Identifying Opiate Withdrawal Symptoms

Identifying Opiate Withdrawal Symptoms

Opiates are often called the lion of drugs. This is not only because of their potency, but also because they cause the most severe withdrawal symptoms when their use is stopped. Severe opiate withdrawal symptoms, although not dangerous by themselves, can cause the individual suffering from it to go back to the drug in order to obtain immediate relief from the opiate withdrawal symptoms. Oftentimes this leads to overdose as abstinence for a certain period of time lowers tolerance. Management of opiate withdrawal in New Jersey is available at several locations: Salem county, Ocean county, Essex county, Atlantic county, Middlesex county, Bergen county, Monmouth county, Somerset county, Hunterdon county, Hudson county, Union county, Morris county, Passaic county, Sussex county, Warren county, Mercer county, Burlington county, etc.

Individuals addicted to opioids find it extremely difficult to stop use because of the severe opiate withdrawal symptoms. While not life threatening, it can cause acute physical distress. Hence, stopping opiate use must be coupled with medical detoxification so that the physical symptoms can be alleviated or eliminated. Opioids such as oxycontin, morphine, heroin, methadone etc. are used widely due to the euphoria and relaxation it provides. It can be dangerous to stop opiate use abruptly as the severe withdrawal symptoms could cause the individual suffering from opiate dependence to go back to opiate use after their physical tolerance level has fallen and consumption of the same dosage of opiate as before could now lead to overdose. Some studies on the etiology of opiate withdrawal suggest that they are related to adenylyl cyclase super activation based central excitation, caused due to three types of opioid receptors namely, mu, delta, and kappa, out of which, the mu receptor heightens actions of opioids. The locus coeruleus of the brain is the site that triggers the opioid withdrawal symptoms. With optimal, medicated assisted treatment, MAT, withdrawal symptoms can be fully addressed.

Opiate Withdrawal Could Cause Psychological Issues

Opioid drug users could experience psychological issues during the withdrawal phase. These include dysthymia, depressed mood and opioid-induced depressive disorder. However, diagnostic investigation is required to identify opioid withdrawal symptoms which are different from general opioid-induced disorders.

Primary Signs of Opiate Withdrawal

Some of the commonly found signs and symptoms of opioid withdrawal include the following:

  1. Lacrimation or rhinorrhea
  2. Piloerection or Goose Flesh,
  3. Myalgia
  4. Diarrhea
  5. Nausea/vomiting
  6. Pupillary dilation and photophobia
  7. Insomnia
  8. Autonomic hyperactivity like tachypnea, hyperreflexia, tachycardia, sweating, hypertension, hyperthermia
  9. Chills
  10. Tremors
  11. Upset stomach

There are certain sedative-hypnotic withdrawal symptoms that are quite similar to opioid withdrawal symptoms, but the latter is defined by lacrimation, rhinorrhea, and pupillary dilation. Similarly, pupillary dilation can be caused due to Hallucinogen and stimulant intoxication, but when it comes to opioid withdrawal symptoms, the person may also experience nausea, diarrhea, vomiting, lacrimation, and rhinorrhea. During diagnosis, symptoms of alcohol intoxication, hypnotic, or anxiolytic intoxication, should be carefully studied and ruled out.

In most cases, urine toxicology can determine which kind of drugs the person has consumed as it turns positive for most opioids like morphine, heroin, codeine, oxycodone, propoxyphene for 12 to 36 hours after use. One must note that most urine opiate tests do not detect the use of Methadone, buprenorphine, and LAAM and hence a special test needs to be conducted for this. Electrolyte abnormalities can be checked through ECG, complete blood count (CBC), and basic metabolic panel (BMP).

The severity of opioid withdrawal is identified generally by the Clinical Opioid Withdrawal Scale assessment, or COWS, which ranges from 0 to 47. It has 11 items of common symptoms of opiate withdrawal. When the reading is between 5 to 12, it’s considered to be mild, 13 to 24 is moderate, 25 to 36 is moderately severe, and greater than 37 is considered to be severe.

