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The idea of going through withdrawal may seem terrifying when you are an opiate addict. While withdrawal is rarely life threatening, it can be uncomfortable and painful. In fact, some drug addicts may feel some of these uncomfortable symptoms when in need of more drugs. The idea of spending hours or days in pain may stop some individuals from treatment.

An opiate detoxification program allows individuals to experience a completely different form of withdrawal. When under the care of medical professionals, everyday thousands of people go through opiate withdrawal with only a minimal amount of discomfort.

The Testing Stage

Detox AssessmentAt the beginning of detox, medical professionals determine what drugs have been taken and when the last dose of drugs have been consumed. Interviews with patients often help with this process. However, medical professionals also perform blood or urine tests to confirm that the information provided is both true and accurate.

The need for heroin detox and other opiatesWhen opiates enter the body, they travel to the brain and latch onto specific receptors and this reduces the perception of pain.[1] Fast-acting opiates tend to cause a significant amount of problems in detoxification.Sudden withdrawal is more likely when people take opiate drugs in large amounts. Some common opiates include:

  • Heroin
  • OxyContin
  • Percocet
  • Vicodin
  • Oxycodone

According to the National Alliance of Advocates for Buprenorphine Treatment, people who use these drugs need to abstain from their use for 12 to 24 hours before taking detoxification medications. So when an individual goes into treatment they may have a waiting period until medication becomes part of the treatment.

Opiates tend to stay completely latched onto receptors for long periods of time. For example, some who use OxyContin may need to wait at least 24 hours before drugs are given in treatment.Some who have been abusing methadone may need to wait even longer. These drugs often stay active in the system for a long time.

Symptom Management

Withdrawal from OpiatesMedication has a key role to play in the detoxification process as it can help manage unpleasant withdrawal symptoms. According to the U.S. National Library of Medicine, mild symptoms can include agitation and anxiety, while severe symptoms might include:

  • Abdominal cramping
  • Diarrhea
  • Chills and goose bumps
  • Nausea
  • Vomiting

Mild symptoms are often treated with supportive care,which includes aspirin and plenty of fluids. However, if symptoms continue to escalate, other medications can ease gastrointestinal distress and agitation. If symptoms worsen, stronger medications maybe given to the patient. One such medication is clonidine. This drug was originally created to address high blood pressure issues. Clonidine has also been proven helpful in treating stress and anxiety.

The decision to use medication to treat withdrawal is very intentional. In fact, according to an article from American Journal of Drug and Alcohol Abuse, there are two separate systems used to assess how the person is feeling as detoxification progresses.[2] One scale, the Subjective Opiate Withdrawal Scale, contains 16 symptoms. Patients rate the intensity of those symptoms on a periodic basis. Another scale is the Objective Opiate Withdrawal Scale. It contains 13 symptoms that medical professionals can see on their own. These tools allow medical professionals to monitor the progress carefully, and to know exactly when medication is needed.

Opiate Medication Therapies

Detoxification MedicationOnce the appropriate amount of time has passed and the person no longer has active opiates in the body, there are two medications often prescribed are methadone and buprenorphine. Both are proven effective in helping to suppress the symptoms of withdrawal.These drugs also help reduce the cravings to use opiates.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the proper dose of methadone can vary. This depends primarily on the level of drugs the person has taken in the past. If the patient continues to report discomfort, the dose might be too low and he/she is given a higher dosage. Once the proper dose is found, it’s typically given once per day.The drug is then slowly tapered over a period of three to five days, SAMHSA reports.

Buprenorphine is given in a similar manner. The main advantage of buprenorphine is that it is available in patch and tablet form. This allows the individual to take home a prescription for the medication. In some situations, he or she can go through detoxification at home. Medical doctors that are not attached to an opioid treatment program can also prescribe Buprenorphine.This makes the medication attractive to someone who does not want to enter a formal detoxification program and who would prefer to work on detox at home.

Both of these medications can be effective in reducing discomfort associated with detoxification. For example, a study published in the journal Clinical Pharmacology and Therapeutics found no significant differences in retention rates, drug use or symptom severity between people who were given methadone and those given buprenorphine. Both medications help people get through the detoxification process.

Preparing for Care

The first step is to sobriety is look at the options available for detoxification. Since opiate detox can be very uncomfortable—and even dangerous without medical assistance—it is advisable to speak with a treatment admissions counselor at a rehab facility or hospital for detox. Insurance coverage may help narrow the options too. In most cases, a doctor may be able to put the addict on a tapering program to make withdrawal symptoms more tolerable. Medical advice should always be sought before opiate detox.

Some patients may not be able to afford inpatient treatment, but there are many long-term advantages to inpatient treatment, as it is easier to make changes in life when away from the current environment. For example, a study in the journal BMJ found that only 17 percent completed opiate detoxification outpatient programs, while 81 percent completed inpatient detoxification programs. While medications can help to ease the physical symptoms of withdrawal, the physical distress is only one part of the detoxification process. The person still has:

  • Habits that promote drug use
  • Friends or family members who also use
  • Access to drugs
  • A lack of coping skills to resist temptation

All of these deficits can be addressed in formal treatment programs for addiction.If a person is just entering detoxification, it can be all too easy for the person to slip right back into old habits. This is especially the case when left in the same place any bad habits had a chance to form.

By contrast, an inpatient program is a controlled environment in which no drugs are present. The person is completely removed from his/her normal surroundings. Thoughts about drugs may persist, but it will be much harder to act upon those thoughts when surrounded by a team of medical professionals. These trained professionals encourage the person to keep moving forward, to keep fighting and to keep working on the addiction.

An important part of the preparation process is making a commitment to sticking with therapy, no matter what happens. The withdrawal process typically takes seven to 10 days to complete, but true recovery from opiate addiction may take up to six months.[3]After recovery, many more months of work are needed in order to ensure that a relapse does not occur.

If you have additional questions about opiate detoxification, please contact us at The Canyon. We have many years of experience in helping people recover from the addiction issues they face. We’re here to help. Contact us today.

[1] How Do Opioids Affect The Brain and Body?

[2]  Two Rating Scales for Opiate Withdrawal. Handelsman, Leonard. Published on July 7th, 2009.

[3] What Are Treatments For Heroin Addiction.