Opium Detox

Opium detoxification cleanses the body of the toxic effects of chronic opium use. Opium detoxification brings a drug-dependent person to a drug-free state. Drug makers isolate the alkaloids of opium and use morphine, codeine, and thebaine to create powerful semi-synthetic drugs, such as OxyContin, heroin, and methadone.

About 4 million people use opium worldwide, consuming 1.1 megaton of opium each year. About 80 percent of these users are in Asia, where smoking opium is a culturally acceptable, traditional practice. In the United States, very little opium remains in its raw form - the majority of opium is broken down into its alkaloids, such as codeine and morphine. Opium is legal with a prescription in the United States, where doctors prescribe opium to relieve diarrhea.

Opium can be a liquid, solid or powder. Opium can be smoked, injected intravenously or pressed into a pill form and swallowed.

Growers make opium by making a small slit in the unripe seedpod of the opium poppy plant, Papaver somniferum. The sap seeps out from the slit and dries as yellowish-brown latex on the outer surface of the pod. The grower then scrapes the dried sap that contains varying amounts of alkaloids such as morphine, codeine, and thebaine. These alkaloids produce various effects that people have used for centuries to relieve pain or other illnesses, in traditional ceremonies, and for recreational purposes.

Afghanistan produces about 80 percent of the world’s opium supply and exports a great deal of it to Iran, Russia, and Europe. In 2010, Afghan growers produced 4,860 megatons of opium. While poppy cultivation in Afghanistan increased between 2011 and 2012, the actual production of opium dropped by about one-third that year because of continuing blight, a plant disease that reduces yield. In response to the growing addiction and dependence problem and increasing pressure from other governments, Afghan officials have outlawed poppy production and have begun to offer opium detoxification and treatment.

Illicit drug makers convert most opium into heroin; pharmaceutical companies now use poppy straw made from the entire poppy plant to create therapeutic drugs rather than using opium. A substantial amount of opium remains in its raw form that most people smoke to get high. All forms of opium and its derivatives cause physical dependence requiring detoxification.

The people in opium-producing countries are more likely to use opium in its raw form rather than to use heroin. This is especially in Afghanistan, the Lao People’s Democratic Republic, Myanmar and the Islamic Republic of Iran, where opium enjoys a place in many cultural rituals and traditions. Additional recreational use increases the risk for opioid dependence and opium withdrawal.

About 4 million people worldwide use opium, consuming 1.1 megatons each year. Approximately 80 percent of those users are in Asia, where smoking opium is a culturally acceptable, traditional practice. Drug makers offer opium as a liquid, solid or powder. The use consumes opium by smoking it, injecting it into a vein, or by pressing opium into a pill and swallowing it. All forms of administration can lead to dependence requiring opium detoxification.

Very little raw opium reaches the United States. Opium is legal with a prescription in the United States, used in weak doses to relieve diarrhea. Heroin and prescription opioid abuse vastly outpaces opium use in the U.S., but there are still many Americans struggling with opium dependence.

Opium and Detoxification

Scientists classify opium as an opioid drug because of the way it binds to opioid receptors in the body’s nervous system to change the way the brain interprets pain signals. Opioids like opium cause other temporary neurological effects; immediately noticeable are relaxation, sedation, and euphoria. These effects make opium a target for recreational users. All opioids, including opium, can cause physical dependence requiring detoxification.

Opium and opioids cause other neurological effects that may not be favorable, such as an inability to think clearly, difficulty communicating thoughts or emotions, and inappropriate or dangerous behavior. With continuous use, the neurological effect become more permanent and affect how the person thinks, feels, and behaves all the time. This can interfere with his ability to work, take care of children or other responsibilities, and interacting with others. Chronic opium use can lead to job loss, divorce, loss of child custody, homelessness, criminal behavior and incarceration, illness, overdose, and death. Opium detoxification begins to reverse these effects and restore the individual to his former life.

Opium acts on other body systems to cause other therapeutic or unwanted physical effects; some of these actions affect withdrawal systems during opium detoxification. Opium and other opioids stiffen smooth muscle groups to make certain organs less functional. Smooth muscles line intestinal walls to slow down digestion and cause constipation during opium consumption; opium detoxification can cause diarrhea. Smooth muscles are also located in the lining blood vessels to change blood pressure during opium detoxification, in the eyes resulting in dilated pupils, and just beneath the skin to cause goose bumps.

