A Guide to Opioid Detox

Opioid addiction is an epidemic in America. A SAMHSA study found that in 2015, 38% of the adult American population used prescription painkillers, over one-third of the entire US population. Americans consume 80% of the world’s opiate supply. The number of individuals who died from an overdose in the USA in 2021 was a record high of 106,699 [4]. In contrast, there were about 22,900 homicides that year. 

What is an Opioid Addiction?

Opioids are a class of drugs that interact with certain proteins in the brain called opioid receptors. Opioid receptors are responsible for managing sensations of pain and pleasure. They help our bodies understand the difference between which things are good for us and which are bad for us.

Related: What is Drug Addiction — and How Can it be Treated?

How Do Opioids Work?

When you consume an opioid drug, whether it’s a prescription painkiller or an illegal substance off the streets, the opioid enters the bloodstream and floods the brain with a sudden rush of dopamine. Depending on the amount and potency of the substance consumed, the rush of dopamine results in the brain gaining a ‘high’. 

What Causes Opioid Dependence?

While opioid medicine serves a critical role in acute, chronic, and severe pain management, their highly addictive nature leads to misuse and dependence. What might start as a legitimate medical prescription can easily devolve into misuse as you chase the euphoric high that opioids provide. As such, you may find yourself increasing your intake just so that you can maintain these effects.

Tolerance will develop, which can lead to consuming larger dosages and potentially transitioning to more potent opioids. Eventually, you can become trapped in a cycle of dependence, as the absence of opioids results in distressing withdrawal symptoms, reinforcing the need for continuous use as dosages rise to dangerous levels. 

Opioid addiction is not solely a result of personal choices; it’s a complex interplay of biological, environmental, and psychological factors. Genetic predisposition, a history of trauma, mental health disorders, and even the accessibility of opioids all contribute to an individual’s vulnerability to addiction.

Related: Understanding and Overcoming Prescription Drug Addiction

Opioids include but are not limited to: 

Prescription Opioids 

• Tramadol: Ultram, ConZip, Rybix ODT 
• Buprenorphine: Suboxone, Subutex, Butrans 
• Methadone: Dolophine, Methadose 
• Codeine: Tylenol with Codeine, Fiorinal with Codeine 
• Hydrocodone: Norco, Vicodin, Lortab 
• Hydromorphone: Dilaudid, Exalgo 
• Oxycodone: OxyContin, Percocet, Roxicodone 
• Oxymorphone: Opana, Opana ER 
• Morphine: MS Contin, Kadian, Avinza 
• Fentanyl: Duragesic, Sublimaze 

Illicit Opioids 

• Kratom: A plant-based, over-the-counter substance that has opioid-like effects and is sometimes used recreationally, though its safety and legality are debated. 
• Lean: Commonly referenced in modern pop music, lean is a street name for a liquid drink of Codeine mixed with other medications like promethazine and soda. 
• Opium: A natural substance derived from poppy plants, from which morphine and other opioids like heroin are derived, though sometimes consumed by itself. 
• Heroin: An illegal opioid derived from morphine that is highly addictive and often laced with other substances. Today, real heroin is exceedingly rare, replaced mostly by fentanyl. 
• Fentanyl: Although sometimes used in hospital settings, illicit fentanyl is also manufactured and distributed on the street. Fentanyl is 50 times more potent than heroin and extremely dangerous. 

There are many more obscure and powerful opioids on the streets, and more are likely being developed. It’s unfortunately common for drug dealers to “lace” or adulterate other drugs with inexpensive opioids such as fentanyl. This dangerous practice can significantly amplify the risk of opioid overdose and unintended consequences, as you can ingest high doses of opioids without even knowing it. 

Understanding Opioid Withdrawal 

When you use or abuse opioids on a regular basis, your body becomes more accustomed to the drug. Eventually, depending on dosage and potency, your body will produce less dopamine on its own because it relies on the dopamine resulting from the drug use.

The longer you engage in the misuse of opioids, the more your body adapts to the drug. Consequently, a decrease in dosage or cessation of the drug will upset your body’s delicate balance, leading to a cascade of physiological and psychological responses. This is called opioid withdrawal syndrome. 

Opioid withdrawal symptoms are usually dependent on the duration, dose, and potency of the opioid being abused. The most severe withdrawal symptoms come from abuse of strong opioids like oxycodone, heroin, or fentanyl. Opioids possess both psychological and physical addictive properties, so you may experience both psychological and physical symptoms of withdrawal.

