Meperidine Withdrawal

Withdrawal is a normal, predictable consequence of a sudden drop in the level of meperidine in the body of someone who is physically dependent on opioids. Withdrawal shows itself in a variety of overpowering physical symptoms that can last five or more days; psychological symptoms associated with meperidine withdrawal can last much longer, especially if left undetected or poorly treated.

Causes

Your body adjusts to the presence of certain substances in the body, including meperidine. Your body may even become tolerant of certain chemicals, which means you have to take more meperidine to relieve your pain or to get high. If you continue to use meperidine, either legally or illegally, you body may become dependent on the chemical. This means you must maintain a certain level of opioids for your body to feel normal.

If the level of opioids drops rapidly, your body struggles to maintain its chemical balance. You feel this struggle through physical and psychological withdrawal symptoms. Rehabilitation specialists call this process "detoxification."

Facts

According to the Centers for Disease Control and Prevention, or CDC, about 9 percent of people abuse opioids such as meperidine at some point in their lives.

Meperidine withdrawal symptoms are uncomfortable and difficult, but withdrawal is usually not life threatening.

Symptoms

Withdrawal from opioids causes physical symptoms similar to the flu, but meperidine withdrawal also causes psychological symptoms. The emotional aspects of meperidine withdrawal can be just as overpowering as the physical symptoms.

Symptoms of meperidine withdrawal typically occur in two waves. The first set of symptoms usually begins 12 hours after the last dose of opioids and includes agitation, anxiety, muscle aches, watery eyes, insomnia, a runny nose, sweating and yawning. Later, symptoms include abdominal cramping, diarrhea, dilated pupils, goose bumps, nausea and vomiting.

Physical

Physical symptoms of meperidine withdrawal last five or more days, with the worst symptoms occurring on or about the fourth day. Physical symptoms of meperidine withdrawal can be relieved with medications that relieve each individual symptom, by taking a replacement drug that mimics opioids or by taking another dose of meperidine. The promise of relief from withdrawal symptoms causes many strong individuals to relapse back to meperidine abuse.

Physical symptoms of meperidine withdrawal include:

  • Abdominal Cramping
  • Diarrhea
  • Fever, Runny Nose or Sneezing
  • Goose Bumps and Abnormal Skin Sensations
  • Hot Sweats and Cold Sweats
  • Insomnia
  • Low Energy Level
  • Muscle Aches or Pains
  • Nausea or Vomiting
  • Pain
  • Rapid Heartbeat
  • Rigid Muscles
  • Runny Nose
  • Shivering, Tremors
  • Teary Eyes
  • Yawning

Psychological

The psychological aspects of meperidine withdrawal are often overlooked and go untreated. These withdrawal symptoms may make you feel unworthy or incapable of recovery. Psychological withdrawal symptoms cloud your thinking and may lead you back to meperidine abuse.

Psychological symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Depression
  • Hallucinations
  • Irritability
  • Poor concentration
  • Restlessness
  • Social isolation

Possible Complications

Meperidine withdrawal is associated with certain complications including vomiting and then breathing the stomach contents into the lungs, a complication known as aspiration. Aspiration can result in fluid in the lungs and lung infections. Extreme vomiting and diarrhea may result in dehydration that can cause dangerous electrolyte imbalances.

The primary complication associated with meperidine withdrawal is the return to opioid abuse. You face a greater risk for overdose right after you go through meperidine withdrawal because detoxification reduces your tolerance to opioids; after experiencing withdrawal symptoms, you can potentially overdose on a smaller dose than you used to take.

Treatment options

An increasing number of American adults and teenagers are becoming dependent on opioids such as meperidine. According to the National Institute on Drug Abuse, more than 23 million people in the United States over the age of 12-years needed treatment for alcohol or substance abuse in 2010; of these, only about 11 percent received treatment at a specialty facility.

About 5 percent of admissions to publicly funded treatment facilities were for treatment of opioid abuse. These substance abuse programs help people to overcome physical dependence and addiction to meperidine.

Rehabilitation restores your neurological function disrupted by opioid addiction. This phase of treatment includes behavior modification and counseling that teaches you how to live without opioids such as meperidine.

Detoxification

Some people try to end an addiction to meperidine through self-detoxification, sometimes called "going cold turkey." This refers to the cold, clammy, pale skin with goose bumps that addicted people experience as they go through detox - your skin looks like a plucked turkey.

If you try self-detoxification, you will experience the full brunt of withdrawal symptoms and face an increased risk for suffering complications.

During self-detoxification, your goal is to last five or more days without taking more meperidine. Many people succumb to overpowering physical and mental withdrawal symptoms and take more opioids just to reduce meperidine withdrawal symptoms.

