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Opiate Withdrawal

What is Opiate Withdrawal?

Opiate withdrawal is an acute sickness caused by the abrupt cessation of opiates after an extended period of use or abuse. The opiate withdrawal process is a physical and psychological response to the opiate detox process that starts roughly 12-24 hours after a person discontinues taking opiates. The acute withdrawal phase can last from 3-7 days and can be profoundly uncomfortable both physically and psychologically. Although not considered “life threatening,” acute opiate withdrawal symptoms can seem unbearable.

There Are Two “Phases” Of Opiate Withdrawal:

The “Acute Phase” of opiate withdrawal begins roughly 12-24 hours after a person has stopped taking opiates. This is the period when withdrawal symptoms are the most intense and typically last from 3-7 days. For most, symptoms will gradually reduce in intensity and dissipate completely after the acute phase of withdrawal.

The “Post Acute Phase” of opiate withdrawal is sometimes referred to as P.A.W.S. (Post Acute Withdrawal Syndrome). It can include ongoing, less severe withdrawal symptoms. Post acute withdrawal can last for weeks or even months. However, it should be recognized that most people do not experience these prolonged symptoms. Most people with P.A.W.S. have been on opiates for many years before they detox. For these folks, it takes the body and brain a bit longer to “re-boot”

Common Physical and Psychological Symptoms

Physical Symptoms of Opiate Withdrawal Can Include:

  • Flu-like symptoms
  • Lethargy
  • Shakiness and muscle jerks
  • Excessive sweating
  • Repetitive yawning
  • Diarrhea
  • Chills
  • Watery eyes
  • Pain (typically in the back and legs)
  • Restless leg syndrome (RLS)

Psychological Symptoms of Opiate Withdrawal Can Include:

  • Depression
  • Anxiety
  • Extreme cravings for more opiates
  • Insomnia
  • Night Tremors and Night Terrors (aka Hypnagogic Jerks)
  • Irritability or rage
  • Guilt

What Is The Specific Cause For Opiate Withdrawal Symptoms?

As I mentioned in our introduction, opiate withdrawal symptoms are the manifestations of the opiate detox process. The physiological explanation for this process is obviously more nuanced and I’ll do my best to explain. Please bear in mind that I’m not a neurologist but I will do my best to describe the more “technical” causes for opiate withdrawal symptoms.

First and foremost let me explain the difference between “detox” and “withdrawal”…as I see it. “Opiate Detox” is the body’s process for eliminating opiates from our bloodstream and nervous system. “Opiate Withdrawal” is a pathological response to the detox process.

Opiates stimulate the production of neurotransmitters called Dopamine and Serotonin by occupying receptors in the reward centers of our brains (nucleus accumbens) and other organs. Dopamine and Serotonin are produced naturally by the brain and are partly responsible for helping us feel happy or emotionally rewarded. However, when opiates are introduced into our systems the production of serotonin and dopamine increases exponentially. As a result of this flood of neurotransmitters, people often feel euphoria and a heightened sense of well-being when they take opiates. This “shimmery feeling” is one of the main reasons why opiates can become so addictive; especially people prone to depression.

However, when you stop taking opiates, those receptors begin to shed and the dopamine and serotonin production that your brain previously enjoyed shudders to a halt. This is the start of opiate detox. As a result, your brain begins to “rebel”, and that rebellion is the beginning of the opiate withdrawal process. As the hours pass and more opiate receptors are emptied, your brain and body become extremely “agitated.” It’s a cascade effect. The result is torment in the form of opiate withdrawals and it will not stop unless opiates are delivered once again. 

FACTOID: Did you know that your gut has opiate receptors? That is why taking prescription painkillers can cause constipation and why opiate withdrawal can cause diarrhea.

 

Morphine

In the graphic above you can see a representation of an opiate stimulating receptors in the brain. Once those opiate receptors are no longer “occupied” they stop making dopamine and serotonin; you don’t want that to happen.

 

Isn’t There A Medicine That I Can Take If I’m In Opiate Withdrawal?

Unfortunately, there is no medicine or cure for opiate withdrawal (other than taking more opiates). However, some medications and remedies can help reduce the severity of the withdrawal symptoms. Ultimately, if a person wants to discontinue their use of opiates after taking them for an extended period of time, they will have to endure some form of opiate detox and withdrawal.

Prescription Medications Commonly Prescribed For Opiate Withdrawal Include:

  • Clonodine: A medication primarily indicated for hypertension that can reduce the overall intensity of opiate withdrawal symptoms.
  • Seroquel: A powerful tranquilizer and sleep aid for opiate withdrawal induced insomnia and restless leg syndrome. Can cause dependency.
  • Benzodiazepines: If prescribed over a short period of time (and taken as directed) Benzodiazepines such as Xanax can help with anxiety and insomnia. Can also cause dependency.
  • Gabapentin: I like Gabapentin because it is non-narcotic and can help with sleep as well as depression and restless leg syndrome.
  • Ultram/Tramadol: I don’t like this but I have to mention it. Sometimes Ultram/Tramadol is prescribed for opiate withdrawal. Somehow, we all believed it was non-narcotic and would not cause dependency or withdrawal symptoms. Gulp.

Over The Counter Remedies for Opiate Withdrawal Include

  • Withdrawal Ease: Hey, if I took the time to write all of this, of course I’m going to list Withdrawal Ease first.
  • Immodium AD: It has an ingredient that is a not-too-distant cousin of opiates called Loperamide that likes to attach to certain opiate receptors in the gut. That is why it is great for diarrhea and also for reducing the severity of withdrawal symptoms.
  • Ben Gay: Restless Legs
  • Tylenol or Advil: I know it seems like a joke when you’re used to taking 20 Vicodin a day but these drugs work well for back pain and other aches.
  • Gatorade: Hydrate!
  • Chocolate: Also stimulates dopamine and serotonin production. Tastes good too!

What Else Can I Do To Reduce The Symptoms?

There are a number of strategies that can help you prepare for and lessen the effects of opiate withdrawal. To that end, Withdrawal Ease has created The Opiate Withdrawal Survival Guide – A Comprehensive Resource for Opiate Addiction and Withdrawal. This informative and helpful guide is included with your purchase of the Withdrawal Ease Opiate Withdrawal Natural Supplement System. Click here for more information on the Withdrawal Ease Opiate Withdrawal Natural Supplement System.

The information above is an excerpt from
The Withdrawal Ease Opiate Withdrawal Survival Guide

Our new, online Withdrawal Survival Guide now has 60-pages of essential information including tips and techniques, “The Art of Opiate Tapering”, and a new section on Suboxone.

Attention Parents and Adults: Opiate abuse among minors often starts at home.
Please keep prescription medications safe and secure.

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