How Do I Deal With Anxiety From Opiate Withdrawal?

Opiate withdrawal symptoms can vary, but many people develop anxiety. While you may feel awful at first, your symptoms should fade as your body adapts to the lack of opiates. Medications can also help to ease your symptoms.

Common opiate withdrawal symptoms include many symptoms that can cause anxiety, such as these:[1-3]

• Drug cravings
• Restlessness 
• Fast heart rate 
• Sweating
• Dizziness
• Nausea/vomiting

If left untreated, withdrawal can lead to a relapse to drug use. While you could try to sit out your anxiety, it’s best to get it treated. Talk to your doctor about Medication for Addiction Treatment (MAT) for opioid use disorder. 

How Long Does the Anxiety Typically Last With Opiate Withdrawal? 

People develop anxiety and other withdrawal symptoms within about 4 to 48 hours of their last opioid dose. Without treatment, your symptoms can last between 4 and 20 days.[4]

How Does MAT Help With Anxiety? 

Suboxone treatment helps to ease opioid withdrawal symptoms, including anxiety.

When the body is without the opioids it is used to, all the opioid receptors in the brain are empty, which means you can experience a number of symptoms, including increased anxiety.

Suboxone binds to those empty receptors and fills them up as a substitute for the opioids that used to be there. This helps to prevent the symptoms of withdrawal, such as anxiety.

Another medication, Clonidine, is also often used either with or without Suboxone to reduce anxiety, particularly when a patient is first detoxing from opioids.

Clonidine is an alpha 2 agonist. It binds to alpha 2 receptors in the brain, which are responsible for “calming down” the body’s sympathetic nervous system, including anxiety.

Other Ways to Help Anxiety From Opiate Withdrawal

While medications are helpful for opiate withdrawal, you can also benefit from other therapies. These are a few of the options your team might try.

1. Hydration

Many people experience dehydration during opiate abuse and withdrawal.[5] A lack of fluids can leave you feeling very anxious. Keep yourself hydrated.

2. Yoga

Yoga has been shown to help reduce stress and anxiety and is often offered to patients undergoing treatment for OUD. 

3. Mindfulness

Most people associate mindfulness with sitting in “meditation”, but this is a misconception. Mindfulness practices are highly variable and can be as simple as even just a few minutes of gentle breathing exercises. Researchers say mindfulness activities could help people stay sober after treatment for a substance use disorder.[6] 

4. Sleep 

Your body needs rest as you heal. Insomnia is a common part of opiate withdrawal, but if you can sleep, you may feel less anxious. [7] Practice good sleep hygiene while in the process of recovery.

Sources

1. Opioid Withdrawal in Adults: Clinical Manifestations, Course, Assessment, and Diagnosis. UpToDate. https://www.uptodate.com/contents/opioid-withdrawal-in-adults-clinical-manifestations-course-assessment-and-diagnosis. March 2022. Accessed July 2022.
2. Influence of the Dose on the Severity of Opiate Withdrawal Symptoms During Methadone Detoxification. Pharmacology. https://www.karger.com/Article/Abstract/109982. 2008. Accessed July 2022.
3. Opioid Withdrawal. Elsevier. https://www.elsevier.com/__data/assets/pdf_file/0019/537031/opioid-withdrawal-ClinicalKey.pdf. 2017. Accessed July 2022.
4. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK310652/. 2009. Accessed July 2022.
5. Substance Use Recovery and Diet. U.S. National Library of Medicine. https://medlineplus.gov/ency/article/002149.htm. May 2020. Accessed July 2022.
6. Mindfulness-Oriented Recovery Enhancement Mediates Hedonic Dysregulation in Opioid Users: Neural and Affective Evidence of Target Engagement. Science Advances. https://www.science.org/doi/10.1126/sciadv.aax1569?cookieSet=1. October 2019. Accessed July 2022. 
7. Anxiety and Sleep. Sleep Foundation. https://www.sleepfoundation.org/mental-health/anxiety-and-sleep. March 2022. Accessed July 2022.