T Nation

Opiate Withdrawal


I had to take a close family member to the hospital today who is going through Oxycodone and Imovane withdrawals. The drugs were not prescribed and were being heavily abused. The person I know quit the Oxy cold turkey 5 days ago and the Imovane 2 days ago and has not sleept since the cessation of the Oxy. Today things got bad enough that we had to go to emergency. This was one of the scarier things I have seen.

The person was violently shaking, taking shallow breaths, had a rapid heart rate, was vomiting(dry) and had diaherra. To make things worse we had to wait 3 1/2 hours like this to see a doctor. We were sitting in the middle of emergency with people all around us watching this...Finally got to see a doctor, got an IV for fluids, some gravol, phenobarbital and a few other drugs to calm the stomach.

We got home from the hospital after 2 liters of saline and the above drugs, withdrawals are still hitting in "waves" and sleep looks unlikely despite the prescribed sedatives.

Don't know why i'm really sharing this, just wanted to get it off my chest I guess. Let this be a warning to anyone who is abusing this stuff, it's nasty. Reading around a bit I have found that people with experience with both say it's very much like coming off heroine.

What i'm particularly worried about is the Imovane, which, according to citations on wikipedia, can have affects that last up to a year after stopping(serious problems to - behavioral changes, chronic depression etc). Surprisingly the doctor didn't mention this.

Has anyone gone through this personally? anyone know and watch someone who has ? Any advice ?


Well hopefully they don't relapse after experiencing this. I know a lot of people that got hooked to oxycontin in high school and have been on it ever since.



Sorry you get to see someone go through that, because it is ugly.


i am a nurse in a regional trauma center/ed. see this shit all the time. thing is, alcohol withdrawal can kill you, so can withdrawal from benzodiazapines. NOT opiate withdrawal. we see people come in to the ED all the time begging for help because they ran out of there supply and cant get anymore, so they flop down at the ED screaming for help. fact is, opiate withdrawal will make you feel like hammered dog shit for a few days, but it will not kill you.

trying to make two points here...first, you seemed incensed that you had to wait so long, on a busy friday night at our trauma center you would have waited longer. we would have put the gunshots, car accidents, heart attacks, strokes, heart failures, acute exacerbation of restrictive airway diseases(people who cant breath), little kids with high fevers, seizures, just about everything cept maybe a cut on the finger or toe ahead of you guys.

second, there has a been a big "push-back" recently for aggressive treatment of opiate withdrawal recently. Not sure what the underlying reason is, but I see it happening. answer this, if all the people who were abusing opiates got aggressive palliative treatment of their withdrawal symptoms, eg, we calm the insomnia, nausea, agitation, etc, would not a less harsh experience be less of a deterrent to go out and make the same bad choices?

why not start your habit again, when you hit bottom, and start going through the hell of withdrawal, just run to the ED and get some meds and treatments to make it less of a horrible experience?


I don't know enough about withdrawal to agree or disagree that it could kill you, but I've been in withdrawal from opiates multiple times and will say that it is hell on earth, and not for a few days either, more like two weeks. I've also had friends who had trouble coming off various opiates, and watching their agony while being helpless to intervene was hell on earth every bit as intense as when I experienced this myself.

I take full responsibility for the mistakes that got me addicted in the first place and understand that I didn't deserve help more than other sick or hurting people, but thank God I was treated by caring individuals who genuinely wanted to help me rather than people like you who would have preferred to watch me suffer while saying "toughen up, it won't kill you."


I think HT was getting at the fact that while 3.5 hours in the ED might seem like a long time he was just saying that the family member was (despite the extreme discomfort) not a high priority case.

The person wasn't croaking anytime soon ergo the people that ARE dying get to the front of the line.


I used to work at a drug and alcohol treatment center. We always had pts taper with suboxone rather than just pulling the drugs outright.

Any drug has long-standing side effects when it comes to mood. Opiates cause a lot of dopamine to be released when you take them, your brain responds by lowering the # of dopamine receptors and starts producing less dopamine on without the drug's stimulus. This takes awhile to reset to normal.. in other words it will be a very long time before the person taking the drugs gets to a "normal" emotional state.

IMO that's not worth worrying about because if they stay sober they'll level out eventually. The real scary thing is relapse... Relapse rates are high, to say the least.


