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Opioids are prescription painkillers, meaning they are only dispensed under a signed and authorized prescription from a registered medical practitioner.
Opioids are substances that can cause euphoria and, when taken in high amounts, can result in sedation and respiratory depression. These substances encompass a group of natural compounds (initially extracted from the opium poppy), along with their partially synthetic and completely synthetic counterparts that attach to particular opioid receptors.
While opioids can be powerful pain relievers and are sometimes used to treat cough and diarrhea, they are also frequently abused due to their widespread accessibility and tendency to produce feelings of euphoria, share experts. (1)
Millions of people around the world use it for nonmedical purposes. This is known as drug abuse and can cause a dependency on opioids. (2)(3) Some people may even start abusing other illegal drugs such as narcotics when they start using opioids for recreational use.
What Is Opioid Withdrawal and Its Signs and Symptoms?
Once someone is dependent on opiates and stops using them, very unfortunate symptoms can occur. This is known as opiate withdrawal. (4)
Usually, the symptoms of opiate withdrawal are generally not fatal or life threatening but can be very difficult to handle. (5) Opiate withdrawal can put an individual into an endless cycle of drug use as they continue to abuse opioids to avoid withdrawal symptoms, making them unable to quit and detox.
The symptoms can lead to serious health escalations and complications. The severity of the symptoms would depend on the degree of dependency on opioids and other factors, (6) which include:
- Duration of use
- Frequency of use
- Overall health
- Whether quitting was done gradually or cold turkey
- Use of other drugs to manage withdrawal symptoms
The abrupt discontinuation of heroin use results in a set of symptoms known as withdrawal syndrome, which are indicative of central nervous system hyperactivity.
Withdrawal symptoms can begin as soon as 4 hours after the last dose, can reach their peak within 48–72 hours, and can last for approximately a week, as explained by experts.
Common withdrawal symptoms include anxiety, drug cravings, and elevated respiratory rates (>16 breaths per minute), along with diaphoresis (excessive sweating), yawning, lacrimation (tear production), rhinorrhea (runny nose), mydriasis (dilated pupils), and stomach cramps.
Other symptoms that may appear later include goose bumps, tremors, muscle twitching, tachycardia (fast heartbeat), hypertension (high blood pressure), fever and chills, anorexia, nausea, vomiting, and diarrhea. (4)(5)
Managing Withdrawal Symptoms
Withdrawal symptoms can get so hard to manage that you would require external help to manage them. Here are some tips to take charge of your health and deal with opiate withdrawal.
1. Keep yourself hydrated
Once your body is hooked on opioids, you’d want them in your body constantly. So, giving up on opioid use will lead to very strong reactions. Before you decide to quit, prepare yourself for all kinds of possible health issues you may face.
One of the most common symptoms is dehydration due to perspiration. As opiate withdrawal causes vomiting and diarrhea, your body starts to lack fluids.
Drink a lot of water and other fluids after cutting off opioids to stay hydrated. Keep electrolytic solutions and juices at home. Also, carry them with you to work and other places in case you need them. (7)
2. Take vitamin supplementation
During withdrawal management, it is important to be provided with multivitamin supplements, especially vitamin B1 (thiamine) supplements, at a daily dosage of at least 100 mg and vitamin C. This is done to prevent any cognitive impairments that may occur during the withdrawal process. (7)
Talk to a healthcare professional for the right multivitamin supplement for you.
3. Trying nonprescription medicines
A lot of over-the-counter medications can help with substance use withdrawal. For instance, diarrhea can be managed with antidiarrheal drugs. For nausea and vomiting, antiemetics can be considered.
Another common symptom is body pain and inflammation, which can be addressed by non-opioid painkillers and NSAIDs. However, you should use them only under the supervision of a doctor. (8)
Note: Withdrawal symptoms from certain drugs, including opioids, can be severe and even life threatening and may require medical intervention. Drug therapy (opioid agonist, opioid agonist-antagonist, opioid antagonist, or clonidine) can be one component of a comprehensive treatment plan for drug abuse, but it should always be carefully monitored by a healthcare professional to ensure safety and effectiveness. (5)(6)
Moreover, it is important to note that you should not use any medicine excessively or for long durations. You should only use it when required in recommended doses only.
4. Practice meditation
Studies show that opiate withdrawal can make you uneasy and jittery. It can cause a lot of mental stress and can increase your levels of anxiety.
To manage this emotional distress, you can meditation and relaxation exercises. Meditation releases a soothing and calming effect on the body. (9)
Meditation and relaxation exercises can help you fight the need to consume opioids. If done regularly, it can be very beneficial in leading a healthy life with reduced symptoms of withdrawal.
5. Stay relaxed
Researchers suggest that staying comfortable while on withdrawal is extremely important. It is also good to keep your mind off substance use.
Stay busy and relax by keeping your mind occupied with the right things. You can watch a movie to laugh it off, read a book to stimulate your mind, or simply go for a walk. (10)
6. Get quality sleep
A good night’s sleep is of great significance to waking up with a fresh start to your day without facing the burden of withdrawal symptoms. Good sleep can fix a lot as it lets your body heal itself.
