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Drug Treatment

The Dangers of Quitting Opiates Cold Turkey

By Anne Watkins

With the increasing prevalence of drugs like Vicodin and OxyContin, along with the continued recreational use of heroin, opiate addiction is a fast-growing issue.

A major component of this problem is the fact that opiate addiction can develop surprisingly quickly -- in as few as one to two weeks of regular use -- so that people often become addicted even when they think they're still in safe territory with their drug use.

For an addiction lasting more than a month, it's recommended that users seek medical treatment to help them get off the drug. This usually involves a detox stage followed by long-term opiate replacement therapy with Suboxone or methadone.

Without professional addiction treatment, people who quit opiates run the risk of serious complications. Opiate withdrawal is not fatal in and of itself, but related complications can be quite dangerous.

That's why quitting cold turkey is almost always a bad idea. Even if you do all of your preparation and have the determination to see it through to the end, you still risk uncomfortable and painful side effects that can cause you to lose your will. Also, without professional guidance and addiction therapy, you'll be much more likely to relapse later on.

How Opiate Addiction and Withdrawal Works

In the brain, opiates bind to specific opiate receptors that usually govern things like mood, emotion, feelings of reward and the natural pain response. When external opiates hit these receptors, they cause them to over-fire, leading in the short term to feelings of euphoria and in the longer term to decreased physical and emotional responses to the normal sources of pleasure and reward.

With regular opiate use, your brain becomes rewired in such a way that the drug becomes your primary source of pleasure in life. All other thoughts and activities start to fall by the wayside, and your entire consciousness gradually shifts its focus, placing abnormally high emphasis on obtaining and taking opiate drugs.

All of this can happen within just a few days of regular use. And what makes opiate addiction so severe is the rapid increase in tolerance that follows. Within a week of taking the drug daily, you may already find that you need twice as much to achieve the same effect. And if you can get your hands on that amount regularly, your addiction will become that much more severe.

In the end, you may end up taking several times more of the drug per day than a doctor would ever recommend -- a recipe for bad withdrawal.

The severe addictive effects of opioids result from your body's natural tendency to try to create homeostasis (i.e., internal balance). When you take drugs regularly, your body readjusts its habitual functioning to accommodate the external substance. Thus, when you suddenly stop taking the drug, your body falls off a cliff. Or, to use a different metaphor, it's as if the wall you've been leaning on suddenly crumbles.

Opiate Withdrawal Complications

It can take the body weeks to recover drug-free homeostasis, and in the meantime the effects can be severe. Within the first few days, you're likely to encounter at least a few of these symptoms:

  • Severe agitation and anxiety
  • Body aches
  • Wet, red and teary eyes
  • Difficulty sleeping
  • Runny nose
  • Frequent yawning
  • Profuse sweating

After the few days, while many of these initial symptoms continue, you may also experience these more severe problems:

  • Painful abdominal cramping
  • Severe nausea
  • Diarrhea
  • Vomiting
  • Goose bumps
  • Chills and shivers
  • Dilated pupils

In cases of severe opiate addiction, you may even experience hallucinations, severe body tremors and suicidal thoughts.

By far, the biggest risk during the detox period is that you'll relapse. People who quit cold turkey usually start off feeling quite strong and determined, but once they get into the throes of withdrawal, they tend to become very different people. Many people reach a point where they will do anything to get more of the drug, even if it involves hurting themselves or others.

And when you relapse soon after going cold turkey, you may be risking your life. While those withdrawal symptoms may seem bad, they're actually the outward effects of your body returning to an internal state of normalcy. Thus, after just two to three days, your tolerance for the drug may already be substantially lower than it was before, so if you take the dosage you usually take, you risk overdose.

While withdrawal is not directly fatal, there are cases of addicts dying during the withdrawal period. This usually happens when addicts allow their bodies to fall into a state of poor health, so that the throes of withdrawal destabilize the body even further, leaving the addict open to infections and other complications. Other addicts fail to keep themselves properly hydrated during the withdrawal process, leading to potentially fatal electrolyte disturbances.

Alternatives to Going Cold Turkey

In light of these complications, the smart thing to do is to consult with a doctor before quitting an opiate drug. He or she will probably recommend that you enter an addiction treatment program consisting of these steps:

  1. Detox: During the detox stage, you are medically assisted and monitored as your body gets rid of any of the lingering drugs and begins to regain homeostasis.
  2. Opiate replacement therapy: With opiate replacement therapy, drugs like Suboxone or methadone trick your body into thinking that it's getting the drug, but you don't experience any of the euphoria or impairment.
  3. Therapy: It's a good idea to seek professional treatment with a therapist specializing in addiction.

Opiate replacement therapy can last as long as you want. Some addicts choose to stay on the treatment indefinitely, while others set a six-month or one-year timeframe for getting off of opiates entirely.

It's also a good idea to seek an opiate addiction support group where you can meet and interact with people who have gone through the same struggles that you have.

by McKayla Arnold