Opiates are a class of drugs that reduce pain and increase feelings of euphoria and relaxation. Some opiates have a place in medical treatment and some are used as illicit street drugs. In all cases, an individual's body will develop tolerance to opiates when they are taken long-term or often enough to maintain blood levels of the drug for more than 6 to 7 days. There are predictable physical and neurological withdrawal symptoms from the chronic long-term use of opiates such as runny nose, insomnia, anxiety and agitation, and pain sensitivity. Unlike withdrawal from other substances, opioid withdrawal is not life-threatening. Most of the withdrawal symptoms can be managed by supportive care and a long-acting benzodiazepine, psychoactive drug such as clonidine.
Runny Nose and eyes
Runny nose (and runny eyes) is a withdrawal symptom resulting from the body being over-agitated. In withdrawal, the nervous system is hyperactive and results in these symptoms. The best management for runny nose and eyes is rest, calm and possibly a controlled regimen of clonidine.
Insomnia
One of the main symptoms of opioid withdrawal is insomnia, the inability to fall asleep. Because opiates keep the nervous system sedated, individuals experience a "rebound" effect when the drugs are stopped. One of the ways the nervous system rebounds from sedation is by not being able to go to sleep. Like other symptoms, insomnia can be managed by supportive care and short course of clonidine.
Anxiety and Agitation
Since one of the other effects of opiates is a calming sedative effect, the withdrawal will always have the opposite: anxiety and agitation. The patient may be jumpy, easily startled and generally restless. The agitation can be managed best by keeping the patient in a low-stimulus environment. This kind of supportive care can be used to manage the withdrawal, along with a short course of clonidine.
Pain Sensitivity
Opioids can depress the nervous system and give a sense of euphoria, thus, the withdrawal phases will encourage too much activity in different parts of the nervous system. One of the chronic symptoms of opiate withdrawal is increased pain sensitivity to touch. Hypersensitivity to pain can be managed with over-the-counter pain medications and a controlled environment.
