euphoria, a feeling of intense pleasure or well-being, by increasing the release of dopamine in the brain’s reward pathway. (16)
While this can provide a temporary sense of happiness, it also contributes to the potential for addiction. Additionally, opiates can cause drowsiness, respiratory depression, and constipation.
Prolonged use can lead to tolerance, requiring higher doses to achieve the same effects, and physical dependence, where the body adapts to the presence of the drug. (16)
How Do Opiates Affect the Brain?
Opiates affect the brain by interacting with the body’s natural opioid receptors, which are primarily located in the brain and spinal cord. When opiates such as prescription painkillers or illicit substances like heroin bind to these receptors, they activate the release of neurotransmitters, particularly dopamine. (9)
Dopamine is a neurotransmitter associated with pleasure and reward. The surge of dopamine creates intense feelings of euphoria and pain relief, reinforcing the desire to continue using opiates. (17)
Over time, as the brain adjusts to the presence of opiates, it may produce less natural dopamine, leading to physical dependence on the drug to maintain normal brain function. (9) This complex interaction is what clinicians say contributes to the addictive nature of opiates and underscores the challenges individuals face when attempting to overcome opiate addiction.
When Is Withdrawing from Opiates Necessary?
Withdrawal from opiates becomes necessary when an individual is struggling with opiate dependence or addiction. Dependence occurs when the body adapts to the presence of opiates and requires them to function normally. Addiction, on the other hand, involves a compulsive pattern of drug abuse, despite negative consequences.
If someone wishes to break free from opiate dependence or addiction, withdrawal is often a necessary step. Withdrawal allows the body to detoxify from the substance, breaking the physical dependence and providing an opportunity for the individual to engage in comprehensive addiction treatment.
It is critical to undergo withdrawal under the guidance of healthcare professionals to manage the associated symptoms and increase the chances of a successful recovery.
Opiate Detoxification Treatment
Medical opiate detoxification is the recommended treatment for anyone seeking to withdraw.
While individuals can withdraw successfully without the supervision of a professional, those who suffer from the most severe opioid addictions will find their detoxification process more efficient in an inpatient or outpatient setting.
Rather than allowing individuals to quit through the “cold turkey” method, most participants in medical detoxification will slowly withdraw with the help of a tapering method.
With the tapering method, doctors create a plan for their patients to slowly reduce the amount of opiate they consume until they are no longer reliant on it. By slowing the withdrawal process, there is less chance for severe consequences—rapidly quitting can increase opiate withdrawal symptoms and make the detoxification process much more painful.
Often, detoxification programs manage withdrawal by using small doses of approved medications to mitigate symptoms and ease the process.
Many approved medications, such as Buprenorphine/Naltrexone/Naloxone, are only allowed to be used in specific licensed programs where withdrawal symptoms are more serious or require hospitalization. (18)
The administration of these medications is another reason why seeking professional oversight during detoxification is important—access to these medications is restricted. They are best used when a doctor is present to prescribe an appropriate dose and oversee any possible signs of relapse or complication.
Whether or not detoxification takes place in an inpatient or outpatient setting, it is important to remember that detox itself is not the only form of treatment that individuals suffering from addiction should participate in.
Drugs Used to Treat Opiate Withdrawal
Medications used to treat opiate withdrawal play a large role in supporting individuals on their journey to recovery. One common medication is buprenorphine, which helps alleviate withdrawal symptoms by binding to the same receptors as opiates without inducing the same intense euphoria. (5)
Methadone is another medication that, when administered in controlled doses, helps manage withdrawal symptoms by satisfying the brain’s need for opioids without causing the disruptive highs associated with illicit opiate use. (19)
Clonidine, while not an opioid, can be used to mitigate certain withdrawal symptoms like anxiety and agitation. (20) These medications, when administered under medical supervision and as part of a comprehensive treatment plan, aid in minimizing the challenges associated with opiate withdrawal, making the recovery process more manageable for individuals seeking to break free from the cycle of addiction.
The Benefits Of Opiate Detoxification
Opiate detoxification, an important step in the journey to recovery from opioid dependence, offers a range of substantial benefits. For those with opioid use disorder, detoxification is highly beneficial.
Here are some positive side effects of monitored detoxification.