Make sure your mattress is comfortable and your room well ventilated. Keep your fan or air conditioning on if you feel too hot as withdrawal can cause excessive sweating. (11)
7. Be cautious
As you go through the tough journey of withdrawal, your mind would wander in different directions. You may inadvertently seek help from unreliable sources on the Internet or from people here and there.
Be mindful of what you’re doing. Do not follow any recipe or home remedy blindly without first checking if it is authentic. Avoid purchasing random medicines and products that claim to aid in withdrawal symptom management unless they have been tested and approved for their safety as well as efficacy. (12)
8. Build a support system
Remember that you don’t have to go through withdrawal alone. It can be dangerous as the journey is not very easy and smooth. Let your friends, family, and loved ones know about your withdrawal journey.
Talk it out whenever possible. Be sure to share how you’re feeling and keep a diary to pen down your journey so far. It will be helpful to look back on and see how far you’ve come.
Moreover, staying with people who care about you can strengthen your spirits and provides you with the motivation to keep going. (13)
9. Seek professional help
You may need help from medical professionals and care providers to point you in the right direction.
They can prescribe the medicines that you may require for treating or easing withdrawal symptoms. They will also monitor your health and progress. They can identify if the treatment route of detoxification is efficacious or not.
A facility for the rehabilitation of people going through opiate withdrawal can develop a treatment plan according to your needs. Personalized care will promote recovery and decrease the chances of complications from withdrawal. (14)
10. Undergo methadone therapy
Replacing opioids with other medications such as methadone to treat the symptoms of opioid withdrawal and make quitting opioids easier is termed methadone therapy. Methadone relieves withdrawal symptoms, which then makes the detoxification process much easier.
Methadone is a synthetic opioid used in patients who have a chronic dependence on opioids. It helps people fight their substance use. It has been in use for decades now and significantly reduces the rates of relapse. (15)
What Health Damage Can Be Caused by Long-Term Opioid Use?
Long-term use of opioids, particularly injection drug use, can result in harmful effects on the heart, lungs, and liver due to infections such as HIV and hepatitis B or C, which are transmitted through shared needles and nonsterile injection techniques.
When used during pregnancy, opioids can lead to physical dependence in the fetus. (2)(3)(4)(5)
When to See a Doctor
Opiate withdrawal is definitely one of the hardest things to go through as it causes uncomfortable and frustrating symptoms. Although withdrawal symptoms are not life threatening, they can be severe.
If your symptoms get out of control and are very hard to manage, so much so that you aren’t able to lead a daily normal life, call a doctor. Personalized therapy and medications will be helpful to manage the symptoms.
The doctor might even run some diagnostic tests to ensure that opiate use has not led to any serious damage to your body and its functioning.
Opioid misuse is categorized under “mental and behavioral disorders due to psychoactive substance abuse” in psychiatry. The International Classification of Diseases (ICD) includes smoking cigarettes containing nicotine or tobacco under the same category of drug abuse. (16)
In 2021, over 8.7 million Americans stated that they have misused prescription opioids, and among them, many have reported using prescription opioids before turning to heroin. Heroin is a powerful opiate drug that is used by almost 1.1 million people in the United States Sadly, opioid overdoses account for more than 68,000 deaths in the country every year. (17)
In India, a survey, “Opioid use in India: Prevalence of current opioid use in different population groups,” found that the prevalence of current opioid use among the total population (between the ages of 10 and 75 years) was 2.1%, with varying rates between demographic groups.
The survey specifically assessed the prevalence of current use and dependence on three opioid sub-categories:
- Opium (including doda/phukki/poppy husk)
- Heroin (including brown sugar/smack)
- Pharmaceutical opioids (including various opioid medications)
The overall prevalence of current opioid use in the country is 2.06%, with heroin being the most commonly used opioid (1.14%), followed by pharmaceutical opioids (0.96%) and opium (0.52%). (18)
Most-Asked Questions About Opioid Withdrawal
What really is opiate withdrawal?
Using opioids and being dependent on them for a long duration can lead to tolerance as your body stops being sensitive to drug use. This makes you need more drugs to get the same euphoric effects (19) Dependency is both physical and psychological.
Moreover, opioids influence your brain, so stopping abruptly leads to discomfort and symptoms including:
- Body pain
- Mood swings
- Increased heartbeat
Some of these symptoms last only for a few weeks after quitting, and later some long-term effects of withdrawal are seen. These long-term symptoms affect your mental state immensely and cause behavioral issues that can lead to troubles in daily life.
How do I know I’m dehydrated due to opiate withdrawal?
One of the major problems after opiate withdrawal is dehydration. It can be very severe and lead to problems such as irregular heartbeat, paving a way for heart issues. Therefore, it is important to catch and manage it timely. (20)
Early symptoms of dehydration may include:
- Dry mouth
- Inability to urinate
- Fever and chills
- Mood swings
- Rapid heartbeat
How is opiate dependence diagnosed?
The diagnosis, according to experts, is primarily made based on clinical criteria, such as the presence of withdrawal symptoms. Urine drug testing can confirm opiate use. In some cases, additional laboratory tests may be needed to assess for drug-related complications.
It is never too late to quit drug abuse. A lot of people go through the process, so remember that you’re not alone. There are rehab centers and support groups to aid you in taking the first step toward getting healthier.
It is important to let go of chronic opioid dependency as it causes serious complications in the long run.
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