What Are Opioid Withdrawal Symptoms, And What’s the Best Way to Manage Them?
According to the National Institutes of Health (NIH), more than 2 million Americans misuse opioids every year. Even more alarming, that number has been increasing over the past several years.
The abuse of opioids and heroin arguably represent a crisis in American health and American life. For example, opioids were directly responsible for more than 20,000 fatalities in 2016. Drug overdoses in fact are currentlyt the number one cause of death for adults less than 50 years of age in the United States.
WHAT IS OPIOID ADDICTION?
Although the causes of opioid addiction are not completely understood (most researchers believe addiction results from a complex set of factors, including genetic, environmental and behavioral), the results of addiction are clear: addiction to opioids and heroin are a dangerous chronic condition, one that impacts an individual’s physical, psychological and financial health and can in the most severe cases take one’s life.
The specific biological and behavioral mechanisms which contribute to addiction are grounded in the body’s natural pain and reward system (the so-called “endogenous opioid system“). That natural system can effectively go off the rails when external opioids are introduced. Said differently, the more someone ingests opioids, the more the body becomes “drug tolerant,” and the less able it is to regulate its natural opioid system. This leads inevitably to the need for increasingly larger amounts of external opioids to alleviate pain and produce pleasure—a vicious cycle which, once started, can be extremely difficult to stop.
As NIH explains, legal (prescription) and illegal opioids (principally heroin) can be equally destructive:
“Opioid addiction is a long-lasting (chronic) disease that can cause major health, social, and economic problems. Opioids are a class of drugs that act in the nervous system to produce feelings of pleasure and pain relief. Some opioids are legally prescribed by healthcare providers to manage severe and chronic pain. Commonly prescribed opioids include oxycodone, fentanyl, buprenorphine, methadone, oxymorphone, hydrocodone, codeine, and morphine. Some other opioids, such as heroin, are illegal drugs of abuse.”
WHAT ARE THE SYMPTOMS OF OPIOD WITHDRAWAL?
Opioids can be useful in easing pain after an injury on invasive surgery. But taken for more than a few weeks, opioids alter the body’s chemistry to such an extent that individuals taking these drugs become dependent. In other words, they will continue to need opioids even after the pain subsides.
When someone using opioids for an extended period of time suddenly stops, they experience opioid withdrawal. It’s important to recognize in the first place that withdrawal from opioids can be extremely dangerous. In fact, especially when attempted without medical intervention, withdrawal from opioids can be fatal. Therefore, it’s critically important for anyone stopping opioids to seek competent medical help.
That said, the severity of withdrawal symptoms varies from one individual to another (based for example on how long someone has been taking drugs and how much they’ve ingested) but generally follow a somewhat predictable pattern, one which changes over time, as follows:
THE FIRST SYMPTOMS
Within the first 24 hours after stopping the use of opioids, symptoms are unpleasant but typically not as severe as later symptoms. People usually experience everything from body aches to increased anxiety, sweating, insomnia and a general restlessness. Some individuals also experience flu-like symptoms, things like a runny nose, tearing eyes and body aches.
The relative lack of severity of early withdrawal symptoms can ironically be their biggest danger. The fact that people don’t experience severe symptoms during the first day or so can make them believe they’re “out of the woods” and don’t need help. That false belief can prevent them from getting the medical help they need, and lead to dangerous consequences.
AFTER THE FIRST DAY
Again, the symptoms of withdrawal vary depending on the amount and type of opioid someone has used, and on how long they’ve been using it. In general, however, withdrawal symptoms become more severe after the first 24 hours.
These later symptoms often include nausea, diarrhea, fever and vomiting. Some people also experience symptoms such as rapid heartbeat and breathing, blurry vision and an increase in their blood pressure. It’s also not uncommon for individuals going through withdrawal to have both hallucinations and seizures.
The duration of withdrawal symptoms also varies from one individual to another. Generally, the worst symptoms subside after 3 days or so, but it’s not uncommon for withdrawal symptoms to persist for as much as a month—in some cases even longer than that. If someone has overdosed on opioids and been prescribed another drug to counteract the overdose, symptoms can come on more quickly and be more severe.
ARE WITHDRAWAL AND RECOVERY THE SAME THING?
Opioid withdrawal and opioid recovery are not the same. Withdrawal from opioids is unpleasant and potentially life-threatening, but it usually lasts no more than a couple weeks. Recovery is a different matter, usually requiring a minimum of 6 months of abstinence.
In some ways, recovery from opioids is more difficult than withdrawal, this because it requires not only a change in behavior, but also a sound recovery plan that includes rehabilitation, personal insight and a strong support system. Some people, for example, benefit from participation in organizations like Narcotics Anonymous (NA) and so-called 12-step programs. It’s also important for people to be honest with themselves and acknowledge the pain they’ve caused friends and family.
The bottom line is that both withdrawal and recovery are difficult (if not impossible) without medical help. That includes both the intervention of experienced health care providers and a holistic approach to recovery—one that reduces drug cravings and symptoms in the fight to beat addiction.
Opioid addiction is more common and more challenging than most Americans are aware. Its causes are many—everything from increased societal pressures to a popular culture which glamorizes drug and alcohol use and a medical community some members of which prescribe opioids too frequently or without proper medical supervision. But the healthcare providers who are most successful in managing withdrawal and advancing recovery are the ones who focus less on blame and more on insight, understanding and compassionate care.
If you or someone you love is struggling with opioid addiction or withdrawal, or if you’re seeking a sound approach to recovery—one which emphasizes compassionate care, repairs brain damage and reduces withdrawal symptoms without the use of addictive medications (our NAD IV therapy), contact us today.