Opiates are one of the most addictive substances that are being abused today. They’re also one of the deadliest. In fact, opioid overdose is responsible for more than 91 deaths in the United States every single day. That’s more than the number of deaths caused by guns or cars. It’s no wonder, then, that improving our methods for treating and understanding opioid drug withdrawal timelines and symptoms has never been more important than today. We are undeniably in the middle of one of the biggest health crises in history. That’s why its crucial to understand the specifics of this dangerous and deadly drug – doing so may give you the knowledge and strength you need to overcome your opioid addiction for good.
Withdrawals from Opiates: Physical & Psychological Symptoms
Dropping your opioid habit can be incredibly difficult. In fact, opiates like heroin and Oxycodone are easily one of the hardest addictions to kick just because of the process of detoxing alone. Withdrawal symptoms are painful, long-lasting, and can be debilitating at times. If you’ve built up even a mild addiction to any of these powerful substances, it can be tough for you to focus on nearly anything else when going through withdrawals. According to MedlinePlus, here’s what to expect during the early stages of the process:
- Runny Nose
- Muscle Aches
- Increased Tearing
Later stage symptoms include:
- Abdominal Cramping
- Goose Bumps
The intensity of these symptoms, of course, depends entirely on your specific body, the length and severity of your addiction, and which methods you choose for detoxification. As you can probably guess, the combination of the symptoms during opiate withdrawals can make it especially problematic if you plan on carrying on with your normal daily routine. As such, the best way to get through your opioid detoxification is by consulting a qualified physician or seeking treatment at a professional addiction center.
Detox Timelines & Stages of Opiate Withdrawal
As with many different types of drugs, how your body reacts during the detoxification process can be entirely different from how someone else experiences it. Even if you take the same number of opioids for the same length of time, it’s still likely that your own experience is going to differ from another’s. As such, the opiate withdrawal timelines below are more of a generalization and are in no way set in stone. Having said that, however, there are a number of reputable sources that have compiled some numbers to give you a better idea of what to expect. Healthline, for example, an online publisher of articles that are regularly reviewed by reputable names in the medical field, notes that some of the early stage symptoms will begin within the first 24 hours after your last use. Later stage symptoms are likely to develop after the first day or so. Mental Health Daily, a similar source, gives a better idea of how long users can expect to experience these symptoms. They report that the most intense opiate withdrawals will typically subside in about 10 days for longer-acting opioids like prescription painkillers and around a week for shorter-acting ones like heroin.
The Clinical Opiate Withdrawal Scale Protocol
In order to best treat and manage the symptoms of opioid withdrawals as well as get a better handle on the detox timeline, clinicians have developed a standardized scale of opiate withdrawal symptoms called the Clinical Opiate Withdrawal Scale or COWS for short. This scale has become instrumental in treating opioid detox because, as with many other drugs, opiate withdrawal is a highly relative experience. One person’s “uncomfortable” may be another’s “unbearable.” Having a standard scale can make this subjective experience more quantifiable and, as such, give doctors the numbers they need to make the decision of when to move on to a different treatment. The COWS assessment looks at eleven different symptoms:
- Resting Pulse Rate
- Gastrointestinal Upset
- Pupil Size
- Anxiety or Irritability
- Bone or Joint Aches
- Gooseflesh Skin
- Runny Nose or Tearing
These eleven symptoms are further broken down, usually into four distinct severity rankings, each with a different point value. After the assessment, the points are added up and the total indicates either mild, moderate, moderately severe, or severe withdrawal. These rankings can also help physicians determine when it is safe to administer various medications as some can only be given in moderate to severe stages. The COWS score to start two of the most common Opioid Replacement Therapies Suboxone and Subutex, for example, must be greater than 5-6 points or else it could bring on precipitated withdrawal symptoms which can be unnecessarily uncomfortable.
Post-Acute Withdrawal Syndrome
In addition to the more acute phase which consists of its own earlier and later symptoms, opioid detoxification (as well as detox from many other drugs) may carry with it the risk of developing what’s known as Post-Acute Withdrawal Syndrome. This stage of detoxification is a bit controversial among addiction scientists since there are not a lot of reputable scientific studies that even verify its existence. As such, some don’t believe it is an actual condition at all. The Diagnostic and Statistical Manual of Mental Disorders, used by physicians and psychiatrists around the world, has in fact yet to list it as an actual condition. However, in the addiction community itself an enormous number of recovering addicts have reported experiencing many debilitating symptoms long after the stages of acute withdrawal have passed, sometimes for months or even years. What’s more, these symptoms are incredibly extensive as well and, according to the online addiction community Bluelight, include:
- Pessimistic Thoughts
- Psychosocial Dysfunction
- Obsessive- Compulsive behavior
- Impaired Interpersonal Skills
- Feelings of Guilt
- Autonomic Disturbances
- Impaired Concentration
- Lack of Initiative
- Inability to Think Clearly
- Emotional Overreactions or Numbness
- Memory Problems
- Sleep Disturbances
- Stress Sensitivity
- Physical Coordination Problems
- Increased Sensitivity to Pain
- Panic Disorder
- Sleep Disorder
- Generalized Anxiety Disorder
One of the best ways to combat this syndrome is by including a variety of counseling options with your treatment as well as ensuring you follow up detoxification with extensive aftercare programs like group meetings and continued therapy. These are all part of a comprehensive recovery program and will help reduce your risk of relapsing in the long-term.