Dependence, Opium Detoxification and Withdrawal

The human body becomes accustomed to toxic substances, including opium. With continual use, the body begins to rely on a certain level of opium in the blood to feel normal - the body becomes opioid-dependent.

When opium levels drop in an opioid-dependent body, it struggles to re-adjust to its new chemistry and cleanse itself of the toxic effects of opioids. Doctors refer to this as opium detoxification. An opioid-dependent person experiences the struggle for opium detoxification through unpleasant withdrawal symptoms.

Opium Detoxification Symptoms

An opioid-dependent person experiences withdrawal symptoms a few hours after smoking or otherwise consuming his last dose of opium. The severity of these symptoms often correlates with the duration and severity of the individual’s opium use.

Opium withdrawal symptoms are similar to other opioids and include:

  • Abdominal cramping
  • Diarrhea
  • Fever, runny nose or sneezing
  • Goose bumps and abnormal skin sensations
  • Hot sweats and cold sweats
  • Insomnia
  • Malaise
  • Muscle aches or pains
  • Nausea or vomiting
  • Pain
  • Rapid heartbeat
  • Rigid muscles
  • Runny nose
  • Shivering
  • Tremors
  • Teary eyes
  • Yawning

Left uninterrupted, these symptoms fade after about five days as the body completes the opium detoxification process and do not come back unless the person again becomes dependent on opium or another opioid.

The patient can use non-opioid medications to ease withdrawal symptoms, such as Imodium for diarrhea and ibuprofen for body aches; these drugs do not interfere with the detoxification process. He could stop withdrawal symptoms completely by consuming more opium but this would stop the detoxification process and return him to an opioid-dependent state.

History of Opium Detoxification

People have used opium to relieve pain since before recorded history but methods of opium detoxification had not emerged until late in the 19th century. Early healers, including Hippocrates, administered opium to relieve pain, calm anxious patients, correct sexual dysfunction, slow diarrhea and more. Opium was effective and most people tolerated it well, so the use of opium spread quickly around the world. Alexander the Great introduced opium to Persia and India; Arab traders then brought opium to China.

Because caregivers administered opium primarily for therapeutic reasons, only those few patients with chronic illnesses grew dependent on opium enough to need detoxification so early healers knew very little about opium detoxification.

In the 15th century, people in Persia and India began started using opium to get high; recreational opium use spread rapidly to other countries, especially China. This widespread use made the opium trade quite lucrative. Queen Elizabeth I first brought opium to England in 1601; by 1637, opium had become the main commodity between England and China. The Dutch started smoking opium in a pipe and this practice caught on in China, increasing the rates of recreational consumption centuries before medical science developed opium detoxification methods.

Using opium to get high greatly increases the risk for dependence, as a recreational use is more likely to use opium regularly for extended periods. In 1830, about 3 million Chinese people were addicted to opium. By the early 1838, some estimate nine out of ten villagers in some Chinese provinces had an opium problem. By 1899, opium dependence and addiction had emptied the silver reserves of the Chinese government, bankrupting the country of China.

Like many governments today, Chinese leaders in 1729 reacted by outlawing the smoking of opium and restricted domestic consumption to licensed medical use only. Outlawing an addictive recreational drug did not work in the 18th century as it does today - the Chinese ban on opium caused it to become a popular form of contraband sold on the black market. Because physical dependence and addiction are neurological problems requiring medical treatment, simply outlawing opium does not resolve the problem.

Opium is highly addictive, requiring a daily dose to avoid withdrawal symptoms. An opium addict of the time frequently sold all his possessions to afford his habit. China was not the only country to struggle with a growing opium addiction problem - recreational users and addicts were springing up all over England and the United States. The U.S. Treasury banned the sales of all legal narcotics in 1925, creating an active illicit opium trade in New York City’s China town.

