Opioids include strong prescription pain relievers, commonly known as oxycodone, hydrocodone, fentanyl, and tramadol. Doctors often prescribe opioids to reduce pain after a significant injury or surgery. They are also prescribed to cope with the pain from health conditions like cancer.
According to The National Institute on Drug Abuse, ongoing abuse of prescription opioids results in aches and pains, muscle spasms/twitching, stomach cramps, muscular tension, heart pounding, insomnia, and problems sleeping, feeling sick, among others.
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Although it gives the user a sensation of living pain-free, opioid abuse is just blocking the transmission of pain messages to the user’s brain. Over time, this can significantly slow down brain functions to the point that it cannot produce the necessary amount of chemicals for optimal brain and body function.
Withdrawal doesn’t have to hurt. Pain free withdrawal is possible with medical detox.
Withdrawal doesn’t have to hurt. Pain free withdrawal is possible with medical detox.
Types of Opioids
Various opioid types can be used for many reasons. Some of these can range from prescription opioids, illegal narcotics, and synthetic drugs that have become popular over the past several years.
Doctors will determine which medication is right for the specific medical situation. However, The National Institute on Drug Abuse (NIDA) states that nearly 80 percent of heroin users got their start using prescription opioids.
These numbers paint a bleak picture of opioid therapy. While it may be useful in many cases, many people fall victim to opioid abuse. Let’s take a look at the different types of opioid drugs that are available, according to WebMD:
- Fentanyl (Duragesic, Actiq, Fentora)
- Hydrocodone (Vicodin, Lorcet, Norco, Lortab)
- Hydromorphone (Exalgo, Dilaudid)
- Meperidine (Demerol)
- Methadone (Methadose, Dolophine)
- Morphine (Avinza, Astramorph, Kadian, MS Contin, Ora-Morph)
- Oxycodone (OxyContin, Percocet, Roxicodone)
Effects Opioids Have On The Body
Opioid drugs attach themselves to naturally occurring receptors in the brain, spinal cord, and gastrointestinal tract. Any time these opioids attach to the receptors, they exert their effects. The brain generates its own set of opioids, and they are responsible for decreasing pain, lowering respiratory rate, and preventing depression or anxiety.
Our bodies do not produce large quantities of these naturally occurring opioids, but it is enough to treat the pain associated with a broken leg, according to Healthline.com.
Opioids can work in the body in many ways that include:
- Brain Stem: Opioids can affect the brain stem, which is responsible for controlling functions such as breathing and heartbeat, by slowing breathing or a reduction in coughing.
- Limbic System: Opioids work on specific areas of the brain known as the limbic system, which controls emotions and is responsible for creating feelings of pleasure or relaxation.
- Spinal Cord: Opioids are designed to reduce pain by affecting the spinal cord, which sends messages from the brain to the body.
Opioid Withdrawal Symptoms
While prescription opioids are beneficial in treating pain, the National Institute on Drug Abuse (NIDA) estimates that 2.1 million people in the United States and 26.4 to 36 million people worldwide abuse opioids.
Opioid withdrawal can be mild, moderate, moderately severe, and severe. Addiction specialists can determine what to expect by assessing the opioid use history and symptoms with tools such as the Clinical Opiate Withdrawal Scale.
The symptoms someone experiences are going to depend on several factors, and everyone experiences them differently. Below is a typical timeline for the progression of withdrawal symptoms.
Early symptoms begin in the first 24 hours after use of the drug stops:
- Muscle aches
- Eyes tearing up
- Runny nose
- Excessive yawning
- Excessive sweating
Later symptoms, which will be more intense and feel like the flu:
- Dilated pupils
- Rapid heartbeat
- High blood pressure
Stages of the Opioid Withdrawal Timeline
Depending on the last dose, patients undergoing an opiate detox will typically experience many withdrawal effects. The withdrawal stages are varied for every person depending on different factors. Some may find themselves working through a short or longer timeline based on the following:
- Whether the individual took short or long-term opiates
- How long opiates were used and for what purpose
- The mental and physical health of the person
The severe of symptoms can last up to a week, after which the symptoms generally fade.
However, psychological and emotional symptoms start taking over at the three-week mark including, depression, irritability, restlessness, trouble sleeping, and anxiety. Cravings for the drug and depression can linger for weeks or even months.
Keeping this in mind, these are the three stages of withdrawal most opiate users experience while detoxing:
This initial challenging phase of opiate withdrawal tends to be the most painful and intense. Symptoms of withdrawal typically begin as early as eight to sixteen hours after the last opiate use and peak at the 72-hour mark. They may last up to five days, depending on the situation. Once successfully through this stage, the body is on its way to re-balancing chemically.
