Opioid And Opiate Withdrawal – Symptoms, Causes, And Treatment

2024 Autor: Cecilia Ryder | [email protected]. Última modificación: 2023-12-17 14:20

Did you know that more than 130 people in the United States die every day after overdosing on opioids (1)? Opiates or opioids are mind-altering natural compounds derived from the resin of the poppy plant. Does the term ‘heroin” sound familiar? Well, it is also an opioid.

Opioids were prescription drugs used for pain management. But people started abusing these drugs over time due to the ‘high’ they gave. Once the body becomes addicted to it, withdrawal from the drug is challenging. What happens when your body stops receiving such opioids after a period of abuse? How bad are the Opiate withdrawal symptoms, and how can you manage them? Find answers to all these and more right here. Read on.

Table Of Contents

• What Is Opioid Withdrawal?
• Types Of Opioids
• Signs And Symptoms
• What Causes Opioid Withdrawal?
• Risk Factors
• How Is Opioid Withdrawal Diagnosed?
• What Are The Treatments Available For Opioid Withdrawal?
• Alternative Treatments
• Opiate Vs. Opioid

What Is Opioid Withdrawal?

Opioids and opiates are drugs that are used for the treatment of pain. The term ‘narcotic’ is also often used to describe these types of drugs. Heavy use of such drugs for a few weeks or more continuously might lead to withdrawal symptoms when you stop using them. This is referred to as opioid and/or opiate withdrawal (2).

These drugs usually work by mimicking endorphins, which are chemicals in the brain that act as natural pain relievers. Opioids are usually derived from the resin of the poppy plant. These drugs can also be prepared in a laboratory. They function by binding to the specific opioid receptors in the central/peripheral nervous system and the gastrointestinal tract.

There are illegal opioids (such as heroin) as well as legal opioids that are prescribed for relieving pain (like hydrocodone). In fact, those who become addicted to prescription opioids often end up using heroin as it is cheaper.

Opioids are classified into three types.

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Types Of Opioids

• Natural Opiates – These are alkaloids that are nitrogen-containing base chemical compounds, which occur naturally in plants like the opium poppy. Drugs like Morphine, Codeine, and Thebaine are natural opiates.
• Semi-Synthetic Or Man-Made Opioids – They are made in the laboratory from natural opiates. Such opioids include Hydromorphone, Hydrocodone, and Oxycodone. Heroin is also a semi-synthetic opioid made from morphine.
• Fully Synthetic Or Man-Made Opioids – These are completely man-made and created from scratch. Synthetic opioids include Fentanyl, Pethidine, Levorphanol, Methadone, Tramadol, and Dextropropoxyphene.

Doctors often prescribe opioids like Morphine, Codeine, and Oxycodone to treat pain and provide relief. However, some individuals end up using these drugs as they are known to produce a “high” or feeling of euphoria. This has also led to overdose death.

The following are the withdrawal symptoms exhibited by those who stop taking opioids after weeks or months of abuse.

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Signs And Symptoms

The early signs and symptoms associated with opioid withdrawal are (3), (4):

• Anxiety
• Craving
• Muscle aches
• Sweating
• Frequent yawning
• A runny nose
• Increased tearing
• Agitation
• Insomnia or sleeplessness

The late symptoms that surface with opioid withdrawal are (4):

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

These symptoms can be very uncomfortable and usually begin within 12 hours of the last heroin use or 30 hours of the last methadone use.

What causes these symptoms? Let’s find out in the next section.

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What Causes Opioid Withdrawal?

Opioids usually cause physical dependence over time (if abused). The individual in question may end up relying on the drug to prevent the symptoms of withdrawal (2).

It is also important to note that, over time, more dosage of the drug is required to produce the same effect. This is referred to as drug tolerance.

However, the time taken to become physically dependent on these drugs may vary from person to person. When the individual decides to stop abusing the drug, their body takes time to recover. This causes withdrawal symptoms. Such symptoms can surface any time when the long-term use of opioids is suddenly stopped or cut back (2).

Some factors can also put you at a higher risk of opioid addiction.

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Risk Factors

The risk factors for opioid addiction and the consequent withdrawal symptoms are:

• Taking opioids continuously for more than a few days
• Taking more than the prescribed dose of opioids
• A family history of substance abuse
• Young age and friend circle
• Emotional trauma from varying factors like unemployment, family or personal issues, etc.
• A history of criminal activities
• Heavy use of tobacco or other drugs
• A history of severe depression and/or anxiety
• Prior alcohol/drug rehabilitation

Even factors like the type of crowd you hang out with or being too young to understand the consequence of drug abuse can put you at a higher risk of opioid addiction.

If the withdrawal symptoms are uncontrollable, it is best to seek medical intervention as not quitting the drugs can put your life at risk.

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How Is Opioid Withdrawal Diagnosed?

Your doctor or healthcare provider will begin by performing a physical examination. They may also ask about your medical history or history of drug abuse.

There is no specific diagnostic test for opioid withdrawal. Following a physical examination and/or assessment of the medical history of the patient, a urine or blood test may be suggested to confirm the use of opiates (5).

Depending on the other concerns of your doctor, a few additional tests may be recommended. They include (5):

• Liver function and blood chemistry tests like CHEM-20
• Complete blood count (CBC) test to help measure your different blood cells
• An X-ray of your chest
• Electrocardiogram (ECG) or heart tracing
• Testing for other medical conditions like hepatitis C, HIV, or tuberculosis as most individuals who abuse opiates are often found to have these conditions.

Once opioid abuse is confirmed, your doctor may discuss the treatment options to tackle the withdrawal symptoms once the drug usage is stopped.

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What Are The Treatments Available For Opioid Withdrawal?

Facing withdrawal symptoms on your own can be quite dangerous. Treating opioid withdrawal symptoms includes a combination of medicines, support, and counseling.

