Opium Detox Guide: Timelines, Symptoms & Effects

Derived from the poppy plant, Papaver somniferum, opium contains some combination of the principal opioid alkaloid precursors—including morphine and codeine—from which illicit narcotics (such as heroin) and prescription pharmaceuticals (such as hydrocodone and oxycodone) are synthesized. Historically, pharmaceutical-grade opium (e.g., the anti-diarrheal medications paregoric and opium tincture) was available in liquid form. As a sappy botanical derivative, unrefined opium is found in solid or semi-solid form; its most common illicit form is a dry brown powder. Opium is a powerful narcotic that is usually smoked, but it can also be injected or taken in pill form ¹.

A Schedule II drug under the Controlled Substances Act, opium relieves pain and produces feelings of euphoria and relaxation. Like other narcotics, repeated opium use can lead to a powerful addiction that is difficult to overcome. Opium addiction occurs when a user engages in compulsive drug use despite negative consequences. Addiction is typically accompanied by a physical dependence on opium, which is the body’s adaptation to the presence of the drug. Once someone is dependent on opium and attempts to quit or dramatically reduce use, unpleasant withdrawal symptoms are likely to emerge. These symptoms can be distressing and many users will return to opium abuse in order to alleviate opium withdrawal syndrome. Professional opium detox programs can provide you with the care and support necessary to withdraw comfortably from the drug.

Opioid abuse is a major public health issue. Below are some statistics surrounding opioid use and abuse ²:

• Prescriptions for opioids increased from 76 million in 1991 to 207 million in 2013.
• Between 2004 and 2008, the number of emergency department visits for prescription painkiller abuse more than doubled.
• As many as 36 million people are current opioid abusers worldwide.
• 16,651 people died from opioid pain reliever overdoses in 2010.
• Over 2 million Americans are addicted to opioid painkillers and another 467,000 are addicted to heroin.

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Opium Withdrawal Syndrome

Repeated opium abuse leads to chemical changes and adaptations in the brain. The user eventually becomes dependent on a routine supply of opium in order to function optimally. Without this supply, extremely uncomfortable withdrawal symptoms ensue. These symptoms are powerful enough to make drug cessation very challenging.

The intensity of withdrawal symptoms depends on the amount of opium typically used and for how long it has been used. Opium withdrawal symptoms are similar to those of other opioids and include ^3,4:

• Insomnia.
• Anxiety and agitation.
• Depressed mood.
• Teary eyes.
• Runny nose.
• Muscle aches.
• Excessive sweating.
• Increased yawning.
• Goose bumps.
• Diarrhea.
• Abdominal cramping.
• Nausea and vomiting.
• Fever.
• Dilated pupils.

If you or someone you care for experiences any of these symptoms when trying to quit opium, consider seeking professional help. Drug detox programs have a proven track record in easing withdrawal and getting addiction treatment off to a good start.

Withdrawal Timeline and Detox Treatment

Even though opium withdrawal syndrome is not typically life-threatening, acute opioid withdrawal of any kind is nevertheless extremely uncomfortable—almost unbearable for some. While every user’s experience is different, opium withdrawal symptoms may emerge, on average, within 6–12 hours after the last dose. Acute withdrawal symptoms tend to peak in severity within 1-3 days and begin to dissipate after 5-7 days, but some withdrawal symptoms, such as anxiety and depression, may persist for several weeks ⁴.

Every user’s withdrawal experience is different. A host of factors may influence the severity of symptoms and the length of time it takes the body to detox from the drug. These factors include:

• The amount of opium consistently used.
• The frequency of opium use.
• The individual’s age.
• The individual’s mental and physical health.
• The use of other mood-altering substances in conjunction with opium.

Professional detoxification from opium involves a carefully structured and supervised program to remove the drug completely from the body while managing acute withdrawal symptoms. Those who undergo these types of services may have a greater chance of successfully transitioning into treatment, and ultimately, lasting recovery.

Opium detoxification is a round-the-clock process and may involve the use of opioid detox medications in combination with supportive psychiatric care. Detox is a vital first step on the continuum of care, but it doesn’t constitute comprehensive opium addiction treatment.

