Pain Medications Withdrawal And Detox: Symptoms and Options

Last Updated: December 18, 2019

Authored by Roger Weiss, MD

Withdrawal from a painkiller starts after significant decreasing the intake or abrupt discontinuation of the medication. While the length and harshness of the symptoms would depend on the type of drug and the amount being used, symptoms will soon start to appear as quickly as one withdraws from pain medication. In severe cases, it can occur within a few hours after taking the last dose.

Pain Medications Withdrawal Symptoms

The process of pain medication withdrawal refers to tapering down the use of painkillers or stopping altogether. There can be variations on how painkillers work in the body, but most of the time, it is the dosage and how suddenly one is coming off the drug that will determine the severity of withdrawal symptoms.

Early Withdrawal Symptoms

How long painkillers stay in system and how long it takes to withdraw from pain meds depends on several individual factors. Extended-release painkillers stay in the body longer; hence, the onset of withdrawal from painkillers will take longer. As with most painkillers, regardless of the type, withdrawal symptoms usually start within 6- 48 hours after the last dose is taken. Early symptoms of pain medication withdrawal include:

  • Sweating
  • Runny Nose
  • Anxiety
  • Agitation
  • Irritation
  • Insomnia
  • Body Aches

anxiety and withdrawal from pain meds

Late Withdrawal Symptoms

The peak of symptoms of withdrawal from painkillers may start to appear in the 2nd or 3rd day. As the stages of withdrawing from pain medication progress, symptoms of late-onset withdrawal may include more uncomfortable symptoms:

  • Diarrhea
  • Abdominal Pain
  • Nausea
  • Vomiting
  • Chills
  • Low energy
  • Tremors or shaking
  • Headache
  • Confusion

After approximately 5 days, for most people, the physical signs of withdrawal from pain meds will start to go away, but this is when psychological symptoms start to manifest themselves. Withdrawal from pain meds is not just about physical dependency, and many people experience mood swings and depression. As their thinking becomes clearer, others may start to feel remorseful for their actions, even attempting suicide.

Stopping Pain Meds

Patients who have been taking pain meds for 2 weeks or less like a simple medication for stomach pain may be able to stop quickly without withdrawal. While this is still unique to every patient, in most cases, the body has not developed tolerance yet during this time frame. For those who have been using more than 6 tablets daily, tapering use down by 1 tablet every 2 to 3 days is highly recommended. This must be approved and supervised by a medical health professional only.  

Among the many effects linked to long-term or excessive use of painkillers, a user must stop the consumption of pain meds if the following warning signs are present:

  • Thinks about the medication a lot
  • Takes different amounts than the doctor’s prescription
  • Does “doctor shopping” to get more prescriptions
  • Gets painkillers from other sources
  • Has been using painkillers for a long time
  • Feels angry if someone talks to him or her about it
  • Not quite himself or herself

Stopping Pain Meds

How to get off painkillers without withdrawal is answered through slow tapering. It is the process of decreasing painkiller doses by 10-20% every 1-3 weeks with close follow-up with a doctor. As soon as the patient is on the lowest drug dose, he or she can now decrease the frequency of use by 1 tablet every week and leaving the nighttime dose as the last before stopping pain meds completely.

Detox From Painkillers

After stopping the use, detox from painkillers will begin. How to detox from painkillers would depend on the severity and other individual requirements. Some users may switch to herbal pain medication, but only with approval from a doctor to avoid allergic reactions and other possible side effects. Other nonpharmacologic techniques like hydration, healthy diet, exercise, and meditation can also help minimize withdrawal symptoms. However, for heavy and long-term users, medical detox remains to be the best course of action. The goal of which is to create a program that will minimize symptoms and help with the safe and effective cessation of drug use. Some of the medications that can be used include:

Methadone and Buprenorphine

These drugs activate the same receptors in the brain as painkillers and help one overcome their addiction and eliminate withdrawals from pain meds. It can help lessen drug cravings without the euphoric feeling.

Suboxone

This is a mixture of Buprenorphine and Naloxone, which is used to reverse opioid painkiller overdose. The presence of Naloxone will discourage the misuse of Buprenorphine by injection.

Naltrexone

This prevents pain meds from triggering the brain’s reward system. It hinders one’s ability to get high, thus discouraging the use or abuse of painkillers.

Benzodiazepines and Barbiturates

These drugs slow down the CNS and produce a calming effect to relieve anxiety and depression. They can also help reduce one’s risk of seizure during withdrawal and detoxification.

Entering A Detox Program

Misuse of pain meds, including pain meds for pregnancy, is very common and can be very dangerous. In fact, according to the National Survey on Drug Use and Health, approximately 4.3 million adults in the US were abusing painkillers in 2014.

Withdrawing from these drugs can subject an individual to several symptoms and other physical health dangers such as respiratory depression (slow breathing) and other severe conditions. There are several treatment options available in plenty of rehabilitation centers in the US.

Entering A Detox Program from pain meds

While it is possible to detox alone at home for non-addictive pain meds and other minor cases, pain medication withdrawals symptoms can be intense to trigger relapse even in committed people. Supervised detoxification will ensure physical comfort and safety during the whole process. Detox from pain meds at rehab facilities will include activities and counseling sessions like one-on-one and group therapies, community-based programs, and other therapeutic activities that will help in their recovery and prevent relapse.


Page Sources

  1. Thomas F. Hilton, Paul A. Pilkonis. The Key to Individualized Addiction Treatment is Comprehensive Assessment and Monitoring of Symptoms and Behavioral Change. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695774/
  2. Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Substance Abuse And Mental Health Services Administration Report. 2015. https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf

Published on: September 25th, 2019

Updated on: December 18th, 2019

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

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