- Generic Name or Active Ingridient: Meperidine
- Muscle aches
- Watery eyes
- Runny nose
- Abdominal cramping
- Dilated pupils
- Goose bumps
Meperidine is a synthetic opioid drug designed to act like morphine. Meperidine is Demerol without any aspirin in it.
Meperidine, morphine, Demerol and other opioids act on the nervous system to change the way the brain receives pain signals. Opioids cause other nervous system changes, including sedation, relaxation and a pleasant euphoric feeling. With continued use, some of the neurological changes become more permanent, altering the way the individual thinks, feels and behaves. These changes often have a negative impact on his ability to work, take care of family or engage in healthy relationships with other people.
Doctors prescribe meperidine to relieve moderate to severe pain. Most patients take meperidine as prescribed and stop using it when they no longer need it to control pain. Some people use meperidine for non-medical reasons, either to get high or to treat pain unrelated to the condition the doctor had intended to treat when she wrote the prescription. Each year, about 5 million Americans use painkillers like meperidine for non-medical reasons.
Anyone who uses meperidine regularly for therapeutic or non-medical reasons can become physically dependent on this opioid after only a few weeks of continued use. With continued use, a person’s body becomes accustomed to the presence of meperidine, and he becomes tolerant to the effects of this opioid. In time, his body starts to depend on a certain level of meperidine to feel normal. If opioid levels drop drastically, his body struggles to regain chemical stability. Doctors refer to this as meperidine detoxification.
The patient experiences detoxification through uncomfortable and demoralizing flu-like symptoms. These symptoms begin a few hours after the last dose of meperidine and, left uninterrupted, will last for a few days. Withdrawal symptoms fade as the body completes the detoxification process and do not return unless the patient becomes opioid-dependent again. Complete meperidine detoxification brings the patient to an opioid-free state.
Meperidine detoxification also refers to the medical procedure that alleviates withdrawal symptoms and decreases the risk for complications. Detoxification can take place at home, through an outpatient clinic or at an inpatient hospital or long-term residential setting.
Meperidine detoxification is an important step in recovery from opioid-dependence but does little to reduce the behaviors that bring many people back to drug abuse. Most patients benefit from rehabilitation including counseling and behavior modification that teach people how to lead a drug-free life.
Meperidine detoxification facilitates the patient’s entry into rehabilitation and helps her remain there long enough to restore some of the neurological, behavioral and social function lost through chronic drug abuse. Meperidine detoxification decreases the risk for relapse and reduces the frequency and severity of drug use episodes when they do occur.
Types of Detox
There are currently about 2 million Americans dependent on meperidine or other opioids. Of those who needed help with opioid-dependence, only about 10 percent received it at a specialty facility, such as an inpatient hospital, inpatient or outpatient rehabilitation facility, or a mental health center staffed with professionals who receive extra training in detoxification principles. Other individuals engaged in self-help, worked with a private physician, sought treatment in an emergency room or while incarcerated in a prison or local jail.
Everyone experiences dependence on meperidine in a different way: one person might have grown dependent on this drug while using it to relieve cancer pain while another individual became opioid-dependent after using meperidine to get high. Each person has different needs when it comes to meperidine detoxification too, with one individual needing the flexibility to work and take care of family while participating in therapy while another person may require strict supervision and close monitoring to prevent complications or relapse. Many patients try different approached to meperidine detoxification until finding one that works for them.
Doctors often recommend that meperidine consumers wean themselves from this drug by taking smaller doses each day until they no longer feel withdrawal symptoms. This tapering method works well for most people but lingering withdrawal symptoms prevent some individuals from discontinuing meperidine at the appropriate time.
The tapering method works well for some people but stubborn withdrawal symptoms prevent many from completing meperidine detoxification, so they try quitting “cold turkey” by discontinuing meperidine suddenly. The phrase “cold turkey” refers to the skin’s poultry-like appearance during meperidine detoxification: pale, cold and clammy with goose bumps. Without the protection of anti-withdrawal drugs or the gradual reduction of opioid levels during weaning, quitting cold turkey can cause severe and protracted withdrawal symptoms.
Many people use natural remedies to reduce withdrawal symptoms during meperidine detoxification, eating only certain herbs, soups or juices. Some use herbal remedies to ease specific symptoms, such as ginger or peppermint for nausea and chamomile or cayenne for diarrhea. Others participate in acupuncture, meditation, yoga, or massage therapy to ease withdrawal.
A patient may take a medical approach and develop a homemade treatment plan that uses a combination of prescription and non-prescription drugs to ease withdrawal. One well-known remedy is The Thomas Recipe, which recommends a benzodiazepine such as Librium or Xanax to calm the patient and help him sleep along with vitamin B6 and hot baths for muscle aches. The Thomas Recipe calls for Imodium to curb diarrhea and L-Tyrosine for a much-needed burst of energy.
