Opiates include the drug opium, as well as medications derived from or that are chemically similar to opium (including heroin, fentanyl and narcotic pain relievers). Opiates are very addictive because the brain gradually adjusts to their presence. This means that when opiate use is stopped, the brain goes into opiate withdrawal that, while not life threatening, can be painful and very difficult. Some patients benefit from using medications to ease the symptoms of opiate withdrawal.
Symptomatic Relief
One type of medication that can be used to treat withdrawal from opiates is clonidine. According to Medline, clonidine is used to treat the agitation, anxiety, muscle cramps, sweating and runny nose that often afflict patients going through opiate withdrawal. These symptoms are a result of a condition known as rebound sympathetic activation. In short, opiate use causes portions of the nervous system to become inactivated. When these patients go into opiate withdrawal, this portion of the nervous system (what is called the "sympathetic" nervous system) becomes hyperactive, leading to the anxiety, agitation, sweating and muscle cramps. Clonidine works by reducing the action of the sympathetic nervous system, helping to relieve these symptoms.
Opioid Agonists
Another type of medication that can be used to ease opiate withdrawal is the partial opiate agonist class of drugs. These medications include the compounds methadone and buprenorphine. According to The Center For Substance Abuse Treatment (part of SAMHSA), these medications work by binding to the same parts of the brain that respond to opiates. The binding of methadone and buprenorphine keeps these parts of the brain from experiencing withdrawal, but also are designed so they don't cause a "high" (the sense of euphoria that accompanies opioid use). As a result, they trick the brain into thinking opioids are there, lessening the withdrawal symptoms.
Opioid Blockers
Another option to treat opiate withdrawal is called naltrexone. Naltrexone works in almost the exact opposite way that methadone and buprenorphine work. Naltrexone blocks the portions of the brain that experience opiate withdrawal. This blocking action has two effects: the withdrawal symptoms are reduced, and the use of opiates has no effect. Thus, naltrexone is useful at preventing relapses because it prevents opiate addicts from getting any pleasure from opioids.
