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Written by Opiates | Published on April 2, 2018 | Updated on July 9th, 2020,
Withdrawal symptoms are the bane of every addicts existence, but in particular opiate addicts fear the onset of withdrawal symptoms probably more so than with any other subset of substance abusers. The reason for this is because opiate withdrawal, while not usually life threatening, can be incredibly uncomfortable, producing similar feelings to the flu, but with psychological and emotional symptoms as well.
In fact opiate withdrawal can be so frightening for the average opiate user that many will continue in their addiction for years past the point where they know they should have stopped all so that they do not have to experience the physical sensations produced by withdrawal symptoms.
Yet as terrible as opiate withdrawals can be, it is important to note that in order to find recovery every opiate addict will have to experience these symptoms to one degree or another. In a sense the opiate withdrawals can be looked at as the right of passage that an addict must pass through in order to find their new life in recovery, and while this thought is not particularly comforting in the time leading up to, or during the experience of withdrawals, it is always important to keep in mind that they will pass in time. It is also important to remember that if you follow the simple suggestions offered in the rooms of recovery, you will never have to experience withdrawals again.
Symptoms of opiate withdrawal can range from mild to severe, depending on how long the individual used opiates for and the amount that used during active addiction. For some individual’s withdrawal symptoms will only last for 24 to 72 hours, but for others, in particular those who have used methadone for years, withdrawal symptoms can last for up to a month or longer. This is not to say that the withdrawal symptoms will be sustained in their severity, but very often an individual can experience post-acute withdrawal symptoms for a while after they have stopped abusing opiates.
Withdrawal symptoms for opiates can be divided into three groups: initial physical symptoms that occur fairly quickly after the last usage, late physical symptoms, which occur usually after 24 hours of not using an opiate based substance, and psychological symptoms, which can occur at any point during the withdrawal process.
Initial Withdrawal Symptoms usually begin to appear between 6 and 12 hours after last usage. They include:
Late Withdrawal Symptoms usually begin 24 hours after last usage and can peak anywhere from 72 hours to a week after they have begun. These symptoms are the bulk of what people think of when they think of opiate withdrawal and they include:
Arguably the worst part of the opiate withdrawal process is the psychological withdrawal symptoms that present themselves during the detox process. As if it wasn’t enough that an individual has to deal with the fact that they feel tremendously physically ill, they also have to contend with a dramatic swing in emotions as their mind struggles to cope with the lack of opiates in their system. For the person experiencing these symptoms it can feel like a preverbal hell, and due to the powerful nature of psychological withdrawal symptoms, it is strongly encouraged that an individual seek professional medical assistance during the detox process, so that they do not relapse back into using.
Some of the most common psychological withdrawal symptoms include:
The last item on this list, craving or obsession for drugs is one of the most powerful side effects not only of withdrawals, but also of drug addiction itself. It is possibly the least understand component of drug addiction in that the individual experiencing this obsession cannot explain it, nor can an individual watching the addict understand why they react the way they do. This obsession to use is what drives many opiate addicts to continue to use and they will stop at nothing to fulfill this obsession. Many times the legal issues they get into, the familial problems they experience, the breakdown of relationships, and health problems that occur are the direct result of the obsession to use and until it is dealt with in a meaningful way, through either a 12-Step Program or some other form of spiritual intervention, little can be truly done to help the addict maintain sobriety.
This is why it is important that for individual who is attempting to stop using opiates to seek the help of professionals when they are going through the detox process and through early recovery. Often times an addict will be able to make it through the initial and late physical stages of withdrawal only to find themselves suffering from a grave obsession to use that they cannot combat on their own. This obsession is not like a craving to eat Italian food or to scarf down a pint of ice cream, but rather it ranges on something carnal within the addict, forcing their hand and causing them to act in ways that are counter intuitive to their well being and happiness.
The question posed above is nonsensical to a certain extent, but yet it is one that many people, both addict and non-addict alike ask. The family of the addict is probably wondering how their precious loved one has become the addict that stands before them, and the addict is wondering how they let themselves fall so far from their desired path. The reality is that we do not know exactly why some people are addicts and some are not. We do not know exactly where the line between dependency and addiction lies, and it is for this reason that addiction and alcoholism are some of the only illnesses where self-diagnosis is the first step to recovery.
