Medical Detox to Treat Opioid Addiction

Although there is no definitive path for receiving treatment of an addictive disorder, the recovery process is most effective when patients are actively abstaining from continued substance misuse. Achieving this initial sobriety to begin treating the underlying addictive and mental health disorders feeding into substance misuse often requires help. Many find themselves experiencing serious withdrawal symptoms as they have become physically addicted to the illicit substances they have been misusing.

Because of the potential severity of withdrawal symptoms that occur from drugs or alcohol, we recommend that all patients receive some form of medically assisted detox before entering any inpatient or outpatient services. For the majority of patients, that means being under the care of trained professionals who can monitor vitals and assist patients as they wean themselves off of an illicit substance safely. In the case of opioid-based addictions, the physical dependence the body develops on opioids can increase the severity of withdrawal symptoms, which may warrant the use of prescription drugs to assist in the detox process. Patients should remember that these prescription drugs used to assist in opioid detoxification are not a cure-all for withdrawal symptoms. The choice to utilize them is entirely up to each patient and the decision should be made after careful consideration with guidance from a medical professional. The majority of these prescription detox drugs are lesser versions of the opioids patients were previously using, and patients eventually need to ween themselves off of them, as well. However, depending on the severity of a patient’s physical dependence, these detox medications can safely ease the pain and severity of initial withdrawal symptoms.

Before we go into the types of medically assisted detox medications, we will provide a quick overview of which drugs in the opioid family can cause an increased physical dependence as well as detail the types of symptoms and a selective, estimated timeframe for withdrawal symptoms to opioid addiction.

Withdrawal Symptoms and Timeframes

Opioids are drugs such as heroin, opium, morphine, codeine, and methadone. Withdrawal from any of these opioids can be very uncomfortable and difficult for patients. The severity of withdrawal symptoms will be different for every patient; however, some of the most common symptoms include:

• Nausea and vomiting
• High blood pressure
• Diarrhea
• Headache
• Chills
• Insomnia
• Anxiety
• Increased body temperatures
• Racing heartbeat
• Muscle and bone soreness
• Sweating

Depending on several factors, opioid withdrawal symptoms can last anywhere from a week to over a month. For heroin and the shorter-acting variety of opioids, withdrawal symptoms are more immediate from the time of last use and will typically peak within 1-3 days persisting for a little over a week at 6-8 days. The shorter-acting opioids which include morphine as well as immediate-release versions of oxycodone, hydrocodone, and fentanyl will result in the onset of withdrawal symptoms around 8-24 hours after the last use with symptoms that can continue for up to 10 days. The longer-acting opioids, such as methadone and extended-release versions of morphine, oxycodone, hydrocodone, and fentanyl, will result in withdrawal symptoms appearing around the 36-hour mark after last use. These symptoms can last the longest with the potential to continue 14 days to a month.

Medical Detox: Prescription Strength Edition

The length of time for opioid withdrawal varies between patients. Some of the factors that contribute to more severe withdrawal symptoms include the type of opioid used as well as the frequency of use. However, just as each addiction is unique to the individual, so is withdrawal. Most patients withdrawing from some form of opioid experience a level of discomfort, and depending on the severity, there are ways to help medically manage those symptoms of withdrawal as patients go through detoxification.

We recommend patients undergo some form of medically assisted detox because the severity of each patient’s reaction to withdrawing from opioids is unknown. With the help of trained professionals, patients can work through the detox process safely and comfortably, Below we have listed the top prescriptions utilized for opioid withdrawal and detoxification.

• Methadone: Methadone is an oral, long-acting prescription-based narcotic alternative for opioid detox that reduces symptoms for a smoother and safer withdrawal. After the initial dose manages a patient’s symptoms, the dosage is gradually reduced, either by decreasing the methadone by 5 mg/day or until zero dosage is reached. This process, when done as an inpatient service, can usually be accomplished in five to seven days with an overall success of around 80%. Outpatient detoxification generally takes longer, as minimizing withdrawal symptoms is drawn out throughout visits, resulting in only about 20% completing treatment.
• Buprenorphine: Buprenorphine is a long-acting, safe, and effective opioid medication used to reduce the severity of opioid withdrawal symptoms. This medication should be given 12-36 hours after the last use of an opioid drug. If administered in the proper time frame, Buprenorphine relieves most symptoms while helping patients to keep the more severe withdrawal signs and cravings at bay.
• Clonidine: Clonidine is a sedative used in opioid withdrawal in both inpatient and outpatient settings for over 25 years. It has proven successful at relieving many of the nervous system’s involuntary reactions to opioid withdrawal. However, it has been less successful in treating residual symptoms such as insomnia, lethargy, muscle aches, and restlessness. When compared to either methadone or buprenorphine, clonidine has more side effects—hypotension being the most common—but clonidine is more effective long-term in reducing chances of a post-withdrawal relapse.
• Ancillary Medications: A variety of additional medications can be used to treat withdrawal-related symptoms for insomnia or pain, which include clonazepam, trazodone, and zolpidem. Each of these drugs can be given in combination with the three primary withdrawal medications listed above. The main function would be to increase patients’ comfort levels and improve the chances of successful detox. Vitamin and mineral supplements are also often given to patients while in detox.

Medically assisted detox for opioid addiction can greatly alleviate symptoms of withdrawal and help patients control cravings. Patients should remember that detoxification from opioids with the assistance of any prescribed medication will only be the first step on their path to long-term recovery. Medication alone is not the cure.

Withdrawal symptoms from substance misuse of opioids can range in severity and last anywhere from a few days to months. Thankfully, there are a variety of medications that can help ease the pain of these symptoms thus improving a patient’s chances of successfully detoxing. If you or someone you love needs treatment for an addictive disorder from opioids, then Choice House has addiction recovery treatment programs that can help. After patients have completed their detox program, we offer men a variety of treatment methods to build a lasting sober foundation based on love and empathy. Located in the Boulder County area of Colorado, our treatment services include a 90-day inpatient program, an intensive outpatient service, and the chance to take up residency at our sober living campus. Our focus is on the dual-diagnosis treatment of addictive disorders, and we utilize a variety of therapeutic modalities to help patients better cope with both the mental and physical components that have previously fueled substance misuse from an addictive disorder. For more information regarding Choice Hosue facilities and addiction recovery treatment services, please give us a call at (720) 577-4422.