What are the Stages of Opiate Withdrawal?

Opiates are those drugs including opium, opium derivatives, and the semi-synthetic or synthetic substitutes with similar chemical structures. The most common opiates are fentanyl, methadone, morphine, codeine, oxycodone, hydrocodone, and the illegal drug, heroin.

No matter which opiate drug you use, repeated use can lead to dependency and subsequently, withdrawals upon ceasing. The stages of opiate withdrawal will be different for everyone and there is no way of predicting who will experience what, when, or how severe they will become. One thing is for sure, every repeat withdrawal and relapse occurrence makes the next withdrawal process more difficult.

In the early stage, opiate withdrawal can cause sweating, chills, and ‘goosebumps’.

The Early Stage

Within hours of the last opiate dose, an opiate dependent individual starts to become irritable and crave more of the drug. During the early stage of opiate withdrawal, symptoms can impair the person’s ability to function in any normal given sense and if they are an experienced opiate user, they know that these symptoms will continue to get worse over the next few days.

Opiate withdrawal include:

• Dilated pupils
• Sweating, chills, or “goose-bumps”
• Runny nose
• Teary or watering eyes
• Involuntary twitches or muscle spasms
• Elevated respiration, heart rate, and blood pressure
• Abdominal pains, nausea, vomiting, diarrhea
• Overall body aches and pains
• Emotional instabilities including drastic mood swings, anxiety, aggression, depression, and possibly violent or suicidal tendencies
• Cognitive difficulties
• Impaired coordination
• Fatigue and weakness
• Restlessness and Insomnia

The Acute Stage of Opiate Withdrawal

The acute stage of opiate withdrawal can exacerbate or magnify underlying physical and mental health disorders and while the physical symptoms may dissipate after 72 hours or so, for most individuals, the psychological symptoms and cravings can go on for several more days.

Opiates are controlled under the CSA based on their medical use, potential for abuse, and safety or dependence liability. According to the DEA 2011 Resource Guide, “If a drug does not have a potential for abuse, it cannot be controlled.” Unfortunately, many opiates have a high abuse potential and are abused via rapid delivery methods, in high dosages, and for long periods of times. The intensity of the withdrawals may become too much to bear and often results in relapse during this phase.

Post Acute Stage of Opiate Withdrawal

Opioids relieve the stress and discomfort of unwanted physical, psychological, or social problems which may co-exist with the individual. Once the opiates are out of the person’s body, all of these issues come to the forefront and become powering reinforcements to get more of the drugs. Cravings for opiates can go on for months or years. Without help and major lifestyle changes, the risk of relapse will remain great.