- Generic Name or Active Ingridient: Oxymorphone
Oxymorphone detoxification brings a person’s body to an opioid-free state. Oxymorphone detoxification is an important part of a treatment plan that helps someone overcome his dependence on oxymorphone.
Oxymorphone is a powerful semi-synthetic opioid pain reliever that drug manufacturers create from morphine, extracted from the opium poppy plant. Drug manufacturers offer several strengths of oxymorphone as tablets and in an injectable form under the brand names Opana, Opana ER, and Numorphan. Doctors prescribe oxymorphone to relieve a patient’s moderate to severe pain.
Oxymorphone works like other opioids on the central nervous system, or CNS, to ease pain. Oxymorphone acts directly on the nervous system to change the way the brain interprets pain signals received from nerve endings around the body. Other neurological reactions to oxymorphone include sedation, relaxation and a pleasant feeling of euphoria. In addition to the CNS, oxymorphone affect the cardiovascular, digestive and other system.
With long-term use, some effects result in semi-permanent changes throughout the brain and body that alters the way the individual thinks, feels and behaves. These alterations may negatively affect his ability to work, take care of responsibilities or interact with others.
Most people use oxymorphone as directed to treat actual pain relating to an illness, injury or invasive medical or dental procedure. Some people use oxymorphone for non-medical reasons, either to get high or to treat a condition other than the one the doctor had intended to treat when she prescribed oxymorphone. Someone can abuse oxymorphone by swallowing a whole tablet or by crushing the tablet then snorting or dissolving and injecting the drug into a vein. Each year, about 5 million Americans use pain relievers such as oxymorphone for non-medical reasons.
Anyone who uses oxymorphone regularly, whether for therapeutic or for non-medical reasons, can become physically dependent on this drug and require oxymorphone detoxification. According to results from a 2011 National Survey on Drug Use and Health, about 1.9 million Americans are dependent on prescription painkillers including oxymorphone. This number has grown slightly since 2004, when there were 1.4 million opioid-dependent people in the United States.
An opioid-dependent person feels uncomfortable flu-like symptoms when she stops using oxymorphone. The human body becomes accustomed to the presence of certain substance, including oxymorphone and other opioids. As someone uses oxymorphone regularly, her body begins to depend on a certain level of opioids to feel normal. When she stops using oxymorphone suddenly, her body struggles to regain its new chemical balance.
Doctors call this detoxification, referring to the way the body rids itself of toxins caused by long-term opioid use. Detoxification reverses some of the immediate effects of oxymorphone use but many physical and neurological changes persist for several weeks or months after complete detoxification.
Detoxification causes withdrawal symptoms in an opioid-dependent person. These withdrawal symptoms begin a few hours after the last dose of hydromorphone and continue for five or more days. Left untreated, these withdrawal symptoms disappear as the body completes the hydromorphone detoxification process and do not return unless the individual returns to an opioid-dependent state.
Someone can stop withdrawal symptoms at any time by taking more oxymorphone, but relapse reverses the detoxification process and returns the individual to an opioid-dependent state.
Detoxification can also refer to a medical process that helps the patient reach an opioid-free state. Oxymorphone detoxification can take place at home, through an outpatient clinic, or at an inpatient hospital setting.
Hydromorphone detoxification is only one phase in the recovery process and, by itself, does little to change behaviors that lead the individual back to drug abuse. Most opioid-dependent individuals benefit from rehabilitation, participating in counseling and behavior modification to learn how to live a drug-free life.
Hydromorphone detoxification facilitates the patient’s entry into rehabilitation by ending withdrawal symptoms permanently, freeing the individual to focus on recovery rather than feeling sick. Detoxification helps the patient remain in rehabilitation long enough to reverse some of the neurological and physical changes associated with chronic or severe oxymorphone abuse.
Detoxification clarifies the patient’s thought patterns, emotional health and restores some of the normal behaviors lost through chronic hydromorphone abuse, helping the individual hold a steady job, take care of family and interact with others in an appropriate way. Because of all these benefits, hydromorphone detoxification usually improves the patient’s self-esteem and emotional well-being.
Hydromorphone reduces the risk for relapse, and decreases the frequency and severity of drug use episodes when relapses do occur.
