Painkiller Withdrawal

The typical duration of painkiller withdrawal is one week. However, symptoms may persist longer depending on the severity of a person’s dependence. Review the safest way stop using painkillers for good here. We’ll help you plan for a drug-free life!

9
minute read

ARTICLE OVERVIEW: Acute withdrawal from pain medications usually takes 7-10 days. This article will review common side effects and their treatment. We’ll also review the safest ways to quit, including tapering protocols. Your questions are welcomed at the end.


ESIMATED READING TIME: 10-15 minutes.


TABLE OF CONTENTS


Withdrawal from pain medicines can be extremely uncomfortable… but the condition is rarely life-threatening.


Common Symptoms

Painkiller withdrawal includes symptoms that are both physical and psychological in nature. Because many symptoms can  manifest in the form of emotions and/or physical reactions…experts recommend medical supervision during acute detox. Common symptoms of painkiller withdrawal include:

Physical symptoms

  • Chills
  • Cold flashes
  • Excessive sweating
  • Fever
  • Flu-like symptoms
  • Irregular heart beat
  • Respiration problems
  • Restlessness
  • Tremors
  • Weakness

Psychological symptoms

  • Anxiety
  • Depression
  • Insomnia
  • Panic attacks
  • Paranoia

One thing you should understand about these symptoms is that they are temporary. Withdrawal does not last forever. It will take a week, or two, before the pain and discomfort end, but the rewards of it are worth all the struggle.
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What is It Like?

Painkiller withdrawal is like a very bad flu. During your first few days of detox you can plan for sweating, fever, and shaking. Nausea and vomitting are also common. Additionally, you will probably face anxiety, depression, and troubles sleeping.

The intensity of symptoms, as well as how long they will last, greatly depends on a few main use patterns. Withdrawal will vary based on:

  1. The level of your physical dependency.
  2. The overall length of time you’ve been taking the medicine.
  3. Your dosing schedule.
  4. Your overall health condition and physical strength.

What Causes Withdrawal

The cause of painkiller withdrawal is simple: drug dependence. In fact, withdrawal is a result of a condition called “physical dependence”.  What is this condition? It’s basically a survival mechanism.

You see, the brain has to adapt to the chemicals found in painkillers in order to keep working.  so, the body modifieslevels of certain neurotransmitters, hormones, and other processes in to compensate for the presence of painkillers in the system. In this case, it “speeds up” some processes in order to balance out the “depressant” effects of the drug.

Over time, the brain adapts to the painkiller. Take away the drug, and it takes time for the chemistry in the brain to even out again. So, when you’re going through withdrawal, you’re actually experiencing the processes that have been “sped up”.

Timeline

Anyone about to go through detox will wonder about the duration of withdrawal. Because metabolism is individual…the amount of time you’ll spend in withdrawal will also be individual. Still, there are some common patterns we can map out in a timline. For example, painkiller withdrawal symptoms are present for 1 week, but for some individuals, they can last longer. The intensity and the variety of the symptoms take the following course:

Days 1 – 3.

The beginning of detox is always the hardest. Physical and psychological symptoms are the most intense during the first few days.  For example, be on the lookout for anxiety and panic attacks as well as physical symptoms.

Withdrawal usually kicks in about 12 hours after your last painkiller dose. Once the withdrawal fully begins, you’ll probably experience muscle aches and pain first. Your muscles have forgotten what it’s like to not be numbed, so the pain can be intense. Early withdrawal is also marked by a runny nose, excessive yawning or general cold symptoms. People then report heavy sweats, diarrhea, appetite loss, and insomnia.

Days 4 – 6.

When you reach the 4th day, the worst of the pain should be over, but not completely gone. The most common symptoms that mark this period include continued problem sleeping, anxiety, goosebumps, shivers, and abdominal cramping. But if withdrawal worsens the DEA warns that, symptoms can include: restlessness, irritability, loss of appetite, nausea, tremors, drug craving, severe depression, vomiting, increased heart rate and blood pressure, and chills alternating with flushing and excessive sweating.

