In 2011, the U.S. Centers for Disease Control officially declared all painkiller-related overdose deaths to be part of an epidemic. This opioid epidemic claims thousands of lives on an annual basis. The beginning of the trend has been traced back to the 1990s. However, 1999 was the first year when data was actively gathered. It wasn’t until 2018 that there was a decline in yearly opioid-related overdose deaths, but the number was still four times higher than in 1999.
The following is information about opioids, opioid withdrawal, symptoms and detox as well as notable statistics to keep in mind. Individuals who have tried to defeat their addictions to the painkillers are not alone. There are reasons why the process is so difficult, but it’s possible to find sobriety.
How Did the Epidemic Begin?
Pharmaceutical companies developed stronger pain killers in the 1990s. They met with doctors and sold them on the new medication. After all, the new pills were far more effective than the options currently on the market. The disconnect occurred when the addictive side effects were not known at the time or were not communicated to the medical field. Either way, the new pharmaceuticals have led to catastrophic results.
Data gathered by the CDC about the epidemic shows:
- 21%-29% of patients who are prescribed an opioid for chronic pain misuse the medication
- 8%-12% of patients who are prescribed an opioid for chronic pain and misuse it develop an addiction
- 4%-6% of patients who misuse an opioid move to heroin
- 80% of Americans who use heroin were first misusing an opioid
From July 2016 to September 2017, there was a 30% increase in opioid-related overdoses in 45 states and 52 areas. The largest increase took place in the Midwest. This region experienced a 70% increase in that time frame.
In 2018, data showed that there were 128 overdose deaths every day in the U.S. The glimmer of hope is that the number of opioid-related overdose deaths did drop 4% from 2017 to 2018. Cities and counties across the United States have developed initiatives to address overdose situations. In New England states like Rhode Island, New Hampshire and Connecticut, first responders have been trained and equipped to treat opioid overdoses on the spot.
The 2018 data also showed:
- 2% decrease in opioid-involved deaths
- 13.5% decrease in prescription opioid-involved deaths
- 4% decrease in heroin-involved deaths
However, there was a 10.2% increase in synthetic opioid-involved death rates not including methadone.
Let’s touch on the types of opioids and why synthetic varieties are the most lethal. This helps explain why opioid withdrawal, the symptoms and detox are so intense.
The main types of opioids are:
Opiates are produced from the opium poppy. From opiates come morphine, codeine and heroin as well as opium. Heroin is usually classified in its own opioid category because it is illegal. Morphine and codeine, on the other hand, are illegal for recreational use but legal for medical use. Prescription opioids include oxycodone (OxyContin), hydrocodone (Vicodin) and methadone.
Synthetic opioids have become the lethal sub-category with fentanyl as the driving force. It is several times more potent than the basic pain-relieving medication. Fentanyl is approved for the treatment of severe pain that results from cancer, but drug manufacturers have found ways to make it more addictive.
To understand opioid withdrawal, it’s a good idea to understand how opioids impact the user. Opioids were introduced to help doctors relieve the pain their patients experience due to injury or disease. One of the reasons why the Midwest and the New England areas have seen devastating opioid-related overdose cases is because those regions still have a lot of manual labor jobs. Farming and construction injuries, for example, are common. Pain-relieving medications are prescribed to injured patients so that they can heal with some comfort and get back to work promptly. The problem with opioids is that they work too well and re-wire the central nervous system.
A pain medication sends signals to the nervous system by creating a sense of euphoria. When you’re in pain, any relief is welcome. Opioids are so effective at alleviating pain and affecting the nervous system that the body continues to crave the feeling of euphoria even after the patient is healed. Many users are not chasing a cure. They are chasing the feeling. Chasing the feeling of euphoria is what leads to prescription misuse, and eventually, addiction.
Opioid withdrawal usually begins six to 12 hours after the last dose. However, it could begin as late as 30 hours since the last dose for some users. The difference in time frames comes down to the type of opioid you are consuming. The short-acting opiates lead to quicker withdrawal symptoms. In both cases, withdrawal symptoms become their most intense 72 hours after the last dose.
An opioid medication does its job by attaching itself to the opioid receptors in your brain, spinal cord and gastrointestinal tract. Then, the medicine is released. Your body already produces opioids. Those quantities are just not enough to help you cope with a broken limb, so you need the extra provided by a prescription. When you feel a decrease in pain or lowering of the respiratory rate, it means the medication has done its job. Some people are given opioids to help with depression and anxiety, too. Essentially, the pharmaceuticals mimic the opioids in your body, but with greater strength.
Opioids will have a major impact on the following parts of the body:
- Brain stem, which controls the rate of breathing and heartbeat
- Limbic system, which controls the emotion such as relaxation and pleasure
- Spinal cord, which sends messages from the brain to the rest of the body about pain
When withdrawal begins, its intensity is determined by how long you’ve been using opioids, the dosage amount and your current tolerance. The first hit of any substance is always the most effective. Those who get hooked spend their time trying to recapture that feeling, which turns into a vicious cycle.
