How to Detox, Taper, or Wean Off Opioids Safely Without Withdrawal
During the late 1990s, opioid pain relievers were believed to be minimally addictive, which caused healthcare professionals to prescribe them to patients more frequently. In truth, both prescription and illicit opioids carry a very high risk of addiction. This led to many individuals developing opioid use disorders, causing what is referred to today as the U.S. Opioid Epidemic.1
Statistics published by the U.S. Department of Health and Human Services indicate that 10.1 million Americans abused prescription opioids during the previous year. 1.6 million of these individuals are believed to have developed a serious substance use disorder (SUD). Furthermore, 2 million individuals used or were still using methamphetamine, while another 745,000 used or were still using the illegal drug heroin. During the 12-month period leading up to June 2020, 14,480 individuals fatally overdosed from heroin, while another 48,006 deaths were caused by synthetic opioid overdoses.1
Individuals who have used prescription or non-prescription opioids for more than two or three weeks are in danger of developing an opioid addiction and should probably stop or reduce their usage as soon as possible. Understanding how to detox and taper off opioids gradually and safely is essential in order to avoid the more severe symptoms of opioid addiction and withdrawal.2
What Are Opioids?
Opioids are a class of drug that affects the user’s opioid receptors in the brain, spinal cord, and the gastrointestinal tract in a way that alleviates pain while also inducing feelings of pleasure and relaxation. They include the illicit drug heroin, the synthetic drug fentanyl, and prescription pain relievers like codeine, morphine, oxycodone (OxyContin), hydrocodone (Vicodin), and various other drugs.3
Opioids are considered to be highly addictive and likely to cause the user to develop an SUD even if they do not otherwise have a propensity toward addiction. This is especially the case with illegal opioids such as heroin, as these are often used recreationally and for prolonged periods of time. Even when used as prescribed by a healthcare practitioner, these drugs carry a risk of addiction and may require the patient to slowly wean off opioids to avoid experiencing unpleasant withdrawal symptoms.3
What Are the Risks of Stopping Opioid Use Cold Turkey?
Individuals who suddenly stop using opioids (eg., who go “cold turkey”) often experience a range of withdrawal symptoms. These can include mental and emotional discomfort, reduced resistance to pain, suicidal thoughts and actions, and other persistent and even life-threatening symptoms that can drive an individual to start using opioids again. This can occur even if opioids have only been used for 2-10 days.4,5
Due to the above risks, individuals who have used opioids for more than a couple weeks should learn how to properly detox and wean off opioids and refrain from attempting to abruptly stop using on their own. Instead, their healthcare professional should prepare a tailored medication withdrawal plan (also known as a “taper”) that gradually limits the amount and frequency of opioid use. The duration of the taper is usually determined based on how long and in which dosages an individual has been using the drug.2,5
What Happens to an Individual’s Body When They Stop Using Opioids?
A certain amount of opioids is automatically produced by the human brain. This aids in pain relief, helps regulate respiratory rates, and serves to alleviate depression and anxiety. However, both legal and illegal opioids contain a much higher amount of opioids than what the body can naturally produce. As a result, these drugs can have a significant effect on the limbic system, affect breathing and heart rate, and produce feelings of euphoria. Individuals who use opioids regularly are at an increased risk of developing an opioid use disorder.6
When an individual who has continuously used opioids for longer than a couple weeks stops doing so abruptly, or greatly reduces the amounts they use, their body is likely to go through two phases of withdrawal. The first stage typically occurs during the first 24 hours after the individual has begun to detox from opioids. These symptoms include:7
- Muscle pain
- Runny nose
- Reduced sleeping quality
- Excessive sweating
Individuals who suffer from a more severe case of opioid use disorder may require specialized withdrawal management medication while detoxing from opioids in order to control or avoid the more serious and dangerous second stage of opioid withdrawal. Individuals who experience any of the following severe symptoms should immediately contact their healthcare practitioner:7
- Nausea and vomiting
- Increased blood pressure
- Unusually fast heart rate
- Cramps in the abdomen
- Severe anxiety
- Shallow, rapid breathing
What Does it Mean to “Wean Off Opioids”?
Due to the highly addictive nature of both prescription and non-prescription opioids, individuals who have been continuously using these drugs for prolonged periods of time may find it difficult and even dangerous to stop using them all at once. Instead, the recommended course of action is to gradually reduce the dosage over the period of multiple weeks or even months, as this aids in controlling withdrawal symptoms and preventing potentially life-threatening complications. Individuals who are going through this process are said to be tapering or weaning off opioids.8
An opioid detox, wean, or taper can be carried out in a variety of different settings. Individuals who have only been using opioids for a few weeks are typically able to complete their taper in an outpatient setting. However, individuals who struggle with more severe opioid use disorder may require a more intensive 3-10 day detox program, as well as extended treatment at an inpatient facility in order to increase the likelihood of long-term success.8
How to Safely Taper Off Opioids?
