Understanding Opioid Withdrawal
What Is Opioid Withdrawal?
Opioid withdrawal is a set of physical and emotional symptoms that occur when someone living with opioid use disorder (OUD) or with a dependence on opioids suddenly stops or decreases their use.
Withdrawal is often very uncomfortable, making maintaining abstinence difficult and necessitating professional support from clinicians when beginning the journey to a drug-free life.
What Happens to Your Body When You Stop Taking Opioids?
When opioids are suddenly removed, the body and brain can react intensely, causing opioid and opiate withdrawal symptoms as normal routines and homeostasis are disrupted.
Opioids have a profound effect on the brain and central nervous system, interacting with opioid receptors in the brain to release dopamine. Repeated use can cause the brain to adapt to their presence, expecting their use and depending on opioids for emotional regulation, needs, and more.
While withdrawal symptoms can be challenging to navigate, especially without professional healthcare providers and withdrawal management, the body and brain can heal and readjust to a new, healthier state without drugs.
What Is Opioid Use Disorder?
Opioid use disorder (OUD) is a form of addiction where a person may use opioids in ways not prescribed or for reasons not directed by medical professionals, leading to difficulty stopping despite negative consequences, using more than intended, or experiencing intense urges and cravings that can lead to further substance abuse.
Someone with OUD may abuse prescription opioids like OxyContin, hydrocodone, codeine, or morphine. However, OUD also refers to addiction to illicit drugs like heroin or the incredibly potent fentanyl.
OUD is more than just the use of opioids. Rather, it also describes side effects and lifestyles that have been informed by drug abuse, including using in secret, self-isolating behaviors, consequences to physical and emotional health, and changes to daily life to facilitate further use.
How Does Opioid Dependence Develop?
As a person uses opioids, the brain increases tolerance, needing more of the drug to achieve the same effects as before, whether for pain tolerance or to release dopamine and “feel good.”
Over time, this can cause the body to rely on opioids to regulate these parts of the brain, creating a dependence on the drug and creating a new “normal,” leading to further use and increased risk of opioid overdose.
Struggling with opioid dependence means professional interventions and opioid treatment with health care providers may be necessary to overcome drug use.
Can Prescription Opioids Cause Dependence?
Yes. Even those with a valid prescription can still be at risk for developing opioid addiction.
Receiving a prescription for chronic pain can be a common introduction to opioids, with long courses potentially coming with a risk of addiction. Using prescription opioids beyond their intended use, such as to address underlying stress, mental illness, or other needs, as well as using more than directed, can increase the risk of addiction.
How Is Opioid Withdrawal Different From Opioid Use Disorder?
Opioid use disorder is a set of challenges, urges, and cravings that focus on the active use of opioids, as well as the lifestyles and consequences that drug use informs, whereas opioid withdrawal is the set of challenges that occurs when those living with OUD suddenly stop using the drug.
While opioid withdrawal can be challenging, it is a necessary first step in overcoming OUD and addiction. Professional substance use disorder detoxification programs are crucial for providing education, support, and empowering a person to overcome withdrawal and commit to long-term change.
Why Opioid Withdrawal Happens
How Do Opioids Affect the Brain and Nervous System?
Opioids bind to opioid receptors in the brain and throughout the nervous system, impacting how a person perceives pain and stress, and even hijacking the reward system to make a person “feel good” for using the drug despite negative consequences.
Reduced pain and increased rewards can cause a person to want to use the drug again. However, as the drug is used, the brain and body start to rely on the drug to do these tasks, rather than managing them itself, leading to dependence.
Why Does the Body Develop Physical Dependence on Opioids?
Physical dependence is a natural adaptation of the body getting accustomed to repeated opioid use, adjusting its own functions and expectations to accommodate the use of opioids, despite worsening consequences.
What Factors Affect the Severity of Opioid Withdrawal?
Several factors impact the severity of opioid withdrawal symptoms, including:
- Frequency of opioid use
- Potency of drugs used, or other substances used alongside opioids
- How long a person has been using opioids
- If a person is cutting entirely or tapering off with professional assistance
- Underlying needs including mental health needs and physiological issues
- Access to professional pharmacology and support from medical professionals
Navigating opioid withdrawal is challenging. Even those committed to change can find it difficult to maintain a drug-free life and manage withdrawal symptoms without proper support. However, healing is always possible.
Does the Type of Opioid Affect Withdrawal Symptoms?
Yes. Short-acting opioids can typically lead to more intense and immediate withdrawal symptoms, while longer-acting opioids can create a more delayed response to opioid withdrawal.
The intensity of opioids can also impact withdrawal, with drugs like fentanyl leading to more intense withdrawal symptoms. However, withdrawal can always be challenging, regardless of what opioid is being used, and professional care is recommended.