What are the Symptoms of Opioid Withdrawal?

Opiate withdrawal is intense and often overwhelming, but it’s the first and most important step in addiction recovery. Opiate withdrawal is a highly individualized experience influenced by factors such as the type and dosage of opiates used, the duration of use, and your unique physiological and psychological makeup. This variability makes predicting the course and severity of opioid withdrawal symptoms a complex task. 

Physical symptoms often include

• Muscle Aches and Pains: Intense discomfort in muscles and joints is often reported, creating a feeling akin to the flu. 
• Gastrointestinal Distress: Nausea, vomiting, diarrhea, and abdominal cramps are frequent companions during opiate withdrawal. 
• Fluctuations in Body Temperature: Sweating, chills, and fever-like sensations contribute to the overall physical unease. 
• Elevated Heart Rate and Blood Pressure: The body’s stress response is heightened, leading to increased heart rate and blood pressure. 
• Sleep Disturbances: Insomnia, restless sleep, and vivid dreams are common, further adding to the physical and mental strain. 

Psychological symptoms can be equally or more challenging and can include

• Anxiety and Restlessness: Feelings of anxiety and restlessness can be overwhelming, leading to a persistent sense of unease. 
• Irritability and Mood Swings: Extreme irritability, mood swings, and emotional volatility are often experienced, creating challenges in interpersonal interactions. 
• Depression and Apathy: A sense of profound sadness, hopelessness, and emotional detachment can take hold. 
• Cravings and Obsessive Thoughts: The relentless desire for the drug, coupled with obsessive thoughts about obtaining and using opiates, can be mentally consuming. 

The Clinical Opiate Withdrawal Scale 

The Clinical Opiate Withdrawal Scale (COWS) is a valuable tool for addiction psychiatrists to assess and quantify the severity of opiate withdrawal symptoms [5]. It was developed to provide a standardized measure of withdrawal intensity to help healthcare professionals determine the most appropriate course of action and treat withdrawal symptoms effectively. 

The COWS evaluates a range of physiological and psychological factors to gauge the overall severity of opiate withdrawal, including: 

• Resting Pulse Rate and Sweating: The degree of elevated heart rate and sweating is indicative of the physiological stress response triggered by withdrawal. 
• Gastrointestinal Symptoms: The presence and intensity of symptoms like nausea, vomiting, and diarrhea contribute to the overall score. 
• Restlessness and Pupil Size: Restlessness, an inability to sit still, and pupil dilation are assessed to gauge the impact of withdrawal on the central nervous system. 
• Bone and Joint Aches: The degree of discomfort in bones and joints is measured, providing insights into physical distress. 
• Runny Nose or Tearing: The presence of runny nose and tearing, often observed during opiate withdrawal, contributes to the overall assessment. 
• Yawning and Sweating: Yawning, a common symptom during withdrawal, and the level of sweating are evaluated. 
• Anxiety or Irritability: Psychological symptoms like anxiety and irritability are assessed to understand the emotional toll of withdrawal. 
• Goosebumps: The presence of goosebumps is an indicator of the body’s response to withdrawal. 

What is the Timeline for Opioid Withdrawal?

Opiate withdrawal symptoms typically begin within hours of the last opiate use and peak within a few days. The intensity and duration of symptoms can vary depending on the severity of use, with acute withdrawal often subsiding after a week or so. However, lingering psychological symptoms and cravings can persist for weeks or even months, requiring ongoing opioid addiction support and coping strategies. 

Is Opioid Withdrawal Management Necessary to Overcome Opioid Addiction? 

To recap, opioid withdrawal occurs when your body becomes so dependent on opioids that when you stop taking the drug, you experience withdrawal symptoms. While opioid withdrawal itself isn’t fatal, certain symptoms can be severe enough to cause life-threatening complications. Issues such as vomiting, diarrhea, fast heart rate, or high blood pressure can become severe enough to induce seizures or cause death. 

Opioid withdrawal is one of the most uncomfortable experiences that you can go through, and attempting to navigate it alone can be overwhelming and risky. It can feel nearly impossible to manage symptoms of opioid withdrawal without medical treatment. Seeking professional help from addiction treatment centers or healthcare providers with expertise in addiction medicine is essential. Medical supervision can ensure a safer detoxification process and the administration of medications to alleviate withdrawal symptoms. 

