More than 11 million people in the United States used opioids without a prescription in 2016. For many of these clients, they developed a dependence on the drugs and experienced opioid withdrawal when they stopped using.
While opioid overdose remains the biggest threat for opioid abusers. Withdrawal is another issue to be aware of, especially when seeking treatment to stop using opioids.
Using opioids regularly can cause your body to build up a tolerance and a physical dependence upon them. This causes people to use them in order to avoid the harmful and dangerous opioid withdrawal symptoms.
Opioid withdrawal occurs when users stop or cut back on opioid drugs after a dependence has built up. Typically, a dependence occurs after heavy use over a few weeks. Some of the common opioid drugs that lead to withdrawal include:
While the physical/mental health symptoms of withdrawal are problematic and uncomfortable, they are not life-threatening like alcohol or benzodiazepine withdrawal symptoms. That being said, it is important to understand what withdrawing from opioids looks like and when it occurs.
Opioid withdrawal symptoms vary based on usage, personal health factors, and how long it’s been since someone last used. Typically, we see the following withdrawal symptoms:
People using short-acting opioids will experience withdrawal symptoms sooner than others. You can expect to see initial symptoms begin about 6-12 hours after your last time using opioids.
The withdrawal effects from long-acting opioids will take longer to set in. You can expect to see initial symptoms about a day or so (apx 30 hours) after you’ve stopped using.
Regardless of the type of opioid; however, most opioid withdrawal symptoms will peak about 72 hours after your last use.
Treatment is most effective when done in a professional, medical setting. Medical professionals can provide clients with the highest form of care and give them a comprehensive treatment program that includes medication, counseling, and follow-up support.
“Detoxification is a set of interventions aimed at managing acute intoxication and withdrawal. It denotes a clearing of toxins from the body of the patient who is acutely intoxicated and/or dependent on substances of abuse. Detoxification seeks to minimize the physical harm caused by the abuse of substances.” – SAMHSA
Opioid detox begins with a medical assessment where clinicians meet with the client to better understand their unique problems. This meeting is typically related to drugs of abuse, family history, personal history, and more. Armed with the client’s unique needs, clinicians will develop a treatment program aimed at helping them detox from opioids.
After the evaluation is complete, clients are checked into detox where they are monitored by medical staff. As withdrawal symptoms arise, the detox team works to properly manage symptoms and keep clients safe.
Following the initial opioid detox program, clients have the best chance of long-term sobriety when enrolling in aftercare. For some that means taking time at an inpatient drug rehab, for others this means going to a weekly support group. It all depends on the specific client’s needs.
While proper aftercare is essential in all types of addiction, it is especially important for opioid users. Using an excessive amount or for a prolonged period of time will chemically alter the user’s mind and require significant commitment to overcome. For this reason, upwards of 35% of clients who undergo opioid detox end up transitioning to further treatment.
Opioid detox is typically conducted in two types of settings based on the level of addiction and what someone can/is willing to commit to. Both options have pros and cons that you should weigh before making a decision — addiction specialists can help you decide the best approach.
Inpatient detox can be done in a residential or hospital setting where clients check-in to the facility for a number of days and are released when their detox symptoms subside.
Outpatient detox is conducted in a doctor’s office where withdrawal symptoms are noted and treatment plans are adjusted accordingly. This is generally for less severe cases.
There are many medications that are proven to help manage withdrawal symptoms and achieve sobriety. Currently 3/4 of the FDA-approved Opioid Use Disorder medications can be used during withdrawal.
Methadone has been used over the last 40 years to treat withdrawal symptoms and following detox. It binds to the opioid receptors in the brain typically eliminating withdrawal symptoms without causing euphoria. Methadone can stay in the system for around 7-10 days and has been less effective as it can only be prescribed in specific clinics and can be addictive.
Buprenorphine works similarly to methadone and was approved by the FDA in 2002. The drug can be paired with naloxone in ongoing treatment to reduce its addictiveness.
The drug has proven to be as effective as methadone and is the first FDA-approved drug that could be prescribed by any practicing physician who became specifically licensed.
Lofexidine, one of the newest approved treatments:
Naltrexone is the fourth FDA-approved medication for opioid use disorder, but it cannot be used during withdrawal or it may cause life threatening problems. The medication; however, is approved for long-term treatment following detox.
These medications are most effective when continued after withdrawal symptoms have subsided and paired with therapy. The pairing of medications and therapy is referred to as medication-assisted treatment (MAT).
Detox is the first step in a lifelong process.
Addiction is not something that magically goes away after detox. Addiction is a disease that will last a lifetime and if clients don’t get the tools and knowledge they need to overcome the problem, they will constantly be a victim to relapse.
The steps that follow detox will depend entirely on client needs. For some, this could mean going to a residential drug rehab to continue to receive comprehensive and holistic treatment for their substance abuse problem. For others, support groups like Narcotics Anonymous can help.
To get the correct treatment, it is best to go with a doctor’s recommendation after they have completed a comprehensive assessment. If you need help deciding what type of treatment is best for you, call our addiction specialists today.