Common Opioid Withdrawal Symptoms
What Are the Symptoms of Opioid Withdrawal?
The exact symptoms and their severity will vary for each individual.
However, there are some common symptoms of opioid withdrawal that each person and family should be aware of, including:
- Sweating, chills, and goosebumps
- Mood swings
- Anxiety, depression, and paranoia
- Diarrhea and gastrointestinal issues
- Elevated heart rate and blood pressure
- Nausea
- Vomiting
- Aches and pains
- Irritability or anger
- Insomnia
These symptoms are often accompanied by intense urges and cravings to reengage with the drug, even if just to get the symptoms to stop, despite a person’s better judgment.
What Are the Early Symptoms of Opioid Withdrawal?
Some of the earlier symptoms of opioid withdrawal include sweating, anxiety, irritability, aches, and intense cravings for the drug.
These symptoms can worsen before improving, necessitating professional support.
What Are the Physical Symptoms of Opioid Withdrawal?
Common physical symptoms of opioid withdrawal include:
- Aches and pains
- Gastrointestinal challenges
- Nausea and vomiting
- Sweating
- Difficulty regulating body temperature
- Insomnia, difficulty staying asleep, or compromised quality of sleep
What Are the Psychological Symptoms of Opioid Withdrawal?
Psychological symptoms of opioid withdrawal include:
- Anxiety
- Depression or dysphoria
- Mood swings
- Anger, frustration, and being easily irritable
- Restlessness
Combined with physical symptoms and intense cravings, a person may feel compelled to use opioids again, even knowing their destructive nature.
Why Does Opioid Withdrawal Cause Muscle Aches, Cravings, and Anxiety?
Opioids not only interfere with pain pathways to relieve pain, but also affect the brain’s reward circuit and impact emotional regulation.
When opioids are suddenly removed, these parts of the brain and nervous system can be ill-adapted to functioning without opioids, leading to a sensitivity to pain and difficulty regulating emotions until the body readjusts to the absence of opioids.
How Can Withdrawal Symptoms Affect Sleep and Daily Functioning?
Compromised sleep, or other symptoms like nausea and restlessness, can make quality sleep difficult and can lead to inconsistent rest.
Difficulty concentrating, intrusive thoughts, and urges to reengage with opioids can also make adhering to responsibilities and daily routines challenging, impacting not just how a person feels, but their ability to go about their daily routine.
Opioid Withdrawal Timeline
When Do Opioid Withdrawal Symptoms Start?
Exactly how long it takes for the first withdrawal symptoms to occur can depend on the frequency and intensity of use, as well as the opioid used.
Short-acting opioids like morphine and oxycodone can lead to withdrawal symptoms within hours of last use. Long-acting opioids like extended-release prescription medications can have a delayed onset of symptoms, but they can be just as intense.
How Long Do Opioid Withdrawal Symptoms Last?
The length of withdrawal will depend on the individual, but it is typically most intense up to a few days following last use.
However, even as the more intense phase of withdrawal subsides, it is still common to experience withdrawal symptoms for longer periods throughout professional detox, inpatient, PHP, and outpatient treatment.
What Are the Stages of Opioid Withdrawal?
The stages of withdrawal typically follow:
- Early Withdrawal: This is when the first withdrawal symptoms, like restlessness, anxiety, and other challenges, begin to manifest and can occur within hours after the last use.
- Peak Withdrawal: After early withdrawal and without reengaging with opioids, withdrawal can become more intense, reaching its most intense symptoms during this phase.
- End of Acute Withdrawal: During this stage, the most intense symptoms begin to subside, with cramps and gastrointestinal challenges beginning to improve. However, there will be some lingering withdrawal symptoms, and the journey is by no means “complete.”
It is also not uncommon to continue to experience lessened withdrawal symptoms throughout the larger healing journey as a person moves through the continuum of care in pursuit of a drug-free life.
Professional support and detox, as well as follow-up support, are necessary during these stages.
How Long Does Fentanyl Withdrawal Last?
Fentanyl can have a highly varied window of withdrawal.
While the most intense symptoms are typically fast-acting and occur quickly after last use, fentanyl can also become embedded in fatty tissue and extend release, and thus also extend withdrawal symptoms.
How Long Does Oxycodone Withdrawal Last?
It depends on whether the oxycodone used is short-acting or extended-release.
Withdrawal is typically most intense up through a few days following last use before acute symptoms begin to improve.
Why Can Opioid Withdrawal Symptoms Feel Worse at Certain Times?
Yes. Underlying needs can inform the severity and fluctuating intensity of withdrawal symptoms.
Likewise, poor sleep, compromised hygiene routines, underlying chronic pains, dietary needs, and more can all impact the journey, making it feel like sometimes symptoms are surging, while other times they are a little more manageable.
