Symptoms of Opioid Withdrawal and Detox
Opioid withdrawal can be painful, and symptoms can last several weeks. Knowing what to expect from withdrawal and the detox process can help you make an informed decision about receiving treatment. Stepping Stone’s opioid detox center can put you or a loved one on the road to recovery.
How Long Do Opioids Stay in the System?
Opioids don’t stay in the system for very long. The half-life is about 3.5 to 9 hours for hydrocodone-based drugs. Similarly, 1.5 – 6 hours for drugs like morphine and heroin. The half-life is the amount of time it takes for the drugs to reduce by 50 percent in the bloodstream. A urine screening can detect the presence of opioids for up to 72 hours after the last use, and blood tests will yield a positive result for up to 24 hours.
Depending on the length and extent of opioid use, symptoms of withdrawal begin to set in between six and 48 hours after the last dose. They can continue for up to a week after ceasing opioid use. The severity and length may vary with different types of opioid-based drugs, but the symptoms are similar regardless of whether withdrawal is from heroin or hydrocodone. Intensive opioid addiction treatment is designed to manage the pain of opioid detox, while the brain and body become accustomed to functioning without drugs.
Opioid Withdrawal Symptoms
Opioid addiction treatment begins with detox to manage withdrawal symptoms, which can become intense. At first, mild symptoms like head and body aches, low-grade anxiety, and restlessness occur. These build with each passing hour after the final dose of opioids is taken, and are accelerated and joined by profuse sweating, chills, goosebumps, vomiting, diarrhea, and drug cravings. The longer an addict goes without using again, the more these symptoms will intensify.
Then, the panic sets in.
The brain is no longer able to function properly without the stimulus from opioids. Mood swings begin, and there may be bouts of depression and fatigue. It may seem easier to just sleep until these feelings pass, but severe or long-time users may experience sleep disturbances and hallucinations. The withdrawal period is extended for those trying to quit taking potent forms of opioids like fentanyl and medications that are formulated for extended-release. Without medication and supervision during this critical phase, many will start using again just to alleviate the pain and discomfort of withdrawal.
Opioid Withdrawal Timeline
The opioid withdrawal timeline varies by the individual, the type of drug dependency, and the length or severity of use. Symptoms begin as the last dosage wears off, and they peak in intensity by about 72 hours after quitting. Most of the physical complaints will taper off and cease by the end of the first week, but the emotional by-products of withdrawal like depression and anxiety may persist for months, even with opioid treatment.
The breakdown of what the body and mind experience during withdrawal will follow this general timeline:
First Two Days
The body will hurt all over, especially in the joints and muscles. A dependent brain believes this is not an addiction, but the body needing something to relieve pain. Severely addicted persons will also experience abdominal cramps, nausea, and sweating during this phase.
Three to Five Days
Drugs are completely out of the system by this point. This is the most critical and painful phase of withdrawal and a time when many individuals who are attempting to quit cold turkey will relapse. Muscle pain and cramping will be joined by excessive sweating, vomiting, and diarrhea as the body rids itself of the toxins that have built up during use.
End of First Week
Most of the physical symptoms of withdrawal will disappear by the end of the first week, but emotional signs of withdrawal return. Depression and anxiety may intensify as the body and brain return to normal, drug-free functioning. Opioid detox is over, and therapy can begin to address the underlying causes and lingering effects of addiction.
Week Two and Beyond
This phase of withdrawal is about becoming stronger and developing the tools necessary to prevent relapse. It can last for several weeks or longer. Severe addictions or substance abusers who have been through rehab before may need a supervised medical maintenance program.
Medications Used by Our Opioid Detox Center
Opioid detox center treatment programs begin with medically supervised withdrawal treatment to alleviate the initial pain that occurs when the brain and body are deprived of drugs. This restores function faster and allows a smooth transition to active opioid treatment. During this period, you try a range of medications. Also, medical maintenance continues for some time after substance abusers leave the treatment facility.
Mild or short-term use can be stepped-down slowly until the patient is weaned off of the medication. Doctors may try anti-anxiety medications and non-narcotic pain relievers to make the patient more comfortable during the first critical week. Severe addictions will require medically assisted treatment (MAT) during this transition and beyond.
MAT is a proven strategy for managing withdrawal symptoms, which can become debilitating. Patients in programs that employ medical assistance are less likely to relapse after treatment and do better during the therapeutic phase. It reduces the likelihood of death by overdose, transmission rates for infectious diseases like HIV and hepatitis, and criminal activity over those who attempt to quit without medical supervision.
Medications used during withdrawal may include methadone and buprenorphine. Once completely out of the system, we introduce naltrexone and suboxone to manage symptoms and prevent relapse. These medications reduce the craving for opioids or block the pleasurable effects of use. Also, they can cause unpleasant side-effects that are similar to withdrawal symptoms if relapse occurs. Methadone and suboxone continue in medical maintenance programs after release from a rehab facility.
What to Expect From an Opioid Detox Center
At the height of the opioid crisis, the Secretary of Health and Human Services (HHS) created a protocol. Meant to more comprehensively deal with opioid treatment, the recommendations covered five critical points. These were considered paramount to successful opioid detox and relapse prevention:
- Increase access to recovery and treatment programs.
- Promote the development and use of overdose-reversing drugs like Narcan
- Facilitate deeper understanding of the nature and patterns of addiction
- Support research into the relationship between pain and addiction, including increased funding
- Encourage researchers and doctors to devise more effective, drug-free pain management practices
Treatment facilities usually provide 30 – 90 days of intensive inpatient treatment. Often this includes private and group therapy sessions, holistic healing practices, and treatment for underlying medical problems. Also, concurrent treatment for those with dual diagnoses of substance use and mental health disorders is offered. Therapy provides individual insight into the underlying causes of addiction, helps identify triggers, and provides tools for coping without resorting to drug use. Aftercare provides continued support after release from a treatment facility.