Opium Withdrawal

Definition

Opium withdrawal is the result of the detoxification process. Withdrawal symptoms are a normal, predictable consequence of a sudden drop of opioid levels in the body of an opioid-dependent person. A doctor will diagnose you as being opioid-dependent if you suffer withdrawal symptoms several hours after your last dose of opium.

Withdrawal manifests itself in a variety of overpowering physical symptoms that can last five or more days. Psychological symptoms of opium withdrawal may last much longer. Left untreated or poorly treated, overpowering physical and psychological withdrawal symptoms can interfere with your attempts to quit opium.

Causes

Your body adapts to the presence of certain foreign substances in the body, including opioids such as opium. Your body can become tolerant of opium, which means you have to consume an ever-increasing amount of opium to get high. With prolonged use, the body may become dependent on the opioids in opium. This means you must continue to smoke opium for your body to feel normal. If the level of opioids drops in your body, your body will struggle to maintain its chemical balance. You will feel this battle through withdrawal symptoms.

Facts

Producers offered about 4,860 megatons of opium in 2010. The amount of opium decreased from 7,853 megatons the year before due to disease in the poppy plants in Afghanistan, the largest producer of opium. While traffickers convert a large percentage of this opium to heroin (the UNODC estimates traffickers offered 460 to 480 megatons of heroin worldwide in 2009), a substantial amount of raw opium makes it into the hands of consumers.

Some opium remains in its raw form. People from opium-producing countries are more likely to use opium than heroin. This is especially true 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 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.

While heroin and prescription opioid abuse outpaces opium use in the United States, anyone who uses opium regularly may become dependent on opium.

Withdrawal symptoms are painful and demoralizing, but usually not life threatening. The severity and duration of your opium withdrawal symptoms may depend on how long you have used opium and the regularity at which you used it.

Abuse, Dependence and opium Withdrawal

Opium is highly addictive and anyone who uses opium for a long time can become opioid-dependent. The U.S. Drug Enforcement Agency, or DEA, classifies substances according to the potential for abuse, and has classified most forms of opium as Schedule II narcotics. This means raw opium carries a relatively high potential for abuse and mental or physical dependence. The DEA classifies the paregoric formula of opium used for diarrhea as a Schedule III narcotic, which means this formula presents less of a risk for abuse than raw opium or its alkaloids.

To reduce this potential for abuse, the DEA prohibits refills on schedule II narcotics such as opium. Many opioid-dependent people try beat the system by placing an emergency call after hours. He may show up at the doctor's office just as it is closing up for the day, and then refusing examination, testing or referral to another facility. He might then stall when asked to provide prior medical records or contact information for other caregivers. He may go "doctor shopping" to get as many written prescriptions as possible.

He may also present phony prescriptions at pharmacies. An opioid-dependent person may seem to lose his prescriptions more than the average person does; he may even tamper with the written prescription so he gets more opium in each bottle.

As the local physicians and pharmacies become familiar with the opioid-dependent individual and begin refusing prescriptions for him, he will have to resort to purchasing it on the street.

Symptoms

Symptoms of opium withdrawal feel like the flu. Opium withdrawal also causes psychological symptoms whose demoralizing affects can be just as overpowering as the physical symptoms of withdrawal.

Symptoms of opioid 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, runny nose, sweating and yawning. Later symptoms include abdominal cramping, diarrhea, dilated pupils, goose bumps, nausea and vomiting.

Physical

Symptoms last five or more days, with the worst symptoms occurring on or about the fourth day. Physical symptoms of opium withdrawal last five or more days, with the worst symptoms occurring on or about the fourth day. You can ease these symptoms by taking medicine to address each symptom, using drugs that mimic opium's effects or by taking more opium. Without medical attention and professional support, the promise of relief from withdrawal symptoms causes many to relapse to opium abuse.

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
  • Low Energy Level
  • Muscle Aches or Pains
  • Nausea or Vomiting
  • Pain
  • Rapid Heartbeat
  • Rigid Muscles
  • Runny Nose
  • Shivering, Tremors
  • Teary Eyes
  • Yawning

Psychological

Psychological symptoms of opium withdrawal can interfere with hopes for recovery. The psychological aspects of opium withdrawal can leave you feeling unworthy or incapable of recovery. Left untreated or poorly treated, these psychological symptoms increase the chances you will return to opium abuse.

Psychological symptoms of withdrawal include:

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

Possible Complications

The greatest complication associated with opium withdrawal is relapse to opioid abuse. Without proper intervention, you may suffer endless cycles of relapse and remission. Every relapse makes recovery seem even further out of reach.

You face a greater risk for toxic overdose if you have experienced opium withdrawal symptoms just before taking more opium. Any amount of detoxification reduces your tolerance to opioids. Even after feeling moderate withdrawal symptoms, you could potentially overdose on a smaller dose of opium than you used to take.

Other complications include vomiting, then breathing the stomach contents into the lungs. This is aspiration and it may result in fluid in the lungs or lung infections. You can suffer dehydration after long bouts of extreme vomiting and diarrhea. Left untreated, dehydration can cause electrolyte imbalances and other serious medical conditions.

Treatment options

Without adequate rehabilitative therapy, you might find yourself trapped in a dangerous cycle of recovery and relapse. Treatment includes two phases: detoxification and rehabilitation. Detoxification deals specifically with the process of opium withdrawal. Rehabilitation helps you avoid relapses and therefore reduce the number of times you will need to endure opium withdrawal.

Detoxification is the medical process of lowering opium levels in your body. With most types of detoxification processes, you can expect several days of intense withdrawal symptoms as your body adjusts to lower opioid levels.

