Most physicians will prescribe opiate medication for the management of pain. Opiates can also reduce anxiety and give the user a sense of euphoria. If a person develops tolerance to this medication, stopping the drug will cause withdrawal symptoms like anxiety, muscle pain, inability to sleep or insomnia and agitation.
Some of the long-term effects of opiate withdrawal can last for several months. These effects can include general malaise, fatigue, lethargy and generalized anxiety. The person might experience cravings for the drug many years after the discontinuation of use. Management of withdrawal symptoms usually involves therapy, counseling, medications and keeping the person in a calm, quiet environment.
Anxiety & Agitation
One of the effects of opiates is to reduce anxiety. Withdrawal symptoms will always have the opposite effect, like increased anxiety and agitation. The patient may be unfocused, anxious, easily distracted and generally agitated. Treatment strategy is to place the patient in a low-stimulus environment. This kind of supportive care can be used to manage the long-term effects of opiate withdrawal, along with a short course of prescription medications like clonidine.
Opiod-Induced Hyperalgesia
The function of opiate drugs is to help manage and reduce pain. One main symptom of withdrawal is opioid-induced hyperalgesia--especially in muscles and joints. Patients develop hypersensitivity to pain as a long-term effect of opiate withdrawal. A review article published in Anesthesiology in 2006 by researcher M.S. Angst cited that this phenomenon presented in many opioid users in long-term withdrawal. This can be managed with over-the-counter pain medications, warm showers or baths and a controlled, calm environment.
Insomnia
Almost all individuals who are in withdrawal from opiates have trouble sleeping. 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. Most long-term users of opiates experience disturbed sleep or low-quality sleep, even for many years after discontinuing use of the medication.
Cravings
The Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) cited cravings as a symptom in patients on long-term withdrawal. In fact, cravings for the drug can occur in patients for many years. There is a higher risk of relapse during this time for most patients.
References
- Merck Manual: Opioids
- "Opioid-induced Hypersentivity"; Angst, MS & Clark, DJ: Opioid-induced hyperalgesia: A qualitative systematic review. Anesthesiology 2006; 104:570--87
- Psychiatry Online: "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision"