With that said and in order to get a better grasp on why you or your loved one has gotten to the point where they are experiencing withdrawals, we will have to take a look at what addiction is, and what it isn’t.
Addiction in its most basic sense is a brain disease that is manifested by compulsive substance use despite harmful consequence. It is the result of genetics, certain biological factors, psychology and environmental factors that allow for its manifestation. An individual who winds up in the throes of addiction does not set out to become addicted, as no one does, but rather they suffer from a predisposition to addictive behaviors, that is nurtured through their substance usage.
One of the largest problems facing potential addicts is that they cannot be aware if they will suffer from addiction until after they ingest their first substance and unfortunately when this occurs they may have already awoken the beast that will drive them until they get help.
Often times family members of the addict will believe that their loved one’s addiction is somehow the result of a failing on their part, but nothing could be further from the truth. Regardless of the upbringing, addiction and in turn recovery are not entirely contingent on the environment, but rather are only aided by this. If the biological and psychological predisposition is not in place then addiction will not rear its ugly head.
For the addict, they may be wondering how they have allowed themselves to get to the point where they live under the constant threat of withdrawal symptoms. They may beret themselves in the dark of the night for being weak and allowing themselves to get to this point, but once again it is important to understand that addiction is not a conscious choice on the part of the addict, but rather is a compulsion to use that override the basic instincts of survival.
Not to mention, and this is very often the case with opiate addiction, an individual will not realize that they are physically addicted until it is too late. Many opiate addicts started using opiates believing that they were able to control their intake. Often times after a period of usage they will either run out or simply not use for a day or so and when this occurs they usually start to feel sick. It is at this point that many begin to realize that they are physically dependent on the opiates and having already experienced the first lashes of opiate withdrawals they continue to use in order to stave off these symptoms.
If you have never experienced opiate withdrawals before and you are thinking about getting help for your opiate addiction, then please understand that this next section is not meant to scare you in any way. It is simply to inform you about what you can expect from the detox process, so that you can make an educated decision and seek professional medical assistance from a detox facility.
Usually an individual will begin to experience withdrawal symptoms anywhere from 6 to 12 hours after their last usage. Many times when a person gets to the point where they have gone without opiates for this amount of time, and they are physically dependent, their anxiety will begin to skyrocket, as they know that withdrawal symptoms are just around the corner.
The next thing that occurs is a pain or cramping in the lower back. It is subtle at first, feeling like you need to stretch, but as time goes on the cramping becomes worse and the withdrawal symptoms begin to settle in.
After this usually the person will begin to yawn more than usual. These yawns are rather deep and the lungs begin to feel strange. When this starts to occur the person usually also begins to feel a strange sensation on their skin. It isn’t so much that their skin is crawling, although that can occur, but rather they are overly aware of the physical sensation of their skin. They usually begin to feel clammy at this point, hot yet cold, sweating but at the same freezing.
Next they will begin to urinate every few minutes. Part of this is the result of anxiety, as frequent urination is a common symptom of high anxiety, and part of this is just the result of withdrawal symptoms. They will also begin to sneeze, usually in threes.
As the hours go on the cramping and pain will begin to go down their legs causing their legs to become restless. They will feel the need to tense every muscle in their body in order to get a reprieve from the strange sensations that they are feeling.
Usually at this point, which is around 24 hours after the last usage, a feeling of hopeless will set in. The individual has more than likely not slept at all, which only adds to this feeling, and if the withdrawal was not planned, usually desperation sets in and a frantic desire to get more of their chosen opiate substance.
At this point they usually feel like they have a terrible flu and due to the constipating effects of opiates they normally begin to feel nausea and even sometimes vomit. These symptoms can occur for a few days or up to a week with varying degrees of severity, and terrible as they may feel it is important to remember that they are not life threatening and that you can make it through them.
The best way to mitigate the symptoms of withdrawal is by attending a detox facility, where you will get the medical attention you need, as well as medications that can help you through this process.
One thing that can really help as well is taking hot baths, as laying in the tub will allow your muscles to relax and will also regulate your body temperature for you. Going along with this, getting a massage can also be helpful as it will relax you, although certain people do not enjoy this during the detox process.
To the best of your ability try to take it easy during this stressful time, and to be surrounded by support and care, so that if the obsession to use comes back, you will be able to navigate these feelings and continue on in your journey of recovery.
Always remember that you are not alone in this process and that millions before you have been exactly where you are and are now living a life on recovery.