What is Opioid Withdrawal?

What should I expect when Experiencing Opioid Withdrawal?

Withdrawal symptoms from opioid use disorder can be quite severe and varied, depending on the duration and intensity of opioid use. These symptoms are a result of the body adjusting to the absence of opioids after developing physical dependence.

Early Symptoms (within the first 24 hours)

Later Symptoms (after the first 24 hours)

Duration and Intensity

Management and Treatment

Risks

Proper medical supervision is crucial during withdrawal to ensure safety and increase the likelihood of successful recovery.

*1 Post Acute Withdrawal

Post-Acute Withdrawal Syndrome (PAWS) from opioids refers to a set of persistent symptoms that can last for weeks, months, or even years after the acute phase of withdrawal has subsided. These symptoms are mainly psychological and emotional, and they can significantly impact an individual's quality of life and their ability to maintain sobriety. Here’s a detailed description of PAWS symptoms and management:

Common Symptoms of PAWS

  1. Emotional Instability
    • Mood Swings: Rapid changes in mood, often swinging from happiness to irritability or sadness without clear triggers.
    • Anxiety: Persistent feelings of worry, nervousness, or panic attacks.
    • Depression: Prolonged feelings of sadness, hopelessness, and a lack of interest in previously enjoyable activities.
  2. Cognitive Difficulties
    • Memory Problems: Short-term memory issues, difficulty recalling recent events or information.
    • Concentration Issues: Trouble focusing on tasks, easily distracted, difficulty completing tasks.
  3. Sleep Disturbances
    • Insomnia: Difficulty falling or staying asleep, restless sleep.
    • Vivid Dreams or Nightmares: Intense or disturbing dreams that can affect sleep quality.
  4. Physical Symptoms
    • Fatigue: Persistent tiredness and lack of energy, even with adequate sleep.
    • Sensitivity to Stress: Increased stress response to normal daily activities or minor stressors.
    • Cravings: Strong urges to use opioids, which can be triggered by stress, emotional states, or environmental cues.
  5. Difficulty Managing Stress
    • Low Stress Tolerance: Difficulty coping with everyday stressors, leading to feeling overwhelmed easily.
    • Irritability: Increased irritability and frustration with minor inconveniences or issues.

Duration of PAWS

The duration of PAWS can vary significantly among individuals. While some may experience symptoms for a few weeks, others might continue to struggle for several months or even years. The intensity and duration can be influenced by factors such as the length and intensity of opioid use, overall health, and the presence of co-occurring mental health disorders.

Management and Treatment

  1. Medications
    • Antidepressants: To help manage depression and anxiety symptoms.
    • Anti-anxiety Medications: To alleviate severe anxiety.
    • Sleep Aids: To address insomnia and improve sleep quality.
  2. Therapy and Counseling
    • Cognitive Behavioral Therapy (CBT): Helps in identifying and changing negative thought patterns and behaviors.
    • Counseling: Individual or group counseling to provide emotional support and coping strategies.
    • Support Groups: Participation in support groups such as Narcotics Anonymous (NA) can provide a sense of community and shared experience.
  3. Lifestyle Changes
    • Healthy Diet: Proper nutrition to support overall health and well-being.
    • Exercise: Regular physical activity to boost mood, reduce anxiety, and improve sleep.
    • Stress Management Techniques: Practices such as mindfulness, meditation, and relaxation exercises to manage stress.
  4. Social Support
    • Family and Friends: Strong support systems can provide encouragement and accountability.
    • Sober Living Environments: Living in a sober environment can reduce exposure to triggers and provide a supportive community.
  5. Routine and Structure
    • Daily Routine: Establishing a regular daily schedule can provide stability and reduce anxiety.
    • Goal Setting: Setting and working towards small, achievable goals can provide a sense of purpose and accomplishment.

Importance of Ongoing Care

Ongoing care and support are crucial for individuals experiencing PAWS. Continuous monitoring by healthcare professionals, participation in therapy, and strong support networks can help manage symptoms and reduce the risk of relapse. Understanding that PAWS is a part of the recovery process and seeking help when needed can significantly enhance long-term recovery outcomes.