The rehabilitation phase includes behavior modification and counseling to teach you how to live without opium. During counseling sessions, trained professionals give you the tools you need to change behaviors associated with opium abuse.

Detoxification

You might someday be tempted to try self-detoxification, or "go cold turkey." Cold turkey refers to your skin's appearance during the detoxification process: pale, cold and clammy with goose bumps, much like a plucked turkey's skin. Your skin will return to normal each time your body adjusts to low levels of opium.

While it is possible to stop using opium without medical assistance, self-detoxification offers no protection against brutal physical and psychological withdrawal symptoms you will endure. During self-detoxification, you will experience the full force of opium withdrawal symptoms unprotected by medicines or trained professionals. You are at greater risk for relapse and complications as well.

The goal of self-detoxification is to make it through five or more days, with the worst symptoms occurring on or about day four. During self-detoxification, you will be tempted to use more opium just to stop the discomfort. Self-detoxification is miserable and ineffective.

Some people use homemade treatment plans including medicines to reduce individual withdrawal symptoms. One such remedy is The Thomas Recipe, which includes valium or some other benzodiazepine to calm your nerves and ease insomnia. Imodium eases your diarrhea while mineral supplements and hot baths soothe your achy muscle.

On or about the fourth day, you will awaken with an overpowering lack of energy and intense malaise that makes it difficult to move around. The Thomas Recipe calls for a L-Tyrosine with B6 for a burst of energy.

While the Thomas Recipe addresses some of the physical withdrawal symptoms, you still face a high risk for complications such as aspiration, dehydration and relapse. Returning to opium addiction after even a short attempt at detoxification may result in life threatening toxic overdose.

Overdose

It is possible to take too much opium. Using high doses of opium, or taking opium after experiencing withdrawal symptoms, increases your risk for toxic overdose. Overdose is a serious, sometimes fatal medical emergency. If you think you or someone you know has taken too much opium, seek emergency assistance immediately by going to the emergency room or calling an ambulance. If you need immediate help, contact your local poison control center at 1-800-222-1222.

Overdose effects include slow breathing, seizures, dizziness, weakness, loss of consciousness, coma and possible death.

Medication-Assisted Treatment

Unlike self-detoxification, Medication-Assisted Treatment, or MAT, reduces opium withdrawal symptoms enough to make the detoxification process tolerable 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 detoxification involves a hospital stay. During inpatient care, doctors administer naloxone and other medications to reduce your opioid levels along with drugs to alleviate your withdrawal symptoms. While standard inpatient MAT relieves the strength and duration of your symptoms somewhat, you still face a long, difficult and demoralizing battle. Lengthy detoxification processes leave psychological scars that can interfere with your recovery. Medically assisted detoxification is only the first stage of treatment for dependence on opium and, by itself, does little to change the behaviors associated with long-term opium use.

Rapid detox is the most humane and efficient form of detoxification available today. Rapid detox quickly puts you in a good place to deal with your dependence on opium. During rapid detox, board certified anesthesiologists give you the standard detoxification and anti-withdrawal drugs along with sedatives and anesthesia, so you will nap in a pleasant "twilight sleep." When you wake up, 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

When people first developed a dependence on opium addiction in China and the United States, healthcare providers did not view opium dependence as a medical problem so much as a cultural, social or legal issue. After decades of clinical studies and medical research, rehabilitation professionals have now established a set of principles for the effective treatment of addiction.

Today, doctors and scientists agree that opium abuse is a complex but treatable condition that affects brain function and behavior. Dependence on opium is a physical condition; it is not an indication of your moral character or willpower.

Opium dependence expresses itself differently for each individual so it is reasonable that no single treatment is appropriate for everyone. There is now a wide variety of treatments available, from long-term inpatient care to monthly counseling sessions.

No matter what type of rehabilitation facility you choose, treatment needs to be readily available to be effective. Many people stop engaging in therapy sessions that are expensive, at inconvenient times or are far away.

Effective treatment attends to your multiple needs, not just your opium addiction. You are a complex person with a complicated medical condition. You may have other social, personal or legal issues that interfere with your recovery efforts.

It is important that you remain in treatment for enough time for your body to resume normal function before you leave the treatment facility. You cannot undo the damage to your brain and body in just a few days or weeks.

Individual, family and group counseling, along with other behavioral therapies, are the most commonly used forms of drug abuse treatment. These therapies teach you how to cope with stress, resolve differences and engage with others in a positive, meaningful way without resorting to opium or other drugs.

Medications are an important element your rehabilitation, especially when combined with counseling and other behavioral therapies. Certain medications can ease withdrawal symptoms, soothe anxieties and help you sleep. Many individuals struggling with opium addiction need medication to address other illnesses that interfere with recovery, such as depression.

Your counselor or physician will continually assess your progress and adjust your treatment plan accordingly. Your needs will change as you take the journey from opium addiction to recovery, and your counselor will modify your course as necessary to ensure it meets those changing needs.

Many drug-addicted individuals also have other mental disorders that worsen opium addiction or prevent recovery. Talk with your doctor or rehabilitation professional if you feel a mental illness is interfering with your attempts at rehabilitation.

Medically assisted detoxification is only the first stage of treatment for your opium addiction treatment. By itself, detoxification does little to change long-term drug abuse because it does not address the behaviors associated with opium addiction.

Treatment for opium addiction does not need to be voluntary to be effective. According to NIDA, individuals under legal coercion tend to remain in treatment longer than and do better than those not under pressure.

Counselors will monitor your drug use continuously during treatment. Relapse to opium use during rehabilitation is common and your healthcare provider must remain vigilant against return to drug use.

Your healthcare provider may test you for HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases. The counselor will discuss with you behavioral changes that will reduce your risk for developing or spreading these diseases.

Facts

Programs

Risks