Pain medications are frequently used to help patients cope after injury or surgery. Unfortunately, these medications can be extremely difficult to stop after extended use, sometimes because the patient fears the return of pain, sometimes because the brain and body have learned to function in the presence of that medication, and sometimes because the patient has learned they enjoy the sedating or intoxicating effects of painkillers.
Worse, when medication is abruptly halted, a number of medical issues and even mental health complications can arise due to withdrawal.
Symptoms can range from dizziness and mild irritation to more dangerous symptoms that can lead to a medical emergency.
The symptoms of withdrawal can also make relapse much more likely, re-starting the cycle of pain medication addiction. That’s why understanding, anticipating, moderating, and preventing severe withdrawal symptoms are so important for reaching recovery. To do so, it is crucial to seek the assistance of medical professionals, skilled therapists, and other rehabilitation professionals who can employ the proper tapering techniques to avoid excruciating discomfort. With tapering, you can find recovery safely while avoiding the long-term effects of pain medications.
To help you achieve this goal, Alternative to Meds Center utilizes research-backed, holistic tools, methodologies, and resources designed to restore necessary nutrients and healthy neurochemistry. With the right therapies, mental health care, and coping tools in place, you can find lasting recovery from pain medication dependence.
What Is Opioid or Pain Medication Withdrawal, and How Does It Work?
Withdrawal associated with pain medication typically occurs after an individual has been taking pain medications for a long period. Over an extended period of use, the body and brain become accustomed to functioning in the presence of the medication. The brain also begins to rely on the compounds in the medication to modulate neurotransmitters like dopamine, commonly known as the “happy neurotransmitter.”
Unfortunately, the natural production of dopamine and other essential neurotransmitters diminishes in the presence of long-term opioid use. Worse, as the brain and body develop a reliance on the medication, it often takes higher and higher doses to have the proper therapeutic effects. If you’ve begun using pain medication for the euphoric or sedating effects it can provide, you’ll also need more and more of the medication to achieve the same pain relief.
Once the pain medication is removed, the brain struggles to adapt without the presence of its effects. Symptoms you experienced previously may return since the brain relied on the substance to address them. In addition, mental health effects can occur, as neurotransmitters like serotonin and dopamine may be in low supply. A variety of cognitive and physical effects can also result from the body’s attempts to adapt and restore function in the absence of pain medication.
While prolonged medication use or addiction is often synonymous with withdrawal symptoms, a person who took pain medication for only a short time can still experience withdrawal symptoms. This is especially true with brief high dosages after a major surgery or injury. In either case, withdrawal symptoms are usually at their worst when people abruptly discontinue use without proper tapering methods.1
Most Common Pain Medication Withdrawal Symptoms
There are a wide array of symptoms when it comes to pain medication withdrawal, and these are often the opposite of the effects the medication was designed to create. In general, less severe symptoms are more common in people who used a low dose for a shorter period, while more severe symptoms may be common for those who experienced heavy use over an extended period.
Common mild withdrawal symptoms include cold-like symptoms, such as a runny nose, fatigue, and watery eyes. Mild withdrawal will often affect your mental health in some capacity as well, with symptoms including increased irritability, mood swings, general anxiety, and restlessness. Sleeplessness or insomnia are also common symptoms of pain medication withdrawal.
Many people experience an increased sense of pain, which typically indicates the return of pain that the medication was able to numb. Many individuals also report feverish chills, sweating, and goosebumps as well. Flu-like muscle cramps and joint pain are examples of other symptoms that can occur. .
In addition, both withdrawal and the prolonged effects of opioid medications can cause issues within the gastrointestinal system, including stomach cramps, nausea, vomiting, and diarrhea.
Severe Pain Medication Withdrawal Symptoms
Withdrawal symptoms can be more severe if you abruptly cease pain medication use, after extended pain medication use, or if you have misused or heavily used the medication. It’s important to work with the proper medical team when discontinuing medication use to avoid these intense withdrawal symptoms.
One of the first severe signs of pain medication withdrawal is tremors or muscle twitching, which can not only be uncomfortable but can also suggest the possibility of seizure. Similarly dangerous symptoms include changes in heart rate and other cardiological functions. Be on the lookout for any major blood pressure changes and an elevated or slowed heart rate that will not rectify itself.