- Withdrawal Symptom Management: Opiate detoxification, often conducted under medical supervision, facilitates the management of withdrawal symptoms. Healthcare professionals employ various strategies, including medication-assisted treatment, to alleviate the discomfort associated with withdrawal, ensuring a more tolerable experience. (21)
- Enhanced Safety and Medical Oversight: Conducting detoxification in a supervised medical setting ensures enhanced safety and continuous medical oversight. This is particularly vital during the initial phases of withdrawal when certain symptoms may require prompt attention. Medical professionals can address emergent issues, promoting a safer detox process.
- Reduced Risk of Complications: Opiate detoxification in a controlled environment reduces the risk of complications that may arise during the withdrawal period. The availability of medical interventions minimizes potential health risks, contributing to a more secure and predictable detoxification process.
- Access to Supportive Resources: Detoxification programs offer access to a range of supportive resources, including counseling, therapy, and peer support. These resources play a pivotal role in addressing the psychological aspects of dependence, helping individuals navigate the emotional challenges associated with detox and early recovery.
- Structured Environment for Recovery: Opiate detoxification programs provide a structured environment conducive to recovery. The structured setting promotes routine, discipline, and focus on the detox process, laying the foundation for subsequent phases of treatment and long-term recovery.
- Professional Guidance for Transition to Further Treatment: Opiate detoxification is often a precursor to comprehensive treatment programs. Professionals guide individuals through the transition from detox to further treatment, whether it involves residential rehabilitation, outpatient programs, or ongoing therapy. This seamless transition enhances the continuity of care.
- Addressing Underlying Issues: Opiate detoxification programs offer opportunities to address underlying issues contributing to opioid dependence. Through counseling and therapeutic interventions, individuals can explore the root causes of addiction, paving the way for comprehensive and holistic recovery.
- Increased Motivation for Continued Recovery: Successfully navigating the challenges of opiate detoxification fosters a sense of accomplishment and motivation for continued recovery. Individuals often gain confidence in their ability to overcome obstacles, setting a positive tone for ongoing treatment and recovery efforts.
- Minimized Risk of Relapse: The structured and supportive environment of opiate detoxification programs contributes to minimizing the risk of relapse during the early stages of recovery. Access to professional guidance and healthcare providers, coping strategies, and ongoing support significantly enhance the likelihood of sustained recovery.
- Improved Overall Well-being: Ultimately, the benefits of opiate detoxification extend beyond the cessation of drug use. By addressing withdrawal symptoms, enhancing safety, and providing comprehensive follow-up support, individuals experience an overall improvement in physical, emotional, and psychological well-being.
Get Help With an Opiate Detox Today
Taking the first step in overcoming opiate addiction is starting with opiate detoxification. This process is all about getting rid of opiates from your body and dealing with the physical side of addiction. But here’s the important thing to know: detox alone isn’t enough. It’s like opening a door – it leads to something more important.
Once you’ve gone through detox, the next part of the process is about your mind and behavior. This means understanding why you got addicted in the first place and finding ways to change your thinking and actions.
Opiate addiction is not just about the body; it’s also about your thoughts and feelings. This second phase uses talking therapies to help you understand and manage these mental and emotional parts tied to addiction.
So, it’s not just about stopping prescription opioids; it’s about learning how to live without them and making changes that last. The combination of detox and talking therapies gives you the tools to break free from the cycle of addiction and helps you build a better, substance-free life.
Say yes to healing your addiction!
Regardless of what your circumstances are today, Zinnia Health can set you up for a brighter tomorrow. Are you interested in learning more about recovery and how it works? Reach out to us today or call (855) 430-9439.
Citations
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520671/
- https://www.cdc.gov/opioids/data/analysis-resources.html
- https://www.dea.gov/factsheets/synthetic-opioids
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070723/
- https://www.ncbi.nlm.nih.gov/books/NBK459126/
- https://www.mayoclinic.org/drugs-supplements/hydromorphone-oral-route/description/drg-20074171
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292527/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4942642/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/
- https://americanaddictioncenters.org/withdrawal-timelines-treatments/opiate
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202507/
- https://www.ncbi.nlm.nih.gov/books/NBK526012/
- https://www.ncbi.nlm.nih.gov/books/NBK310652/
- https://www.webmd.com/mental-health/addiction/opioids-post-acute-withdrawal-syndrome
- https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
- https://nida.nih.gov/research-topics/parents-educators/lesson-plans/mind-matters/opioids
- https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain
- https://www.samhsa.gov/medications-substance-use-disorders
- https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/methadone
- https://www.addictioncenter.com/treatment/medications/clonidine/
- https://store.samhsa.gov/sites/default/files/treatment-criminal-justice-pep19-matusecjs.pdf
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