How to 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 could also help to ease your symptoms. 

Common opiate withdrawal symptoms include many symptoms that could be synonyms for anxiety, such as these:[1]

• Drug cravings
• Restlessness 
• Fast heart rate 

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. 

What Does Anxiety From Opiate Withdrawal Feel Like?

As your opioid habit progressed, your body became accustomed to the drug's constant presence. Your brain cells are sedated and calm. When you remove opioids, those quiet cells awaken, and their overactivity can feel like anxiety.

Unfortunately, the more anxious you feel, the stronger your withdrawal symptoms tend to be.[2] You'll think about how miserable you feel, and then you'll feel worse, and then the cycle repeats. 

In addition to anxiety, you might experience the following:[3]

• Anorexia 
• Depression
• Fatigue
• Insomnia
• Inability to concentrate 

Some people also develop relentless nausea and vomiting, accompanied by diarrhea. Visiting the bathroom so many times can be stressful, and with each visit, your anxiety levels can rise. 

How Long Does the Anxiety Typically Last With Opiate Withdrawal? 

Your brain cells can heal, and you can learn to live without drugs. But your body needs time to heal as well. 

People develop anxiety and other withdrawal symptoms within about 8 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. Nutrition

Many people experience dehydration during opiate abuse and withdrawal.[5] A lack of fluids can leave you feeling very anxious and worried. Drinking cool fluids regularly, even when you don't feel thirsty, may help.

Loading up on your favorite foods may also help. Each meal helps you remember how good life can be, and you'll be reminded of why you're working so hard to leave your opioid use disorder behind. 

2. Yoga

You may not feel ready for full-body workouts while you're going through withdrawal. But you might enjoy gentle stretches during a yoga class. 

If you feel dizzy or uncomfortable, stop as soon as you can. But you might like the majority of the moves. And when you're moving into a sober life, you might enjoy the community you build at a yoga studio. 

3. Mindfulness

Most people associate mindfulness with meditation, but even gentle breathing exercises can count. The closer you link the way you think and the way you feel, the more control you'll have over your anxiety.

Researchers say mindfulness activities could help people stay sober after treatment for a substance use disorder.[6] Even if they don't, you might like the calming effect of deep breathing. 

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. 

If you wake up worried about your health and your recovery, you may struggle to fall asleep again.[7] Do your best to keep from brooding. Remember that you're on the path to a new life. Rest when you can. 

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.