Hey man how long you been working ER. I did 14 years as a RN, and all good points.


Your friend is lucky they aren't on actual benzos, and just the Imovane/Oxy because he could be dead if that was the case. The only two "drugs" that include death in the WD symptoms are bezos and alcohol. Although, if I was having all of those symtoms all at once I'd probably want to die. Good luck and keep your chin up, I hope this person has learned a lesson.


do you know how many people i see in there late teens, early 20's, who already have a polypharm problem? they are on ritlin, aderal, vicodin, norco, paxil, prozac, and, of course, "medical" marijuana, hahaha!

I'm sorry, this generation needs some tough love. Opiates have a very small window of actual therapeutic effect. take them longer than a few weeks, and it will severely alter your brain chemistry where your brain will perceive the absence of the euphoria the drugs produce as pain.

these kids need to get in there 40's, and THEN tell me how much they hurt each day, and how they can't manage the stress of life. boo-fucking-hoo.

so yes, i think a little "toughen up, it wont kill you and maybe it will teach you not to go down that road again" is in order.

that sounds harsh to the soft easily offended politically correct ears of this society i realize, but like i said, some tough love is in order.

the medical community cannot continue this course as it is not sustainable.

since we have made patients pain level the "5th vital sign" (that is, the patients pain is whatever he/she says it is, and we HAVE to treat it with whatever the patient perceives as effective" deaths due to opiate overdoses from PRESCRIPTION drugs has increased over 500%!!!!

dont challenge me on this son. I have been to seminars all over the country about this subject, been on the quality action committee at my hospital trying to find some solutions to this problem, I can counter anything you come back at me with with science and real life experience. this is a growing problem in this country and this new breed of "addicts" are clogging up the emergency medical system and interfering with delivering care to the people who we(EMS) were originally designed to help.


for the most part you are correct. average wait time in ED in california is app 5 hours. we are more concerned with the person who comes in by ambulance that has NOT run out of their scripts or "supply" and has taken so much the are not breathing and have to be intubated and put on a breathing machine. the person who has run out and is now feeling like death on a stick, well, that persons problem is solving itself. so to speak.




16 years.


yes, good post, suboxone is something i see more and more. to be fair though, those people who have been in treatment and have been placed on suboxone STILL hit the ED PISSED OFF and wanting narcotics or heavy doses of benzos to ease withdrawal symptoms.

the request i hear often almost to the word from many people is: cant you just put me "out" for a few days till this is over?

they want to be heavily sedated so they literally sleep through withdrawal. hmmmm... now that wont encourage them to go out and relapse will it?


It is my understanding that ranked by the dangers of dying during withdrawal it goes:


All can be quite brutal.


Anybody here ever hear of Ibogaine. It is a drug synethesized from African tree bark. It has been shown in clinical studies to end opiate withdrawal symptoms by binding the dopamine or whatever receptor.

It is also an illegal drug in its own right because it has highly hallucinogenic properties. You can't get it in the US, but there are clinics in the USA and Canada where you can go to get this treatment.

Here is an interesting 50 minute documentary that the producers uploaded to Google videos:

Fascinating stuff, both from a bio-medical-chemical standpoint but also a legal one as well.


i had close freinds in college that turned a little weekend fun pill popping into a hole 'man i sold my tv to buy more pills' kind of problem.

a co worker had started experimenting with them on the weekends, and i told him that i know he wont listen but he is heading down a very slippery slope. fast forward 2 years - he is divorced and lost his job and his house but HE finally go clean. i he would come into work all pilled up and get in trouble, try to stop doing pills and 'not be able to' - i even offered to go to NA with him... its just crazy to see what people throw away for drugs..


i will read up on that.

i am wary of drugs that supposedly help with withdrawal/addiction by binding to the same receptors.

for example, methadone was used to help with heroine addiction/withdrawal, but methadone and the "oxys" are the biggest problem with people O.D.ing and also coming in needing a fix because they have overused there scripts or supply and are now withdrawing.

I think, think, that heroin was originally developed and used to help people with morphine addiction, no?


copy that. I have a lot of addictions, raunchy porn, big booty women, pizza, brownies, but opiates addiction is one monkey I am glad I dont have on my back.


speaking from personal experience? sorry in advance if that is too personal...