Opioid drugs are either partial modifications of these naturally occurring substances (semi-synthetic) or are completely artificial (fully synthetic) 1. Many opioids have legitimate, medical uses like alleviating various types of pain, managing cough, and treating diarrhea. Opioid medications are widely prescribed with about 207 million total prescriptions written in 2013, according to the National Institute on Drug Abuse (NIDA) 2.

Prescription opioids include 1:

These prescription medications all carry the risk of opioid addiction and dependence, especially when misused 1.The opioid class of substances also includes heroin, which is an illicit drug synthesized from morphine 1. The Drug Enforcement Administration (DEA) considers all opioids to be controlled substances. Heroin is Schedule I with no recognized medical purpose and many of the opioid painkillers are Schedule II, meaning they have medicinal uses but carry a high risk of abuse 10.

Opioid abuse is a worldwide problem with as many as 36 million people abusing these substances 2. In the U.S. alone 2:

All opioids can have a lasting negative impact when abused, but these substances also result in very distressing effects when the user quits. Opioid withdrawal symptoms can be erratic, yet quite severe as they impact numerous aspects of a person’s physical and mental health.

Opioid Withdrawal Symptoms

Though each person’s experience during opioid withdrawal will be quite different, many opioid detox symptoms are similar across substances and include 5,6,7:

If you worry that you or a loved one is at risk of opioid withdrawal symptoms, seeking detox treatment is a safe decision.

Detox Length

The individual differences will dictate many aspects of withdrawal and detox, including the timeline and intensity of symptoms, be they acute or protracted in nature. Detoxification (drug detox) is the term used to describe the process of the body clearing a drug from the system 6. The opioid detox timeline is influenced by many factors related to patterns of use and other individual characteristics including 6:

Withdrawal symptoms from short-acting opioids, like heroin, present 6 to 12 hours after last use and will last for 5-7 days overall 5. Long-acting opioids, like methadone, will have delayed withdrawal symptoms and longer total durations with symptoms arising between 2-4 days after the most recent dose and possibly lasting for 3 weeks 5,6,7.

Following any period of acute detox, some people in recovery from opioid dependence may experience delayed or extended withdrawal symptoms lasting 6 months as part of a phenomenon termed protracted withdrawal or post-acute withdrawal syndrome (PAWS) with symptoms like 8:

Again, the individual differences will dictate many aspects of withdrawal and detox, including the timeline and intensity of symptoms, be they acute or protracted in nature.

Effects of Opioid Detox

Although opioid withdrawal symptoms are not typically life-threatening, they can still produce significant medical and mental health complications, especially when left untreated 6,7. The effects of opioid withdrawal include 5,6,7:

Withdrawal Treatment Options

Attempting to detox alone can cause unnecessary pain and distress. Professional detox options specialize in managing withdrawal symptoms and cravings while improving comfort and safety 6,9. Different drug detox options are available at varying levels of need but are commonly separated into 6,9:

Man in inpatient treatment counseling

Medication may be used to mitigate unwanted withdrawal symptoms and alleviate opioid cravings. Medication-assisted treatment options for opioid withdrawal include 11:

As mentioned, opioid detox programs are short-term. They do not serve as a substitution for comprehensive substance abuse treatment. Following detox, it is important that an individual in recovery pursues opioid addiction treatment to promote increased success and longer periods of abstinence 9.

Sources

  1. National Institute on Drug Abuse for Teens. (2016). Prescription Pain Medications: Opioids.
  2. National Institute on Drug Abuse. (2014). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.
  3. Drug Enforcement Administration. (n.d.). Narcotics.
  4. Medscape. (2016). Withdrawal Syndromes.
  5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  6. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
  7. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Setting.
  8. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
  9. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.
  10. Drug Enforcement Administration (2006). Practitioner’s Manual: An Informational Outline of the Controlled Substances Act.
  11. National Institute on Drug Abuse. (2014). What are the treatments for heroin addiction?