During the next few decades, chemists learned how to create stronger medications from the alkaloids of opium, such as heroin and oxycodone. In the middle of the 20th century, heroin and cocaine addiction became more commonplace than opium addiction, although illicit drug abusers still enjoy using opium for recreational purposes. Using opium or any other opioid regularly can cause dependence requiring detoxification.

Benefits of Detoxification

Opium detoxification ends withdrawal symptoms and brings the patient to an opioid-free state but is only one part of the recovery process. By itself, opium detoxification does little to change the behaviors associated with drug abuse that increase the risk for relapse. Most opioid-dependent people benefit from some degree of rehabilitation to learn how to live without opium.

Detoxification facilitates the patient’s entry into recovery. Opium detoxification helps the patient think clearly and make reasonable decisions about his own recovery. The detoxification process ends withdrawal symptoms, allowing the patient to focus on treatment. Opium detoxification makes the individual feel better physically and emotionally, helping him remain in rehabilitation long enough to reverse the neurological effects of opium abuse. Detoxification also promotes abstinence and reduces the severity of opium abuse when relapses do occur.

Types of Opium Detoxification

While detoxification happens naturally, the word “detoxification” can refer to the medical process of lowering opium levels and relieving withdrawal symptoms. Detoxification can take place at home, with the help of an outpatient clinic, in a hospital or mental health institution, or at a dedicated detoxification facility.

About 2 million Americans are dependent on opium and other opioids; only about 10 percent of these individuals will seek help from a hospital, outpatient clinic, or specialized detoxification clinic. Everyone else will try self-care, getting help from a family doctor, going to an emergency room, or quitting while in jail or prison. Each of these is a viable approach to opium detoxification as long as it delivers effective care safely.

Self-Detoxification

Many people perform self-detoxification from opium at home, without any medication to reduce withdrawal symptoms or help from a medical professional. One effective method is tapering, where the individual consumes successively smaller doses of opium each day until he no longer experiences withdrawal symptoms.

Self-detoxification is appropriate for those who have been dependent on opium for only a short time, expect only moderate withdrawal symptoms, and are not likely to suffer complications.

Cold turkey

Some people “quit cold turkey” by discontinuing opium abruptly, which brings about severe withdrawal symptoms. As long as the individual does not use opium or other opioids, quitting cold turkey brings him to an opioid-free state in a relatively short time.

Natural remedies

Some people use natural remedies to relieve withdrawal symptoms caused by opium withdrawal. Chamomile, for example, alleviates diarrhea while ginger ease nausea.

Other people create treatment plans incorporating prescription and non-prescription drugs to relieve withdrawal symptoms. The Thomas Recipe calls for a benzodiazepine like Xanax or Librium to calm nerves and help with sleep, vitamin B for muscle aches, and L-Tyrosine for malaise.

Medical Detoxification

Medical detoxification, sometimes called medication-assisted detoxification, uses opioid or non-opioid drug to control the onset of opium detoxification and manage withdrawal symptoms. This type of care is available through outpatient clinics and inpatient facilities.

Outpatient Detoxification
Outpatient clinics usually administer opioid replacement drugs, such as methadone or buprenorphine, as an aid to opium detoxification. Because these replacement drugs are opioids, they mimic the effects of opium enough to reduce withdrawal symptoms. Patients start out on a relatively high induction dose of the replacement drug then gradually taper buprenorphine or methadone dosages until they are no longer opioid-dependent.

Outpatient detoxification is appropriate for those patients that have been dependent on opium for more than a year and who require little supervision.

Methadone

Doctors normally start patients on an induction dose of 10 to 15 mg methadone and increase dosages by 10 mg each day until the patient no longer experiences withdrawal symptoms. Once the physician determines a safe and effective induction dose, he decreases subsequent doses by 10 mg each day until the patient is no longer dependent on opioids.

Patients drink a beverage containing methadone.

Buprenorphine

A patient uses buprenorphine like methadone as an aid to tapering, except they place a buprenorphine tablet under his tongue where it dissolves and enters the bloodstream at the appropriate rate. Some patients abuse buprenorphine intravenously by dissolving the medication before injecting it into a vein.

