Opiates or opioids are drugs used to treat pain and are often abused recreationally. The term narcotic refers to either type of drug. If you stop or cut back on these drugs after heavy use of a few weeks or more, you will have a number of symptoms. This is called withdrawal.
Opioids change the way the brain responds to pain stimuli and can also produce a “high” feeling by disrupting the reward and pleasure centers in the brain. Opioids look like chemicals in your brain and body that attach to tiny parts on nerve cells called opioid receptors. Scientists have found three types of opioid receptors: mu, delta, and kappa (named after letters in the Greek alphabet). Each of these receptors plays a different role. For example, mu receptors are responsible for opioids’ pleasurable effects and their ability to relieve pain.
Repeated use or abuse of an opioid drug can actually change the way an individual’s brain chemistry works and lead to physical and psychological dependence. The body may not feel “normal” anymore without the drug’s interaction, and withdrawal symptoms may start in between doses or when an individual stops taking the opiate.
What Are Opiate Withdrawal Symptoms?
Opiate drugs, including prescription painkillers and heroin, can produce withdrawal symptoms just hours after the last dose, and the symptoms can last for a week or more.
Early symptoms of withdrawal include:
- Muscle aches
- Increased tearing
- Runny nose
Late symptoms of withdrawal include:
- Abdominal cramping
- Dilated pupils
- Goose bumps
Unassisted withdrawal may not be life-threatening, but it can lead to relapse. Medications like Buprenorphine as well as individual and group therapy, accessed in medical detox, may make relapse less likely.
The National Institute on Drug Abuse (NIDA) publishes that between 26.4 million and 36 million people around the globe abuse opiate drugs, which includes prescription pain relievers and the illegal drug heroin.
Cause and Effect
Every day, more than 115 people in the United States die after overdosing on opioids. The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. In the US alone, an estimated 54 million people over the age of 12 have used prescription drugs for nonmedical reasons in their lifetime.
Most abused prescription drugs fall into four categories, based on the number of people who misuse the drug:
- Painkillers – 3.3 million users
- Tranquilizers – 2 million users
- Stimulants – 1.7 million users
- Sedatives – 0.5 million users
Narcotic pain relievers and other opiates include:
- Hydrocodone (Vicodin)
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
- Oxycodone (Percocet or Oxycontin)
These drugs can cause physical dependence. This means that a person relies on the drug to prevent withdrawal symptoms. Over time, more of the drug is needed for the same effect. This is called drug tolerance. How long it takes to become physically dependent varies with each person.
When the person stops taking the drugs, the body needs time to recover. This causes withdrawal symptoms. Withdrawal from opiates can occur any time long-term use is stopped or cut back.
Seeking Opiate Addiction Treatment
Withdrawal from these drugs on your own can be very difficult and uncomfortable. Treatment most often involves medicines, counseling, and support. You and your Right Path Care Provider will discuss your care and treatment goals in your first meeting.
Withdrawal can take place in a number of settings:
- At-home, using medicines and a strong support system. (This method is difficult, and withdrawal should be done very slowly.)
- Using facilities set up to help people with detoxification (detox).
- In a regular hospital, if symptoms are severe.
- Outpatient Treatment Center like Right Path
Medication-Assisted Treatment (MAT) and Medicines
Methadone relieves withdrawal symptoms and helps with detox. It is also used as a long-term maintenance medicine for opioid dependence. After a period of maintenance, the dose may be decreased slowly over a long time. This helps reduce the intensity of withdrawal symptoms. Some people stay on methadone for years.
Buprenorphine (Suboxone / Subutex) treats withdrawal from opiates, and it can shorten the length of detox. It may also be used for long-term maintenance, like methadone. Buprenorphine may be combined with Naloxone (Bunavail, Suboxone, Zubsolv), which helps prevent dependence and misuse.
Clonidine is used to help reduce anxiety, agitation, muscle aches, sweating, runny nose, and cramping. It does not help reduce cravings.
Other medicines can:
- Treat vomiting and diarrhea
- Help with sleep
- Naltrexone can help prevent relapse. It is available in pill form or as an injection.
- People who go through withdrawal over and over should be treated with long-term methadone or buprenorphine maintenance.
Most people need long-term treatment after detox. This can include:
- Self-help groups, like Narcotics Anonymous or SMART Recovery
- Outpatient counseling
- Intensive outpatient treatment (day hospitalization)
- Inpatient treatment
Anyone going though detox for opiates should be checked for depression and other mental illnesses. Treating these disorders can reduce the risk of relapse. That’s one of the reasons seeing a licensed addiction treatment specialist is so important.
Support groups, such as Narcotics Anonymous and SMART Recovery, can be enormously helpful to people addicted to opiates:
If you or your loved one is experiencing withdrawal and are ready to seek treatment, contact us today. Right Path offers same-day appointments and now accepts Virginia Medicaid. The most important step in the road to recovery is the first one. Delaying access to treatment when a person is ready to start is often a huge gamble. Call today, we are here to help.