Can Opioid Withdrawal Cause Death?

It is a misconception that only opioid overdose and not withdrawal can lead to serious complications. However, opioid withdrawal can also be life-threatening, resulting from opioid dependence. Opioid withdrawal causes persistent vomiting and diarrhea, leading to severe imbalances of essential nutrients (sodium, potassium, and chloride). These imbalances can cause heart failure and coma. Keeping in mind these life-threatening complications of opioid withdrawal, it is essential to take preventive steps to avoid such a situation. 

Confidant Health offers a safe exit from opioid dependence, providing medical management and guidance by certified healthcare professionals. Medication Assisted Treatment (MAT) provides not only FDA- approved medications but also counseling and behavioral therapies to help you cope with opioid withdrawal symptoms.

Common Opioid Withdrawal Symptoms

Opioid withdrawal usually presents with the following symptoms:

Overactive central nervous system

A hyperactive brain may cause hallucinations in which you may feel something moving on your skin (Body sensations) and hear the sounds or see objects that are not present in reality (Psychotic symptoms). Some people can also have seizures characterized by jerking movements of arms and legs and body stiffness. 

Uncontrolled anxiety

Cravings for the opioids during withdrawal can cause anxiety that results in increased respiratory rate, lacrimation, stomach cramp, increased heart rate (tachycardia), fever, and nausea. Hand and body tremors may also be present in some cases. This uncontrolled anxiety occurs due to a lack of opioids in the body and the body’s cravings for opioids. 

Rhinorrhea

Opioid withdrawal also presents with symptoms of a runny nose and watery discharge from the nose. Moreover, you may also have a metallic taste in your mouth, anosmia (reduced sense of smell), nasal congestion, or headache.

Mydriasis

Eye pupils usually get bigger or smaller in response to the light changes. However, opioid withdrawal can damage the normal functioning of these mechanisms and result in blurry vision due to over-dilation of the pupil. These symptoms of opioid withdrawal may remain from a few hours to days.

Persistent Vomiting and Diarrhea

As mentioned above, opioid withdrawal also leads to persistent vomiting and diarrhea. Although these symptoms initially seem mild and not life-threatening, vomiting and diarrhea can result in severe electrolyte imbalances. These imbalances include hyponatremia (reduced sodium levels), hypokalemia (decreased potassium levels), hyperchloremia (increased chloride levels), and metabolic disorders.

If only sodium levels are disturbed due to opioid withdrawal, you may have confusion, heart problems, and a life-threatening coma. Thus, these electrolyte imbalances need to be managed quickly, and opioid withdrawal should be managed under professional guidance like the Confidant Health platform.

What Happens During Opioid Withdrawal?

When you take opioids for extended periods, the body gets used to its intake. However, sudden cessation of opioids causes drastic effects as changes in the brain or respiratory functions.

Our body has specific receptors that respond when particular types of chemicals attach to them. What happens in opioid use is the continuous stimulation of these receptors. However, when you try to cut down, these receptors respond in adverse ways, causing many symptoms, as mentioned above. Sometimes, the response of receptors is so intense that you may end up having seizures and hallucinations.

Symptoms of withdrawal depend on the drugs and the amount you used to take. For example, short-acting opioids or heroin symptoms can be seen within 8-12 hours of withdrawal.

Can you die from opioid withdrawal?

The straightforward answer to this question is, “Yes'', you can die from opioid withdrawal. The most common cascade behind death in opioid withdrawal is persistent vomiting and diarrhea. 

Prolonged vomiting and diarrhea cause loss of body fluids, minerals, and electrolytes, resulting in severe dehydration and metabolic disorders. Metabolic disorders can be characterized by sweating, palpitations, shortness of breath, respiratory depression, and coma. Similarly, dehydration can lead to lethargy, fatigue, loss of respiratory effort, and confusion. 

If left untreated, these symptoms can lead to life-threatening coma and death. However, the earlier treatment provided in Medication Assisted Treatment (MAT) can prevent you from severe symptoms.

Other Frequently Asked Questions

How quickly do withdrawal symptoms start?

The symptoms that appear depend on the type of opioid you were taking, as short-acting opioids with immediate release formulations, such as heroin, fentanyl, hydrocodone, and oxycodone, show symptoms within 6-24 hours of withdrawal. And symptoms can continue for ten days at least.