Suboxone

Drug makers discourage this abuse by adding naloxone to buprenorphine in the brand name preparation, Suboxone. When taken under the tongue, naloxone has no effect. Intravenous naloxone use, however, neutralizes buprenorphine so the consumer does not get high. Furthermore, intravenous naloxone use causes withdrawal symptoms in an opioid-dependent consumer.

Inpatient Detoxification
Inpatient detoxification facilities perform opium detoxification without the use of opioids. Detoxification specialists give the patient drugs to lower opioid levels along with powerful anti-withdrawal drugs. The patient may receive an anti-emetic like Hydroxyzine or Promethazine to calm nausea, Loperamide for diarrhea, and Clonidine for a variety of symptoms including watery eyes, sweating and restlessness.

Inpatient opium detoxification is right for anyone who has little success with self-detoxification or outpatient care. Inpatient care is appropriate for those likely to suffer serious withdrawal symptoms or complications. This type of opium detoxification is suitable for those with serious psychiatric problems that may interfere with recovery, especially depression with suicidal thoughts or acute psychosis.

Rapid Opiate Detox

Rapid opiate detox is a safe and effective procedure that rids the body of opiates while the patient rests in a comfortable “twilight sleep.” Anesthesiologists sedate and anesthetize patients before administering the usual detoxification and anti-withdrawal drugs. Rapid detox patients awaken a few hours later, unaware of the uncomfortable and demoralizing withdrawal symptoms that may have prevented recovery in the past.

Our detox center: Who we are and what we do

We are a dedicated group of detoxification professionals. Our board-certified anesthesiologists and nurses have delivered compassion and effective care for more than a decade.

We prescreen patients for any illnesses that illnesses that may cause complications then develop a treatment plan designed to optimize the patient’s success; this care plan may include rapid detox. After completing opium detoxification, patients may continue treatment in our quality aftercare facility.

Comparisons of Opium Detoxification Approaches

Choosing between the various approaches to opium detoxification can be confusing, so it is often helpful to compare the treatment forms side by side to highlight the benefits and disadvantages of each.

Self-detoxification is the least expensive because it does not include anti-withdrawal drugs or professional guidance but, without these advantages, self-detoxification is most closely associated with severe withdrawal symptoms, complications, and relapse. Self-detoxification brings the patient to an opioid-free state in a relatively short time.

Outpatient maintenance is better than self-detoxification in that it offers replacement drugs that aid in tapering the benefits of professional counseling. Using these drugs can slow detoxification; some patients remain on methadone or buprenorphine for months or even years.

Inpatient care offers the strongest anti-withdrawal drugs, prescreening, professional treatment plans, and the closest patient monitoring to reduce complications and relapse.

Rapid detox is the most humane and efficient approach, offering fast and complete detoxification. Rapid detox brings the patient to a drug-free state in hours rather than days or months. Rapid detox frees the patient from the uncomfortable and demoralizing withdrawal symptoms that interfere with recovery.

Possible Complications from Opium Detoxification

The detoxification process is not usually a life-threatening procedure but complications can be dangerous. Pre-existing medical conditions and co-existing substance abuse problems increase the risk for complications, as do pregnancy and long-term or severe substance abuse.

Relapse is the primary complication associated with opium detoxification. Some people take more opium to stop withdrawal symptoms during the detoxification process; others relapse after completing opium detoxification.

Self Detox Possible Complications

Extreme and prolonged vomiting and diarrhea may cause dehydration and imbalances in potassium, sodium and other electrolytes. Withdrawal symptoms such as increased blood pressure, increased pulse, and sweating can worsen some heart conditions

Outpatient Care Possible Complications

Some people become dependent on the replacement opioid drugs and remain on methadone or buprenorphine for years. Methadone and buprenorphine can be unsafe - methadone accounts for a third of opioid pain reliever deaths, up six fold in ten years, even though methadone sales account for only 2 percent of the prescription painkiller market. Intravenous buprenorphine abuse can be fatal, especially when patients combine it with benzodiazepines like those used in The Thomas Recipe.

Inpatient Detox Possible Complications

Inpatient care provides great protection from complications but patient may still suffer obstacles during inpatient opium detoxification, especially those battling withdrawal from multiple substances, especially alcohol, benzodiazepines, sedatives and anti-anxiety drugs.

