The United States is in the middle of an opioid epidemic. Overdoses involving opioids, such as heroin and prescription painkillers like hydrocodone and oxycodone, kill an estimated 78 people per day 1. With opioid abuse becoming more prominent than ever before, there has never been a better time to quit using these addictive drugs and begin on the road to recovery. Quitting can be difficult due to the often intensely uncomfortable withdrawal symptoms that emerge when someone cuts back or stops using altogether. A quality detox program can help to manage your withdrawal symptoms, curb cravings, and reduce the risk of relapse.
Drug addiction is a complex condition; you may find yourself desperate to stop taking drugs, but unable to quit. Learning more about opioid withdrawal and treatment programs will help you decide what to do next.
This article will cover the following topics:
- Opioid withdrawal symptoms.
- Opioid withdrawal treatment.
- Find a detox program today.
Opioid Withdrawal Symptoms
Long-term opioid abuse leads to drug tolerance due to chemical changes in the brain. The brain adapts to the presence of opioids, requiring larger amounts to produce pleasurable effects. Chronic opioid use can also lead to the development of physical dependence, meaning a person must continue taking opioids to function normally and avoid withdrawal symptoms 2. Dependence is not the same as addiction, as people who are taking therapeutic doses of a prescription opioid can become dependent, but it can be a contributing factor in the development of problematic use and subsequent addiction.
Once someone is addicted to opioids, such as Vicodin, Percocet, OxyContin, or heroin, it can be challenging for someone to quit using on their own. The length and severity of withdrawal symptoms can vary from person to person, but they have the potential be very painful and disconcerting. Detox programs can alleviate these uncomfortable withdrawal symptoms and facilitate your transition into a comprehensive, ongoing treatment program once you have been stabilized.
Opioid withdrawal symptoms may include 2,3:
Symptoms of Opioid Withdrawal
- Muscle aches.
- Agitation or irritability.
- Anxiety or nervousness.
- Depressive mood.
- Stomach pain/cramping.
- Increased sensitivity to pain.
- Nausea and vomiting.
- Excessive sweating.
- Goose bumps.
- Runny nose and watery eyes.
If you or someone you know suffers from an addiction to opioids, you might want to seek professional help. A detox program can help manage the painful symptoms of withdrawal. Call our helpline at 11111 to speak to a treatment advisor about detox options.
Opioid Withdrawal Timeline
The opioid withdrawal timeline can vary depending on the drug and its half-life, which is the amount of time it takes 50% of the drug to be eliminated from the body. Heroin and some prescription painkillers are relatively short-acting. Withdrawal symptoms for short-acting opioids may appear within a few hours of the last dose 3. Other prescription opioids come in extended-release forms with a more gradual onset of effects and lengthier durations of action. Withdrawal symptoms associated with these long-acting opioids may, in some cases, not appear for 1-2 days following the last dose 3. Many of the commonly encountered physical symptoms of opioid withdrawal last for around several days to a couple weeks; the psychological symptoms, on the other hand, have the potential to last much longer.
Post-Acute Withdrawal Syndrome
Post-Acute Withdrawal Syndrome (PAWS) refers to a set of withdrawal symptoms that can persist for several weeks, months, or even years after the body has fully cleared itself of opioids. PAWS is sometimes referred to as post-withdrawal syndrome, prolonged withdrawal syndrome, or protracted withdrawal syndrome. PAWS causes symptoms similar to those associated with mood and anxiety disorders 4.
Approximately 90% of opioid users in recovery experience withdrawal symptoms to some extent 4. Scientists do not understand the exact cause of PAWS but they believe the lasting symptoms are a result of chemical changes in the brain resulting from opioid abuse. Symptoms of PAWS vary in severity and may disappear at times, only to reappear days or weeks later 4.
The following are common symptoms of Post-Acute Withdrawal Syndrome 4:
- Cognitive impairment (decreased memory recall, learning, problem-solving).
- Anxiety or panic attacks.
- Intense cravings for opioids.
- Obsessive-compulsive behaviors.
- Sleep disturbances.
- Sensitivity to stress.
Opioid Withdrawal Treatment
Drug detox is the process by which opioids are eliminated from the body. In instances of medication-assisted opioid detox, physicians administer specific treatment medicines to help manage the unpleasant symptoms of withdrawal. Detoxification is not considered to be sufficient treatment in and of itself; its purpose is to minimize the harm associated with addiction without addressing the underlying influences of addiction.
It is an extremely important first step in the recovery process. According to research, people who don’t enroll in an additional treatment program following detoxification are more likely to relapse into drug use 5. Therefore, people who want the best chance at recovery tend to transition into an inpatient or outpatient opioid treatment program once they have completed detox.
Short-term detox programs can minimize harm caused by the opioid, treat co-occurring physical conditions, and provide medication that eases cravings and alleviates the distressing symptoms associated with opioid withdrawal. Once you complete a detox program, receiving ongoing addiction treatment can provide you with the skills you need to prevent relapse in the long run.
