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Opiate Withdrawal

Last updated May 22, 2018

Approved by: Krish Tangella MD, MBA, FCAP


Opiate Withdrawal (or Opioid Withdrawal) refers to the widespread symptoms that occur after discontinuing use or reducing use of opiate drugs, following chronic and heavy use.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Dope Sickness
  • Opioid Withdrawal
  • Withdrawal from Opioids

What is Opiate Withdrawal? (Definition/Background Information)

Basic information on Opiate Withdrawal is as follows:

  • Opiate Withdrawal (or Opioid Withdrawal) refers to the widespread symptoms that occur after discontinuing use or reducing use of opiate drugs, following chronic and heavy use
  • Opiates are a category of drugs prescribed to treat pain. They are derived from the poppy plant, which produces opium. Opioid drugs reduce the amount of pain signals that are sent to the brain and alters the brain’s response to pain
  • Opioids are often prescribed for relief of pain due to toothaches, dental procedures, injuries, surgeries, and chronic conditions such as cancer
  • Opiate drugs include morphine, codeine, heroin, methadone, oxycodone, and other drugs. The term opiate is often used to describe close relatives of opium, including codeine, morphine, and heroin, while the term opioid refers to the entire class of drugs
  • Opiate intoxication and dependence is age and race non-specific. Genetics can play a role in opiate drug use and addiction
  • The cause of Opiate Withdrawal is a chronic use of opiates that is reduced or discontinued
  • The signs and symptoms of Opiate Withdrawal can range from mild to severe and occur in two stages:
    • Early symptoms include agitation, insomnia, low energy, and muscle pain
    • Late symptoms include nausea or vomiting, goose bumps, diarrhea, and dilated pupils

Medications are often administered for the treatment of Opiate Withdrawal, under the supervision of a physician. Therapy and self-help groups are recommended for long-term treatment

Withdrawal from opiates is painful, but typically not life-threatening. Opiate Withdrawal with treatment from healthcare professionals can lessen the symptoms and pain. The prognosis is dependent on the length of time and the severity of opiate dependence

Who gets Opiate Withdrawal? (Age and Sex Distribution)

  • Opiate intoxication and dependence is age non-specific. Opiate Withdrawal is observed in those who reduce or discontinue the use of opiate drugs
  • Research suggests that women progress from drug use to dependence more quickly than men, and suffer more physical and emotional consequences of drug use
  • Genetics can play a role, as certain genes for addictive traits and disorders can cause one to become dependent on opiate drugs
  • Caucasians tend to experience a higher level of withdrawal symptoms than other racial/ethnic groups

What are the Risk Factors for Opiate Withdrawal? (Predisposing Factors)

The risk factor for Opiate Withdrawal includes:

  • Discontinuation or reduction in the usage of opiate drugs

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others. 

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Opiate Withdrawal? (Etiology)

The causal factors for Opiate Withdrawal include:

  • Chronic use of opiates that is reduced or discontinued 
  • Hospital administration of opiate drugs for pain that is reduced or discontinued

What are the Signs and Symptoms of Opiate Withdrawal?

The signs and symptoms of Opiate Withdrawal can range from mild to severe and may include:

Early symptoms:

  • Depression and anxiety
  • Agitation
  • Muscle pain and aches 
  • Insomnia
  • Runny nose and teary eyes
  • Hot and cold sweats
  • Yawning
  • Low energy and fatigue

Late symptoms:

  • Nausea or vomiting
  • Abdominal cramping
  • Chills and goose bumps
  • Diarrhea
  • Dilated pupils

Opiate Withdrawal symptoms can last from one week to one month. Emotional symptoms, such as depression, anxiety, low energy, and insomnia, can especially last for a few months after discontinuing high doses of opiates.

How is Opiate Withdrawal Diagnosed?

Opiate Withdrawal is diagnosed using the following methods:

  • A physician will conduct a thorough physical examination, correlated with a complete medical history (including family and social history)
  • Urine or blood tests to screen for the presence of opiate drugs
  • Depending on the physician’s concern for additional medical problems, the following tests may be performed:
    • CBC (complete blood count)
    • Blood chemistries and liver function tests, such as CHEM-20

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Opiate Withdrawal?

Complications due to Opiate Withdrawal could include:

  • Returning to opiate drug use: A majority of opiate overdose-related deaths occur when those who have discontinued or detoxed from the drug, return to opiate use. This is because withdrawal lessens one’s tolerance to the drug and lesser amounts are needed for an overdose situation
  • Vomiting and breathing in of the contents in the stomach into the lungs; a condition known as aspiration, which can cause lung infection, dehydration, and electrolyte instabilities
  • Depression and other mental illnesses occur in patients experiencing withdrawal from opiates

How is Opiate Withdrawal Treated?

The treatment measures for Opiate Withdrawal include:

  • Several medications are used for withdrawal from opiates. These medications cause the body to feel, as though it is receiving opiates and lessens the withdrawal symptoms
  • A common medication, called clonidine, mainly reduces agitation, anxiety, sweating, muscle aches, cramping, and runny nose
  • Buprenorphine is used to treat withdrawal symptoms from opiates and shorten the detoxification time
  • The medication known as methadone is often used as replacement for heroin or other opiates. However, methadone is also a highly addictive drug. For patients on methadone, physicians slowly decrease the dosage over time, lessening the intensity of withdrawal symptoms
  • Following withdrawal from opiates, it is recommended to follow long-term treatment and therapy, such as through self-help groups, outpatient counseling, day hospitalizations, or inpatient treatment
  • If one has taken a prescription opioid over a long period of time, then the physician can gradually reduce the dosage over time, until the medicine is no longer needed

How can Opiate Withdrawal be Prevented?

Preventive methods for opiate intoxication and opiate dependence could include:

  • Using opiate medication under the supervision of a qualified healthcare provider
  • Do not use the medication beyond the prescribed amount or duration
  • Discard the remaining medications from home if there are remaining pills after you have recovered from the condition for which pain medication was prescribed. This will reduce access to other members of the household
  • If you have been treated for opiate withdrawal or addiction, then it is very important to be aware for recurring signs and symptoms. If you feel that similar signs and symptoms of Opiate Withdrawal are occurring, then seek immediate medical attention. This is a very important step in preventing Opiate Withdrawal
  • Always keep your follow up appointment with your healthcare provider

What is the Prognosis of Opiate Withdrawal? (Outcomes/Resolutions)

  • Withdrawal from opiates is painful, but typically not a life-threatening situation
  • Opiate Withdrawal, with proper treatment through healthcare professionals, can lessen the symptoms and pain
  • The prognosis is dependent on the length of time and severity of opiate dependence

Additional and Relevant Useful Information for Opiate Withdrawal:

Opiate intoxication and dependence is a common condition that not only impacts individuals, but also their family members. Proper health education is an important step at a community level to tackle this condition.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 23, 2015
Last updated: May 22, 2018