SAFETY ALERT FOR ORAL BUPRENORPHINE
In January 2022, the Food and Drug Administration (FDA) issued a
Opioid drugs like codeine, hydrocodone (Vicodin), and oxycodone (OxyContin, Percocet) treat pain. These drugs are very effective, but they’re also highly addictive. Up to
Opioids are believed to change brain chemistry and alter the brain’s pleasure-reward circuits. When you take an opioid, it produces feelings of intense euphoria or relaxation. For some people, these feelings make it hard to stop taking the drug.
Using opioids long-term can lead to dependence, which means you need to keep taking the drug just to function. Once you’re reliant on opioids, stopping them can lead to unpleasant withdrawal symptoms such as:
- agitation or irritability
- fast heartbeat
- belly cramps
- muscle aches
- sleep problems
If you have symptoms like these when you try to stop taking opioids, see your doctor for help.
Opioid withdrawal treatment must be carefully supervised to prevent you from relapsing and going back on the drugs. Your doctor or the staff at an addiction treatment center will oversee your care to make sure you stop taking these drugs safely and prevent withdrawal symptoms.
Here are some of the medications and other methods doctors use to help people gradually taper off of opioids.
Withdrawal symptoms are caused by a rapid drop in opioid levels in the brain. Treatment for these symptoms involves tapering off of opioids slowly.
The main treatment is to replace the short-acting drug with a longer-acting opioid, such as methadone or buprenorphine (Buprenex). Your doctor will gradually lower the dose of the drug over one or two weeks to give your body time to adjust.
Once you have finished your supervised program, you may be prescribed an opioid antagonist drug like naltrexone (Revia, Vivitrol) or naloxone (Evzio, Narcan). These drugs block the effects of opioids in your brain, so you won’t get a euphoric feeling if you take them. They can help you stay off opioids.
Methadone and Buprenex are also used long-term as maintenance therapy. Suboxone and Zubsolv contain a combination of naloxone and buprenorphine to prevent relapses.
While you taper off of opioids, these non-opioid drugs can help relieve your withdrawal symptoms:
- for anxiety, clonidine (Catapres) and tizanidine (Zanaflex)
- for diarrhea, loperamide (Imodium) and bismuth subsalicylate
- for nausea, prochlorperazine (Compazine)
- for belly pain, dicyclomine (Bentyl)
- for general pain, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve)
In 2018, the FDA approved lofexidine hydrochloride (Lucemyra), the first non-opioid drug to manage withdrawal symptoms. It can help reduce these symptoms for up to two weeks.
Drug dependence has physical and emotional effects. A comprehensive drug treatment program will help you deal with both of these issues.
Education and therapy are two important components of opioid withdrawal treatment. Your doctor or the staff at your drug rehab center will teach you the skills you need to stay off these drugs long-term. You can also see a counselor or join a self-help program such as Narcotics Anonymous (NA).
Some of the methods these programs use include:
- education about the risks of opioid use, and the benefits of stopping
- incentives and rewards to motivate you to change
- advice on preventing the behaviors that cause you to use opioids
- tips on how to deal with cravings and avoid a relapse
Medication is the main way to stop using opioids, but there are also a few things you can do at home to help yourself feel better.
- Drink extra fluids. Diarrhea and vomiting can leave you dehydrated. Drink water or sports drinks to replenish any fluids you lose.
- Stay cool. Sweating is one of the more uncomfortable side effects of opioid withdrawal. Keep a fan and wet washcloth close by to cool down.
- Use distractions. Opioids can consume your thoughts when you’re trying to wean off them. Occupy your mind with distractions. Read a good book, watch a funny movie, or take a walk outside.
- Have a support system in place. When the urge to use opioids hits, call a friend or family member to talk you through it. Ask someone to check in on you regularly during your recovery.
Tapering off opioids is a process that takes time and effort. Withdrawal symptoms are unpleasant, but they will eventually stop. The right treatments can help you avoid many of these symptoms.
Get help from your doctor, an addiction treatment center, friends, and family. The more support you have, the greater your odds of successfully staying off these drugs.