There are several essential opioid detox options available. The opioid class of drugs–narcotic analgesic painkillers–relieve pain by working on the brain directly, causing pain relieving chemicals to be released while at the same time reducing the brain’s sensitivity to pain. These drugs become addictive when taken over a long period of time or not taken according to a doctor’s precise instructions.
Essential Opioid Detox Options
Opioid abuse, even if it is fairly limited in duration, alters the brain and body to become reliant physically and psychologically on the drug. Removing the opioid from an individual’s body is stressful, as the entire pain suppression system has become dependent on the continued intake of opioids. As well, the effects of the ongoing abuse level intake of opioids on the brain’s dopamine and serotonin systems wreaks havoc on a person’s ability to function in daily life. The drugs have to go. But transitioning to a state of being free of opioids, detoxification, can be very painful to agonizing.
Right now, the options for doing this are as follows:
Cut out the drug completely on your own. Also known as “cold turkey”. Depending on which opioid a person has been abusing or to which they’ve been addicted, the detox phase might range from severe discomfort to excruciating. The physiological urge to take just a little bit of the drug in order to relieve the pain is huge, and every time the drug re-enters the system, the addict has to go through the entire painful detox process again. With cold turkey, there’s no professional support, and the strain on the body during the detox can be dangerous. This method has a low success rate and a high pain rate. Almost everyone who goes cold turkey will relapse within 3 months.
Tapering. Slowly reducing the amount one uses of the opioid over time is a very safe way to minimize discomfort. It also allows the body’s dopamine and serotonin systems to slowly heal, as well as other systems in the body to become healthier again. Tapering however is best used for those people who fear they are becoming addicted or dependent on a legally prescribed opioid drug, and wish to prevent true addiction from taking place. Logically, an addict cannot taper down and simply quit, as that very ability is contrary to what and who an addict is. Addicts can cut back, can reduce their usage, but they will return to full usage quite soon. Tapering is a good choice for people who have become over-dependent on medication, but not a good choice for addicts.
Medical detox. In medical detox, one enters a medically facility for the purpose of receiving round the clock medical care as well as medications that stabilize the body’s reaction to the absence of opioids. The opioid drug is tapered off, but more rapidly, while supportive drugs are given that relax or prevent painful withdrawal symptoms. Having medical staff around is a huge benefit. Opioid withdrawal can produce severe cramping, muscle spasms, vomiting, dehydration, shakes, even seizures. A medical detox provides medications that can gently relieve the body’s overall stress reaction, control vomiting and diarrhea, prevent or reduce muscle cramps, and ensure the body remains hydrated. The length of time in the hospital depends on the primary opioid of addiction combined with a person’s age and overall wellness. It’s very rare for a detox to last longer than two weeks inpatient. More common time periods are between 3 and 7 days. Detox does not provide any form of addiction education, relapse prevention education, nothing like that at all. It is, by itself, not rehab. For one thing, a person in detox is not in a good frame of mind to do any kind of mental activity. Thus, one has to go into a rehab program, inpatient or outpatient, to address the drug addiction itself.
There’s a special warning here: when a person has gone through detox and is in rehab (or not) and relapses, the amount of the drug they take is often at the same dose level they remember before they got clean. This results in many, many fatal overdoses. After getting clean, the body can become hypersensitive to opioids, and a what a long time addict would consider a fairly small dose will be lethal to them after they get clean. It is a particular peculiarity of the opioids that makes them horribly dangerous to abuse. Heroin overdose is quite common.
Ultra Rapid Opiate Detox (UROD). This is a very radical approach. In a hospital setting, an addict is heavily sedated, even anesthetized. Then, an opioid purging drug such as Narcan (naloxone) is injected. The body purges all opioids and its breakdown products immediate, over a span of hours instead of days. This would be incredibly painful if a person were awake. However, simply because a person is anesthetized does not mean their body is not undergoing great stress. The use of Narcan has been as an emergency treatment for opioid overdose. Naloxone saves lives, but the drug and procedure were meant to be used only in the case of overdose, not voluntary “purging”. One side effect of UROD is vomiting and aspiration of emesis into the lungs. Emergency intubation and lung clearing can prevent this from being fatal, but any kind of UROD must be carried out in a full accredited medical center with a great track record for successful UROD.
People who undergo UROD are as likely to relapse as anyone else. If they do not get into rehab, the UROD is largely worthless, and can lead people into a false sense of security. People who’ve gone through ultra rapid opioid detox still report drug cravings. Finally, this is a very expensive form of treatment, due to a person requiring full anesthetic and large amount of direct doctor care. In a way, it’s much more like a surgery than a treatment, in analogy.