Risks and Complications of Opioid Withdrawal
Can Opioid Withdrawal Be Dangerous?
While certainly uncomfortable and difficult, opioid withdrawal is not typically dangerous on its own.
However, in some rare circumstances, it can be dangerous. Talking to a professional and engaging in professional care is necessary for safe, effective care.
Can Opioid Withdrawal Be Life-Threatening?
While incredibly rare, opioid withdrawal syndrome can potentially be life-threatening.
Professional care, support, psychiatry, and pharmacology are always recommended to navigate opioid withdrawal.
Why Does Opioid Withdrawal Increase the Risk of Overdose?
While symptoms are intense, the body is already readjusting to life without opioids, decreasing tolerance.
If a person reengages with opioid use, they may do so at the intensity of previous levels, with the sudden and high level of use in the body increasing this risk.
What Happens If Someone Returns to Opioid Use After Withdrawal?
A person will increase the risk of overdose, emergency department visits, and a return to self-destructive lifestyles.
However, a return to substance use does not mean someone is beyond healing or help. Rather, it means that a new approach and personalized support are necessary.
Should Someone Seek Medical Help for Opioid Withdrawal?
Yes. Opioid withdrawal can be complicated, and access to professional care, health information about the medical condition, evidence-based care, and medications to address withdrawal symptoms and needs are all crucial for effectively navigating this stage of recovery.
Managing Opioid Withdrawal
How Is Opioid Withdrawal Treated?
Opioid withdrawal is treated with a combination of medication, evidence-based care, holistic healing and therapy, diet and hydration, and professional care for underlying mental health and personal challenges.
This is all backed by transition support across the continuum of care and relapse-prevention strategies.
What Medications Are Used to Manage Opioid Withdrawal?
An opioid agonist like naloxone or Suboxone is commonly used throughout the withdrawal process to help manage symptoms.
However, these medications will not eliminate them or the need for personal commitment to healing.
How Do Buprenorphine and Methadone Help With Opioid Withdrawal?
These medications can help lessen cravings and suppress some opioid addiction withdrawal symptoms.
They can also be used in helping to taper off opioids.
What Is the Role of Clonidine in Opioid Withdrawal Treatment?
Clonidine helps address nervous system symptoms like anxiety, sweating, nausea, and elevated heart rate typically associated with opioid withdrawal, but does not necessarily manage cravings.
Can Medications for Opioid Use Disorder Prevent Severe Withdrawal?
Yes, medications can help lessen severe withdrawal symptoms.
However, they are not a replacement for professional care and may not eliminate them entirely. Professional support is still recommended.
Why Is Medical Support Important During Opioid Withdrawal?
Withdrawal can be unpredictable, with varying symptoms, severity of symptoms, and underlying personal needs all informing this part of healing.
Medical support is crucial for monitoring symptoms while staying committed to change, as well as adjusting to changing needs and challenges during this important first step.
Professional care can also structure a person’s transition to further levels of care to maintain a healthy, drug-free life.
Detox and Treatment for Opioid Use Disorder
What Happens During Opioid Detox?
During opioid detox, a person will work with a healthcare professional to understand their history with opioids, monitor symptoms and medical signs, administer medications, address underlying needs like hydration, dieting, and mental health needs, and begin the process of transitioning to ongoing rehab for OUD.
What Happens After Opioid Detox?
After detox, a person will transition to another level of care to manage ongoing symptoms, continue to engage in medication-assisted treatment (MAT), and work with professionals and peers to understand addiction, its impact on daily life, and develop and update coping skills to prevent relapse.
However, the level of care can vary, with inpatient care, partial hospitalization programs, and intensive outpatient care all available depending on needs, goals, severity, and other factors.
When Is Inpatient Treatment Recommended for Opioid Addiction?
Inpatient care is recommended for those with severe addiction to opioids, who have additional underlying needs like mental health disorders and co-occurring disorders, or who may lack an at-home support system to keep them accountable while building new skills.
What Outpatient Treatment Options Are Available for Opioid Addiction?
Outpatient treatment options often include partial hospitalization programs (PHPs), intensive outpatient programs (IOPs), and outpatient treatment, depending on the severity of addiction, personal needs, and progress in rehab.
Does Treatment Address the Causes of Opioid Addiction?
Professional care for OUD at Resilience Recovery Resources combines strategies for managing addiction and its effects with strategies to explore underlying needs and factors that informed use in the first place for comprehensive, holistic care.
Why Is Family Involvement Important in Opioid Addiction Treatment?
Families can be crucial supports, with integrated family programs helping to educate families on addiction, improve communication and accountability, and even inform families on signs of potential relapse, with caring, knowledgeable supports even going as far as to carry Naltrexone for potentially life-saving measures in the case of relapse and overdose.
Mental Health and Opioid Addiction
How Can Opioid Withdrawal Affect Mental Health?