In phase 2 of opiate withdrawal, the body is working to flush out all substances and rebalance the endorphin levels that were depleted during opiate addiction. The cravings will be significantly reduced, giving the user relief. Symptoms continue to peak at the 72-hour mark, which is why it’s crucial to maintain physical strength and drink enough liquids, especially water, as eating may still pose a challenge.
This stage of opiate withdrawal is the longest. It can last anywhere from one week to two months. While the user is in the clear and the body has flushed out the toxins, it’s still common to experience continued nausea, anxiety, insomnia, and other withdrawal-related symptoms but on a much less intense level. Experts recommend that to ensure a safe recovery, one should stick to a low-stress routine to continually distract the mind from the cravings.
Opioid Withdrawal Treatment Steps
Managing the opioid withdrawal process requires the support of a professional team in addition to the emotional support of family and friends. One can also manage opioid addiction through the use of home remedies, but the most severe cases of opioid addiction are best managed at a rehabilitation center.
A full continuum of care is imperative for managing the opioid withdrawal process successfully. It typically includes three levels: detox, residential, and outpatient services.
The goal of the first stage of withdrawal treatment or detox is to eliminate the physical need for the drug. Typically, a medical team consisting of doctors, nurses and staff will do a complete medical evaluation to determine the level of addiction and health needs resulting in a detox plan which starts the detox process.
Detox at Arete Recovery also includes FDA-approved medications to limit withdrawals such as this one throughout the entire process. Following medical detoxification, a patient will be admitted to either an inpatient or residential program depending on the medical evaluation and the degree of substance abuse in patients.
This next stage of withdrawal treatment is to continue treatment in a residential facility. Depending on the medical detox plan, patients can either spend full-time at a short-term facility (approximately 45 days), or a more extended period (60-90+ days) at a residential recovery. They are similar in that they both ease the patient from detox to fewer intensive forms of treatment. They are different in that a “resident” is learning valuable life skills and coping strategies at a residential recovery to prevent relapse at a residential recovery, so s/he is better equipped for long-term recovery.
Professionals at Arete Recovery provide medical supervision and support in both the inpatient and residential recovery to help the patient transition effectively from treatment to the outpatient stage.
After the successful completion of inpatient or residential recovery, the client may transition to an intensive outpatient program designed to provide ongoing counseling that extends beyond the walls of the inpatient clinic and residential recovery.
Transitioning to an intensive outpatient program (OP) is imperative for preventing relapses and abstaining from opioids for the long-term. Contrary to on-site programs like inpatient and residential recovery, outpatient clinics give clients the flexibility to commit to their responsibility while supporting them with rehab services at a facility, clinic or hospital for ongoing treatment. A client’s treatment is determined by what is most essential for his/her recovery.
Help for Opioid Addiction
We provide a secure and comfortable environment for detox, with medications to help manage the symptoms of withdrawal. The caring, trained medical staff at Arete Recovery are there during medical detox, and our therapists are paramount to the care given in residential treatment.
National Institute on Drug Abuse. "FDA approves first medication to reduce opioid withdrawal symptoms." NIDA. 16 May 2018. 04 Feb. 2019 from https://www.drugabuse.gov/news-events/news-releases/2018/05/fda-approves-first-medication-to-reduce-opioid-withdrawal-symptoms
National Institute on Drug Abuse. “Prescription Opioids.” NIDA, 7 June 2018 from http://www.drugabuse.gov/publications/drugfacts/prescription-opioids
Opiate Withdrawal. (2019). Opiate Withdrawal. from http://www.opiatewithdrawal.org/
National Institute on Drug Abuse. (2014, May 14). America's Addiction to Opioids: Heroin and Prescription Drug Abuse. from https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2014/americas-addiction-to-opioids-heroin-prescription-drug-abuse
First Aid for Broken Bones and Fractures. (n.d.). from https://www.healthline.com/health/first-aid/broken-bones
Opioid and Opiate Withdrawal: Symptoms and Treatments. (n.d.). from https://www.healthline.com/health/opiate-withdrawal#opioid-effects
What are some types of opioid (narcotic) pain medications? (n.d.). from https://www.webmd.com/pain-management/qa/what-are-some-types-of-opioid-narcotic-pain-medications
National Institute on Drug Abuse. (n.d.). Prescription opioid use is a risk factor for heroin use. from https://www.drugabuse.gov/publications/research-reports/relationship-between-prescription-drug-heroin-abuse/prescription-opioid-use-risk-factor-heroin-use