When a person who has become dependent upon heroin stops taking the drug, he starts to experience a set of symptoms, known collectively as the opiate withdrawal syndrome, that lasts for five to seven days. These symptoms include, nausea and diarrhea, diffuse body pain, anxiety, profuse sweating, insomnia and restlessness. While the withdrawal syndrome is extremely unpleasant, it is almost never medically dangerous. Remedies for heroin withdrawal focus on alleviating as many of the symptoms as possible in order to make the process more bearable.
Aches and Pains
The diffuse body pain an addict experiences during withdrawal is comparable to an extremely severe case of the flu. There is an overall sense of low- to moderate-level pain but nothing particularly intense. Ibuprofen is extremely effective at treating these types of aches and pains. While it will not make the aching feeling entirely disappear, it will make it much more bearable. Patients who cannot tolerate ibuprofen can use Tylenol, although it tends not to be as effective.
Nausea and Vomiting
The anti-histamine hydroxyzine, sold under the trade name Vistaril, is effective against the nausea and vomiting seen in withdrawal and can also help with the anxiety and insomnia. Other antihistamines, such as diphenhydramine, or Benadryl, and dimenhydrinate, or Dramamine, may also help.
Diarrhea
Loperamide, or Imodium, is effective against the diarrhea experienced during withdrawal. For less severe diarrhea, a simple remedy such as bismuth subsalicylate, or Pepto Bismal, can provide relief and may help with the nausea and vomiting as well.
Clonodine
Clonodine, sold under the trade name Catapres, is one of the most useful medications for treating the symptoms of heroin withdrawal. It is extremely effective at reducing the profuse sweating, restlessness and anxiety seen in the withdrawal syndrome. Since the restlessness and anxiety are often the most difficult symptoms to bear, clonodine provides more subjective relief from the withdrawal syndrome than any other single medication. Clonodine lowers blood pressure significantly, so patients must be monitored to make sure their pressure is not already too low before it is given.
Insomnia
Insomnia makes all other symptoms seem worse, so helping a patient get to sleep can make everything better. By reducing the restlessness and anxiety, clonodine often improves insomnia as well. For patients who cannot use clonodine, or for whom clonodine alone is not sufficient, medications such as diazepam, or Valium, lorazepam, or Ativan, and zolpidem, or Ambien, can also promote sleep by reducing anxiety and restlessness.
References
- "Current Diagnosis & Treatment: Psychiatry", 2nd Ed.; Michael H. Ebert, et. al., eds.; 2008
- "Harrison's Principles of Internal Medicine" 16th edition; Dennis L. Kasper, et al., ed.; 2005