After you pass the first three days, it’s very important to pay attention to your diet and make sure you are constantly hydrated. Eating solid foods means including vegetables and fruits on your daily menu. The diarrhea should stop during this period.

Day 7 and beyond.

Once you get to day 7, you’ll begin to feel some achievements, but all is not quite over yet. You may still experience difficulties eating. Don’t feel afraid if nausea and anxiety are still present. The best thing to do at this point is keep your mind and body active.

At this point of withdrawal it is crucial not to let yourself feel miserable or depressed. Whatever you do, make sure you keep your spirits up. Take your mind off negative thoughts. Do some light exercise, such as walking. If possible get out and get some fresh air. For more on the withdrawal timeline , check out this clinical guide by IHS.gov.

Side Effects

Most of the side effects of painkiller withdrawal are limited to withdrawal symptoms. The symptoms are fairly predictable in nature and can be treated as they occur. However, there are a few notable complications that can arise during withdrawal:

  1. Serious mood swings.
  2. Problems sleeping.
  3. Relapse.
  4. Possible effects of other drug withdrawal.

Your history of drug use matters greatly when you undergo detox. This is the main reason why detox clinics examine your history of drug abuse before making a detox plan. They need to know your condition well before determining the dynamics of the withdrawal journey as well as the medications that need to be administered.

Because these issues can lead you back to drug use…it is essential that you seek medical supervision during withdrawal! Painkiller use after detox can trigger an unwanted overdose and even death. Reassurance and support are critical during withdrawal.  So, be sure to schedule AT LEAST brief, daily clinic visits with a nurse, pharmacist, or behavioral health counselor in the first 7-10 days of withdrawal for vital sign assessment, to review menacing symptoms and apprehensions, and get the help that you need.

Medications

There are three medications used during painkiller withdrawal: buprenorphine, clonidine, and methadone.

1. Buprenorphine is a partial opioid agonist used to minimize symptoms caused by painkiller dependence. It is also used in longer-term maintenance programs for people who have become addicted to painkillers; it works by curbing cravings for stronger drugs.

Buprenorphine has many of the same properties as other opioids. The most important characteristic of this medication is that it does not cause the same level of effects other painkillers do. Buprenorphine has a ceiling effect, so if you use it in high doses, it does not produce the same effects of high.

2. Clonidine is a central acting alpha-agonist. This medication is commonly used during painkiller withdrawal. Normally, a person can go through the withdrawal process with the help of clonidine in a week or two. Since clonidine is not an opioid itself and does not occupy the same receptors in the brain that painkillers do, it cannot treat cravings for these drugs as a symptom of withdrawal. However, this drug is very effective at minimizing the following withdrawal symptoms during painkiller detox:

  • agitation
  • anxiety
  • cramps
  • muscle and bone pain
  • runny nose
  • sweating

3. Methadone is an opioid agonist used to treat painkiller withdrawal in all its forms, whether caused by abuse of the drug or not. This medication successfully relieves withdrawal symptoms and make detox less painful. Methadone is often used for those who require intensive treatment for painkiller withdrawal. People with severe pain and other intense symptoms will often be better treated with methadone than any other medication. But, because methadone is addictive, it is important to be taken exactly as prescribed. In order to protect people from abusing this medication, methadone is only available with a prescription.

The Safest Way to Quit

When you decide to stop taking painkillers, make sure you do it the right way. The safest and most effective way of coming off painkillers is with professional help. You can seek help through:

  • A local detox clinic
  • A pharmacist
  • An addiction specialist
  • Your general physician or prescribing doctor
  • An inpatient addiction treatment center

To begin, we suggest that you contact your family doctor and listen to what s/he has to say. Sometimes doctors offer new alternatives that will work better for you.

Look for a tapering protocol and little by little you’ll decrease your medication dosage before you completely quit. Take a look at this Opioid Tapering Decision Tool produced by the Veteran’s Association for help in making a decision. Whatever you do, DON’T stop taking your medication on your own. Even with a slow weaning process, you still may experience withdrawal symptoms. Still, they will be much milder than if you quit your painkiller cold turkey.

