Opioid withdrawal period: Stages, healing process, and additional details
Opioid withdrawal is a complex physiological process that occurs when a person with opioid use disorder suddenly stops using opioids. This article aims to provide a clear and concise overview of the stages, symptoms, and treatment options associated with opioid withdrawal.
Anyone experiencing symptoms of opioid withdrawal should seek immediate medical attention, especially if they are experiencing worsening symptoms, relapsing, or taking a different dose of withdrawal medication than recommended by their doctor.
Opioid withdrawal symptoms can be divided into two main phases: acute withdrawal and post-acute withdrawal syndrome (PAWS).
Acute Withdrawal (Detox Phase)
The initial phase, lasting about a week, is characterized by intense physical symptoms such as nausea, vomiting, diarrhea, muscle cramps, chills, sweating, agitation, and anxiety. The severity of these symptoms depends on the duration and amount of opioid use. Physical symptoms peak within a few days and gradually subside over about a week.
Post-Acute Withdrawal Syndrome (PAWS)
PAWS occurs after the acute phase and can last from several months up to two years. Primarily involving psychological symptoms such as mood swings, anxiety, depression, insomnia, irritability, and intense cravings, PAWS is a challenging phase as the brain gradually recovers from the effects of addiction.
During the progression of opioid use disorder, behavioral and cognitive changes such as impaired judgment, social withdrawal, neglect of responsibilities, secretive behavior, and escalating opioid use are common. Tolerance builds, requiring higher opioid doses for the same effect, deepening dependence and increasing overdose risk.
Opioid withdrawal can be painful and potentially dangerous. Withdrawal symptoms become progressively more severe as opioids leave the body. At the peak stage of withdrawal, a person may feel very sick and be at higher risk of relapse.
Long-acting or extended-release opioids may take 1-3 days to cause withdrawal symptoms after discontinuation, with the peak of symptoms occurring 3-8 days after the last dose, and withdrawal symptoms persisting for several weeks. Short-acting opioids can include oxycodone, codeine, hydrocodone, morphine, and illegally manufactured fentanyl.
Opioid use disorder is a medical condition that requires professional treatment. This may include medications such as methadone or buprenorphine, treatment for chronic pain or underlying medical conditions, psychotherapy, joining support groups like Narcotics Anonymous, treating any underlying mental health issues, seeking education about addiction, and finding support from organizations like Narcotics Anonymous, Substance Abuse and Mental Health Services Administration (SAMHSA), FindTreatment.gov, and the U.S. Department of Health and Human Services (HHS).
Mild opioid withdrawal symptoms may linger and become bothersome without treatment, but having the right medical support can make it easier and improve the chances of a positive outcome. The American Society of Addiction Medicine (ASAM) recommends using medication to treat the symptoms of opioid withdrawal.
It is crucial for individuals experiencing opioid withdrawal to seek immediate medical attention if they lose consciousness, experience chest pain, or are pregnant and feel very sick.
In summary, opioid withdrawal has a complex symptom profile evolving through an acute physical withdrawal week-long phase to a longer, psychologically challenging post-acute phase. Awareness of these stages is crucial for effective treatment and management of opioid use disorder.
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