Opioid Withdrawal

Increased used of prescription opioid medications has led to widespread misuse of both prescription and non-prescription opioids. An estimated 11.4 million people in the U.S. misused prescription opioids in 2016, according to the National Survey on Drug Use and Health. In that same year, an estimated 2.1 million people had an opioid use disorder. 

Opioid addiction is considered a chronic medical condition. With repeated use or abuse, opioids create changes in the brain that foster addiction. Opioid withdrawal is a long and often strenuous process as patients face a wide range of physical effects that can lead to relapse.

Opioid withdrawal can take hours to weeks and in rare cases, months. It involves going through detoxification, during which drugs are eliminated from the system, and follow up care to prevent drug use. During withdrawal, patients may experience symptoms such as nausea, body aches, agitation, chills, diarrhea and craving for drugs.

Treatment for opioid use disorder varies depending on the level of addiction.

Mild opioid withdrawal

Patients should drink at least 2-3 liters of water per day during withdrawal to replace fluids lost through perspiration and diarrhea. They should be given vitamin B and vitamin C supplements.

Mild opioid withdrawal can sufficiently be managed with symptomatic treatment and supportive care.

Moderate to severe opioid withdrawal

Patients should follow the same guidelines as for mild opioid withdrawal but may additionally be treated with medications such as buprenorphine or methadone.

  • Buprenorphine is an opioid medication that can alleviate withdrawal symptoms and reduce cravings. Because of its pharmacological action as a partial opiate agonist, buprenorphine should only be given after a patient begins to experience withdrawal symptoms.
  • Methadone is a synthetic analgesic drug that can alleviate opioid withdrawal symptoms and reduce cravings. Methadone is useful for detoxification from longer acting opioids such as morphine or methadone itself.
  • Codeine phosphate alleviates opioid withdrawal symptoms and reduces cravings. Codeine has no effect for 2–10% of people.

Treatment with Vivitrol®(Naltrexone)

Vivitrol®is an opioid antagonist that can be administered after detox. It blocks opioid receptors in the brain and helps help prevent relapse while patients focus on counseling. It is an injectable treatment administered once monthly. Patients must stop using any type of opioid including opioid-dependence treatments such as buprenorphine and methadone, for at least 7 to 14 days before starting Vivitrol®. 

Treating Patients with Drug Relief®

Drug Relief® developed and manufactured by DyAnsys Inc., can be used during detox (and before treatment with Vivitrol®) to relieve the symptoms of withdrawal. 

Drug Relief® has been cleared by the FDA as an aid to reduce the symptoms of opioid withdrawal.

Drug Relief®is a percutaneous electrical nerve field stimulator (PNFS) designed to administer auricular therapy over 120 hours. The treatment is administered over a period of five days as part of a longer-term withdrawal process.

The content provided on this website is for information purposes only and is not a substitute for professional medical advice. Treatment decisions should be made in consultation with a qualified medical provider.



National Institutes of Health <https://www.ncbi.nlm.nih.gov/books/NBK310652/>

Alkermes, Inc. <www.vivitrol.com>

Principles of Addiction Medicine – American Society of Addiction Medicine <https://www.asam.org/resources/definition-of-addiction>


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