Contributor: Sonja K. Negrean, RN BS, Assistant Director of Nursing at Timberline Knolls Residential Treatment Center
It is so easy to become addicted to opiates and so very difficult to break that addiction. Opiate drugs, this includes heroin, impact an individual on every level, physically, mentally and emotionally.
Detox from opioid drugs is not quick nor easy. In order to achieve a successful detox, the medical team must know two important facts in advance: the type of drug used and the length of duration. Both of these issues must be established before any detox is started.
The team must exactly know what the person has been taking. It isn’t enough to say OxyContin. The number of pills each day, the milligram strength, as well as the use of other drugs, must be disclosed.
The Importance of Having the Specifics
What’s more, the root of administration must be made clear. Was the drug ingested, injected or inhaled? If ground up and inhaled through the nose or transformed into a liquid and shot into a vein, the symptoms associated with withdrawal will prove more severe.
Alcohol involvement is a game-changer. The detox process when alcohol has been abused looks entirely different than if the person had exclusively swallowed pills or injected heroin. This is because, unlike pharmaceuticals, alcohol can cause death during detox.
Knowing what specific medications and how often is crucial, as is the last time of day they used. Drug withdrawal tends to follow a particular time trajectory, so it is relevant as to how recently the substance was placed into the body.
Heroin withdrawal usually begins approximately 12 hours after the last dose and peaks around the 24-hour mark.
Duration of use is also germane. An adolescent dependent on pills for one year will have a vastly different experience than an adult who has used heroin for five years.
Typically in detox, somewhat mild symptoms are initially experienced: minor nausea, slight depression, and agitation. In time, symptoms ramp up in severity and include, palpitations, elevated blood pressure, muscle cramping, diarrhea, anxiety, and vomiting.
These symptoms can be excruciating. To make matters worse, as physical symptoms increase, craving for the drug becomes intense.
Unfortunately, the only factor that can alleviate this reality is time. Complete opiate detox takes approximately five to seven days.
During this time, the nursing staff monitors 11 different signs and symptoms of withdrawal to determine the severity of detox using the clinical opiate withdrawal scale or assessment (COWA).
To ensure safety, close watching of vital signs must be part of this process. This monitoring includes oxygen saturation rate, heart rate, blood pressure, temperature, respiration rate, etc. A seizure could result if not carefully watched.
Additionally, other medical problems that the individual might have, such as diabetes or hypertension, must also be managed throughout the process.
When Addiction Requires Detox
If a person requires detox, the importance of the experience, knowledge, and understanding of the treatment team cannot be understated.
At Timberline Knolls, we know if a woman is using alcohol, has a vastly complicated history of drug use, is in very poor health or is prone to seizures, she should detox in a hospital. However, if these conditions do not exist, she is not only safe in our care but will receive the compassion she deserves.
We know how hard detox is because we have watched women go through it for years. Therefore, we do everything possible to ease the discomfort of withdrawal with anti-nausea medication, anti-diarrheal, hydration, cold or warm packs, rest, etc.
The greatest hope we can give them is that when someone is in the mild to moderate stage of withdrawal–depending on the nursing assessment–the physician will evaluate and determine the best time to start Suboxone.
The primary reason why most detox attempts fail is the person’s relentless craving for the drug. Suboxone is a medication that suppresses this intense desire, which allows the person to focus on recovery.
Although difficult, it is important to know that opiate detox is possible. With qualified people providing medical management, stabilization, and support, a person can move from a life of complete dependence on drugs to a life of freedom.
About the Author: Sonja K. Negrean, RN BS, is the Assistant Director of Nursing at Timberline Knolls Residential Treatment Center. Sonja facilitates staffing and assists with residents who are medically complicated or have higher acuity needs. She also manages any concerns that present via our patient advocate hotline.
Sonja has a vast medical background. She worked at Rush University for more than 10 years, specializing in neurology, pediatric intensive care and surgery. At Shriners Hospital, she was involved in Pediatric Intensive Care and at Dreyer Medical Clinic she was the Manager of the Family Practice Department. She was also the Manager of the Ortho/Neuro unit, Med surgical unit and Oncology unit at Mercy Medical Center.
Sonja received her nursing degree from the college of DuPage and her Bachelor’s degree from Northwestern. She is both Chemo Certified and Stroke Certified.
Sonja is a member of the American Nurses Association and The Oncology Nursing Association.
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Published on November 1, 2017
Reviewed By: Jacquelyn Ekern, MS, LPC on November 1, 2017.
Published on AddictionHope.com