Once detox is completed, drug abuse treatment typically follows. Guided by potentially distinct treatment philosophies, each specific treatment program is likely to utilize its own combination of therapeutic interventions. When looking for a treatment program that best fits your needs, know that effective ones share some common approaches and techniques that may include:

• Individual therapy.
• Group counseling.
• Relapse prevention classes.
• Medical and psychiatric care.
• Aftercare planning.

After successfully completing opium abuse treatment, a user generally transitions into some form of aftercare treatment that provides ongoing support and helps to build upon the coping and relapse prevention skills learned in rehab.

Should I Seek Withdrawal Management?

You may be unsure of whether you have an addiction to opium or, furthermore, if you would benefit from detox services. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), you may have an opium addiction, or opioid use disorder, if you exhibit at least 2 of the following signs and symptoms within a one year period ⁴:

• Using larger amounts of opium or for a longer period of time than originally intended.
• Attempting to quit opium but failing to do so.
• Spending excessive amounts of time obtaining the drug, using it, or recovering from its effects.
• Experiencing intense cravings for opium.
• Using opium negatively affects your performance at work, school, or home activities.
• Continuing to use opium even after the drug has led to interpersonal or social problems.
• Using opium takes priority over important social, work, or recreational activities.
• Using opium in physically hazardous situations, such as while driving or operating dangerous equipment.
• Continuing to use opium in spite of the harmful psychological or physical consequences.
• Developing a tolerance to opium, in which you need ever-increasing amounts to achieve the same desired effects.
• Experiencing opioid withdrawal symptoms when you try to quit using the drug.

If you suffer from an opium or opioid addiction, a detox program can be extremely beneficial in helping to manage withdrawal symptoms and reduce cravings.

Harms of Continued Opium Abuse

Failing to recognize you have an opium abuse problem can have negative long-term consequences. Over time, opioids (including opium) can cause ^4,7:

• Chronic constipation.
• Respiratory depression.
• Increased risk of overdose and death.
• Excessive pain sensitivity.
• Increased risk of cardiovascular events, such as heart attack or heart failure.
• Higher rates of fractures.
• Sexual dysfunction.
• Infertility.
• Suppressed immune system.
• Injection effects, such as collapsed veins, puncture marks, abscesses, cellulitis, vascular inflammation, bacterial endocarditis (infection of the heart lining), and systemic infections, such as hepatitis and HIV.
• Suicidal ideation and behaviors.

Detox and substance abuse treatment can be vital steps in preventing or initiating the healing process for the long-term effects of opium abuse. The longer you delay treatment, the higher the risk of experiencing adverse mental and physical effects.

Choosing the Best Program

Several pathways exist to effective opium detox and withdrawal treatment. For example, you can receive detoxification services at both the inpatient and outpatient level. Which path is best for you begins with a conversation with your treating physician.

Outpatient drug detox involves visiting a treatment center to obtain the necessary medication and counseling services to comfortably withdraw from opium. This can be achieved at a doctor’s office or at an outpatient detox facility. This provides people with the opportunity to continue meeting their everyday responsibilities while quitting opium use.

Inpatient detox services are beneficial for those suffering from a severe opium addiction. If you abuse other substances, such as alcohol or sedatives, in addition to opium or you are experiencing mental or physical health issues that are complicated by the withdrawal process, inpatient detox is likely the more appropriate option. Inpatient detox programs require that you reside at the facility for the duration of detoxification, which may last anywhere from a few days to a couple weeks. At a residential detox program, you receive 24/7 support and monitoring to address any complications that may arise during the withdrawal process.

Whichever pathway you follow, keep in mind that drug detox is only the beginning. The principle purpose of detoxification services involves evaluation, stabilization, and fostering entry into an addiction treatment program ⁸. Simply removing the drug from your system is not enough, and an effective addiction treatment program following opium detox is an essential next step. Discovering what led to the addiction and learning how to avoid its recurrence helps ensure long-term recovery.

