Opiate Withdrawal and Detox
Opiate addiction is a worldwide disease of epidemic proportion. It affects people of every nation, ethnicity, culture, and socioeconomic status. Recently, the American Society of Addiction Medicine released its annual report that listed some staggering statistics, illustrating the pervasiveness of opiate addiction:
- 9 million* Americans abuse or are addicted to prescription opiates
- 75% of those addicted to prescription opiates will make the switch to heroin during the course of their addiction.
- 517,000 Americans are addicted to heroin
- 17,000* Americans die annually from prescription opiate overdose
- 46 deaths each day
- 2 deaths every hour
- At the height of the opiate addiction epidemic, in 2013, over 100 Americans died of opiate overdose every day.
Most addiction specialists define opiate addiction as a chronic, relapsing, progressive brain disease, characterized by compulsive drug seeking and drug use, despite negative and harmful consequences. As users develop tolerance to the drug, the physical condition of the user deteriorates. Over time, the user’s body and brain adapt to the presence of the drug; abstaining from using leads to uncomfortable physical and psychological withdrawal symptoms. There are two phases of withdrawal: acute and post-acute. Acute withdrawal symptoms typically begin 24-36 hours; symptoms last approximately 1-2 weeks
Symptoms of Acute Opiate Withdrawal:
- Extreme anxiety, agitation
- Tremors, muscle spasms, cramps, aches
- Hot-and-cold flashes
- Profuse sweating
- Nausea, Vomiting, Diarrhea
- Flu-like symptoms, including running nose, watery eyes
- Abdominal cramping
- Low energy, lethargy, loss of motivation
It is important to remember that acute-withdrawal symptoms, although non-fatal, can lead to life-threatening complications, especially if the user is in a compromised state of health. A frequent complication encountered by individuals attempting to detox by themselves is dehydration; in severe cases of dehydration, electrolyte imbalances can cause delirium, hallucinations, and if left untreated, possible death. For this reason, detoxification should be done in an addiction treatment center when possible. There are many methods of detoxification available in modern treatment facilities; some offer radical, accelerated detox and many offer gradual detox with opiate replacement therapy as an adjunct treatment. The goal of detox is to remove all traces of the opiate and residual toxins from the body, thereby returning the body to its natural, balanced state.
- Accelerated Medical Detoxification
- Stepped Rapid Detoxification
- Medical Detoxification
- Outpatient Detoxification
Opiate addiction is very resistant to treatment because continued use of opiates changes the brain’s neural pathways and cognitive function. Opiates effect on the brain’s limbic system, the area commonly referred to as the “reward center” is long lasting. When opiates are present in the body, the brain’s limbic system is flooded with dopamine, the neurotransmitter responsible for pleasure and the sense of well-being. Without opiates, an opiate-dependent user experiences dysphoria, a profound state of dissatisfaction and unease, users in this state often describe it as feeling “uncomfortable within one’s skin”. In extreme cases, dysphoria is accompanied by apathy, a lack of emotional response to otherwise pleasurable events. Together, dysphoria and apathy can lead to depression and suicidal thoughts. These psychological symptoms are post-acute withdrawal symptoms of opiate addiction; symptoms can last up from six to twenty-four months after last use.
Symptoms of Post-Acute Opiate Withdrawal:
- Loss of self-esteem and confidence
- Racing thoughts
- Personality changes, frequent mood swings
- Memory loss
- Decreased ability to concentrate
- Decreased ability to manage or cope with stress
For those recovering from opiate addiction, the long-term withdrawal symptoms make relapse a very dangerous possibility. Relapsing after a period of abstinence can be fatal because drug tolerance is significantly reduced by abstinence. Individuals accidentally overdose when they relapse because they often return to using a high dose or amount of drug.
Outpatient treatment and opioid replacement therapies have proven to significantly reduce the rate of relapse and effectively treat the psychosocial factors that play a significant role in chronic opiate addiction. Opiate addiction is a treatable disease and long-term sobriety is a possibility for all people struggling with opiate addiction. The most important step is finding the right treatment and treatment facility for your addiction needs.