Opiate Withdrawal Timeline

Understanding the withdrawal process is a crucial part of the path to recovery, as experts in the detox space we are breaking down the general opiate withdrawal timeline and detail out that various factors that will affect this process.

According to the American Society of Addiction Medicine, over 21 million Americans ages 12 and older experienced a substance abuse order in 2014; with nearly 600,000 people abusing heroin specifically.

Heroin is one of the most addictive and dangerous opiates there is today. Opiates fall into a class of drugs that includes popular prescription medications, such as oxycodone, codeine, morphine, and hydrocodone. Many people who use heroin are first introduced to the drug through one of these prescription opiates used to alleviate pain.

The dosage and frequency a person is prescribed pain medication is crucial because addiction is a dangerous risk. Once a person becomes addicted, he or she craves the feeling of pain relief or euphoria and relentlessly searches for ways to get the next “fix.” When they can longer get their prescription fulfilled, they turn to other means to find the drug.

An individuals opiate withdrawal symptoms timeline will vary drastically as withdrawal from opiates can last for months, years, or in some cases, a lifetime. The initial withdrawal symptoms may not reach that full length of time, but the long-term effects of opiates can have a long-lasting impression. It not only changes the body, but how a person acts, functions, feels, and behaves.

The timeline for opiate withdrawal depends on a variety of factors including age, how long the person has been using opiates, and how much of the drug has been consumed. For example, older people who have been addicts for years or decades go through a withdrawal process that typically lasts longer and is more difficult than a younger person who may have used for a few months.

This isn’t to say drug use of two months isn’t as dangerous as using for two years. Any time a person takes opiates, there is a risk for addiction and worse, overdose. However, in this scenario, a young person can metabolize drugs at a much faster rate. The body hasn’t become consumed by drug dependency, and the immune system is typically stronger than someone who is older.

Regardless of what stage of life a person decides to enter detox, drug withdrawal is highly uncomfortable and an often painful experience. This is a key reason why addicts are reluctant to ever refrain from using drugs. One, their bodies do not know how to function normally without drugs and two, the intense pain of withdrawal is too much to bear.

For addicts who choose to detox, it’s not recommended they go through the process alone, since there is a higher chance of relapse. A treatment center is a preferred option for success.

A Short History on Opiates

Opiates are derived from opium poppy and have been used for centuries for both medicinal and recreational purposes. Its most active substance is morphine, a commonly prescribed painkiller, which is also highly addictive.

Morphine originates from the Greek god of dreams, Morpheus, and was prepared in the past as part of an alcoholic solution. Over time, opium was extracted in its pure form and was a popularly used painkiller during the American Civil War.

New painkillers like Percocet and OxyContin were introduced in the mid- to late-90s as man-made opiates or “designer drugs” used to imitate the body’s natural painkillers. Fast forward to current day and opiates are still widely prescribed for patients post-surgery and for those who experience chronic pain.

In 2014, drug overdose was the leading cause of accidental death in America. Over 47,000 people overdosed on legal drugs. Opioid addiction was the leading cause with nearly 19,000 deaths attributed to an overdose of prescription pain relievers. This is approximately 9,000 more than the number of overdose deaths related to heroin in the same year.

Heroin has infiltrated suburban neighborhoods, in addition to the inner city areas where it was previously prominent, due to the rise of heroin supply and demand. The problem has grown so rapidly in the past few years that the government has categorized it as a national epidemic.

How Do Opiates Affect the Body?

Opiates are attached to receptors, which occur naturally in the brain. The brain can create its own opioids, which result in pain relief. However, the body is not able to produce opioids on a large enough scale to cause an overdose. Regardless of what is creating the feeling, it is the euphoric high that drug abusers chase.

When a person has taken opiates for a long time, the body isn’t affected as much as before. Addicts need more frequent, stronger doses to feel the same effects they did when they began using. This immediate need can quickly lead to overdose.

What to Expect from Opiate Withdrawal: The Symptoms of Opiate Withdrawal Timeline

Millions of people are drug dependent on opiates, and the withdrawal symptoms can range from mild to severe with different levels of intensities in between. Each withdrawal period will differ based on varying influences, and each person will go through a unique experience. However, the timeline for opiate withdrawal is approximately seven days.

The first few days are the most difficult because the body is used to functioning with drugs in the system. Opiates change the physiology of the body and affect major organs including the heart and brain. When opiates are suddenly eliminated without immediate replenishment, the body’s reaction is severe.

Setbacks are most common in the first few days of withdrawal. The painful effects of symptoms are too much to handle, leading people to use again. It is a tough process, but not an impossible one.

Symptoms start approximately 12 hours after the last opiate dosage. Most noticeably, an addict will experience muscle aches at first. Often, these are initially mistaken for the flu or a bad cold. Also, a person withdrawing from opiates may experience:

• Diarrhea
• Vomiting
• Profuse sweating
• Insomnia
• Loss of appetite

These are only a few of the symptoms common to withdrawal, and they will endure for several days before they begin to subside. By day four or five, the pain may lessen, but it won’t be entirely gone. It still may be difficult for the person to get a good night’s sleep or feel like eating properly. Secondary side effects during these few days may include shivers and cramping. It’s the body’s way of working the drug out of the system.