Addiction Recovery Options

Relapse is the greatest threat to opioid addiction recovery, but an effective treatment program helps to reduce that risk. Detoxing from opium, while important, does little to prevent relapse on its own, particularly if the individual returns to their old, opium-using environment immediately after detox completion.

Successful drug abuse treatment helps you understand the underlying issues that led to opium abuse in the first place. These programs focus on teaching you drug-free coping skills. You learn to identify triggers that led to the desire for opium along with an understanding of the associated thoughts and feelings. Learning these things helps you adopt new and healthier behaviors.

As with detoxification services, drug abuse treatment programs are available in both outpatient and inpatient settings. In either setting, a wide variety of programs and services cater to varying populations and treatment needs. The cost for such treatment depends on factors like insurance coverage, services provided, duration of the program, and whatever amenities are provided. The most effective form of opium addiction treatment largely depends on the individual’s needs and addiction.

Inpatient Treatment

Inpatient addiction treatment requires a commitment to a 24/7 residential setting. One main advantage of this option is that it removes you from your previous drug using environment and provides some distance between you and potential triggers leading to opium abuse. Inpatient care can be especially helpful to those dealing with polydrug addictions and those with concurrent medical or mental health issues.

In these settings, individualized addiction treatment plans generally utilize a combination of individual, family, and group therapies and relapse prevention training. Every inpatient recovery program differs in its philosophy.

Some treatment centers employ medication-assisted treatment approaches and will administer medications approved to manage opioid dependence—such as methadone, buprenorphine or Suboxone, and naltrexone—in combination with behavioral therapeutic interventions.

Some may integrate 12-step classes into the treatment plan while others may use a more holistic approach and combine traditional interventions with meditation and yoga. Amenities vary as well and some program types, such as luxury recovery programs, place an importance on comfort while patients recover from an addiction. Luxury treatment centers are often in desirable locations and offer upscale amenities, such as gourmet meals, swimming pools, and private rooms. Executive treatment programs often combine the comfort of luxury programs with the practicality of internet, phones, and conference rooms for people to continue working during recovery.

Outpatient Treatment

Sometimes used as a bridge between inpatient treatment programs and longer-term recovery services, outpatient treatment programs can also be the initial or primary means of substance abuse rehabilitation services. Outpatient programs vary in intensity and services provided. Since they are not residential in nature, they offer the advantage of allowing patients to continue vocational and educational activities.

Generally, 3 different outpatient treatment levels are available. The outpatient options include:

• Day treatment: Also known as partial hospitalization, day treatment is the most intense outpatient option, requiring a commitment of at least 5 days weekly and 4-6 hours per day. These programs are able to administer treatment medications, such as methadone and buprenorphine, should a medication-assisted approach to recovery be in place. Supportive counseling at both the individual and group level accompanies drug avoidance training.
• Intensive outpatient: This type of outpatient treatment provides similar services but will often require patients to receive medications from an outside source. The time commitment is reduced to 2-4 days every week for 2-3 hours.
• Standard outpatient: This type of care requires a commitment of 1-2 hours per day for 1–2 days a week ⁹.

Sources

1. U.S. Drug Enforcement Administration (2015). Drugs of Abuse: Opium.
2. National Institute on Drug Abuse (2014). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.
3. National Library of Medicine (2016). Opiate and Opioid Withdrawal.
4. American Psychiatric Association. (2015). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C.: American Psychiatric Association.
5. Substance Abuse and Mental Health Services Administration (2006). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol.
6. National Institute on Drug Abuse (2014). Drugs, Brains and Behavior: The Science of Addiction: Treatment and Recovery.
7. National Library of Medicine (2012). A Review of Potential Adverse Effects of Long-term Opioid Therapy: A Practitioner’s Guide.
8. Substance Abuse and Mental Health Services Administration (2006). Detoxification and Substance Abuse Treatment.
9. Centers for Medicare and Medicaid Services (2009). Impacts Associated with the Medicare Psychiatric PPS: A Study of Partial Hospitalization Programs.