Opiate detox
and withdrawal treatment

Opiate and opioids detox

As I've written before opiates and opioids are very addictive and dangerous substances and intoxication due to overdose may be life-threading (respiratory depression is unfortunately possible). Situation is the more thrilling that opiate and opioids addiction touches especially young people. Intoxication requires immediate treatment.

Medicament used in such a cases is called naloxone hydrochloride (dose: 0.4-0.8 mg) which is a opiate antagonist. Respiratory problems and central nervous system depression reverses very quickly, usually after 2 minutes. If not, after a while (2-3 minutes) – second and further third, fourth and so on – doses are ingested until expected positive effect will be achieved.

Great risk of overdose after opiate detox

Opiates and opioids generate very deep tolerance. During detox this tolerance is very reduced or even eliminated to zero. Patient with reduced / eliminated tolerance are in risky situation because going back to addiction is life-threading. Opiate dose, which was usually taken when organisms biochemistry was far from equilibrium and involved in tolerance mechanism, after detox can be dramatic for its functions and lethal! That's because opiate dose which was used to be recognized as typical, now, in this new after-detox situation, may be easily an overdose. It's greatly important to explain all of the people who have taken detox, that after it next use of opioid is exceptionally hazardous. In this case it's very important to engage patients not only to undergo detox but also withdrawal treatment. Additionally psychological therapy may be needed and for example participancy in residential treatment of Therapeutic Community (outpatient treatment programs supplemented by self-help groups).

Opiate Withdrawal Treatment

During opiate withdrawal treatment methadone is used very often. This medicament is generally illegal, but possessing for medical use is legal in hospitals. Methadone cannot be used out of hospital to treat outpatients if there's no license for treatment program. Initial doses are 15-20 mg taken orally or by injection. Usually 40 mg of medicament per day is a dose large enough to control withdrawal. Its acting is long in time.

Second medicament which can be used is buprenorphine and its use is not restricted by law like in methadone case (all physicians have to do is to take training). Buprenorphine is a component of drugs called Subutex and Suboxone and is introduced under the tongue. Difference between Subutex and Suboxone is that Suboxone consists naloxone additionally. Buprenorphine is an drug that acts in long-term but its initial dose have to be used carefully. There's some period of time needed to be passed between last dose of opiate and initial dose of buprenorphine to make medicine's action harmless. Treatment lasts two weeks.

There are also some non-narcotic medicaments to treat opiate withdrawal symptoms, for example clonidine, clonazepam, ibuprofen, Toradol.