A Quick Warning
Before launching into the different methods used when detoxing from opiates, it’s important to give a brief disclaimer first. The methods below can be grouped into two categories: those that are performed at a professional clinic under the guidance of qualified physicians and those that can be done at home. While it is possible to detox from opioids on your own, it is highly inadvisable for a number of reasons. In the first place, doing so increases the likelihood that you will relapse, either during the detox itself or afterwards. Secondly, there are a number of complications that can arise from opioid withdrawal including dehydration and complications from vomiting. A knowledgeable medical staff can prevent these from becoming a problem. Ultimately, anyone looking to detox from opioids should seek medical help. It’s the safest, most effective way of getting clean.
Tapering: A Proven Method of Minimizing Opiate Withdrawals
In addition to a treatment program that encompasses a variety of supplementary treatment options, the best recovery programs will also feature the use of an individually tailored tapering program as well. Rather than abruptly ceasing opiate use all at once (cold turkey), many programs will help you come up with a program to use less and less opioids over long periods of time. This can help cut down on the severity of the symptoms of withdrawal and make it more comfortable, manageable, and more likely to abstain from using again. And while it may be tempting to create your own tapering program, the hands-down best way to ensure you do it correctly is by seeking out the help of an addiction specialist. Otherwise, you’re risking a host of excruciating physical effects along with a higher likelihood of turning back to opiates. What’s more, many addiction professionals also have access to certain prescription medicines that were created and used specifically to treat the symptoms of opioid withdrawals.
Opioid Withdrawal Medications Currently Available
A large number of addiction facilities have begun supporting opiate withdrawals with specialized medications. This type of treatment, known as medication-assisted treatment or MAT, can help reduce symptom severity, eliminate cravings, and decrease the incentives of relapsing. The use of MATs, however, is problematic for some. The idea of treating an addiction with another potentially addictive drug can be tough to wrap your head around. As such, some people think these types of treatments should be outlawed entirely. There are a number of points worth looking at with this issue though. First, the dosages of these drugs are highly controlled and when used properly, do not create a high. Second, MATs like those used for opioid dependency have been shown to decrease opioid use, reduce opioid-related overdose deaths, diminish criminal activity, and lessen the transmission of infectious diseases according to the National Institute on Drug Abuse. Popular MATs for opiate addiction include:
- Buprenorphine – a light opioid, buprenorphine staves off withdrawal symptoms and helps keep down cravings.
- Naltrexone – an opioid antagonist, naltrexone blocks the pleasurable effects of opioids and also helps to reduce cravings.
- Naloxone – another drug that helps keep recovering addicts from feeling euphoria from opioid abuse, reducing the likelihood of relapse.
- Methadone – one of the most common opioids for opiate maintenance therapy, this drug is often taken long-term to hold back withdrawals and cravings, similar to buprenorphine.
Opiate Withdrawal Supplements & Remedies
As mentioned before, detoxing from prescription painkillers or other opioids can in fact be done at home, but should be avoided at all costs. Not only can it help increase the likelihood of a full recovery, it can also make the withdrawal symptoms much more bearable and manageable. Having said that, the key to opiate detoxification is enduring the symptoms. Countless addicts end up abandoning their efforts before the process is fully complete because these symptoms are so excruciating. There are a number of herbs and supplements that the addiction community holds in high regard when it comes to dealing with the various symptoms of withdrawal:
- Kava Kava for anxiety
- Melatonin, valerian root, skullcap, and hops for sleep
- Whey protein shakes for amino acids
- Multi-vitamins and minerals to combat poor diet and symptoms like diarrhea and vomiting
- Fish oil for omega fatty acids
- Vitamin C
The Thomas Recipe – For Opiate Withdrawal
One of the most widely used opiate withdrawal home remedies is the Thomas Recipe. It doesn’t have much of a presence in the medical community and it’s worth noting that it comes not from a doctor, but from a former opioid addict. As such, this method is not necessarily condoned by any medical professionals and should be used at your own risk.
- Begin by taking wide-spectrum mineral supplements with at least 100% of your daily recommended value of zinc, copper, magnesium, phosphorus, and potassium.
- Use sleep aids like melatonin or other natural substances. You can also use prescription drugs to help bring on sleep, as long as they were obtained legally of course.
- Take hot baths or Jacuzzis as often as needed to help with muscle aches.
- Use Imodium frequently to combat the diarrhea.
- Begin taking L-Tyrosine around the end of the fourth day at around 2000 mgs along with B6 to help with absorption.
- Try to get some mild exercise as soon as you can.
Opiate Withdrawals: A Difficult & Necessary Part of Your Path to Sobriety
Having the courage to admit that you have an opioid use disorder can be incredibly difficult. What’s more, maintaining the willpower necessary to endure the sometimes-unbearable symptoms of opiate withdrawals can be even worse. That’s why it’s absolutely crucial that you enlist the help of a qualified physician or addiction specialist during your detoxification. Not doing so can make the experience much more painful, protracted, and fruitless than it needs to be.
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