Withdrawal can also have severe mental health consequences, including anxiety, depression, thoughts of suicide, and other negative, intrusive thoughts. If you begin having these thoughts, consult a mental health professional or mental health hotline immediately. On rare occasions, withdrawal from specific opioids can also cause hallucinations or psychosis.2
Other Pain Medication Withdrawal Complications
Pain medication withdrawal can present other complications, especially for people with specific health conditions. For example, those with a pre-existing heart condition have a higher risk of dangerous cardiac rhythms during withdrawals. Similarly, excessive nausea or stomach issues such as diarrhea and vomiting could cause dehydration which could cause hypernatremia, ischemia, and potential heart failure.3
As you taper away from pain medication, it is important to note that your tolerance for that medication will lessen, as well. This means if a relapse does occur, you are at an increased risk of accidental overdose. This is especially significant in the case of opioid medications.
How Many Days Does It Take to Get Pain Medication Out of Your System?
The amount of time a pain medication will stay in your system depends on many factors, including age, presence of liver or other dysfunction affecting metabolism, length of time that the drug was used, and on the specific medication involved and how it is designed to interact with your body’s opioid receptors. This time period is typically expressed in half-lives, or the time it takes for your body to eliminate half of the active drug in your system. Mathematically speaking, it takes up to five half-lives to fully eliminate a drug, but half-lives can differ depending on the drug.4
Some opioids are short-acting and provide quick, brief pain relief, which means they will not remain in your body for long. Longer-acting opioids are designed for sustained activity within the human body and will take significantly longer to fully leave the system. Common pain medications like hydrocodone and oxycodone can be detected in the blood anywhere from 12 to 24 hours later.
While the effects of pain medications may only last a few hours, and they are only detectable in blood or urine for a matter of days, withdrawal symptoms most often begin within about eight hours of your last dose. However, this is dependent on the medication, your duration of use, and your dose, and variations in the rate of metabolism . After withdrawal symptoms begin, they are likely to peak between 24 and 72 hours later. Most people will experience withdrawals lasting several days, which is why detox programs often last seven to ten days; however, some patients may continue to feel discomfort for weeks.
Long-Term Effects of Pain Medication Withdrawal
If properly managed with a tapering plan, there should be no permanent long-term effects of pain medication withdrawal. Typically, the most common effects of withdrawal include mild symptoms like occasional headaches, fatigue, and brief restlessness or anxiety. Most people find these symptoms are completely gone between six months and a year after ceasing use without relapse. Gastrointestinal symptoms typically take even less time to subside.
Tapering can ease the severity of withdrawal symptoms, but it may require long-term strategies where symptoms are present for a bit longer. Still, it’s important to remember that discontinuing a pain medication too quickly could lead to severe withdrawal or additional complications. Tapering and its mild effects are also preferable to prolonged opioid misuse, which can cause many lasting complications.
What Is The Best Way To Detox From Pain Medication?
The best way to detox from pain medications is by establishing a discontinuation program with a professional. Professional techniques like medication management can ensure you set up a safe and effective tapering plan that minimizes withdrawal symptoms and leads to the best possible outcome with less risk of relapse. Combining therapeutic techniques can help you manage the severity of any withdrawal symptoms.
If you have been taking pain medication for medical purposes, consult with your doctor to set up a schedule to safely reduce your dose with each use. Tapering will help the brain and body begin to re-establish their own capability to produce the right chemicals and function independently from the medication. If you have become dependent on the euphoric or sedating effects pain medications can provide, you may find it pragmatic to speak with a rehabilitation professional about beginning a detoxification and rehabilitation program.
15 Years Experience by Professionals Who Understand Your Journey.
While you are likely to experience at least mild withdrawal symptoms, there are a number of ways to help mitigate their severity and frequency, starting with a safe, medically-supervised tapering process. Your medical team should carefully monitor this and other withdrawal counter-measures and may offer other medications to relieve the worst of the withdrawal symptoms. Other holistic pain management measures may include the following.
It’s important to stay hydrated and even increase your water intake to counter issues like nausea, headache, and other mild withdrawal symptoms. Becoming dehydrated can worsen the symptoms of withdrawal and cause discomfort on its own. Proper hydration is key in battling discomfort during the recovery process.
