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Opioid Detox: What to Expect From Opioid Detoxification

Dr. Jeffrey Berman, MD By April 23, 2019
opioid detox

Opioids wreak havoc on your central nervous system. Over time, your body adjusts and requires more and more of the drug to function. If you cut down your dose or cut it out completely, you’ll begin going through opioid withdrawal in as few as 12 hours.

Opioid detox is inevitable whether you have been using for months or years. The first stage of withdrawal lasts for weeks, but the second stage can last for months or even years.

Are you considering an oxycodone or fentanyl detox and want to know what to expect? We put together a guide to the symptoms of withdrawal, how to get through it, and when to seek help.

Signs You Are Going Through Opioid Withdrawal

You might go through opioid withdrawal in an opioid detox center, or whenever you stop or cut back on your usage on your own.

The early signs of withdrawal are unpleasant and mostly physical. You might experience muscle aches, sweating, insomnia, and a running nose. However, there are also psychological symptoms: anxiety and agitation are common, and you’ll begin to feel the need to get a fix.

When withdrawal begins in earnest, it hits you like a truck. Symptoms of late-stage opioid withdrawal include:

  • Abdominal cramps
  • Diarrhea
  • Nausea
  • Vomiting
  • Goosebumps
  • Dilated pupils

These often cause great discomfort, but they are inevitable.

When Do the Symptoms Begin?

Symptoms usually begin 12 hours after your hit of heroin or around 30 hours after you last took methadone.

Can Withdrawal Kill Me?

Withdrawal is horrible – there’s no doubt. However, withdrawal symptoms themselves aren’t life-threatening in almost all cases.

There are two things that you must look out for because they can be lethal. If you experience continued vomiting and/or diarrhea, you can become dehydrated and experience hypernatraemia (high blood sodium levels). These can lead to heart failure.

If you or someone you love is going through withdrawal and losing fluids this way, then you should seek medical attention from a hospital.

Trying to quit opioids on your own is the most challenging way of stopping even if you do manage your symptoms. And if you do choose to do so at home, you need to work slowly and ensure you have a solid support system behind you.

The Two Stages of Opioid Withdrawal

You may spend a week to a month completing the full withdrawal from opioids.

The first phase is known as acute withdrawal. These are the symptoms you experience in the first 12-30 hours after your last use from a runny nose and muscle aches to the more serious abdominal cramping and digestive issues.

The symptoms begin to peak after three to five days, and you could experience some of them for as long as a full month (four weeks).

As your symptoms abate, you move into the second phase of opioid withdrawal: post-acute withdrawal. You’ll find the signs here are more psychological and emotional: anxiety, mood swings, low energy, sleep issues, little enthusiasm, and trouble concentrating.

The emotional symptoms are less severe than the physical symptoms at their peak stage. However, they do last longer and may require management.

Withdrawal: At Home or in an Opioid Detox Program?

Are you ready to quit opioids? Unfortunately, withdrawal is inevitable, but you can choose where you go through it.

You have two options for opioid detox: detoxing at home or going to an opioid detox facility.

Detoxing at Home

It’s not impossible to detox at home, but it is also incredibly unpleasant.

You need a strong support system and a stable, healthy home environment to successfully withdraw at home. There should be no access to opioids available to you – at all. And you’ll need careful supervision to help identify any psychological symptoms like depression and anxiety.

Staying at home has its merits: you can be near friends and family and sleep in your own bed.

However, if you don’t have a dedicated care system in place, it is not a good idea.

Overall, home detoxes are more likely to result in relapses – and relapse after withdrawal can be deadly. Additionally, you need to make sure you can get to a hospital in case you begin experiencing dehydration as a result of vomiting and diarrhea.

Detoxing in a Center

Support is an integral part of finding success when you are going through an opioid detox. That’s why detox centers play such a crucial role during the process.

Detox centers can provide professional support in two ways. First, they can provide a medically assisted detox that eases the symptoms of withdrawal and prevents you from turning back to drugs to stave off the adverse side effects. Drugs like suboxone can help patients safely withdraw from serious addictions to heroin or Oxycontin by shortening the length and severity of the symptoms.

By using medical withdrawals, you’ll reduce the risk of relapse an avoid intravenous use and receive medical supervision during the process. However, suboxone is still a partial opioid, so you’ll still need to withdraw from the maintenance doses at some point.

Second, they provide support that keeps you from experiencing one of the darkest parts of withdrawal: depression and suicide ideation.

Suicidal ideation is a dangerously overlooked symptom of withdrawal. Not everyone will experience it, but anxiety, agitation, and depression are all common. Detox centers can provide counseling and regular support to remind patients that the dark days will be over and to protect patients from both self-harm and relapse during the most difficult parts of withdrawal.

These supports are so crucial because suicidal ideation can become suicidal behavior. Additionally, a relapse is dangerous because overdoses are common when a patient is going through withdrawal. What was once a usual dose can become too much for the body, which is extra sensitive after withdrawal.

You Don’t Have to Go Through Opioid Detox Alone

Opioid detox is one of the hardest things you’ll ever do. But it is possible, and you’ll have a far greater chance of success of succeeding.

Using an addiction rehab center means you’ll have both the emotional and medical support you need to detox safely. Ready to learn more? Click here to learn what drug rehab is really like.

Article Reviewed by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.

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