As with other types of substance use disorder (SUD) treatment, the safest and most effective way to wean off opioids is with the assistance and supervision of a trained healthcare provider. An opioid taper usually begins with a slew of lab tests and an extensive physical assessment. During this time, the patient will also be screened for any co-occurring mental health disorders that may have caused, or been caused or exacerbated by, their opioid use disorder.5
The patient will then be given a personalized plan that gradually reduces their opioid usage over the next couple of weeks or months. In the majority of cases, patients will be prescribed an opioid treatment medication that is designed to lessen the severity of withdrawal symptoms and keep the individual stable while they detox from opioids. Patients who have a milder case of opioid use disorder will likely be able to live at home while going through their taper. However, patients who suffer from severe SUD may be required to stay at the rehab center for the duration of their treatment.5
How Long Does It Take To Wean Off Opioids?
Since no two SUDs are quite the same, the specifics of every opioid use disorder treatment have to be determined based on the patient’s specific needs and situation. Key factors that affect the duration of treatment include which opioid type and dosage the individual is taking, whether they are combining opioids with other drugs, and their overall physical and mental wellbeing.9
Research has shown that rehab programs that last 60-90 days (or longer) and include a comprehensive aftercare plan are significantly more likely to ensure lasting sobriety and prevent relapse than 28-30 day (or shorter) addiction treatment programs. This is because longer, more intensive treatments provide individuals with more time to understand their addiction and work through the underlying problems that may have caused them to develop an SUD in the first place.9,10,11
Can I Detox From Opioids at Home?
It depends on each patient’s unique circumstances and requirements. Treatment-seeking individuals who are diagnosed with mild opioid use disorder, do not have a history of relapse, do not suffer from co-occurring mental health problems, and have a supportive social circle and home environment, may be able to stay at their homes and keep going to work or school while detoxing from opioids.9
However, individuals who have used opioids for a prolonged period of time and/or have relapsed in the past, or who suffer from mental and physical issues that can be exacerbated by opioid withdrawal, should remain at a specialized opioid rehab center near them for the duration of their treatment. To maximize the chance of achieving long-term sobriety, their opioid detox and rehab treatment of choice should also include a customized aftercare plan.9,11
Best Way to Detox from Opioid Addiction
Research shows that the safest and most effective way to wean a patient off opioids is to create a tailored tapering plan that addresses their particular requirements and situation. Optimally, this plan should be created by a qualified healthcare provider who is familiar with the patient’s medical history and is trained in the treatment of opioid use disorder.9
If you or a loved one are misusing opioids or battling any other type of substance use disorder, it is strongly advised that you consult with your medical doctor, or reach out to a 24/7/365 opioid abuse hotline and speak to an experienced and compassionate admissions navigator in total privacy. The navigator will be able to answer any questions you may have, recommend the most suitable drug and/or alcohol addiction treatment centers, verify your or your loved one’s healthcare coverage for addiction treatment, and discuss the available payment options for substance abuse rehab. If the treatment-seeking individual suffers from severe SUD and/or is in immediate danger of an overdose, the navigator will also be able to arrange for same-day admittance into a nearby rehab center.
How to Help Someone Else Get Off Opioids?
Many individuals who struggle with opioid use disorder are unaware that they have a problem and/or unwilling to admit the reality of their situation to themselves and others. If you suspect a loved one may be misusing opioids, it is recommended that you speak to them about their issue, help them understand that addiction is a disease, and convince them to seek evidence-based treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends the following approach to people who are looking to confront their loved ones about their opioid use:12
- The conversation should be held in a peaceful and private setting.
- You should discuss your concerns gently, yet candidly. Avoid acting in a judgmental or harsh manner toward the struggling individual.
- The struggling individual should be offered emotional support and invited to speak about their feelings.
- Help your loved one understand that opioid addiction is a disease, and that it can be treated.
- Do not be in a rush or try to compel your loved one to enter into treatment. It frequently takes time for a person to accept that they suffer from an SUD. Continue reaching out to them with offers to listen and help.
It is important to note that many people who abuse opioids are reluctant to seek professional help because they believe they are unable to cover the costs of treatment. In truth, there are many different ways to pay for drug and/or alcohol rehab, and all healthcare plans in the US are required by law to offer some level of addiction treatment coverage. In addition to various rehab centers that offer affordable treatment, there are also many state-funded opioid rehab facilities that provide free treatment to eligible individuals. Your financial situation should never stop you from providing yourself or your loved one with the help you need.13
Should Medication Be Used to Wean Off Opioids?
Many tapering plans use opioid treatment medications like buprenorphine, naltrexone, and methadone to reduce or eliminate withdrawal symptoms, stabilize brain chemistry, and reduce the likelihood of relapse. These medication-assisted detox plans are typically combined with behavioral therapy to maximize the chance of long-term recovery.2
Instead of attempting to get off opioids on their own, treatment-seeking individuals should consult with their physician and/or the admissions team at their rehab facility of choice. These healthcare professionals will perform a thorough assessment and create an individualized tapering plan. Depending on the patient’s unique needs and the specifics of their opioid use disorder, their tapering plan may or may not include opioid treatment medications.2
How to Stay Off Opioids After You Have Successfully Stopped?
It can take a long time for an individual to completely wean off opioids. Comprehensive aftercare plans that may include individual therapy, group meetings, stress-relieving activities, and even long-term stays at halfway houses may be required in order to help patients remain sober and avoid a relapse. In most cases, the duration and specifics of this aftercare plan will be determined by your medical doctor, or by the team at the rehab facility where the individual has completed their initial treatment.11,14