Similarly, it’s important for people in recovery to eat consistently and incorporate healthy meals with plenty of nutrients. Maintaining a healthy caloric intake, and giving your body the vitamins, minerals, and nutrients it needs by consuming lean proteins, whole grains, healthy fats, vegetables, and fruits, can help combat withdrawal symptoms. You’ll be providing the nutrients necessary to restore your body’s ability to heal itself.
Exercise the Body and Mind
To cope with the anxiety and other mental health issues caused by withdrawal, it may help to utilize deep-breathing tactics. You may also want to engage in stretching and gentle exercise like yoga to alleviate restlessness. Moderate exercise like walking or therapeutic activities like swimming and more can also be a key tool to help with physical and mental discomfort.
Therapeutic activities like equine therapy, meditation, and more can help to address discomfort, restlessness, and other mental health symptoms. Books, television, and music can also provide a much-needed distraction from both physical and mental health withdrawal symptoms.
It’s equally important to maintain your own positive state of mind via constructive self-talk and examining the roots of your pain medication use, particularly if you began misusing prescription medications. Individual and group therapy, particularly as a component of a rehabilitation program, can coach you on the mental tools you’ll need to handle the emotions and other effects of withdrawals with a positive outlook. Therapy can also provide you with a support structure you can rely upon throughout your recovery, including both professional and peer contacts. Noone successfully climbs a mountain by themseves.
Pain Medication Withdrawal FAQs
Withdrawal resulting from pain medications is as unique as you are. However, learning more about some common withdrawal questions can help you anticipate what to expect as you stop using pain medications.
Q: Which Drug Is Responsible for the Most Severe Withdrawal Symptoms?
A: Benzodiazepines are commonly used for chronic pain, but are recognized as causing the most severe withdrawal symptoms, which can include slowed breathing, seizures, and even death. Alcohol, cocaine, and methamphetamines similarly cause severe withdrawals if chronic use is ceased suddenly. Opioid pain medications like oxycodone can also cause severe withdrawals, and and fentanyl is the most deadly opioidto stop without medical intervention.
Q: What Is the Best Way to Recover from Pain Medication Addiction?
A: The best pain medication addiction recovery plans involve several components, including medical intervention for easing withdrawals and tapering pain meds, as well as therapeutic professionals for coping with the resulting effects.
With a team of experts who understand the science behind addiction, and adequate emotional support needed during and after treatment, you’ll be tackling your pain medication addiction with the best tools available. Holistic techniques like meditation and mindfulness, equine therapy, art therapy, and more can ensure you develop a variety of tools to use to prevent relapse in the life you’ll build in recovery.
Q: What Are the Risks of Not Treating Pain Medication Withdrawal Symptoms?
A: In extreme circumstances, the failure to treat severe withdrawal symptoms can lead to death or injury to vital components of the body, including the heart. There are also short-term risks for not treating moderate withdrawal symptoms, including discomfort and an increased risk of relapse.
Do You Fear Withdrawal? Alternative to Meds Center Can Help
Although withdrawal symptoms can be intimidating, they can be reduced or even eliminated with proper tapering and medically-assisted detoxification from opiates/opioids. Certainly, the mild symptoms associated with a proper taper are preferable to the lifelong damage that can occur with extensive pain medication use or abrupt medication discontinuation.
At Alternative to Meds Center, we firmly believe in an individualized medication withdrawal program that features a holistic approach coupled with specialized therapies designed to support continued recovery. We provide medical oversight, guidance, detailed information, physical therapies, and emotional support throughout the duration of your treatment.
*Editor’s Note: This article was originally published and has been revised February 20, 2023.
2. Bluthenthal, R. N., Simpson, K., Ceasar, R. C., Zhao, J., Wenger, L., & Kral, A. H. (2020). Opioid withdrawal symptoms, frequency, and pain characteristics as correlates of health risk among people who inject drugs. Drug and alcohol dependence, 211, 107932. https://doi.org/10.1016/j.drugalcdep.2020.107932
3. Biswas, A. K., Feldman, B. L., Davis, D. H., & Zintz, E. A. (2005). Myocardial ischemia as a result of severe benzodiazepine and opioid withdrawal. Clinical toxicology, 43(3), 207-209. https://doi.org/10.1081/CLT-53099
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.