Medications for opioid withdrawal
Not everyone who goes through opioid withdrawal is an addict. But opioid addiction can occur even in people who take opioids as prescribed, including low risk opioids like tramadol which cause tramadol symptoms of withdrawal. Here we’ll review medications you can take during acute detoxification and over the long term to help control opioids cravings. Please leave your questions in the comments section below. We’ll be happy to answer them!
What is withdrawal?
Opioids are powerful medications that can help relieve pain. But you can also become dependent on opioids as your body adapts to the presence of the drugs. When you are dependent on opioids, you feel sick if there are no opioids in the body. This sickness is called withdrawal.
Medications for different stages of treatment
Detoxification is the necessary first step to getting opioids out of your body. But there is no reason that you should suffer during detox. In fact, painful withdrawal decreases likelihood that you stop taking opioids. So what will you experience during withdrawal? And what kind of medications do doctors use to treat the two different stages of detox?
During the first stage of withdrawal (acute detoxification) withdrawal from opiates is painful, but not life threatening. The second stage of treatment addresses possible opioid addiction, and uses a different set of medications to help opioid addicts manage cravings and stay off drugs.
1. Acute detoxification and withdrawal from opioids
Certain medications and vitamins for drug withdrawal can be prescribed during the acute stages of withdrawal, when discomfort is the greatest. Opioid withdrawal can last from 7-10 days, and can be painful and difficult. The medications listed below can help ease the immediate symptoms of withdrawal, resulting in better chances for staying off opioids in the long run. We review the most common medications and their uses here.
Anti-diarrheal drugs – These drugs are used to treat diarrhea and can include Diphenoxylate and Loperamide
Antiemetic drugs – This class of drugs helps prevent or reduce nausea and vomiting associated with opioid withdrawal. Two drugs used to manage symptoms of nausea and vomiting include Hydroxyzine and Promethazine.
Buprenorphine – Buprenorphine has been shown to work better than other medications for treating withdrawal from opiates, and can shorten the length of detox. It may also be used for long term maintenance treatment of opioid addiction like methadone (see below).
Clonidine – Clonidine is the most commonly prescribed medication for opioid withdrawal and it helps to controls autonomic symptoms of withdrawal such as restlessness, sweating, runny nose and watery eyes. Clonidine also helps ease anxiety and can shorten overall withdrawal duration.
Dicyclomine hydrochloride – Dicyclomine hydrochloride is used to treat abdominal cramps and cramping experienced during opioid withdrawal.
Methadone – Methadone blocks withdrawal symptoms by binding to opioid receptors in the brain. This stabilizes your brain long enough to get through the detoxification process, but may also be continued during long term treatment.
Methocarbamol – Methocarbamol is used to treat muscle cramps and joint pain.
Trazodone – Trazodone may be prescribed to treat depression and anxiety in people coming off of opioids. Opioid euphoria can become
Buprenorphine (Suptex) has been shown to work better than other medications for treating withdrawal from opiates, and can shorten the length of detox. It may also be used for long-term maintenance like methadone.
2. Longer term opioid addiction treatment medications
Most people cannot just walk away from opioid addiction after detox. Today’s doctors can prescribe medicines that make you feel similar to being on an addictive drug. These medications address the long-term issues associated with opioid withdrawal such as cravings and relapse. Over time, doctors gradually reduce doses and eliminate drugs when you are ready. But in general, these medications are often prescribed over long term treatment periods (longer than 6 months) and then gradually reduced under medical supervision.
Buprenorphine – Buprenorphine occupies opiate nerve receptors where opioids used to bind, essentially tricking the brain into thinking it is still getting the problem opioid. You feel normal on buprenorphine (not high), withdrawal does not occur, and this drug also helps reduce cravings.
LAAM – LAMM is the abbreviated name for a chemical called levo-alpha-acetyl-methadol. LAAM blocks the euphoric effects of stronger opioids while also controlling opiate craving and can suppresses opioid withdrawal symptoms for 48-72 hours or longer.
Methadone – Chemically, methadone is the simplest of the opioids. Like buprenorphine, methadone occupies opiate nerve receptors where opioids used to bind. And it is also used to mimic and block the effects of stronger opioids. Methadone suppresses opiate withdrawal symptoms for 24 hours or longer. An opioid itself, at proper dosing, methadone usually reduces the appetite for and need to take stronger opioids.
Naltrexone – Naltrexone is used after acute withdrawal to help prevent relapse. Naltrexone blocks the effect of opioid drugs so that you don’t feel high if you take opioids again.
Opioid addiction can be supplemented with medicine to make your chances for staying off opioids better. Although some people may see this as drug substitution, people on opioid maintenance programs in the care of a supervising physician can lead normal, healthy lives. At some point in recovery from addiction, we all need help to change addictive behavior into nonaddictive, healthful patterns. Learning to cope with cravings is difficult. But opioid maintenance can give you the balance you need to look at other life issues.
Questions about opioid withdrawal
We hope to have answered your questions about opioid withdrawal medication options. Please let us know if you have any other questions by writing to us. We answer all legitimate requests with a personal response!
Reference sources: University of Utah Addiction Treatments Past and Present
Medication-Assisted Treatment for Opioid Addiction
University of Maryland Medical Center medical encyclopedia on opiate withdrawal
LAAM in the Treatment of Opiate Addiction Treatment Improvement Protocol (TIP) Series 22
Photo credit: Toca Boca