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Opioid Withdrawal and its Treatment

Opioid Withdrawal Symptoms:

There are two phases to opioid withdrawal. The first phase includes several symptoms such as:

  • Low energy
  • Excessive yawning
  • Sleeplessness
  • Excessive sweating
  • Runny nose
  • Tearing eyes
  • Agitation
  • Anxiety
  • Restlessness
  • Muscle aches
  • The second phase is characterized by:
  • Goose bumps
  • Rapid heartbeat
  • Dilated pupils
  • Vomiting and nausea
  • Abdominal cramps
  • Diarrhoea

These initial phases can last between one week to one month. They are often followed by long-term withdrawal symptoms, which involve behavioral and emotional issues.

Opioid Withdrawal and its Treatment
The majority of addicts are unable to walk away from their addiction after detox. Doctors will often prescribe a substitute medication that has a similar effect as an addictive drug. These medications are responsible for addressing relapses and cravings. Doctors will gradually reduce your dosage over time, and take you off it completely when you feel you are ready. These medications are typically prescribed for treatment periods of longer than 6 months.  Here are some medications that your doctor is likely to prescribe to assist in the withdrawal process-

  • Buprenorphine: Buprenorphine is responsible for occupying the opiate nerve receptors that opioids attach themselves to. It deceives the brain into believing that it is getting the dose of opioid that it is used to. You will neither feel any different when you are on buprenorphine nor will you experience any withdrawal symptoms.
  • Methadone: Methadone reduces the desire for stronger opioids. It has a similar effect to buprenorphine and attaches itself to the opiate nerve receptors, which prevent stronger opioids from having an effect on the body. Methadone suppresses the symptoms of withdrawal for approximately 24 hours.
  • LAAM: LAAM is the acronym for a chemical referred to as Levo-alpha-acetyl-methadol. It is responsible for hindering the euphoric effects of the stronger opioids; while simultaneously regulating opiate cravings and suppressing withdrawal symptoms for longer than 72 hours.
  • Naltrexone: This drug is administered after the withdrawal process to help prevent relapse. Naltrexone halts the effect of opioids so that you are unable to feel anything when you take the drug again.
  • Trazodone: Anxiety and depression are symptoms associated with withdrawal. Trazodone is prescribed to treat them.
  • Buprenorphine Subutex: This is the most effective drug for treating withdrawal symptoms. It shortens the length of the detox and is also used in a similar way as methadone for long term maintenance.
  • Methocarbamol: Methocarbamol is used for the treatment of joint pain and muscle cramps.
  • Dicyclomine hydrochloride: For treating cramping and abdominal cramps experienced during withdrawal.
  • Clonidine: Clonidine is the most commonly prescribed medication to treat opioid withdrawal. It helps to control symptoms such as watery eyes, runny nose, sweating and restlessness. Clonidine also shortens withdrawal duration and treats anxiety.
  • Antiemetic: These drugs assist in preventing and reducing the vomiting and nausea that comes with withdrawal. The main drugs prescribed are Promethazine and Hydroxyzine.
  • Anti-diarrheal : As the name suggests, these are drugs that are used to treat diarrhoea. The main drugs prescribed are Loperamide and Diphenoxylate.
  • Rapid Detox Therapy: Rapid detox is a drug and alcohol detoxification system that accelerates the process of withdrawal. The process is achieved by administering drugs like narcotic antagonists; they restrict the receptors in the brain to induce withdrawal quicker than cold turkey. In the majority of cases, a combination of medications is administered to treat the symptoms of withdrawal. On occasion, a patient is rendered unconscious with anaesthetics, so that they can sleep through the withdrawal. Withdrawal is completed within five days with rapid detox.
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