At-home management can be quite difficult and should be done slowly and cautiously.

Treatment can also be carried out in a setup with facilities to help in the detoxification of the affected individuals.

If the symptoms are severe, the treatment is carried out in a hospital under the supervision of a medical professional.

Medications that help relieve opioid withdrawal symptoms are (6):

• Methadone – It relieves withdrawal symptoms and also helps with detoxification.
• Buprenorphine – It alleviates withdrawal symptoms and also shortens the length of detox.
• Clonidine – It helps with symptoms of anxiety, agitation, sweating, muscle aches, and cramping.
• Naltrexone – It can help prevent a relapse and is available in the form of pills as well as injections.
• Vitamin B and C supplements

It is enormously helpful if the affected individuals seek solace in support groups for opiate addicts. More details about alternative treatments for addressing opiate withdrawal are provided below.

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Alternative Treatments

Most patients require long-term treatment post detox. This may include:

• Asesoramiento para pacientes ambulatorios

• Grupos de autoayuda, como Narcóticos Anónimos o SMART Recovery

• Tratamientos para pacientes hospitalizados y tratamientos intensivos para pacientes ambulatorios como hospitalización diurna

• Terapia cognitivo-conductual que trabaja para modificar pensamientos, sentimientos o comportamientos negativos. Puede incluir actividades como leer un libro o simplemente ir a nadar. Hablar con un familiar o un amigo cercano también ayuda (7).

• Manejo de contingencias que brinda a los pacientes una recompensa luego de cada muestra de orina libre de medicamentos recolectada.

Las personas que luchan contra la abstinencia de opioides a menudo padecen otras afecciones mentales como la depresión. Abordar y tratar estos trastornos también puede reducir en gran medida el riesgo de recaída.

Si lo ha notado, los términos opioides y opiáceos a menudo se usan juntos en algunos lugares. ¿Hay alguna diferencia entre los dos o son los mismos medicamentos? Vamos a averiguar.

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Opiáceos vs. Opioide

Opiáceo es un término farmacológico para compuestos naturales que alteran la mente con beneficios medicinales que se encuentran en el opio. A veces, este término también puede usarse para referirse a compuestos semisintéticos derivados de estas sustancias naturales. El opio es la resina que se obtiene de la planta de adormidera.

Por otro lado, opioide es un término moderno que se usa para todos los compuestos que actúan sobre los receptores de opioides en su cuerpo, e incluye todos los opioides, así como compuestos completamente sintéticos.

Dejar de consumir opio puede convertirse en una de sus peores pesadillas convertidas en realidad. Por lo tanto, busque intervención médica si ha estado involucrado en el abuso de sustancias o quiere retirarse de él. Sea consciente de las consecuencias del abuso de drogas y difunda el conocimiento que tiene para evitar que otros caigan presa de tales hábitos.

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Espero que esta publicación te ayude a ti oa alguien cercano que haya estado luchando contra la adicción a los opioides o los síntomas de abstinencia. Comparta sus pensamientos sobre esto en los comentarios a continuación.

Respuestas de los expertos a las preguntas de los lectores

¿Cuándo llamar a un médico para la abstinencia de opioides?

Si ha estado tomando opioides u otros medicamentos similares y descubrió que ahora es adicto a ellos, no pierda el tiempo buscando una intervención médica. Quienes estén dispuestos a dejar de tomar opioides o quienes hayan comenzado a enfrentar los síntomas de abstinencia también deben consultar a un médico de inmediato.

¿La gabapentina ayuda con la abstinencia de opiáceos?

Sí, la gabapentina puede ayudar con la abstinencia de opiáceos al ayudar en el proceso de desintoxicación (8). Sin embargo, aunque se ha encontrado que este medicamento es útil para tratar los síntomas de abstinencia de opiáceos, se asocia con muchos efectos secundarios. Por lo tanto, hable con su médico para encontrar el mejor plan de tratamiento para usted.

¿Cuánto dura la abstinencia de opiáceos?

Los síntomas de la abstinencia de opiáceos pueden comenzar dentro de las 12 horas posteriores a la última dosis, y para los opiáceos de acción prolongada, los síntomas pueden tardar hasta 30 horas en aparecer. Durante los siguientes dos días, los síntomas continuarán empeorando hasta que empeoren alrededor de la 72ª hora. Cuando finaliza el tercer día, la mayoría de los síntomas físicos desaparecen. Los síntomas psicológicos que los acompañan, así como los antojos, pueden continuar durante una semana o más.

Referencias

1. “Crisis por sobredosis de opioides” Instituto Nacional sobre el Abuso de Drogas.
2. “La neurobiología de la dependencia de opioides: implicaciones para el tratamiento” Science & Practice Perspectives, Biblioteca Nacional de Medicina de EE. UU.
3. "La relación entre el deseo, la ansiedad y otros síntomas de la abstinencia de opioides". Journal of Substance Abuse Treatment, Biblioteca Nacional de Medicina de EE. UU.
4. “Delirio por abstinencia de opio: informes de dos casos” Psicofarmacología, Biblioteca Nacional de Medicina de EE. UU.
5. "Opioide, abstinencia" StatPearls, Biblioteca Nacional de Medicina de EE. UU.
6. “Manejo de la abstinencia” Organización Mundial de la Salud 2009, Biblioteca Nacional de Medicina de EE. UU.
7. “Terapia cognitivo-conductual para trastornos por uso de sustancias” Clínicas psiquiátricas de América del Norte, Biblioteca Nacional de Medicina de EE. UU.
8. "Importancia de la dosis de gabapentina en el tratamiento de la abstinencia de opioides". Revista de psicofarmacología clínica, Biblioteca Nacional de Medicina de EE. UU.