Long-acting opioids whose formulation and release are extended or controlled, such as morphine and methadone, may show withdrawal symptoms after 36 hours of stopping the use for 24 days or more. This is because most opioids have a short half-life (i.e., the time they remain in the body before elimination) of a few hours compared to the others.

What does it feel like when you go through withdrawal?

You feel helpless and lethargic as your body undergoes opioid withdrawal, and certain psychological and physical changes also occur in your body. Opioid withdrawal makes you feel ill, anxious, and tired and only think about opioids. You may also have a very intense and painful feeling as if something special has been snatched from you. However, these feelings are unfortunately not under your control.

How long do these withdrawal symptoms last? 

Symptoms appear or remain of opioid withdrawal depending on the type of drugs, but mostly the symptoms last for 3-7 days or can be prolonged for days to weeks or months. Moreover, it also depends on the signs; for instance, vomiting and diarrhea last longer than the others.

Which are the worst days of opiate withdrawal? 

The worst days of the withdrawal are during the starting of withdrawal symptoms (usually 6-36 hours after the last dose) characterized by pain, emotional damage, palpitations, sleeplessness, runny nose, and psychological issues. During the initial phase of withdrawal symptoms, guidance from licensed healthcare professionals can be beneficial as they can prescribe certain medications and therapies to give you relief from these symptoms.

Which drug has the most withdrawal symptoms?

Although most opioids can cause severe withdrawal symptoms, heroin and morphine are considered the most dangerous in terms of withdrawal symptoms. This is because heroin rapidly converts into its more active forms (i.e., morphine-6-glucuronide and morphine), which can cause withdrawal symptoms from 6 hours to 10 days. 

When should you stop taking opioids?

Opioid withdrawal symptoms indicate that reducing the amount of opioid intake is better as soon as possible. Within two weeks of opioid usage, try to cut it off to avoid the severe consequences of its long-term use. However, you might need a medication withdrawal plan to prevent opioid withdrawal symptoms while cutting them down. 

How fast can you taper opioids?

As mentioned above, sudden cutting down of opioids can result in life-threatening adverse effects on the body. You need to taper opioids slowly, depending on the types of drugs and the number of doses you are taking, but proper medication to replace the opioid is the only safe way to taper opioids. The way to taper opioids is to reduce them by 5-20% every four weeks. Safe tapering is 10% every week or month.

In fast tapering: 20-50% of a dose is reduced after a few days, which causes some withdrawal symptoms that remain for a short-time period.

In slow tapering: After every 1- 3 weeks, you need to reduce the dose by 10-20% to avoid withdrawal symptoms.

What are moderate opioid withdrawal symptoms?

While tapering off the opioids, you might still experience abdominal cramps, unusual skin sensations, mild diarrhea and vomiting, and a fast heart rate. However, MAT therapy can help you reduce these moderate withdrawal symptoms to minimal levels. 

How to feel better when withdrawing from opioids?

There are certain self-help steps that you can take to feel good while cutting down the opioid use, such as,

• Try to increase the intake of water or liquids more than usual. 
• Do walk or exercise daily as stretching or deep breathing.
• Engage yourself in activities that make you happy such as playing cards, going out for dinner with family, or watching sports.
• Eat nutritious meals regularly and keep your diet well-balanced.
• Do not cut off opioids suddenly from your routine. Instead, try to remove them slowly.

Moreover, get help from a healthcare professional who can navigate you through the withdrawal phase. 

Does alcohol help with opiate withdrawal?

No, alcohol is unsafe to take with opiates or to avoid opiate withdrawal symptoms. It can aggravate many symptoms of opioid withdrawal, including dehydration, nausea, vomiting, and poor or weak immunity. Opiate and alcohol consumption can lead you towards coma and death more rapidly if taken together and in excess amounts.

How to stop cold sweats during opiate withdrawals?

The best way to stop sweating is to use prescribed antiperspirants or creams. In addition, meditation techniques, hydration with warm fluids, and MAT can also help deal with the sweats.

Opioid withdrawal with Confidant Health

Confidant Health provides professional guidance under its Medication Assisted Therapy to cope with the issues related to opioid withdrawal. In this therapy, licensed professionals will provide counseling and medications to overcome opioid withdrawal symptoms so you can come out of opioid addiction. You can download Confidant Health’s app to start your recovery path.