Many substance abuse treatment programs combine medication-assisted treatment (MAT) with behavioral therapies. There are several forms of therapy that are successful in treating opioid addiction, including cognitive behavioral therapy (CBT) and contingency management (CM) 5. The treatment program may also utilize group counseling to help you build sober social skills and provide you with support during this major life change.
After a short-term opioid detox program, there are many formal substance abuse treatment or rehabilitation programs you can enter, such as:
- Inpatient treatment: Residential programs that provide 24-hour structured treatment, ongoing detox support, individual and group counseling, and medical care.
- Outpatient treatment: Includes varying levels of care involving behavioral counseling in both an individual and group setting. Outpatient programs allow you to live at home and continue working or going to school while recovering from an opioid addiction.
- Community-based treatment: This includes peer-to-peer programs like Narcotics Anonymous (NA), Heroin Anonymous (HA), and Pills Anonymous (PA), as well as church groups, and other support programs.
- Specialized treatment: Some treatment programs specialize in treating specific populations, due to their unique needs and experiences. These populations may include LGBT people, teens, veterans, and gender-specific groups.
- Luxury treatment: Inpatient programs that provide luxury residential facilities often in vacation-like settings, such as the countryside or the beach, and added amenities, such as Olympic-sized swimming pools, gourmet meals, golf, tennis, massage therapy, and exercise facilities.
- Executive treatment: Inpatient programs that cater to high-profile business executives who can’t afford to take the time off work. Amenities include high-speed internet, phone access, and private work spaces. Many of the amenities may be similar to luxury treatment centers as well.
- Holistic treatment: Programs that combine traditional interventions, such as therapy and counseling, with alternative practices like massage, acupuncture, meditation, equine therapy, and creative arts therapy.
If you are struggling with an opioid addiction, we are here to help. Call our helpline at [phone] to speak with a treatment advisor about your detox options.
Medication for Opioid Withdrawal
Opioid treatment programs use several different medications to treat opioid withdrawal and addiction symptoms. These medications include 2,5,6:
- Methadone: This is a long-acting opioid that is taken orally once per day. It prevents withdrawal symptoms from developing. It is an opioid, but it is not associated with as pleasurable a high as many other abused opioids when taken as directed. It is only available from approved outpatient treatment clinics.
- Buprenorphine: This is an opioid medication that relieves cravings similarly to methadone, yet has an upper limit to its opioid effects, thus minimizing its abuse potential. It is FDA-approved, which means physicians can prescribe it, eliminating the need for patients to travel to special treatment clinics. A combination formula, Suboxone, includes buprenorphine and naloxone, which prevents the medication from producing a high when injected.
- Naltrexone: This is an opioid antagonist, which means it blocks the desirable effects of opioids. It isn’t used in detoxification settings, but rather for those who have completed detox and want to remain drug-free. There is no potential for abuse associated with naltrexone. The FDA recently approved an injectable long-acting form of naltrexone called Vivitrol that only needs to be taken once per month, which may increase compliance.
Opioid Detox Aftercare
Drug detox programs are only the first step toward recovery from opioid addiction. Treatment programs allow you to acquire coping skills and relapse prevention strategies necessary to maintain sobriety post-treatment. Once you complete a recovery program, aftercare can help you to maintain sobriety and build upon the skills you learned in rehab. Aftercare consists of any form of ongoing treatment once initial treatment has been completed. Many recovery centers create an aftercare plan for you to follow once you leave rehab.
Aftercare treatment is available in many forms, such as:
- Sober living homes: Sober living homes provide an individual with a structured, substance-free environment, in which they can come and go as they please, but are subjected to regular drug tests. Oftentimes, there are house rules that they must follow, such as being home by curfew and completing chores.
- 12-step programs: 12-step meetings are free to attend. Many people attend them for life due to the support and encouragement they receive from recovering peers.
- Non-12-step programs: Some people prefer evidence-based programs, such as SMART Recovery or Secular Organizations for Sobriety (SOS), that utilize scientific and addiction research while recovering. Much like 12-step meetings, people may attend these alternative meetings for life.
- Outpatient treatment: Many people who complete an inpatient program find that transitioning into an outpatient program is a quality step-down treatment option.
Find a Treatment Program Today
It is never too late to get help for your opioid addiction and make a positive change in your life. No matter what your situation is, we can help. Call our helpline at [phone] to speak with a treatment advisor today about detox and recovery options.
- Centers for Disease Control. (2016). Injury Prevention & Control: Opioid Overdose.
- U.S. National Library of Medicine. (2016). Opiate and opioid withdrawal.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Semel Institute. (2016). Post-Acute Withdrawal Syndrome.
- National Institute on Drug Abuse. (2016). Treatment Approaches for Drug Addiction.
- National Institute on Drug Abuse. (2014). What are the treatments for heroin addiction?