Anxiety, depression, dysphoria, and mood swings are all common as a result of opioid withdrawal, as a person’s emotional regulation is impacted by the drug.
Legal consequences and chronic pain can also be tied to traumatic experiences, further impacting mental and emotional wellness.
What Mental Health Conditions Can Occur Alongside Opioid Use Disorder?
OUD can occur alongside any mental health condition, including anxiety, depression, ADHD, panic disorder, and various personality disorders and mood disorders.
However, just because a person has a mental health disorder does not mean they will necessarily develop addiction, nor is an underlying mental health disorder a prerequisite for OUD.
Why Is Treatment for Co-Occurring Mental Health Conditions Important?
Dedicated co-occurring disorder treatment is crucial, addressing not just the effects of OUD, but developing strategies for addressing the mental health needs that informed their use in the first place for a comprehensive approach to wellness and change.
Addressing underlying needs can also ensure that each person can develop personalized coping strategies and relapse-prevention strategies while understanding how thoughts and behaviors impact attitudes toward drug use.
How Can Therapy Help During Opioid Addiction Recovery?
Professional therapy can help a person understand patterns of use, thoughts, and beliefs, and their connection to drug use.
Using this information, therapists can focus on personal needs, from coping strategies and problem-solving skills to emotional wellness and management, self-esteem, and mental health needs to prevent falling back into past routines.
How Can Family Therapy Support Recovery From Opioid Addiction?
Communication, accountability, and understanding are all parts of effective family therapy, which updates strategies while educating and providing support to maintain boundaries.
Family therapy also empowers families to act on warning signs and adjust treatment plans as necessary for a unified, honest, and effective approach to healing.
Recovery After Opioid Withdrawal
What Happens During Early Recovery From Opioid Addiction?
Early recovery from opioid addiction involves managing withdrawal symptoms and reaching a point of stabilization, focusing on cravings, decreasing physical symptoms, changes in sleep and wellness, mood swings, and beginning to understand triggers and personal needs in a safe environment.
How Can People Develop Coping Skills After Opioid Withdrawal?
Working with professionals to understand a person’s relationship and history with opioids, personal and underlying needs, and more can all inform appropriate coping skills.
Using journals, working to understand triggers, addressing environmental factors, focusing on diet and hydration, and practicing breathing techniques and mindfulness strategies can help people develop skills pertinent to their unique situation.
Why Are Life Skills Important During Opioid Addiction Recovery?
Life skills empower those in recovery not just to overcome opioid use, but to build a new life without drugs, working toward personal goals, professional ambitions, academic success, and embracing agency to manage stress, improve emotional resilience, rebuild relationships, and become the agent of a person’s own change.
How Can Ongoing Support Reduce the Risk of Relapse?
Ongoing support from family and outpatient programs can address new stresses and challenges before an individual falls back into self-destructive routines.
Support can also help people update coping strategies and prevent triggers and urges from affecting their hard-earned sobriety.
What Does Long-Term Recovery From Opioid Addiction Look Like?
Long-term recovery from OUD is a combination of ongoing therapy and support to update strategies and blend therapy with professional skills, balancing academics, professional development, and ongoing healing with engagement with peers and professionals in a dedicated healing community.
Updating family support and relapse-prevention strategies are also a significant piece of long-term recovery.
FAQs About Opioid Withdrawal
What drug has the most withdrawal symptoms?
There is no single drug with the “most” withdrawal symptoms.
Rather, it depends on the frequency and severity of use, underlying needs, and an array of personal factors that all inform each person’s experiences with withdrawal.
Are Withdrawal Symptoms Different for Fentanyl or Oxycodone?
While they share many symptoms, their timing can be different depending on whether the opioids are short-acting or extended-release.
However, each experience with withdrawal is always unique in its symptoms and severity.
Can Opioid Withdrawal Be Managed Without Medication?
While possible, medication is still recommended to address opioid withdrawal and its symptoms for effective and safe detox or tapering.
Can You Prevent Opioid Withdrawal?
Those living with OUD should expect to experience some withdrawal symptoms when stopping the use of opioids, or even decreasing use under the supervision of a professional.
While they may not be completely preventable, they can be substantially eased with medication and professional care.
When Should Someone Seek Medical Help for Opioid Withdrawal?
If a person experiences severe symptoms, reengages with opioids to get the symptoms to stop, or is experiencing opioid withdrawal in conjunction with other underlying needs, then medical help may be necessary.
However, it is never too early to contact a professional detox facility or Resilience Recovery Resources to understand your unique situation and options.
Resilience Recovery Resources offers comprehensive opioid addiction treatment for young men in Florida, combining professional care and clinical excellence with a commitment to long-term wellness. Call us today to learn more about how we can help your son begin their healing journey.
