Opioid Withdrawal: Know Your Options
Emily Pevtsov is a psychiatrist physician assistant practicing at Blooming Medical Group, PLLC, a 100% telehealth psychiatric practice. Blooming Medical Group serves residents of NC and KY, ages 18+. Appointments can be made via our website at Bloomingmedicalgroup.com.
So, you're sick. You ran out of your last Percocet and your doctor won't fill it because she suspects you've been abusing it. You're starting to feel sick to your stomach, have diarrhea, anxious, can't sleep, achy all over. What are your options?
Option 1) Quit cold turkey. Not recommended, particularly if you have serious medical problems including heart issues or uncontrolled hypertension. Additionally, severe opioid withdrawal can cause nausea and diarrhea, putting you at risk for dehydration and consequent electrolyte abnormalities. Yes, opioid withdrawal is not as dangerous as alcohol withdrawal, but it still has its risks.
Option 2) Gradually tapering yourself off of opiates. Can get very tricky, unless you have a legitimate prescription for an opiate medication and your provider gives you a detailed taper schedule. If you plan on tapering yourself off heroin or drugs you're getting on the street, understand the risks of OD. You do not know what you're getting, and heroin laced with Fentanyl (one of the main reasons people OD) is a major risk. Additionally, if you take benzodiazepines (e.g., Xanax), antihistamines (e.g., Benadryl), or alcohol, these risks go way up.
Option 3) Go to the hospital for inpatient detox. This is the safest option, where you'll be monitored by medical providers 24 hours a day, and they will provide a medication like Subutex to manage any withdrawal symptoms, so your discomfort is minimal. They will monitor things like blood pressure and heart rate to make sure you're medically stable. This is also a good opportunity for them to test you for HIV and Hepatitis C, two illnesses you're at an increased risk for if you are an IV drug user. They will only discharge you once your withdrawal symptoms have been gone for 24 hours.
Option 4) Get outpatient treatment, either in person or via telehealth platform (Our practice BloomingMedicalGroup.com offers this). As with Option 3, you'll be monitored by a medical professional while you go through what's called induction. You will be given buprenorphine or methadone to manage your withdrawal symptoms and will be given home instructions for the subsequent days on how much to take and how frequently. You will have the option to taper off the medication completely (which most individuals can do within a week) or to continue on it for what's called maintenance treatment.
Good luck and be safe.