Types of Detox
While nearly 2 million Americans had a substance abuse problem relating to prescriptions painkillers like oxymorphone in 2011, only about 726,000 received treatment in the prior year. Each year, only about 10 percent of those that need help for a substance abuse problem receive it in a specialty facility, such as an inpatient hospital, outpatient clinic, or mental health institution. Everyone else tries self-help, working with a private physician, gaining emergency help in a hospital ER, or while in jail or prison.
When it comes time for someone who uses oxymorphone to treat chronic pain to discontinue this medication, his physician will typically suggest the patient wean himself from opioids by taking consecutively smaller doses - just enough to stop withdrawal symptoms - each day.
Self-detoxification is most appropriate for those who have been dependent for only a short time and are still under the care of the physician who prescribed oxymorphone.
Tapering works well for most people but stubborn withdrawal symptoms prevent some people from stopping oxymorphone at the appropriate time. An individual might be tempted to quit cold turkey by discontinuing oxymorphone abruptly, intending to just ride out withdrawal symptoms long enough to complete the detoxification process.
Quitting cold turkey is physically difficult, especially without medications to ease the severity of withdrawal symptoms. The phrase “cold turkey” refers to the skin’s appearance during oxymorphone detoxification - pale, cold, and clammy with goose bumps, much like a plucked and frozen turkey.
Cold turkey is appropriate for those who have been opioid-dependent for only a short time and who are unable to wean themselves from oxymorphone.
Without the protection of anti-withdrawal drugs, many who try quitting cold turkey fail. Some use natural remedies to strengthen the body during the detoxification process or to buffer themselves from withdrawal symptoms. Meditation, acupuncture, yoga, and massage ease body aches, promote relaxation and help with sleep. Consuming ginger or peppermint soothe nausea; chamomile or cayenne slow diarrhea.
Some take a pharmaceutical approach to oxymorphone, incorporating prescription and over-the-counter remedies into homemade treatment plans. One such remedy is The Thomas Recipe, in which the patient takes benzodiazepines such as Xanax or Librium to calm anxiety and promote sleep at night, vitamin V6 and supplements along with hot baths for muscle aches and restless leg syndrome, Imodium for diarrhea and a dose of L-Tyrosine for a burst of energy during the day.
Many patients achieve an opioid-free state after engaging in medical detox, sometimes called medication-assisted detoxification. Medical detoxification procedures use opioid or non-opioid drugs to help the patient complete the oxymorphone detoxification process.
Outpatient clinics use low doses of opioids in one of two ways to help someone control his dependence on oxymorphone. Most people are familiar with drug replacement or maintenance programs in which the patient takes methadone or another drug to delay detoxification while the individual participates in rehabilitation. The patient typically takes doses too low to cause euphoria but just strong enough to prevent the onset of withdrawal symptoms. The patient weans himself from the replacement drug once he learns how to live without oxymorphone.
Today, outpatient clinics offer medication-assisted detoxification using methadone or buprenorphine to help the patient control withdrawal symptoms during the tapering process. Patients start out on a high induction dose of methadone or buprenorphine then take a smaller dose each day during the tapering period until the patient achieves an opioid-free state.
Outpatient medication-assisted detoxification is appropriate for patients who need to work or cannot otherwise spend time in a hospital, and who cannot safely or effectively wean themselves from oxymorphone.
A previously unknown German chemist first synthesized methadone for use as a pain reliever in 1939. Doctors worldwide still prescribe methadone to relieve pain today. During its years as an analgesic, physicians noticed methadone stopped withdrawal symptoms in heroin addicts. In 1964, doctors used methadone to curb a heroin epidemic sweeping across New York City. The FDA approved methadone as a treatment for opioid dependence in 1972.
Today, about 100,000 Americans use a methadone maintenance program. Many outpatient clinics now offer methadone as part of medication-assisted treatment, with patients taking large induction doses of methadone then lowering dosages throughout the tapering phase.
Some patients use buprenorphine instead of methadone as an aid to oxymorphone detoxification. The patient places the buprenorphine tablet under his tongue where it dissolves and enters the blood system. It may take longer for some patients to complete the detoxification process, but many who use buprenorphine complete the detoxification process in as little as one week, taking high induction doses for the first three days then tapering during days four through seven. Subutex is a brand name drug containing buprenorphine.
It is possible to abuse buprenorphine intravenously by dissolving the tablet before injecting it into a vein. Drug makers deter this practice by adding naloxone to the brand name buprenorphine preparation, Suboxone.
