What is withdrawal?
When a person decides to stop or reduce his or her use of an opioid drug that he/she has been using in large amounts over a long period of time, the person will experience withdrawal. Withdrawal consists of many different painful symptoms that occur as opioid levels in the body decrease. A physically dependent or addicted person may be tempted to begin using opioids again to relieve the pain of withdrawal. What does withdrawal feel like? How long does it last? Withdrawal may last for different lengths of time, and be more or less intense, for different people and with different types of opioids. For example, heroin withdrawal is often very intense but short-lived, while methadone withdrawal may be less intense but longer lasting. Generally, a person physically dependent on a bigger dose of an opioid will experience more intense withdrawal than a person who used smaller amounts. Many other factors, such as a person’s general health and state of mind, can also affect how he or she experiences withdrawal.
Table 3. Opioid Withdrawal Signs and Symptoms
| Signs and Symptoms of Opioid Withdrawal | ||
|---|---|---|
| Early | Late | 6-8 months |
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| Sources:Kreek, M. J. (2008). Neurobiology of Opiates and Opioids. In M Galanter & H Kleber (Ed.), Textbook of Substance Abuse and Treatment (4th ed.) Arlington, VA: American Psychiatric Publishing. American Psychiatric Association. (2013). Opioid Withdrawal. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. | ||
*Cravings for Opioids A “craving” is an intense desire or urge for a drug. Cravings often involve such a strong urge to use the drug that a person cannot think of anything else. Cravings can occur at any time, but they are more likely to happen in a place where a person has used or bought a drug, around people that are involved in their drug use, or around drug-related items. Emotions such as stress, anger, and depression also may trigger cravings.[1] Cravings activate the reward system in the brain. Any use of an opioid by a person previously addicted to opioid drugs can also cause an increase in cravings for the drug, leading to relapse. Medical professionals may ask their patients about their cravings throughout treatment. The presence of cravings may help measure how treatment is going, and can help predict a person’s risk for relapse.[2]
[1] Jaffe, Jerome H. & Jaffe, Ari B. (2004). Neurobiology of Opioids. In M Galanter & H Kleber (Ed.), Textbook of Substance Abuse and Treatment (3rd ed.) (p. 27). Arlington, VA: American Psychiatric Publishing.
[2] American Psychiatric Association. (2013). Substance Use Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