Some clinics offer medication-assisted treatment. This programs use medications to help patients detoxify from meperidine or manage withdrawal symptoms while the patient participates in rehabilitation.
Outpatient treatment is appropriate for patients who have been opioid-dependent for more than a year and who require little supervision. Patients use methadone or buprenorphine to keep withdrawal symptoms at manageable levels or as an aid to weaning themselves from meperidine.
When used as part of drug replacement therapy, methadone and buprenorphine mimic the neurological effects of meperidine in a way that prevents the detoxification process from starting. These replacement drugs are weak opioids, so they do not produce euphoria when taken as directed. Patients take methadone or buprenorphine while they engage in rehabilitation. Once the patient gains the tools he needs to refuse drugs when offered, he weans himself from the replacement drug.
Sometimes outpatient clinics will administer methadone or buprenorphine as a “step down” drug to ease withdrawal symptoms in patients attempting meperidine detoxification at home. Doctors refer to this as medication-assisted treatment or medically supervised withdrawal. Patients start out on a high dose of the replacement drug during the induction phase and reduce the daily dosage over the course of several days or weeks during the tapering phase.
About 100,000 Americans use a methadone maintenance program. First synthesized for use as a pain reliever, FDA approved methadone for use in the treatment of opioid dependence in 1972. Patients come to the methadone clinic to drink a beverage containing this replacement drug. The patient will feel the effects of one dose of methadone for 24 to 36 hours.
Patients may take buprenorphine as part of a drug maintenance program or medically supervised withdrawal. When used as part of a drug maintenance program, patients take buprenorphine three times a week by placing a tablet under the tongue, where it dissolves and enters the bloodstream. Buprenorphine provides more flexibility than morphine in that patients receive buprenorphine prescriptions for take-home use. Now even new patients can take home enough buprenorphine to last a week or longer.
Some patients use buprenorphine as part of medically supervised withdrawal. While there is no set tapering schedule, some patients can complete detoxification in as little as one week, spending the first one to three days in the induction phase and tapering during days four through seven.
Suboxone and Subutex
Buprenorphine is relatively safe when taken as directed but some recreational drug abusers dissolve buprenorphine before injecting it into a vein. This intravenous use produces some euphoria. Drug manufacturers address this abuse by adding naloxone to brand name buprenorphine preparations, Suboxone and Subutex. When taken as directed under the tongue, naloxone has little to no effect. When taken intravenously, naloxone neutralizes the effects of buprenorphine to prevent euphoria and cause withdrawal symptoms in opioid-dependent people.
Inpatient detoxification programs typically offer complete meperidine detoxification using a variety of non-opioid drugs to ease multiple withdrawal symptoms. Doctors will give one drug for nausea, for example, a second for diarrhea and a third for anxiety. Nurses and other trained professionals monitor the patient for complications and take immediate action as necessary.
Inpatient meperidine detoxification is helpful for those who need a little extra support in overcoming withdrawal symptoms and for those with a documented history of not fully participating in or benefiting from less restrictive forms of treatment. Inpatient care is appropriate for those who are at risk for severe withdrawal symptoms or complications or who have co-existing conditions or substance abuse issues that make outpatient detoxification unsafe.
Inpatient meperidine detoxification is mandatory for those recovering from a drug overdose or for who cannot otherwise safely participate in outpatient detoxification. Patients with psychiatric problems that impair the ability to participate in treatment consistently should engage in inpatient care, especially those with acute psychosis or depression with suicidal thoughts. Inpatient care is necessary for anyone who exhibits behaviors that could cause a danger to the patient or others.
Rapid Opiate Detox
Rapid opiate detox is the safest and most humane approach to complete meperidine detoxification. Rapid detox patients receive anesthesia and sedatives prior to the standard detoxification and anti-withdrawal drugs. Rapid detox patients doze in a comfortable “twilight sleep” during the detoxification process and awaken a few hours later, feeling refreshed and renewed.
Our detox center: Who we are and what we do
Our detox center is a fully accredited hospital, equipped with cutting-edge technology and a compassionate, caring staff. For more than a decade, our board-certified anesthesiologists and other highly trained medical professionals have helped thousands of patients achieve a drug-free state.
We believe that patients deserve respect while they recover from this chronic and debilitating condition. We treat patients as people, not as drug addicts.