During this crucial time, a person may switch between having no appetite and throwing up anything that was eaten, which makes proper nutrition difficult to achieve. A healthy diet is important now more than ever because the body needs its strength and the immune system needs to be intact.

Once someone has reached day six or seven, the end of the withdrawal response is near. After the week-long phase is over, it doesn’t mean opioids cannot still be found in the system. It also doesn’t mean an addict has achieved recovery. Withdrawal is a sensitive period because a person can use again at any step during the process and would have to start the withdrawal process all over again. This, along with countless other reasons, is the reason why it’s highly encouraged to go through detox with the assistance of others.

Detoxing in a supervised center not only helps people avoid relapse, but also provides them a safe environment where they are monitored and taken care of throughout the duration of the process. When a person reaches the end of the withdrawal timeline, it’s a good idea for them to stay active rather than focusing on drugs or the familiarity life with drugs brings.

In a treatment facility, healthy activities are planned to help keep people engaged, while also teaching them about life following detox. Counseling is usually available as well as medical attention, when necessary. Going through opiate withdrawal alone doesn’t take the person away from the temptation, negative influences, or access to drugs. There is not only one step to success when it comes to achieving long-term sobriety. There are several.

Types of Opiate Withdrawal

Opiate withdrawal symptoms are the result of discontinued use of an opiate after becoming physically dependent on the drug. The duration of time that withdrawal symptoms last, though slightly different for each patient, generally coincides with an addict’s history with the drug. Although withdrawal is not life-threatening, it can make abstaining from opiate abuse very difficult to achieve.

Acute Withdrawal

Acute withdrawal symptoms can last a few days or a few weeks. These symptoms may be treated by a medical professional through medication to help reduce the user’s discomfort and cravings. At this phase, the person will most likely experience one or more of the following:

• Muscle cramps
• Diarrhea
• Abdominal pain
• Irritability
• Anxiety

Symptoms usually begin with 24 hours of the last taken dose and could take up to two days before taking full effect.

Protracted Withdrawal

Protracted withdrawal involves a similar set of symptoms, but occurs after acute withdrawal. A study from the National Institute of Health determined people in recovery from heroin addiction or other forms of opiate addiction likely experience the following symptoms of protracted withdrawal, which can last for months following acute withdrawal:

• Disrupted sleep
• Inability to focus
• Anxiety
• Fatigue
• Irritability
• Depression.

Opiate withdrawal will begin at approximately the same time when the next drug use would likely occur. The person would refrain from using instead of taking the next dose. Drug addiction means a person already has a perpetual cycle in place of how often he or she uses, almost like second nature.

The time span between doses can be anywhere from 4-6 hours and may occur more frequently for users addicted to painkillers. The type and severity of symptoms vary per person because of how the body reacts to the drug and the effects when the body is without it. When speaking on an average scale, it can take up to 28 days for withdrawal from methadone and no more than two weeks to withdraw from prescription painkillers.

What Kind of Treatment is Available?

Self-treatment, or attempting to tackle opiate withdrawal alone, is less than ideal. There is lack of support with no accountability, which is why it’s easy to hit a wall and return to drug use within the first few days. The process is painful no matter where or how a person decides to detox, but with the aid of individuals who are trained to assist addicts, it can be much smoother.

A treatment facility provides a calming atmosphere with immediate access to medical staff who can monitor patients’ detox process in a healthy and secure way. For those who are struggling with the severe side effects of withdrawal, treatment center staff can also administer and monitor the use of naloxone, an opiate which does not have the same addictive effects of other opiates, but can be used to treat withdrawal symptoms to lessen the intensity. Since it is still a drug, the right dosage and application should only be determined by a doctor or other medical professional.

In rare instances, rapid detoxification is an option. This type of drug withdrawal is performed under anesthesia with naloxone or another opiate-blocking drug. In some research, it has shown to decrease symptoms but isn’t impactful on the length of time it takes for a person to complete the full timeline of withdrawal.

Since vomiting is a common side effect of opiate withdrawal, the possibility of vomiting while under anesthesia increases the risk of death. Therefore, this rapid method is infrequently used; the risks outweigh the potential added benefits.

Once a person has gone through detox, the next step is continued rehabilitation and treatment. An individual may choose inpatient or outpatient care to learn about addiction, how it affects the body, and how it has an impact on a person’s life and those around them.

Addicts learn what triggers their addictions so they can learn how to avoid temptation in the future. Different treatment centers and programs offer individual counseling and group therapy to talk through challenges and work on problem-solving skills.

In many facilities, there are healthy activities and educational classes available to teach people how to live a life without a dependency on drugs. It’s this deep understanding of addiction and ability to address it head on, which helps lead to a successful, long-term recovery.

Sources:

“Opiate Withdrawal and Detox.” Addiction Center. 11 Mar. 2019. https://www.addictioncenter.com/opiates/withdrawal-detox/

Lautieri, Amanda. “Opiate Withdrawal Timelines, Symptoms and Treatment.” American Addiction Centers. https://americanaddictioncenters.org/withdrawal-timelines-treatments/opiate

“Opiate Addiction Withdrawal.” Drugabuse.com. 11 Mar. 2019. https://drugabuse.com/opiates/withdrawal/