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.

Opiate Detox program

Opiate Detox program


SAMHSA Responds to Opiate Detoxification Need

SAMHSA, the Substance Abuse and Mental Health Services Administration, is a federal agency that sits at the apex of alcohol and drug treatment, research, referral and other services. SAMHSA has the best response to opiate detox program and opioid treatment needs through a free national helpline that provides treatment referral and information.

The telephone number for the helpline is 1-800-662-4357 (HELP). The Center for Network Therapy is the nation’s leading addiction treatment provider – opiate detoxification, benzo detoxification, and alcohol detoxification – and is licensed by SAMHSA to provide addiction treatment.

SAMHSA’s national helpline operates 24/7, 365 days a year. The service is free of charge and can be accessed in English or Spanish. All information provided is kept confidential.

SAMHSA’s website also has a treatment locator provision to find facilities that provide opiate detoxification and the Center for Network Therapy can be located using SAMHSA’s treatment locator.

Opioid and Heroin Facts – Highlights Need for Opiate Detox:

    • About 808,000 people had used heroin in the past year.
    • 10.3 million people over the age of 12 misused opioids in the past year – most misused prescription pain relievers.
    • Roughly 2 million people over the age of 12 suffered from an opioid use disorder – all these people will need opiate detoxification.
    • Injection opioid use raises risk of contracting HIV, Hepatitis B, and Hepatitis C. People who injected drugs accounted for 9 percent of HIV infections in America.
    • About 130 people die from opioid overdose every day – access to opiate detoxification could save thousands of lives. Opiate detoxification utilizes methadone, buprenorphine, suboxone or Subutex.


Opiate program and Opiate Detoxification Guidelines

1. Addiction to opiates is a chronic, but treatable illness – opiate dependence often requires continuing care for effective treatment rather than episodic, acute-care treatment approach.

2. Treatment providers should approach Opiate Use Disorder as a chronic illness, so that they deliver care that will help patients stabilize, achieve remission of symptoms and establish and maintain recovery.

3. Medication alone is not enough – patients should be able to access mental health services, addiction counseling and recovery support services.

4. Patient treatment time with medication will vary depending on the individual – one size does not fit all.

5. Treatment with medication saved lives – methadone, extended release injectable naltrexone (XR-NTX) and buprenorphine were found more effective in reducing opiate use than no medication at all. Buprenorphine and methadone were associated with reduced risk of overdose.

Emerging Trends in Substance Abuse:

Methamphetamine—Use is rising in America with 1.9 million using methamphetamine in the past year. Roughly 1.1 million people had a methamphetamine use disorder, much higher than in 2016. Overdose death rates involving methamphetamine quadrupled between 2011 and 2017. Frequent meth use leads to mood disturbances, hallucinations, and paranoia.

Cocaine—About 5.5 million people over the age of 12 or were past users of cocaine, including about 775,000 users of crack. Overdose deaths involving cocaine increased by one-third from 2016 to 2017. Short-term effects of cocaine include increased blood pressure, restlessness, and irritability. Over the longer term, cocaine can cause heart attacks, seizures, and abdominal pain.

Kratom—Kratom is a tea leaf like substance that comes from a tropical plant from Southeast Asia. The leaves, when brewed, provide psychotropic effects by affecting opioid brain receptors. This product is not regulated despite a high risk of abuse and dependence. Kratom can cause nausea, itching, seizures, and hallucinations. Kratom acts like an opiate, and same protocols as that for opiate detoxification – i.e. methadone, buprenorphine, Suboxone or Subutex.

Mixing Opiates With ‘Benzos’

Mixing Opiates With ‘Benzos’

Benzodiazepine Withdrawal

According to the National Institute on Drug Abuse, nearly 200 people in the United States die due to opiate overdose every day.

That is of epidemic proportions! Despite various efforts by the federal and state bodies, the epidemic continues unabated.

One of the reasons the opioid overdose deaths continue to rise is because of the influx of fentanyl, which is a synthetic opioid that is 50-100 times more potent than heroin and individuals addicted to opiates spiking the opiate high through the use of another class of drugs called benzodiazepines or benzos.

Benzodiazepines are psychoactive drugs that have legitimate uses in treating a range of mental health illnesses such as anxiety and insomnia. The non-addictive, longer-acting benzodiazepines are also utilized to help individuals addicted to addictive, short-acting benzos and alcohol.

Like opiates, benzodiazepines are also central nervous system depressants. Both opiates and benzodiazepines are used by physicians to help people with genuine ailments. When used together, it can lead to overdose more quickly. Over one-third of all opioid or opiate overdoses happen when they are mixed with benzos.

This combination is dangerous because both drugs cause sedation and slow down breathing to a point where the brain forgets to breathe, causing overdose fatalities. Also, this prescription drug may lead to hard withdrawal symptoms that simply require medical and treatment.

People suffering from addiction often like to mix opiates and benzos because benzos spike the euphoric high caused by opiates. Opiates not only cause intoxication and make a person high but also affect the entire body, which can lead to other illnesses.

When mixing benzos and opiates, the person may experience decreased awareness, confusion, delirium, slow shallow breathing, and nausea and vomiting.

Even though people using both usually know that it is a dangerous combination, they still do it to intensify the high. When people use substances repeatedly, they build up a tolerance and need more or stronger doses to achieve the same high.

Dr Cidambi, a leading expert in addictions, said, “We need to find a way to reverse the growth trend of benzodiazepine abuse. I truly believe that, unless we do something immediately, our country is on the brink of escalating the national drug epidemic into a pandemic.”

Dr. Cidambi has some recommendations for limiting the co-abuse of benzos with opiates:

Patients being prescribed benzodiazepines for anxiety need to be monitored closely and they should not be prescribed beyond a short period of time – say about 3 months. While many states are limiting the prescriptions for opiates, there are no limits on the prescriptions for benzos. The prescribing physician should be aware of the addictive nature of these medications and recommend the patient also address the issue through talk therapy such as Cognitive Behavioral Therapy, or CBT. After three months the patient should be switched to non-addictive medications.

The prescription monitoring systems that most states currently have should be extended across state lines or made national. This is because Many people get prescriptions filled across state lines.

Utilizing alternative types of therapy like meditation and acupuncture should be considered, along with outpatient talk therapy and non-addictive medications.

For more information, please contact us. : Lt. Governor Kim Guandango tour center for network therapy

New Jersey’s Lt. Governor, Kim Guadagno, visited the Center for Network Therapy to understand the ambulatory Detox model and find out how CNT is able to address the needs of individuals suffering from opiate withdrawal, benzo withdrawal and alcohol withdrawal. She was impressed by the efficacy of the program.

Dr. Oz The Good : The first implant for opioid addiction just recieved FDA approval

Dr. Oz’s online health site seeks addiction expert, Dr. Cidambi’s views on Probuphine, which was recently approved by the FDA. Probuphine is intended for treatment for opioid dependence and it is used to treat individuals suffering from opiate withdrawal and opiate cravings. Dr. Cidambi, Center for Network Therapy’s medical director argues why Probuphine will flop.


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