Some patients do not realize that they have become dependent on their prescriptions. A sign that dependence has occurred is feeling physically sick between doses. Your doctor may direct you to take a pill every 12 hours. If you cannot make it to 12 hours, you have become dependent on your prescription.
Opioid Withdrawal Symptoms
Becoming physically ill is a sign that you are experiencing withdrawal symptoms. Very often, the original pain heals in the time a doctor predicts. While the original pain is no longer an issue, addiction becomes the problem.
Early opioid withdrawal symptoms are:
- Excessive yawning but cannot fall asleep or stay asleep
- Racing heartbeat
- Sweats and fever
Withdrawal symptoms at the 72-hour mark include:
- Nausea and vomiting
- Stomach cramps
Teary eyes, restlessness and blurry vision are also common.
Research has found that mothers who consume opioids during pregnancy increase their risk of giving birth to a baby with withdrawal symptoms.
A newborn who is experiencing opioid withdrawal may have the following symptoms:
- Digestive issues
For adults, withdrawal symptoms begin to fade after the 72-hour mark. Withdrawal is your body purging the opioids from your system. Your body is getting used to what it feels like to not have them entering your system anymore. It is making adjustments. Although the process is uncomfortable, you have to go through it to get clean.
If you believe that you’ve become dependent on opioids, you are encouraged to get help with the recovery process. A person can detox alone. Your body actually begins to detox on its own, but if you need help getting through the withdrawal phase, help is readily available.
Green Mountain Treatment Center in New Hampshire, for example, is a private rehabilitation center that offers inpatient treatment programs. We also offer a medical detox program.
Anyone seeking to get over their opioid tolerance must detox first. The substance must be out of your body before you can begin treatment. If you are feeling fatigue, restlessness or anxiety during your sessions, the sessions will not be efficient or effective.
When you seek help at a rehab facility, medical professionals will examine you, your symptoms and current condition. Through a series of questions and visual inspection, they can determine if you’re truly experiencing withdrawal. Then, they take notes. Their job is to take your full medical history. The staff that’s going to work with you has to know if there are any other substances involved. Each substance has its own withdrawal period as well as symptoms. Cocaine, for example, has a withdrawal period of up to 10 days. Meth, however, has a withdrawal period of up to three weeks.
Today, rehabilitation treatment plans are customized. Rehab centers no longer take a one-size-fits-all approach. The medical and rehab fields have enough research and data that tells them how to help every patient based on their medical history. Co-occurring mental health issues have become more common. Therefore, a treatment plan may include cognitive behavioral therapy sessions that address mental health, too.
The Green Mountain Treatment Center is a facility located in a serene, secluded and peaceful area of New Hampshire on purpose. To help you get through the opioid withdrawal and detox phase, you are encouraged to enter a program. This gives you access to a support team that’s trained to help you through the process. After the detox process, therapy and education sessions begin.
A program at Green Mountain Treatment Center may include an individualized treatment plan of:
- Medical detox
- 12-step curriculum
- Holistic therapy sessions
- Individual and group therapy sessions
- Co-occurring mental disorder treatment
You’ll get the opportunity to:
- Participate in yoga and meditation sessions
- Exercise at the on-site gym
- Use the transportation
- Enjoy nutritious chef-prepared meals
For extra comfort, the programs and accommodations are separated by gender. Plus, all treatment plans are centered around evidence-based clinical methods.
Once detox is completed, you enter your recovery treatment plan. The goal is to prepare you to enter the world after 30 days. It’s important that you understand why you became dependent on opioids. Then, when you are confronted with situations that trigger your cravings, you will be able to cope. If you’re ever faced with a difficult situation, you’ll have the tools to resist and then make an exit.
The medical detox program at Green Mountain Treatment Center is designed for clients who have a high-to-manageable withdrawal risk. There is a medical and rehab staff available around the clock to monitor the progress of each client. The staff is compassionate, licensed and trained in addiction medicine.
Typically, an opioid detox program uses two methods: pharmacological and psychological treatment. Close supervision is provided. Patients are made to feel as comfortable as possible in a process that’s going to be intense. Outpatient programs are an option for those whose withdrawal symptoms are not overwhelming. Generally, though, inpatient is recommended. Vital signs are taken because they help determine medicine dosages. Patients who need help managing their blood pressure may need a pharmacological solution. The goal is to administer everything safely. Naloxone and naltrexone are opioid antagonists that may be used.
Medical detox is one component of an overall treatment plan.
After detox and a 30-day program are completed, outpatient programs offer long-term care. If your opioid dependence was due to chronic pain or the dependence becomes a chronic condition, you are encouraged to seek help to manage it. Long-term care management includes counseling, ongoing education as well as family and individual therapy. Attending support group meetings is also highly recommended.
Opioid detox is one step that must be accomplished to get over a dependence. Getting through this phase is a great step toward a renewed sober life.