Opiate Withdrawal Syndrome
The Next Step
In the book Heroin Diaries: A Year in The Life of a Shattered Rock Star, Nikki Sixx provides this handy definition of addiction: “When you can give up something at any time, as long as it’s next Tuesday.” For people who are addicted to opiates such as heroin, morphine or methadone, it seems that next Tuesday will never truly arrive. Each time they try to stop abusing their drug of choice, the addiction strengthens its grasp and they find it even harder to stop. It can seem as though the addiction is simply unbeatable. Thankfully, this is not the case. People with opiate addictions can heal, but they may need to accept outside help and enroll in a structured program.
Opiate Withdrawal Syndrome
Each time a person uses an opiate, the drug moves into the bloodstream and attaches to specific receptors. The body treats the opiate as a natural, normal chemical and when it’s attached to receptors, the body begins to undergo a series of chemical reactions in response. This may all sound benign enough, but over time, the changes become more significant. The body stops producing certain chemicals altogether, since the user is supplying substitute chemicals through the drug use. If the addict stops using drugs, the body has no access to these needed chemicals, and it begins to set off a series of alarm bells to warn the brain and nervous system that something has gone horribly wrong. As a result, the addict may feel a variety of symptoms, including:
- Abdominal pain, nausea, vomiting and diarrhea
- Muscle aches
- Anxiety and agitation
These symptoms may not be life-threatening, but the symptoms can be severe and they can last for up to a week. It can be hard to tolerate these symptoms when the addict knows that he or she can simply shut them off by taking drugs once more. Therefore, the goal of a detoxification program is to reduce or eliminate the symptoms of opiate withdrawal.
If the addict isn’t uncomfortable, he or she is more likely to complete the detoxification process and move forward with additional addiction therapies.
An addict that enters an inpatient detoxification program is forced to step away from his or her life for a period of time and really focus on the addiction. The authors state that this can “…interrupt a cycle of drug use, even in the absence of medically dangerous withdrawal symptoms. For some, the safety of an inpatient environment and a period of time of respite can help in their attempts to make important life decisions.” In other words, checking into a program, and truly focusing on the addiction and the changes that need to take place, can be one of the most helpful parts of a structured inpatient detoxification program. It’s hard to obtain this sort of meditation time during a standard day spent at home. During an inpatient detoxification program, however, that time is made available.
In addition, during the detoxification process, the staff works hard to stress the importance of completing a drug rehabilitation program. They may ask the addict to attend meetings with other people in recovery, or the addict may meet an addiction counselor and begin participating in one-on-one sessions. Overlapping detoxification programs and rehabilitation programs in this way allows the addict to stay motivated and keep the momentum moving forward.
You Might Also Be Interested in: The History of Opiates
In order to keep the patient comfortable and relaxed during detoxification, consulting medical staff may prescribe a wide variety of medications. Buprenorphine is one of the most common medications prescribed in opiate detoxification, but use of medications is not universal among treatment centers. Your doctor will have to determine what is right for you. Buprenorphine is a medication that functions in much the same way as an opiate. It attaches to the same receptors and sets off the same sorts of chemical reactions. It does not cause euphoria, however, and it is not considered addictive. Depending on the patient’s condition, consulting physicians may prescribe high doses of buprenorphine at the beginning of the detoxification process and then give smaller and smaller doses as the program progresses.
According to the National Alliance of Advocates for Buprenorphine Treatment, the drug isn’t always adequate to control symptoms in all addicts. For example, some people who take extremely high doses of the drug methadone may need to taper their methadone dose down for several days before they begin taking buprenorphine. The drug just isn’t strong enough to provide enough relief to people who have a high tolerance for strong drugs like methadone.
As detoxification progresses, the consulting medical physicians run a series of checks to ensure that the person feels comfortable and isn’t experiencing severe symptoms. Consulting professionals may do the following:
- Check the addict’s blood pressure
- Measure the addict’s heart rate
- Look for sweating or excessive tear production
- Ask the addict to describe his or her mental state
- Measure how much the addict is eating and drinking
If the addict begins to experience symptoms, the consulting physicians may increase the dose of buprenorphine, or they may introduce a separate medication to ease specific symptoms. The consulting professionals may provide a sleeping medication or an anti-nausea medication can help smooth out symptoms the addict might be experiencing. The goal is to keep the patient comfortable and relaxed while the body adjusts to the lack of opiates in the bloodstream.
Michael’s House ascribes to the social model form of detox in collaboration with consulting physicians, but other programs have different styles of detox. In order to reduce all symptoms of opiate withdrawal, some providers introduced a new detoxification method known as rapid detox. In this process, the addict is placed under sedation and given the medication naltrexone. This medication renders all opiates in the addict’s system inactive, forcing the person into immediate withdrawal. Since the person is sedated, he or she feels no symptoms. Often, manufacturers claim that people can be “cured” via this method in as little as a weekend.
While this might sound like a real breakthrough in the world of addiction medicine, experts have been less enthusiastic about the method. For example, the National Institute on Drug Abuse states that the method is no more effective in helping people kick drug habits than standard detoxification programs. Also, the risk of death exists in a rapid detoxification program. People who are undergoing opiate withdrawal tend to vomit, and people who vomit while under anesthesia can breathe that fluid into their lungs and die. This is not a risk in standard detoxification programs, and if the long-term addiction cessation results are no better, the risk doesn’t seem like one worth taking.
In addition, a rapid detoxification program doesn’t provide the addict with the opportunity for quiet reflection. Some people need time and space to adjust to the idea of a drug-free lifestyle, and a rapid detox program doesn’t support this sort of activity.
The Next Step
The publication Cochrane Summaries attempted to compare success rates between two different types of detoxification programs. As a side note, the authors discovered that all of the people who completed the programs relapsed into opiate use once more. It’s clear that this is a difficult addiction to truly conquer and the average addict is going to need a significant amount of help in order to be successful. Drug rehabilitation programs can provide that help, and once the addict has completed the detoxification process, he or she is ready to begin work on those important therapies.
At Michael’s House, we offer inpatient detoxification programs for opiate addiction. Our consulting medical physicians are adept at creating the right programs to meet the needs of our patients, and we offer a significant amount of medical and emotional support to ensure that the process goes smoothly.
Give us a call today to find out more.