Some people develop treatment plans including medicine to ease withdrawal symptoms. One such treatment is The Thomas Recipe, which includes valium or some other benzodiazepine to calm you down and help you sleep. Imodium eases your diarrhea while mineral supplements soothe muscle aches. On or about the fourth day, you will awaken with overwhelming fatigue and lack of energy that makes it difficult to move around. To remedy this, the Thomas Recipe calls for L-Tyrosine with B6 to give you a surge of energy.

While the Thomas Recipe eases your withdrawal symptoms a bit, you are still at risk for complications such as aspiration, dehydration and relapse.

Using meperidine again may cause a dangerous overdose, which can be fatal. Symptoms of meperidine overdose include:

  • Breathing that Stops
  • Cold, Clammy Skin
  • Confusion
  • Extreme Drowsiness
  • Fainting
  • Pinpoint Pupils
  • Shallow Breathing
  • Weak Pulse

Meperidine overdose is a serious, life threatening medical emergency requiring immediate care. In the emergency department, doctors give you naloxone and other medications to reduce meperidine to safe levels. Nurses establish an airway to help you breathe, monitor your vital signs and protect you from complications. Nurses may empty your stomach or administer charcoal to absorb excess meperidine. If necessary, nurses and doctors perform life-saving measures such as CPR.

If you are in otherwise stable condition and not have a toxic level of meperidine in your blood, you may benefit from Drug Replacement Therapy, or DRT. Once enrolled in DRT, you will replace illegal drugs with medications such as methadone, Suboxone or buprenorphine. DRT medications act similarly to opioids, so you will not experience withdrawal symptoms, but DRT drugs do not cause euphoria - you will not get high on them. This allows you to put off the detoxification stage while you engage in behavioral modification. After you learn how to live without meperidine, you will wean yourself from the replacement drug.

DRT helps many people to participate in treatment without missing work or being away from family. Opponents of DRT say it is merely trading one addiction for another. If you are like many people, you may have trouble quitting the replacement drug. Harvard Medical School cites estimates that 25 percent of methadone DRT patients eventually abstain, another 25 percent continues to take the DRT drug and 50 percent go on and off methadone.

DRT is just one kind of Medication-Assisted Treatment, or MAT. Medications reduce the overpowering symptoms of withdrawal; this helps you tolerate the process long enough to successfully detoxify your body.

Rehabilitation professionals say that MAT is an important and effective treatment approach because it:

  • Improves Survival Rates
  • Increase Retention in Treatment
  • Decreases Illicit Opioid Use
  • Decreases The Risk for Hepatitis and HIV
  • Decreases Criminal Activities
  • Increases Employment
  • Improves Birth Outcomes for Pregnant Women Battling Addiction

Standard MAT involves an in-patient hospital stay. During standard detoxification, doctors give you naloxone and other medications to reduce meperidine levels plus other drugs to ease the ensuing withdrawal symptoms. While standard inpatient MAT relieves the strength and duration of symptoms a bit, you could still face a lengthy, uncomfortable and demoralizing battle that leaves psychological scars, which can interfere with your recovery. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse or meperidine addiction.

Rapid detox is cutting-edge and well-established approach to treatment, thought by many to be the most humane form of detoxification available today. During rapid detox, board certified anesthesiologists administer the standard detoxification and anti-withdrawal drugs to you, alongside sedatives and anesthesia so that you will doze in a pleasant "twilight sleep." When you awaken a few hours later, you will have no memory of the grueling detoxification process. Instead of a few days, you are ready for meaningful behavior modification in a few hours.

Rehabilitation

Because meperidine addiction is a neurological disease that manifests itself through behaviors such as craving and drug-seeking, your recovery depends on behavioral modification. Addiction is a complex but treatable disease; each person experiences addiction differently, therefore no single treatment is appropriate for everyone. Effective treatment addresses your multiple needs, not just your drug abuse. Many who suffer addiction to meperidine or other drugs have other mental disorders, legal trouble, social problems or relationship issues that compound addiction and increase the chances for relapse.

Your treatment program may require you be tested for conditions such as HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases. Rehabilitation programs should include counseling to help you modify or change behaviors that place you at special risk of contracting or spreading infectious diseases.

While in treatment, you will likely engage in individual counseling, group therapy and other behavioral modification programs. Whatever type of treatment you require, it needs to be readily available to encourage maximum participation. It is critical that you remain in treatment long enough to make the behavioral and biological changes associated with recovery.

Your counselor will monitor your treatment course and progress to make sure treatment meets your needs. Relapse is common and professional monitoring reduces your risk for returning to meperidine abuse.