Opioid Withdrawal Symptoms: What to Expect and How to Find Relief

Introduction

Opioids are drugs usually used to treat pain, they include opioids like codeine, heroin, morphine, poppy, and opium, and also synthetic opioids like fentanyl, oxycodone, and methadone. While opioids are potent pain-relief medications, on the flip side, they lead to dependence and opioid use disorders. These are chronic and life-threatening conditions, and among other things, can also lead to opioid withdrawal.

Opioid withdrawal symptoms are intense and unpleasant, and can require hospitalization. In this blog, we shall seek to understand what opioid withdrawal symptoms are and how to manage them.

What is Opioid Withdrawal?

Opioids have high potential for dependence and misuse, as they are highly addictive. When a person takes opioids for a long time, then the body becomes dependent on them. It begins to need opioids for proper functioning and over time keeps needing more and more of it as well to achieve the same effects and feel content.

If the body does not get opioids for some time, opioid withdrawal is the outcome. Opioid withdrawal is an intensely unpleasant experience and can also need hospitalization. In many cases, it becomes difficult to give up opioids because of these withdrawal symptoms and doing so without medical supervision can also be severe and lead to relapse. Hence, it is always necessary to seek medical advice and professional help while quitting opioids after prolonged use.

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Common Opioid Withdrawal Symptoms

Some common symptoms of opioid withdrawal are the general withdrawal symptoms. They are as follows:

• Cravings

• Restlessness

• Anxiety

• Teary eyes

• Runny nose

• Sweating

• Frequent yawning

• Sleep difficulties

• Muscle aches

Some of the more intense symptoms of opioid withdrawal, which usually begin after a day are as follows:

• Vomiting

• Diarrhea

• Stomach cramps

• Dehydration

• Blurred vision

• Dilated pupils

• High blood pressure

• Increased heart rate

Opioid withdrawal symptoms generally reduce within 72 hours, however, this depends on the severity and frequency of opioid use. Sometimes, hospitalization might be required.

Opioid Withdrawal Causes

Opioid withdrawal is usually observed in cases of opioid use disorders, which is characterized by a dependence on opioids. It is due to the prolonged and frequent use of opioids, especially given their high potential for misuse.

When the body gets used to regular doses of opioids, it changes the way nerve receptors function in the brain. Soon, these nerve receptors begin to need opioids for functioning. The body becomes physically dependent on opioids.

Opioid withdrawal happens when the body does not get its general dose of opioids, leading to intensely unpleasant symptoms known as the opioid withdrawal symptoms. These can range from general restlessness and anxiety to vomiting, diarrhea, increased blood pressure, and rapid heart rate.

Usually, opioid withdrawal symptoms begin anywhere between 8 – 24 hours of the last dose and can last for anywhere between 4 – 10 days. Opioid withdrawal symptoms generally subside over a period of time, however, this depends on the severity and frequency of use. In severe cases, opioid withdrawal can require hospitalization as well.

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Opioid Withdrawal Timeline

Usually, for short-acting opioids, like codeine, heroin, morphine, oxycodone, the onset of withdrawal symptoms is relatively quick. They begin around 8 – 24 hours after the last dose. These symptoms can last for 4 – 10 days.

For long-acting opioids, like methadone, the onset of withdrawal symptoms is relatively late. They begin around 12 – 48 hours after the last dose. These symptoms can last for a relatively longer period of time as well, for nearly 10 – 20 days.

Factors Affecting the Severity of Opioid Withdrawal

Several factors can affect the severity of opioid withdrawal, and they are as follows:

• Type of Opioids – Short-acting opioids can lead to intense withdrawal symptoms, while long-acting opioids can lead to withdrawal symptoms that last for a long period of time but are less intense.

• Duration and Frequency of Use – Usually prolonged and frequency of use of opioids lead to more severe opioid withdrawal symptoms.

• Use of Other Substances – Other substances, like alcohol or benzodiazepines, can exacerbate opioid withdrawal symptoms and complicate conditions if taken with opioids.

• Age and Genetics – Age and genetics can impact metabolism rates. Metabolism rates play a key role in how quickly the opioid is eliminated by the body, which can, in turn, affect the onset and severity of the opioid withdrawal.

• Overall Health – Physical and psychological health can affect the severity of opioid withdrawal. Pre-existing health conditions can exacerbate these symptoms.

Given that there are several factors that affect the severity of opioid withdrawal, understanding these factors is essential for effective opioid withdrawal management.