We offer pre-screening in our accredited facility to familiarize ourselves with each patient, learn his needs and reveal any previously undiagnosed conditions that could interfere with treatment. We create a professional treatment plan focusing on bringing the patient to a drug-free state as quickly and safely as possible, usually in one to two hours. Once we stabilize the patient’s condition, he may move onto our qualified aftercare facility for further treatment.
Every form of meperidine detoxification has its benefits and drawbacks. Without the expense of anti-withdrawal drugs or medical guidance, self-detoxification is the least expensive and the most private. Patients who attempt self-detoxification face a high risk for complications due to uncontrolled withdrawal symptoms and the lack of professional monitoring whereas patients who engage in outpatient treatment receive counseling and drugs to control withdrawal symptoms.
Self-detoxification provides complete meperidine detoxification in a few days whereas patients can remain in outpatient programs for months or years. The average length of stay for detoxification is 4 days, compared with 197 days for medication-assisted therapy. Rapid detox provides compassionate and complete detoxification in even less time, usually within one or two hours.
Detox Possible Complications
The meperidine detoxification process is not usually life-threatening but severe and uncontrolled withdrawal symptoms and pre-existing conditions can cause dangerous complications that can sometimes be fatal. Acute or prolonged substance abuse also increases the risk for complications, as do pregnancy and co-existing substance abuse problems.
Relapse is the primary complication of all forms of meperidine detoxification. A patient may relapse during detoxification to stop the uncomfortable withdrawal symptoms, or return to meperidine abuse shortly after completing detoxification.
Relapse increases the risk for fatal overdose because the detoxification process lowers the individual’s tolerance to meperidine, making him more sensitive to its effects. Because of the way detoxification lowers tolerance, it is possible for a person to overdose on a smaller amount of meperidine than he used to take before experiencing minor withdrawal symptoms for even a short time.
Overdose from opioid pain relievers like meperidine claim the lives of 14,800 Americans in 2008. That year, overdoses from prescription opioids took more lives than cocaine and heroin overdoses combined.
Self Detox Possible Complications
Without anti-withdrawal drugs, prescreening for underlying conditions or professional monitoring, withdrawal symptoms associated with self-detoxification can result in unexpected complications, including dehydration from excessive vomiting and diarrhea. Dehydration may cause imbalances in potassium, sodium and other electrolytes. The patient may suffer aspiration, where the individual vomits and inhales stomach contents. Aspiration may result in fluid in the lungs and lung infections.
Left unprotected from withdrawal symptoms, patients who attempt self-detoxification are at great risk for relapse.
Outpatient Care Possible Complications
With drugs to control withdrawal symptoms and professional support to guide treatment, outpatient care reduces the risk for complications, especially for patients who are already at risk from co-existing conditions like pregnancy or pre-existing illnesses.
Some patients become dependent on the replacement drug and have trouble tapering methadone or buprenorphine use after completing rehabilitation. Methadone withdrawal symptoms start 72 to 96 hours and can linger for days or weeks.
Patients may have trouble establishing a safe dose that still suppresses withdrawal symptoms. Excessively high doses may cause dizziness, drowsiness and other unpleasant effects while inadequate doses can cause withdrawal symptoms.
Methadone may cause serious heart and breathing problems. The risk for these complications is highest during initial doses, when switching to methadone from another opioid, and after dosage increases. Patients should seek help immediately if they have trouble breathing, experience fast, slow or irregular heartbeats, or feel faint, dizzy or confused.
The number of deaths associated with methadone overdose has been rising. In 2009, there were 5.5 times as many deaths associated with methadone as there were in 1999. Today, methadone overdose now accounts for about one-third of all prescription drug overdoses even though it represents only about 2 percent of the prescription painkiller market. Most of these cases involved the use of multiple substances and methadone abuse.
Patients sometimes experience complications of buprenorphine use. Inadequate dosing can cause breakthrough withdrawal symptoms, especially during the induction phase. Buprenorphine is also associated with abuse, as recreational users dissolve and inject buprenorphine into a vein to get high.
Inpatient Detox Possible Complications
Inpatient meperidine detoxification provides the greatest protection from complications but they do occur in some patients. Withdrawal from multiple substances, especially alcohol, benzodiazepines, sedatives and anti-anxiety drugs can complicate inpatient treatment, as can some co-existing medical conditions.
Rapid Detox Possible Complications
Rarely, a patient can suffer an allergic reaction to the medications used in rapid detox procedures. High doses of some sedatives may cause breathing and heart problems. Intravenous anesthesia may result in infection, bruising or swelling at the injection site.
Despite decades of research and a mountain of information gained from real patients and detoxification specialists, myths surrounding meperidine detoxification still prevent some people from getting the help they need.
Self Detox Myths
Myth: Self-detoxification is safe for anyone.
