Opiate Withdrawal


What is Opiate Withdrawal?

Oxytocin, vicodin, dilaudid, morphine sulphate, methadone are opiates that are prescribed to treat pain. Its illegal forms include drugs like heroine. The brain itself produces opioids that perform certain functions, but they are produced in limited amounts as per the basic requirement of the body. When opiates are consumed they attach themselves to the opioid receptors present in various parts of the body, such as the brain, gastro intestinal tract, spinal cord, etc.

It affects the body by lowering respiratory rate, causing relief from anxiety and depression, decreasing pain, etc. These effects are also produced by the opioids released by the brain; however, use of such drugs causes an excessive release that result in overdose and addiction. Once the brain gets used to the effects caused by this excessive release of opioids, it has a difficulty in coping with an absence of the drug, when a person decides to get rid of the addiction. The period of Opiate detox is termed as Opiate withdrawal.

Opiate Withdrawal

Opiate Withdrawal Symptoms

  • Restlessness
  • Anxiety
  • Muscle aches
  • Insomnia
  • Excessive sweating
  • Lacrimation (eyes tearing up)
  • Runny nose
  • Yawning very often
  • Abdominal cramping
  • Diarrhea
  • High blood pressure
  • Rapid heart beat
  • Goose bumps on skin
  • Dilated pupils
  • Nausea
  • Vomiting
  • Blurry vision

Assessment

  • Physical examination is made based on the symptoms that are experienced.
  • Urine and blood tests may be conducted to check the presence of opiates in the body.
  • Knowledge about patient’s medical history must be known to decide upon a correct treatment procedure.
  • A psychiatrist may be spoken to, in order to know any psychological reasons for the use of the drug.
  • Pattern of consumption related to the dosage and frequency of use must be known to the doctor.

Treatment

  • Opioid intoxication: These are supportive measures that assesses the patient’s condition and provides a support ventilation if needed. The process also involves assessment and support of the cardiac functions and providing IV fluids. The vital signs and cardiopulmonary status of the patients need to be frequently monitored until the system gets cleared. Doctors also recommend IV naloxone as it’s a specific opiate antagonist with no euphoriant properties. A regulated intake has the potential of reversing the respiratory depression as well as sedation caused due to the intoxication.
  • Opioid maintenance therapy: Pharmacologic therapy is one of the popular therapies that help in reducing the symptoms and cravings during the period of withdrawal. Other therapies that have been used for different forms of opioid substances include methadone maintenance therapy, buprenorphine maintenance therapy, etc.
  • Inpatient or Outpatient Therapy: Detoxification of opioids through both inpatient and outpatient therapy depends upon the presence of comorbid medical as well as psychiatric problems. It also considers the availability of social support and polydrug abuse to determine the method for detoxification.

Timeline for withdrawal

Time taken for detoxification varies according to the level of dependence. The timeline is usually spread over 30 hours after which the withdrawal symptoms begin to show. The withdrawal process can be divided into various stages according to the different symptoms that are experienced as well as the severity of the symptoms.

  • Early stages – This stage begins 30 hours after quitting the use of the drug. It may last for a period of time whose extent is dependent on the amount of drug that has been consumed.
  • Later stages – During these stages the intensity and severity of the withdrawal symptoms are higher. This stage 72 hours after quitting the use of the drug.

The worst part of the process is experienced during the first week of the withdrawal. However, withdrawal symptoms are expected to last for a period ranging from 1-3 months.

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