Methods for Succesful Opiate and Opioid Detox
Opiate and opioid detox can be challenging events for individuals seeking treatment options for recovery. Multiple substances fall under each category, respectively, all of which lead to severe withdrawal symptoms.
Opiates and opioids have different chemical makeups and act in different ways on the receptors in the brain. These characteristics have a significant role during the detox process, leading to different levels of severity.
Understanding opiate and opioid detox begin by first having a firm grasp on the differences and similarities between these two classes of drugs. The following section provides an overview of opiates and opioids to lay the educational foundation regarding the detox process.
An Overview of Opiates and Opioids
The primary difference between opiates and opioids is the fact that the former is the natural version while the latter is synthetic.
Opiates
Opiates are chemical compounds that are extracted and refined from natural plant matter. The specific plant from which these substances are derived is the poppy. Some of the most common forms of opiates include:
- Opium
- Morphine
- Codeine
- Heroin
Opioids were created to mimic the properties of opiates.
Opioids
Opioids are not derived from natural plant matter. Instead, these are made in a lab or synthesized in a controlled environment.
Certain opioids are only partially synthesized from the chemical components of opium. Some of the most well-known opioids are:
- Dextromethorphan
- Dextropropoxyphene
- Loperamide
- Hydrocodone
- Oxycodone
- Oxymorphone
- Meperidine
- Methadone
- Fentanyl
- Cartafentanyl
Both groups of these drugs are specifically referred to as narcotics. When an individual is dependent on either of these substances, they may find it possible to maintain their dependence by switching to an alternative opiate or opioid. The goal of this is to avoid the symptoms of withdrawal in an effort to continue living a normal life.
Individuals attempting to detox from opiates or opioids will find several challenges involved with withdrawal symptoms. One of the primary questions asked regarding this process is whether there is a need for detox for opioid dependence.
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Do I Need Detox for Opioid Dependence?
Any situation that involves prolonged, regular use of opiates or opioids requires a period of detox. This detox is the process in which all traces of either of these drugs are eliminated from the system.
The overall goal of a detox program is to make the symptoms more manageable, leading to a successful recovery. Certain measures are taken to provide relief for opiate and opioid withdrawal symptoms.
Opiate and Opioid Withdrawal Symptoms
The symptoms associated with detox are known as withdrawal. Withdrawal symptoms present several physical and mental challenges that can make successfully detoxing quite difficult. Symptoms of withdrawal include:
- Agitation
- Anxiety
- Muscle spasms
- Insomnia
- Runny nose
- Sweating
- Abdominal cramps
- Diarrhea
- Nausea
- Tremors
- Sudden changes in blood pressure
Medical detox is often recommended to promote a safe withdrawal period. The availability of medical professionals may reduce the risk of challenges associated with withdrawal.
Medical Detox for Safe Withdrawal
Medical detox for safe withdrawal is one of the most efficient courses of action when it comes to detox. Choosing to participate in a medical detox program includes the following benefits:
- The constant availability of medical professionals
- Monitoring of vital signs to avoid health challenges
- Access to certain medications to relieve the symptoms of withdrawal
The primary goal of medical detox is safely navigating the timeline of opiate and opioid withdrawal. In the following section, an example timeline of opioid withdrawal is highlighted.
Potential Timeline of Opioid Withdrawal
The following section outlines the most prevalent stages of opioid withdrawal.
Anticipatory
The anticipatory stage of withdrawal includes anxiety or fear related to the anticipation of the onset of symptoms. Cravings and drug-seeking behavior are also common symptoms present during this stage. This stage normally begins three to four hours after the last dose.
Early Acute
During this period, feelings of anxiety and restlessness will increase as time continues. Flu-like symptoms will also begin, including nausea, sweating, and stomach cramps. Intense cravings will continue during this period. Early acute symptoms begin sometime around 10 hours after the last dose.
Fully-Developed Acute
This period includes the most intense symptoms as withdrawal hits its peak. The most prevalent symptoms include body tremors, spasms, diarrhea, insomnia, and high levels of blood pressure. Cravings may be the most intense during this period. The window for the onset of this stage is normally one to three days after the last use.
PAWS or Post Acute Symptoms of Withdrawal
Post-acute withdrawal symptoms will persist for up to 24 months after an individual’s last dose. During the post-acute withdrawal period, the most common symptoms are mood swings, cravings, drug dreams, anxiety, and insomnia. Individuals are especially vulnerable to relapse during this period and should be aware of possible triggers.
Medication-assisted treatment programs may be the best course of action after the withdrawal period and throughout the post-acute withdrawal stage. These programs can decrease cravings and prevent possible relapse.
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Medication-Assisted Treatment Programs
Medication-assisted treatment programs are potential options after detox or to possibly avoid detox entirely. There are several options included in the category of medication-assisted treatment programs.
Suboxone and Subutex
Using the appropriate methods of tapering, Suboxone and Subutex may be efficient options for treatment. Individuals are prescribed one of these medications to prevent the withdrawal symptoms associated with fentanyl detox or other forms of opioid detox.
These medications act on the opiate receptors in the brain, allowing for the prevention of withdrawal symptoms. When used in the short term, these medications can wean an individual off of opiates. A long-term prescription is available to keep cravings under control.
When a short-term taper is administered, individuals will begin with moderate doses of Suboxone or Subutex. These substances are slowly introduced to the body to prevent precipitated withdrawal, which is the sudden onset of severe withdrawal symptoms.
