You’ve heard it in the news: our country is in the midst of an opioid epidemic. From prescription pain relievers like Vicodin to illegal drugs like heroin, we’ve seen a dramatic rise in abuse of opioids. Opioids are addictive, and the withdrawal symptoms can be so intense that individuals may continue to use just to avoid experiencing them. Finding treatments to help manage opioid withdrawal is paramount in combating this crisis.
Opioids can help treat pain, but over time your body can become physically dependent on them. After a period of time without the drug, withdrawal symptoms can start. It’s often described as feeling like you have a severe viral illness, such as the flu.
Common symptoms include:
- agitation or anxiety
- muscle aches
- watery eyes
- runny nose
- difficulty sleeping
- sweating
- chills or goosebumps
- nausea
- vomiting
- diarrhea
- confusion
Withdrawal can start within hours after the last usage. It often peaks around 72 hours but can persist for a week or more.
For several years, two main medications have been used for treating opioid withdrawal symptoms: methadone and buprenorphine. Both of these are opioids themselves.
Methadone
Methadone is a full agonist opioid. This means it activates the opiate receptors in your body, sending the same kind of chemical message your brain and body receive if you use another opioid like heroin or fentanyl. Because of this similarity, there’s a potential it can be abused, but when it’s given at appropriate doses as part of an addiction treatment program, it can help lessen or eliminate withdrawal symptoms without producing the same “high.” The goal is to slowly and gradually reduce the amount of methadone given while minimizing the experience of withdrawal.
Buprenorphine
Buprenorphine is a partial agonist opioid. It also activates the opioid receptors, decreasing withdrawal symptoms and cravings. But compared to methadone, its effects are weaker, making it less likely to be misused or result in overdose. It’s often combined with another drug called naloxone. If an individual attempts to crush or inject this combination, it will cause immediate withdrawal symptoms. This further lessens the chance the drug will be misused.
Several formulations of buprenorphine have been released:
- Suboxone: This a film that’s dissolved under your tongue and is taken daily. It’s a combination of buprenorphine and naloxone. It’s also available in a generic form, making it cost-effective and more accessible to more people.
- Zubsolv: This opioid withdrawal treatment is another combination of buprenorphine and naloxone. It comes as a daily tablet that’s dissolved under your tongue.
- Bunavail: Another version of buprenorphine and naloxone, this is a film that is placed inside your cheek each day.
- Probuphine: This is an implant placed under your skin. It delivers a steady supply of buprenorphine for six months.
- Sublocade: This is a once-monthly injection of buprenorphine.
In 2018, lofexidine (Lucemyra) was approved to help reduce symptoms of opioid withdrawal. It’s the first non-opioid medication used to help treat the physical discomfort of withdrawal. It lowers the release of a chemical in your body called norepinephrine that’s believed to play a role in withdrawal symptoms. It can be used for up to 14 days.
Since lofexidine isn’t an opioid, there’s no risk of addiction, although there are some potential side effects, including dizziness, dry mouth, low blood pressure, and fatigue.
Other medications may also be used to treat specific opioid withdrawal symptoms. This includes sleep supplements or medications to stop vomiting or diarrhea.
With over
Behavioral therapy helps people remain sober, modify their attitudes and actions related to drug use, and manage stress and environmental cues that might trigger a craving for opioids. Talk to your doctor about your relationship with opioids, and together you can develop a treatment plan that’s right for you.