Opiates are drugs that treat pain. Legal use of prescription opiates provides tremendous pain relief to people suffering from severe physical pain, such as from a serious accident or the progression of a disease. In certain cases, strong doses are required to cope with conditions that would otherwise cause unbearable suffering.

Opiates relieve pain by altering the chemical functioning of the brain. In the case of prescription opiates, pain is relieved through the medication’s mechanism that blocks the transference of pain messages between the spinal cord and the brain. Opiates bind to the receptors in the nerve cells that modulate the sensation of pain. The opiates inhibit the activity of these nerves, which results in pain relief.

In addition to stopping pain, opiates induce feelings of euphoria. This is because opiates interact with receptors in the brain that release feelings of pain and pleasure. At the same time that the opiates are blocking the sensation of pain, they are also attaching to the receptors of nerve cells that induce pleasure and activating them. Because of this dual pain-blocking and euphoria-inducing action, opiates are used as both medicinal painkillers and recreational drugs.

Common opiate painkillers include Codeine, Hydrocodone (Vicodin), Hydromorphone (Dilaudid), Meperidine (Demerol), Morphine, and Oxycodone (Percocet or Oxycontin). Common opiate recreational drugs include heroin and opium. Prescription painkillers are also often used for recreational purposes.

What makes opiates so addictive?

Opiates are powerful and cause both physical dependency and addiction. Physical dependency means that the body experiences painful withdrawal symptoms when the opiate is stopped. Addiction means that the user continues using the drug despite terrible consequences to themselves and others.

Examples of addictive behavior includes spending money needed for necessities like food, housing, and transportation on opiates. People suffering from addictive behavior may also skip school, work, and family activities. This behavior may cause them to fail in school, lose a job, and become isolated from friends and family. Opiate users who are desperate for more of the drug but cannot afford it often resort to crime. Addictive behavior also takes the form of continuing opiate use despite clear signs that the user’s health is being compromised. They may even return to using opiates despite a nearly lethal overdose.

In many cases, these dangerous and life-altering addictive behaviors result from a physical dependence on opiates. Opiates adjust the chemical composition in the brain. Over time, the brain becomes accustomed to this altered state and changes its functioning in response to the drug’s presence. When the drug wears out of the brain, the body experiences withdrawal symptoms because it has become accustomed to the opiate.

The period that withdrawal symptoms persist is known as the withdrawal period. During this time, the brain is readjusting itself back to its makeup prior to the opiate’s presence. The withdrawal period is necessary to recover from opiate dependency and addiction. The symptoms are challenging but can be managed through rehabilitation therapy, which includes supervised withdrawal that provides treatment to relieve the withdrawal symptoms.

There are three opiate withdrawal stages. The first acute stage begins about 12 hours after opiate cessation and peaks around 72 hours after cessation, lasting for about one week. Symptoms are most troublesome during this period. The second rebalancing stage is where the brain’s chemicals adjust. This stage causes a variety of troublesome but less intense symptoms. During the final stage, symptoms are much less intense but cravings and the temptation to take opiates persists.

The details of the three opiate withdrawal stages are as follows:

Stage 1 (Acute Symptoms) – Acute withdrawal symptoms include nausea, vomiting, diarrhea, muscle aches, and muscle cramps. As these symptoms progress, many people also experience mood swings, depression, and insomnia. Many people describe this stage as being flu-like.

For heavy opiate users, the acute phase can become so severe that hospitalization is required. The person experiencing these symptoms may have no choice but to continue taking opiates to stave off withdrawal unless they are treated in a supervised detox facility. This is because the symptoms can become much more powerful than the symptoms experienced with illnesses like the flu. Supervised detox is recommended during the acute phase so that the patient’s pain can be relieved with non-opiate medications and treatments.

Stage 2 (Rebalancing) – Though much less dangerous and difficult than the acute phase, without proper treatment, the rebalancing phase is still challenging and painful. During this time, afflicted individuals experience irregular body temperatures, dilated pupils, and leg cramps. As a result, they may feel chills and develop goosebumps. Though these symptoms may be uncomfortable, the body is healing by rebalancing endorphin levels to the natural state.

Stage 3 – This stage can last for a week to several months, depending on the individual’s history of opiate use, age, health status, and physical makeup. During this phase, people in recovery experience heightened anxiety, nervousness, excess energy, and insomnia. At this stage, the body is becoming free of opiate dependence and patients feel much better overall.

Though feeling better, individuals in the third stage of opiate withdrawal are still at risk for relapse. They may experience cravings and feel tempted to use opiates again during stressful situations or if they began to experience pain. It is crucial that the recovering person receive ongoing treatment and support during this time and care for any emotional, psychological, or physical difficulties that could trigger a relapse.

Withdrawal symptoms can result from heavy use of opiates over just a few weeks. If experiencing opiate withdrawal, it is important to reach out for support. Treatment with medications and counseling can manage the opiate withdrawal process. For individuals experiencing pain from a medical condition, alternative therapies and medications can be provided while opiate withdrawal is taking place.

People experiencing opiate withdrawal have the lowest relapse rates when they receive treatment in a supervised detox facility, or, in severe cases, a hospital setting. This approach allows for effective symptom management. Once detox is complete, rehabilitation counseling makes a huge difference in helping someone once addicted to opiates live a life free of these powerful and highly addictive substances.