The dose is increased until a peak is hit and will be maintained for a short time. Afterward, the dose is slowly decreased until the individual is able to cease using the medication altogether. The average taper normally occurs over a six to twelve-week period.
Sublocade
Sublocade is a form of buprenorphine (Subutex) that’s administered for maintenance. Instead of a daily dose, however, Sublocade is taken once per month in the form of an injection. Sublocade is typically prescribed for individuals who have already started a regimen of oral Suboxone or Subutex. Sublocade is designed for gradual release, staying in your system for much longer than Suboxone sublingual medications.
Vivitrol Shot
The Vivitrol shot is a monthly injection that individuals receive after detox is complete. Abstinence must be achieved for a period of around ten days to avoid precipitated withdrawal.
While Vivitrol isn’t used for short-term treatment of withdrawal symptoms, it is effective at combatting post-acute withdrawal. This medication will interact with receptors in the brain to decrease cravings and other negative effects during this phase of recovery.
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Methadone
Methadone is another common medication prescribed for the treatment of opiate dependence. This medication is administered daily to prevent cravings and avoid withdrawal symptoms.
The goal of methadone treatment is an eventual taper similar to that of Suboxone or Subutex. However, methadone treatment is drawn out much longer, often over six months to a year.
It’s important to note that there is a risk of overdose from fentanyl or other opioids even with medical treatment and maintenance programs. Although the risk isn’t as high as when an individual abuses opiates and opioids for intoxication, education is still key regarding these risks.
The availability of Narcan is important for combatting the risk of death associated with overdose. At all doctor’s offices and clinics that provide doses of any of these medications, especially methadone, Suboxone, and Subutex, Narcan is available at all times.
Additionally, patients may also be sent home with Narcan in the event of an adverse reaction to the medication. Narcan is a medicine that knocks all opiates and opioids off the receptors in the brain to reverse the symptoms of an overdose immediately.
Regardless of the form of medically assisted treatment, one of the most important elements of recovery is identifying underlying causes. This is accomplished through dual-diagnosis treatment during inpatient or outpatient rehab.
Dual Diagnosis and the Underlying Causes of Drug Use
Dual diagnosis treatment is the process in which underlying causes of drug use are identified and treated. Together, clients and mental health professionals (psychologists and psychiatrists) will coordinate to uncover the real issues at the center of substance abuse disorder.
Normally, this is accomplished through talk therapy and other methods of counseling. Dual diagnosis is becoming more prevalent in mental health circles and drug treatment programs. Mental health and opiate use seem to go hand-in-hand, especially as more research is conducted on this issue.
Mental Health and Opiate Use
Research and patient study have shown a clear connection between mental health and opiate use. This connection seems to give more credibility to the theory that for many clients a dual diagnosis treatment of some kind is needed during rehab.
Some of the most common mental health issues associated with opiate abuse are:
- Depression
- Bipolar disorder
- Anxiety/panic disorder
- Social anxiety
Many individuals that struggle with opiate abuse begin their misuse of these substances to mask the side effects of these mental health challenges. This is often done automatically, with many patients not even being aware this is taking place.
This is why education and treatment are vital pieces of the foundations for recovery following detox. What else is required for long-term recovery from opiates and opioids?
Foundations for Recovery Following Detox
There are several important elements regarding long-term recovery from opiates and opioids. After detox, the physical withdrawals may be over. However, this is only a small portion of the battle. Individuals must seek the most efficient avenues to become better educated regarding the true reason for their abuse.
This education is obtained through inpatient rehab or outpatient rehab programs. In these programs, clients will have a chance to work closely with multiple mental health professionals regarding a number of issues.
Not only do one-on-one counseling sessions provide valuable insight and treatment for dual diagnosis and co-occurring disorders, but information regarding triggers and relapse is also available. Clients are prepared to re-enter society through different forms of education and preparation.
Certain behavioral therapies teach clients how to deal with cravings or triggers involved in everyday life. Once individuals have completed treatment, the chances are much higher to maintain a normal life and achieve long-term recovery.
However, there is one final element in the battle to stay sober. Continued treatment and aftercare services are the last pieces of the puzzle for recovery.
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Aftercare Services and Continued Treatment
The completion of inpatient or outpatient rehab is a huge step, and clients should be recognized for following through with this commitment. However, it’s important to note that the battle with addiction is a lifetime ordeal.
Individuals must remain proactive in conquering their disorders, or they run the risk of relapse by letting their guard down. It takes a constant search for education and more information regarding substance abuse disorders and the underlying mental issues that accompany these disorders.
Continued treatment comes in the form of continued attendance to mental health counseling sessions. This ensures that individuals continue to receive the proper care to manage mental health challenges as time continues.
Additionally, peer counseling sessions are effective at allowing individuals to engage with others going through the same ordeal. These individuals may provide each other with insight and examples of trials and tribulations that shaped their experiences.
Many times firsthand knowledge from peers can be a great source of motivation and inspiration. Understanding that you’re not alone in a battle can provide the courage some individuals need to continue being successful in recovery.
The battle to remain sober isn’t an easy one. However, the rewards of conquering this battle are well worth any pain experienced during recovery.
Individuals that don’t take the time to properly address their substance abuse disorders stand to lose all of the important elements in their lives. This includes family, friends, careers, and other important dynamics.
Let the staff at Icarus Behavioral Health help you navigate your recovery. We have years of experience and have helped countless individuals conquer substance abuse and return to a normal life. One of our admissions specialists is waiting to hear from you and is ready to answer any questions you may have regarding our programs.