Opioid Detox: Options, Phases, Dangers & How To Manage

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Overcoming an opioid addiction on your own can be physically and emotionally challenging. It comes with unpleasant withdrawal symptoms that can hinder your progress.

Opioid detox programs can help you navigate your condition comfortably while managing these unpleasant symptoms.

This guide will cover everything you need about opioid detox to help you take the first step toward sobriety.

What is Opioid Detox?

Opioid detox (medically supervised withdrawal or detoxification) is a structured program offered by a substance abuse center or rehab facility. It’s designed for patients who suffer from opioid addiction or opioid use disorder and want to get sober.

This program helps you stop using opioids while minimizing the severity of the uncomfortable withdrawal symptoms you’ll inevitably experience.

When you join an opioid detox program, you’re put on a strict treatment plan that helps clear all the toxins and opioids from your system.

Some programs have trained medical professionals who monitor you around the clock. If you experience severe withdrawal symptoms, they quickly step in to ease your pain.

Other programs give you more space and flexibility while monitoring your progress every week or so. Regardless of what type of program you join, the main goal of opioid detox is to guide you to sobriety.

This guidance is meant to stabilize you physically and emotionally, empowering you to get your life back on track.

Understanding Opioid Addiction

Opioid addiction, or opioid use disorder, is a compulsive need to take opioids despite its negative impact on your life. Patients with opioid dependence know how harmful opioids can be to their physical and mental health but can’t stop taking them.

The urge to take prescription opioids or even illicit opioids is more substantial than their will to quit. Hence, there is a need for opioid detox programs.

They help you build up the willpower to fight drug abuse by slowly lowering your physical dependence on them. Physical dependence means not only your mind craves opioids, but your body’s become accustomed to them. Your body refuses to carry out its normal physiological and mental processes without a dose of opioids.

How Opioid Addiction Starts

Most patients who become addicted to opioids don’t start with heroin or illicit drugs. Studies by the NIDA (National Institute on Drug Abuse) show that about 80% of heroin users started with prescription opioids.

While prescribing opioids could be questioned, given the high statistics, it must be noted that healthcare providers follow specific guidelines.

Your doctor will only recommend prescription opioids to treat pain when regular analgesics are inadequate. For example, if you’ve just undergone surgery or experienced severe trauma or an accident, opioids are the first choice for pain relief. Chronic pain is another common indication.

When opioids first enter your body, they search for specific opioid receptors in the central and peripheral nervous systems. Upon finding them, opioids latch onto the receptors, triggering a series of reactions that cause:

  • Pain relief (reduced perception of pain)
  • Respiratory depression (slowed breathing)
  • Cough suppression
  • Relaxation
  • Euphoria

Pain relief and relaxation are the main benefits, but euphoria is why you might get addicted to opioid analgesics.

When you take opioids for too long or larger doses than you’re supposed to, your body gets hooked on the euphoric feeling. It always craves the rewarding sensation, resulting in a constant urge to take opioids.

The problem is your body is constantly adapting to your opioid doses. That means you’ll need to keep increasing your dose each time to get the same euphoric effect you crave. With time, you become addicted.

For some patients, upping the dose isn’t enough. They might switch from prescription opioids to illegal opioids like heroin to satisfy their urge. Eventually, this can result in an overdose or death.

Signs and Symptoms of Opioid Addiction

Opioid drugs are relatively safe if you follow your doctor’s instructions. They’ll usually prescribe an opioid medicine briefly to avoid addiction or substance abuse disorders.

However, it would help if you watched for signs and symptoms of opioid addiction. The sooner you identify the problem, whether you’re addicted or a family member is, the better your chances of treatment and recovery.

Identifying these symptoms can help your healthcare providers choose the right detox program.

Here are the most common signs and symptoms to look out for:

  • Impaired daily activities
  • Opioid tolerance
  • Opioid withdrawal syndrome (experiencing unpleasant symptoms when you stop taking opioids)
  • Opioid cravings
  • Uncontrolled opioid use
  • Need for significant or prolonged opioid doses

According to the American Addiction Centers, if you experience at least two of these symptoms in a year, you’re probably addicted to opioids.

Commonly Abused Opioids that Require Detox

Opioids have different potentials for abuse and addiction. Most patients who join a medical detox program have taken one of the following prescription opioids:

  • Oxycodone (OxyContin)
  • Hydrocodone (Vicodin)
  • Codeine
  • Morphine
  • Fentanyl

Some patients also take illicit opioids such as heroin and carfentanil. These usually require more strict detox programs and make it very hard to manage opioid withdrawal.

