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What is Precipitated Drug Withdrawal?

Opioid drugs are incredibly habit-forming, with the potential to cause addiction if you take them long-term. Opioids include medications like oxycodone, morphine, Vicodin, and illegal substances like heroin. These drugs all belong to the same drug class and produce similar effects on the brain and body.  

When you are addicted to opioids, your body begins to think it needs them to function properly, resulting in extremely uncomfortable withdrawal symptoms if you abruptly stop taking opioids. Many people who try to detox without medical treatment end up continuing their drug use rather than completing detoxification due to the severity of their symptoms. 

Medical detox centers can prescribe medications that treat symptoms of opioid withdrawal, thereby helping support individuals while they are detoxing. However, misusing the medications associated with MAT programs can result in the development of a distressing condition known as precipitated drug withdrawal. One of the most common causes of precipitated withdrawal is taking Suboxone or another medication that contains buprenorphine too early.

What is Precipitated Drug Withdrawal?

Opioid addiction is often treated through a process known as medication-assisted treatment (MAT). Some of the medications used during MAT include Suboxone, Subutex, and Naltrexone.[1] 

Suboxone and Subutex are made with a medication called buprenorphine. Buprenorphine binds to and activates the brain’s opioid receptors, reducing opioid withdrawal symptoms.[2] 

Naltrexone, on the other hand, blocks opioid receptors to reduce cravings and prevent the substances from getting you high in the case of a relapse.

Precipitated drug withdrawal can occur if you take one of these medications while opioids are still in your system. Taking Suboxone too early can lead to sudden and severe symptoms of withdrawal.[3]

Opioid withdrawal symptoms are uncomfortable and sometimes painful, but they are not life-threatening. If you develop precipitated withdrawal, the symptoms become much worse. The intense symptoms associated with this condition can cause health problems and potentially require hospitalization, making it imperative that all steps are taken to avoid this syndrome. 

Why Does Precipitated Drug Withdrawal Happen?

Opioid agonist medications like heroin, morphine, and fentanyl activate the opioid receptors in your brain to create the effects associated with opioid substances. This is why people experience symptoms of pain relief, and euphoria.

Partial opioid agonists like buprenorphine sit in your opioid receptors and prevent anything else from affecting it. These drugs partially activate the receptors, providing enough of an opioid effect to prevent you from experiencing symptoms of withdrawal. Partial opioid agonists also have a stronger binding affinity than full opioid agonists do, meaning they will bind to your opioid receptors and immediately knock all full opioid agonists off of the receptors. 

When all of the opioids are immediately removed from the opioid receptors, precipitated withdrawal occurs, throwing people into severe and painful withdrawal.[3] In comparison, during cold-turkey opioid withdrawal, opioids slowly leave the opioid receptors and the effects wear off over time. The sudden shock produced by taking a drug like Suboxone too early is what causes severe symptoms of withdrawal.

What are the Symptoms of Precipitated Withdrawal?

Precipitated drug withdrawal causes a range of uncomfortable symptoms. The symptoms are described as the opposite of an opioid high. While opioid drugs provide pain relief and euphoria, this condition causes a sudden onset of intense pain and anxiety. Without medical intervention, the symptoms of precipitated withdrawal can last anywhere from a few hours to a couple of days. 

Symptoms include:

  • Abdominal pain
  • Nausea and excessive vomiting
  • Excessive diarrhea
  • Severe muscle aches and pains
  • Altered perception and confusion
  • Fever
  • Low blood pressure and elevated heart rate
  • Headaches
  • Anxiety and agitation
  • Fever, sweating, and chills

Typical drug withdrawal occurs slowly and intensifies over some time, but precipitated withdrawal happens suddenly. Severe symptoms of withdrawal can occur seemingly out of nowhere, making it exceptionally painful and disorienting. 

How Can a Drug and Alcohol Detox Center Help?

Precipitated withdrawal can be completely prevented by detoxing under medical supervision and taking medications as prescribed. Precipitated withdrawal happens when you take opioid antagonists and partial agonists like Suboxone too early. Staff at medical detox centers are aware of the guidelines for using these medications so they will not give you your first dose until your last dose of opioids has left your system.

If you were addicted to a short-acting opioid like heroin or oxycodone, you will wait for at least 12 to 24 hours before taking Suboxone. If you were addicted to long-acting opioids like methadone or oxycontin, you will wait 24 to 48 hours before starting an opioid withdrawal medication.[4]

If you come to an opioid detox center already presenting the symptoms of precipitated drug withdrawal, there are things medical professionals can do to help. Ironically, buprenorphine can effectively alleviate precipitated withdrawal symptoms even if that is what caused the condition to occur in the first place.

Either way, you must choose to get help from a medical detox center to overcome the symptoms of withdrawal and start your recovery. Attending one of these programs can prevent you from experiencing precipitated drug withdrawal in the first place. 

Medically Supervised Drug & Alcohol Detox in West Palm Beach, Florida

If you or a loved one suffer from opioid addiction, it’s time to seek help. A drug and alcohol detox center can provide you with the proper treatment, support, and medications to prevent you from experiencing severe symptoms of withdrawal. Being under the supervision of medical professionals will save you from developing concerning conditions like precipitated withdrawal. 

The Mandala Healing Center understands that addiction presents differently with each patient, as each substance affects individuals in unique ways. After a careful assessment of each patient’s history and patterns of drug use, a personalized detoxification plan is developed. After the physical addiction is treated, healing can then begin.

Contact the Mandala Healing Center today to get started.

References:

  1. https://www.samhsa.gov/medication-assisted-treatment
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994593/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094723/
  4. https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-021-00244-8