Opioid Withdrawal and Detox: Symptoms & Duration of Detox

Opioid detox is the process that reduces the shock to the brain and body as they react to the sudden absence of the drug that they were accustomed to. This sudden shock of rebounding from drug use is why opioid withdrawal symptoms occur. Medical detox cleanses the body safely and makes patients as comfortable as possible.

What Are Opioids?

Opioids are often used to manage pain for patients recovering from surgery. They are also prescribed for those with severe pain due to injury, cancer or other illnesses. Although opioids can effectively manage pain, they have addictive qualities. This can be risky for patients, even when they take them as directed.

Opioids work well for relieving pain because they bind to opioid receptors in the brain and other parts of the body. Opioids then block pain signals from the body on their way to the spinal cord and brain. The reaction opioids cause in the body triggers the release of endorphins. These endorphins cause feelings of pleasure, euphoria and a heightened sense of well-being. 

The “high” opioids provide can be difficult to resist, and users can begin to crave the drug. Over time, higher doses and more powerful opioids or opiates are required to enact the same euphoric sensations. Users can then end up in a downward spiral with a desire to chase the next high.

What Causes Opioid Withdrawal?

When the brain is exposed to opioids repeatedly, it undergoes changes in its chemistry to adapt to the drug’s effects. Normally, the brain tries to maintain a constant chemical balance. These brain chemicals, or “neurotransmitters,” are responsible for how the brain functions. They control everything from how people think and feel to how they move and behave. 

Opioid withdrawal happens when opioid use is suddenly stopped. The brain reacts to the abrupt change in its chemistry by attempting to restore balance. Until this occurs, its function becomes disrupted, and symptoms result.

Opioids also cause massive releases of the brain’s feel-good chemicals, which form its reward system. The brain tries to compensate for these huge surges in the reward chemicals by down-regulating the reward system. As a result, during opiate withdrawal, the brain’s reward system is functioning at very low levels. This causes people to feel low, lethargic and listless.

List of Opioid Pain Relievers

Common opioid pain relievers include: 

• Hydrocodone (an ingredient in Vicodin)

• Oxycodone (OxyContin and an ingredient in Percocet)
• Morphine
• Codeine
• Fentanyl
• Hydromorphone (Dilaudid)
• Meperidine (Demerol)
• Tramadol (Ultram)
• Tapentadol (Nucynta)

Opioid Withdrawal Symptoms

The severity of opioid withdrawal symptoms depends on several factors. These include a person’s overall health, the strength of the opioid, how long they’ve been using it and the dosage. Opioid withdrawal symptoms may include:

• Goosebumps
• Dilated pupils
• Sweating
• Insomnia
• Yawning
• Runny nose
• Shaking 
• Hot and cold chills
• Fatigue
• Intense cravings
• Anxiety
• Depressed mood
• Agitation
• Feelings of guilt, remorse, self-loathing, low self-esteem or anger

• Muscle aches
• Loss of appetite
• Diarrhea
• Nausea or vomiting

Opioid Withdrawal Symptoms Timeline

It is difficult to predict how long opiate withdrawal symptoms last for a particular individual. However, withdrawal symptoms usually taper off and end after 4–10 days.

Acute withdrawal symptoms usually start a few hours to a few days after the last use. This depends on the half-life of the opioid that was used. For example, fentanyl has a very short half-life, so withdrawal symptoms begin within hours. Methadone, however, has a long half-life, so it may take days before withdrawal effects become apparent.

Protracted withdrawal symptoms may last weeks to months.

Factors Affecting Withdrawal Duration

Opiate withdrawal and duration of symptoms usually follow a general timeline. However, some factors affect withdrawal that are specific to individuals. These factors may include the individual’s:

• Age
• Gender
• General health
• Liver and kidney health
• Genetic and biological makeup
• Concurrent use of other drugs
• Co-occurring mental health disorder (if any)
• Use of medically assisted detox

Opioid Detox and Withdrawal Treatment Options 

Withdrawal symptoms can be uncomfortable and even dangerous. However, proper opioid detox can help patients safely transition away from substance use.

Medical Detox

Medical detox for opiates includes medical supervision with or without medication. This treatment helps people withdraw from opioids safely and comfortably. For some, inpatient medically assisted opiate detox programs are essential. This may be because they fear withdrawal and will avoid it without assistance. Even if someone tries to go through withdrawal on their own, strong cravings and discomfort can be too difficult to overcome. As a result, they end up using drugs again to end the sickness.

Medications 

There are currently three opioid withdrawal treatment medications approved by the FDA:

• Methadone: opioid replacement
• Buprenorphine: opioid replacement
• Extended-release naltrexone: blocks opioid effects

Extended-release naltrexone is a non-opioid medication. However, it reduces cravings by blocking opioid receptors in the brain. If the recipient relapses and uses opioids, the naltrexone will block the drug’s physical effects. The only downside is that the recipient must already be detoxed from opioids before starting this medication.

There are other opiate detox medications used during opioid detox to help with specific symptoms. These include sedatives, antidiarrheals and the medication clonidine. 

Methadone

Methadone is a fully synthetic opioid. It is used for both pain management and opioid replacement therapy in those who are overcoming opioid addiction. Methadone treatment can help people taper off opioids and avoid major withdrawal symptoms. It can be maintained indefinitely to help people avoid relapse. Methadone use for opiate withdrawal may be an attractive option for those who find fear of withdrawal to be a barrier to recovery.

Buprenorphine

Buprenorphine is one of two FDA-approved opioids used for opioid withdrawal treatment protocols. Of those two, buprenorphine generally has a more favorable side effect profile. Buprenorphine treatment for opioid addiction often involves using the buprenorphine product Suboxone. Besides buprenorphine, Suboxone also contains naloxone, which blocks the high from an opioid. Buprenorphine products may be continued indefinitely to help avoid relapse. 

Clonidine

Clonidine is an older type of blood pressure medication that has some efficacy in reducing withdrawal symptoms. Opioid withdrawal treatment with clonidine also comes with some unpleasant side effects. It can cause low blood pressure, rebound high blood pressure and rapid heart rate when discontinued. The drug may be taken by mouth and injection. There is also a clonidine patch for opiate withdrawal.

Opioid Rehab Treatment

Opioid dependence and addiction leave a lasting impact on the brain. The very structure and function of the brain can be altered in ways that are difficult to reverse. Opioid addiction and withdrawal can have harsh consequences on the body. Therefore, professional rehab is highly recommended for anyone struggling with opioid misuse. 

The Recovery Village Palm Beach at Baptist Health Drug and Alcohol Rehab offers a wide range of opioid addiction treatment programs to help you get your life back. Our state-of-the-art treatment options include:

• Medical Detox: This is the first step in the opioid addiction treatment process. We’ll work with you to cleanse your body of opioids and keep you as safe and comfortable as possible during the withdrawal process.
• Inpatient Treatment: We provide a safe space for you to heal from opioid addiction. We offer therapy, medical support and evidence-based care to set you up for lifelong sobriety.
• Aftercare: Before graduating from treatment, we will work with you to create an aftercare plan that will help you with long-term recovery. 

At The Recovery Village, our mission is your recovery. We believe that anyone can recover from addiction. Our evidence-based addiction treatment programs will help you take back control of your life. If you need help with opioid addiction for yourself or a loved one, our Recovery Advocates are available to connect you with support and resources today.