When placed under the tongue, naloxone has very little effect on the users. When injected into a vein, however, naloxone neutralizes the effects of buprenorphine so that the consumer does not get high. Additionally, intravenous naloxone use causes withdrawal symptoms in opioid-dependent consumers.
Many people benefit from inpatient oxymorphone detoxification because of the powerful anti-withdrawal medications and close patient supervision that only a hospital can provide. Most inpatient facilities administer non-opioid medications to help the patient complete oxymorphone detoxification, such as hydroxyzine or promethazine for nausea, Loperamide for diarrhea, and clonidine to treat a variety of symptoms, including watery eyes, sweating, and restlessness.
Inpatient oxymorphone detoxification is helpful for anyone who desires the benefits of inpatient care, and for those with a proven history of poor performance in or not benefiting from other less-restrictive approaches, such as self-detoxification or outpatient care. Inpatient care is also appropriate for those at risk for severe withdrawal symptoms or dangerous complications.
Inpatient oxymorphone detoxification is necessary for anyone with underlying medical conditions that make outpatient detoxification unsafe, such as heart conditions. Inpatient care is also right for someone who has not responded to other forms of treatment and who suffers dependence severe enough to pose a danger to his own safety or to the safety of other others.
Anyone who is recovering from an overdose or who cannot otherwise receive safe treatment as an outpatient must engage in inpatient oxymorphone detoxification. Inpatient care is essential for someone with psychiatric problems that interferes with his ability to participate in outpatient treatments, especially those with acute psychosis or depression with suicidal thoughts.
Rapid Opiate Detox
Rapid detox rids the body of oxymorphone while the patient dozes in a comfortable “twilight sleep.” Prior to the usual detoxification and anti-withdrawal drugs, rapid detox physicians anesthetize and sedate the patient so that he rests comfortably throughout the oxymorphone detoxification procedure. When the patient awakens a few hours later, he will have no memory of the difficult detoxification process.
Our detox center: Who we are and what we do
We are a group of board-certified anesthesiologists and other dedicated professionals who help patients complete the oxymorphone detoxification process in a safe and effective manner using cutting-edge rapid detox procedures. We have helped thousands of people achieve an opioid-free state since opening our doors more than a decade ago.
We believe in treating patients as people, not as drug addicts. We listen closely to their needs during prescreening in our accredited hospital, creating an individualized treatment plan to reduce any complications that could interfere with complete oxymorphone detoxification. Following rapid detox, we invite patients to continue the recovery process in our qualified aftercare facility.
Each opioid-dependent person is unique; every person experiences substance abuse and recovery in a slightly different way. This means no single treatment is right for everyone. It also means someone may try different approaches to oxymorphone detoxification before finding one that works well for him.
With all the different approaches, choosing a treatment program can be a daunting task - picking the right treatment program can make all the difference between relapse and recovery. It can sometimes be helpful to compare the various approaches to oxymorphone detoxification.
Without the expense of anti-withdrawal drugs or professional medical care, self-detoxification is the least expensive approach to oxymorphone detoxification. However, without anti-withdrawal drugs and professional care, self-detoxification leaves the patient unprotected from severe and prolonged withdrawal symptoms and complications. Self-detoxification does bring the patient to an opioid-free state in a week or two, especially if the individual quits cold turkey.
Outpatient detoxification can bring the patient to an opioid-free state in a week or so, but sometimes the patient has trouble discontinuing methadone or buprenorphine and remains opioid-dependent for months or even years. Outpatient detoxification is superior to self-detoxification in that it addresses withdrawal symptoms and provides professional guidance, reducing the risk for complications somewhat. Outpatient care is more flexible than inpatient detoxification, allowing patients to complete the process without the inconvenience of a hospital stay.
Inpatient care provides the greatest protection from withdrawal symptoms and complications, and offers the highest level of supervision to reduce complications and relapse. Inpatients usually complete oxymorphone detoxification and reach an opioid-free state in 4 days, compared with 197 days for medication-assisted therapy.
Rapid detox is the most efficient and humane approach to oxymorphone detoxification. Rapid detox frees patients from the uncomfortable and demoralizing detoxification process in just a few hours.