Opioid Withdrawal Symptoms

Opioid withdrawal symptoms are inevitable. Even if you go through an opioid detox program, there’s still a significant chance you’ll experience symptoms.

However, detox programs are designed to cushion the blow and ease your discomfort as much as possible. Every person experiences different symptoms of opioid withdrawal depending on the following:

  • How long you’ve been taking opioids
  • The amount of opioids you’ve taken
  • The type of opioids in your system
  • The opioid formula you’ve taken (injections, extended-release pills, etc.)

For example, if you’ve taken an oral prescription opioid like codeine, you might experience mild withdrawal symptoms. On the other hand, an illicit drug like heroin can cause severely unpleasant symptoms within 12 hours of quitting.

Withdrawal Phases

Generally speaking, the withdrawal period can be divided into two phases, each with its withdrawal symptoms.

The First Day

During the first 24 hours after quitting opioids, you can expect some of the following symptoms:

  • Muscle pains and aches: Your muscles can feel sore and uncomfortable because they’ve grown accustomed to the painkilling effect of opioids.
  • Agitation and restlessness: Without the relaxing effect of opioids, you can find yourself constantly fidgeting or pacing.
  • Overwhelming anxiety: You might feel so anxious that you can’t function properly at work, school, or daily interactions.
  • Watery eyes and runny nose: Opioid withdrawal can lead to increased secretions, especially from the eyes (lacrimation) and nose (runny nose).
  • Profuse sweating: The increased bodily secretions and anxiety can lead to excessive sweating.
  • Insomnia: You might have a hard time falling asleep or staying asleep, which makes your anxiety worse and interferes with your productivity.
  • Excessive yawning: The lack of sleep often leads to frequent yawning, a sign of overall exhaustion.

After the First Day

After the first 24 hours, you’ll experience slightly worse withdrawal symptoms, such as the following:

  • Gastrointestinal problems: This includes stomach cramps, diarrhea, bloating, and other gastrointestinal symptoms.
  • Chills: Chills and skin goosebumps are common symptoms of opioid withdrawal. You might feel a general coldness spreading through your body.
  • Nausea and vomiting: Opioids usually have an antiemetic effect (prevent you from vomiting), and once you stop, the nausea and vomiting might rebound suddenly.
  • Eye problems: Classic effects of opioid withdrawal are dilated pupils and blurry vision.
  • Tachycardia and hypertension: Anxiety and sleep deprivation can cause tachycardia or rapid heart rate. They can also raise your blood pressure, leading to hypertension.

Symptoms will usually improve within 72 hours, and you’ll feel much better. It might take about a week before you stop experiencing withdrawal symptoms altogether.

People rarely experience withdrawal symptoms after a week of detox, but you should contact your healthcare provider if this happens.

If you’re a pregnant mother going through an opioid detox program, your baby might experience some withdrawal symptoms after delivery, which is called neonatal abstinence syndrome.

Symptoms of neonatal abstinence syndrome include:

  • Gastrointestinal problems such as poor digestion
  • Vomiting and dehydration
  • Seizures
  • Refusal to feed or poor feeding

Preventing Opiate Withdrawal Symptoms

Preventing opioid withdrawal symptoms is only possible if you haven’t become addicted. When you first start taking opioids, gradual tapering is the most effective method to avoid withdrawal symptoms.

Your healthcare provider can help you taper off the drug over some time so your body slowly becomes accustomed to the absence of opioids.

This requires a carefully planned tapering schedule that considers how long you’ve been on opioids, their dosage, and any underlying medical conditions you might have.

Tapering is essential if you’ve been on opioids for at least two weeks. If it’s only been a few days, you likely won’t need an opioid tapering schedule, but you should still consult your healthcare provider before stopping your doses.

Opioid Detox Options

Once you’ve become addicted, opioid detox programs are the best way to manage withdrawal symptoms.

Detox programs are generally divided into inpatient and outpatient settings. Some programs incorporate a mixture of both, where you start with an inpatient setting and then follow up with an outpatient program.

Both types include supportive therapies such as counseling and group therapy sessions.

Outpatient Detox Setting

Outpatient detox settings are designed for patients who don’t require around-the-clock medical supervision.

You get all the medicine, counseling, and treatment you need in an outpatient detox setting without staying at a treatment facility or rehab center. You can stay home, go to work or school, and continue your day as you normally would.

However, you must visit the treatment center daily or as frequently as your treatment plan requires for medication, management, and support.

