Ending Physical Dependence is a Necessary Step Toward Healing. Withdrawal is Not.

Opioid withdrawal is a clear indication of the body’s attempt to recover from opioid dependence. Although stopping your body’s dependence is a necessary first step away from opioids, suffering through untreated opioid withdrawal or without physical, mental, and emotional support isn’t.

As you begin the recovery process, it’s important to know the various treatment options, including opioid withdrawal management, and have a plan. This way, you can choose the right course of action for you and your situation. It also helps to guard against surprises along the way.

The Science of Opioid Withdrawal

What is opioid withdrawal?

Opioid withdrawal occurs when the body reacts to the reduction or absence of opioids—a class of drugs often prescribed for pain relief but also includes illicit drugs like heroin or street fentanyl. As opioid use continues, the body adapts to the presence of these substances, leading to physical dependence. When opioid use is reduced or stopped, the body’s newfound equilibrium is disrupted, causing withdrawal symptoms.

Why does opioid withdrawal happen?

Opioids bind to specific receptors in the brain, reducing pain and creating feelings of euphoria. However, regular use alters brain chemistry, leading to tolerance and dependence. When opioid use stops, the brain demands the substance it’s accustomed to, resulting in withdrawal symptoms.

Recognizing Withdrawal Symptoms

What symptoms are common in opioid withdrawal?

Each person’s journey through opioid withdrawal is different. Withdrawal symptoms can range from mild to severe, typically beginning within hours of the last opioid dose, and can include:

• Pain: Muscle aches and joint pain are common as the body craves the pain-relieving effect of opioids.
• Gastrointestinal Issues: Nausea, vomiting, and diarrhea are prevalent symptoms, leading to dehydration if not managed properly.
• Restlessness: A deep sense of discomfort, including tremors, body chills, and inability to stay still, often plague individuals undergoing withdrawal.
• Mental Health Fluctuations: Anxiety, irritability, and mood swings are also symptoms of opioid withdrawal.
• Insomnia: Opioid withdrawal makes falling asleep and staying asleep very hard to do.
• Miscellaneous Symptoms: Running nose, tearing, yawning, and/or “goosebumps” (with body chills)

Measuring Withdrawal – In-Patient

In a clinical setting, opioid withdrawal is measured using the Clinical Opioid Withdrawal Scale, or COWS. This is a trusted tool that in-patient healthcare professionals use to gauge the intensity of opioid withdrawal symptoms. This assessment carefully examines 11 signs and symptoms that are frequently observed during opioid withdrawal. Scores on the COWS range from 0 to 47, with the results indicating the level of withdrawal severity:

• Mild (5 to 12)
• Moderate (13 to 24)
• Moderately severe (25 to 36)
• Severe (greater than 37)

The COWS allows for accurate, medically informed decisions to manage and support individuals through withdrawal.

Measuring Withdrawal — Self Assessment

If managing and measuring opioid withdrawal symptoms on your own at home, The Subjective Opioid Withdrawal Scale, or SOWS, can be used. This is a self-assessment tool that provides insight into an individual’s personal experience with opioid withdrawal. Unlike the COWS, SOWS relies on the individual’s own report of their withdrawal symptoms instead of vital sign measurements. It measures a range of symptoms, such as anxiety, cravings, restlessness, and physical discomfort, among others.

This SOWS scale helps the patient and the healthcare provider understand the severity of withdrawal from the patient’s perspective, to help track progress and ensure a more tailored approach to treatment and support.

In-patient/ Out-patient Treatment Options for Opioid Withdrawal

Structured in-patient and outpatient opioid withdrawal management (also called “detox”) programs are offered through behavioral health facilities and some private physician practices nationwide. Beyond detox, these programs may also provide a roadmap to sobriety, with varying levels of physical, mental, and emotional supportive care, depending on individual needs.

In an inpatient setting, specific opioid detox treatments are designed to be both safe and comfortable, supervised by medical professionals around the clock. Detox typically begins with a medically assisted withdrawal, using medications like clonidine, buprenorphine, methadone, and other comfort meds to ease various withdrawal symptoms.

Additionally, patients can access comprehensive care, including behavioral therapy, counseling, and support groups, which are crucial for long-term recovery. Nutrition, hydration, and rest are also carefully managed to support the body’s healing. This supportive environment is structured to address both the physical and psychological aspects of addiction, providing a solid foundation and ongoing support for the journey to recovery.

It’s important to note that not all in-patient or outpatient programs support the initial detox process, as many programs require a person to have already finished the opioid withdrawal process. In those instances, it might be necessary to manage the withdrawal process before admission (see Managing Opioid Withdrawal from Home).

Managing Opioid Withdrawal from Home

Some patients can’t or don’t want to leave their homes, jobs, families, or pets to begin the recovery process. In situations like these, home-based opioid detox may be necessary or preferable. This step-by-step guide is designed to help you successfully navigate the at-home opioid withdrawal process with care and understanding.