Detox Possible Complications
Oxymorphone detoxification is not normally life-threatening but severe withdrawal symptoms, co-existing illnesses or substance abuse problems, pregnancy, or chronic oxymorphone abuse increases the risk for dangerous complications.
Relapse is the primary complication associated with oxymorphone relapse, and can result in accidental overdose. The detoxification process lowers the individual’s tolerance of oxymorphone, making him more sensitive to the effects of opioids. This lowered tolerance and increased sensitivity puts the individual at heightened risk for overdose after relapse - it is possible for someone to take a fatal overdose on a smaller amount of oxymorphone than he used to take before experiencing modest withdrawal symptoms for a short time.
Overdose from opioid pain relievers like oxymorphone claim the lives of 14,800 Americans in 2008, killing more people than overdose from cocaine and heroin combined. According to statistics cited by the U.S. DEA, the total number of emergency department visits associated with oxymorphone skyrocketed in just one year, rising from 855 ER visits in 2008 to 2,248 in 2009. In Florida alone, the number of oxymorphone-related deaths increased by more than 242 percent in that same year, rising from 69 deaths in 2008 to 236 in 2009.
Self Detox Possible Complications
Severe and prolonged withdrawal symptoms can result in dangerous complications, especially in the presence of pre-existing illnesses, substance abuse problems, pregnancy and acute opioid dependence. Without professional monitoring, these complications can become serious.
Protracted bouts of extreme vomiting or diarrhea can lead to dehydration and electrolyte imbalances, such as low potassium and sodium levels. Oxymorphone detoxification may sometimes increase blood pressure, pulse and perspiration in a way that worsens some pre-existing heart conditions. The detoxification experience is stressful and can increase anxiousness in someone already suffering from an anxiety disorder. Oxymorphone detoxification can also cause the return of pain in patients suffering from chronic pain disorders, such as arthritis or cancer.
Outpatient Care Possible Complications
Outpatients suffer fewer complications than do those who attempt self-detoxification but medication-assisted detoxification does cause complications for some patients. Patients may have trouble establishing a safe, effective dose of methadone or buprenorphine that still covers withdrawal symptoms. A few individuals have trouble quitting the replacement drug; some remain on methadone for years or even for life.
Methadone is not entirely safe. Despite accounting for only about 2 percent of sales on the prescription painkiller market, methadone accounts for a third of opioid pain reliever deaths. The number of methadone-related overdoses is on the rise: in 2009, there were 5.5 times as many deaths associated with methadone as there were in 1999. Most of these overdoses were associated with methadone abuse and combining methadone with other substances.
While associated with fewer cases of fatal overdoses than methadone, it is still possible to abuse buprenorphine through intravenous use. Doctors have reported fatalities associated with buprenorphine abuse when the patient combined this drug with other substances, especially benzodiazepines used in The Thomas Recipe.
Patients may experience withdrawal symptoms while trying to establish a safe and effective buprenorphine dosage.
Inpatient Detox Possible Complications
Patient screening, professional treatment plans including anti-withdrawal medications, and close patient supervision reduces complications during inpatient oxymorphone detoxification. Co-existing medical conditions and coinciding withdrawal from multiple substances can cause complications in inpatients, especially for those detoxifying from oxymorphone and alcohol, benzodiazepines, sedatives and anti-anxiety drugs.
Inpatients may suffer a reaction to the medications used in inpatient treatment.
Rapid Detox Possible Complications
Rarely, a patient will suffer an allergic reaction to the medications used in rapid detox. High doses of sedatives may cause the patient to have trouble with breathing, blood pressure and heart rate. A patient might experience infection, swelling or bruising at the anesthesia injection site.
Despite decades of medical research and clinical experience reported by real doctors and patients, myths prevent many people from getting the help they need to complete the oxymorphone detoxification process.
Self Detox Myths
Myth: Self-detoxification is simply mind-over-matter; anyone can complete oxymorphone detoxification if he has enough determination.
Fact: While willpower is important when presented with the opportunity to take more drugs, oxymorphone detoxification is an intense physiological process that occurs whether the individual is determined or not. Self-control would not reduce withdrawal symptoms any more than it would ease symptoms associated with the flu.
Myth: Home remedies like The Thomas Recipe are safe and effective because they include prescription and non-prescription drugs just like the doctors use.
Fact: Combining prescription and over-the-counter remedies can result in dangerous drug interactions, especially when the patient already has high levels of opioids in her system.
