Opioids are the category of drugs that include Heroin, Percocet, Oxycontin, Vicodin, Lortab, Tylenol with Codeine, and Ultram.  Technically speaking, Ultram is not an opioid.  The pharmaceutical companies developed and marketed Ultram as a non-narcotic alternative to the other drugs mentioned.  However, it does act at the opioid mu receptor.  I see patients that abuse Ultram and become addicted to it.

Symptoms and signs of opioid withdrawal, ranging from mild to severe, include body aches, chills, sweats, runny nose and eyes, diarrhea, nausea and vomiting, mydriasis (dilated pupils), piloerection (goosebumps), and depression, .  In general, whichever effects one gets from a drug, one gets the opposite effects when it is taken away.  The severity of withdrawal depends on the doses used, duration of use, route of administration (taken by mouth, sniffed, smoked, or injected), and each individual’s natural physiology.

It is a misperception that opioid withdrawal cannot be life threatening.  It is true that most people do not die or have a serious medical complication from opioid withdrawal.  However, it is important to treat it so that serious complications do not develop.  For example, intractable diarrhea, and intractable nausea and vomiting, can lead to severe dehydration with electrolyte disturbances.  Severe electrolyte abnormalities can cause seizures, cardiac arrhythmias (abnormal heart rhythms), coma, and death.  Patients that have co-morbid medical conditions are more susceptible to becoming seriously ill or dying.  It is interesting to note that repeated, forceful vomiting can cause a tear in the esophagus.  Patients can become seriously ill and die from this complication.

Opioid detoxification to follow in my next blog……