What Are the Stages of Opiate Withdrawal?

Opiate withdrawal occurs in two distinctive stages---the acute withdrawal phase and post-acute withdrawal syndrome (PAWS). Acute withdrawal causes symptoms that are primarily physical in nature, such as diarrhea and fever, while PAWS mainly affects mental and emotional functioning.

Gastrointestinal Symptoms

Gastrointestinal upset is among the first effects to be felt during opiate withdrawal. Symptoms may include diarrhea, intestinal cramping, nausea and vomiting.

Flu-Like Symptoms

Those undergoing acute opiate withdrawal often experience runny nose, extreme fatigue, fever and chills.

Joint and Muscle Pain

Because opiates are potent painkillers, withdrawal often causes rebound pain throughout the body. Flu-like muscle pains and sore joints are common and can range in severity from mild to debilitating.

Anxiety and Insomnia

While they may appear secondary to physical symptoms, mental and emotional disturbances like anxiety, irritability and insomnia frequently occur during the acute withdrawal phase.

Depression and PAWS

Depression and low mood may persist until the body begins to produce its own endorphins again. According to addictionsandrecovery.org, post-acute withdrawal syndrome (PAWS) can last more than two years and includes symptoms like depression, inability to concentrate and low energy.

References

• Addictions and Recovery: Post-Acute Withdrawal Syndrome (PAWS)

Resources

• NIH.gov: Opiate Withdrawal