Outpatient Detox Myths
Myth: It would be cheaper to toss oxymorphone abusers in jail than to provide treatment.
Fact: One year of methadone costs an average of $4,700 per patient. One year of imprisonment costs about $24,000 per prisoner.
Myth: Methadone was originally named Dolophine, after Adolf Hitler.
Fact: Drug makers combined the Latin word for pain, dolor, with the French word for end, fin, to create the brand name Dolophine.
Inpatient Detox Myths
Myth: Inpatient care is useless - people who are dependent on oxymorphone will always relapse back to drug abuse.
Fact: Relapse rates for drug addiction are similar to those of other chronic diseases, such as high blood pressure, diabetes or asthma - about 40 to 60 percent.
Myth: Communities cannot afford wasting money on drug treatment programs right now.
Fact: Communities can save money by investing in drug treatment programs. Experts estimate every dollar spent on drug treatment programs returns a yield between $4 and $7 in reduced drug-related crime rates and criminal justice costs. Add in healthcare costs associated with drug dependence and these savings leap to $12 gained for every dollar invested.
Rapid Detox Myths
Myth: Pain and humiliation are important to oxymorphone detoxification; they teach the patient a lesson about abusing drugs.
Fact: Suffering is never a part of a treatment plan for any medical condition, including opioid dependence. In fact, the uncomfortable and demoralizing aspects of withdrawal increase the risk the patient will relapse. Rapid detox is the most humane and efficient approach to oxymorphone because it allows the patient to rest comfortably during the otherwise difficult procedure.
Myth: It takes days, weeks or months to complete oxymorphone detoxification.
Fact: A rapid detox patient can achieve an opioid-free state in one to two hours.
Detox and Pregnancy
Opioid-dependent women face an increased risk of certain ailments including anemia, heart disease, hepatitis, pneumonia, blood infections, and depression or other mood disorders. These conditions increase the risk for serious complications during pregnancy, labor and delivery, such as wildly fluctuating blood sugar levels, hemorrhage, slowed fetal growth, separation or irritation of the tissues surrounding the baby, premature labor and delivery, spontaneous abortion and fetal death.
These conditions and complications may make it dangerous for pregnant women to attempt oxymorphone detoxification. Methadone reduces these complications. Currently, methadone maintenance is the only approved approach to treating opioid dependence in pregnant women.
A baby born to a woman who uses opioids regularly during pregnancy may be born opioid-dependent and suffer withdrawal symptoms in the first weeks or months of life. These babies tend to suffer from low birth weight, seizures, breathing difficulties, feeding problems, and death.
Self Detox and Pregnancy
The medical conditions and complications associated with opioid-dependence and pregnancy may make self-detoxification dangerous for pregnant women. A pregnant woman should consult with a physician before attempting self-detoxification.
Outpatient and Pregnancy
The pregnant woman may choose to start methadone maintenance as an outpatient. Doctors typically start pregnant women out on 10 to 20 mg of methadone and gradually increase dosages to find one that adequately covers her withdrawal symptoms. The patient may have to return to the outpatient clinic twice a day to help the physician establish dosage. Some women require larger doses late in pregnancy.
Inpatient and Pregnancy
The opioid-dependent woman may start methadone maintenance as an inpatient, where doctors can monitor her condition closely. This inpatient stay typically lasts three days. Inpatient care often includes fetal movement monitoring to assess the baby’s response to methadone.
Babies born to women taking methadone during pregnancy usually remain in the hospital for the first 72 hours of life.
Opiate detox symptoms
Oxymorphone detoxification typically causes withdrawal symptoms that appear in two waves, with the first set of symptoms beginning a few hours after the last dose of oxymorphone. Initially, the patient may feel anxious or agitated and have trouble sleeping. His eyes may be watery and his nose might run.
Later, he may develop stomach cramps, diarrhea, nausea, and vomiting. His pupils may grow large and he might get goose bumps on his skin.
What is the best method to detox from this drug?
The best method of oxymorphone detoxification depends largely on individual need. The person should assess her own ability to avoid risky behaviors and refuse drugs when given the opportunity then choose a form of treatment that reflects her capabilities. Most specialists suggest a patient select the least restrictive setting that is still likely to be safe and effective.
- Oxymorphone Detox