To summarize, the SAFEST way to quit painkillers is attending a medical detoxification facility. The medical staff will monitor your health as you detox, and prescribe you medication that will help ease the symptoms of withdrawal. Medications will eliminate withdrawal symptoms, while also blocking the effects of opioids on your body.

Suggestions to Make it Easier

Good preparation is the key to withdrawal success!

When your body’s used to receive painkillers to function regularly, it means that you’ve developed dependence on them. Suddenly cutting yourself off from painkillers will  cause a strong reaction. Although it is not recommended, when trying to go through painkiller withdrawal, you’ll need to be prepared. These suggestions may help you learn how to beat painkiller withdrawal:

#1: Slowly taper off painkillers before you go off them completely. This will decrease the intensity of your withdrawal. Given the compulsive nature of addiction, most people find self-regulated tapering almost impossible. This often leads to a full relapse into addiction. That’s why it’s vital to consult a doctor for the tapering regime. Plus, tapering guidelines for chronic pain will differ from tapering for substance use.

#2: Drink a lot of water and fluids. Dehydration due to vomiting and diarrhea is common and could lead to serious health complications. Many people end up in the hospital with dehydration when they’re going through withdrawal. Drinking plenty of hydrating fluids during withdrawal is very important. Electrolyte solutions, such as Pedialyte, may help keep you hydrated.

#3: Use over-the-counter help. Taking the correct doses of over-the-counter medications might help. The following OCT may ease your symptoms:

  • Loperamide (Imodium) for diarrhea.
  • Acetaminophen (Tylenol) or Ibuprofen for aches and pains.

#4: Try acupuncture and Chinese herbal medicine. Several studies have demonstrated reduced drug withdrawal symptoms when combined with certain medicines. Examples of Chinese herbal medications used to treat painkiller addiction include:

  • Tai-Kang-Ning used for easing withdrawal symptoms.
  • U’finer, a Chinese herbal blend used to repair the damage painkillers have done to the brain.

#5: Make sure your environment is as comfortable as possible. Have soft blankets, a fan, and extra sheets. Change your bedding due to excessive sweating.

#6: Keep your free time occupied with movies, books, and other distractions. Do things you enjoy to increase your body’s endorphins. This can improve your chances for long-term success.

#7: Make sure a friend or family member knows that you plan on attempting the withdrawal process. Beyond support, you’ll need someone to check on you.

#8: Be cautious of recipes and stories described in online forums. None of them have gone through rigorous testing for safety or efficacy.

IMPORTANT: Never use any of these medication for longer than recommended by your doctor or in larger doses than the prescribed ones.

Cold Turkey

Quitting painkillers abruptly leads to intense withdrawal symptoms. It can also trigger strong desire for the drug and eventually lead to relapse. In fact going cold turkey off painkillers is consider unnecessary and potentially a dangerous method for withdrawal. There are many risks associated with going cold turkey off painkillers such as:

  • increased levels of anxiety
  • restlessness
  • strong headaches
  • vomiting

In sum, going cold turkey off painkillers is not recommended.

Any decision to quit a medication after long term use should be made in accordance with a doctor. This way you will receive a suitable tapering before attending a supervised detox program at a recovery center.  It is important to ensure you follow the quitting plan of the painkillers given by your doctor in order to avoid negative withdrawal symptoms.

Did We Miss Anything?

If you or a loved one is dependent or addicted to painkillers, it’s important to look for professional help immediately. The earlier treatment takes hold, the less likely you or your loved one will relapse in early recovery. Do not ignore withdrawal symptoms. Instead, choose a painkiller rehab that can help you quit your painkillers safely and as effectively as possible.

Find out more about abuse, painkiller addiction treatment, and more by exploring the content of our site. We invite you to ask questions and share your personal opinions or experiences and post them in the comments section below. All legitimate inquiries will be provided a personal and prompt response.

Reference Sources: Medline Plus: Opiate and opioid withdrawal
NIH: Effective Treatments for Opioid Addiction
SA Health: Opioid withdrawal management
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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