Opioids, also known as opiates, are a class of drug frequently used for the treatment of pain. These drugs are narcotic and possess strong psychoactive properties, making them liable for causing addiction.
Excessive consumption of opiates has a potential to induce physical and psychological dependence in the users. This means that use of these medications is necessary to avoid withdrawal symptoms.
The treatment of opiate addiction is possible, and there are a lot of ways to pursue it. One of these methods includes the use of medications such as methadone, buprenorphine, and clonidine for opiate addiction treatment.
What are Opiates?
Opiates refer to a category of drugs derived from a poppy plant. These drugs are particularly famous for their high analgesic effects. The typical examples of opiates include codeine, morphine, and heroin.
Opioids mainly refer to both synthetic and semi-synthetic derivations. This category encompasses a broad range of prescription medications which may include Fentanyl, Oxycontin, Methadone, and Percocet.
Opiates are of particular medical significance because of their potent pain-relieving properties.
The use of opiates is, in fact, regarded as the standard of care in most of the world. However, their prolonged use causes higher incidences of addiction and withdrawal.
Effects of Opiates on body
According to the recent survey, over 26.4 to 36 million people tend to suffer from opiate abuse on a global level.
In the year 2012, it was estimated that 2.1 million people in the United States alone suffer from substance abuse disorders related to the use of prescription opioids. At the same time, 467,000 people were addicted to heroin.
The alarming statistics compels to know about how opiates affect your body and what happens when you stop taking it.
A study published in a Journal named Anesthesiology attempts to explain effects of opiates on the central nervous system.
The research has identified four different types of receptors for the attachment of opiates. These receptors include kappa (κ), Mu (μ), delta (δ) and opioid receptor-like-1 (ORL1) receptors.
All of these receptors work through G-protein couple mechanism causing an activation of the inhibitory G-proteins and signaling kinase cascades to produce varying effects in the body.
Opiates usually cause the release of artificial endorphins in the central nervous system. These endorphins are also responsible for the good feelings that accompany the opiates.
Over the passage of time, the continued use of opiates tricks the brain into inhibiting the natural production of these endorphins. At this point, the person becomes addicted to these opiates for producing endorphins and feeling good.
Some opiates are so strong that they can stimulate the Production of endorphins over a 100 times more than the natural rate. Imagine what would be the impact of this on the brain and other nerve cells.
As the brain becomes completely dependent upon the opiates, a vicious cycle initiates urging you to consume a higher amount of opiates to regulate mood and control pain.
As soon as you stop taking opiates after developing an addiction, the body starts feeling sick.
The feelings of depression prevail, and a series of harsh symptoms start appearing; a condition which you refer to as opiate withdrawal.
Opiate withdrawal refers to the collection of mental and physical symptoms that appear due to a missed dose of opiates.
The process manifests itself differently in every individual with a set of painful effects that may intensify with time.
The stage one of opiate withdrawal comprises of the most painful symptoms.
These symptoms start appearing within 8 to 16 hours of the last opiate dose.
In case of heroin users, these effects appear much earlier and quicker as compared to other drugs.
The common withdrawal symptoms during stage one include:
- Loss of appetite
- Abdominal cramps
- Runny nose
- Pain in muscles, joints, and bones
Stage one tends to last for a 1 to 2 days but may lengthen in some cases. The chances of relapse are the highest in this case.
The stage two of opiate withdrawal is relatively more bearable as compared to the previous one.
However, problems will still exist such as pain, difficulty in eating solid foods, dehydration, and diarrhea.
Symptoms included in stage two are:
- Problem in eating
The stage three is a relatively painless stage with a few mild physical symptoms.
This stage comprises of problems like insomnia, anxiety, and nausea.
Although the symptoms are less intense, this stage is important as you may still feel mental problems for a long period.
Treatment for Opiate Withdrawal
Treatment of opiate withdrawal is possible. The following course of treatments are advisable for treatment of opiate withdrawal:
- Using detox facilities for getting rid of opiate withdrawal
- Getting a treatment in a regular hospital, in case the symptoms are severe
- Continuing a treatment at home using medicines
Using medications for Opiate Withdrawal
The treatment of opiate withdrawal using medicines is possible. However, before consuming any medicines, it is essential to go through a mental health screening.
