Withdrawal from opiates can be a terribly uncomfortable experience, and although it is not life threatening, it can be one of the most unpleasant experiences one will ever have to go through!

There is a very wide variation when it comes to the intensity and duration of opiate addiction. Some have been on opiates for years and some only for weeks or months. Some of you may take 25 pills a day and some may just take 5 a day. But you must consider that everyone will react differently to the withdrawal process.

Many factors must be taken into consideration including medical history, current medical conditions, and medications when making a determination of the appropriate treatment path.

NBRC takes every measure possible to help patients though the withdrawal stage with as little discomfort as possible.  Through the use of various medications, vitamins and supplements, this process is much easier than ever before. 

What Is Opiate Withdrawal?

Opiates stimulate the reward/pleasure centers of our brains and release a neurotransmitter called Dopamine, which can create analgesia (pain relief) and feelings of euphoria or a sense of “well-being.” Most drugs either stimulates dopamine release or enhances its activity, directly or indirectly.

When opiates are taken for an extended period of time (10 days or longer), the brain begins to build tolerance to the drug and subsequently alters the pleasure pathways which become more accustomed to higher levels of dopamine. I other words, your brain becomes accustomed to being stimulated by the opiates and steadily needs more drugs for you to feel that “sense of well-being.”

When you take away the substance that produces these euphoric feelings, your brain begins to rebel and that rebellion is the beginning of the withdrawal process.

The brain experiences a complicated series of

events in the withdrawal process.

Types of Withdrawal

Acute Withdrawal Symptoms occur upon the sudden stopping of taking opiates - or tapering the dosage too fast.

Post–acute withdrawal syndrome (PAWS) is a set of persistent impairments that occur after opiate Acute Withdrawal Symptoms have subsided.

Factors that contribute to the intensity and duration of opiate withdrawals:

1: Type of drug: The brand and strength of the particular drug that you were addicted to.  Some opiate drugs are stronger than others.

2: Duration: The amount of time that you were taking the drug.

3: How much you have taken : The amount of the particular drug that you were taking most consistently. Some people may take whatever comes their way. Some have been prescribed the same amount and have never abused the drug, but nonetheless have become dependent.

4: Tolerance: The extent to which your body and brain become accustomed to opiates and developed the ability to process higher doses of the drug. More and more must be taken as time goes by to get the same effect. It’s similar to alcohol tolerance but much more profound and shorter acting. i.e. It takes years and years for an alcoholic to develop higher tolerances for booze…it only takes weeks for an opiate addict to develop tolerance for a certain amount of the drug.

5: Half-Life: The amount of time it takes for 50% of a particular type of opiate to leave your body (From 12 hours in some cases to 3 days or longer in other cases). In other words, some drugs (like methadone and time release drugs such as Oxycontin) stay in your system longer.

Common Physical Symptoms of Opiate Withdrawal

Pupil Dilation (Large pupils): When in withdrawal, the pupils get pretty large and as a result, the eyes can become a bit more sensitive to sunlight.

Tremors (Hands and feet): The tremors are mostly in your hands but can also be evident in other parts of the body.

Watery Eyes and Nose (not related to allergies): No itchiness, just tears running down your cheeks.

Excessive Sweating: The sweating can be in sudden bursts or over an extended period of time and can include the hands and feet.

Goose-Flesh (goose bumps): Goose bumps are the by-product of the shivering that happens during withdrawals. Although not terribly uncomfortable, they are prevalent throughout the withdrawal process.

Lack of Appetite: A lack of appetite is common during the withdrawal process. The body needs fuel to fight this withdrawal process so a conscious effort must be made to keep well hydrated and well nourished.

Bone and Joint Aches: The knees, shoulders, and hips may hurt along with other joints; especially in the extremities.

Sudden Muscle “Jerks”: The sudden muscle jerks can be somewhat alarming to a lot of people but they are nothing to worry about. They are all part of the withdrawal process and will dissipate, then go away altogether. These muscle jerks are sudden and random and can happen anywhere in your body.

Muscle Aches: These are a part of the flu-like syndrome but muscles can ache as if one had a really hard workout.

Back Pain: Usually lower back pain but sometimes it can also be in the thoracic region (middle back).  Almost all patients complain of low back pain.

Shivering: Throughout the withdrawal process, one will be shivering and cold, or hot and sweaty. It will become a constant battle to keep comfortable and will be one of the more consistent issues during your withdrawal process.

Hot Flashes: Hot flashes happen when the body feels as though a wave of warmth has overtaken you and may begin to sweat.

Restlessness (Restless Leg Syndrome): One of the most frustrating symptoms. You feel as though your “bones itch” and have the urge to constantly move your legs and sometimes your whole body. This is especially acute at night when you're trying to go to sleep.

Flu-like Symptoms: This can be a combination of symptoms but flu-like symptoms feel as though your body is fighting something off…and losing.

Upset Stomach (Diarrhea, cramping, and nausea): This is also a very common symptom and one that can be a primary source of discomfort and inability to function. Most people going through withdrawals will have nausea, vomiting, diarrhea or all three: Thus, it is important to stay hydrated.

Lethargy or Low energy: This can be troublesome. You may not have ANY energy. You’ll feel as though is difficult to just get going.  Even going to the bathroom is a chore both physically and psychologically.

Depression: Perhaps the most insidious and cruel part of withdrawal is depression. Depression is very common for most people in withdrawal and it can be quite acute. The depression that most people feel is centered around the guilt and shame of their predicament. Many people have feelings of worthlessness and dread as well as feelings that their situation will never get better.