More than 1.6 million U.S. adults abuse opioids, according to data from the National Survey on Drug Use and Health. This category of drugs includes prescription painkillers such as morphine, hydromorphone (Dilaudid), hydrocodone (Vicodin) and oxycodone (OxyContin), as well as heroin and methadone. Many people don’t realize they’ve developed an addiction until they begin experiencing opioid withdrawal symptoms when they stop using the drug. If you or a loved one struggles with opioid use disorder, understanding the symptoms of withdrawal can help you prepare for the detox and recovery process.
Categories of Opiate Withdrawal
Doctors use the Clinical Opiate Withdrawal Scale to determine whether you’re experiencing mild, moderate, moderate-severe or severe signs and symptoms of withdrawal. The extent of your withdrawal symptoms depends on your history of opioid use disorder, your medical history, your overall health and other factors. The severity of withdrawal affects how your health care team will manage symptoms.
The type of opioid medications or illegal drug use also affects the length of opiate withdrawal. Not all drugs within this class have the same effect on the body.
Timeline of Opioid Withdrawal Symptoms
Early Withdrawal Symptoms
The early symptoms of opiate withdrawal start within 24 hours after you discontinue the use of most opioids. You’ll notice physical symptoms such as:
- Uncontrollable yawning, exhaustion or fatigue
- Inability to fall asleep, insomnia
- Sweating
- Runny nose
- Watery eyes
- Muscle aches
Many people describe early withdrawal symptoms as similar to moderately severe flu. Opiate withdrawal also causes emotional and mental health indicators. You may experience anxiety and restlessness.
Later Withdrawal Symptoms
Withdrawal symptoms tend to worsen after the first 24 hours. During this stage of withdrawal from opioids, physical symptoms include:
- High blood pressure
- Elevated heart rate and pulse
- Blurred vision
- Dilated pupils
- Nausea
- Vomiting
- Goosebumps
- Stomach cramps
- Diarrhea
Most people find that the worst of the vomiting, nausea and other painful symptoms ends in about 3 days. Usually, those who are physically dependent on opioid medication report that they feel better after about a week of withdrawal.
Causes of Opiate Withdrawal
You’ll experience withdrawal symptoms if you take opioid medications or use heroin for an extended period of time. This occurs because the body makes natural opiates that interact with opioid receptors in the nervous system. The body stops producing opioids with extended substance abuse, which prevents the brain from functioning correctly without the drug.
Over time, you need more of the substance for pain relief and other desired effects. You have an increased risk for overdose whether you become addicted to prescription opioids or illegal drugs such as heroin. If you stop taking the drug, you’ll experience specific symptoms during the withdrawal process.
Signs of Opioid Overdose
The Centers for Disease Control and Prevention reports that more than 100,000 Americans died from prescription drug overdose from April 2020 to April 2021, more than a 28% increase over the fatality rate for the previous year. If you or family members struggle with opioid addiction, you should know these symptoms of a life-threatening accidental overdose:
- Slowed or stopped heartbeat or breathing
- Inability to talk
- Inability to be awakened
- Gurgling or vomiting sounds
- Blue or purple-tinged lips or fingernails
- Muscle limpness
- Clammy and pale skin
Call 911 right away if someone shows any of these symptoms of opioid medication overdose. While waiting for help to arrive, you should also perform CPR and administer naloxone if available.
Risk Factors for Opioid Overdose
Some people have a higher risk of overdose when they use opioids. You should be especially aware of the signs in individuals who have a history of substance abuse, respiratory conditions such as lung disease and mental health disorders. Young adults aged 18 to 25 and seniors aged 65 and older are also more likely to overdose on prescription opioids.
It’s dangerous to mix opiates with other medications. If your doctor recommends prescribing opioids for severe pain, make sure to tell them if you also use street drugs, alcohol, antipsychotic drugs such as risperidone, muscle relaxants, sedatives or benzodiazepines.
