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Opiate (Opioid) Withdrawal Cycle

Table of Contents

Opiate Withdrawal Cycle

Opiates including highly addictive prescription drugs are abused by over 15.1 million Americans. This data from the National Center on Addiction and Substance Abuse at Columbia University is a conservative number – the horror is multiplied when you include the family members and concerned friends who suffer with the addict as he or she goes through abuse and withdrawal.

Prevalence of Opiate Addiction

Opiates are so easily habit-forming that 9% of the population becomes addicted in their lifetime. When an individual takes opioid painkillers consistently for an extended period of time, tolerance can develop. This means their body has become used to the drug and the same dose no longer has the same effect. Therefore, the dose must be increased to experience the same level of pain relief. Once tolerance develops, this is usually a sign that the individual is physically, and possibly psychologically, dependent on the drug.
Opioid painkillers are prescribed for pain because they are effective but the benefits are often outweighed by the potential for addiction. Opioid addiction rates have increased exponentially since 1999. In 2012, healthcare providers wrote enough opioid prescriptions that every American could have a bottle of pills. Opioids became more easily accessible than ever before and drug abuse skyrocketed.
There are a number of drugs that are considered to be opiates. These include morphine, OxyContin, Dilaudid and illicit drugs like heroin and fentanyl. Replacement drugs, like methadone and buprenorphine which are used in treatment programs, are also opiates.

Symptoms of Withdrawal

Users considering opiate withdrawal should thoroughly understand the risks and benefits associated with ordinary methods of detoxification. The withdrawal syndrome can last days or weeks without medical intervention, depending on a number of factors. These factors include length of use, type of opioid, health history, mental health history, and other drugs of abuse. Unfortunately, some patients taking prescription painkillers undergo involuntary withdrawal. The addictive potential is so high that neither the patient nor doctor is aware of the dependence until flu-like symptoms develop after the drug intake decreases or stops.
Certain withdrawal symptoms last longer than others depending on the drug. Those using short-acting opiates like heroin may begin experiencing symptoms after just a few hours. Meanwhile, those taking long-acting opioid drugs, like methadone, may not experience symptoms until 30 hours after their last dose.
These withdrawal symptoms can include:

  • Muscle aches
  • Stomach pain
  • Anxiety or agitation
  • Nausea and vomiting
  • Diarrhea
  • A runny nose
  • Sweating and/or chills
  • Excessive yawning
  • Insomnia
  • Fatigue

These are just some of the common symptoms during the withdrawal cycle, but there is a great deal of variation, especially when using illicit drugs with unknown additives. Additionally, underlying emotional issues can cause more intense psychological withdrawal symptoms. These can include strong drug cravings and depression.
Although opiate withdrawal syndrome is rarely fatal, those with underlying medical conditions, such as hypertension or diabetes, are at risk of death. Additionally, a person’s health can be severely compromised by complications from withdrawal syndrome. For example, vomiting and diarrhea can cause dehydration.

Diagnosis

Doctors and addiction specialists easily diagnose opioid use disorder and withdrawal through detailed history and observation of signs and symptoms. Urine or blood tests for drug screening are confirmatory.

Withdrawal Treatment

Traditional treatment programs primarily provide supportive care. In many cases, the patient is given fluids to prevent dehydration and supportive medication may be given to ease the severity of symptoms. There is often no medical support so if complications arise, the patient has to be transported to a hospital.

Complications

The number one complication is the return to drug use after rehabilitation. Most accidental overdose deaths paradoxically occur after some sort of withdrawal and rehabilitation. Drug cravings can last for months after treatment without continued care. When a patient relapses the risk of a fatal overdose is greater because their tolerance has likely decreased. Once the patient leaves the rehab center and returns to normal life and stress, they are at risk of relapse unless they have the continued support they need. Most of those suffering from drug addiction also have underlying emotional issues. That is why ongoing professional support is often required while the patient is transitioning to their daily life without drugs.
Medical programs such as the Waismann Treatment reduces this risk by providing a smooth transition including follow-up counseling and non-narcotic medications to reduce opioid cravings. Patients can begin taking Naltrexone orally or receive the Vivitrol shot post-detox. This allows a safety net both by limiting drug cravings and by blocking the body’s opiate receptors. Therefore, in the event of a brief relapse, the patient cannot obtain the euphoric effects they desire. Additionally, there are a number of medical complications which can occur during opiate withdrawal. For example, vomit can accidentally enter the lungs and cause aspiration pneumonia. Vomiting and diarrhea cause dehydration and electrolyte imbalance that can mimic a heart attack if potassium levels decrease.

Prognosis

Cold turkey withdrawal is not only dangerous but has an extremely low success rate because most people are unable to tolerate the withdrawal syndrome. Drug treatment centers also have extremely low success, but return rates are very high. On average a patient will attend rehab at least seven times. One major problem is that traditional rehab centers don’t address the individual emotional needs of the patient which leads to drug abuse.
Although substance abuse has a history of lower success in comparison to other conditions, that does not have to be the case. Opioid addiction is a curable disease with the right drug treatment. Medical detox is the first step and then the patient can receive accurate therapeutic intervention for any co-occurring mental health conditions.
Waismann Method® has been providing the highest level of medical detox for over 21 years. Patients can admit to a full-service hospital and receive complete medical care in order to detox safely and more comfortably. All treatment plans are tailored to the specific needs of the patient based on a detailed medical history and comprehensive pre-screening. With nearly 100% opiate detox success, the patient can begin their journey with the best foot forward.

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