Step 1: Consult with a Healthcare Professional

Discuss your plan with a healthcare provider in person or via telehealth. They can offer valuable advice, ensure that at-home withdrawal is safe for your specific situation, and provide comfort medications and devices as well as additional resources for emotional support.

One new way to manage painful and uncomfortable withdrawal symptoms is through wearable neurostimulation devices, like Sparrow Ascent. This is a clinically proven safe, comfortable, drug-free option to overcome withdrawal symptoms at home. You can have Sparrow Ascent prescribed via telehealth and delivered to your doorstep – so it’s ready to help you manage opioid withdrawal symptoms from start to finish.

Step 2: Understand the Withdrawal Process

Before beginning, it’s essential to understand what opioid withdrawal entails. Remember, it’s the body’s natural response to not receiving opioids after a period of regular use, leading to a series of uncomfortable physical and psychological symptoms.

Step 3: Prepare Your Environment

If your provider recommends a home-based withdrawal, planning is essential. Before withdrawal begins, creating a comfortable, calming space where you can rest and recover is important. Have easy access to:

• Comfortable bedding with blankets
• A bathroom
• A variety of fluids with electrolytes to stay hydrated
• Over-the-counter medications for pain and fever
• Easy-to-digest and comfort foods – like chocolate

If you plan to use Sparrow Ascent to support your opioid withdrawal, be sure to schedule your telehealth appointment before stopping opioids and have your prescription shipped to your home so you have it on hand before withdrawal symptoms begin.

Step 4: Plan for Hydration and Nutrition

Dehydration can be a serious concern during withdrawal. And, getting out to the grocery store during withdrawal may not be in the cards. So, stock the pantry shelves in advance so you’re prepared to:

• Drink plenty of water and electrolyte-replenishing beverages.
• Avoid caffeine and alcohol, which can worsen dehydration and withdrawal symptoms.
• Eat small, light meals if you have nausea.

The use of Sparrow Ascent for opioid withdrawal can also help ease withdrawal-related gastric upset.

Step 5: Manage Pain and Discomfort

Withdrawal often includes muscle aches and pains. Sparrow Ascent can help you manage the full opioid withdrawal process, including aches and pains by activating key areas of the brain that release endorphins, the body’s natural opioids, and dopamine, a natural “feel-good” brain chemical.

Other ways to manage discomfort include:

• Taking over-the-counter pain relievers as recommended by your healthcare provider
• Using heating pads or take warm baths or showers to soothe aching muscles
• Engaging in gentle stretching or relaxation exercises if possible
• If you’re not nauseated, eating a small bit of chocolate can help

Step 6: Address Emotional Well-being

Mood swings, irritability, and anxiety are common during opioid withdrawal. In addition to helping manage withdrawal symptoms like nausea, vomiting, and diarrhea, Sparrow Ascent wearable neurostimulation also works to reduce anxiety throughout the withdrawal process.

Other tools to support your mental health include:

• Reaching out to friends or family members who can offer support.
• Letting the people you live with know that you’re stopping opioids and you may be irritable
• Joining online forums or support groups for those going through similar experiences.
• Practicing stress-reduction techniques like deep breathing, meditation, or mindfulness.
• If you’re feeling up to it and your doctor approves, take a walk or a slow jog. Exercising can help release nervous energy, make you feel better, and is a great activity to keep your mind busy.

Step 7: Establish a Routine

Sparrow Ascent wearable neurostimulation can help with opioid withdrawal symptoms like restlessness, but you may also want to:

• Try to go to bed and wake up at the same time each day.
• Schedule meals and activities at regular intervals.
• Include time for relaxation and light exercise, such as walking.

Step 8: Monitor Your Symptoms

Keep a journal of your symptoms, noting their severity and frequency, as well as the time of day they happen. You can use the SOWS tool to help you measure consistently. This can help in:

• Recognizing patterns or triggers
• Communicating effectively with healthcare providers
• Adjusting your care plan as needed

Step 9: Seek Medical Attention if Necessary

If you experience severe symptoms such as extreme dehydration, persistent vomiting or diarrhea, high fever, unusual or abnormal heartbeats, or unmanageable pain, seek medical attention immediately.

Step 10: Consider Support for Long-Term Recovery

Once acute withdrawal is managed, consider long-term support options like counseling or therapy as well as local community and online support groups to address the underlying causes of opioid dependence. 9 out of 10 participants who completed detox using Sparrow Ascent accepted a referral to continue substance use disorder treatment, which dramatically increases the likelihood that a person does not relapse back to using opioids. You made it this far, so keep moving forward! There’s a great deal of support and resources available to help maintain long-term recovery from opioids and other substances.

This guide offers a framework for managing opioid withdrawal at home. Always remember, every step taken towards recovery is a victory, and help is available every step of the way. You CAN get off of opioids, but don’t have to do it alone. A better life awaits.

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