Opioid Detox Treatment 

The best way to navigate opioid detoxification is by seeking out a medical detox center. At a professional detox center, various options are available to help you overcome your drug abuse.

Medical detox facilities offer around-the-clock medical supervision and support to manage opioid withdrawal symptoms, ensuring your comfort and safety throughout the detoxification process. These centers provide all-encompassing care that not only addresses but also attends to the psychological and emotional dimensions of opioid addiction and recovery. 

What is Opioid Detox Like? 

Throughout the process of opioid detoxification, medical and mental health professionals work to alleviate withdrawal symptoms and manage drug cravings. Medications may be administered to ease withdrawal discomfort, stabilize vital signs, and minimize the risk of complications. Furthermore, behavioral therapies and counseling play a pivotal role in addressing the root causes of opioid use disorder and developing coping mechanisms for sustained recovery and sobriety. 

The duration of detoxification from opioids can vary significantly and is influenced by several factors, most notably the severity and duration of drug use. While some might experience a relatively shorter detox period lasting a few days, others with more prolonged or intense opioid use may require a longer period, potentially spanning several weeks.

Your physical health, metabolism, and the specific opioids used also play a role in determining the length of the detox process. Medical professionals assess these factors to create a personalized detox plan that ensures the individual’s safety, comfort, and successful transition to subsequent stages of addiction treatment. 

How Long Will Opioid Withdrawal Symptoms Last? 

The duration of opioid withdrawal symptoms can vary, but generally, the most intense withdrawal symptoms tend to arise within 12 to 48 hours after the last opioid dose and typically ease off within a span of 5 to 10 days. 

Even as the acute withdrawal symptoms wane, other complexities might emerge. This phenomenon is known as Post-Acute Withdrawal Syndrome (PAWS), characterized by: 

• Feelings of depression, anxiety, or restlessness 
• Heightened vulnerability to overdose due to reduced drug tolerance 
• Lingering discomfort and diminished well-being post-detox 
• Intense cravings for the drug while abstinent 
• Elevated risk of relapse and continued substance misuse 

These symptoms can persist for several months beyond the peak of opioid withdrawal and the duration of medically supervised detox. While there isn’t a fixed timeline for PAWS related to opioids, it is essential to maintain patience and commitment throughout the recovery journey. With time and proper support, you can gradually overcome these residual symptoms, steer clear of substance abuse, and regain mastery over your life. 

The Importance of Aftercare 

Opioid addiction recovery is a multifaceted endeavor that goes beyond detoxification. Upon completing detox, you are encouraged to participate in ongoing treatment programs, such as residential or outpatient rehab, to further tackle the psychological and social factors contributing to addiction. These programs provide a nurturing environment and equip you with the tools needed to uphold sobriety and avert relapse. 

Detoxing from opioids and entering recovery are highly personalized processes. The gravity of the addiction, physical health, mental well-being, and individual circumstances must all be considered when formulating the most suitable treatment plan. This tailored approach ensures you receive the essential support to conquer your addiction and reclaim command over your life.

Detox From Opioids Today at Clear Behavioral Health

Detoxing from opioids and going through opioid withdrawal is a challenging but important step toward regaining control over your life. 

At Clear Behavioral Health, we understand how difficult opioid detox and opioid withdrawal can be. We understand how important it is to ensure a safe and comfortable withdrawal experience for you or your loved one. 

Our dedicated medical opioid detox centers provide comprehensive withdrawal management for all opioids including fentanyl, and our inpatient rehab facilities can help you maintain sobriety and address underlying mental health conditions. We offer a wide range of treatment options in the Los Angeles, CA, area, including Redondo Beach and Gardena, CA. Get in touch today to learn more about how our continuum of care can guide you toward a healthier, clearer life. 

References: 

1. Opiate and opioid withdrawal. (2025, January 6). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/opioid-withdrawal 
2. Shah, M., & Huecker, M. R. (2023, July 21). Opioid withdrawal. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK526012/ 
3. Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. (n.d.). https://medlineplus.gov/ency/article/000949.htm 
4. Spencer, M., Miniño, A., & Warner, M. (2022). Drug overdose deaths in the United States, 2001–2021. https://doi.org/10.15620/cdc:122556
5. Wesson, D. R., & Ling, W. (2003). Clinical opiate withdrawal scale. Journal of Psychoactive Drugs, 35–35(2), 253–259. https://nida.nih.gov/sites/default/files/ClinicalOpiateWithdrawalScale.pdf