The most common medications for opiate withdrawal are methadone, clonidine, and buprenorphine.
Methadone is a type of opioid agonist which is an active form of treatment for opiate addiction.
It can treat all kinds of opiate addiction and relieve the symptoms of withdrawal.
The use of methadone can make detox better and smoother. Additionally, it is also perfect for use as a long-term maintenance medication in case of opiate dependence.
You can wean off this drug once the withdrawal symptoms subside or can continue using it for an indefinite amount of time without fearing any side effects.
Methadone is the drug of choice for those who require a high and intensive treatment for opiate withdrawal.
People suffering from severe forms of pain and other symptoms of withdrawal are treated better with methadone than any other drug.
Despite the beneficial effects of methadone, its liability to abuse is high. Therefore, it is essential to use it according to the prescription.
According to a study published in the Western Journal of Medicine, methadone in an amount of 10 to 20 mg is sufficient to begin a detoxification treatment. The dose increases to 10 mg until the withdrawal symptoms start to subside.
The study also highlights the maintenance dose for methadone as high as 40 mg to control the withdrawal symptoms.
Buprenorphine for Opiate addiction
Buprenorphine works as a partial opioid agonist which makes it suitable for treatment of opiate addiction.
Being a partial agonist means that buprenorphine possesses similar properties as those of other opioids but is not able to produce the same level of effects.
In other words, the potency of buprenorphine is lesser as compared to other opioids.
In addition to this, buprenorphine also produces a ceiling effect. This means that the intake of this medicine at higher doses causes its effects to stop gradually.
The ceiling impact of buprenorphine makes it a relatively safer drug to use as compared to other opiates.
Buprenorphine mimics the mechanism of action presented by methadone to minimize the withdrawal symptoms occurring due to opiate dependence.
It is suitable for use in a detox program but can also make a good choice of drug for a longer maintenance program.
It is a common practice to pair buprenorphine with naloxone to reduce the liability of abuse in the patients.
Because of this purpose, this medicine is readily available, and you can safely use buprenorphine for opiate addiction treatment at home.
A study in the Cochrane Database of Systemic Reviews regards buprenorphine as an even more effective agent for treatment of opiate addiction as compared to lofexidine and clonidine.
It is an efficient way of getting rid of opiate addiction regarding severity and duration of withdrawal symptoms as well as the completion of therapy.
Clonidine for Opiate addiction
As per the National Library of Medicine, clonidine belongs to the category of drugs known as the central acting alpha-agonist hypotensive agent.
Clonidine has a potential to treat all types of opiate addictions and withdrawals.
However, it is most suitable for those who are not heavily addicted and do not suffer from severe opiate dependencies.
On average, clonidine can help you get rid of opiate addiction and withdrawal within one to two weeks.
Clonidine is not an opiate in nature. Therefore, it does not act on the same receptors of the brain as that of opiates.
For this reason, it might not be able to treat the cravings for these drugs, a common symptom of opiate withdrawal.
However, clonidine can efficiently minimize many other symptoms associated with opiate withdrawal such as:
- Bone pain
- Runny nose
A study published in a journal named Bulletin on Narcotics justifies the role of clonidine in the treatment of opiate addiction.
The study signifies that clonidine can help the patients detoxify in even less than two weeks.
The rate of success is extremely high as far as the achievement of zero dosage is concerned.
Clonidine has successfully reduced the signs of opiate withdrawal in patients who have been abusing on up to 75 mg of opiates on a daily basis.
Which medicine is the best for you?
No treatment program can be perfect for every person. Similarly, a single medication might not be equally effective in different individuals. The choice of drug for opiate addiction treatment varies from person to person.
If you suffer from a mild opiate abuse and have a low dependence, clonidine might be the best and the most suitable drug for you to achieve a faster detox.
On the contrary, if you are a heavy abuser with high dependence on opiates, methadone or buprenorphine will serve you the best.
In cases of extremely high dependencies, methadone might work better as compared to buprenorphine because buprenorphine is milder and might not be able to produce the same level of effects as that of methadone.