Pros

  • Flexibility: You can go about your daily obligations, such as school or work, which further helps you reintegrate into society for a normal, drug-free life.
  • Cost-effective: This option is typically less expensive because you don’t need to pay for room and board and require less medical supervision.
  • Community involvement: Allows patients to remain engaged with their friends and family during the treatment process, strengthening their ties and supporting their sobriety.

Cons

  • Lack of around-the-clock support: You might not have access to medical professionals 24/7 in case of emergencies or relapse.
  • Distractions: Since you don’t stay at the treatment facility, you might be exposed to familiar triggers and temptations, which could result in a relapse or delay your recovery.
  • Less intensive treatment: Outpatient detox programs generally offer fewer hours of therapy and support than inpatient programs, which may not be sufficient for patients with complex or severe addictions.

Inpatient Detox Setting

In an inpatient detox program, patients live in a treatment center for the entire detoxification process. This is usually reserved for patients with a risk of developing severe withdrawal symptoms.

A medical team monitors your vitals around the clock and follows therapeutic interventions if you exhibit discomfort.

Inpatient detox programs include medical support and emotional and mental therapies to help you address the psychological aspects of recovery.

Some programs don’t end when the detoxification process is complete. Instead, patients must stay at the rehab center for some time for counseling and supportive therapy.

These detox programs cover the dangers of substance abuse disorders and teach patients different coping mechanisms to prevent relapse.

Pros

  • Faster: Inpatient settings are typically faster because patients spend all their time undergoing treatment.
  • Safer environment: Being in a treatment facility 24/7 means you won’t have access to drugs or temptations, which makes you less likely to relapse during treatment.
  • Quick interventions: Medical teams can quickly intervene with medication if you experience severe withdrawal symptoms or unexpected complications during your withdrawal period.

Cons

  • More expensive: Inpatient settings are more costly since they require a room and 24/7 medical supervision.
  • Inconvenient: Not being able to leave the treatment facility means you can’t go to work, school, or home, putting your life on hold.
  • Dangers post-treatment: After being discharged from a safe and controlled environment with no temptations, you might not be ready to face the triggers of the real world.

Medications Used in Opioid Detox

Opioid detox plans use a combination of medicines to manage your opioid withdrawal symptoms comfortably. Here are a few commonly prescribed medications in outpatient and inpatient settings.

Clonidine

Clonidine is a medication that helps manage the restlessness, anxiety, and insomnia accompanying opioid withdrawal. It works by blocking impulses in the central nervous system and reducing stress hormones, which causes relaxation.

Clonidine is usually given orally briefly until your anxiety becomes manageable.

Methadone

Methadone is an opioid agonist, meaning it binds to the same opioid receptors as heroin and other opioid painkillers. However, methadone has a much slower onset and longer duration of action. It also doesn’t cause euphoria, unlike other addictive opioids.

This means methadone can provide the painkilling effect you need from opioids without the high risk of addiction.

In detox programs, methadone is usually given gradually in decreasing doses over days or weeks to minimize withdrawal symptoms.

Some programs follow up with maintenance treatment, where a small, steady dose of methadone is given daily for an extended period. This helps manage cravings and prevent relapse over time.

Suboxone

Suboxone is a drug commonly used in MAT (medication-assisted treatment) for opioid use disorder. It contains a combination of the following two drugs:

  • Naloxone: An opioid blocker that renders the opioids in your system ineffective but causes withdrawal symptoms.
  • Buprenorphine: A mild opioid that works similarly to methadone but has a much smaller chance of addiction.

By blocking opioid receptors, naloxone forces the body to eliminate the opioids in your system. Hence, detoxifying your body.

Buprenorphine is combined with naloxone to give a mild opioid-like effect so that the withdrawal symptoms of naloxone aren’t too severe.

Other Medications

Some less common medications can be used to manage specific symptoms, such as the following:

  • Metoclopramide: Can reduce nausea or vomiting in both outpatient and inpatient settings.
  • Non-opioid analgesics: Mild painkillers such as aspirin, ibuprofen, and paracetamol can help with muscle aches, headaches, and chronic pain. These provide pain relief without the risk of addiction or relapse.
  • Diazepam: An anti-anxiety medication that is typically used in inpatient settings
  • Loperamide: Can help with diarrhea and gastrointestinal withdrawal symptoms

Conclusion

Opioid detox can help you navigate the physical and emotional aspects of opioid withdrawal.

It’s no easy feat, but with the right detox program, you can eliminate opioids from your system and your life for good.

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