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stages of opiate withdrawal

Stages of Opiate Withdrawal

Stages of Opiate Withdrawal

Opiates are addictive in part because they activate parts of the brain associated with pleasure. However, that is only part of the story. A person who takes painkillers or other opioids will find themselves chemically dependent on the drugs. Once this happens, overcoming addiction can be extremely difficult. The physical and emotional withdrawal symptoms pose a tremendous challenge to individuals looking for recovery.

How Opioids Work in the Brain

Your body naturally produces opioids, which attach to special receptors in the brain. These neurotransmitters help the body naturally regulate pain and stress.

Chemical opioids attach to the same receptors in the brain and have a similar effect of producing euphoria. However, they are significantly stronger than anything the body can produce on its own. These fake neurotransmitters flood the system and eventually prevent the body from producing opioids of its own. Part of what causes drug withdrawal symptoms is this lack of dopamine and related chemicals in the brain as the body adjusts to the absence of opioids.

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Stages of Opiate Withdrawal: A Timeline

Drug withdrawal presents a set of physical and emotional symptoms that can be extremely difficult to endure. However, it’s important to remember that withdrawal is temporary.

If you or a loved one is facing detoxification and rehab, know that the worst of the symptoms will last just a few days. Knowing what to expect and having a timeline of events in mind can help to ease some of the psychological pressure when facing withdrawal and recovery.

Withdrawal symptoms for short-acting opiates will begin within 12 hours of the last dose. For long-acting opiates, symptoms may start within 30 hours. Over the next two days, symptoms will continue to worsen, peaking around the 72 hour mark. By the end of the third day, most physical symptoms will have resolved. Psychological symptoms and cravings may continue for a week or more.

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stages of opioid withdrawal

Early withdrawal symptoms include the following:

  • Drug cravings
  • Agitation or anxiety
  • Muscle aches
  • Sweats and fever
  • Increased blood pressure and heart rate
  • Sleep disruption

These initial symptoms may cause restlessness and mood swings.

The later stage of withdrawal produces flu-like symptoms:

  • Nausea, vomiting or diarrhea
  • Goosebumps and shivering
  • Stomach cramps and pain

Depression and intense drug cravings may accompany this stage. These symptoms will generally peak within 72 hours and resolve within five days. From a physical standpoint, recovery is well underway. Physical symptoms of withdrawal may disappear quickly after the third day of detox. However, psychological symptoms may linger, and drug cravings may persist or come and go in the weeks and months that follow.

What About Drug Replacement?

In some cases, an alternative substance like Suboxone may be provided to help mitigate the effects of chemical dependence. This drug is classified as a “partial opioid agonist,” which means that it is a weaker type of opioid that cannot be abused. Other replacement drugs, like methadone, may also sometimes be used.

Addiction clinics and rehab facilities offer these medications as a stepping stone to help reduce the severity of drug withdrawal symptoms. However, users will still undergo withdrawal when weaning off of the replacement drug, and recovery will take longer when these medical aids are offered. There is also the risk of finding a way to abuse these medications.

The Importance of Support During Withdrawal

Drug detox and addiction recovery services are crucial to helping people recover safely throughout the stages of opiate withdrawal and stay away from drugs long-term.

One important but often overlooked symptom of withdrawal is suicidal ideation. Not everyone who undergoes withdrawal feels suicidal, but the feelings of depression can be overwhelming. People in the grip of withdrawal may experience mood swings and dark thoughts that seem to have no end point. The feeling that life may never be better than it is in that dark moment or that the addict can never be happy again without drugs can be overwhelming. For this reason, a strong support system is essential to the safety of people overcoming addiction. Recovering addicts need to know that their symptoms are temporary. They also need to be protected from opportunities for self-harm and relapse.

Protecting recovering addicts from relapse is especially important because many deadly overdoses occur during relapse. Because the user’s body is no longer accustomed to the drug, it will be more sensitive. What would have been a normal dose for the user before withdrawal can become a deadly overdose in the weeks that follow.

The best drug rehabilitation programs provide a strong support network for recovering addicts throughout all stages of recovery, including the difficult weeks that follow acute drug withdrawal. By continuing to offer support after the initial symptoms have faded, the rehab program can provide the best environment for successful and permanent drug cessation.

opiates and alcohol

Why Opiates and Alcohol are Such a Deadly Combination for Arizona Drug Users

Overdosing From Combining Opiates and Alcohol Is a Real Risk 

Media reports frequently focus on cases of opiate use, with Governor Doug Ducey even declaring a state of emergency due to the sharp rise in opioid overdose among Arizona drug users. However, little attention was given to the dangers of mixing opiates and alcohol until news reports emerged that Cory Monteith’s death was caused by combined drug intoxication from champagne and heroin which shed light on the deadly drug combination of opiates and alcohol. Although under-reported, over 70 percent of opiate-related deaths involve the use of another substance, and alcohol is present in more than 50 percent of opiate fatalities. 