Detox treatments to recover from withdrawal symptoms vary depending on the type and severity of these symptoms.

Opiate detox treatment in New Jersey, to recover from opiate withdrawal symptoms vary depending on the type and severity of these symptoms. The Center for Network Therapy has three locations in New Jersey to treat opiate withdrawal and perform Opiate detoxification. CNT has locations in Freehold in Monmouth County, West Orange in Essex county and Middlesex in Middlesex county. CNT is an expert at addressing Suboxone withdrawal in New Jersey.


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Will Government Initiatives Help The Opioid Crisis?

Will Government Initiatives Help The Opioid Crisis?

Around 30 states have implemented new laws and policies, limiting physician’s ability to prescribe opioid pain pills to their patients. The most common method is to put a limit on the first prescription for opioid pills, stipulating that it should be for a week or less. There are also rules about the potency of these pills.


Some state governments have also increased or initiated funding to educate people on the dangers of opioid addiction, treatment, and prevention. This needs to be stronger than a warning label from the pharmacist.


States hope to lower the rate of addiction to opiate pain pills and slow the supply of legal opiate pain pills that seeps into the black market. However, the problem is deeper with ingredients, such as fentanyl, and pill makers available on the dark web. Building a wall would have little effect as small quantities of fentanyl to make these pills come through the mail.


Curbing prescriptions is a start, but people who have already developed an addiction will find the pills needed to sustain their addiction harder to obtain from legal sources, such as their doctor. Many individuals addicted to opiates order variants of the drug online from other countries and have them delivered right to their door.


Individuals addicted to opiates go “doctor shopping” to find other doctors who turn a blind eye or have several fake IDs set up to evade identification to ensure their supply never runs out. People who obtain opiate pain pills through their doctor sometimes sell the pills to other individuals addicted to opiates, rather than use it themselves. Some doctors also continue to prescribe them, for physical and mental health concerns.


Street drugs are the answer for many people who have been thrown off the system and this is riskier. Alternatives to opiate pain pills, such as heroin or fentanyl are often cheaper on the street, readily available and are often times much more potent. There is also the concern that people needing their fix will take whatever is available, and that can raise the risk of overdose.

Dr. Cidambi argues there are better ways to deal with the problem.

First is education. Many of these medications are prescribed by physicians who do not fully understand the addictive nature of these medications. Healthcare providers need to be educated on these issues so they can prescribe responsibly. They will be armed with information about the dangers the medications pose, are will be able to counsel their patients.

Once they understand the potential dangers, they will also be able to recognize the signs of addiction. Through continuous education, they will understand how addiction develops and be able to intervene before the patient becomes addicted.

Second is to provide more treatment options. Working with a patient on an outpatient basis allows them to engage in treatment while not disturbing their daily life. It also reduces the stigma associated with the disease of addiction.

The integration of the home environment into treatment and involvement of family, or other loved ones results in better outcomes. This is vital, as the patient is still in touch with his work and the patient’s family now understands the chronic nature of addiction better. It enables the patient to begin making lifestyle changes when they are in treatment with professional detox support.


Chicago Tribune : Expert offers ways to tell if you’re drinking too much

Chicago’s leading newspaper, sought out CNT’s Medical Director’s expertise to identify the difference between “moderate” and “heavy” alcohol consumption and suggest ways to cutback.

Indra Cidambi, M.D. is widely recognized as America’s leading expert on alcohol and drug treatment issues.

RALLY Health : Six Signs of Painkiller Problem, and How to Help

CNT’s Medical Director and leading chemical dependency expert, Indra Cidambi, M.D., helps individuals spot signs of painkiller addiction in a loved one. Fifteen million Americans misuse or abuse prescription painkillers every year almost 4 in 10 people surveyed said they knew someone who was affected by it.


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