Fact: Self-detoxification produces uncontrolled withdrawal symptoms that may result in dangerous or life threatening complications, especially for individuals with co-existing illnesses substance abuse issues.
Myth: Home remedies like The Thomas Recipe are safe and effective.
Fact: Combining medications may result in dangerous drug interactions. Only a physician has the training and legal power to prescribe safe and effective drugs for meperidine detoxification.
Outpatient Detox Myths
Myth: Tossing opioid-dependent people into jail is a cost effective approach to treatment.
Fact: One year of methadone costs an average of $4,700 per patient while that same year of imprisonment costs taxpayers about $24,000 per prisoner.
Myth: Methadone rots your teeth and bones.
Fact: Inadequate doses of methadone can cause withdrawal symptoms, including bone ache. Additionally, methadone can cause a dry mouth that, without proper care, promotes plaque leading to gum disease and tooth decay. Methadone patients should drink plenty of water and brush and floss each daily.
Myth: Methadone causes weight gain.
Fact: Methadone may slow metabolism and cause urinary retention in a way that results in weight gain. In addition, methadone helps restore a healthy appetite that leads to an increase in fat and muscle mass.
Myth: Outpatient meperidine detoxification is as safe and effective as inpatient detoxification.
Fact: Inpatient care includes a high degree of supervision. Doctors and nurses monitor for complications and respond accordingly.
Inpatient Detox Myths
Myth: Treatment is useless as all opioid-dependent people relapse.
Fact: Relapse rates for drug addiction are similar to those of other chronic diseases, such as high blood pressure, diabetes or asthma. Even with treatment, relapse rates for drug addiction are 40 to 60 percent. Relapse does not mean treatment has failed - it just means the individual needs to return to treatment or engage in a form of therapy that offers a higher level of supervision.
Fact: Experts estimate every dollar spent on drug treatment programs returns a yield between $4 and $7 in reduced drug-related crime rates, criminal justice costs and theft. When these experts add in healthcare costs associated with dependence, savings rise to $12 gained for every dollar spent.
Rapid Detox Myths
Myth: Pain and humiliation are important to the detoxification process as they teach the patient a lesson.
Fact: Punishment is never an appropriate approach to treating a patient suffering from medical condition, such as opioid dependence. In fact, the pain and suffering associated with withdrawal can prevent many people from completing the detoxification process. Rapid detox is the most humane approach to meperidine detoxification as it allows the most protection from the discomfort and demoralization of meperidine detoxification.
Myth: Medical detoxification takes at least a week.
Fact: Rapid detox completes meperidine detoxification in as little as one to two hours.
Detox and Pregnancy
Detoxification is unsafe for pregnant women. Opioid-dependent women have a higher risk for certain medical conditions, such as anemia, blood infections, heart problems, mood disorders and infectious diseases that could complicate pregnancy, making meperidine detoxification risky. Opioid dependence increases the likelihood a pregnant woman will suffer complications during pregnancy, labor and delivery, such as hemorrhage, slowed fetal growth, premature labor and delivery, spontaneous abortion, and fetal death.
Methadone is currently the only approved approach to treating opioid dependence in pregnant women. Methadone reduces complications in pregnant women, improving the health of both the mother and unborn baby.
Self Detox and Pregnancy
A woman should never attempt self-detoxification while pregnant. Dangerous complications could arise that endanger the life of the mother and the baby.
Outpatient and Pregnancy
A pregnant woman may choose to start methadone treatment as an outpatient. The initial dose for pregnant women is 10 - 20 mg of methadone, with daily increases of 5 to 10 mg each day until she finds a safe and effective dose. The maximum dose for a pregnant woman is 60 mg.
Women using methadone to maintain opioid dependence may suffer withdrawal symptoms late in pregnancy and require increased dosages. Women may continue methadone treatment or choose meperidine detoxification after delivery. Hospitals generally hold these babies for close observation for 72 hours after delivery.
Inpatient and Pregnancy
An opioid-dependent woman may choose to start methadone treatment as an inpatient, where she can receive adequate medication, observation and fetal monitoring. She can expect to stay in the hospital about three days before continuing methadone treatments as an outpatient.
Opiate detox symptoms
Opiate detox symptoms usually appear in two phases with the first wave appearing a few hours after the last dose of meperidine. Early symptoms are:
Later, other symptoms may develop, such as:
What is the best method to detox from this drug?
The best method of meperidine detoxification depends heavily on the patient’s personal needs. He should assess his own ability to refrain from substance abuse and choose a facility that best reflects this self-control. He should choose the treatment approach that offers the most flexibility while still offering safe and effective care.
- Meperidine Detox