Alcohol Is a Depressant 

Alcohol‘s ability to pass the blood-brain barrier allows it direct access to the GABA receptors and neurotransmitters of the central nervous system. These neurotransmitters are responsible for sending messages from the brain to every part of the body, including the limbs, muscles and organs. Alcohol blocks the nerve receptors’ messages, slowing down the central nervous system. As a result, bodily functions are altered. Changes in the body from alcohol consumption are felt and observed through a number of signs and symptoms:

  • Altered speech
  • Difficulty walking
  • Dulled senses
  • Illegible handwriting
  • Impaired hearing
  • Mental confusion
  • Memory lapses
  • Poor coordination
  • Slow reaction times

Drugs That Are Classified As Opiates

Derived from the opium of poppy plants, opiates are a Schedule II substance that is prescribed to physical pain. When used as intended, opiates bind to the body’s opioid receptors, blocking pain signals. Opiates and opioids are two terms that are often used interchangeably. Opioid was a term that once was only used to describe synthetic opioids. However, the term opioid is now used to describe all four categories of opiates, which are the endogenous opioids made by the human body, opium alkaloids like codeine and morphine, semi-synthetic opioids such as oxycodone and heroin and fully synthetic opioids like methadone. 

Opiates Are Also a Depressant 

The human body contains naturally occurring opioid-like neurotransmitters and opioid receptors. While these organic substances send signals that block pain, the body does not make enough of its own opioids to stop severe pain or overdose itself. When someone takes opiate drugs, they easily bind to these receptors because they are similar in chemical structure to the body’s natural opioid neurotransmitters. However, opiate drugs do not act the same way as opioid neurotransmitters, which causes the transmission of abnormal messages throughout the body. Heroin’s impact on the body is dependent on a whole host of factors. These factors include the user’s current state of health, their weight, whether they are male or female. How the person takes opiates, how much opiates he or she takes, how long they have engaged in opiate use, the simultaneous consumption of other drugs or alcohol and their mental health also play a role on how heroin will affect the body. In terms of how opiate drugs interfere with these signals produces a variety of effects: 

  • Confusion
  • Constipation
  • Drowsiness
  • Lack of coordination
  • Poor decision making
  • Sedation
  • Shallow breathing

The Effects of Combining Opiates and Alcohol

Since opiates and alcohol are both considered to be depressants, they can be a deadly drug combination when taken together. When someone takes an opiate and drinks alcohol, the opiate will increase the body’s absorption rate of the alcohol, increasing the likelihood of alcohol poisoning. Additionally, this mixture slows down brain functioning and subsequently, the body’s circulatory and respiratory systems. Signs and symptoms of an opiate-alcohol overdose include drowsiness, dizziness and slowed heart rate and breathing rate. Their heart can even stop beating. The longer someone engages in this type of polydrug use, they increase their chances of a fatal overdose

Why Arizona Drug Users Are Taking Opiate-Alcohol Cocktails

With such a high risk of death from consuming opiates and alcohol, it is surprising that the number of fatalities is so high. Often, people turn to this type of substance use to relax as opiates’ ability to cause the feeling of euphoria lasts longer when this drug is combined with alcohol. Other people choose to take both of these substances at the same time as an escape because the combo either makes them fall asleep for a long period of time or gives them a more intense high than taking opiates alone. 

This Dangerous Trend Is Running Rampant Among Youth

The results of 2012 study by McCabe and other researchers indicate that a significant portion of young people are mixing opiates with other substances, including other opiates. Approximately 1 of 8 teenagers in high school have used opiates with for recreational purposes, and 70 percent of these teens are combining opiates with one or more substances. Although they are using opiates in conjunction with amphetamines, tranquilizers, marijuana and cocaine, 52.1 percent of teenagers from this study are also combining opiates with alcohol. 

More People Are Turning to Heroin 

Due to the alarming rate of prescription opioid abuse, authorities in Arizona and the rest of the country are taking a hardline approach to curbing the distribution of these medications. Therefore, people who are dependent or addicted to opiates are using heroin. Estimates by the National Survey on Drug Use and Health show that almost 700,000 people in America are using heroin. Approximately 170,000 people tried heroin for the first time in 2012. Looking at the rates from the 1960s to the 1970s when heroin reached its height of popularity, current heroin-use rates are on reaching the same level. Heroin users state that street heroin is easier to access that legitimate prescriptions and cheaper to buy than illicit prescription painkillers.