Managing Opioid Withdrawal Symptoms

Opioid withdrawal symptoms can range from mild and moderate to severe. Usually, these symptoms are diagnosed by performing physical examinations and asking questions regarding the symptoms. Moreover, scales to measure the severity of the opioid withdrawal is also administered. Generally, the Short Opioid Withdrawal Scale is used where the common symptoms of opioid withdrawal are rated as mild, moderate, or severe.

Mild opioid withdrawal symptoms can be managed by treating the symptoms, drinking necessary fluids, and taking vitamins B and C supplements.

Meanwhile, moderate to severe opioid withdrawal symptoms require careful medical observation and monitoring. Clients must be observed 2 – 3 times a day and at the same time, the treatment is focused on the symptoms, and medication-assisted treatment (MAT) for opioids is also provided, with methadone or buprenorphine.

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Home Care Tips for Mild Withdrawal

Mild opioid withdrawal can be managed at home. The symptoms require treatment, however, in addition to that:

• Drinking Fluids – Drinking 2 – 3 liters of water per day and consuming other fluids like sport drinks can help fight dehydration and keep the body hydrated.

• Vitamin Supplements – Taking Vitamins B and C supplements also helps in managing mild opioid withdrawal.

• Keeping Cool – As opioid withdrawal symptoms can lead to sweating and other unpleasant symptoms, keeping cool is important. Sitting under the fan or using wet cloth are some ways to keep cool.

• Distractions – Keeping the mind occupied and distracted is a good way to not let the thoughts go toward opioid withdrawal. Maybe watching a funny show or movie can help. Even having a strong support system provides the distraction one needs, as they can call a trusted loved one for a daily check-up, chat, and so on.

Why Medical Supervision is Important?

While mild opioid withdrawal symptoms can be managed at home, the moderate to severe opioid withdrawal symptoms need medical supervision. The reason being, they require MAT, which includes methadone or buprenorphine treatments generally.

Medicines generally used are:

• Methadone – Reduces opioid withdrawal symptoms and facilitates detoxification. It is long-term, and is used to treat opioid dependence as well.

• Buprenorphine – Like methadone, it reduces opioid withdrawal symptoms and helps in detoxification. It is also used to treat opioid dependence and is a safer option than methadone during pregnancy.

• Naltrexone – It is used to treat opioid withdrawal symptoms and also prevents relapse.

• Clonidine – It is used to treat opioid withdrawal symptoms like teary eyes, runny nose, sweating, aches, and cramps.

Moreover, as symptoms can also be more intense, observation and monitoring of these symptoms is important for effective opioid withdrawal management. Clients need to be observed 2-3 times in a day, which cannot be done at home.

Polydrug use, like alcohol or benzodiazepines, can further complicate the withdrawal symptoms and lead to more severe conditions. If not for medical supervision, then these can easily turn into life-threatening conditions.

Therefore, if anybody is suffering from opioid withdrawal symptoms, it is important to contact the nearby healthcare providers immediately so as to not let them deteriorate any further.

Long-Term Treatment Options After Withdrawal

Usually, long-term treatment options can be required after opioid withdrawal. This includes methadone and buprenorphine maintenance treatment.

Intensive outpatient programs, which combine psychotherapy and medication help in the more holistic treatment of opioid use disorder. They help in addressing the underlying reasons for opioid use, reshape unhealthy thinking, emotional, and behavioral patterns, and also equip with healthy coping skills. Common psychotherapeutic interventions used are motivational interviewing, cognitive behavioral therapy, contingency management, and even complementary therapies like art therapy and mindfulness therapy.

Outpatient counseling services and joining informal peer groups like Narcotics Anonymous (NA) can help in providing ongoing care and social support. These go a long way in facilitating recovery and preventing relapse.

When to Seek Help for Opioid Withdrawal?

While opioid withdrawal symptoms are not life-threatening and subside over a period of time, for effective management of opioid withdrawal, it is necessary to seek help immediately. Treatment for opioid withdrawal must be consistent, and it is also crucial that other long-term treatment options like intensive outpatient programs, outpatient counseling, and 12-step recovery programs are also considered for recovery from opioid use disorder and for lasting sobriety.

Frequently Asked Questions

How long do withdrawal symptoms last?

For short-acting opioids, like heroin, morphine, withdrawal symptoms last for 4 – 10 days. For long-acting opioids, they can last for 10 – 20 days.

Do I need medical supervision for opioid withdrawal?

Yes, for moderate to severe opioid withdrawal symptoms, medical supervision is required.

What are the most common opioid withdrawal symptoms?

Common opioid withdrawal symptoms are cravings, restlessness, anxiety, teary eyes, runny nose, sweating, aches, cramps, vomiting, and diarrhea.