Rapid Detox Possible Complications

Rarely, someone could suffer an allergic reaction to the drugs used in rapid detox. Strong sedatives may complicate breathing, heart rate, and blood pressure. Patients receiving anesthesia may develop infection, swelling, or bruising at the injection site.

Detox Myths

Despite centuries of opium use and decades of research into the science of drug abuse, myths shrouding opium detoxification prevent many people from getting the help they need.

Self Detox Myths

Myth: Self-detoxification is not life-threatening, so it is always safe for everyone.
Fact: Self-detoxification can cause extreme withdrawal symptoms that cause dangerous complications for some people.

Myth: Home remedies like The Thomas Recipe are safe and effective because they include prescription and non-prescription drugs to reduce the threat of complications caused by withdrawal symptoms.
Fact: Combining prescription and non-prescription medications may cause dangerous drug interactions during opium detoxification.

Outpatient Detox Myths

Myth: It is cheaper to imprison drug abusers than to treat them.
Fact: One year of methadone costs an average of $4,700 per patient while 12 months of jail costs taxpayers about $24,000 per inmate.

Myth: Methadone causes weight gain.
Fact: Methadone restores a healthy appetite that leads to an increase in eating patterns and muscle mass.

Inpatient Detox Myths

Myth: Treating opium-dependent people in a hospital is a waste of space because addiction is incurable.
Fact: Drug dependence is a chronic neurological disease that has relapse rates similar to other high blood pressure, asthma, diabetes, and other chronic conditions - about 40 to 60 percent.

Myth: Spending money on drug treatment is a waste of precious resources.
Fact: Investing in drug treatment programs can actually return money to communities in need. 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: The pain and humiliation of opium detoxification is important, in that it punishes the patient for abusing drugs.
Fact: Suffering is never an appropriate part of any treatment plan. In fact, discomfort and despair actually reduce the chances someone will complete opium detoxification. Rapid detox is a humane approach to medical detoxification because it spares patients the uncomfortable and demoralizing withdrawal symptoms that may have prevented recovery in the past.

Myth: It takes days or weeks to complete the opium detoxification procedure.
Fact: It takes a reputable expert one to two hours to perform rapid detox.

Opium Detoxification and Pregnancy
Women dependent on opium have a higher risk for developing illnesses that cause complications during pregnancy, labor and delivery. These complications can endanger the lives of the woman and her fetus, causing hemorrhage, slowed fetal growth, premature labor and delivery, spontaneous abortion and fetal death. Methadone reduces these complications and is currently the only approved treatment plan for pregnant women.

Self Detox and Pregnancy

Self-detoxification may be unsafe during pregnancy. A pregnant woman should consult with a doctor before attempting even tapering.

Inpatient Induction to Methadone Maintenance during Pregnancy

A doctor will likely admit a pregnant woman to a hospital to start methadone treatments. The clinician will start the woman on a relatively low dose of methadone and increase daily dosages based on her response to treatment. He will perform fetal monitoring to gauge how well the baby tolerates methadone. This inpatient stay typically lasts three days before the hospital discharges the mother to outpatient care, where she continues methadone treatment until delivering her baby.

Inpatient and Pregnancy

A pregnant woman may start methadone as an outpatient. She will come to the clinic twice a day in the beginning, once for a daily dose and again for evaluation. She can reduce visits to once daily after the clinician establishes a safe maintenance dose. Women using methadone to maintain opioid dependence may suffer withdrawal symptoms late in pregnancy and require larger doses of methadone.

The woman may remain on methadone after delivering her baby or participate in detoxification from methadone.

Babies born to women taking methadone during pregnancy will remain under close observation in the hospital for 72 hours after delivery. These babies may suffer withdrawal symptoms during the first weeks or months of life, along with low birth weight, seizures, difficulties with feeding, breathing problems, and death.

What is the best method of opium detoxification?
Everyone experiences opium dependence a little differently and most people respond to opium detoxification in a slightly different way - what works for one person may not work for another. Someone considering opium detoxification should assess the potential severity of withdrawal symptoms, the likelihood of complications, and his ability to refrain from opium then choose the most restrictive approach to opium detoxification that is still likely to deliver safe and effective care.