What makes opiates last longer

Treatment for opiate addiction requires long-term management. Similarly poor results are seen with medication-assisted detoxification. This article provides a topical review of the three medications approved by the Food and Drug Administration for long-term treatment of opiate dependence: the opioid-agonist methadone, the partial opioid-agonist buprenorphine, and the opioid-antagonist naltrexone.

Basic mechanisms of action and treatment outcomes are described for each medication. Opiates suppress pain, reduce anxiety, and at sufficiently high doses produce euphoria. Most can be taken by mouth, smoked, or snorted, although addicts often prefer intravenous injection, which gives the strongest, quickest pleasure. The use of intravenous needles can lead to infectious disease, and an overdose, especially taken intravenously, often causes respiratory arrest and death. Addicts take more than they intend, repeatedly try to cut down or stop, spend much time obtaining the drug and recovering from its effects, give up other pursuits for the sake of the drug, and continue to use it despite serious physical or psychological harm.

Some cannot hold jobs and turn to crime to pay for illegal drugs. Heroin has long been the favorite of street addicts because it is several times more potent than morphine and reaches the brain especially fast, producing a euphoric rush when injected intravenously. In anyone who takes opiates regularly for a long time, nerve receptors are likely to adapt and begin to resist the drug, causing the need for higher doses.

The other side of this tolerance is a physical withdrawal reaction that occurs when the drug leaves the body and receptors must readapt to its absence. This physical dependence is not equivalent to addiction. Many patients who take an opiate for pain are physically dependent but not addicted: The drug is not harming them, and they do not crave it or go out of their way to obtain it.

During the s, there was a push by public health officials to improve pain treatment in the United States. Although the public health effort was well intentioned, the consequences are now very well recognized. Because doctors have needed to reduce opioid prescribing, many people have needed to turn to street dealers to get drugs.

But prescription narcotics are expensive. So people have often switched to heroin, which is much cheaper. And street heroin today is commonly laced with the even more dangerous drug fentanyl.

For some people with opioid use disorder the new terminology instead of addiction , the beginning of treatment is detoxification — controlled and medically supervised withdrawal from the drug. By itself, this is not a solution, because most people with opioid use disorder resume taking the drug unless they get further help. The withdrawal symptoms — agitation; anxiety; tremors; muscle aches; hot and cold flashes; sometimes nausea, vomiting, and diarrhea — are not life-threatening, but are extremely uncomfortable.

The intensity of the reaction depends on the dose and speed of withdrawal. Short-acting opiates, like heroin, tend to produce more intense but briefer symptoms. No single approach to detoxification is guaranteed to work well for all patients.

Many regular heroin users are switched to the synthetic opiate methadone, a longer-acting drug that can be taken orally or injected. Then the dose is gradually reduced over a period of about a week. The anti-hypertensive blood pressure lowering drug clonidine is sometimes added to shorten the withdrawal time and relieve physical symptoms.

Methadone was first discovered in through the groundbreaking research of scientists at the Rockefeller Institute. Extended use of opiates changes the structure of nerve cells in your brain.

These cells will begin to need the drug just to function properly. When you stop using opiates abruptly, your body will react, leading to symptoms of withdrawal. These initial phases, which can last anywhere from a week to a month, can be followed by long-term withdrawal symptoms. Long-term symptoms are often less physical in nature and may involve emotional or behavioral issues.

Suddenly cutting yourself off from opiates may cause a strong reaction. Try to slowly taper off opiates before you go off them completely. This might limit the intensity of your withdrawal.

However, given the compulsive nature of addiction, most people find self-regulated tapering to be impossible. It often leads to a full relapse into addiction. Dehydration due to vomiting and diarrhea is common and could lead to serious health complications. Drinking plenty of hydrating fluids during withdrawal is very important.

Electrolyte solutions, such as Pedialyte, may help keep you hydrated. Using the correct doses of over-the-counter OTC medications can help. Consider loperamide Imodium for diarrhea. You can also try antihistamines like Benadryl. Aches and pains that seem to crop up everywhere can be treated with acetaminophen Tylenol or nonsteroidal anti-inflammatory drugs NSAIDs like ibuprofen Motrin , Advil.

Never use any medication for longer than its recommended usage or in larger doses than recommended. Preparation can be essential. Withdrawal symptoms can last from days to weeks. But be careful not to use these medications in amounts greater than the recommended dose. In the case of acupuncture, several studies demonstrated reduced withdrawal symptoms when combined with certain medicines.

The report of studies on Chinese herbal medications found that the herbs were actually more effective at managing withdrawal symptoms than clonidine was. People who have gone through withdrawal recommend trying to stay as comfortable as possible.

Keep your mind occupied with movies, books, or other distractions. Make sure you have soft blankets, a fan, and extra sheets. You may need to change your bedding due to excessive sweating.

Make sure a friend or family member knows that you plan on attempting the withdrawal process. Be cautious of recipes and anecdotal stories described in online forums. None of them have gone through rigorous testing for safety or efficacy. This can improve your chances for long-term success. Treat yourself to some chocolate.