Common Co-Occurring Physical and Mental Health Disorders
According to the U.S. Department of Health and Human Services, about 25% of people who have a serious mental health disorder also abuse drugs or alcohol. The most common co-occurring mental health conditions with substance abuse disorder include:
- Personality disorders
- Schizophrenia
- Anxiety disorders
- Attention deficit hyperactivity disorder
- Post-traumatic stress disorder
- Conduct disorder
- Major depressive disorder
- Bipolar disorder
- Schizophrenia
These disorders share causes and characteristics with substance abuse, including childhood stress and trauma, genetic makeup and brain composition changes. The DHHS also notes that many people who have mental health disorders try to control the symptoms by using drugs such as opioids. Drugs can also bring about mental health symptoms. Because of these complex factors, co-occurring dual diagnoses require a team approach with professional substance abuse counselors and mental health care providers.
Drug abuse can also lead to physical health problems. The National Institute on Drug Abuse reports that people who abuse drugs have a higher risk of infectious diseases such as hepatitis C and HIV. They’re also more likely to struggle with chronic pain. If you develop a chronic illness, it can be difficult to follow your doctor’s recommended treatment if you’re also struggling with untreated addiction.
Finally, people who misuse substances are more likely to smoke or use tobacco. This increases the risk for cancer, heart disease, high blood pressure and other cardiac issues.
Risk Factors for Opioid and Drug Abuse
You may be at risk for opioid addiction if you’ve been taking opioids for more than a few weeks. Many people develop physical dependence and substance use disorder after they receive opioid analgesics from their doctor following a surgical procedure or a serious injury that causes severe pain.
While anyone who takes opioids can develop physical dependence and addiction, it’s much more common among some groups. According to the Mayo Clinic, those at higher risk for opiate addiction include people who:
- Have abused drugs and alcohol before
- Live in stressful circumstances, such as unemployment, poverty and danger
- Have a history of anxiety or depression
- Use tobacco
- Take part in other risky behaviors
- Commonly experience problems with jobs and in relationships
- Spend time with people who abuse substances
- Have a family history of drug and alcohol use
- Were younger than 25 when they began using drugs
Treatment for Opiate Withdrawal
When you seek medical help for opioid use, the health care team will confirm a diagnosis of opioid use disorder with urine and blood tests. They’ll also do a physical exam and take a full medical history, including questions about your history of key substance use as well as the use of other substances.
Based on this information, the health care provider may recommend medication or other methods of treating symptoms of withdrawal. Over-the-counter pain relief medications like acetaminophen can help with mild symptoms. You should also get plenty of rest and drink lots of water and other fluids.
Your health care provider may also recommend over-the-counter or prescription medications to help with diarrhea and nausea. Very severe withdrawal may require hospitalization and treatment with medications such as clonidine. The AMA Journal of Ethics reports that clonidine can reduce withdrawal signs by up to 75%, particularly aching and cramping, runny nose, watery eyes, sweating, restlessness and anxiety.
Preventing Opioid Withdrawal and Overdose
You can take steps to avoid becoming dependent on opioid medications if your doctor prescribes you these drugs. The Substance Abuse and Mental Health Services Administration recommends the following:
- Only take your own prescription medication. Never take opioid medication or other drugs prescribed to someone else.
- Stop taking opioids as soon as your pain begins to resolve. Switch to over-the-counter pain medications like aspirin or NSAIDs.
- Follow your health care provider’s instructions carefully when taking oxycodone, methadone or other opioids you’ve been prescribed.
- Don’t take other illegal drugs, sleeping medications or alcohol while taking prescribed opioids.
- Don’t take a larger dose or take the drug more often than prescribed by your health care professional.
- Keep naloxone on hand in your home or vehicle and learn how to use it if an overdose occurs.
- Seek options other than opiates if you have chronic pain, like relaxation techniques and physical therapy.
- Safely dispose of your prescription drugs when you no longer need to take the medication.
- Talk openly to your family members about the dangers of drug dependence and addiction.
If you or a loved one needs help with addiction to opioids or other drugs, contact Anchor Addiction and Wellness Center today to learn more about our comprehensive treatment programs.